Background Herpes simplex virus (HSV) disciform stromal keratitis is a T cell-mediated delayed-type hypersensitivity of corneal stroma.The treatment of HSV disciform stromal keratitis is the combination of glucocorticoid and antiviral drug before.However,the therapy is limited for intolerantble patients to glucocorticoid.In addition,the adverse reactions following usage of glucocorticoid can not be ignored.FKS06 solution is proved to has the immunosuppressive and antiinflammatory acttions with less side effects than glucocorticoid drug.But the study on the application of FK506 solution in treatment of HSV disciform stromal keratitis is lack.Objective This prospective clinical trail was to evaluate the efficacy of topical tacrolimus for HSV disciform stromal keratitis and its safety.Methods A prospective study was performed on 18 consecutive cases (18 eyes) who were diagnosed as active HSV disciform stromal keratitis from June 2011 to June 2012 in Zhongshan Ophthalmic Center under the approval of the Ethic Committee of Zhongshan Ophthalmic Center and informed consent of the patients,including 3 patients with refractory to prior steroid eyedrops.All patients received a combination topical tacrolimus eyedrops 4 times per day with topical and systemic anti-viral therapy for mean (56.0±7.9) days.Corneal thickness by slit lamp biomicroscope,visual acuity,intraocular pressure,corneal fluorescein staining,Schirmer Ⅰ test (S Ⅰ t) and tear breakup time (BUT) were performed on the patients before and 1 month,2 months after treatment and at the drug withdrawal to assess the treating efficacy of FK506,and the adverse reactions of eyes were recorded.Results Corneal edema was alleviated in (8.3 ± 2.5) days after treatment in all the patients and returned to normality in (25.3±11.5) days.Corneal edema of 2 eyes with refractory to previous steroid eyedrops showed a slower recovery procedure than that of the others.Corneal fluorescence staining scores were 4 (6,2),1 (2,1),1 (1,0) and 0 (1,0) before and 1 month,2 months and at drug withdrawal,respectively,with a significant difference among the four time points (H=39.90,P＜0.001),and the scores were significantly lower after treatment than before (all at P＜0.01).The S Ⅰ t values were (6.78±1.90),(7.39±3.53),(8.06±2.92) and (8.11±3.05) mm/5 min,respectively in the 4 time points,without statistically significant difference among various time points (F =0.94,P =0.43).The BUT values were (0.39 ± 0.50),(1.11 ± 0.90),(2.00 ± 1.08) and (3.39 ± 0.92) seconds,respectively,showing a significant difference among the 4 time points (F=34.54,P＜0.01) and had the increased values after treatment of FK506.Recurrence was seen in 2 eyes in 2 months and 5 months after cessation of tacrolimus.However,the eyes were healed after a second round regimen.No elevation of intraocular pressure and secondary infection were found in the patients during the treatment and follow-up period.Conclusions The combination therapy of tacrolimus with antiviral drug is effective and safe for HSV disciform stromal keratitis by alleviating corneal edema and promoting the rehabilitation of tear film.

Objective:To study retention force durability of root-type attachments.Methods:Five magnetic attachments(Magfit EX-600),semi-precise stud-type attachments(Bedent) and precise stud-type attachments(Dalbo-classic) were fixed on a thermal-cycling and mechanical-loading machine respectively.The retention force of each attachment was measured at the baseline and after every 1,000 cycles of seating-removing.Results:The average retention force of magnetic attachments was(3.85?0.107) N at the baseline which attenuated for 3.38% after 10,000 cycles;The retention force of semi-precise group was(14.10?0.144) N originally and decreased 90.06% of the original force after 10,000 cycles.The primary force of the precise group was 33.14 N and was adjusted to(11.95?0.082) N as baseline attenuating for 74.56%.Conclusion: The retention force of magnetic attachments is lower than the stud attachments but is stable for 10 years.The retention force of stud-type attachments is larger at the baseline but reduced rapidly.

Objective To observe the morphology of neuronal necrosis by kainic acid(KA) induced status epilepsy (SE) in rats, and to study the brain protective effect of Mg 2+.Methods 75 adult male Wistar rats were randomly divided into KA group, Mg 2+ group and normal saline group. SE was induced with KA for 3 hours, and the rats in Mg 2+ group were intraperitoneal injected magnesium sulfate before being injected KA. 72 hours later the rats were killed. We had all rat brain sections and observe the morphology of neuronal necrosis with microscope and electron microscope.Results In KA group, seizure was induced 16.1?4.7 min after injection of KA, but seizure delayed to 25.4?6.2 min in Mg 2+ group. There was a significant difference between two groups (P

Objective To study the role of gap junctions in epileptiform activity. Methods The epileptiform activity was induced by zero-Mg 2+ medium in cultured hippocampal neurons of newborn rats. Immunocytochemistry and real time RT-PCR were introduced to evaluate the expression of gap junction Cx32 and Cx43. Results The level of Cx32 mRNA increased quickly one hour after the neurons were treated with zero-Mg 2+ medium and was raised by 10 times 5 hours later, while Cx32 protein began to develop at the 2nd hour (21.80?1.74) and was raised by 5 times at the 8th hour (47.30?5.75). The expression of Cx43 mRNA went up obviously 5 hours later, and Cx43 protein developed visibly 8 hours later. Carbenoxolone depressed the expressions of Cx32 and Cx43. Conclusions The expression of Cx32 and Cx43 increases dramatically after epileptic discharges and carbenoxolone inhibits both the discharges and the expression of gap junctions, which indicates that gap junction could contribute to epileptogenesis.

Objective: To measure the position of the mandibular nerve canal at the mandibular second molar by CBCT image data, analyze the theoretical implantation range of trans-alveolar implantation, and provide a theoretical solution to insufficiency of posterior mandibular bone volume in clinical practice. Methods: Eighty patients with missing mandibular second molars whose vertical bone height of the edentulous area was less than 9 mm were selected for CBCT image measurement, and the distances from the mandibular nerve canal to the buccal cortex, lingual cortex, and alveolar crest were measured to simulate trans-inferior alveolar nerve implantation. The angular range of the buccolingual inclination of the implant was also measured. Results: The distances from the mandibular nerve canal to the buccal cortex, lingual cortex and alveolar crest at the mandibular second molar were(6.913±1.222)mm, (2.859±0.891)mm and (7.991±0.783)mm, respectively. The distance from the mandibular nerve canal to the buccal cortex was significantly greater than that to the lingual cortex. And, 75% of the patients could be implanted by the inferior alveolar nerve. The minimum angle of buccolingual inclination of the simulated implant was 19.360°±7.086°, and the maximum angle was 39.462°±6.924°. Conclusion The mandibular nerve canal at the mandibular second molar is inclined toward the lingual side, which ensures sufficient buccal bone volume. Most patients with severe mandibular atrophy can still adopt implants of conventional length by trans-inferior alveolar nerve implantation to keep a safe distance from the nerve canal.

Intrahepatic cholangiocarcinoma (ICC) is characterized with low incidence, high malignancy and poor prognosis. In China, hepatitis B virus (HBV)-associated ICC is the most common subtype of ICC and its incidence rate is on the rise. The pathogenesis and clinical characteristics of HBV-associated ICC are different from other types of ICC. In recent years, the targeted therapy has brought significant survival benefits for patients. This article reviews the pathogenesis of HBV-associated ICC and the latest research progress of the clinical characteristics and treatments of patients.

Objective:To explore the CT three-dimensional reconstruction in percutaneous balloon compression of the semilunar ganglion of trigeminal nerves.Methods:Thirty-one patients with trigeminal neuralgia, admitted to our hospital from May 2018 to August 2018, were treated by percutaneous balloon compression of the semilunar ganglion of trigeminal nerves. All patients underwent intraoperative mobile CT scan; the distance from the external aperture of foramen ovale to the petrous ridge, the angle from puncture needle and the petrous ridge, and the angle from puncture needle and the clivus were analyzed by three-dimensional reconstruction technology. Prognoses were recorded immediately after surgery and 10-12 months after follow-up.Results:The distance from the external aperture of foramen ovale to the petrous ridgea was (2.14±0.17) cm, ranged from 1.83 cm to 2.42 cm. The angle from puncture needle and the petrous ridge was (102.03±7.60)°, ranged from 91.00° to 116.00°. The angle from puncture needle to the clivus was (68.03±7.06)°, ranged from 52.00° to 80.00°. The puncture succeeded in all patients under the help of CT three-dimensional reconstruction. The volume of the inflated balloon ranged from 0.30 cm 3 to 0.47 cm 3 (averaged 0.42±0.05 cm 3). The compression time ranged from 3.00 min to 5.00 min (averaged 4.72±0.53 min). The incidence of diplopia was 3.23%, and the incidence of dry eyes/decreased corneal sensation was 12.90%. During the follow-up, one patient relapsed 10 months after surgery; the left patients recovered with disappeared complications. Conclusion:The CT 3D reconstruction can reduce the difficulty of ovale foramen puncture during operation, assist the judgment and adjustment of intraoperative balloon volume, and improve the surgical efficacy.

Blepharitis is one of the common eye diseases,it may cause ocular irritation symptoms,and even cause damage of visual function,if it involves the meibomian gland and cornea.Recent studies have shown that Demodex infestation may be an important but under-estimated cause of blepharitis,its diagnosis and treatment become the focus of blepharitis research,clinical doctors should pay adequate attention to this.Demodex blepharitis still faces many uncertain problems and challenges.In this paper,the controversial problems of Demodex blepharitis diagnosis and treatment,combined with domestic and foreign research results and the author's experience was analyzed,and we also discussed that how to improve the accuracy of clinical diagnosis and improve the treatment effect of Demodex blepharitis.Herein,we emphasize on the diagnosis and treatment options of Demodex blepharitis.Early detection of the pathogen and prompt treatment would ultimately improve the prognosis of Demodex blepharitis.

This study is designed to test the agreement in measuring left ventricular systolic function between transthoracic two-dimensional echocardiography (2DTTE) and "gold standard" of non-invasive cardiac imaging, magnetic resonance imaging (CMRI) and their impacts on the classification of patients according to the left ventricular ejection fraction (EF). 32 patients who were suspected with heart disease were evaluated by CMRI and 2DTTE examinations. End diastolic volume (EDV), end systolic volume (ESV), EF and left ventricular function category were then calculated and compared. There was no significant difference (P=0.504) for EDV, while ESV of CMRI was significantly higher than that of 2DTTE (P=0.049), and EF of CMRI was significantly lower than that of 2DTTE (P= 0.018). There was no significant difference (P=0.077) in left ventricular functional category. Bland-Altman analysis of LV volumetric data and EF measurements showed a good agreement between two methods. The 2DTTE over-estimated I (n=5) or II (n=1) degrees of functional classification when compared with the CMRI. Both CMRI and 2DTTE are of great clinical value in evaluating left ventricular systolic function, while CMR may be more beneficial to patients with abnormal LV functions.
Adolescent ; Adult ; Aged ; Echocardiography ; Female ; Heart Diseases ; physiopathology ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Retrospective Studies ; Systole ; physiology ; Ventricular Function, Left ; physiology ; Young Adult