Objective To evaluate the clinical efficacy of coaxial micro-incision phacoemulsification for intraoperative floppy iris syndrome (IFIS) during cataract surgery.Methods A prospective randomized control study was conducted in 80 patients (80 eyes) taking tamsulosin more than two weeks with age-related cataract from October 2014 to October 2016.All cases were randomly divided into microincision group (MICS group) and standard incision group (SICS group),40 cases in each group.Coaxial 1.8 mm microincision cataract surgery was performed in the MICS group,and coaxial 2.6 mm standard incision cataract surgery was performed in the SICS group.The incidence and the degree of IFIS and complications were recorded during the operation.The uncorrected visual acuity (UCVA) was compared at 1 day,1 week,1 month after surgery.Results At postoperative 1 day,1 week and 1 month,UCVA was 0.83 ± 0.12,0.86 ±0.10,0.89 ±0.11 in the MICS group,and was 0.71-±0.12,0.75 ±0.11,0.83 ±0.12 in the SICS group,there were statistical differences (all P ＜ 0.05),the UCVA of MICS group was better than that of SICS group.The incidence of IFIS was 60.0％ in the MICS group,and 82.5％ in the SICS group,there was statistical difference (P ＜ 0.05).There was statistical difference on degree of IFIS between two groups (P ＜ 0.05),the degree of IFIS in the MICS group was lower than that in the SICS group.Conclusion The coaxial microincision phacoemuisification is a safe and effective surgery for the patients with cataract and high risk of IFIS.

Aim To investigate the inhibitory effect of Bupleurum chinense-Scutellaria baicalensis decoction(CQ)on activation of rat HSC induced by CCl4 and the mechanism.Methods Cells in logarithmic growth phase were cultured in culture medium without FBS for 24 h.After disassociated using 0.25％EDTA-trypsin,the cells were seeded into respective plates at the density of 1.5×109· L-1 and cultured overnight.The cells were divided into the following groups:control group(no treatment),model group(treated with 6 mmol·L-1 CCl4 for 24 h),CQ groups(pretreated with 6 mmol·L-1 CCl4 for 24 h and 400,500,600 mg·L-1 CQ for 24 h).Concentrations of hyaluronidase(HA),laminin(LN),procollagen Ⅲ(PCⅢ),collagen type Ⅳ(Ⅳ-C)were assayed by ELISA kits.Gene expressions of Toll-like receptor 4(TLR4)and NF-κB were examined by RT-PCR analysis.Protein expression of TLR4 and NF-κB was examined by Western blot.Results CQ could significantly inhibit cell proliferation induced by CCl4.Furthermore,CQ at 600 mg·L-1 significantly downregulated gene and protein expressions of TLR4 and NF-κB.And CQ reduced the secretion of HA,LN,PCⅢ,Ⅳ-C.Further studies disclosed that the TLR4 inhibitor TAK-242 and NF-κB inhibitor BAY 11-7082 could significantly inhibit the gene and protein expressions of NF-κB,but could not change gene and protein expression of TLR4,and reduced the secretion of HA,LN,PCⅢ,Ⅳ-C.Conclusion CQ could inhibit inflammatory responses in HSC induced by CCl4 probably by inhibiting the transcription activity and protein expression of TLR4-NF-κB,which indicates its possible therapeutic effect on liver fibrosis.

0.05).The rates of the local hematoma,pseudoaneurysm and aberration reflex in Group via radial artery were significantly lower than those in Group via femoral artery.Conclusion The transradial approach of PCI compared to traditional transfemoral approach in STEMI is safe and feasible,with relatively less vascular complications and more comfortable to the patients.

Objective To study the effect of biodegradable polymer drug-eluting stents (DES) on maintenance hemodialysis (MHD) patients with acute coronary syndrome. Methods From 2008 January to 2013 July, a total of 100 MHD patients with ACS who were treated with PCI in our centre were randomly divided into two groups, 50 patients in the EXcellstent group (biodegradable polymer DES) and the others in the FIREBIRD stent group (Ordinary DES). The patients included 61 male and 39 female, while the mean age was (58.4±9.2) years old (43-74 years old). After procedure, the EXcellstent group patients took aspirin (100 mg qd) and clopidogrel (75 mg qd) for 6 months, then aspirin (100 mg qd) for lifelong. The FIRDBIRD stent group patients also took aspirin (100 mg qd) and clopidogrel (75 mg qd), then aspirin (100 mg qd) lifetime too. To observe the main adverse cardiovascular and cerebrovascular events (MACCE) and bleeding events during 12 months after procedure. Results The clinical data and angiographic results had no significant difference. No MACCE occurred during hospitalization. In 12 months after PCI, MACCE had no significant difference between two groups (P>0.05), and no stent thrombosis occured. One patient presented gastroin testinal bleeding in the EXcellgroup and 2 patients had cerebral hemorrhage in the FIRBIRD group. FIRBIRD group had more total hemorrhages events than that in EXcellgroup (P<0.05). Conclusions The treatment of biodegradable polymers DES in MHD patients with ACS was effective, and dual anti-platelet for 6 months was safe.

Listeria monocytogenes(L.monocytogenes)is an important human foodborne pathogen responsible for listeriosis.It is one of the hot topics in food safety area on how to detect L.monocytogenes rapidly and effectively.In recent years,its detection assays have a rapid development.The purpose is to summarize the culture-dependent enrichment,immunoassay-based and nucleic acid-based methods for detection of L.monocytogenes at present.Lastly,the review introduced the new strategy of detection assays.

ObjectiveTo evaluate the long-term efficacy of covered stent implantation in the treatment of elderly patients with coronary perforation while undergoing percutaneous coronary intervention (PCI).MethodsFrom June 2004 to June 2012, our center has followed ten elderly patients (age≥ 60 years) who sustained coronary perforation during PCI. The major adverse cardiac events (MACE) were observed as well. The patients were advised to take 75 mg/day Clopidogrel for two years, and indefinite use of 100 mg/day enteric-coated aspirin.ResultsSix out of the 10 patients aged from 60 to 76 years old (mean 68.6 ± 5.2 years) were male, four were female. The average diameter of the implanted stents was 3.3 ± 0.3 mm, and the average length was 22.1 ± 3.7 mm. All the ruptures were successfully sealed without intra-procedural death. The follow-up duration ranged from 0.6 to 67 months (mean 31.7 ± 24.5 months). One patient died of multiple organ failure due to lung infection in 19 days after PCI; one died of cardiac sudden death in 13 months after PCI; one had angina pectoris in 53 months after PCI; one underwent multi-slice CT examination in six months after PCI, and no in-stent restenosis was found. The other four patients received angiography follow-up, and the results showed that three patients had no intra-stent restenosis, while one had left anterior descending (LAD) restenosis in the covered stent in 67 months after PCI. The in-hospital mortality was 10% (1/10). The MACE rate in 12 months after PCI was 10% (1/10). During the entire followed-up period, the restenosis rate in target vessels was 20% (1/5), mortality was 20% (2/10), and the MACE rate was 40% (4/10).ConclusionTreatment of coronary perforation by using covered stents can achieve favorable long-term results; a two-year dual antiplatelet therapy (DAPT) after PCI can effectively prevent intra-stent thrombosis.

Objective: To review the systematic reviews of acupuncture for diabetic peripheral neuropathy (DPN) and to provide evidence for clinical decisions. Methods: Published systematic reviews targeting acupuncture treatment of DPN were searched using computer through both Chinese and English databases till July 1, 2019. Two researchers screened the papers based on inclusion and exclusion criteria and conducted report quality evaluation, methodological quality assessment and evidence quality grading using the preferred reporting items for systematic reviews and meta-analyses (PRISMA), assessment of multiple systematic review 2 (AMSTAR 2) and grading of recommendations assessment, development and evaluation (GRADE). Results: Ten systematic reviews were included, involving 11 outcome measures. According to PRISMA, 6 items were sufficiently reported while 1 item was not; AMSTAR 2 appraised that all the included systematic reviews were of low quality in the methodological evaluation; according to GRADE, of the 30 clinical evidences, only 5 were graded moderate while the remained were graded low or extremely low. Descriptive analysis showed that acupuncture can significantly improve DPN symptoms, accelerate the conduction velocities of sensory and motor nerves, and up-regulate the content of plasma nitric oxide (NO), while the adverse reaction rate was low. Conclusion: Acupuncture can produce satisfactory clinical efficacy in treating DPN, but the existing problems, such as low-quality evidence, unitary outcome measures, poor methodological quality of systematic reviews and nonstandard reporting, need to be treated cautiously; meanwhile, more high-quality clinical trials are required to elevate the level of evidence.

To construct a scFv library by phage display technique from the spleen cells of mice immunized with B3HM cells. Three mice were immunized with B3HM cells, and their spleen cells were harvested. The genes of VH and Vk were amplified by RT-PCR from the cDNA of the immunized spleen cells and a scFv-phage display antibody library was constructed. The capacity of library was measured,and the variety of the library was analyzed by digesting with restriction endonuclease BstNI.ScFv phage clones were randomly picked and identified phage-scFv clone by binding B3HM cells using immunofluorescein.A scFv library containing 5?106 individual clones which showed different patterns after digested with restriction endonuclease BstNI was produced. Individnal phage-scFv clone showed B3HM cells positive using immunofluorescein. A scFv library of anti-B3HM cell surface molecules has been constructed. It will be useful for finding out some novel genes of causing leukemia, and establishs the infarctate foundation of clarifying the pathogenesis of leukemiagenesis.

BACKGROUNDAbout 50% - 70% of patients with Chiari malformation I (CMI) presented with syringomyelia (SM), which is supposed to be related to abnormal cerebrospinal fluid (CSF) flow around the foramen magnum. The aim of this study was to investigate the cerebrospinal fluid dynamics at levels of the aqueduct and upper cervical spine in patients with CMI associated with SM, and to discuss the possible mechanism of formation of SM.

METHODSFrom January to April 2004, we examined 10 adult patients with symptomatic CMI associated with SM and 10 healthy volunteers by phase-contrast MRI. CSF flow patterns were evaluated at seven regions of interest (ROI): the aqueduct and ventral and dorsal subarachnoid spaces of the spine at levels of the cerebellar tonsil, C2 - 3, and C5 - 6. The CSF flow waveforms were analyzed by measuring CSF circulation time, durations and maximum velocities of cranial- and caudal-directed flows, and the ratio between the two maximum velocities. Data were analyzed by t test using SPSS 11.5.

RESULTSWe found no definite communication between the fourth ventricle and syringomyelia by MRI in the 10 patients. In both the groups, we observed cranial-directed flow of CSF in the early cardiac systolic phase, which changed the direction from cranial to caudal from the middle systolic phase to the early diastolic phase, and then turned back in cranial direction in the late diastolic phase. The CSF flow disappeared at the dorsal ROI at the level of C2 - 3 in 3 patients and 1 volunteer, and at the level of C5 - 6 in 6 patients and 3 volunteers. The durations of CSF circulation at all the ROIs were significantly shorter in the patients than those in the healthy volunteers (P = 0.014 at the midbrain aqueduct, P = 0.019 at the inferior margin of the cerebellar tonsil, P = 0.014 at the level of C2 - 3, and P = 0.022 at the level of C5 - 6). No significant difference existed between the two groups in the initial point and duration of the caudal-directed CSF flow during a cardiac cycle at all the ROIs. The maximum velocities of both cranial- and caudal-directed CSF flows were significantly higher in the patients than those in the volunteers at the aqueduct (P = 0.018 and P = 0.007) and ventral ROI at the inferior margin of the cerebellar tonsil (P < 0.001 and P = 0.002), as so did the maximum velocities of the caudal-directed flow in the ventral and dorsal ROIs at the level of C2 - 3 (P = 0.004; P = 0.007).

CONCLUSIONSThe direction of CSF flow changes in accordance with cardiac cycle. The syringomyelia in patients with CMI may be due to the decreased circulation time and abnormal dynamics of the CSF in the upper cervical segment. The decompression of the foramen magnum with dural plasty is an alternative for patients with CMI associated with SM.

Adolescent ; Adult ; Arnold-Chiari Malformation ; cerebrospinal fluid ; complications ; diagnosis ; Electrocardiography ; Female ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Syringomyelia ; etiology

Background To investigate the effects of collateral coronary circulation on the outcome of the patients with anterior myocardial infarction (NII) with left anterior desending artery occlusion abruptly.Methods Data of 189 patients with acute anterior MI who had a primacy percutaneous coronary intervention (PCI) in the fast 12 h from the onset of symptoms between January 2004 and December 2008 were retrospective analyzed.Left anterior descending arteries (LAD) of all patients were occluded.LADs were reopened with primary PCL According to the collateral circulation,all patients were classified to two groups:no collateral group (n＝111),patients without angiographic collateral filling of LAD or side branches (collateral index 0) and collateral group (n＝78),and patients with angiographic collateral filling of LAD or side branches (collateral index 1,2 or 3).At one year's follow-up,the occurrence of death,reinfarction,stent thrombosis (ST),target vessel revascularization and readmission because of heart failure were observed.Results At one year,the mortality was lower in patients with collateral circulation compared with those without collateral circulation (1% vs.8%,P＝0.049),whereas there were no differences in the occurrence of reinfarction,ST,target vessel revascularization and readmission because of heart failure.The occurrence of composite of endpoint was lower in patients with collateral circulation compared with those without collateral circulation (12% vs.26%; P＝0.014).Conclusions Pre-exist collateral circulation may prefigure the satisfactory prognosis to the patients with acute anterior MI after primary PCI in the fast 12 h of MI onset.