AIM: To analyze the clinical value of femtosecond laser in vitrectomy combined with phacoemulsification and intraocular lens (IOL) implantation.
METHODS: We selected 100 patients ( 102 eyes ) undergoing vitrectomy combined with phacoemulsification and IOL implantation in our hospital from October 31 2013 to October 31 2015. They were divided into routine operation group, 50 cases (52 eyes), and femtosecond laser group, 50 cases (50 eyes). The parameters were compared between the two groups, including total operation time, postoperative complications ( elevated intraocular pressure, uveitis, vitreous hemorrhage, and retinal detachment ), postoperative intraocular pressure and postoperative half of the visual acuity ( near visual acuity, visual acuity, uncorrected visual acuity, corrected visual acuity).
RESULTS: The difference on total operation time of the two groups was statistically significant ( P < 0. 05). The differences between the two groups on postoperative intraocular pressure, uveitis, vitreous hemorrhage, retinal detachment were not statistically significant ( P >0. 05). There were no significant differences on internal pressure, near visual acuity, far visual acuity, uncorrected visual acuity, corrected visual acuity at 6mo after surgery (P>0. 05).
CONCLUSION: Femtosecond laser in vitrectomy combined with phacoemulsification and IOL implantation has a high safety and efficacy with the advantages as accurate, efficient.

Objective To analyze the change and clinical significance of blood lipid and high sensitive-C reactive protein (hs-CRP) in patients with subclinical hypothyroidism.Methods Fifty patients with subclinical hypothyroidism were selected as observation group,and 50 health people with the same gender and age were selected as control group.The blood lipid and hs-CRP levels in the two groups were measured and compared.Results The total cholesterol (TC),triacylglycerol (TG),and low density lipoprotein cholesterol (LDL-C) in observation group were significantly higher than those in control group [(5.20 ±0.84) mmol/L vs.(4.79 ±0.80) mmol/L,(2.21 ±0.97) mmol/L vs.(1.78 ±0.60) mmol/L,(3.25 ±0.65) mmol/L vs.(2.83 ±0.51) mmol/L],high density lipoprotein cholesterol (HDL-C) was significantly lower than that in control group [(1.18 ± 0.15) mmol/L vs.(1.28± 0.22) mmol/L],and there were statistical differences (P ＜ 0.05 or ＜ 0.01).The hs-CPR in observation group was significantly higher than that in control group [(4.2 ± 1.1) mg/L vs.(3.0 ± 0.8) mg/L],and there was statistical difference (P ＜0.01).Conclusions Subclinical hypothyroidism can cause increased TC,TG,LDL-C and hs-CRP and decreased HDL-C,which may accelerate atherosclerosis and cardiovascular disease.It is necessary to timely screen and treat the disease.

Objective To investigate the efficacy and safety of intraarterial or intravenous recombinant tissue plasminogen activator(rtPA) for patients with acute cerebral infarction.Methods 60 patients consistent with the inclusion criteria were divided into intra-arterial thrombolysis group, intravenous thrombolysis group and control group. rtPA of 10～20 mg was infused over the course of 30 minutes in intra-arterial thrombolysis group. rtPA was administered in a dose of 0.7～0.8 mg/kg(maximum dose 50 mg),with 100% as a constant infusion over a period of 90 minutes in intravenous thrombolysis group.24 hours late, both groups were followed by subcutaneous injection of low molecular weight heparin(0.4 ml,twice daily) for 7 days. The control group received only routine treatment. European Stroke Scale(ESS) and Barthel Index(BI) were used to evaluate the recovery of neurological functions.Results The efficacy in both thrombolysis groups was significantly higher than that in the control group(all P 0.05).But in intraarterial group, the stenosis of intracranial arteries or extracranial arteries could be found, and new thrombosis could be prevented by transluminal stent-assistant angioplasty. One case of intracerebral hemorrhage and one case of asymptomatic hemorrhage occurred in intraarterial thrombolysis group. One case of asymptomatic hemorrhage was found in intravenous thrombolysis group and control group respectively. No dead case was found in the three groups.Conclusion Thrombolytic therapy of intra-arterial and intravenous rtPA can be performed safely and efficaciously in patients with acute cerebral infarction within 6 hours from the onset.

Objective To explore the clinical modalities and diagnosis of respiratory failure due to laryngotracheal disorders in children,in order to reduce the misdiagnosis.Methods Fifteen patients(11 cases were male,4 cases were female) with respiratory failure in Intensive Care Unit, Tianjin Children′s Hospital from Jul.2006 to Jul.2009 were selected.Data including history,characteristics and results of spiral computerized tomography(CT) and reconstruction and magnetic resonance imaging(MRI) were reviewed.Results The major clinical manifestations indicated that 7 cases had laryngeal stridor,6 cases had recurrent pneumonia,5 cases had cyanosis after crying,and 12 patients were complicated with respiratory failure in 12 hours.Nine cases were recovered,3 cases were given up,and 3 cases died.All patients were performed with CT about laryngohypopharynx,and the results were cyst of root of tongue in 3 cases,trachea pressed by cyst of parapharyngeal space in 1 case.There were 11 cases examined by spiral CT and reconstruction,in which 6 cases were confirmed as tracheal stenosis,2 cases were left bifid tracheostoma,2 cases were pulmonary artery sling,and 1 case was diagnosed as tracheomalacia.Chest X-ray radiograph indicated that bronchopneumonia in 8 cases,bronchitis in 3 cases and negative in 4 cases.Echocardiograph examination was performed among 11 cases,in which 2 cases were pulmonary artery sling,2 cases were atrial septal defect,1 case was patent ductus arteriosus, and 6 cases were negative.Conclusions There is high morbidity of respiratory failure caused by laryngotracheal disorders in infants,but misdiagnosis ccures usually because of non-specific symptoms.If the infant must depend on mechanic ventilation for a long time and has airway obstruction,he should be examined early by using spiral CT.

Humans ; Hyperthyroidism ; Infant, Newborn

BACKGROUND:Knowledge of retropedtoneal space communications might influence catheter placement,and understanding the normal anatomy of the retroperitoneal space is a prerequisite for predicting the distribution of inflammation or other fluid collections in this region. Until recent years,the media/ attachment of the posterior renal fascia remained controversial. The multiple detector spiral CT can show the abdominal anatomic details. So,using the multiple-detector spiral CT to study the anatomy of posterior renal fascia has clinical significance. OBJECTIVE:To describe the medial attachment of the posterior renal fascia by using multiple-detector spiral CT. DESIGN,TIME AND SETTING:A retrospective case analysis was performed at Department of Radiology,Affiliated Hospital of Weifang Medical College between June 2003 and November 2007. PARTICIPANTS:A total of 52 patients with retropedtoneal inflammatory diseases were retrospectively reviewed through analysis of their CT data. METHODS:Toshiba Akuilion 16-detector spiral CT was employed for scanning. Of the 52 patients,15 were proved by clinical and laboratory findings and 37 were proved by surgery and pathology. Among the 52 patients,17 suffered from appendicitis,1 from ureteritis,2 from abscesses in the perirenal space,3 from abscesses in the posterior pararenal space,and 29 from pancreatltis. MAIN OUTCOME MEASURES:Medial attachment of the bilateral posterior renal fascia. RESULTS:At the level of the upper pole of kidney,the posterior renal fascia fused with the fascia of the ipsilateral quadratus lumborum muscle. Forty-six patients manifested the attachment site of the left posterior renal fascia transforming from the quadratus lumborum muscle fasciae to the psoas major muscle fascia at the level of the lower pole of kidney or the infrarenal space. Fifty patients showed the attachment site of the right posterior renal fascia transforming from the quadratus lumborum muscle fascia to the psoas major muscle fascia at the level of the lower pole of kidney or the infrarenal space. CONCLUSION:The posterior renal fascia attachment site is not the same all the time. At different levels,the attachment site of the posterior renal fascia is distinct.

Objective To evaluate the inhibitory activity of Herba Taraxaci extract on Escherichia coli DH5α (E. coli DH5α) and to investigate proteomic response of E. coli. Methods Medicinal powder of Herba Taraxaci was extracted with the solvents of different polarity ( n-hexane, ethyl acetate, distilled water) , and then the obtained 8 different extracts were subjected to thin layer chromatography ( TLC) analysis. Microdilution method was performed to detect the minimum inhibitory concentration ( MIC) of different extracts and the growth curves were described. The protein expression profiles of E . coli treated with the extracts were analyzed by sodium dodecyl sulfate polyacrylamide gel electropheresis ( SDS-PAGE) and two dimensional electrophoresis (2-DE) . Results Water decoction of Herba Taraxaci could obviously suppress the growth of E. coli with a MIC of 1.95 mg/mL. The different extractions exhibited no antibacterial activity except ethyl acetate phase 3 with a MIC of 0.13 mg/mL, which was equal to 19.23 mg/mL of crude drugs. The results of TLC analysis showed that chlorogenic acid was undetectable in n-hexane extract and ethyl acetate phase 1 extract, and ethyl acetate phase 2 and 3 extracts showed obviously increased spots. The results of SDS-PAGE and 2-DE showed that water decoction of Herba Taraxaci had inhibitory effect on the expression of functional protein. The results of 2-DE showed that after treatment with ethyl acetate phase 3 at the concentration of 2 × MIC for 21 hours, the amount of protein spots were 92 less than those of the blank control group, the spots of E. coli DH5α soluble protein with expression amount down-regulated doubly were 24, and those with expression amount up-regulated doubly were 19. Ethyl acetate phase 3 extract had an effect on down-regulating the protein expression of E. coli DH5α soluble protein pH3-10, and water decoction of Herba Taraxaci had inhibitory effect on E. coli DH5αprotein expression. Conclusion Herba Taraxaci has significant antibacterial activity on E. coli DH5α, and the water-soluble fraction of chlorogenic acid and caffeic acid might be the active components. The possible antibacterial mechanism may be related with the regulation of bacterial protein expression.

Objective To observe the expression of cysteine rich-protein 61 (Cyr61) on renal tubular cells,to explore its effects against hypoxic induced kidney injury and the underlying mechanisms.Methods A stably Cyr61 expressed tubular cell line Cyr61-HK2 was established based on HK2 cells and recombinant Cyr61-lentivirus.BrdU incorporation assay was used for cell proliferation.The apoptosis of cells was analyzed by flow cytometry with Annexin V and propidiumiodide staining.Western bloting was used to detect the protein expression of BAD,Akt and ERK.Results (1) Cyr61-HK2 cells displayed more proliferation ability than HK2 cells.(2) Under hypoxia condition,the apoptosis of both HK2 and Cyr61-HK2 cells increased,but the apoptosis of Cyr61-HK2 cells was lesser than HK2 cells.(3) The expression of Cyr61 led to the phosphorylation of BAD,Akt and ERK on 0 h,0.5 h,1 h (all P ＜ 0.05).Conclusion The expression of Cyr61 can promote cell proliferation and dampen cell apoptosis induced by hypoxia,which may be involved in the Akt/ERK signal pathway.

Objective To investigate experience in nursing the patients with emergency traumatic injury combined with postoperative atelectasis. Method The clinical data of 11 patients with emergency traumatic injury combined with postoperative atelectasis were reviewed for summarizing the nursing experience. Result The clinical symptoms of all the 11 patients disappeared and the lungs reexpanded. Conclusion Careful observation of the disease conditions in order to prevent and treat atelectasis by airway humidification, sputum drainage and early exercises are effective for the cure of postoperative atelectasis.

Objective: To explore the relationship of life events, negative cognitive processing bias (NCPB) and mental health of recruits. Methods: The Life Events Scale (LES), NCPB questionnaire and Military Mental Health Scale (MHS) were used for investigation in 2193 recruits from a certain troop. The SPSS 22.0 software was used to analyze the data. T-test and ANOVA were adopted to explore the influence of demographic factors on the mental health of recruits. Correlation analysis was performed to investigate the relationship of life events and NCPB to the mental health of recruits. The influence of life events and NCPB on the mental health of recruits was investigated by regression analysis. The mediating effect analysis was conducted for in-depth discussing the influence of NCPB in life events on the mental health of recruits. Results: Male and highly educated recruits had significantly higher scores in mental health ability and quality (P<0.01, P<0.05). Scores of life events and NCPB total score and its factors were negatively correlated with the mental health ability and quality of recruits (r=-0.07-0.46, P<0.01), and positively correlated with the mental health status (r=0.08-0.45, P<0.01). The mental health status of recruits was predictable with negative events, negative atention bias and negative rumination bias in an interpretation rate of 24.1%. Path analytic model showed that NCPB mediated the relationship between life events and mental health of recruits. Conclusion: Life events and NCPB are closely related with the mental health of recruits, and NCPB acts as an intermediary between life events and mental health; reduces life events and NCPB is helpful in maintaining and promoting the mental health of recruits.