Objective To explore the clinical efficacy of modified corneal ulcer debridement combining with anti-fungal agents in the treatment of keratomycosis(fungal corneal ulcer).Design Prospective case series.Participants Criteria for inclusion:1)fungal corneal ulcer was diagnosed under direct 10% KOH wet film microscopic examination;2)corneal ulcer located away from the center with superficial infiltration,or located in the center but in small size;3)depth of corneal infiltration was uncertain.From January,2007 to December,2009,141 cases of fungal corneal ulcer patients in Shandong Eye Institute affiliated to Qingdao Eye Hospital were recruited into this study.Methods All patients received modified corneal ulcer debridement including stripping off ulcer lesion as well as infiltrated tissue,and repairing ulcer fringe.For postoperative treatment,0.25% amphotercin B or 5% natamycin and 0.5% fluconazol eye drops were topically administrated with high frequency to the diseased eye.In the meantime,itraconalzole was orally taken as systematic treatment.Clinical efficacy of the above therapy was evaluated at last.Main Outcome Measurs Corneal ulcer infiltration,corneal epithelium reparation and recovery of vision acuity were closely observed following surgery.Results 10% KOH wet film examination showed that hypha was found in all of the 141 cases.The average time for postoperative follow-up was 29 days(from 14 to 60 days).All 141 cases of fungal corneal ulcer were completely healed,of which 127 cases were healed by taking corneal ulcer debridement surgery and anti-fungal medication,and the other 14 cases had to take penetrating keratoplasty(10 cases) or lameller keratoplasty(4 cases) due to uncontrolled infection.No recurrence was found during follow-up.The average time for healing in the 127 cases was 8.5 days,and among these cases,29 cases had a preoperative visual acuity below 0.05,80 cases between 0.05 and 0.3,and 32 cases between 0.3 and 1.0.Postoperative evaluation showed that 6 cases had a visual acuity below 0.05,42 cases between 0.05 and 0.3,93 cases(65.96%) between 0.3 and 1.0,and among 93 cases,81 cases(57.45%) had a visual acuity between 0.5 and 1.0.Conclusions The modified corneal ulcer debridement combining with anti-fungal agents has proved to be an effective treatment for fungal corneal ulcer.It greatly improves patient's visual acuity and shortens the disease duration.For cases of superficial or uncertain infiltration,corneal ulcer debridement enables better ulcer observation and provides guidance for further treatment.

Adult ; Aged ; Aged, 80 and over ; Antigens, CD ; metabolism ; Antigens, Differentiation, Myelomonocytic ; metabolism ; Carcinoma, Squamous Cell ; metabolism ; pathology ; Esophageal Neoplasms ; metabolism ; pathology ; Female ; Follow-Up Studies ; Humans ; Lymphatic Metastasis ; Macrophage Activation ; Macrophages ; metabolism ; pathology ; Male ; Middle Aged ; Neoplasm Staging ; Prognosis ; Receptors, Cell Surface ; metabolism ; Survival Rate

Objective To design a hemostatic clip and evaluate its efficacy and success rate of closure of stomach wall defect after full thickness resection (FTR).Methods A full thickness circular or linear resection (3 to 5 cm) was made on each model's antrum with needle knife and insulated-tip knife.The specimens were divided into 2 groups, using either an interrupted or continuous suturing method.Then the closure condition, suturing time, number of clips required and success rate of closure were compared.Results All 12 defects were successfully closed.The average closing time of interrupted and continuous suturing group were 13.33 ± 1.09 and 10.17 ±2.11 minutes, and the mean number of clips used were 4.67 ± 0.82 and 2.67 ± 0.82.The success rate was 100％.Conclusion This newly designed clip is a fast, reliable and convenient tool for stomach wall defect closure after FTR.

[Abstratc] Objective The function of cIAP1 in the progression of ovarian cancer has not been clarified . This study is to explore the involvement of cIAP 1 in regulating biological behaviors of ovarian cancer cells by u-sing RNA interference(RNAi)technology.Mte hods The short hairpin RNA plasmid targeting cIAP1 was con-structed and transfected into Skov 3 cells.The levels of cIAP1 mRNA and protein were investigated by RT -PCR and Western Blot respectively .MTT assay and flow cytometry were used to evaluate cell proliferation and apopto-sis.R esults The rate of cIAP1 transfection was 74.7%performed by flow cytometric analysis .cIAP1 expression was significantly down -regulated at both mRNA and protein levels ,which resulted in a decrease of cell prolifera-tion and invasion capability in vitro .Conclusion This study implies that cIAP 1 might play an important role in the progression of ovarian cancer ,and it could be a potential target for therapeutic anti -cancer drugs .

Probability of causation (PC) was used to facilitate the adjudication of compensation claims for cancers diagnosed following exposure to ionizing radiation. In this article, the excess cancer risk assessment models used for PC calculation are reviewed. Cancer risk transfer models between different populations, dependence of cancer risk on dose and dose rate, modification by epidemiological risk factors and application of PC are also discussed in brief.

Objective To evaluate the therapeutic effect of percutaneous endoscopic necrosectomy (PEN) in treating infectious pancreatic necrosis (IPN).Methods A retrospective review of clinical data of 6 patients with IPN who received PEN in Changhai Hospital, Second Military Medical University from Dec 2015 to Sep 2016 was performed.Clinical parameters were recorded, including basic information, severity evaluation and therapeutic methods and times.In addition, vital sign parameters and inflammatory marks before and after PEN treatment were compared.Results There were 4 patients with severe acute pancreatitis (SAP) and 2 patients with moderately severe acute pancreatitis (MSAP) in these 6 patients with IPN.Mean APACHEⅡ score was 12 (10~15), and mean MCTSI scores was 9.3(8~10).All 6 patients received a total of 13 times PEN treatments, with a mean of 2.2(1~3) times.Each patient was treated with a mean of 2.5(1~4) drainage tubes placed in the peripancreatic abscess after PEN treatment, and the mean time for drainage was 139 d(106~183 d).Besides, the mean hospitalization time was 116 d (48~223 d).All the patients′ condition was improved significantly after PEN treatment, including reduced heart rate, body temperature and inflammatory markers, without bleeding or other serious complications.Only 1 patient had pancreatic fistula after treatment, and no patients needed open abdominal drainage surgery.Patients with higher MCTSI scores likely required more times of PEN and more drainage catheters, longer length of drainage and hospital stay.Conclusions PEN was safe and effective for treating patient with IPN, but those with higher MCTSI scores were associated with more PEN treatments, more drainage tubes, and longer time of drainage and hospitalization.

[ABSTRACT]OBJECTIVETo investigate the morbidity rate and the epidemiological characteristics of snoring among the elderly in Yangpu District of Shanghai City.METHODSOne thousand six hundred and thirty persons(≥60 years) were investigated through questionnaires in Yangpu District of Shanghai City by a method of cluster sampling.The prevalence and risk factors of snoring were estimated. The relationship between snoring and the common clinical complications was observed by correlation factor analysis.RESULTS1630 questionnaires were provided, among which 1489 questionnaires(91.35%) were effective for evaluation.Of 1489 subjects, 213(14.3%) subjects had habitual snoring. Multivariate analysis revealed that obesity as a significant risk factor of snoring. The prevalence rate of snoring in the elderly with hypertension and poor quality of sleep was higher than that in the normal elderly.CONCLUSIONThe prevalence of snoring in the elder persons (≥60 years) in Yangpu District of Shanghai City is high. Obesity is a significant risk factor of snoring. The main clinical presentations of snoring in the elderly are atypical by the performance of poor sleep quality and the complication of hypertension.

Objective To determine the diagnostic value of shoulder MR arthrography in revealing the injuries of anterior glenoid labrum,and to compare MR arthrography with arm in neutral position with MR arthrography with arm in abduction and external rotation(ABER)position.Methods MR arthrography of the shoulder,including additional oblique axial sequences with the patient in the ABER position,was performed in 44 patients.The injuries of anterior glenoid labrum of these patients were retrospectively evaluated.The result was compared with that of arthroscopy.Results For displaying the abnormalities of anterior glenoid labrum,the sensitivity,specificity,and accuracy of axial MR images with arm in neutral position were 79.3%(23/29),100%(15/15),and 86.4%(38/44),respectively.While the results of ABER position oblique axial images were 93.1%(27/29),100%(15/15),and 95.5%(42/44), respectively.The difference of sensitivity between axial and ABER-position scans was statistically significant (P

3T3-L1 adipocytes were cultured with various concentrations of high-density lipoprotein ( HDL, 0, 10, 50, and 100 μg/ml ) for 16 h and with lipopolysaccharide ( LPS, 100 ng/ml ) for another 6 h. Interleukin-8 in the medium was determined by ELISA, and PPAR-γ mRNA expression by reverse transacription polymerase chain reaction (RT-PCR). Interleukin-8 levels were increased in LPS-treated cells ( P＜0.05 ), but decreased in HDL-treated cells in the dose-dependent manner. PPARγ mRNA expressions were increased in HDL-treated groups than those treated only with LPS. These results suggested HDL may decrease interleukin-8 secretion via up-regulating PPARγ expression in adipocytes.

Objective To demonstrate the effect of comprehensive treatment under nasal endoscopy for epistaxis. Methods The bleeding sites of 92 patients were defined by nasal endoscopic examination. Epistaxis was cured by single pole or bipolar coagulation, combined with micro packing and systemic treatment. The bleeding sites and effect were studied retrospectively. Results The hemorrhagic foci were found in the following sites: 60.87%(56/92) in Little area, 13.04%(12/92) in the middle and back of nasal septum, 10.87% (10/92) in olfactory sulcus, 8.70% (8/92) in middle turbinate , 3.26% (3/92) at the top of inferior meatus, 2.17% (2/92) at the top of nasal cavity, 1.09% (1/92) at unknown part at the back of nasal cavity. Epistaxis was successfully controlled by once nasal endoscopic examation and hemostasis in 86 of 92 patients. While in 5 of 92 patients, epistaxis was cured by twice nasal endoscopic examation and hemostasis. Endoscopicligation of the sphenopalatineartery was performed in 1 patient with unknown posteriorepistaxis. In 92 patients,15 cases were given micro packing combined with systemic treatment. All the patients were cured and were followed up for 3 months without recurrence and the cure rate was 100.00%. Conclusions The major bleeding site is Little area. Single pole or bipolar coagulation, combined with micro packing and systemic treatment under nasal endoscope is effective for epistaxis and worth of clinic application extensively.