AIM:To evaluate the short-term efficacy of posterior chamber phakic intraocular lens implantation for moderate to high myopia.METHODS:Fifty-three eyes of 27 patients with moderate to high myopia (-3.25 to-21.5D) were received posterior chamber phakic intraocular lens implantation with 2.8mm clear corneal incision.Changes of visual acuity, intraocular pressure(IOP), counts of endothelial cells and surgically induced astigmatism at 1mo after surgery were observed.RESULTS:The preoperative best corrected visual acuity (BCVA LogMAR) were 0.05±0.18, the postoperative BCVA at 1d were 0.02±0.14, the postoperative BCVA at 1wk were-0.05±0.11, the postoperative BCVA at 1mo were-0.07±0.10.The postoperative BCVA were statistically significant differences in different time(P<0.05).The preoperative endothelial cell count was 2932.5±270.8/mm2, the postoperative endothelial cell count at 1d was 2917.1±299.0/mm2;the postoperative endothelial cell count at 1wk was 2902.5±288.6/mm2;the postoperative endothelial cell count at 1mo was 2855.3±284.2/mm2.The postoperative endothelial cell count was not statistically significant differences in different time.The preoperative IOP was 15.8±2.5mmHg;the postoperative IOP at 1d was 15.3±2.9mmHg;the postoperative IOP at 1wk was 17.4±5.8mmHg;the postoperative IOP at 1mo were 15.8±2.6mmHg.The preoperative IOP was significantly different compared with postoperative IOP at 1d, 1wk and 1mo.The postoperative IOP at 1d and 1wk were statistically significant differences (P<0.05).The surgically induced astigmatism at 1d was 0.74±0.39D;the surgically induced astigmatism at 1wk was 0.57±0.28D;the surgically induced astigmatism at 1mo was 0.44±0.21D.The postoperative IOP were statistically significant differences in different time (P<0.05).The preoperative anterior chamber depth was 3.26±0.25mm;the postoperative central vault at 1d were 654.5±345.2μm;the postoperative central vault at 1mo were 683.0±211.7μm.The postoperative central vault were significantly different between that at 1d and 1mo after operations.Operations went without serious complications.CONCLUSION:Posterior chamber phakic intraocular lens implantation for moderate to high myopia were safe, effective and predictability.But long-term effect remains needed to be further follow-up.

The validity of HbA1C and fasting plasma glucose(FPG)for screening of diabetes in community population was investigated.A total of 1 794 subjects from two sub-districts of Yangpu District,Shanghai,underwent a 75 goral glucose tolerance test(OGTT)and HbA1C determination.Based on 1999 World Health Organization criteria,there were 1 411 subjects with normal glucose tolerance(NGT),111 impaired fasting glucose(IFG),73 impaired glucose tolerance(IGT),33 IFG+IGT,and 166 diabetes.According to the receiver operating characteristic curve,the optimal cut-point of FPG for diagnosing diabetes was 6.15 mmol/L with sensitivity of 89.0%,specificity of 92.8%,and area under the curve of 0.959.The cut-point of HbA1C for diagnosing diabetes was 6.5% with a sensitivity and specificity of 71.1% and 80.2%.The area under the curve was 0.822.The screening model using FPG ≥6.1mmol/L and HbA1C≥6.5% had sensitivity of 66.9% and specificity of 97.0%.When the model was FPG ≥6.1 mmol/L or HbA1C ≥6.5%,the sensitivity and specificity was 96.3% and 76.7% respectively.The results suggest that both FPG and HbA1C have good value for screening diabetes in community,and FPG combined with HbA1C may further promote diagnostic efficacy.

Objective To investigate the effect of curcumin pretreatment on endoplasmic reticulum stress induced by global cerebral ischemia-reperfusion (I/R) in rats. Methods One hundred forty-four male SD rats weighing 200-250 g were randomly divided into 4 groups (n = 36 each): sham operation group (group S) ; I/Rgroup; curcumin group (group Cur) and vehicle control group (group VC). Global cerebral I/R was produced by four-vessel occlusion technique in S, I/R, Cur, VC groups. Bilateral vertebral arteries were cauterized. Bilateral common carotid arteries were occluded by clipping for 15 min. Curcumin 200 mg/kg was injected intraperitoneally (IP) at 1 h before cerebral ischemia. Global cerebral ischemia was confirmed by unconsciousness and disappearance of papillary and righting reflex. Animals were sacrificed at 12 h, 1,3 and 7 d of reperfusion. Neuronal apoptosis in hippocampal CA1 region was detected by TUNEL assay. Apoptosis index (AI) was calculated. The expression of glucose regulated protein 78 (GRP78) ,growth arrest and DNA damage inducible gene 153 (GADD153) and caspase-12 protein in hippocampal region was assessed by Western blot analysis. Results Cerebral I/R significantly increased AI and GRP78 and caspase-12 protein expression in hippocampus as compared with group S( P <0.05) . Curcumin pretreatment significantly decreased AI, increased GRP78 protein expression and decreased caspase-12 protein expression as compared with group I/R ( P < 0.05) . There was no significant difference in the GADD153 protein expression among Cur, VC and I/R groups ( P > 0.05) . Conclusion Curcumin pretreatment can significantly reduce global cerebral I/R-induced neuronal apoptosis in hippocampus by increasing GRP78 expression and decreasing easpase-12 expression in hippocampus.

Objective To explore the impact of metabolic syndrome (MS)in bone mineral density (BMD) in elderly male type 2 diabetics (T2DM). Methods One hundred and fourty cases were divided into MS group and non-MS(NMS)group according to with or without MS. Height,weight were measured, body mass index(BMI) were calculated and the total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), glycated hemoglobin (HbA1c)were tested. The bone mineral density (BMD) was measured by dual-energy X-ray absorptiometry (DEXA). The differences among these groups were compared and the risk factors for MS were analyzed. Results The MD, BMI, TC,TG in MS group was higher than that in NMS group (P < 0.05 vs. P < 0.01),and HDL-C was lower than NMS group (P < 0.05). Correlation analysis showed that BMD was negatively correlated with age , TG , HDL-C , and was positively correlated with BMI.The results of multiple stepwise regression analysis showed that age ,HDL-C,BMI were independent risk factors for BMD. Conclusion The BMD significantly increases in T2DM with MS.Obesity and low HDL-C have positive effects in bone mass.

Objective To examine cardiotoxicity of anthracyclines and trastuzumab in patients with breast cancer by two dimensional speckle tracking imaging. Methods Fifty-eight human epidermal growth factor receptors-2 (HER2) positive patients with breast cancer treated by anthracyclines and trastuzumab were monitored by echocardiography before treatment (Group A), after completion of anthracyclines (Group B), and at follow-up of 3 months (Group C) and 12months (Group D) after using trastuzumab. LVEDD, IVSTD, PWTD, LVEDV, LVESV were measured in the apical four- and two-chamber views. Left ventricular ejection fraction (LVEF) was measured using a modified Simpson's biplane method. Global longitudinal strain (GLS) and longitudinal strain rate (LSR) were calculated via Qlab8.0 analysis software off-line. Results LVEDDs in A-D groups were (47.95 ±4.12), (48.45 ±4.02), (48.91 ±3.83) and (49.98 ±3.72) mm, respectively, and LVEDVs were (108.70 ±21.26), (111.90 ±20.91), (113.50 ±20.25) and (119.20 ±20.02) ml, respectively. LVEDD, PWTD [(9.14 ±0.76) mm vs. (9.00 ±0.82)mm], LVEDV, LVESV [(54.60 ±14.58) ml vs. (50.97 ±14.35) ml] were increased in group B compared with those in A group (all P<0.05). LVEDD and LVEDV were increased in group C(P<0.05) compared with those in group B. CLVEDD, LVEDV, LVESV [(59.18±13.88) ml vs. (55.23± 13.81) ml] were increased in group D compared with group (P<0.05). Differences of LVEF between group C and group D were statistically significant[(59.48±2.62) % vs. (62.00±1.40) %, P<0.001]. Differences of GLS [(-21.16±2.33)%, (-19.76±1.98) %, (-19.22±1.89) % and (-18.74±1.79) %, respectively, P<0.001] and LSR [(-1.27±0.11), (-1.22±0.09), (-1.17±0.07) and (-1.14±0.06) /s, respectively, P<0.001] among four groups had all statistically significant. Conclusions Longitudinal left ventricle systolic function are impaired in patients with breast cancer treated by anthracyclines and trastuzumab. GLS and LSR of myocardium traced by two dimensional speckle tracking imaging would be useful for early evaluation of the severity.

Objective To observe the correlation between cardiac two-dimension global strain-speckle tracking imaging (2D-STI) and coronary artery disease index (CADi) scores in patients with acute myocardial infarction(AMI). Methods Eighty patients with AMI were chosen and given myocardial motion analysis using 2D-STI. The global longitudinal strain (GLS), global radial strain (GRS) and global circumferential strain (GCS) was calculated. All patients were given scoring according to CADi scores standard by coronary angiography. The correlations between 2D-STI indexes and CADi scores were analyzed. The area under curve(AUC) of the receiver operating characteristic curve (ROC) of critical coronary stenosis was calculated. Results GLS, GRS and GCS was all correlated to CADi scores (r=0.670, -0.621, 0.525, all P < 0.01). The sensitivity, specificity and AUC of GLS for critical coronary stenosis was 82.35%, 80.43% and 0.831. The sensitivity, specificity and AUC of GCS for critical coronary stenosis was 76.47%, 76.09% and 0.797. The sensitivity, specificity and AUC of GRS for critical coronary stenosis was 97.06%, 78.26% and 0.880. The AUC of GLS and GRS was larger than that of GCS, and the sensitivity, specificity for critical coronary stenosis was larger. Conclusions 2D-STI indexes have correlation with CADi scores. GLS and GRS has correlation with coronary artery stenosis.

Biopsy, Fine-Needle ; methods ; Breast ; pathology ; Breast Neoplasms ; pathology ; Carcinoma, Ductal, Breast ; pathology ; Female ; Humans ; Immunohistochemistry ; methods ; Lymph Nodes ; pathology ; Lymphatic Metastasis ; Paraffin Embedding ; methods ; Receptor, ErbB-2 ; metabolism

Objective To study the clinic time and patient satisfaction degree after implemented outpatient process reforming so as to improve the quality of nursing.Methods The questionnaire investigation was used,and 246 pregnant women before outpatient process reforming implemented and 283 pregnant women after it implemented were recruited and investigated.The clinic time and satisfaction degree of pregnant women were compared before and after it implemented.Results After the outpatient process reformed,the clinic time and satisfaction degree of pregnant women were ( 156.53 ± 9.23 ) min and 79.86％,and that of before it implemented were( 180.82 ± 8.86 ) min and 67.07％,and the differences were statistically significant ( t =16.87,x2 =68.48;P ＜ 0.05).Conclusions Outpatient process reformed can reduce the clinic time of pregnant women and improve their satisfaction degree,and provide high-quality nursing service and indicate the principle of patient-centered.

Objective To evaluate the effect of video- assisted thoracoscopic pulmonary segmentectomy in patients with isolated pulmonary arteriovenous fistula (PAVF). Methods A retrospective analysis was performed on 10 patients with PAVF in the department of thoracic surgery of the first affiliated hospital of Nanjing Medical University between January 2010 and December 2016. Computed tomography angiography (CTA) and three-dimensional reconstruction were performed before operation, and all patients accepted video-assisted thoracoscopic pulmonary segmentectomy. Results The diagnosis of PAVF was identified by CTA, with maximum diameter of tumor of 3.0- 5.0 cm. No perioperative mortality or postoperative complications were observed including bleeding, hemoptysis, serious air leakage, and bronchopleural fistula. The lesions were completely removed in all 10 patients, and no patients converted to open surgery intraoperatively. Blood gas analysis showed that oxygen partial pressure before operation, in the first day after operation and the third month after operation was (62.5 ± 6.7), (70.2 ± 4.8) and (75.4 ± 4.8) mmHg (1 mmHg = 0.133kPa) respectively; which was significantly increased successively (P<0.05). After a follow-up time of 3-30 months, no recurrences were observed. Conclusions Video- assisted thoracoscopic pulmonary segmentectomy guided by preoperative CTA and three-dimensional reconstruction is a very effective method for the treatment of isolated PAVF.

Objective To investigate the clinicopathological characteristics and postoperative prognosis analysis of intra-thoracic localized Castleman disease (LCD).Methods The clinical data of 9 patients with intra-thoracic LCD who accepted surgical treatment were retrospectively analyzed.There were 5 males and 4 females,with age of (32.8 ± 10.9) years.Two patients complained of chest pain,1 patient suffered from paraneoplastic pemphigus,and the rest were diagnosed by physical examination.Four cases were diagnosed with LCD by preoperative CT examination.Results All patients underwent surgical resection.Four patients were performed open surgery and 5 patients had video assisted thoracic surgery.All patients accepted radical surgery.But 2 of these patients had postoperative complications.One patient was the injury of phrenic nerve and another was pericardial effusion.Patho-histological showed hyaline vascular type of Catleman disease in all patients.All patients survived without recurrence during the follow-up for 2-53 months.Conclusions Intra-thoracic is rare and liable to misdiagnosed.For increasing the preoperative diagnosis rate of LCD,the combined application of imaging tests is important,and clinicians and radiologists should also enhance the awareness of this disease.Complete surgical resection of the tumor is the best therapeutic alternative for intra-thoracic LCD.