Background Full femtosecond laser refractive surgery has been generally applied,but the improvement of visual quality after surgery is a vital problem.It is well-known that modulation transfer function (MTF) is a major evaluation indicator.Objective To investigate the change of the MTF of operated eyes after the full femtosecond laser refractive surgery.Methods A retrospective series of cases study was adopted.Forty eyes of 23 patients with the spherical equivalent of-2.25 to-5.75 D who received full femtosecond laser refractive surgery were enrolled in Nanjing General Hospital of Nanjing Military Command from July to October,2012.The change of visual acuities was analyzed and compared among before operation and 1 day,1 week and 1 month after operation.MTF value in total aberration,low and high order aberrations under the 3.0 mm and 6.0 mm pupil size conditions were detected with i-Trace Visual Function Analyzer at above time points.The MTF values among various time points,between different pupil diameters and different spatial frequencies (5,10,15,20,25 c/d) were compared respectively.Results Compared with the preoperation,the visual acuity improved in postoperative 1 day,1 week and 1 month,showing a significant improvement among various time points (F =10.341,P =0.000).Corrected diopter was 3.795 D at average.MTF values under the 3 mm pupil diameter gradually elevated with the lapse of time after operation,without significant differences among different time points whatever total aberration,low and high order aberrations(all at P＞0.05).The MTF values under 6 mm pupil diameter of total aberration and low order aberration were significantly higher in postoperation than those in preoperation(all at P＜0.05),but no significant difference was seen in MTF of high order aberration among various time points (F =0.260,P =0.854).Compared with the MTF under the 3 mm pupil diameter,those of low and high order aberrations under the 6 mm pupil diameter considerably declined in preoperation and postoperative 1 month (preoperation:P =0.050,0.001 ; postoperation:P =0.012,0.001).MTF values under the 3 mm pupil diameter were not different at various spatial frequencies (all at P＞ 0.05).However,MTF values under the 6 mm pupil diameter were gradually increased from preoperation through postoperative 1 month at 10,15,20 and 25 c/d (P =0.044,0.043,0.024,0.014).Conclusions Full femtosecond laser refractive surgery can eliminate low aberration,increase the MTF and acuity,and therefore improve the visual quality.MTF is one of the key indicators assessing visual quality after full femtosecond laser refractive surgery.

The recent development and wide application of ultrasonography and ultrasonography-guided fine needle aspiration biopsy have greatly facilitated the detection of papillary thyroid microcarcinoma (PTMC).Currently, the occurrence, development and pathological features of PTMC are not clearly understood.Therefore, no consensus on the diagnosis and treatment has been reached.Patients with PTMC are suggested to be closely observed and periodically examined with ultrasonography in some countries such as Japan, and these patients are to be operated when the tumor enlarged or new lymphatic metastasis are found.Operation is the first choice in the European and American countries, and the long-term survival rates of these patients are nearly 100％.For the PTMC patients with the risk factors such as thyroid capsule invasion, lymphatic metastasis,multi-focal lesion, higher degree of malignancy, thyroid stimulating hormone suppression therapy was given after operation, which may reduce the local recurrence rate.In China, we should hold well thelimitation and choose the best way for different patients according to the personalized principle in clinical practice.

Objective To analyze clinicopathologic features and treatment strategy of postsurgical incidental papillary thyroid microcarcinoma(PTMC).Methods A total of 305 patients undergoing surgery for thyroid diseases from Apr.2012 to Mar.2013 were retrospectively analyzed.Results Among the 305 patients,19 patients(18 females and 1 male)showed PTMC incidentally after surgery.The mean age was (43.2 ± 12.8)years (ranging from 23 to 67 years old).All patients underwent subtotal thyroidectomy,including 17 endoscopic surgery and 2 open surgery.All frozen sections were benign during operation while pathologic results were PTMC after surgery.The average size of tumors was(2.2 ± 1.5) mm which all was unicentric with no lymph node enlargement intraoperatively.Immunohistochemistry showed that the positive rate of cytokeratin 19,galectin-3,mesothelial cell,and CD56 was 87.5％,43.8％,81.3％ and 18.8％,respectively.There were 4 cases of B-raf V600E mutation found in 6 patients.All patients discharged 1 to 3 days after surgical treatment with no complication and received levothyroxine therapy with a suppressive dose of thyrotropin(TSH).131I therapy was not given.Conclusions PTMC is found more common in female and younger age under 45 years.Tumor is usually unicentric and less than 5 mm.Lymph node metastasis is rare.Immunohistochemistry and B-raf V600E mutant test can help the diagnosis.Initial endoscopic subtotal thyroidectomy is effective.There is no need of further surgery and 131I therapy.

Objective:To summarize the ultrasound features of medullary thyroid cancer (MTC) and analyze its diagnosis value for MTC.Methods:91 patients with medullary thyroid carcinoma (103 nodules) in Department of Thyroid Surgery of the First Affiliated Hospital of Zhengzhou University from Apr. 2013 to Nov. 2018 were retrospectively analyzed, including 36 males and 55 females. Preoperative ultrasound features and serum calcitonin levels were recorded. SPSS 22.0 was used and the measurement data of normal distribution was expressed as ± s, and the enumeration data was described by ratio or rate. The comparison between groups was performed by single factor ANOVA and rank sum test. Results:83.5% (86/103) of the MTC nodules were located in the middle and upper thyroid gland. Hypoechoic accounted for 78.6% (80/103) . 81.6% (84/103) of them had calcification and 74.8% (77/103) of these nodules had abundant blood flow signals (color Doppler flow imaging, CDFI Ⅱ-Ⅲ) . 91.3% (94/103) of them had aspect ratio less than 1, 87.4% (90/103) were solid and 35.0% (36/103) had comet tail sign. The positive rate of preoperative serum calcitonin was 86.8% (79/91) . There were significant differences in shape ( P=0.001) , margin ( P=0.012) , cystic ( P=0.004) , comet-tail ( P<0.001) , lymph node ( P<0.001) and color Doppler flow imaging ( P=0.001) through comparing MTC nodules in different TI-RADS grades. Conclusions:MTC can behave as single, solid, hypoechoic, large round nodule located in the middle or upper thyroid gland, with thick calcification and abundant blood flow signals in ultrasound. The surrounding area may be accompanied with comet tail sign, and the probability of lymph node metastasis is high. The suspicious nodules screened by ultrasound can be further diagnosed by serum calcitonin.

Objective To observe the difference in number of epidermal stem cell and its function between wild-type (WT) mice and the third generation of Terc knockout (G3Terc-/-) mice. Methods Flowcytometry was used to analyse and sort epidermal stem cells;Quantitative real-time PCR is used to analyse the relative expression level of p 21 in epider-mal stem cells;Self-renewal ability was reflected by the number of colonies formed by epidermal stem cells. Results Basal and suprabasal ratios in epidermal stem cells in WT mice were (9.56 ± 1.06)% and (1.22 ± 0.08)% respectively; basal and suprabasal ratios in epidermal stem cell in G3Terc-/-mice were (17.36±3.56)%and (2.92±0.72)%respectively. Relative p21 expression level in G3Terc-/-mice was 6.40 fold to WT mice;Number of colonies formed by WT mice epidermal stem cells were (280.20±29.81) per 104 cell, number of colonies formed by G3Terc-/-mice epidermal stem cells were (29.28±5.24) per 104 cell, which present significant difference to each other(P<0.05). Conclusion Compared to WT mice, epidermal stem cells in G3Terc-/-mice were aging.

Objective To investigate the problem of adverse effects in common AIDS patients and AIDS patients with tuberculosis after highly active antiretroviral therapy (HAART). Methods The case group was composed of 106 patients with both AIDS and tuberculosis. The control group was composed of 134 common AIDS patients. The rates of adverse effects and the increase of CD4 + T cell count in those groups after first year HAART were observed and compared. Results The rates of adverse effects in the case group was 36. 8% ,which was more than that in the control group (26. 9%), but the difference was not significantly different(x2 =2.715, P =0. 099). The count of CD4+ T cell in most of the patients was increased after HAART (P ＜ 0. 01). The increase of CD4 + T cell count in the case group [(147.2 ±137.6)/μl] was higher that in the control group[(142. 1 ± 127. 0)/μl after six months HAART vs. (166. 5±133. 1)/μl in case group], and it was lower than that in control group after nine months HAART [(172.7±107.5)/μl], however the difference was not significant(P ＞0.05). Conclusions HAARTcould reconstruct the immunition of AIDS patients. The increase of CD4 + T cell count did not show significant difference between common AIDS patients and AIDS patients with tuberculosis after HAART. AIDS patients with tuberculosis might not increase the risk of development of adverse effects during HAART.

China is the country possessing the largest amount of trade and consumption of medicinal plants in the world. Research and application of gene engineering on medicinal plants are the one of the most promising ways to increase the productivity and quality of medicinal plants, reduce the resource stress, and enhance the competitive power and sustainable development ability of the medicinal plants industry. In spite of the great progress in research and application of plant gene engineering worldwide, the research of gene transformation has mostly been conducted on some model plants, and the application of transgenic plant has been limited to a few staple and important crop species. For medicinal plants, recently the researches of gene transformation has emerged, however, compared with other crop and economic plants, it is still a very limited amount. On the basis of a general introduction of application of transgenic plants, this paper focuses on the present situation of the research and application of gene engineering on medicinal plants, to put forward the problems in this field, and give a prospect for its development.
Breeding ; Drug-Related Side Effects and Adverse Reactions ; Drugs, Chinese Herbal ; Genetic Engineering ; methods ; Humans ; Plants, Genetically Modified ; Plants, Medicinal ; genetics

Objective To study the related prognostic factors influencing rectal neuroendocrine tumor prognosis.Methods We retrospectively reviewed tumor clinical and pathology material of 183 cases with rectal neuroendocrine in our hospital during recent 10 years and reclassified them according to the 2010 WHO pathology classification.Single factor and multivariate analysis were performed to find related prognostic factors.Results Single factor analysis showed that tumor size (＜ 1 cm,1-2 cm,＞2 cm,98.77％ vs 78.57％ vs 28.57％,x2 =71.4793,P =0.0001),pathological grading (G1,G2,G3,98.73％ vs.76.19％ vs 25.00％,x2 =56.5121,P =0.0001) and the stage (stage Ⅰ,Ⅱ,Ⅲ,Ⅳ period,99.40％ vs 50.00％ vs 60.00％ vs 16.67％,x2 =105.0383,P =0.0001) among the three variables survival difference was statistically significant.Multivariate analysis (Cox regression) indicated that the tumor stage were independent factors affecting the prognosis,regression coefficient was 1.277 (B),Wald value of 28.145,Exp (B) a value of 3.586,95％ CI:2.237-5.747.Conclusion Tumor staging is an independent risk factor of survival,without considering other factors,different tumor size and pathologic grade also have different prognosis.Clinicians in making treatment plan should fully consider the above factors before choosing the appropriate follow-up plan.

Objective To investigate the injury of nonsteroidal anti-inflammatory drug (NSAID) in small intestinal mucosa and the protective role of muscovite.Methods From December 2012 to June 2013,28 healthy volunteers without intestinal mucosal injury showed by capsule endoscopy were selected as objects of this study.Based on computer-generated random number table,the subjects were divided into muscovite group and control group.Subjects of muscovite group orally took muscovite 3 g twice daily,diclofenac 75 mg twice daily and omeprazole 20 mg once a day.The medicine for control group were as same as muscovite group but no muscovite.Patient in both groups took medicines for two weeks.All subjects underwent capsule endoscopy examination after the medication.Before and after the medication,the clinical symptoms of subjects and the changes of small intestinal mucosa under endoscopy were compared.The t-test was performed for comparison between the groups in normally distributed measurement data.For non-normal distributed measurement data,Wilcoxon rank sum test was used for comparison between the groups.Chi-square test or Fisher's exact test was implemented for comparison between the groups of count data.Results There were no differences in the incidences of the injury of the intestinal mucosa,ulceration,petechiae and (or) erythema,mucosal exposure between muscovite group (5/14,4/14,3/14 and 1/14,respectively) and control group (10/14,8/14,7/14 and 3/14,respectively) (all P＞0.05).Both the incidences of intestinal mucosal erosions and lymphangiectasis of muscovite group (4/14 and 1/14) were lower than those of control group (10/14 and 8/14) and the differences were statistically significant (x2 =5.143,Fisher's exact test,both P＜0.05).All the number of injury of the intestinal mucosa,ulceration and erosions of muscovite group (0.00(2.00),0.00(1.00),0.00(1.25),respectively) were lower than those of control group (5.50(17.25),2.00(9.75),3.00(5.00),respectively) and the differences were statistically significant (Z=-2.156,-1.988 and -2.338,all P＜0.05).There was no statistically significant difference in the number of petechiae and (or) erythema between muscovite group and control group (P＞0.05).In muscovite group,the number of grade zero,one,two,three and four intestinal mucosa injury was nine,zero,one,three and one; in control group was four,zero,two,two and six.There was statistically significant difference between the two groups (Z=-2.108,P＜0.05).In muscovite group,the number of mucosa injury in the upper,middle and lower sections of small intestine was 0.00(0.25),0.00(0.25),0.00(0.75),respectively,and there was no significant difference in the distribution of small intestinal mucosa injury in the group (all P＞ 0.05).In control group,the number of mucosa injury in the upper,middle and lower sections of small intestine was 2.00(4.00),0.00(4.25),3.00(9.75),respectively,and there was statistically significant difference in the distribution of small intestinal mucosa injury in the group (x2 =7.189,P＜0.05).The number of small intestinal mucosa injury in the upper and lower sections of control group was more than that of muscovite group and the difference was statistically significant (Z=-2.087 and-2.502,both P＜ 0.05).Conclusion Short-term orally taking NSAID lead to small intestinal mucosal injury and muscovite could reduce NSAID-related small intestinal mucosal injury.

Objective To summarize radiographic manifestations of granulocytic sarcoma (GS),in order to investigate its radio-graphic feature.Methods Nine patients of GS confirmed by surgery pathology and immunohistochemistry were collected.There were four cases underwent CT scan,2 underwent MRI,3 underwent CT and MRI meanwhile.Results There were 4 cases in the lymph nodes,4 cases in the bone,1 case in the enterocoelia.The density of enlarged lymph node was inhomogeneous,and smaller lymph node was homogeneous density,both enhanced obviously.The density or intensity of the lesions occurred in the canalis verteb-ralis and paravertebra was also homogeneous,slightly enhanced,with bone and medulla ossea invasion.Lesions in the enterocoelia was inhomogeneous desity with clear boundary,enhanced inhomogeneously.Conclusion GS is a rare extramedullary malignant tumor composed of immature myeloid cells.CT and MRI can provide a certain diagnostic value.The perplexity in diagnosing such lesions highlighted the need of careful interpretation of all clinacal,radiographic,histopathological and immunochistochemical details as it is one of the most frequently misdiagnosed disorder.