AIM:To study the changes of tear film and ocular surface after the coaxial incision 2.5mm and 3.0mm in the phacoemulsification.METHODS: Seventy patients (92 eyes) from February 2015 to February 2016 in our hospital were enrolled.The patients were randomly divided into two groups.Thirty-four patients (46 eyes) in Group A: coaxial 2.5mm incision phacoemulsification cataract extraction and intraocular lens(IOL) implantation.Thirty-six patients (46 eyes) in Group B: the conventional coaxial 3.0mm small incision phacoemulsification cataract extraction and IOL implantation.The break up time (BUT),Schirmer`s Ⅰ test (SⅠt) and lid-parallel conjunctival folds (LIPCOF) were assessed preoperatively and postoperatively.RESULTS: At 1wk,1 and 3mo postoperatively,the BUT in two groups decreased after operations,and the BUT of Group B was significantly lower than those of Group A,the differences were statistically significant (t=3.089,4.497,4.322;all P<0.05).The SⅠt in two groups increased after operations,the SⅠt of Group B was significantly higher than those of Group A and the differences were statistically significant (t=-6.286,-3.992,-3.278;all P<0.05).The LIPCOF score in two groups increased after operations,the LIPCOF score of Group B was significantly higher than those of Group A and the differences were statistically significant (t=-6.552,-5.131,-3.652;all P<0.05).At 6mo postoperatively,compared with the preoperative data,the BUT,SⅠt and LIPCOF score in Group A showed no statistically significant differences (t=0.646,0.551,0.165;P>0.05).The BUT,SⅠt and LIPCOF score in Group B showed statistically significant differences (t=-4.059,3.629,4.211;all P<0.05).CONCLUSION: Ocular surface has less damage and tear film has little influence at early stage after the coaxial 2.5mm incision phacoemulsmcation,compared with the conventional coaxial 3.0mm incision phacoemulsification surgery.

Brain Injuries ; etiology ; Child ; Heart Defects, Congenital ; complications ; Humans

BACKGROUND: Demineralized bone matrix and bone morphogenetic protein have been shown to have good bone induction, but less studies concerned nanometer demineralized bone matrix. Its physical and chemical properties and biological security are not yet clear.
OBJECTIVE:On the basis of preparing the nanometer human demineralized bone matrix in previous experiment, we mixed the recombinant human bone morphogenetic protein-2 together to obtain the new bone graft substitute and to research its physical and chemical properties and biological security.
METHODS:The human demineralized bone matrixes were prepared by the method of modified Urist and nano-processed then mixed with the bone morphogenetic protein-2 in specific proportions in order to be lyophilized to complete the fol owing experiments. (1) Pyrogen experiment:the material extracts were injected in the rabbits by ear intravenous. (2) Toxicity experiments:material extracts and saline were separately injected via the tail vein of mice in vivo. (3) Implantation experiments:experimental materials andβ-tricalcium phosphate were implanted into rabbits on both sides of the hindlimb muscle.
RESULTS AND CONCLUSION:After lyophilized shaping, the nanometer demineralized bone matrix material had dense surface and it’s pore diameter was 100-400μm. The pore distribution was less uniform and the porosity was of less than 30%. The main elements were carbon, oxygen and nitrogen. Nanometer human demineralized bone matrix with recombinant human bone morphogenetic protein-2 did not have pyrogen effect and the rabbits’ body temperature had no significant fluctuations after injection. The acute systemic toxicity test results showed that the nanometer human demineralized bone matrix with recombinant human bone morphogenetic protein-2 complied with the relevant provisions of the State, without obvious toxic reaction. The inflammatory response of nanometer human demineralized bone matrix with recombinant human bone morphogenetic protein-2 was significantly lighter than the reaction ofβ-tricalcium phosphate. The results showed that the nanometer human demineralized bone matrix with recombinant human bone morphogenetic protein-2 is a nanometer al ogeneic bone graft substitutes with nontoxicity, good biocompatibility, high bioavailability, and less inflammatory reaction.

AlM:To investigate the influence of phacoemulsification with different incision on tear film.
METHODS:Tear film was monitored in 152 patients (169 eyes) after phacoemulsification. Patients were divided into two groups according to the type of incision:group A (76 patients, 83 eyes) with a 3. 2mm corneoscleral limbus incision phacoemulsification and group B (76 patients, 86 eyes ) with a sclemtic tunnel incision. Tear break-up time ( BUT ) , cornea fluorescein staining ( CFS ) , lid-parallel conjunctival folds ( LlPCOF) and lid-wiper epitheliopathy ( LWE ) were observed at 3d preoperatively and 1wk, 1, 3 and 6mo postoperatively. The results were analyzed using a Chi-square test and t-test with SPSS 17. 0.
RESULTS:BUT: The BUT of two groups was obviously shorter at 1wk, 1mo postoperatively, the differences were statistically significant (P<0. 05), however, there were no statistically significant at 3, 6mo(P>0. 05). CFS score:There was a large increase in CFS at 1wk, 1mo postoperatively, the differences were statistically significant between the two groups(P<0. 05), however, there were no statistically significant at 3, 6mo (P>0. 05). LlPCOF:There was a large increase in LlPCOF at 1wk, 1 and 3mo postoperatively, the differences were statistically significant between the two groups (P<0. 05), however, there were no statistically significant at 6mo (P>0. 05). LWE: There was a large increase in tear osmolarity at 1wk, 1mo postoperatively. The differences were statistically significant between the two groups (P<0. 05), however, there were no statistically significant differences between the two groups at 3, 6mo (P>0. 05).
CONCLUSlON:The stability of tear film in patients with scleral tunnel incision is much better than in patients with 3. 2mm corneoscleral limbus incision phacoemulsification. There is no significant difference between the two groups during later postoperative periods.

Objective To evaluate the olfactory functions in patients with Parkinson's disease (PD) with a smell identification test developed for the Chinese population and to examine possible factors contributing to PD patients' olfactory performance.Methods Fifty-five patients with idiopathic and nondementia PD and 55 demographically matched healthy controls (HC) were recruited and their olfactory identification tested using the Chinese Smell Identification Test developed by the Institute of Psychology at Chinese Academy of Sciences.Results Olfactory identification score was significantly lower (t =-6.827,P＜0.01) in the PD group (19.3 ±5.4) as compared with the HC group (26.5 ±5.7).Of all PD patients,63.6％ scored over 1 SD below the age norm.In particular,of those with Hoehn-Yahr ratings between 2 to 3,77.8％ scored over 1 SD below the age norm.Receiver operating characteristic (ROC) curve analysis indicated that a cut-off score of 22.5 on the Chinese Smell Identification Test distinguished between PD patients and HC with a sensitivity of 74.6％ and specificity of 70.9％.Within the PD group,age,education,Hoehn-Yahr rating and Mini-Mental State Examination score were not found to correlate with olfactory performance (all P ＞ 0.05).Conclusion PD patients in China show significant impairment of olfactory identification,which is effectively captured by the Chinese Smell Identification Test.

Objective To evaluate the accuracy and value of measurement of left ventricular systolic function in dilated cardiomyopathy (DCM) and hypertrophic cardiomyopathy (HCM) patients with stereo three-dimensional echocardiography (S3 DE). Methods End-diastolic volume (EDV), end-systolic volume (ESV),stroke volume(SV) and ejection fraction(EF) of the left ventricle were measured with M-mode echocardiography(ME),two-dimensional echocardiography(2DE) and S3DE in DCM patientsC20 cases). HCM patients(20 cases),and normal controls(20 cases). The different results among the three groups or three methods were analyzed. Results (①In all the three groups,the results of EDV,ESV,and SV obtained with ME were significantly higher than those obtained with S3DE( P <0. 01). Only in normal group( P <0. 01) and HCM group ( P <0. 05) ,the results of EF obtained with ME and 2DE were significantly higher than that obtained with S3DE. ②By S3DE,compared with normal group,EDV,ESV were increased and EF was decreased obviously in DCM group (all P <0. 01); while in HCM group, only SV was significantly higher( P < 0. 01). ③EDV, ESV, and EF measured by S3DE were correlated and fit well with those measured by 2DE(r = 0.778,0.876, 0.932;R2 =0.605,0.767,0.869;all P <0.01). ④Within HCM group,excluding the impact of heart rate,cardiac output (CO) was highly correlated with SV( r = 0. 987,P < 0. 01). Conclusions S3DE can real-time display the stereo structure of the heart, and accurately and reliably assess the left ventricular systolic function, with a priority over traditional ME and 2DE methods. EDV,ESV, and EF are still effective indicators for the clinical assessment of left ventricular systolic function. SV obtained with S3DE will be expected to be the more sensitive and accurate value in assessing left ventricular systolic function in patients with early-stage cardiomyopathy.

BACKGROUND: Pancreatic damage in critically ill patients is associated with the progressive failure of multiple organs, but little is known about its clinical characteristics. At present, no guidelines are available for the diagnosis and management of pancreatic damage. This study was undertaken to analyze the clinical and pathologic characteristics of pancreatic necrosis in critically ill children, and to find some biological markers of pancreatic damage or pancreatic necrosis. METHODS: We retrospectively reviewed the clinical data, laboratory results, and autopsy findings of 25 children, who were admitted to Hunan Children's Hospital, China from 2003 to 2009, and died of multiple organ failure. The autopsy revealed pancreatic necrosis in 5 children, in whom sectional or gross autopsy was performed. RESULTS: The 5 children had acute onset and a fever. Two children had abdominal pain and 2 had abdominal bulging, flatulence and gastrointestinal bleeding. Four children had abnormal liver function, characterized by decreased albumin and 3 children had elevated level of C-reactive protein (CRP). B-ultrasonography revealed abnormal acoustic image of the pancreas in all children, and autopsy confirmed pancreatic necrosis, which may be associated with the damage of the adrenal gland, liver, lung, heart, spleen, kidney, intestine, thymus, mediastinal and mesenteric lymph nodes and other organs. Children 1 and 2 died of acute hemorrhagic necrotizing pancreatitis (AHNP);children 3-5 died of multiple organ dysfunction syndrome (MODS) due to pancreatic necrosis. CONCLUSION: Pancreatic damage or pancreatic necrosis in critically ill children is characterized by acute onset, severity, short course, multiple organ damage or failure. It may be asymptomatic in early stage, and easy to be ignored.

OBJECTIVETo explore the effect of Jinwu Jiangu Recipe (JJR) on the expression of synovial cells' nuclear factor-kappaB (NF-kappaB) and serum interleukin 17 (IL-17) in collagen induced arthritis (CIA) rats.

METHODSTotally 60 Wistar rats were randomly divided into 6 groups, i.e., the blank control group, the model group, high, middle, and low dose JJR treatment groups, and the tripterygium control group, 10 in each group. Except rats in the blank control group, CIA model was established in rats of the rest 5 groups. Then they were treated from the 7th day of modeling. After 4 weeks of medication they were sacrificed, serum collected, and synovium of joints were isolated. The expression of serum IL-17 was detected in synovium of joints by enzyme linked immunosorbent assay (ELISA). And the expression of NF-kappaB/P65, Ikappabetaalpha and NF-KappaB/P50 were detected by Western blot.

RESULTSCompared with the blank control group, the serum IL-17 level increased in the model group (P <0. 01). Compared with the model group, the serum IL-17 level obviously decreased in high and middle dose JJR groups and the tripterygium control group (P < 0.01). Results of Western blot showed, when compared with the blank control group, protein activities of NF-kappaB/P65 and NF-kappaB/P50 were significantly enhanced in the model group (P < 0.01). Compared with the model group, protein activities of NF-kappaB/P65 and NF-kappaB/P50 significantly decreased in high and middle dose JJR groups and the tripterygium control group (P < 0.05, P < 0.01). All indices mentioned above were higher in the low dose JJR group than in the tripterygium control group (P < 0.05, P < 0.01).

CONCLUSIONJJR could lower the expression of serum IL-17 in CIA model rats, and inhibit protein activities of NF-kappaB/P65 and NF-kappaB/P50.

Animals ; Arthritis, Experimental ; drug therapy ; metabolism ; Drugs, Chinese Herbal ; chemistry ; Interleukin-17 ; blood ; NF-kappa B ; metabolism ; Random Allocation ; Rats ; Rats, Wistar ; Synovial Membrane ; drug effects ; metabolism ; Tripterygium ; chemistry

OBJECTIVETo investigate the clinical significance of promoter methylation status of hPer3 gene in acute myeloid leukemia (AML) patients and the in vitro effect of decitabine (DCA) on AML cell lines HL-60 and U937.

METHODSThe promoter methylation status of hPer3 gene and mRNA expression levels in bone marrow of 206 AML and 40 iron deficiency anemia (IDA) patients (as control) were detected by methylation specific PCR (MS-PCR) and real-time PCR (RT-PCR). The HL-60 and U937 cell lines were treated with different concentrations of DCA for 48 and 72 h. The inhibition rates of cell proliferation were detected by methyl thiazolyl tetrazolium (MTT); the early apoptosis rates by staining with Annexin V and PI; the CD14 and CD11b expressions by flow cytometry (FCM); the promoter methylation status of hPer3 gene by MS-PCR; and the hPer3 mRNA expressions levels by RT-PCR.

RESULTSThe promoter methylation rates of hPer3 in newly diagnosed (ND) group, partial remission(PR) group, complete remission (CR) group, relapse (R) group and control group were 93.65% (59/63), 54.39% (31/57), 24.66% (18/73), 61.54% (8/13) and 0% (0/40), and the hPer3 mRNA expression levels were 0.19 ± 0.08, 6.28 ± 2.11, 52.76 ± 14.17, 8.18 ± 4.36, 75.03 ± 18.16, respectively. There was a significant statistic difference between any two group (P < 0.01) excepting for between PR and R group (P > 0.05). After DCA treatment, the promoter hypermethylation status of hPer3 was reduced and the mRNA and CD14, CD11b expression levels were up regulated in a dose dependent manner with an induction of cell apoptosis.

CONCLUSIONSPromotor methylation status and mRNA expression of hPer3 gene may be indicators for evaluating AML. DCA can induce the expression of hPer3 gene and cells apoptosis in AML.

Adolescent ; Adult ; Aged ; Azacitidine ; analogs & derivatives ; pharmacology ; Cell Proliferation ; DNA Methylation ; Female ; HL-60 Cells ; Humans ; Leukemia, Myeloid, Acute ; genetics ; metabolism ; pathology ; Male ; Middle Aged ; Period Circadian Proteins ; genetics ; Promoter Regions, Genetic ; U937 Cells ; Young Adult

OBJECTIVE: To investigate the effect of anti-psoriatic drug fumaric acid esters (FAE) on the differentiation of dendritic cells (DC). METHODS: Dendritic cells were obtained by differentiating human monocytes in vitro. Flow cytometry was used to analyse the effect of FAE on cell surface expression of CD1a, CD14, CD40, CD80, CD86 and HLA-DR by monocyte-derived dendritic cells (MoDC). Mixed lymphocyte reaction (MLR) was made to demonstrate the influence of FAE on T cell stimulatory activity of MoDC. RESULTS: Dimethylfumarate and methylhydrogenfumarate-calcium-salt (0.01 approximate, equals 100 mg/L) inhibited MoDC differentiation as well as reducing the capacity of MoDC to stimulate lymphocytic proliferation in MLR. CONCLUSION: The mode of action of FAE in pso riasis may be mediated by inhibition of DC differentiation.