0.05),the average survival time of HES solutions was longer than that after LR or GEL infusion(t=3.012,P

Background Postoperative ametropia, especially large astigmatism after deep anterior lamellar keratoplasty (DALK) for keratoconus often results in poor visual acuity.Though postoperative ametropia can be corrected by wearing glasses or performing corneal refractive surgery, the visual quality of patients is still poor, and the operations are difficult to implement because of insufficient corneal thickness.Toric intraocular collamer lens (TICL) implantation appears to have good corrective efficacy on severe astigmatism,but the research on the eyes after DALK is still less.Objective This study was to evaluate the efficacy and safety of TICL implantation for the ametropic eyes following DALK for keratoconus.Methods This study protocol was approved by Ethic Commission of Nanjing Drum Tower Hospital,and written informed consent was obtained from each patient prior to any medical procedure.A self-controlled serial observational research was carried out.Eight ametropic eyes of 8 patients who received the DALK for keratoconus before 18 months were enrolled in Nanjing Drum Tower Hospital from August 201 1 to March 2012, with the spherical diopter range from 0 D to-7.5 D and cylindrical diopter range from-2.5 D to-6.0 D.TICL implantation was performed on the eyes.The eye examinations were carried out before surgery and 1 week,3 months,6 months, 1 year and 2 years after surgery,including uncorrected visual acuity (UCVA) ,best corrected visual acuity (BCVA) ,comprehensive optometry, corneal astigmatism degree, the central corneal thickness and anterior chamber depth (ACD), corneal endothelial cell counts (ECD) ,intraocular pressure.The examination outcomes were compared before and after surgery.The intraoperative and postoperative complications were observed to evaluate the safety of TICL implantation for the ametropic eyes following DALK for keratoconus.Results The UCVA and BCVA were obviously improved at 6 months after TICL implantation in comparison with before surgery and maintained stable during the follow-up duration.The mean spherical diopter was from-0.5 D to-1.0 D and the mean cylindrical diopter was from-0.5 D to-2.0 D after surgery.The corneal endothelial cell counts were (2 520.2 ± 307.2) , (2 496.2 ± 306.2) , (2 469.6±304.5) , (2 432.0 ± 305.4), (2 383.4 ± 309.4)/mm2, and the intraoeular pressures were (14.57 ± 3.75), (16.62±4.21), (16.57±3.56), (15.66±3.37), (15.13±3.48) mmHg, showing insignificant differences among different time points (F =0.375,P =0.825;F =9.871, P =0.394).No significant differences were found in mean ACD and intraocular pressure between before and after surgery (t =1.56 ,P =0.16).The axial deviation of TICL was less than 10° in all the operated eyes 6 months after surgery.No intraoperative and postoperative complications were found during the follow-up duration.Conclusions TICL implantation is a safe and effective alternative and viable approach to myopic and astigmatism patients following DALK for keratoconus.

Objective To study the percutaneous permeability through mouse skin of lidocaine hydrochloride-loaded destran-based niosomes(LID-HLD-BNs)in vitro and in vivo. Methods HPLC was employed to exam lidocaine hydrochlo?ride. Lidocaine hydro-chloride-loaded conventional liposomes (LID-CLs) and lidocaine hydrochloride injection (LID-IJ) were used as control. Isolated mouse skin was added into Franz diffusion cell to evaluate the permeability of LID-HLD-BNs in vitro. Confocal Laser Scanning Microscopy(CLSM)was used to observe the permeation depth of mouse skin in vivo. Re?sults The permeation rate and cumulative permeation amount were significantly higher in LID-HLD-BNs group than those of LID-CLs and LID-IJ groups (P<0.05). CLSM studies also confirmed that HLD-BNs reached deeper layers of the skin. Conclusion LID-HLD-BNs has good transdermal ability.

Objective To explore the effect of three-stage Traditional Chinese Medicine (TCM) rehabilitation on neurological function and motor function in patients with cerebral ischemic stroke. Methods 100 patients with acute cerebral ischemic stroke were randomly divided into experimental group (n=50) and control group (n=50). The three-stage TCM synthesis rehabilitation was used in the experimental group; the 2-week western medicine rehabilitation was used in the control group. The scores of National Institutes of Health Stroke Scale (NIHSS) and Fugl-Meyer assessment (FMA) were evaluated. Results There was no significance in the scores of NIHSS and FMA between both groups before and 4 weeks after treatment (P>0.05). The score of NIHSS was lower (P<0.01), and the score of FMA was higher (P<0.05) in the experimental group than in the control group in the 12th week. Conclusion Three-stage TCM synthesis rehabilitation can facilitate the recovery of neurological and motor function of patients with acute cerebral ischemic stroke.

Objective To explore the change of plasma Apelin level in the patients with acute pancreatitis(AP) and its clinical significance.Methods Fifty cases of AP in the hospital from July 2015 to June 2016 were collected as the AP group and divided into the mild AP group(MAP) and severe AP group(SAP).Other contemporaneous 30 healthy volunteers undergoing physical examination were selected as the control group.The differences in Apelin-13,Apelin-36 and C reactive protein(CRP) levels on admission and were APACHE Ⅱ score were compared between the two groups.The correlation between Apelin-13 and Apelin-36 with APACHE Ⅱ score was analyzed.The differences of plasma CRP,Apelin-13 and Apelin-36 levels on 4 d after admission were compared between the MAP group and SAP group.Results Plasma Apelin-36,Apelin-36 and CRP levels and APACHE Ⅱ score on admission in the AP group were significantly higher than that in the control group(P＜0.05),plasma Apelin-13,Apelin-36 and CRP levels and APACHE Ⅱ score in the SAP group were significantly higher than those in the MAP group(P＜0.05),the plasma Apelin-13 and Apelin-36 levels were positively correlated with the APACHE Ⅱ score(P＜0.05);the plasma Apelin-36,Apelin-36 and CRP levelson 4 d after admission in the SAP group were higher than those in the MAP group(P＜0.05).Conclusion Early stage of AP has the changes of plasma Apelin-13 and Apelin-36 levels,which are closely correlated with the severity of disease.

OBJECTIVETo prepare a new dental topical anesthetics, lidocaine hydrochloride loaded trans-activator of transcription peptide conjugated nano-niosome (LID-TAT-N), and to evaluate its transdermal properties and topical anesthesia effects.

METHODSLID-TAT-N was prepared using reverse-phase evaporation method, and lidocaine loaded conventional liposome (LID-CL) was prepared in the same manner as positive control. The diameter, ζ potential and encapsulation efficiency of LID-TAT-N and LID-CL were measured. The skin permeation of LID-TAT-N was examined, and compared with LID-CL and lidocaine injection (LID-IJ, as negative control), using a Franz diffusion cell mounted with depilated mouse skin in vitro for 12 hours. Each experiment was repeated six times. The anesthetic effect of the new topical anesthetic was investigated on the cornea of rabbits.

RESULTSThe mean diameter of LID-TAT-N was smaller than that of LID-CL [(152.7 ± 10.6) nm vs. (259.5 ± 15.5) nm, P < 0.01]. The 12 h cumulative permeation amount was significantly higher in LID-TAT-N group [(1 340.0 ± 97.5) µg · cm(-2)] than those of LID-CL and LID-IJ groups [(1 060.6 ± 80.2), (282.6 ± 65.1) µg · cm(-2), respectively, P < 0.05]. Rabbit corneal reflex results showed that LID-TAT-N had anesthetic effect and the duration of analgesia [(24.8 ± 2.8) min] was also longer than that of LID-IJ [(14.5 ± 2.3) min, P < 0.05].

CONCLUSIONSLID-TAT-N had good transdermal ability, and the advanced skin penetration feature can improve its tropical anesthetic effect.

Administration, Cutaneous ; Anesthesia, Dental ; Anesthetics, Local ; administration & dosage ; pharmacokinetics ; Animals ; Blinking ; drug effects ; physiology ; Cornea ; drug effects ; physiology ; Lidocaine ; administration & dosage ; pharmacokinetics ; Liposomes ; Mice ; Nanoconjugates ; administration & dosage ; chemistry ; Peptides ; Rabbits ; Skin ; metabolism ; Skin Absorption ; Trans-Activators ; administration & dosage ; chemistry ; pharmacokinetics

Objective:To compare the one-year postoperative visual quality after trifocal intraocular lens (IOL) implantation and monofocal IOL implantation.Methods:A cohort study was conducted.Forty-one eyes from 41 age-related cataract patients who underwent phacoemulsification extraction combined with IOL implantation in Nanjing Drum Tower Hospital from May 2017 to June 2018 were enrolled.The patients were divided into trifocal IOL group (20 eyes) receiving ZEISS AT LISA tri 839MP trifocal IOL implantation and monofocal IOL group (21 eyes) receiving ZEISS 603P monofocal IOL implantation according to their willingness.One year after surgery, uncorrected distant visual acuity (UCDVA), uncorrected intermediate visual acuity (UCIVA), uncorrected near visual acuity (UCNVA), best corrected distance visual acuity (BCDVA), distance corrected intermediate visual acuity (DCIVA) and distance corrected near visual acuity (DCNVA) were detected in both groups.The patient point spread function (PSF), modulation transfer function (MTF) cutoff frequency, Strehl ratio (SR), OQAS Ⅱ values at 100%, 20%, and 9% contrast (OV 100%, OV 20%, OV 9%) and objective scattering index (OSI) were measured by OQAS Ⅱ.Wavefront aberrations including total aberration (TA), total high order aberrations (tHOAs), spherical aberration, coma, trefoil aberration, total low order aberrations (tLOAs), defocus, and astigmatism were evaluated with the iTrace visual function analyzer.All aberrations were represented by root mean square.The visual acuity of operative eyes was measured with a phoropter, and defocus curves were drawn with visual acuity better than 0.5 LogMAR.The incidence of posterior capsular opacification (PCO) in the IOL region was quantitatively analyzed by Sellman method.Visual function was scored by visual function index (VF-14). This study adhered to the Declaration of Helsinki.The study protocol was approved by an Ethics Committee of Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School (No.2018-219-01). Written informed consent was obtained from each subject prior to any medical examination.Results:One year after the operation, UCIVA, UCNVA, DCIVA, and DCNVA of trifocal IOL group were significantly better than those of monofocal IOL group, and the differences were statistically significant (all at P<0.001). OQAS Ⅱ visual quality indicators showed that the MTF cutoff frequency, SR, OV 100%, and OSI values of trifocal IOL group were significantly higher than those of monofocal IOL group, showing statistically significant differences (all at P<0.001). No significant difference in wavefront aberrations was found between the two groups (all at P>0.05). Defocus curve showed that the LogMAR visual acuity of patients at -1.0 D, -1.5 D, -2.0 D, -2.5 D, -3.0 D, and -3.5 D (namely, 1 m, 66 cm, 50 cm, 40 cm, 33 cm, and 29 cm) in monofocal IOL group were significantly better than those in trifocal IOL group (all at P<0.05). There was a higher incidence of PCO in trifocal IOL group than monofocal IOL group, with a statistically significant difference ( χ 2=41.0, P<0.001). The VF-14 score of trifocal IOL group was 87.99±1.09, which was significantly higher than 81.49±1.67 of monofocal IOL group ( t=10.301, P<0.001). Conclusions:One year after trifocal IOL implantation, the full range of vision, subjective and objective visual quality of eyes are better than eyes implanted with monofocal IOL.