? AIM: To investigate the efficacy and safety of phacoemulsification combined with intraocular lens implantation in the treatment of shallow anterior chamber with cataract.?METHODS: Retrospective case series. From February 2014 to July 2015 in our hospital,65 eyes in 65 patients with cataract were enrolled and divided into mild and high risk of shallow anterior chamber group. Best-corrected visual acuity ( BCVA ) , intraocular pressure ( IOP ) , central anterior chamber dept ( CACD ) , angle opening distance ( AOD ) , complications pre- and post treatment, were observed and analyzed as outcome measures.?RESULTS: In this study, the mild shallow anterior chamber group included 34 eyes; postoperative BCVA were improved in 29 eyes, with 4 eyes remaining stable and decreased in 1 eye; BCVA was improved in 16 eyes, with 10 eyes remaining stable and decreased in 5 eyes in high risk of shallow anterior chamber group postoperatively. BCVA had a better prognosis in the mild shallow anterior chamber group than another group ( t=-2. 956, P<0. 05). Meanwhile, IOP decreased by 5. 71± 2. 07mmHg and CACD increased by 1. 37 ± 0. 38mm in the mild shallow anterior chamber group, by 9. 77±4. 04mmHg and 1. 67±0. 43mm respectively in high risk group, and the difference has statistical significance ( t=-5. 02,-3. 04; P<0. 05). The mean preoperative nasal AOD500 was 200. 57± 33. 74μm, and they were 346. 62 ± 101. 37μm and 410. 75 ± 137. 48μm and 398. 69 ± 122. 28μm respectively at postoperative 1d, 1 and 3mo, and all nAOD500 comparing with preoperative were increased obviously, and the difference has statistical significance (F=203. 75, P<0. 01). And AOD500 at temporal, superior and inferior presented similar trends. Complications were corneal edema ( 5 eyes ) , transient intraocular hypertension ( 2 eyes ) , posterior capsular opacification ( 4 eyes ) , and posterior capsular rupture (1 eye).?CONCLUSION:Micro incision cataract surgery is useful, effective and safe in patients with cataract and shallow anterior chamber which can stabilize or improve BCVA, reduce IOP, deepen CACD and open the anterior chamber angle.

Objeetive To investigate the expression of claudin-4 in the eutopic and ectopic endometfium of women with endometriosis and evaluate the role of clandin-4 in the pathogenesis of endometriosis.Methods Thiny-five women with endometriosis and 35 controls were studied.Expression of elaudin-4 was investigated using immunohistochemistry,western blot and RT.PCR,respectively.Morphologic change of tight junction was also observed in different kinds of endometria.Results (1)G1andular epithelial cells of control endometrium and eutopic endometrium showed intact tight iunctions in electron micrographs,whereas the morphology of tight junctions in ovarian endometriotic tissue was disrupted and collagen bundles could be easily detected.(2)The immunohistochemical staining of claudin-4 was localized to the glandular epithelial cell membrane.Deftcient or weak staining Wag found in ovarian endometriotic tissues. In control endometrium.eutopic and ectopic endometrium of women with endometriosis,the expression of clandin-4 protein Was 89±24.84±22 and 27±14.respectively.Relative expression of claudin-4 mRNA Was 14.5±6.8,13.8±9.5 and 2.6±2.5.respectively.Expression of claudin-4 Was significantly lower in the ectopic endometriotic tissue than in the eutopic cndometrium and the control at both mRNA and protein levels(P<0.05). N0 significant difference Was foand between eutopic endometrium from women with endometriosis and control endometrium from women without endometriosis (P>0.05).Conclusion Down-regulated expression of claudin-4 might play a pathogenic role in the formation of endometriosis.

AIM:To investigate the expressions of methylthioadenosine phosphorylase(MTAP)and ornithine decarboxylase(ODC)in human ovarian cancer.METHODS:60 fresh samples of ovarian cancer were collected.The expressions of MTAP mRNA and protein were analyzed by using RT-PCR and Western blotting,respectively.ODC activity was measured by high performance liquid chromatography.RESULTS:The expression levels of MTAP mRNA and protein in ovarian cancer were lower than those of control.In 9 of the 60 samples(15%)there were absence of detectable MTAP mRNA and protein.No significant relevance was found between the expression of MTAP and clinical pathologic features.ODC activity in ovarian cancer was(3.82?1.03)U,which was higher than that of normal ovarian tissues(1.38?0.59)U.ODC activity was related with tumor grade.In MTAP-deficiency ovarian cancer tissues ODC activity was significantly increased when compared with that of MTAP-expressing ovarian cancer samples.CONCLUSION:Down-regulated MTAP expression and up-regulated ODC activity really exist in ovarian cancer.Activation of ODC resulting from MTAP deletion may be one of the pathogenetic factors of ovarian cancer.

[ ABSTRACT ] AIM: To investigate the toxicity and reproductive effect of vascular endothelial growth factor ( VEGF)/basic fibroblast growth factor ( bFGF) complex peptide vaccine ( VBP3) on the female-mice.METHODS:The VBP3 was purified with Ni-NTA affinity chromatography.The female BALB/c mice were immunized with the purified VBP3.The antibody titer in the serum was detected by ELISA.The data of the body weight and the organ weight of the par-ent mice were gathered and analyzed, and the pathological changes of the organs were observed with HE staining to investi-gate the toxicity of VBP3.To investigate the toxicity of VBP3 in the F1 mice, the parent immunized female mice were ma-ted with the parent non-immunized male mice.After the F1 mice were born, the survival rate was calculated, the change of the body weight and the organ weight of the F1 mice were also determined.The pathological changes of the organs in F1 mice were also observed with HE staining.RESULTS: In the parent mice, high titers of the antibodies were detected against VEGF and bFGF, and no difference of the body weight, the organ weight and the pathological change between the immunized mice and control mice was found.In the F1 mice, a low titer of anti-bFGF antibody was detected compared with blank group.The survival rate in control group was higher than that in immunized group.In the 2 groups of the F1 mice, no obvious difference of the weight of the spleen, kidney, lung and heart was observed, and there was some difference in the weight of liver between the 2 groups.The results of the HE staining in the F1 mice showed some difference in the liver between the 2 groups.CONCLUSION:VEGF/bFGF complex peptide vaccine has no obvious organ toxicity in the parent female mice, but has some side effects on the reproductive and the healthy processes of F1 mice.

Objective To describe a technique of closed reduction and percutaneous internal fixation for the treatment of displaced patellar fractures and evaluate the clinical results. Methods Fifteen cases (nine males and six females with mean age of 35.5 years, ranging from 24 to 65 years) with displaced patellar fractures were treated with closed reduction (or an arthroscopic-assisted reduction) and percutaneous cannulated screw fixation (or Kirschner wire tension band wiring technique) under guidance of fluoroscopy or C-arm X-ray tomography. Controlled passive range of motion exercises started on the first postoperative day. The mean follow-up was 28 months (24-35 months). Results All cases healed successfully with healing time of (1.2?2.2) months and mean Lysholm II score of 86.8 (79-96), except for one patient regained full knee range of motion. Compared with the contralateral side, a mean quadriceps atrophy of 0.8 cm was seen in unilateral cases based on Tandogan measurement. There was no implant failure or postoperative infection. Conclusions The technique of closed reduction and percutaneous internal fixation is appropriate for displaced, transverse, longitudinal or oblique patellar fractures and can facilitate early postoperative range of motion exercises and accelerate rehabilitation of the affected knee with few complications and minor incision without disturbing blood supply of the patella. But, this method is not suitable for severely comminuted fractures.

Objective To investigate the possibility,surgical methods,outcome and surgical indications of minimal invasion dynamic hip plate (MIDHP) through percutaneous limited open reduction in treatment of subtrochanteric femur fractures.Methods All cases underwent percutaneous limited open reduction with MIDHP.Duration of operation,intraoperative bleeding volume,length of incision,incidence of intra-or post-operative complications of all case were recorded.X-ray films were reviewed periodically after operation to analyze aspects of fracture displacement,loosening of intemal fixation,screw cutting femoral neck,screw penetrating out of or withdrawing from femoral head,bending or breaking of internal fixation,and fracture healing.Hip joint function was evaluated according to Huang' s criteria.Results Operation lasted for 45-55 minutes (average 50 minutes),showing the incision length of 4.0-5.0 cm (average 4.5 cm) and blood loss of 50-200 ml (average 150 ml).A total of 21 cases were enrolled in the study and were followed up for 6-28 months (average 18 months).In the follow-up,loosening or bending of internal fixation,fracture displacement,screw cut-out,and screw penetrating or withdrawing from femoral head did not occur.In the meantime,incision,bone,and joint were not infected.All cases had bony fusion within 3 months with the fracture healing rate of 100％.According to Huang' s criteria,hip function was excellent in 19 cases and good in two.Conclusions MIDHP with percutaneous limited open reduction is characterized by less trauma,small incision,less blood loss,less postoperative complications,firm fixation,early functional exercise,free load,and good hip functional recovery and hence is suitable for cases of different subtrochanteric femur fractures,especially for cases combined with osteoporosis.

Objective To perform a mechanical test of fresh cadaver specimens and compare the biomechanical properties of the novel minimal invasion dynamic hip plate (MIDHP) and the dynamic condylar screw (DCS) in treatment of subtrochanteric fractures of the femur.Methods All specimens were firstly used to simulate models of Seinsheimer type ⅡA subtrochanteric fractures of the femur,which were later divided into DCS group and MIDHP group.Based on experimental requirements,the femoral head and distal femur were embedded using seff-freezing type dental base acrylic resin powder.Torsion strength test was given in the first place,succeeded by compression strength test.Finally,destructive test was made to record the limit load.All experimental data were analyzed statistically.Results Torsion strength test showed that specimens of both groups were basically stable as the reverse was within 3°.Torque for specimens in DCS and MIDHP groups was (3.16 ± 0.13) N · m and (3.31 ± 0.27) N · m respectively as the reverse was 1.5°.Both torque and torsion stiffness had no statistical significance between the two groups,and the anti-rotation features of the two internal fixations were similar.Compression strength test showed that compression stiffness of specimens in DCS group was (532.27 ±61.02) N/mm and (581.98 ±77.56) N/mm in MIDHP group at a load of 800 N,with evidently higher compression displacement and stiffness in MIDHP group (P ＜ 0.05).Destructive test showed the maximum load of specimens in DCS and MIDHP groups was (2 994.38 ±244.81) N and (3 322.13 ± 141.21) N respectively,far higher in MIDHP group (P ＜ 0.01).Conclusions MIDHP is characterized by reasonable design,strong anti-rotation property and anti-compression property over DCS.In comparison with DCS,MIDHP has biomechanical advantage in treatment of femoral subtrochanteric fractures,for it can be performed minimally invasive and is worthy of further application.

AIM:To explore the effect of Delta-like ligand 4 (Dll4)-Notch signaling pathway blockade on the development of Thelper 17(Th17) cells in the asthmatic mice.METHODS:Male BALB/c mice were randomly divided into 5 groups:control group, asthma group, normal saline group, anti-Dll4 antibody group, and immunoglobulin G group.The protein expression of Dll4 was detected by immunohistochemical staining.The proportion of Th17 cells in mouse spleen isolated CD4+ T cells was measured by flow cytometry.The protein expression of Th17 transcription factor retinoid-related orphan receptor γt (RORγt) was determined by Western blot.The serum level of interleukin (IL)-17 was measured by enzyme-linked immunosorbent assay (ELISA).RESULTS:The expression of Dll4 in the lung tissues from asthma group significantly increased as compared with anti-Dll4 antibody group.The proportion of Th17 cells in CD4+ T cells was significantly down-regulated, and the protein expression of RORγt in the lung tissues was significantly reduced in anti-Dll4 antibody group compared with asthma group (P<0.05).Moreover, the serum level of IL-17 in anti-Dll4 antibody group was significantly reduced compared with asthma group (P<0.01).CONCLUSION:The blockade of Dll4-Notch signaling pathway inhibits the differentiation of Th17 cells in asthmatic mice.

Objective The stress reaction in double-balloon enteroscopy was investigated,the influencing factors and intervention countermeasures were studied.Methods Cardiovascular effects and physiological reactions of 60 double-balloon enteroscopy patients were surveyed.The patients were divided into 2 groups according to the cardiovascular effects to underwent single factor analysis of related factors.Results The incidence of physiological reactions was 68.3%,the incidence of cardiovascular reactions was 56.7%.Evident difference existed in blood pressure,heart rate and blood oxygen saturation rate before,during and after examination.The grouping analysis showed cardiovascular effects were influenced by many kinds of factors.Conclusions Different degrees of the stress reactions in double-balloon enteroscopy might appear.The influencing factors included the enteroscopy mode and time,gender,age,mood,and physician operation experience.The stress reactions might be reduced by taking the corresponding intervention measures according to the influencing factors.

Objective To explore the clinical manifestations,imaging findings,pathological classification and treatment of congenital cystic adenomatoid malformation (CCAM)of the lung.Methods The clinical features,imaging findings,pathology information,diagnosis,treatment method and its prognosis of children with CCAMconfirmed by ope-ration and pathology were retrospectively analyzed in Yuying Children′s Hospital Affiliated to Wenzhou Medical Univer-sity from August 2006 to August 201 4.Results Eleven patients were boys and 4 patients were girls.One case had a-symptomatic clinical features,1 2 cases had pulmonary infection,1 case had recurrent chest pain,and 1 case had de-pressed deformity in sternum inferior segment.Chest CT scanning indicated that 9 cases had multiple gas cysts at unila-teral side of lung,among which 1 case was of funnel chest and pulmonary sequestration,1 case of huge cyst containing air and fluid at inferior lobe of left lung,and 4 cases of high density lung shadow;CT examination indicated that 1 case had recurrent chest pain and eventration of diaphragm of the right side combined with pulmonary sequestration.All ca-ses were treated by surgical resection,of whom 1 case was given cystectomy and sequestrectomy,diaphragmatic plication respectively,1 case complicated with funnel chest disease underwent lesion pulmonary lobectomy,sequestrectomy and minimally invasive corrective surgery in pectus excavatum (Nuss surgery),and the remaining 1 2 cases received lesion pulmonary lobectomy.All of 1 5 cases recovered well without complications.Pathological classification type of CCAMin-cluded 1 1 cases of type Ⅰ,3 cases of type Ⅱ and 1 case of type Ⅲ,among which 2 cases had pulmonary sequestration. Conclusions CCAMis a rare disease which can be discovered along with pulmonary infection.Multiple gas cysts are the most common imaging findings and the preoperative diagnosis of CCAM is mostly based on chest CT examination. Type Ⅰ and type Ⅱ are the most common pathological classification.The surgical resection should be given early surgi-cal resection and the prognosis is usually good.