Objective To evaluate the clinical value of early alterations of carotid arterial intima-media thickness (IMT) and elastic function in patients with hypertriglyceridemia (HTG) using ultrasound radio-frequency technique.Methods 48 patients (triglyceride value ≥ 1.8 mmol/L) were chosen as HTG group.Quantitative intimamedia thickness (QIMT) and quantitative arterial stiffness (QAS) techniques were used to observe the alterations of carotid arterial IMT and elastic index,including diameter of carotid artery (D),distensibility coefficient (DC),compliance coefficient (CC),elasticity coefficient (α),elasticity coefficient (β) and pulse wave velocity (PWV).50 healthy subjects were recruited in control group.Differences of the above-mentioned parameters were analyzed,as well as the elastic index connections between the two groups.Results IMT,α,β,and PWV index of bilateral carotid arteries in HTG group was higher than that of the control group,while the DC and CC index was lower,and the differences was statistically significant (P＜0.05).Within the groups there were differences between the elastic indexes of bilateral carotid arteries.In control group and the HTG group:CCL＞CCR,αL＞αR,βL＞βR,PWVL＞PWVR.CC was negatively correlated to α,β and PWV (P＜0.05).Meanwhile,there was positive correlation among α,β and PWV (P＜0.05).The differences of D between two groups had no statistical significance (P＞0.05).Conclusions The abnormity of arterial occurs earlier than the morphological change,while the ultrasound radio-frequency technique can provide information of earlier alteration of common carotid arteries structure and elastic function in patients with HTG,which is a significant method of testing early alteration of carotid elastic in patients with HTG.

Objective To compare the efficacy and safety of excimer laser 308 nm phototherapy alone and the combination of excimer laser 308 nm and topical application of vitamine D3 alanogue tacalcitol in the treatment of vitiligo. Methods Seventy-eight patients with vitiligo were enrolled in the single-blind clinical trial, treated with excimer laser 308 nm. The lesions were devided into two groups: patients in the experimental group were instructed to use tacalcitol ointment and the control group were applied with placebo ointment. The lesions were evaluated once per month and photos taken for analyses of clinical effects. Results The results in different locations were compared, the effective rates of the experimental group in cephalofacial site, trunk and limbs were 93.51%, 84.16 % and 42.35 %, respectively. The effective rates of control group in opposite and adjacent sites were 90.9 %, 77.45 % and 34.15 %, respectively (P ＜ 0.05). The comparison of results in different types of lesions indicated that the effective rate of the experimental group in vitiligo vulgaris and segmental vitiligo were 73.81% and 84.00 %, respectively. The effective rate of control group in vulgaris and segmental vitiligo were 86.8 %, 77.45 % and 34.15 %, respectively (P ＜0.05 ). The comparison of results in radiation times and doses of phototherapy showed that the radiation time and dose on the time of initial pigment regeneration were (16. 15 ± 3.22)times and (4.40 ± 5.03)J/cm2 in the experimental group, while ( 18.56 ± 3.50) times and ( 6.60 ± 1.01 ) J/cm2 ( P ＜ 0.05 ) in the control group, the time and dose on the time of apparent effect were ( 20. 36 ± 1.50 ) times and ( 7.50 ± 3.54 ) J/cm2 in the experimental group, and (21.68 ± 2.40) times and( 8.80 ± 9.24)J/cm2 (P ＜ 0.05 ) in the control group. Conclusion Application of tacalcitol ointment in combination with twice-weekly 308 nm excimer laser light phototherapy is an effective alternative treatment for patients with generalized vitiligo.

AIM: To observe effect of the iris location to femtosecond - combined wavefront guided LASIK for myopia and astigmatism.?METHODS:The patients with astigmatism >1. 0D during the same time and followed up for 1a were selected. A total of 129 eyes in 67 patients were treated under iris location with femtosecond-combined wavefront guided LASIK ( experimental group) and 161 eyes in 82 cases with femtosecond-combined wavefront guided LASIK ( control group) . Laser cutting went with the same laser machine. The uncorrected visual acuity ( UCVA ) , best corrected visual acuity ( BCVA) , and wavefront aberration between the two groups were compared at 1, 3, 6mo and 1a after surgery.?RESULTS:At 1 and 3mo after surgery, the number of patients with better postoperative UCVA than preoperative BCVA between the two group showed a statistically significant difference (χ2=6. 423, P=0. 011,χ2=14. 431, P=0. 01 ); at 1d and 1mo after surgery, the residual astigmatism showed a statistically significant difference between two groups (t=1. 98, P<0. 05; t=2. 23, P<0. 05). At 3, 6mo and 1a after surgery, the differences on the change of residual astigmatism between the two groups weren’t significant ( P > 0. 05 ). At 6mo and 1a after surgery, the differences on UCVA between the two groups weren’t significant ( P > 0. 05 ). Until 1a after surgery, the root mean square ( RMS ) of high order wavefront aberration of the two groups, spherical aberration and coma aberration ( COMA ) were all enhanced compared to before surgery(P<0. 05). At 1, 3mo after surgery, the RMS showed a statistically significant difference between two groups (P<0. 05). At 1, 3, 6mo, 1a after surgery, the increase of COMA in experimental group was significantly lower than that in control group (P<0. 05).? CONCLUSION: Iris location technology applied in femtosecond - combined wavefront guided LASIK for myopia and astigmatism, can make the vision recovery faster, the RMS of high order and COMA increase less, the residual astigmatism less, show better and more stable treatment effect.

AIM:To contrast analysis of postoperative variation of corneal posterior surface heights after Femtosecond LASlK ( FS - LASlK ) and small incision lenticule extraction ( SMlLE) for high myopia.
●METHODS: Sixty-seven cases of high myopic patients (132 eyes) operated with laser corneal refractive in our hospital from May to Dec. in 2015 (-6. 00D≤spherical equivalent degree≤-10. 00D) were selected and divided into FS-LASlK group and SMlLE group. The thickness of corneal flaps at FS-LASlK and the thickness of map at SMlLE were designed to be 110μm. Corneal posterior surface heights were examined by Pentacam at preoperation, postoperative 3 and 6mo after FS-LASlK and SMlLE operation. Surface height changes after preoperative, postoperative 3 and 6mo were compared by measuring Pentacam corneal analysis system.
●RESULTS: Six months after operation, the FS-LASlK posterior corneal surface height was 6. 47 ± 1. 65mm, significantly higher than 5. 20 ± 1. 32mm before operation. SMlLE posterior corneal surface height was 6. 40 ± 1. 33mm, significantly higher than 5. 18 ± 1. 25mm before operation, the differences were statistically significant( P<0. 05). Six month after surgery, two methods of corneal surface height variation obtained was 1. 29 ± 1. 28mm and 1. 22 ± 0. 89mm, there was no significant difference ( P>0. 05).
●CONCLUSION:After FS-LASlK and SMlLE, the corneal posterior surface is protrusive. FS - LASlK is slightly obvious than SMlLE in early period. The stability of the posterior surface is better after SMlLE.

Mutagenicity Tests ; methods ; Tobacco Smoke Pollution ; adverse effects

Acute Disease ; Adult ; Ethylene Dichlorides ; poisoning ; Female ; Humans ; Male ; Neurotoxicity Syndromes ; therapy

Objective To evaluate the effect of early continuous renal replacement therapy(CRRT)on patients with acute kidney injury(AKI)induced by severe sepsis. Methods A prospective study was conducted. 160 patients with AKI induced by severe sepsis admitted to intensive care unit(ICU)of Qingyuan People's Hospital between October 2009 and June 2013 were enrolled. According to the starting time of CRRT,the patients were randomly divided into two groups:an earl y treatment group and a regular treatment group(each,80 cases). All patients were treated in accordance with the principle of the cluster of severe sepsis. In early treatment group,the patents began to receive CRRT when the amount of urine output was<0.5 mL?kg-1?h-1 and had taken continuous conventional treatment over 6 hours,but the curative effect was not ideal. In the regular treatment group,the patients began to apply CRRT when the amount of urine output was<0.5 mL?kg-1?h-1 and had taken continuous conventional treatment persistently over 24 hours or difficultly corrected acidosis or heart failure developed. The changes in urine output,creatinine,saturation of blood oxygen,and albumin,and 28-day survival rate,length of ICU stay,time of organ support were measured and compared between the two groups to evaluate the therapeutic significance of the early CRRT. Results The mean length of ICU stay(day:6.5±1.7 vs. 8.2±1.6),length of organ support(day:5.3±1.8 vs. 6.0±1.4),the recovery time of urine amount(day:3.4±0.9 vs. 4.8±0.5)in early treatment group were significantly shorter than those in regular treatment group(all P<0.01);recovery ratio of urine in 1 week in early treatment group was significantly higher than that in regular treatment group(46.2%vs. 28.8%,P<0.05). The creatinine recovery ratio in 1 week in early treatment group was lower than that in regular treatment group(55.0%vs 78.8%),but there was no statistically significant difference(P>0.05). Early treatment group and regular treatment groups of creatinine recovery time were similar(day:5.1±1.3 vs. 5.2±1.2). 28-day survival rate in early treatment group was higher than that in regular treatment group(41.2%vs. 35.0%),but there was no statistically significant difference(P>0.05). Conclusion It is found that there is no evidence to suggest that early CRRT may improve the prognosis of the patients with AKI induced by severe sepsis,but it may be in favor of shortening the time of urine recovery,length of stay in ICU,length of organ support and length of dialysis.

Objective To determine the optimum dose of dexmedetomidine (DEX) for endoscopic retrograde cholangiopancreatography (ERCP) in elderly patients when combined with propofol.Methods Ninetytwo ASA physical status Ⅰ or Ⅱ] elderly patients,aged 65-80 yr,with body mass index 18-25 kg/m2,scheduled for elective ERCP,were randomly assigned into 4 groups (n =23 each) using a random number table:fentanyl group (F group),low-dose DEX group (D1 group),medium-dose DEX group (D2 group) and high-dose DEX group (D3 group).Fentanyl 1.0 μg/kg and DEX 0.4,0.7 and 1.0 μg/kg (in normal saline 20 ml) were infused over 10 min via a pump in F,D1,D2 and D3 groups,respectively.At the end of infusion,propofol targetcontrolled infusion was started with the target plasma concentration set at 4 μg/ml,and after the mirror passed through the throat,the target plasma concentration of propofol was adjusted to 2.5 μg/ml.At 10 min after admission to the operating room,immediately after completion of fentanyl or DEX infusion,immediately after the effect-site concentration of propofol reached 4 μg/ml,immediately after the mirror passed through the throat,while pulling the stone,at end of surgery and when the patients were awake,the depth of sedation (NT value) was reccorded and the development of hypoxemia was also recorded.Arterial blood samples were collected at 10 min after admission to the operating room and at the end of operation to record PaCO2.The consumption of propofol,duration of ERCP,and emergence time were recorded.The body movement and requirement for vasoactive drugs were also recorded.Results Compared with F group, NT value and the incidence of hypoxemia were significantly decreased in D1-3 groups,PaCO2,the incidence of body movement and amount of propofol consumed were decreased in D2 and D3 groups,and the emergence time was prolonged and the requirement for atropine was increased in D3 group (P ＜0.05).Compared with D1 group,the PaCO2,NT value,incidence of body movement and amount of propofol consumed were decreased in D2 and D3 groups,the emergence time was prolonged and the requirement for atropine was increased in D3 group (P ＜ 0.05).Compared with D2 group,the consumption of propofol was decreased,the emergence time was prolonged,aud the requirement for atropine was increased in D3 group (P ＜ 0.05).Conclusion The optimum dose of dexmedetomidine is 0.7 μg/kg for ERCP in elderly patients when combined with propofol.

Objective To explore the risk factors for asthma in children.Methods A 1:1 matched and hospital-based case-control study was conducted to analyses risk factors for asthma in 300 pairs of children by logistic regression analysis. Results The result of univariate Logistic regression analysis showed that there were 17 related factors for children asthma, including disease history of parents in respiratory system,family income,atopie character,history of acute respiratory infections, eating habit,the amount of sea foods intakes,foam plastics,family decoration,the way of exhaust fume in kitchen,the exhaust effectiveness,raising pet in house,family history of asthma,family history of allergic rhinitis,family history of food allergy,dust allergy of parents,systemic therapy after the first attack.With multivariate Logistic regression analysis,7 factors were entered the model,6 risk factors including father's history of respiratory diseases(OR 3.771,95%CI 1.533～9.278),low family income(OR 1.503, 95%CI 1.258～1.795),atopy(OR 3.788,95%CI 2.368～6.058),meat-eating habit(OR 2.042,95%CI 1.481～2.815),asthma history of family members(OR 1.710,95%CI 0.988～2.958),the family history of allergic rhinitis(OR 1.991,95%CI 1.234～3.211), and 1 protective factor of raising pet in house(OR 0.443,95%CI 0.265～0.739).The coefficients of these factors in multivariate logistic regression model were 1.327、0.407、1.322、0.714、0.536、0.689、and-0.814 respectively.Conclusion Children asthma was a multi-factorial complex disease,and the interaction of environmental and genetic risk factors played an important role in the onset of this disease.

Objective To study the relationship between serum tumor marker level and the apoptosis regulation gene of tumor tissue in the patients with primary hepatocarcinoma .Methods 40 cases of primary hepatocarcinoma and 40 healthy people were in‐cluded into the observation group and control group .Then the levels of tumor marker GP73 ,TK1 ,DKK1 in serum and the expres‐sion of apoptosis regulation gene in tumor tissue were detected in the two groups .Results The serum GP73 ,TK1 and DKK1 levels of the observation group were significantly higher than those of the control group ,the difference was statistically significant (P<0 .05) .The apoptosis inhibiting gene Plk1 ,Livin and Xiap levels in the hepatocellular carcinoma tissue were higher than those in the adjacent normal tissues ,while the pro‐apoptotic gene M TS1 ,Caspase‐3 and Caspase‐8 levels were lower than those in the adjacent normal tissues ,the difference had statistical significance (P< 0 .05) ;serum GP73 ,TK1 and DKK1 levels were positively correlated with Plk1 ,Livin and Xiap levels and negatively correlated with M TS1 ,Caspase‐3 and Caspase‐8 levels .Conclusion The levels of se‐rum GP73 ,TK1 and DKK1 in the patients with primary hepatocarcinoma are abnormally increased ,moreover which are closely cor‐related with the apoptosis regulating gene expression and the ideal indexes to evaluate the disease condition of primary hepatocarci ‐noma .