AIM: To study the effect of torsional mode phacoemulsification on cornea in patient with age-related cataract.METHODS: Totally 161 age-related cataract patients (196 eyes) were assigned randomly to phacoemulsification by torsional mode(Group A) or conventional ultrasound mode (Group B) in our hospital from January 2012 to December 2014.The intraoperative data of effective ultrasound time(UST)and effective cumulative dissipated energy(CDE) were recorded.Postoperative outcomes and the change of the best corrected visual acuity(BCVA),corneal edema degree(CED),central corneal thickness(CCT) and endothelial cell count were also recorded and compared.RESULTS: For grade Ⅰ,Ⅱ,Ⅲ and Ⅳ nuclear density,the mean UST and mean CDE were significantly lower in Group A.The average BCVA of Group A was better than Group B at 1 and 7d after surgery.But at 30d postoperative,there was no statistical difference between these two groups(P>0.05).The corneal clarity and the mean change of central thickness showed significantly less corneal edema in Group A than Group B in 1 and 7d postoperatively.This difference was no longer found significantly at 30d after surgery(P>0.05).At 7 and 30d postoperative,the endothelial cells in Group B were lower than in Group A.CONCLUSION: By reducing the effective UST and CDE intraoperatively,the main effect of torsional mode phacoemulsification on cornea shows less damage to endothelium cells,and patients get better prognosis.But the damage to cornea by torsional mode phacoemulsification isn`t fundamentally solved.

Objective To study the relationship among apoptosis,NF-KB activation and uPA expres- sion in human colon carcinoma cell line HCTll6 induced by 5-fluorouracil,and to observe the effect of in- hibiting activity of NF-KB by PDTC on apoptosis as well as expression of uPA.Methods Cell apoptosis was analysed by Annexin V-FITC.Fluctuation of NF-KB and uPA was detected by semi-quantitative immuno- histochemistry.Results 5-fluorouracil could induce apoptosis and activate NF-KB.PDTC could significantly increase the apoptosis and suppress the activation of NF-KB induced by 5-fluorouracil.There was a positive correlation between the changes of uPA and NF-KB.Conclusion 5-fluorouracil could induce apoptosis,ac- tivate NF-KB and up-regulate expression of uPA of HCT116 cells.The mechanism of enhanced apoptosis by PDTC may be related to suppressing activation of NF-?B and down-regulating expression of uPA.

AIM:To observe the structural basis of ocular motility abnormalities in patients with congenital fibrosis of the extraocular muscles type Ⅰ ( CFEOM Ⅰ) due to missense mutations in the developmental kinesin KIF21A using high - resolution magnetic resonance imaging ( MRI) .
METHODS: Totally 11 affected individuals reported KIF21A mutations were correlated with MRI studies demonstrating extraocular muscles ( EOMs ) size, location, contractility, and innervation. EOMs and the motor nerve in the orbits were imaged with T1 weighted in a triplanar scan using a dual-phased coils with 2. 0mm thick. Motor nerves were imaged at the brainstem using head coils and 3D-FIESTA with 0. 6-mm thick.
RESULTS: Patients with CFEOM Ⅰ exhibited different degrees of hypoplasia of oculomotor nerve, the abducens nerve and the trochlear nerve were also affected, of which 8 cases of orbital section could see the signal of abnormal nerve dominated by oculomotor nerve to lateral rectus. The both sides of six EOMS in all patients exhibited variable atrophy and abnormal bright internal signal on T1 imaging, particularly severe for the superior rectus and levator muscles.
CONCLUSION: High - resolution MRI can directly demonstrate pathology of motor nerves,affected EOMs, and ‘Pulley' hypoplasia caused by CFEOM Ⅰ due to mutations in KIF21A,and these findings suggest that the neuronal hypoplasia is the etiological factor of CFEOM.

Adult ; Female ; Humans ; Kidney Glomerulus ; metabolism ; pathology ; Lipoproteins ; metabolism ; Male ; Nephrosis, Lipoid ; metabolism ; pathology

OBJECTIVETo investigate the effect of fetal bovine serum (FBS) on expression of pigment epithelium-derived factor (PEDF) in normal epidermal keratinocytes and dermal fibroblasts.

METHODSKeratinocytes and fibroblasts were incubated with 10% FBS. PEDF protein level in the cells was determined by immunofluorescence and Western blot.

RESULTSPEDF was localized mostly in the cytoplasm,while some in the nuclei. The distribution of PEDF in cytoplasm was in a granular pattern. 10% FBS increased the expression of PEDF both in keratinocytes and fibroblasts,but histamine and Phorbol 12-myristate 13-acetate (PMA) did not interfere the distribution of PEDF in cells.

CONCLUSION10% FBS can upregulate expression of PEDF in epidermal keratinocytes and dermal fibroblasts.

Animals ; Cattle ; Cells, Cultured ; Epidermis ; cytology ; metabolism ; Eye Proteins ; genetics ; metabolism ; Fetus ; Fibroblasts ; cytology ; metabolism ; Keratinocytes ; cytology ; metabolism ; Nerve Growth Factors ; genetics ; metabolism ; Serpins ; genetics ; metabolism ; Serum ; physiology ; Skin ; cytology ; metabolism ; Up-Regulation

Objective To study the psychological and psychosomatic status of children with pectus exca vatum and the significance of orthotherapy. Method Eighty-seven patients and 87 healthy children were interviewed with the Achenba ch Child Behavior Checklist (CBCL),the symptom Checklist (SCL-90)and the psycho logical and psychosomatic status checklist contrived. Results The children with pectus excavatum showed higher frequency in interpersonal sens itivity, depression,anxiety,obsession compulsion and also more mental difficul ties than those of control group.The differences between the patients and health y children were significant statistically.Conclusions The psychological and psychosomatic status of children with pectus excavatum are worse than those of healthy children,so it is reasonable to perform an operati on earlier for improvement of physiological, psychological ,social aspects in ch ildren with pectus excavatum. J Appl Clin Pediatr,2005,20(2):178-179

BACKGROUND AND OBJECTIVES: Frontal sinus fracture can have serious consequences due to proximity of the sinus to the intracranial cavity and the potential for serious combined injuries. Management of the Fractures depends on the type and severity of the fracture and the presence of associated injuries. In this article, we present an overview of fracture treatment options, and offer a simple algorithm for management based on the type and severity of the facture. PATIENTS AND METHODS: Twenty-three patients with frontal sinus fractures were analysed. All patients were male, with the mean age of 31. The average follow-up length was 13 months. Of 23 patients, 8 patients had anterior wall fractures and 15 patients had anterior and posterior wall fractures. Their types of fracture, combined injuries, surgical methods, surgical results, and complications were analysed. RESULTS: Six patients had conservative management and 17 patients had surgery. Of 17 patients who had surgery, 6 patients had only repair of the fracture, 3 patients had repair of the fracture with sinus obliteration, and 8 patients had repair of the fracture with cranialization of the frontal sinus. The most common associated injury was fractures of other facial bones (83%), especially the orbit. Traumatic optic neuropathy was the most common complication associated with the frontal sinus fracture or its accompanying injuries. CONCLUSION: Frontal sinus fractures were safely managed with repair of the fracture, sinus obliteration, or with sinus cranialization which was used irrespective of type and severity of fractures.
Facial Bones ; Follow-Up Studies ; Frontal Sinus* ; Humans ; Intraoperative Complications ; Male ; Optic Nerve Injuries ; Orbit

Cultivation of clinical profession ability of integrated traditional Chinese and Western medicine graduates involves the policy, management, evaluation, training, and many other aspects of colleges and universities. This article put forward the organic convergence of cultivation education and clinical profession post competence. According to the real situation of graduates, sectional, individualized, and true practice of clinical cultivation education was conducted, which could make graduates get into the cultivation education mode of "early clinical practice, more clinical practice, true clinical practice". This could effectively enhance the cultivation effects and clinical profession post competence of integrated traditional Chinese and Western medicine graduates.

Subcutaneous emphysema often occurs as a result of surgery, trauma of the aerodigestive tract, and increased alveolar pressure. Generally, spontaneous emphysema is rare, because "spontaneous" is only used to describe emphysema that has no obvious etiology. We reviewed six cases of non-traumatic subcutaneous emphysema occurring in the head and neck. Among them, four cases were associated with pneumomediastinum. Two occurred without obvious etiology, another two were due to heavy lifting events, one due to severe vomiting, and the last one due to severe blowing. Most cases occurred in young males. Clinical symptoms, commonly involved sites, treatments and results of these cases of spontaneous emphysema were analysed.
Emphysema ; Head* ; Humans ; Lifting ; Male ; Mediastinal Emphysema ; Neck* ; Subcutaneous Emphysema* ; Vomiting

Background: Sacroiliac (SI) screw fixation is a demanding technique, with a high rate of screw malposition due to the complex pelvic anatomy. TiRobot? is an orthopedic surgery robot which can be used for SI screw fixation. This study aimed to evaluate the accuracy of robot?assisted placement of SI screws compared with a freehand technique. Methods:Thirty patients requiring posterior pelvic ring stabilization were randomized to receive freehand or robot?assisted SI screw fixation, between January 2016 and June 2016 at Beijing Jishuitan Hospital. Forty?five screws were placed at levels S1 and S2. In both methods, the primary end point screw position was assessed and classified using postoperative computed tomography. Fisher's exact probability test was used to analyze the screws'positions. Secondary end points, such as duration of trajectory planning, surgical time after reduction of the pelvis, insertion time for guide wire, number of guide wire attempts, and radiation exposure without pelvic reduction, were also assessed. Results: Twenty?three screws were placed in the robot?assisted group and 22 screws in the freehand group; no postoperative complications or revisions were reported. The excellent and good rate of screw placement was 100% in the robot?assisted group and 95% in the freehand group. The P value (0.009) showed the same superiority in screw distribution. The fluoroscopy time after pelvic reduction in the robot?assisted group was significantly shorter than that in the freehand group (median [Q1, Q3]: 6.0 [6.0, 9.0] s vs. median [Q1, Q3]: 36.0 [21.5, 48.0] s; χ2 = 13.590, respectively, P < 0.001); no difference in operation time after reduction of the pelvis was noted (χ2 = 1.990, P = 0.158). Time for guide wire insertion was significantly shorter for the robot?assisted group than that for the freehand group (median [Q1, Q3]: 2.0 [2.0, 2.7] min vs. median [Q1, Q3]: 19.0 [15.5, 45.0] min; χ2 = 20.952, respectively, P < 0.001). The number of guide wire attempts in the robot?assisted group was significantly less than that in the freehand group (median [Q1, Q3]: 1.0 [1.0,1.0] time vs. median [Q1, Q3]: 7.0 [1.0, 9.0] times; χ2 = 15.771, respectively, P < 0.001). The instrumented SI levels did not differ between both groups (from S1 to S2, χ2 = 4.760, P = 0.093). Conclusions: Accuracy of the robot?assisted technique was superior to that of the freehand technique. Robot?assisted navigation is safe for unstable posterior pelvic ring stabilization, especially in S1, but also in S2. SI screw insertion with robot?assisted navigation is clinically feasible.