AIM:To compare the effect of three types of pterygium surgery and on tear film in patients with type 2 diabetes mellitus. ·METHODS:A total of 102 patients ( 102 eyes ) with pterygium combined with type 2 diabetes mellitus treated in our hospital from March 2013 to March 2016 were analyzed retrospectively. The patients were divided into three groups including the 34 cases ( 34 eyes ) with simple excision of pterygium ( resection group ) , pterygium excision combined with conjunctival flap transplantation in 34 cases (34 eyes, as conjunctival flap group ) and pterygium excision combined with limbal stem cell transplantation in 34 cases ( 34 eyes, as stem cell group ) . The wound repair time, complications, recurrence rate, uncorrected visual acuity (UCVA), tear film break-up time ( BUT ) and basal tear secretion test (SⅠt) were observed before, and 6 and 12mo after surgery in the three groups, respectively. ·RESULTS:The postoperative UCVA of the three groups was significantly higher than that preoperation ( P =0. 039, 0. 013, 0. 024 ), and there was no significant difference among the three groups ( P = 0. 317 ). The wound repair time was 5. 67 ± 1. 45d in the resection group, which was significantly higher than that in the conjunctival flap group (4. 18 ± 0. 76d) and the stem cell group (4. 09±0. 79 d) (P<0. 001), there was no significant difference between the conjunctival flap group and the stem cell group ( P = 0. 937 ). There were 4 cases in resection group reappeared, and the recurrence rate was 11. 8%, which was significantly higher than the other two groups ( P = 0. 037 ). There were 1 recurrences in the conjunctival flap group, and the recurrence rate was 2. 9%, while the patients in the stem cell group had no obvious recurrence. SⅠt and BUT increased significantly after operation (P<0. 05), especially in conjunctival flap group and stem cell group (P<0. 001). There was no significant difference between the conjunctival flap group and the stem cell group (P=0. 845, 0. 894). · CONCLUSION: Pterygium excision combined with conjunctival flap transplantation or limbal stem cell transplantation for the treatment of type 2 diabetic patients with normal blood glucose and tear film function has the similar effect, and is better than simple pterygium excision.

Objective To monitor the activities of orbicularis oculi muscle by analyzing the electroneurogram (ENG) of its innervating nerve. Methods The ENG was recorded in vivo by a cuff electrode implanted around a dog’s zygomatic branch of facial nerve. The differences between the ENG during relaxing period of the orbicularis oculi muscle and during the constricting period were analyzed to explore a way to monitor the muscle activities. Results The ENG signals indicating occurrences of eye blinking events were extracted in the study. Time-frequency analysis showed that there was no ENG difference when the orbicularis oculi muscle was in relaxing periods no mater whether it was in the nature eye-opening period or in the interval of eye blinking. The ENG of orbicularis oculi muscle in constricting period was different from the ENG in relaxing period at amplitude and frequency. Conclusion It is feasible to monitor the orbicularis oculi muscle activities by ENG analysis.

Purpose To investigate the clinicopathologic features of desmoplastic fibroma of bone (DF).Methods The clinical and pathologic profiles of 7 cases were retrospectively analyzed.Results Desmoplastic fibroma of bone was a rare neoplasm of bone,which typically occurred in young children and adolescents.The tumor showed infiltrative and locally aggressive nature,the most common sites were long tubular bones and mandible.Microscopically,the tumor was composed of sparse fibroblasts in a rich background of collagen fibers.Immunohistochemically,the tumor cells were positive for vimentin and SMA.Conclusion Desmoplastic fibroma is a rare,locally aggressive fibroblasticlesion of bone.It can make an accurate diagnosis by integrating the clinical location with histopathological features.Trauma,hormone and horomosome aberration may be related with its pathogenesis.

AlM:To evaluate the efficacy of retrobulbar injection of triamcinolone acetonide ( TA ) combined with 577nm laser macular grid photocoagulation for the treatment of cystoid macular edema.
METHODS: Fifty-eight cases ( 66 eyes ) with cystoid macular edema caused by different diseases were recruited in this study. The included patients were treated with both retrobulbar injection of triamcinolone acetonide and 577nm laser macular grid photocoagulation. The best corrected visual acuity, macular thickness, fundus and intraocular pressure were observed in the 1wk, 1 and 3mo after the treatment in all of the included cases.
RESULTS: After treatment, all of the 66 eyes showed cystoid macular edema partially or completely subsided according to optical coherence tomography and fluorescence fundus angiography; 54 eyes ( 82%) visual acuity improved, 12 vision remained the same.
CONCLUSlON: Retrobulbar injection of triamcinolone acetonide combined with 577nm laser macular grid photocoagulation has good curative effect, simple operation procedure and rare complications in the management of cystoid macular edema.

How to identify active constituents of traditional Chinese medicines (TCMs) and study their interactions are key problems in the development of TCMs. The inhibitory effect of six alkaloids from Rhizoma Coptidis (RC) on Shigella dysenteriae (S. dysenteria) growth had been investigated by microcalorimetry in this study. Main active constituents of RC were confirmed by comparing their contributions to the bacteriostatic effect, and the interactions among active constituents were further researched. According to the result, in 0.8 mg-mL-1 extract of RC, the contributions of six active alkaloids including berberine, coptisine, epiberberine, palmatine and the combination of jatrorrhizine and columbamine were 52.83%, 36.31%, 2.49%, 4.27% and 3.21%, respectively. Therefore, berberine and coptisine were the main active constituents of RC that inhibited the growth of S. dysenteria. The study of interactions among the six alkaloids indicated that, 1 there were some contstituents antagonizing the inhibitory effect of RC, 2 there was a synergy effect between berberine and coptisine, 3 there were additive effects between other four alkaloids and the main active constituents. These results may provide some useful references for the establishment of the quality standard for RC and the development of multi-component TCMs.
Alkaloids ; analysis ; pharmacology ; Berberine ; analogs & derivatives ; analysis ; pharmacology ; Berberine Alkaloids ; analysis ; pharmacology ; Coptis ; chemistry ; Drug Interactions ; Drug Synergism ; Plants, Medicinal ; chemistry ; Quality Control ; Rhizome ; chemistry ; Shigella dysenteriae ; drug effects ; growth & development

OBJECTIVETo study the necessity, feasibility, security of carotid angioplasty and stenting (CAS) for symptomatic carotid stenosis combined with kinking.

METHODSTwelve patients with symptomatic carotid stenosis and kinking demonstrated by digital subtraction angiography (DSA) received CAS from December 2003 to December 2009. There were 9 male and 3 female patients, age ranged from 59 to 77 years (mean 69.3 years). All the patients' clinical, imaging, intervention and follow up data were collected and analyzed.

RESULTSAll CAS procedures were successfully performed with 14 self-expandable stents placed. The mean degree of stenosis was reduced from 85.6% before stenting to 11.2% after stenting, the angle of kinking, according to Metz' category, were improved from less than 90° to more than 120° in each case. No perioperative procedure related stroke and transient ischemic attack (TIA) occurred. The clinical symptoms and signs of cerebral ischemia were improved or disappeared for all patients. During follow-up of these 12 patients for 6 to 72 months, one patient experienced ipsilateral carotid territory TIA and another patient experienced contralateral carotid territory TIA. DSA follow up of 5 patients demonstrated 1 case with in-stent restenosis and arterial kinking remote to the stent of internal carotid artery. CAS were performed again and CT angiography follow up demonstrated no kinking and restenosis 2 years after the intervention. Duplex scan of the other 7 patients demonstrated neither kinking nor restenosis.

CONCLUSIONSCAS seems to be feasible and safe for the patients with symptomatic kinking and stenosis, and maybe helpful to lower the risk of cerebral ischemia, but further study is needed.

Aged ; Angioplasty, Balloon ; methods ; Carotid Stenosis ; surgery ; Feasibility Studies ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Stents ; Treatment Outcome

OBJECTIVESTo investigate adverse factors that may hinder successful placement and stabilization of the microcatheter during endovascular therapy of micro-intracranial aneurysms (&le; 3 mm in maximum diameter), and to explore the relevant managements.

METHODSForty-six patients with fifty-one micro-intracranial aneurysms treated by endovascular therapy from June 2001 to October 2009 were retrospectively analyzed for their intervention data.

RESULTSAdverse factors of optimal micro-catheterization mainly included, tortuosity of the proximal vessels (PVs) and the parent artery (PA), relative large gap in diameter among the PVs, the PA and the microcatheter, relative large divergence in direction among the PVs, the PA and the aneurysm dome, and stent deployed in the PA.

CONCLUSIONSCarefully considering the direction of the PVs and the PA, the aneurysm's location and dome orientation, choosing the microcatheter and microwire after balancing among their physical properties, as well as utilizing balloon and/or stent assistance, can facilitate micro-catheterization during endovascular treatment of micro-intracranial aneurysms.

Adult ; Aged ; Aged, 80 and over ; Catheterization ; methods ; Embolization, Therapeutic ; methods ; Female ; Follow-Up Studies ; Humans ; Intracranial Aneurysm ; therapy ; Male ; Middle Aged ; Retrospective Studies ; Stents ; Treatment Outcome

Objective To study the changes of plasma biomolecules in patients with acute cerebral infarction(ACI) and the potential influences from lumbrukinase and aspirin(ASA). Methods Seventy patients with ACI were randomly divided into three groups according to the ways of administration: lumbrukinase group(n=26),ASA group(n=24)and lumbrukinase + ASA group(n=20).Plasma levels of P-selectin,D-dimer(D-D),tissue plasminogen activator(t-PA),plasminogen activator inhibitor-1(PAI-1),plasmin-antiplasmin complex(PAP),thrombin-antithrombin complex(TAT),homocysteine(Hcy) and thrombin-activatable fibrinolysis inhibitor(TAFI) were measured in these patients with ACI and normal individuals(n=20) by ELISA method.Changes of these parameters were detected before and after the treatment,and the diagnostic efficiencies for ACI were compared by receiver characteristic curve(ROC).Results Before the treatment,all the parameters in patients with ACI were significantly higher than those in the healthy controls(P0.05).However,there were significant changes of PAP in the lumbrukinase group(P

[ ABSTRACT] AIM:To evaluate the effect of intravenous injecting plasmid encoding interleukin-19-IgG on exper-imental autoimmune myocarditis ( EAM) in rats.METHODS:Cardiac myosin was emulsified with equal volume of com-plete Freund’ s adjuvant.The animal model of EAM was established by injecting with the preparation in both footpads of the Lewis rats.The rats were intravenously injected with the plasmid encoding IL-19-IgG on day 6.Echocardiography was per-formed before the rats were sacrificed on day 17.The effect of IL-19-IgG plasmid injection was evaluated by measuring the heart weight/body weight, myocarditis area, relative expression levels of atrial natriuretic peptide ( ANP) and brain natri-uretic peptide (BNP) in the hearts.The mRNA expression levels of related cytokines including IL-18, IL-1β, IL-12p35 and IFN-γwere detected.RESULTS:The rats in model group showed significant myocardial damage and a decrease in the left ventricular functions.The rats in the treatment group injected with IL-19-IgG plasmid showed an improvement of the cardiac functions.The ratio of heart weight/body weight, the area of myocarditis and the mRNA levels of ANP and BNP were significantly lower in IL-19-IgG treatment group than those in model group.The mRNA levels of IL-18, IL-1β, IL-12p35 and IFN-γwere also significantly decreased in IL-19-IgG treatment group.CONCLUSION:Intravenous injection of plasmid encoding IL-19-IgG effectively prevents the development of the left ventricular remodeling and myocardial damage in EAM rats.

ObjectiveTo evaluate the effect of auscultation, partial pressure of carbon dioxide in end-expiration (PETCO2), transillumination technique to judge whether the endotracheal tube is misplaced into the esophagus. Methods A blinded randomized controlled trial was conducted. Sixty patients with American Society of Anesthesiology (ASA) gradeⅠ-Ⅱundergoing endotracheal intubation in Fengxian Central Hospital admitted from September 2014 to February 2015 were enrolled. Two endotracheal tubes with the same size were respectively inserted into the trachea and esophagus for the same depth after general anesthesia by the same person. Two blinded anesthetists with different experience checked the tube position using three methods including auscultation, PETCO2, and transillumination technique, respectively. The order of the tubes tested (trachea or esophagus) and the method used were randomized according to randomise numbers table. The experienced anesthetists conducted the test first, followed by an inexperienced anesthetist conducting the same methods. The numbers of right and wrong determinations with different methods by different anesthetists were recorded.Results Sixty patients underwent the procedures for 180 times, with intratracheal intubation for 90 times, and esophageal intubation for 90 times. It was shown that the results were not different in two groups [96.7% (174/180) vs. 92.2% (166/180),χ2 = 3.500,P = 0.057]. By using auscultation, the correct rate of experienced anesthetist was higher than that of inexperienced (95.0% vs. 78.3%,χ2 = 5.786,P = 0.013). Using PETCO2, both anesthetists were correct in all cases, and the accuracy was 100%. Using transillumination, the experienced anesthetist was mistaken in 3 cases (accuracy was 95.0%), while the inexperienced mistook in 1 case (accuracy was 98.3%), and no significant difference was found between two groups (χ2 = 0.500,P = 0.250). The correct rate of using transilluminaion was significantly higher than that of using auscultation (χ2 = 7.563,P = 0.004). The sensitivity and specificity of the auscultation was 70.0% and 80.0%, that of transillumination technique was 96.7% and 93.3%,and PETCO2 was 100%, respectively, for two groups.ConclusionsPETCO2 is the most reliable method for determining tube position, and it is superior to auscultation and transilluminaion. Transillumintaion technique is superior to auscultation, irrespective of anesthetists' experience, while the accuracy of auscultation showed an obvious relationship with the anesthetists' experience.