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.

Objective To compare the results between double-threaded compression screws and cannulated lag screws for Garden type Ⅰ/Ⅱ femoral neck fractures.Methods Data of 56 patients with Garden type Ⅰ/Ⅱ femoral neck fractures who were treated with internal fixation from July 2012 to March 2016 were retrospectively analyzed.According to different fixation,the patients were divided into two groups:double-threaded screws group (group A) including 27 cases (7 males and 20 females,with an average age of 55.5±10.0 years,14 cases Garden type Ⅰ and 13 cases Garden type Ⅱ,the proportion of osteoporosis 10/27;And lag screws group (group B) including 29 cases (8 males and 21 females,with an average age of 57.2±9.5 years,11 cases Garden type Ⅰ and 18 cases Garden type Ⅱ,the proportion of osteoporosis 15/29.The 2 groups were compared with respect to bony fusion time,nonunion,avascular necrosis of femoral head,shortening of femoral neck and Harris Hip Score.Results The average follow-up time was 20.3±8.7 m in Group A and 24.5±7.9 m in Group B.The average bony fusion time was 5.3±0.6 m in Group A and 4.1±0.8 m in Group B,and there was significant difference between the groups (t=5.758,P=0.00).1 avascular necrosis of femoral head was found in both groups.In group A,there were 3 cases of bone nonunion (11.1％,3/27).There were one bone nonunion (3.4％,1/29) case in group B,with no statistically significant difference between groups.Shortening of femoral neck occurred in both groups,the average horizontal shortening was 5.8±2.9 mm and vertical shortening 7.0±3.4 mm in Group A,which were lower than group B (8.2±3.1 mm,9.4±3.6 mm),and the differences showed statistically significant (t=-2.94,P=0.005;t=-2.48,P=0.016).In group A,the average Harris Hip score was 88.2±8.3,while that in group B was 89.9±7.2.There was no statistically significant difference between two groups.Conclusion It seems to us that in the treatment of Garden type Ⅰ/Ⅱ femoral neck fractures,doublethreaded compression screws fixation could reduce femoral neck shortening,but there is no difference on functional outcome compared to cannulated lag screws fixation.On the contrary,double-threaded compression screws fixation is not conducive to fracture healing due to lack of sliding compression.

Objective To investigate effects of Kanglaite injection on proliferation, cycle and apoptosis of human breast cancer MCF-7 cells;To discuss its relevant mechanism. Methods Logarithmic growth phase cells were divided into control group and Kanglaite-treatment group (10, 20, 40μL/mL). Cells were cultured in RPMI-1640 for 24 h before drug treatment. The inhibition rate of Kanglaite injection on proliferation of human breast cancer MCF-7 cells was detected by MTT assay. Apoptosis and cell cycle of MCF-7 cells were detected by flow cytometry. Changes in cell nucleus were determined by Hochest staining assay. Protein expressions of Bcl-2 and Bax were detected by ELISA and Western blot. Results Kanglaite injection for 12 h, 24 h or 48 h resulted in a significant inhibition of MCF-7 cells proliferation (P<0.05, P<0.01);Compared with the control group, Kanglaite injection-treated cells showed increased percentage in G2/M and G0/G1 phases (P<0.001, P<0.01), but showed decreased percentage in S phase (P<0.01), and apoptosis rate increased (P<0.05, P<0.001). Kanglaite injection significantly decreased protein expression of Bcl-2, and enhanced protein expression of Bax of MCF-7 cells (P<0.01, P<0.001). Conclusion Kanglaite injection can inhibit the proliferation of human breast cancer MCF-7 cells, decrease cell cycle and induce apoptosis, the mechanism is related with decreasing protein expression of Bcl-2 and enhance the protein expression of Bax.

Acupuncture Points ; Acupuncture Therapy ; Adolescent ; Adult ; Aged ; Facial Paralysis ; therapy ; Female ; Humans ; Male ; Middle Aged ; Young Adult

Objective To evaluate the clinical safety for outpatients over 80 years old after phacoemul sification surgery. Methods The 184 cases (226 eyes) of aged patients with cataracts were operated on with phacoemulsification and IOL implantation. The safety, complications during and after operation, visual recovery and others were followed up over that period. Results All eyes were operated on without any danger and no serious complications were found. The vision acuity was 0 5 or better in 198 cases (87 6%), 1 0 or better in 102 eyes (45 1%). The main complication was corneal edema in 58 eyes(26 2%), rupture of posterior capsule in 12 eyes (5 3%) and posterior capsular opacity in 16 eyes (7 1%). Conclusions The phacoemulsification and IOL for over 80 years outpatients were safe and effective. The key points are systemic physical examination and careful eye examination. Stimulations during operation and postoperative complications should be prevented.

The survey aims at probing into the current development of medical instruments in hospitals and computerized quality control,upgrading the competence of hospital engineering departments and guiding the development of medical clinical engineering.Questionnaire surveys were made to the medical engineering departments of 195 hospitals above secondary hospitals in Zhejiang,totaling 1001 professionals.The results indicate significant differences among hospitals of various scales in terms of deployment of medical engineering Professionals,working conditions,and computerized applications,yet a consistency in academic title promotion and training requirements.In this consideration,it is imperative to build the team,maintain consistency in professional certification of medical engineering professionals,build a regular and systematic examination,promotion and certification system,enhance training in professional knowledge and equipment quality control,as well as promoting information and resources sharing.All these efforts are essential for better quality control and management of medical engineering departments,and promoting computerized management of medical instruments.

Objective To analyze the changes of thyroid function of healthy primipara before 20 weeks of gestation to establish normal gestational age-specific reference interval of thyroid hormones,and to investigate the prevalence of maternal thyroid disorders during the first half of pregnancy.Methods A total of 1605 healthy primipara without risk factors of thyroid diseases before 20 gestational weeks and 200 non-pregnant healthy women who accepted pre-conception care in Beijing Friendship Hospital from September 2010 to June 2011 were tested for serum thyroid stimulating hormone (TSH),free thyroxine (FT4) and thyroid peroxidase antihody (TPOAb) by chemiluminometric immunoanalysis.One thousand two hundred and fourty-three pregnant women among them with negative thyroid antibooly and without previons thyroid diseases were selected as the standard population for normal interval.Gestational age-specific percentile categories for TSH and FT4 were calculated.The prevalence of maternal thyroid disorders was examined by gestational agespecific intervals.Results (1) Compared with non-pregnant women,the median value of serum TSH in pregnant women decreased by 29.56％ to the value of 0.91 mU/L; while that of FT4 rose by 7.79％ to the value of 11.33 pmol/L before 12 weeks; and TSH increased while FT4 decreased during 13 to 20 weeks.(2) The median values and reference intervals (2.5th percentile,97.5th percentile) for TSH were 1.59 mU/L (0.15 mU/L,5.19 mU/L) in no-pregnant women,1.12 mU/L (0.03 mU/L,3.67 mU/L) at 8-12+6 gestational weeks,1.21 mU/L (0.05 mU/L,3.74 mU/L) at 13-16+6 gestational weeks,1.50 mU/L (0.31 mU/L,4.33 mU/L) at 17-19+6 gestational weeks; and the median values and reference intervals (2.5th percentile,97.5th percentile) for FT4 were 9.91 pmol/L (6.69 pmol/L,14.03 pmol/L),10.68 pmol/L (7.98 pmol/L,18.66 pmol/L),10.04 pmol/L (6.18 pmol/L,16.22 pmol/L),9.40 pmol/L (6.44 pmol/L,13.51 pmol/L) respectively.(3) According to gestational age-specific reference intervals,the general prevalence of maternal thyroid disorders,including hyperthyroidism,hypothyroidism,subclinical hypothyroidism and hypothyroinemia,was 3.55％ (57/1606).At 8-12+6 gestational weeks,13-16+6 gestational weeks and 17 19+6 gestational weeks,the occurrence of hyperthyroidism was 0.00％,0.13％ and 0.00％;that of hypothyroidism was 0.00％,0.13％ and 0.00％; the incidence of subclinical hypothyroidism was 3.60％,2.76％ and 3.00％; the occurrence of hypothyroxinemia was 0.16％,0.26％ and 0.86％,respectively.The positive rate of TPOAb at 8-12+6,13-16+6 and 17-19+6 gestational weeks were 22.91％ (140/611),16.56％ (126/761) and 15.45％(36/233),and the total positive rate of TPOAb was 18.82％ (302/1605).The median level of TPOAb was 38.90,41.87 and 39.10 mU/L,respectively.Conclusions Before 20 gestational weeks,specific changes occur in maternal thyroid function.TSH level decreases during 8 to 12 gestational weeks,and then increases gradually; while FT4 level increases during 8 to 12 weeks,and then decreases gradually.Thyroid dysfunction during pregnancy is common and subclinical hypothyroidisum is the leading problem in thyroid disorders.Screening for thyroid function during early pregnancy is suggested.

Objective:To analyse the stress distribution of the tooth and inlay with the restoration of resin,porcelain,gold alloy,co-balt chromium materials respectively.Methods:3-D finite element models of mandibular first molar with meiso-occlusal (class II) cavity and different inlays were established.Von-mises stress distribution on the tooth and inlay with vertical load and lingual load at 45°were analyzed.Results:After restoration peak stress of high elastic module materials and dental inlays was higher than that of the low elastic module material inlays,however,the restorations of the different elastic module materials had the similar stress distribution trend.The stress under of lateral load(lingual at 45°)to the teeth inlays was significantly higher than that under vertical load.Peak stress concentration of tooth was on the bottom of the cavity near the pulp chamber dentin;inlay peak stress distribution is mainly in its corresponding to the gingival wall.In the tooth tissues stress level of the contact surface of inlay restoration,the strength was as the fol-lowing:Composite resin inlay >ceramics inlay >the gold alloy ceramics inlay >cobalt chromium alloy inlay.The stress level of the inlay of the four kinds of inlay restoration materials was just opponent with the tooth tissues.Conclusion:Gingival wall is the weakest part of meiso-occlusal(class II)cavity inlay restoration,while near the pulp chamber at the bottom of the cavity is the weakest part of the tooth.Among the 4 materials Under the same load condition,composite resin inlay restoration has minimal tooth stress and uniform stress distribution,and can reduce the posibility of odontoschism and microleakage.

Objective To analyze the incidence,risk factors,clinical characteristics and pregnant outcomes of perinatal pulmonary embolism(PPE).Methods Clinical data of eight patients who were admitted to Beijing Friendship Hospital of Capital Medical University for PPE from January 2006 to March 2016 were collected.General condition,symptoms,laboratory examinations,images,treatments and outcomes of these patients were analyzed retrospectively.Results The ten-year incidence of PPE was 0.029％ (8/27 560) in this hospital.Among the eight cases,two cases were diagnosed in the first trimester,and treated successfully by thrombolytic therapy.But one of two cases stopped growth,while the other one was premature labor.There were one case in the third trimester who had successful anticoagulant therapy and five cases in the postpartum period after cesarean delivery.Among the five cases,three cases were recovered after anticoagulant therapy,one case was recovered after thrombolytic therapy and one case died.All of the eight patients were immobilized before the onset of PPE,and five of them were diagnosed after cesarean section.Four out of the eight patients were obese.Five patients had three or more high-risk factors for pulmonary embolism and the other three had two.Conclusions It is necessary to pay close attention to gravidas who have two or more high-risk factors of PPE due to its fatal outcome.

Objective:To determine the in vitro release of two kinds of Changankang Pellets (Radix Astragall, Rhizama coptid) coated with Surelease and Eudragit respectively and verify their colon-targeted release in vivo through X-ray photography. Methods: Changankang Pellets were made by mixing the medical BaSO 4 powder and appropriate drugs together according to original produce and coat methods. After determining their in vitro release, they were tested in vivo by 2 volunteers. X-ray films were taken after appropriate time and analyzed to determine the location and status of these pellets inside healthy objects. Results: Pellets made by this way can carry drugs through stomach, intestine and targeted-release them in colon; the coating combined with pH-dependent and time-dependent Eudragit thin layer has better results. Conclusion: X-ray radiography applying BaSO 4 powder could be taken as a quality control method for colon-targeted release drugs. The preliminary results showed that Changankang Pellets met the requirements of colon-targeted release.