The all-in-one femtosecond laser corneal refractive surgery,especially small incision lenticule extraction (SMILE),has gained more and more attention in clinic,because of its small incision,“no flap” and corneal biomechanical stability advantages.However,like any other kind of corneal refractive surgery,the all-in-one femtosecond laser refractive surgery not only exists its clinical advantages,but also has its limitations.It is very important to put into perspective clinical advantages and limitations of all-in-one femtosecond laser corneal refractive surgery.

BACKGROUND:Previous studies have found that the expression level of miR-486 in glioma stem cels (CD133+) is significantly down-regulated compared with that in glioma non-stem cels (CD133-), but the effect of down-regulation of miR-486 on CD133+ cels remains unclear . OBJECTIVE: To explore the effect of miR-486 on CD133+ cels. METHODS:CD133+ glioma stem cels and CD133- glioma cels were separated from U87 cels by flow cytometer. miR-486 overexpression glioma stem cels were constructed by lipofection transfection. RESULTS AND CONCLUSION:After sorting and purification, the content of the CD133+ fraction was enriched up to 83.5%. The expression level of miR-468 in CD133+ glioma stem cels was obviously down-regulated compared with that in CD133- glioma cels. CD133+ glioma stem cels overexpressing miR-486 were fabricated successfuly. Results from in vitro experiments showed that miR-486 overexpression could dramaticaly decrease the proliferation of glioma stem cels, induce a cel cycle arrest in G1/S phase for CD133+ glioma stem cels and promote cel apoptosis. These findings suggest that miR-486 can be a suppressor of glioma stem cels, which offers a novel potential therapeutic target for glioma stem cels and human glioma.

Objective To investigate the relations between BNP and cTnI leveh in patients with CHF and cardiac function.Methods 75 patients with CHF were selected as observation group and another 30 healthy people were selected as control group.BNP and cTnI levels were detected by electrochemiluminescence immunoassay and the data were analyzed.Results BNP and cTnI of observation group were significantly higher than control group,the difference was statistically significant(t=3.897,4.127,all P＜0.05);comparison of BNP and cTnI levels in different classification of cardiac function of observation group had significant difference(F=4.765,5.876,allP＜0.05);Linear corrlation analysis showed that:BNP and cTnI both positively correlated to classification of cardiac function(r=0.853,0.647,all P＜0.05),BNP and cTnI increased significantly with the increase of cardiac function classification.Conclusion BNP and cTnI increased significantly in patients with CHF and closely related with cardiac function.they were ideal index to evaluate the CHF severity and had a good clinical value to judge the status and function of heart in patients with CHF.

10.3969/j.issn.2095-4344.2013.25.021

Objective To investigate the clinical significance of Doppler flow waveform of ductus venosus (DV) in screening of fetal cardiac malformation.Methods Color Doppler ultrasonography was used to study DV flow in 240 normal fetuses and 20 fetuses with cardiac malformation that were screened out from the high-risk fetuses with congenital heart disease (CHD).Results ① The normal Doppler flow waveform of the DV was a characteristic triphasic pattern with forward flow during cardiac cycle,reflecting ventricular systole (S),ventricular diastole (D) and atrial systole (A).② In the group of 20 fetuses with cardiac malformation,eight had reverse flow and nine had decreased or absent flow during atrial contraction,the indices of the DV in fetuses with cardiac malformation were higher than those in gestational age-matched normal fetuses ( P

Objective To explore the clinical manifestation and laboratory examination of chronic diarrhea in children with acquired immunodeficiency syndrome(AIDS) and analyze the reasons that causes the chronic diarrhea in children.Methods Clinical data of 7 patients (male 4 cases,famale 3 cases)with AIDS with manifestation of chronic diarrhea among the 17 cases were diagnosed as AIDS in Beijing children′s hospital from Jan.1999 to Dec.2006.The time of diarrhea,degree of dinrrhea,characteristic of stool,accompaniment symptom,laboratory examination were retrospectively analyzed.Results The average onset age was 6 years old(from 2-9 years old).The average time of diarrhea was 6 months(from 1-16 months).Four cases main complained with chronic diarrhea,3 cases came to the hospital because of fever,cough and wasting;6 cases with diarrhea,7 cases with malnutrition and anemia,5 cases accompanied hypokalemia and metabolic acidosis,6 cases had delay in growth and development,2 cases with abnormal stool routine exam,1 case with positive stool culture of fungi.All patients were with lower CD4,5 cases with lower CD4/CD8.Conclusions Chronic diarrhea is a common symptom in children with AIDS,and usually accompanied by obvious delay in growth and development,malnutrition and anemia,the reasons that causes the chronic diarrhea are consi-dered to be related with both the opportunistic infection and HIV infection.

OBJECTIVETo evaluate the effect of taper and inserting angle on stability of micro-implants in type II bone and to provide theoretical evidence for clinical selection of taper and inserting angle.

METHODSThree-dimensional finite element models of type II bone sections and micro-implants were fabricated. They were designed using different tapers (diameter between 1.1 to 1.6 mm, taper between 0 to 0.0625) and different inserting angles ranging from 30 degrees to 90 degrees (30 degrees, 45 degrees, 60 degrees, 75 degrees, 90 degrees). Effects on the maximum von Mises stresses in mandible and micro-implants, as well as on the maximum displacements in micro-implants, were analyzed under an applied 2 N horizontal force.

RESULTSThe inserting angle had a significant effect on stresses and displacements, with lower distribution of stresses and displacements occurring at 60 degrees. The effect of the taper was also related to the inserting angle. The minimum stresses were 5.013 4 MPa (cortical bone) and 25.1310 MPa (micro-implant) in model D at 60 degrees. The displacements of micro-implants were proportional to the taper.

CONCLUSIONThe inserting angle has a significant effect on stability of micro-implants, and the recommended inserting angle is 60 degrees. The influence of taper on the stability of micro-implants is related to the inserting angle. The micro-implant with 0.0375 taper (maximum diameter is 1.6 mm, minimum diameter is 1.3 mm) is more suitable for type II bones.

Anticonvulsants ; adverse effects ; Body Weight ; drug effects ; Epilepsy ; drug therapy ; Female ; Fructose ; adverse effects ; analogs & derivatives ; Humans ; Infant ; Male

Objective To study the apoptotic changes in hepatocytes and the expression of apoptosis-associated proteins Bax and Bcl-2 in the liver tissue of a rat nonalcoholic steato-hepatitis (NASH) model, and explore the relationship between hepatocyte apoptosis and the degree of NASH pathological changes. Methods A rat model of NASH was reproduced with feeding a fat-rich diet for a period of 2, 4, 6, 8 and 12 weeks. Cells apoptosis was evaluated by TdT-mediated dUTP nick end labeling (TUNEL), and the expression of Bax and Bcl-2 proteins was detected by immunohistochemistry in rat liver tissue of control and model groups respectively. Results The number of TUNEL-positive cells was increased in the second week, peaking at the 8th week, and it was significantly correlated with steatosis and hepatic fibrosis (r=0.707 and 0.750, respectively, P0.05). The expressions of Bax and Bcl-2 proteins were mainly located in cytoplasm of hepatocytes, some of which contained lipid droplets. Bax and Bcl-2 positive cells increased gradually with the progression of NASH. In early stage of modeling, the number of Bax positive cells was greater than that of Bcl-2, but the number of the both proteins tended to be about same in the late stage of modeling. Conclusion The cell apoptosis is a main pattern of liver damage in the process of NASH, and it is closely associated with the pathological changes. Proapoptosis protein Bax and antagonisitic protein Bcl-2 might participate in the modulation of hepatocytes apoptosis in the early stage of NASH, and they also have a marked effect in the whole process of NASH.

Objective To investigate the gastroscopic manifestations and pathological diagnosis of large gastric folds.MethodsClinical data of 161 cases with large gastric folds,who were diagnosed by gastroscopy from January 2002 to April 2008,were analyzed.Endoscopic mucosal resection or strip-off biopsy by ultrasonic endoscopy was performed if diagnosis could not be identified using routine biopsy by the gastroscopy.ResultsOf the 161 cases,79 patients had chronic inflammation(49.1%),67 had gastric cancer(41.6%),11 showed malignant lymphoma(6.8%),2 suffered from Menetrier's disease(1.2%),1 had acute inflammation(0.6%),and 1 showed no obvious lesion(0.6%);the rate of Helicobacter pylori infection was 42.2%(68/161),and the positive rate for Helicobacter pylori in patients with gastric cancer was 34.3%(23/67).Endoscopic mucosal resection biopsy was performed on 15(9.3%) of the cases,5 of them had chronic inflammation,5 showed gastric cancer,4 were confirmed with malignant lymphoma,and 1 was diagnosed as having Menetrier disease.The lesion of large gastric folds involved the whole stomach in 10 patients,the gastric fundus in 10,gastric corpus in 86,gastric antrum in 5,both the gastric fundus and corpus in 31,and both the gastric corpus and antrum in 19.All of the 10 cases,who had the whole stomach being invaded,were diagnosed as having gastric cancer.Though both gastric cancer and chronic inflammation showed similar manifestations under gastroscope,the levels of the characteristics were significantly different(Dilatancy poor: ?2=10.093,P=0.001;peristalsis poor: ?2=19.116,P=0.000;gastric cavity narrowing: ?2=18.159,P=0.000;texture stiffness: ?2=54.302,P=0.000;texture brittle: ?2=6.132,P=0.013;erosion: ?2=5.619,P=0.018;and ulcer: ?2=22.743,P=0.000).ConclusionsMost of the patients with large gastric folds are diagnosed as having chronic inflammation,gastric cancer,or malignant lymphoma,while Menetrier disease and acute inflammation seldom occur.The lesion usually involves the gastric corpus.For those who have the whole stomach being invaded,gastric cancer can be revealed.Most of the malignant cases show ulcers,dilatancy poor,and peristalsis poor under a gastroscope.Endoscopic mucosal resection biopsy is effective for identifying the diagnosis of malignant lesions.