AIM:To study the effect of different surgeries for vision and postoperative complications in leprosy patients with lagophthalmos.METHODS:A retrospective analysis.Totally 68 leprosy patients (97 eyes) with lagophthalmos were selected who treated with different surgeries during May 2007 to September 2015 in our sanatorium.The surgeries included nylon thread correction surgery, tarsorrhaphy, temporalis transposition surgery.We observed and compared the best corrected visual acuity(BCVA) and the rate of postoperative complications, such as epiphora, lacrimal duct injury, hard to open eyes, infection at the inner and lateral canthus and scar formation of lacrimal apparatus.RESULTS:The effect on BCVA of patients treated with nylon thread correction surgery and tarsorrhaphy:the preoperative and postoperative BCVA was significantly different of the two groups (Z=-4.193,-4.213;P<0.05);the preoperative and postoperative BCVA was not significantly different of the patients underwent temporalis transposition surgery (Z=-1.532, P >0.05).The postoperative complications:(1) epiphora:there was 91% in patients underwent nylon thread correction surgery, 89% in patients underwent tarsorrhaphy, 59% in patients underwent temporalis transposition surgery, the difference was statistically significant (χ2=12.198, P<0.05);(2) lacrimal duct injury:there was 66% in patients underwent nylon thread correction surgery, 95% in patients underwent tarsorrhaphy, 41% in patients underwent temporalis transposition surgery, the difference was statistically significant (χ2=22.415, P<0.05);(3) hard to open eyes:there was 56% in patients underwent nylon thread correction surgery, 55% in patients underwent tarsorrhaphy, 22% in patients underwent temporalis transposition surgery, the difference was statistically significant (χ2=8.795, P<0.05);(4) infections:there was 84% in patients underwent nylon thread correction surgery, 3% in patients underwent tarsorrhaphy, 11% in patients underwent temporalis transposition surgery, the difference was statistically significant (χ2=60.858, P<0.05).CONCLUSION:There are certain clinical efficacy for lagophthalmos caused by leprosy after surgery, especially patients after temporalis transposition surgery can close eyes by oneself.And their vision does not change significantly, which suggests that this surgery may prevent exposure injury for cornea.But the iatrogenic injury, the vision decrease in patients underwent other surgeries and the ocular tissue damage, such as epiphora, lacrimal duct injury, hard to open eyes, infection at the inner and lateral canthus and scar formation of lacrimal apparatus should be pay more attention to.

Objective To evaluate the diagnostic evaluation of isotropic scanning and Lung Care soft- ware in solitary pulmonary nodules,and to improve the diagnostic accuracy.Methods 52 patients suffered from SPN were included in our study.Two experts in CT analyzed the films.First,they read the axial images and made diagnosis.Then isotropic scanning and lung care software approaches were used on 16 spiral CT and another analysis were made again.The results were compared with pathological diagnosis respectively. Results Spiculated sign,lobulated sign,vessel convergence were found more on isotropic scanning approach, that had significant difference with axial images analysis(P

Objective To explore the value of two-dimensional strain echocardiography for quantitative assessing the change of regional left ventricular myocardial function in rats following acute myocardial infarction. Methods Sixty Wistar rats were randomly divided into two groups. The study group consisted of 50 rats with occlusion of LAD for 30-45 minutes and the sham-operated group consisted of 10 rats without occlusion of LAD. Echocardiography were performed before operation, which was defined as baseline, and 1 week, 4 weeks and 8 weeks after operation. Left ventricular internal diameter at diastole ( LVIDd) and systole < LVIDs), fractional shortening( FS), ejection fraction (EF) and left ventricular mass(LVM) were measured by anatomical M-model echocardiography. High frame rate two-dimensional images were recorded in the left ventricular short-axis views at the papillary muscle level. Peak systolic radial strain(PRS) and circumferential strain(PCS) of each segment were measured using 2-dimensional strain software. The rats were sacrificed and the infarcted size of each segment was measured using triphenyl tetrazolium chloride (TTC) after echocardiography was performed. Fibrosis of left ventricular myocardium was displayed using Van Gieson stain in 1 weeks after infarction. Results Based on the TTC findings,the left ventricle of the study group was divided into three regions:infarcted,peri-infarct and remote myocardial regions. Van Gieson stain showed fibrosis existed in all the three regions. Compared with baseline and sham-operated group, PRS and PCS of infarcted, peri-infarct and remote myocardial regions of the study group significantly decreased within 1 week after operation ( P <0. 01) and persisted for 8 weeks. PCS and PRS of infarcted, peri-infarct and remote myocardial regions of the study group in 4 weeks and 8 weeks after operation showed no significant difference when compared with those in 1 week after operation ( P >0. 01). Compared with baseline and sham-operated group,LVIDd,LVIDs and LVM of study group all increased significantly ( P <0. 05) in 4 weeks and 8 weeks after operation,and FS and EF reduced significantly ( P <0. 05). Two-dimensional strain obtained in interobserver and intraobserver both showed high agreement. Conclusions Two-dimensional strain echocardiography can assess regional function of myocardium with different perfusion in rats following acute myocardial infarction, and provides a sensitive and reliable method to follow up the process of left ventricular remodeling after myocardial infarction.

Animals ; DNA, Complementary ; genetics ; Genome, Viral ; Humans ; Influenza Vaccines ; genetics ; immunology ; Orthomyxoviridae ; genetics ; immunology ; RNA, Viral ; genetics

Objective To analyze the factors affecting the cleanliness level and infection control in the clean area for pharmacy intravenous admixture service (PIVAS) based on continuous monitoring.Methods The cleanliness indexes such as suspended particle and settling bacteria,infection control indexes such as the hygiene of object surface and hand as well as the noise in the clean area for PIVAS from 2013 to 2016 were monitored continuously according to GB 50457-2008 Clean factory building design specifications of medical industry and Intravenous admixture quality control specification.Results All the indexes accorded with the requirements for cleanliness and infection control except some odd cases unqualified in hand hygiene.Suspended particles increased as the time went by,and decreased along with noise after replacing high-performance filter.Conclusion It's of great significance to qualify the clean area of PIVAS to maintain air conditioning purification system periodically,implement anti-infection measure strictly and standardize continuous monitoring and evaluation.

Objective To observe the value of two-dimensional speckle tracking imaging (2D-STI) in assessing regional myocardial viability of rats after acute myocardial infarction. Methods Twenty Wistar rats were randomly divided into acute myocardial infarction group and sham-operation group (each n=10). Echocardiography was performed at baseline and 24 h after reperfusion. High frame rate two-dimensional images were recorded from the left ventricular short-axis views at the papillary muscle level. Peak radial strain (PRS) and peak circumferential strain (PCS) of each segment were measured at systolic period. Left ventricular internal diameter at diastole (LVID_d) and systole (LVID_s), fractional shortening (FS), ejection fraction (EF), wall thickening rate (TR) were measured with anatomical M-model echocardiography. Area of necrosis (AN) of each segment was measured after triphenyl tetrazolium chloride (TTC) staining. Based on TTC staining, ROC curve was used to analyze the accuracy of two-dimensional strain and TR index in identifying infarcted segment. Results ①Compared with acute myocardial infarction group at baseline and sham-operation group after operation, LVID_d and LVID_s of acute myocardial infarction group after operation increased significantly respectively (P<0.05), FS, EF and anteroseptal wall TR reduced significantly (P<0.05). ②Compared with acute myocardial infarction group at baseline and sham-operation group after operation, PRS and PCS decreased significantly in anteroseptal, anterior, anterolateral, inferolateral and inferoseptal segments of myocardial infarction group after operation (P<0.05), especially in anterosepetal, anterior and anterolateral segments (P<0.05). ③ROC analysis showed PCS had the best ability to identify infarcted myocardium as defined by AN>50%. Using a cut-off of -6.14%, PCS had a sensitivity of 93.75% and specificity of 90.91% for distinguishing infarcted from viable myocardium. Conclusion 2D-STI can accurately quantify regional myocardial function, providing a sensitive and noninvasive means to assess regional myocardial viability.

Antimetabolites, Antineoplastic ; adverse effects ; therapeutic use ; C-Reactive Protein ; analysis ; Child ; Child, Preschool ; Cytarabine ; adverse effects ; therapeutic use ; Diagnosis, Differential ; Female ; Fever ; blood ; chemically induced ; diagnosis ; Humans ; Infant ; Male ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; blood ; drug therapy ; Teniposide ; therapeutic use

To determine wether there were connections among hepatocyte nuclear factor-1 alfa (HNF-1a), liver receptor homolog-1 (LRH-1), apolipoprotein M (apoM) and to investigate the effects of HNF-1a in HepG2 on the expressions of apoM, apolipoprotein A-I (apoA-I) and the key enzymes in cholesterol metabolism and biotransformation. The mRNA expressions of apoM, LRH-1 and HNF-1a were detected by RT-PCR. HNF-1a was interfered and RT-PCR was used to detect the changes of apo M, apo A-I, Cyp7A1, farnesoid X receptor (FXR) and small heterodimer partner-1 (SHP-1). Western blot was used to detect the change of apo M protein. The expressions of apoM, LRH-1 and HNF-1amRNA were obviously higher in HCC tissue than that in para-cancer tissue (the vaule of t is -7.167, -7.075, -8.803, P less than 0.01 respectively). HNF-1a and LRH-1 positively correlated with the expression of apoM (r=0.353, P less than 0.01; r=0.523, P less than 0.01 respectively); RT-PCR and western blot results showed that the expressions of apoM, FXR and SHP-1 mRNA, could be obviously suppressed by HNF-1a interfering as compared to the negative controls by 47.4%, 47.9%and 65.2% (P less than 0.01) respectively, and the expression of apoM protein also decreased by 54.3% (F = 43.482, P less than 0.01). The expressions of HMGCR and CYP7A mRNA increased by 101.1% and 138.5% (P less than 0.01) respectively as compared to the negative control. But there is no effect on expression of apoA-I mRNA (F = 0.170, P more than 0.05). HNF-1a could promote cholesterol biotransformation by increasing the expression of apoM and the key enzymes in cholesterol metabolism and decreasing inhibiting factor. So HNF-1a provided protection against cardiovascular disease.

To investigate the adjuvant effect of plasmid DNA encoding superantigen SEA (D227A) (pmSEA) on immune responses induced by HBV DNA vaccine containing HBV preS2 and S antigen in BABL/c (H-2d). BALB/c mice were immunized intramuscular injection with HBV DNA vaccine (pHBVS2S) mixed with or without pmSEA plasmid. Antibodies againat HBV PreS2 and S antigen in the sera were accessed by Anti-HBs ELISA, and the HBsAg specific cytotoxic T lymphocytes (CTLs) activity was determined by 5 Chromium Release Assay. The HBs peptide-specific IFN-gamma secreting T cells were detected by ELISPOT. Anti-HBs antibody titers and CTLs activity in mice immunized with pmSEA + pHBVS2S group were significant higher (P < 0.05) than pHBVS2S DNA vaccine group. The ratio of IgG1/IgG2a (0.282) was apparently different from the group immunized with peptide (10). Mice immunized with HBV DNA vaccine plus adjuvant produce higher titer of IgG1 and IgG2a antibodies against HBV S antigen 1.36 and 1.73 time higher than that without adjuvant respectively. HBs peptide--specific IFN-gamma secreting T cells increased 2 - 3 times by the pmSEA adjuvant, compared to DNA vaccine group. HBV DNA vaccine (pHBVS2S) induces humoral and cellular immuno-responses in BALB/c mice, and the responses could be significantly boasted by the plasmid encoding mSEA. Therefore the pmSEA was a potential adjuvant for DNA vaccines.
Adjuvants, Immunologic ; Animals ; Enterotoxins ; immunology ; Hepatitis B ; immunology ; prevention & control ; therapy ; Hepatitis B Antibodies ; blood ; Hepatitis B Vaccines ; immunology ; Interferon-gamma ; secretion ; Mice ; Mice, Inbred BALB C ; Staphylococcus aureus ; immunology ; Superantigens ; immunology ; T-Lymphocytes, Cytotoxic ; immunology ; Vaccination ; Vaccines, DNA ; immunology

OBJECTIVETo compare two different procedures of colostomy in the laparoscopic- assisted abdominoperineal resection(LAPR), and to reduce the related complications of colostomy.

METHODSSixty- three cases with anorectal cancer undergone LAPR from June 2001 to December 2005 were registered and followed up. Circular stapler anastomosis with sigmoid colon and abdominal skin were applied on 61 cases of the colostomy, and 2 cases were hand sutured. All patients were assigned to group A and B. Thirty- seven cases received the procedure of colostomy through the rectus abdominis peritoneally in group A,other 26 cases through extraperitoneal tunnel and the rectus abdominis in group B.

RESULTSDescending colon, sigmoid colon and rectum were dissected using laparoscopic instruments in 63 cases. No conversion to open procedure and no operative death occurred in two groups of patients. There was no significant difference between two groups in mean operation time, but significant differences were found in the time of return of bowl function[A group (2.4 +/- 1.1)d vs B group (1.9 +/- 0.8)d,P < 0.05], duration of postoperative hospital stay [A group (19.9 +/- 7.8)d vs B group (14.5 +/- 3.9)d,P < 0.01] and stoma related complications(A group 29.4% vs B group 4.0%,P < 0.05). Postoperative hospital stay were shorter, and less colostomy related complications were found in group B.

CONCLUSIONColostomy through extraperitoneal tunnel and the rectus abdominis is a better procedure in LAPR, which can reduce the related complications of colostomy and shorten postoperative hospital stay.

Abdominal Cavity ; surgery ; Adult ; Aged ; Aged, 80 and over ; Anal Canal ; surgery ; Colostomy ; methods ; Female ; Humans ; Laparoscopy ; Male ; Middle Aged ; Neoplasm Staging ; Peritoneum ; surgery ; Rectal Neoplasms ; pathology ; surgery