To describe a modified simple iris suture for pupillary dilation technique during vitrectomy in cases with a miotic pupil.Four translimbal incisions were created with a sharp straight blade at 1:30,10:30,4:30,and 7:30 o'clock,respectively.The straight needle of 10-0 polypropylene suture and a Sinskey IOL hook was used to displace the pupillary margin toward the limbus.In 3 cases,four sutures caused a 6-mm to 9-mm square-shaped pupil,and the pupil was allowed to return to a smaller size at the end of the operation.It is simple and may reduce postoperative complications.

Objective To investigate the prognostic factors of life and functional outcome of the first hemiparetic stroke patients. Methods One hundred and eighteen stroke subjects were registered prospectively. The Barthel index (BI) , Rankin scale (RS) , Mortricity index(MI) , Mini-mental state examination (MMSE) , Montgomery-Asberg depression scale (MADRS) and a scale of general state and risk factors were used to evaluate at the 48th hour, the 15th day and the 90th day after stroke. Results The patients' performance, as demonstrated by their scores with all the evaluation instruments, changed significantly at all the time points of evaluation after stroke (P ＜0.05). There was no significant difference between the performance at the 48th hour and the 15th day after stroke ( P ＞ 0.05 ). But at the 90th day after stroke, the activity of daily living performance and the depression status recovered significantly (P ＜ 0.01 ). Logistic regression analysis showed that, such factors as pneumonia, urinary incontinence within 48th hour and deep sensation disturbance might adversely influence patients' activity of daily living performance at the 90th day after stroke; the muscle strength of upper extremities at the 48th hour, and MMSE scores at the 15th day after stroke acted as the protective factors. Conclusions The stroke patients improved significantly with regard to their clinical and functional manifestations when evaluated 90 days after stroke onset. The main factors influencing the activity of daily living performance 90 days after stroke onset included deep sensation disturbance,pneumonia, urinary incontinence and muscles strength of upper extremities at 48th hour, and MMSE scores at the 15th days after onset.

Acinetobacter baumannii ; drug effects ; isolation & purification ; Drug Resistance, Multiple, Bacterial ; Female ; Humans ; Infant, Extremely Low Birth Weight ; Infant, Newborn ; Pneumonia, Ventilator-Associated ; etiology

Background Central retinal vein occlusion (CRVO) is a common retinal vascular disease.Intravitreal injection of ranibizumab, a vascular endothelial growth factor (VEGF) antibody, is being a useful approach to the treatment of macular edema secondary to CRVO.However,little literature about choroidal thickness variations following intravitreal injection of ranibizumab for CRVO is published up to now.Objective This study was to observe the dynamic changes of macular choroidal thickness after intravitreal injection of ranibizumab in CRVO eyes.Methods A self-controlled series cases study was designed.Thirty-one eyes of 31 CRVO patients were included in Tianjin Eye Hospital from June 2013 to November 2014,with the males 19 and females 12 and mean age of (51.13±16.65) years.Ranibizumab (5 mg,5 ml) was intravitreally injected in the CRVO eyes once per month for 3 times by the same operator.A enhanced depth image (EDI) mode of spectral-domain OCT system was employed to measure the choroidal thickness at subfoveal, 1 mm from fovea nasal and 1 mm from fovea temporal before and 1 month,2,3 months after first injection in both CRVO eyes and contralateral healthy eyes, respectively.The best LogMAR vision was recored.This research protocol was approved by the Ethic Committee of this hospital, and written informed consent was obtained from each individual prior to any medical examination.Results Retinal bleeding was exhibited in the CRVO eyes in color photography,and fundus fluorescein angiography showed the fluorescine leakege in the early phase and fluorescine accummulation in the late phase.The mean choroidal theckness value was (325.32±83.04) , (294.83±80.61), (315.95±90.77) and (314.81±84.98) μm before injection and 1,2,3 months after injection,respectively,showing a significantly difference among various time points (F =7.96,P =0.00) , and the choroidal theckness values were evidently reduced in various time points after injection in comparison with before injection (P =0.01,0.01,0.00).The choroidal thickness value at foveal was (314.81±84.98) μm in the CRVO eyes 3 months after injection,and that in the fellow eyes was (260.47±55.90) ,with significant difference between them (t =2.95, P =0.01).The LogMAR vision was 0.17±0.09,0.37±0.23,0.42±0.26 and 0.49±0.21 before and 1,2,3 months after injection,with the significant difference among various time points (F =21.50, P =0.00) and showed considerable improvement after intravitreal injection of ranibizumab(all at P＜0.01).The mean retinal thickness value was (244.14-±23.28) μm in the fellow eyes, and those in 1 month, 2,3 months after injection were (523.81 ± 147.61), (352.13 ± 166.71),(376.39±209.46) and (369.00±225.61) μm in the CRVO eyes, showing obvious reduce after intravitreal injection, with significant difference among different time points (F =7.09, P＜0.01).Conclusions Choroidal thickness at macular fovea is obviously increased in CRVO eyes compared with the contralateral healthy eyes.Intravitreal injection of ranibizumab can reduce choroidal thickness and therefore improve vision.EDI OCT is available in the evaluation of dynamic change of choroidal thickness.Macular choroidal thickness could be used as a predictor of CRVO prognosis following intravitreal ranibizumab.

Adult ; Arterio-Arterial Fistula ; pathology ; Coronary Vessels ; pathology ; Female ; Humans ; Pulmonary Artery ; pathology

BackgroundSeveral cornea collagen crosslinking methods have been used to treat keratoconus.However,the safety of these methods is dissatisfactory.Glyceraldehyde is a very potent and highly reactive crosslinking agent,with little toxicity,but its effect on corneal biomechanical property is poorly clear.ObjectiveThe aim of this study was to evaluate the biomechanical effects of glyceraldehyde collagen crosslinking on rats cornea.Methods Fifteen clean SD rats were randomly divided into 0.005 mol/L glyceraldhyde group,0.050 mol/L glyceraldhyde group and blank control group.Glyceraldhyde drops was topically administered in the right ryes 2 times per day for consecutive 7 days in the 0.005 mol/L and 0.050 mol/L glyceraldhyde groups,and no any eye drops was used in the blank control group.Seven days later,the rats were sacrificed.Transparency of corneal buttons in these different groups was evaluated.The central corneal strips of 2 mm×6 mm with 2 mm scleral tiasue were obtained for the biomeehanical stress-strain measurement,including ultimate stress ( MPa),ultimate strain (％) and 6％ elastic modulus (MPa).Corneal collagen fibril density was assessed by histological examination under a light microscopy.The use of the animals followed the Regulations for the Administration of Affair Concerning Experimental Animals by State Science and Technology Commission.ResultsThe words could be clearly displayed transcorneally in all the three groups.When strain was 6％,the stress was (0.463±0.065 ) MPa in 0.005 mol/L glyceraldehyde group,(0.846±0.240) MPa in 0.050 mol/L glyceraldehyde group,both showing a significant increase in comparison with (0.195±0.103 ) MPa of the blank control group (P=0.029,0.000 ).Following the crosslinking treatment,the ultimate stress was significant elevated in 0.050 mol/L glyceraldehydes group compared with the blank control group ( ( 10.759 ± 3.337 ) MPa vs.(5.295± 1.313 ) MPa,P =0.007 ),but no significant change between the 0.005 mol/L glyceraldehydes group and the blank control group ( ( 6.043 ±2.084) M Pa vs.(5.295 ± 1.313 ) MPa,P =0.660 ).Corneal ultimate strain was lower in the 0.005 mol/L glyceraldehyde group and 0.050 mol/L glyceraldehyde group than the blank control group (36.57％ ±3.09％ vs.43.87％ ± 1.89％,P =0.009;28.53％ ±1.89％ vs.43.87％ ± 1.89％,P =0.000).However,significantly increased 6％ elastic modulus were seen in the 0.005 mol/L glyceraldehyde group and 0.050 moL/L glyceraldehyde group compared with the blank control group ( ( 7.718 ± 1.076 ) MPa,( 14.102 ± 4.011 ) MPa vs.( 3.252 ± 1.717 ) M Pa),with statistically significant differences ( P =0.029,0.000).Histological examination showed a increase of collagen fiber density in the 0.050 mol/L glyceraldehyde group.Conclusions Corneal collagen crosslinking induced by glyceraldehyde strengthens biomechanical intensity and increases the density of corneal collagen fiber.But the safety of glyceraldehyde crosslinking for keratoconus needs further study.

A sesquiterpene synthase (AsSS4) full-length open reading frame (ORF) cDNA was cloned from wounded stems of Aquilaria sinensis by RT-PCR method. The result showed that the ORF of AsSS4 was 1,698 bp encoding 565 amino acids. Prokaryotic expression vector pET28a-AsSS4 was constructed and transformed into E. coli BL21 (DE3) pLysS. Recombinant AsSS4 protein was obtained after induction by IPTG and SDS-PAGE analysis with a MW of 64 kD. Enzymatic reactions using farnesyl pyrophosphate showed that recombinant AsSS4 protein purified by Ni-agarose gel yielded five sesquiterpene compounds, cyclohexane, 1-ethenyl-1-methyl-2, 4-bis(1-methylethenyl)-, β-elemene, α-guaiene, α-caryophyllene and δ-guaiene. This paper reported the first cloning and functional characterization of AsSS4 gene from A. sinensis, which will establish a foundation for future studies on the molecular mechanisms of wound-induce agarwood formation in A. sinensis
Alkyl and Aryl Transferases ; biosynthesis ; genetics ; Azulenes ; Cloning, Molecular ; DNA, Complementary ; Escherichia coli ; Open Reading Frames ; Polyisoprenyl Phosphates ; Recombinant Proteins ; biosynthesis ; Sesquiterpenes ; metabolism ; Sesquiterpenes, Guaiane ; Thymelaeaceae ; enzymology ; genetics

Clinical trial protocol is the document that illustrates the background of a clinical trial, theoretic basis, objective, design, methods, and organization, as well as statistical calculating, implement, and conditions for completion. Clinical trial protocol is the basic measure for ensuring the validity of scientific results and reducing bias. In order to optimize the design of clinical trial protocol, we generalize main problems in Chinese medicine clinical trials, key points of clinical trial protocol, as well as report standards.
Clinical Trials as Topic ; Drugs, Chinese Herbal ; therapeutic use ; Humans ; Medicine, Chinese Traditional ; Research Design ; standards

Objective To investigate the spectrum,diagnosis,time of therapy and management of the congeni-tal heart disease(CHD)in patients with Down′s syndrome(DS).Methods A retrospective report was undertaken of 96 cases in children with DS accompanied by CHD in Department of Pediatric Cardiology,Beijing Anzhen Hospital Af-filiated to Capital Medical University.Data were collected and analyzed about their clinical characteristics,and types of cardiovascular abnormalities,and the important laboratory examinations such as echocardiography and catheterization as well as the procedures of diagnosis and treatments were summarized.Then the interventions,complications and prognosis of different patients were estimated.Results (1)Single congenital heart disease was found in 33 cases (34.38%),a-mong which ventricular septal defect was the most common (14 cases,14.58%),followed by atrioventricular septal de-fect and atrial septal defect (equally,7 cases,7.29%).Multi -cardiovascular abnormalities were discovered in 63 ca-ses,and patent ductus arteriosus turned out to be the most common (42 cases,66.67%).(2)Cat-heterization was car-ried out in 18 cases of serious pulmonary arterial hypertension,and 8 cases were proved resistant pulmonary arterial hy-pertension without operation opportunity.The other 8 cases were estimated as high pulmonary arterial hypertension and medical therapy was suggested before reassessment to reduce surgical risks.(3)Operations were undertaken in 61 ca-ses,among which percutaneous interventional occlusion was performed in 7 cases and surgical interventions were per-formed in 54 patients,in which perioperation complications and death were found in 5 cases and 4 cases,respectively. Conclusions Operation interventions are practicable and most cases recovered well with systematic examinations and assessment in patients with DS and cardiovascular malformations.Early diagnosis and timely interventions are highly suggested.Also close attentions should be paid to follow -up and re -estimation after medical therapy.

Objective To explore the value of axillary MRI in differential diagnosis of metastatic axillary lymph nodes in patients with breast cancer.Methods Axillary MRI was performed in 44 breast cancer patients proved by pathology.Long axis,short axis,cortex thickness,ADC value,hilus,margin,perifocal fat gap,signal intensity on DWI,enhancement pattern and time-signal intensity curve were analyzed.The diagnostic ability of long axis,short axis,cortex thickness and ADC value were analyzed with ROC curves.Results Twenty-four patients (24/44,54.55 ％) were proved with metastases axillary lymph nodes,the other 20 patients (20/44,45.45％) were negative.Long axis,short axis,cortex thickness,ADC value,hilus absence,irregular margin,fuzzy perifocal fat gap,high signal intensity on DWI and heterogeneous enhancement showed statistically significant between patients with metastatic and without metastatic axillary lymph nodes (all P＜0.05).The area under ROC curve of long axis,short axis,cortex thickness and ADC value were 0.797,0.765,0.848,0.749 respectively.Conclusion MRI plays an important role in differential diagnosis of axillary lymph nodes me tastasis.The cortex thickness larger than 0.54 cm can help to predict metastatic axillary lymph nodes.