Objective To analyze the corneal flap thickness in laser in situ keratomileusis(LASIK) using Moria M2 microkeratome and to identify the related factors. Methods Sixty patients with LASIK were divided into two groups: M2 90 group,using the Moria M2 90 microkeratome,n=30;M2 110 group,using the Moria M2 110 microkeratome,n=30.All were performed on both eyes with the right one treated first.Subtraction pachymetry was used to measure corneal flap thickness which was analyzed statistically with the data including age,preoperative corneal diameter,curvature,corneal thickness and refraction. Results In the 30 patients of M2 90 group,the mean corneal flap thickness of right eye and left eyes were(128.03?12.03)?m(105~156 ?m) and(123.40?12.38) ?m(92~147 ?m),respectively,and the corneal flap thickness were statistically different between the right and left eyes(P

OBJECTIVE: To investigate the clinical features and operation treatment of the congenital middle ear cholesteatoma. METHOD: A retrospective review of clinical and surgical records of 10 patients with congenital middle ear cholesteatoma were performed. All patients were treated by surgeries,5 of 10 cases deal with one-stage tympanoplasty after drum exploration by external auditory meatus, 3 cases dealed with closed mastoidotympanectomy and tympanomastoidectomy, 2 cases dealed with open mastoidotympanectomy and tympanomastoidectomy. RESULT: The cholesteatomas were located at or around the posterior tympanum or mesotympanum in 5 patients, confined to the tympanic cavity and attic in 3 patients, advanced cholesteatoma that extended from the tympanic cavity into the mastoid antrum was seen in 2 patients. The mean postoperative PTA was 30 dB HL, the mean ABG was within 20 dB, after six months. No residual or recurrence of cholesteatoma was found. CONCLUSION The congenital cholesteatoma often originates from the posterior or anterior of the middle ear, with hiding lesion, thus result in severe conductive hearing loss. Imaging examination plays an important role in diagnosing and treating of congenital cholesteatoma. Early stage surgical treatment can obtain a good hearing reconstruction effect.
Adolescent ; Adult ; Child ; Child, Preschool ; Cholesteatoma ; congenital ; surgery ; Cholesteatoma, Middle Ear ; surgery ; Ear, Middle ; physiopathology ; Female ; Follow-Up Studies ; Humans ; Male ; Retrospective Studies ; Tympanoplasty ; methods ; Young Adult

ObjectiveTo investigate the value of CEUS in differential diagnosis of benign and malignant thyroid solid lesions.MethodsTotally 45 patients with thyroid solid lesions underwent CEUS examination.The enhancement mode and blood perfusion characteristics of malignant and benign lesions were analyzed,and the results were compared with pathology.ResultsCEUS diagnosed 31 benign lesions and 14 malignant masses.The diagnostic accordance rate of CEUS was 93.75％ (30/32) and 92.31％ (12/13) for benign and malignant lesions respectively.In 31 benign lesions,27 (27/31,87.10 ％) showed entire homogeneous enhancement,4 (4/31,12.90％) presented inhomogeneous enhancement.In 14 malignant masses,1 (1/14,7.14 ％) showed homogeneous hypoechoic enhancement,12 (12/14,85.71％) presented inhomogeneous hyperechoic enhancement and 1 (1/14,7.14％) presented non-enhancement.ConclusionCombined with two-dimensional grey scale ultrasound and CDFI,CEUS enables dynamic observation of the microvascular perfusion of thyroid lesions,therefore helps to differentiate benign and malignant thyroid lesions.

Objective To investigate the accuracy of predicting middle cerebral artery infaction with contin -ue electroencephalograph .Methods 40 cases with middle cerebral artery infaction were divided into malignant groups(14) and binigan groups(26).They were all with continued beside electroencephalograph within 24 hours after admission.Results Abnormal CEEG rate in malignant groups [85.71%(12/14)]was significantly higher than that in binigan groups[65.38%(17/26)](χ2 =10.405,P=0.001).In malignant groups,severe abnormal CEEG was seen in 4 cases developed coma at the second day of admission ,moderate abnormal CEEG was found in 6 cases,slight abnormal CEEG was detected in 2 cases,normal CEEG was detected in 2 cases.Conclusion Early CEEG has a cer-tain value for predicting middle cerebral artery infaction .

Objective To study clinical efficacy of porcine-derived small intestinal submucosa (Surgisis) in treatment of pelvic organ prolapse (POP).Methods From Mar.2012 to Mar.2013,15 patients with POP at more than Ⅲ of POP quantitation (POP-Q) staging system undergoing pelvic reconstructive surgery with Surgisis in Peking University People's Hospital.The mean age was 59 years old (39-82).The variable site of POP-Q staging systemn was compared between preoperative and postoperative status among those patients.Quality of life questionnaire of pelvic floor impact questionnaire (PFIQ-7),pelvic floor distress inventory short form (PFDI-20) and PISQ-31 were studied to evaluate subjective satisfaction,recurrence and the quality of life's improvement.Results All patients were followed up at mean of 9.9 months (3-15 months),the mean time of surgery was 96 mins (65-120 mins),the mean blood loss was 159 ml (50-500 ml).No infection and erosion was observed on those patients.The rate of subjective satisfaction was 14/15,the recurrence rate of prolapse was 2/15.Scoring system of PFDI-20 was from 87 (56-124) at operative status to 30 (22-48) at postoperative status.PFIQ-20 was from 129 (85-158) at preoperative status to 24 (18-48) at postoperative status.PISQ-31 was from 48 (32-55) at preoperative status to 79 (66-89) at postoperative status,which all reached statistical difference (all P ＜0.05).Total 9 patients obtained satisfactory sexual life.Conclusions The short-term clinical effect of pelvic reconstructive surgery with Surgisis was satisfied,quality of life and sexual life was improved,and less complication were observed.However,long-term clinical effect on patients should be warranted to follow up.

Objective To investigate the changes of IL-8 in peripheral blood of patients with pustular psoriasis after acitretin treatment.Methods Dual antibody sandwich enzyme-linked immunosorbent assay (ELISA)was performed to measure the IL-8 levels in the peripheral blood of 30 patients with pustular psoriasis and 30 patients with psoriasis vulgaris before and after treatment,and in 30 normal human controls.The relationship between the IL-8 level and disease severity was assessed for patients with pustular psoriasis.Results After acitretin treatment,the condition was improved greatly in patients with pustular psoriasis,together with a significant decrease in the level of IL-8 in the peripheral blood(57.07 ± 12.02 pg/ml vs.96.84 ± 14.68 pg/ml,P ＜ 0.05).Conclusion IL-8 may be involved in the therapeutic mechanism of acitretin in pustular psoriasis.

Objective To explore the repair possibilities of endothelial progenitor cells (EPCs)in peripheral blood in patients with different extents of obstructive sleep apnea (OSA) through measuring the levels of pro-angiogenic factors and different subgroups EPCs in peripheral blood in patients with OSA. Methods Ninety adult patients with OSA, 30 healthy controls with matched age and gender were enrolled for this study. The subjects performed Polysomnography, were divided in-to four group based on Apnea Hypopnea Index (AHI). The serum levels of HIF-1α, SDF-1αand VEGF were assessed by ELISA. Mononuclear cells were isolated from peripheral blood with density gradient centrifugation, and flow cytometry was used to detect levels of CD133+KDR+EPC, CD133+CD34+EPC, CD34+KDR+EPC and ALDHloCD34+KDR+EPC based on AL-DH activity, and CD133, CD34, PE-KDR related cell surface markers. Results The levels of CD133+KDR+EPC, CD133+CD34+EPC, CD34+KDR+EPC were higher in OSA groups than those of control group, both of which were higher in severe OSA group than those of in mild and moderate OSA groups. The levels of ALDHloCD34+KDR+EPC were higher in mild and moderate OSA groups than that of the control groups, and the levels of ALDHloCD34+KDR+EPC were significantly lower in se-vere OSA group than those of control, mild and moderate OSA groups. Serum levels of HIF-1α. VEGF were significantly high-er in OSA groups compared to those in control groups, both of which were higher in severe OSA group than those of mild and moderate OSA groups. Serum levels of SDF-1αwere significantly lower in severe OSA groups than those of mild, moderate OSA and control groups (P<0.05). Conclusion The mobilization and recruitment of different subtypes of EPCs are obvious-ly increased in patients with OSA, but ALDHloCD34+KDR+EPC with vascular repair capacity keeps to invariability, even de-creases in patients with severe OSA, which results in endothelial damage, and increases the risk of cardiovascular disease.

OBJECTIVE:To evaluate the effects of clinical pharmacists'intervention on prophylactic use of antibiotics in re-moval of internal fixation device for fracture. METHODS:Totally 117 patients underwent removal of internal fixation device for fracture were selected from some on third grade class A hospital during Mar.-Jul. 2015 as pre-intervention group. Totally of 266 pa-tients underwent removal of internal fixation device for fracture were selected during Aug. 2015-May 2016 as post-intervention group. Clinical pharmacists performed interventions based on Rationality Evaluation Criteria for Prophylactic Use of Antibiotics in Removal of Internal Fixation Device for Fracture. The prophylactic use of antibiotics was compared between 2 groups before and af-ter intervention. RESULTS:No unreasonable single dose or additional drug during surgery was found before and after intervention. After intervention,utilization rate of antibiotics for prophylactic use,the proportion of patients receiving antibiotics without indica-tions,the proportion of medication duration more than 24 h decreased from 84.6%,71.8%,48.7% to 17.3%,9.8%,4.9%,re-spectively. Average antibiotics cost,the proportion of total drug cost in hospitalization cost,the proportion of antibiotics cost in to-tal drug cost were all decreased significantly compared to before intervention,with statistical significance(P<0.05). There was no statistical significance in the proportion of patients with unreasonable drug choice,unreasonable initial prophylactic medication tim-ing and unreasonable drug combination,the proportion of different antibiotics types,average hospitalization cost and average drug cost(P>0.05). CONCLUSIONS:Clinical pharmacists'interventions significantly reduce the utilization rate of antibiotics for pro-phylactic use in patients underwent removal of internal fixation device for fracture,improve drug use without indications and ratio-nality of prophylactic use of antibiotics. There still are problems,such as unreasonable medication timing,continuous use time of more than 24 h,etc. It is necessary to continuous follow-up intervention.

OBJECTIVE:To synthesize the aryl-pyridazinone acid and curcumin ester. METHODS:With the raw material of 5-methyl-2-(3-chloro-4-fluorophenyl)-2-oxo-pyridazine acid (compound 1) and curcumin,there was ester-forming in the two sides of a phenolic hydroxyl and pyridazin-6-one carboxyl in curcumin by the catalysis of N,N-dicyclohexyl carbodiimide(DCC)/4- dimethylaminopyridine (DMAP). The targeted product,MS and NMR characterization of the structure were obtained through column chromatographic separation. Single factor was adopted to detect the effect of mixture ratio of curcumin and compound 1,re-action temperature and time and catalyst on the reactions. RESULTS:The productivity of targeted product (aryl-pyridazinone acid and curcumin ester)was 56.3%(in curcumin),the content by HPLC was 98.1%. The optimum conditions were as follows as the mixture ratio of curcumin and compound 1 was 1∶3,reaction temperature was 50 ℃,reaction time was 10 h and the catalyst was DCC/DMAP. CONCLUSIONS:The aryl-pyridazinone acid and curcumin ester is successfully synthesized with stable process.

Objective To explore the mechanism of vessel endothelial dysfunction in rats under intermittent hypoxia (IH). Methods The respiratory simulation system was used to simulate IH. Sixty C57BL/6J rats (male) were randomized into control group and IH group. The rats of IH group were exposed to IH 8 hours per day for 6 weeks. The serum levels of hypoxia inducible factor (HIF)-1a and stromal cell derived factor (SDF)-1a were assessed by ELISA. The serum levels of reactive oxygen species (ROS) were detected in two groups. The serum expression of miR-199a-5p was detected by real-time fluorescent quantitative PCR in two groups. The dual luciferase report system and point mutation test were used to verify target gene for HIF-1a. Results The serum levels of HIF-1a and SDF-1a were significantly higher in IH group than those of control group (μg/L:1.60±0.02 vs. 1.19±0.02, 1 823.00±8.97 vs. 1 444.00±17.90, P<0.01). The serum level of ROS was significantly higher in IH group than that of control group (U/mL:487.66±35.73 vs. 211.57±23.82, P<0.01). The serum level of miR-199a-5p expression was significantly lower in IH group compared to that of control group (1.31±0.07 vs. 3.47± 0.17, P<0.01). The result of dual luciferase reporter gene detection confirmed that target gene of miR-199a-5p was HIF-1a. Conclusion The serum level of miR-199a-5p is decreased first due to IH, and then its target gene (HIF-1a) is increased. HIF-1a can induce the increased level of SDF-1a, and its receptor (CXCR-4 ) is also increased. Finally, HIF-1a can increase the serum level of ROS, resulting in the endothelial dysfunction.