Background The incidence of dry eye is gradually increasing,and the aging of population is one of factors.Researches showed that the change of tear film stability leads to shift of corneal refractive power, which probably affects the measurement of intraocular lens (IOL) power.The influence of dry eye on the calculation of IOL power is worth paying close attention.Objective This study was to investigate the influence of dry eye on the accuracy of IOL power calculation in age-related cataractous patients.Methods A non-randomized controlled clinical study was performed.Two hundred and sixteen eyes of 216 cataract patients were enrolled in Yanbian Eye Ear Nose and Throat Hospital from May 2013 to February 2014.The visual acuity, intraocular pressure, break up time of tear film (BUT),Schirmer Ⅰ test (S] t) and corneal fluorescein staining were examined in all the eyes,and then the patients were assigned to mild dry eye group (73 eyes), severe dry eye group (68 eyes) and non-dry eye control group (75 eyes).The axial length (AL) and anterior chamber depth (ACD) were measured using IOL Master for the calculation of IOL power and K value (corneal curvature).Phacoemulsification with IOL implantation was performed on all the eyes,and the refractive power was measured with KR 8100 automatic optometry 2 months after operation.The mean absolute refractive error (MARE) between actual refraction and predicted refraction was calculated, and percentage of eyes in different refractive error ranges was compared between the dry eye group and non-dry eye control group.The correlations of dry eye-related parameters with peroperative K value and refractive error were analyzed.This study was approved by the Ethics of Yanbian University,and written informed consent was obtained from each subject prior to entering the cohort.Results No significant differences were found in age, gender, AL,ACD and MARE among the mild dry eye group,severe dry eye group and non-dry eye control group (all at P＞0.05), and significant differences in BUT,S Ⅰ t and corneal fluorescein staining scores were found among these three groups (F=5.460,4.521,3.572, all at P＜0.05).The K values were (43.59± 1.39) , (44.66± 1.53) and (43.42± 1.32) D in the mild dry eye group,severe dry eye group and non-dry eye control group,and the K value in the severe dry eye group was significantly higher than that in the non-dry eye control group (P =0.012).The percentage of eyes with +0.50-+0.75 D deviation was significantly elevated(28.8％ versus 13.3％), and that with-0.50--0.75 D deviation was significantly declined (17.3％ versus 28.0％) in the dry eye group compared with non-dry eye control group (x2 =4.513 ,P=0.032;x2 =4.236,P=0.037).A negative correlation was found between BUT and K value (r=-0.204,P=0.011).Conclusions Dry eye affects the accuracy of the determination of IOL power.Compared with the preoperative refraction predictive value,the postoperative refraction shift toward hyperopia.

Objective To evaluate the role of oxidation reaction in the decrease in the activity of acetylcholinesterase (AChE) in the diaphragm of rats with sepsis.Methods Thirty pathogen-free healthy adult male Sprague-Dawley rats,weighing 220-260 g,were divided into 3 groups using a random number table:sham operation group (group S,n=8),sepsis group (group Sep,n =12) and antioxidant group (group Ant,n=10).Sepsis was induced by cecal ligation and puncture.Group S underwent simple laparotomy.N-acetylcystein 20 mg/kg was injected subcutaneously at 3,6,12 and 18 h after operation,and deferoxamine 20 mg/kg was injected subcutaneously at 3 h after operation in group Ant,while the equal volume of normal saline was given instead in S and Sep groups.At 24 h after operation,the surviving rats were sacrificed,and the diaphragm was removed for determination of the malondialdehyde (MDA) content and activities of AChE,myeloperoxidase (MPO),superoxide dismutase (SOD) and catalase (CAT).SOD/CAT ratio was calculated.Results Compared with group S,the AChE activity was significantly decreased,and MPO and SOD activities were increased in Sep and Ant groups,the MDA content and SOD/CAT ratio were significantly increased,and the CAT activity was decreased in group Sep,and the CAT activity was significantly increased in group Ant (P＜0.05).Compared with group Sep,the AChE and CAT activities were significantly increased,and the MDA content,MPO and SOD activities and SOD/CAT ratio were decreased in group Ant (P＜0.05).Conclusion Oxidation reaction is partially involved in the decrease in the activity of AChE in the diaphragm of rats with sepsis.

Objective: A new type of molecular probe design method was established to improve the sensitivity and specificity of microRNA detection. Methods: This is an experimental study. The target hybridization sequence was designed on the stem side of the molecular beacon using the strand displacement principle and based on this, a new probe was designed by using the nucleic acid structure analysis software DNAman to optimize the secondary structure of the molecular probe, which was called as strand displacement molecular probe (MB-D) and MB-D plus. Taking microRNA-21 as an example, microRNA-21 and its related single nucleotide mutations were detected using conventional molecular probe (MB-C) and redesigned MBs (MB-D and MB-D plus) to analyze the differences on minimum detection limit, repeatability and specificity for microRNA detection among these three probes. Results: The minimum detection limit of MB-C for microRNA-21 was 1 nmol/L, and the minimum detection limits for MB-D and MB-D plus were 0.1 nmol/L and 0.01 nmol/L, respectively. The established MB-D plus can significantly distinguish between miR-21 and single nucleotide mutations. Conclusion The molecular probe based on the principle of strand displacement and optimized by secondary structure can significantly increase the sensitivity and specificity of the probe for microRNA detection.(Chin J Lab Med, 2018, 41: 541-546)

OBJECTIVETo investigate the treatment of infected total knee arthroplasty (TKA).

METHODSBetween 1983 and 2000, 6 patients with infection after TKAs were treated, including 2 men and 4 women, aged on average 63 years (44 - 75 years). Initial knee arthroplasty was performed for osteoarthritis in 4 patients and for rheumatoid arthritis in 2 knees. The timing of diagnosis of infection after knee arthroplasty averaged 50 months (range, 1 month-11 years). Simple debridement and antibiotic treatment were prescribed for 3 patients, debridement and one-stage reimplantation for 1, debridement and two-stage reimplantation for 1, and athrodesis for 1.

RESULTSOf the 3 patients with simple debridement, one was cured, one failed but underwent athrodesis later, and one lost to follow up. Two patients with reimplantation were cured and had good function recovery. All of the 6 patients were followed up on average for 4 years. No infection recurred except one who lost to follow-up.

CONCLUSIONSManagement of infection after total knee arthroplasty includes antibiotic suppression and debridement with prosthesis retention, insertion of another prosthesis as a one-stage or two-stage exchange technique, knee arthrodesis and amputation. These treatments have specific indications. To treat infection after total knee arthroplasty, suitable method should be taken according to patient's condition. Arthrodesis is the best salvage operation, though it may handicap patients' daily life. Reimplantation of another prosthesis could maintain a functional joint.

Adult ; Aged ; Arthrodesis ; Arthroplasty, Replacement, Knee ; adverse effects ; Debridement ; Female ; Humans ; Infection ; therapy ; Male ; Middle Aged ; Postoperative Complications ; therapy ; Reoperation

Although subacute granulomatous thyroiditis(SGT) is usually diagnosed clinically, papillary carcinoma or other thyroid conditions must be considered in the differential diagnosis. We retrospectively reviewed the clinical and fine-needle aspiration(FNA) cytologic findings seen in 10 SGT cases to decide what are the most reliable cytologic findings and the most helpful molecular tools for reaching a confident cytologic diagnosis. The most representative smear slides were retrieved to perform immunocytochemistry for cytokeratin19(CK19) and Ret protein. Five papillary carcinomas(PTCs) were included as controls. The constant and typical cytologic findings of SGT were multinucleated giant cells(MGCs) (100%), epithelioid granulomas(90%), an inflammatory dirty background(90%) and plump transformed follicular cells(80%) without fire-flare cells, oncocytic cells or transformed lymphocytes. The immunoreactivities for CK19(37.5%) and Ret(10%) of the follicular cells of SGT were less than those(CK19 and Ret:100%) of PTC. CK19 immunoreactivity of the MGCs was seen in only one case of PTC. There was no significant difference between CK19 and Ret immunocytochemical staining for the MGCs of both SGT and PTC. The results of this study demonstrate that the cytological diagnosis of SGT can be improved by employing a combination of the typical and constant diagnostic cytological features and immunocytochemical results.
Biopsy ; Biopsy, Fine-Needle ; Carcinoma, Papillary ; Diagnosis, Differential ; Factor IX ; Immunohistochemistry ; Lymphocytes ; Retrospective Studies ; Thyroid Gland ; Thyroiditis

Objective To investigate the resistance of clinical Stenotrophomonas maltophilia isolates from 15 hospitals in several regions of China during 2011.Methods Fifteen repre-sentative general hospitals were involved in this program. Bacterial susceptibility testing was carried out by means of a unified protocol using Kirby-Bauer method and MIC determi-nation.Results were analyzed according to CLSI 2011 break-points.Results Majority (93.3%) of the 1 889 clinical strains of S.maltophilia were isolated from inpatients.On-ly 6.7% of the isolates were from outpatients.About 62.9% of these S .maltophilia strains were isolated from old patients whose age was 60 years or older.Only 8.2% of the strains were from the patients younger than 18 years old.Sputum and re-spiratory tract secretion were the most common specimen source,accounting for 82.6%.Another 4.2% isolates were from blood,abdominal fluid and other sterile body fluids.The percentage of the S .maltophilia strain resistant to trimethoprim-sul-famethoxazole,levofloxacin and minocycline was 16.6%,10.0% and 1.8%,respectively.The strains resistant to cefopera-zone-sulbactam accounted for 19.0%.About 37.1% of the strains isolated from blood or sterile body fluids were resistant to trimethoprim-sulfamethoxazole,significantly higher than the strains from urine or wound specimens (P < 0.01).Conclusions S.maltophilia strains are mainly isolated from inpatients.The most common source is sputum and other respiratory speci-mens.Most of the patients with S.maltophilia isolate are 60 years of age or older.The S.maltophilia strains are constitu-tively resistant to several antibacterial agents,but showed relatively lower resistance to trimethoprim-sulfamethoxazole,levo-floxacin and minocycline.Cefoperazone-sulbactam is still active against these strains.The antimicrobial therapy targeting S. maltophilia infections should be selected cautiously according to the results of antimicrobial resistance surveillance.

Objective To investigate the antimicrobial resistance of clinical strains of K lebsiella spp .isolated from 15 hospitals in China CHINET during 2012 .Methods Kirby-Bauer method and automatic microbiology analysis system were employed to study the antimicrobial resistance . WHONET 5 .6 software was applied for data analysis according to Clinical and Laboratory Standards Institute (CLSI) 2012 breakpoints .Results A total of 9 621 clinical K lebsiella isolates were analyzed ,including 8 772 strains of K . pneumoniae and 804 strains of K . oxytoca . About 54 .9% (5 285/9 621) of the K lebsiella strains were isolated from sputum ,and 16 .3% (1 564/9 621) were isolated from pediatric patients .Antimicrobial susceptibility testing showed that about 8 .9% ,10 .8% and 12 .9% of the strains were resistant to imipenem ,meropenem and ertapenem ,respectively .About 14 .1% and 17 .0% of the strains were resistant to piperacillin-tazobactam and cefoperazone-sulbactam , respectively . Carbapenem-resistant K lebsiella strains were identified from all the 15 hospitals ,including 945 strains of K .pneumoniae and 45 strains of K .oxytoca ,which were resistant to either imipenem ,meropenem or ertapenem .Conclusions The Klebsiella isolates collected from 15 hospitals in China during 2012 are relatively sensitive to carbapenems ,cefoperazone-sulbactam and piperacillin-tazobactam .The prevalence of carbapenem-resistant strains is still increasing in China ,about 10 .3% in 2012 ,and relatively higher in Eastern China .More efforts should be made to control the superbug .

Objective To investigate the antimicrobial resistance in the A cinetobacter baumannii strains in different parts of China during 2012 .Methods A total of 8 739 clinical isolates of Acinetobacter were collected from 13 general hospitals and two children’s hospitals ,of which most were A . baumannii (89 .6% , 7 827/8 739 ) . Antimicrobial susceptibility testing was carried out by means of Kirby-Bauer method according to the unified protocol . The susceptibility testing data were analyzed by WHONET 5 .6 software according to CLSI 2013 breakpoints .Results Majority (85 .4% ) of the Acinetobacter strains were isolated from inpatients .The remaining 14 .6% were from outpatients and emergency room patients .Of the 7 827 strains of A .baumannii , 10 .9% ,35 .2% ,35 .7% and 43 .4% were resistant to tigecycline ,minocycline ,cefoperazone-sulbactam and amikacin , respectively .The percentage of A .baumannii resistant to imipenem and meropenem was 63 .5% and 68 .2% ,respectively . The antimicrobial resistant pattern varied in different hospitals . The resistance of A . baumannii varied between different clinical departments .A number of pandrug resistant (PDR) (20 .0% ,1 567/7 827) and multidrug-resistant (MDR) (45 .0% , 3 521/7 827 ) A . baumannii were identified . Conclusions A . baumannii is the most popular pathogenic bacteria among Acinetobacter .The antibiotic resistance of A .baumannii is still increasing .Cefoperazone-sulbactam and minocycline has good in vitro antibacterial activity against A .baumannii .The antibiotic resistance of A .baumannii varies greatly with hospital and department .

Objective To investigate the distribution and antibiotic resistance of clinical Enterobacter isolates .Methods A total of 3 031 clinical strains of Enterobacter were collected from 15 hospitals from January 1 through December 31 , 2012 . Antimicrobial susceptibility testing was performed with Kirby-Bauer or minimum inhibitory concentration method .The results were analyzed according to CLSI 2012 breakpoints .Results Enterobacter cloacae and Enterobacter aerogenes accounted for 73 .0% (2 212/3 031) and 23 .9% (725/3 031) of all the Enterobacter strains .The isolates of other Enterobacter species accounted for 3 .1% (94/3 031 ) . The main source of the isolates was respiratory tract specimen , accounting for 53 .2% (1 612/3 031) .Most (> 89% ) of the Enterobacter strains were resistant to cefazolin and cefoxitin . Generally ,54 .4% ,47 .5% and 34 .3% of the strains were resistant to cefuroxime ,cefotaxime and cefazidime ,respectively . About 6 .6% to 26 .3% of the strains were resistant to amikacin ,gentamicin ,piperacillin-tazobactam ,cefepime ,cefoperazone-sulbactam ,ciprofloxacin and trimethoprim-sulfamethoxazole .Imipenem ,meropenem and ertapenem showed the highest activity , to which only 3 .5% ,3 .7% and 10 .3% of the strains were resistant ,respectively .About 8 .9% (269/3 031) of the strains were resistant to at least imipenem ,meropenem or ertapenem .Four Enterobacter strains were extensive-drug resistant (XDR) .Conclusions The prevalence of antibiotic resistance in Enterobacter isolates decreased slightly in 2012 compared to the data in 2011 ,but the situation is still very serious .We should continue to take effective measures to control the resistant strains .

Objective To investigate the distribution and susceptibility of carbapenem-resistant Enterobacteriaceae (CRE) isolates in 2012 from CHINET surveillance .Methods Antimicrobial susceptibility testing was carried out according to a unified protocol using Kirby-Bauer method or automated Systems .Results were analyzed according to the breakpoints of CLSI 2012 M100-S22 .Results A total of 1 499 CRE isolates were collected from January to December 2012 ,of which K lebsiella spp .,Enterobacter spp .and E .coli accounted for 63 .5% ,15 .1% and 13 .7% ,respectively .Of the 1 499 isolates , 48 .2% and 29 .3% were from respiratory tract and ICU , respectively . The results of antimicrobial susceptibility testing showed that the resistance rate of CRE isolates to most antimicrobial agents was 70 .0%-100% except amikacin (46 .9% ) and trimethoprim-sulfamethoxazole (49 .8% ) .CRE isolates from adults were more resistant to ciprofloxacin ,aminoglycosides and trimethoprim-sulfamethoxazole than those from children .Conclusions The antibiotic resistance of CRE isolates is very high . The spread of CRE strains in a specific region such as ICU and neurosurgery ward poses a serious threat to clinical practice and implies the importance of strengthening infection control .