AIM: To investigate the safety and efficacy of undersurface ablation of the flap ( UAF ) for laser in situ keratomileusis ( LASIK ) retreatment in eyes with regression.
METHODS: Twelve patients ( 22 eyes ) with regression after LASIK were performed undersurface ablation of the flap. The mean of preoperative refractive error was -2. 27±0-88D, the astigmatism was -0. 44±0. 30D, the central corneal thickness was 424. 9±8. 2μm. The follow-up time was 1a, including visual acuity, refractive error, the elevation of posterior cornea, WavScan. The data was analyzed with Student's t test andχ2test.
RESULTS:During the operation, the measured stromal thickness was 275. 4±9. 3μm, the flap thickness 144. 7±7-5μm, the depth of ablation 28. 1±9. 3μm. The mean postoperative uncorrected visual acuity (UCVA) was 4. 99±0. 04, best corrected visual acuity ( BCVA) 5. 03±0. 04, at 1a follow up. There was no patient with postoperative BCVA decreasing, compared to preoperation. Mean spherical refraction decreased to-0. 22±0. 19 D at 1a follow up (t=10. 232, P<0. 001) and the astigmatism decreased to -0. 24±0. 26 D (t=2. 365, P=0. 028). The elevation of posterior cornea changed from 1. 95 ± 1. 68μm preoperatively to 2. 00±1. 88μm after 1a, but there was no statistical significance (t=0. 090, P= 0. 929). The coma changed from 0. 283±0. 112μm preoperatively to 0. 331±0-149μm after 1a (no statistical significance, t=1. 452, P=0. 161) and the spherical aberration changed from 0. 320±0. 119μm to 0. 341±0. 103μm (no statistical significance, t=0. 390, P=0. 674).
CONCLUSION:UAF, as one of a choice, is an effective and safe procedure for the treatment of regression after LASIK, based on the reasonable surgery design.

Adult ; Animals ; Ear Auricle ; parasitology ; Female ; Humans ; Male ; Tick Infestations ; Ticks

Neurosyphilis is a serious clinical stage of syphilis caused by Treponema pallidum invading the nervous system, and risk and predictive factors of neurosyphilis are different between syphilis patients with and without HIV infection. The risk factors for neurosyphilis in HIV-negative patients with syphilis mainly include gender, age, clinical stage of syphilis, treatment, etc.; the predictive factors include serological titers, changes in some indicators of cerebrospinal fluid, neurological or ophthalmic symptoms. HIV viral load, CD4 + T cell counts and antiretroviral treatment are the main predictors and risk factors for neurosyphilis in HIV-positive patients with syphilis.

Objective Explore the effect of case method on clinical teaching of Medical Oncology. Methods The case method was taken in the teaching of Clinical Oncology for trial group,and the traditional method teaching was taken for contrast group of our university. At the end of term, we made a questionnaire and statistics examination records. Results (1) It was conducive to good learning ability. Case method teaching in Clinical Oncology could cultivate student's ability to study independently. (2) Comparing examination records of the two groups, it also showed a significant difference ( <0.05) . Conclusion (1) Case method teaching has good teaching effect, and it can cultivate student's ability to study independently. (2) Application of case teaching method in Clinical Oncology received a very good teaching result, but the assessment system should be established and improved.

Objective To investigate the relationship between concentration change of serum 5‐hydroxy tryptamine and clinical symptoms improvement in primary premature ejaculation with the treatment of paroxitine .Methods 81 cases of lifelong PE and an intra‐vaginal ejaculation latency time (IELT ) ≤60 s were included in this study .Subjects were divided into 2 groups according to the IELT ,group A (IELT≤30 s) and group B (30 s

AIM:To compare the refractive errors measured by the VISX WaveScan, OPD - Scan Ⅲ and the subjective refraction.
METHODS: Seventy - six patients ( 152 eyes ) were recruited from January 2013 to December 2013. All patients were measured with subjective refraction by the phoropter (NIDEK, RT-5100), objective refraction by the WaveScan ( AMO Company, USA) , OPD-ScanⅢ ( Nidek Technologies, Japan). The sphere, cylinder, axis of the three methods were compared and analyzed.
RESULTS: The sphere measured by WaveScan was lower than that by subjective refraction, the difference was 0. 13±0. 30D (t=3. 753, P<0. 001). For cylinder, the difference was 0. 13±0. 43D (t=3. 664, P<0. 001). There was no significance for sphere, cylinder, and spherical equivalent between OPD - Scan Ⅲ and subjective refraction (P>0. 05). The value of the difference between WaveScan and subjective refraction was 5. 87o±6. 19o for the axis and the difference between OPD-Scan Ⅲ and subjective refraction was 3. 82o±3. 95o. There was statistic significance (t=2. 817, P=0. 006).
CONCLUSION: For sphere and cylinder, WaveScan generated some deviation relative to subjective refraction. The Nidek OPD-ScanⅢ gives more accurate measures of objective refraction when compared with subjective refraction.

BACKGROUND:Surgical accuracy is a key to surgical success.The traditional positioning method mainly depends on surgeons' experience,which is too subjective to cause screw misplacement.Three-dimensional (3D) printing technology-assisted pedicle screw placement can make individualized surgical scheme,most importantly,it is accurate and simple showing promising application prospect.OBJECTIVE:To design an individualized pedicle guide plate with 3D printing and to simulate screw placement in vitro,and to explore its feasibility in vertebral pedicle screw placement.METHODS:Lumbar spine CT data of 11 patients with degenerative lumbar spine were selected from April 2016 to July 2016 at Hebei General Hospital,and 3D reconstruction of L1,L3 and L5 vertebrae of each case was performed.Pre-experiment was conducted based on one patient's lumbar CT data:according to the principle of screw placement,the screw position and orientation were designed to prepare the best pedicle guide plate model.Afterwards,the screw placement in vitro was simulated,and was then cut by chainsaw to verify the accuracy of screw placement.RESULTS AND CONCLUSION:(1) A total of 30 pedicle guide plates were used,and 60 screws were inserted in the patients,and the placement process was successful.The guide plates adhered well,none appeared with screw perforating the pedicle cortex,and the screw position was accurate and reliable.(2) There were no significant changes in the transverse section and sagtial section angles of the left and right pedicle screws before and after placement (P ＞ 0.05).(3) These results suggest that the 3D-printed individualized pedicle guide plate holds a good accuracy of placement,which can be applied in the vertebral pedicle screw placement,but further clinical trials are needed.

Objective To evaluate the value of D-dimer in assessing severity and predicting longterm prognosis in patients with community acquired pneumonia (CAP).Methods From June 2009 to December 2010,a total of 189 patients with CAP were enrolled.After admission,D-dimer,procalcitonin (PCT) and C-reactive protein (CRP) were measured,and Pneumonia Severity Index (PSI) was calculated.They were assigned into two groups according to their D-dimer levels:high D-dimer levels group (D-dimer levels≥500 μg/L) and normal D-dimer levels group (D-dimer levels ＜ 500 μg/L).The followup time was one year.A Kaplan-Meier survive curve was constructed to assess the 1-year mortality,and multivariate logistic regression analysis were used to assess the value of D-dimer for predicting long-term prognosis.Results D-dimer levels increased with increasing PSI class [class Ⅰ-Ⅲ:378.37 μg/L (216.74,649.50) μg/L; class Ⅳ:673.41 μg/L (544.77,866.85) μg/L; class Ⅴ:831.58 μg/L (591.78,1066.39) μg/L,x2 =56.58,P ＜ 0.01].The Kaplan-Meier survival curve showed that 1-year mortality rate of high D-dimer levels group was higher than normal D-dimer levels group (log-rank test,x2 =52.51,P ＜ 0.01).The multivariate logistic regression analysis showed an independent relationship between higher D-dimer levels and long-term mortality (OR =2.05,95％ CI:1.48-2.61,P ＜ 0.01).Conclusion D-dimer is an independent predictor of severity and long-term prognosis in patients with CAP.

Objective:To observe the effect of different concentration HMGB1 on the secretion of TNF-αand NO from Ana-1 infected with DEN2 and virus copy.Methods:DEN2 were proliferated and identified by conventional methods.The adherence of DEN2 to Ana-1 was observed by direct immunofluorescence and RT-PCR.The level of virus mRNA were detected by qRT-PCR.The concentration of TNF-αwas detected by ELISA.The concentration of NO was detected with Griess reagent.Results:Ana-1 was able to adhered for DEN2.Compared with DEN group,the inhibition ratio(%) of the level of virus mRNA in D-HMGB1-1 group,D-HMGB1-10 group,D-HMGB1-100 group,D-HMGB1-1000 group was 41.53 ±2.12,55.30 ±1.59,74.75 ±1.12,86.35 ±1.42.Compared with DEN group,the level of TNF-αand NO decreased in D-HMGB1 groups(P<0.05).Conclusion:HMGB1 can be effectively regulated of Ana-1 secreted inflammation factor of infected with DEN2,and inhibited DEN2 replication.

In temporomandibular disorders (TMD), pain takes place when neuropeptides stimulate synovial tissue to produce several cytokines such as interleukin (IL)-1β, IL-6 and tumor necrosis factor (TNF)-α, which activate neurons and glia of synovial membrane at the bilaminar regions of temporomandibular joint (TMJ). It has been reported that, after neurogenic differentiation, the synovial mesenchymal stem cells (SMSCs), deriving from TMJ, possess the same cytological features as the neuronal cells. This study examined the ability of substance P (SP) and calcitonin gene-related peptide (CGRP) to stimulate SMSCs and neurogenic SMSCs secreting inflammatory cytokines during TMD, evaluated the mutual effects of inflammatory cytokines and neuropeptides and tested the analgesic effect of hyaluronic acid (HA). The levels of IL-1β, IL-6 and TNF-α in SMSCs and neurogenic SMSCs in the presence of neuropeptides were measured by ELISA. SP and CGRP produced by SMSCs and neurogenic SMSCs were determined by RT-PCR and Western blotting. The results showed that the expression of SP and CGRP was significantly enhanced in the neurogenic SMSCs in response to IL-1β, IL-6 and TNF-α, and the effect was remarkably inhibited by HA. IL-1β, IL-6 and TNF-α, in return, could be enhanced in the neurogenic SMSCs upon stimulation by SP and CGRP. Neuropeptides and inflammatory cytokines might work mutually on the TMD pain. The HA-mediated analgesic effect may be implicated in the inhibition of SP and CGRP expression in neurogenic SMSCs.