Abstract?AlM:To compare the effects of different adjustable suture in glaucoma trabeculectomy on early tear film function.?METHODS:Sixty-eight cases of primary glaucoma ( 76 eyes) during January 2012 to June 2014 in our hospital were selected and divided into exposure conjunctival suture group ( 34 cases, 36 eyes ) and embedded conjunctival suture group ( 34 cases, 40 eyes ) according to treatment. Adjustable suture exposed conjunctival suture and embedding conjunctival suture was given to two groups, respectively. lntraocular pressure ( lOP ) before and after treatment 7, 14, 30d were observed and Schirmer test, tear break-up time, No Hikaru sensitivity and the occurrence of adverse reactions after treatment 1, 30d were recorded.?RESULTS: After the treatment, the mean lOP of two groups were decreased significantly ( P < 0. 05 ). The average lOP after treatment of 1d in the two groups were not statistically different (P>0. 05), after treatment 7, 14, 30d embedded conjunctival suture group was significantly higher than that of exposure conjunctival suture group ( P<0. 05). After 1d of treatment, Schirmer test, tear break-up time, No Hikaru sensitivity of two groups compared no significant difference (P<0. 05). After treatment 7, 14, 30d embedded conjunctival suture group Schirmer test, tear break- up time, was significantly superior to expose conjunctiva suture group (P<0. 05). The 30d package after treatment of conjunctival suture group buried adverse reaction rate was significantly lower than that of exposed conjunctival suture group (P<0. 05).? CONCLUSlON: Trabeculectomy operation with adjustable thread embedding conjunctival suture has few effects on the tear film function in patients with early postoperative complications, lower, and operation effect is better than that of exposed conjunctival suture.

Objective To describe the effect of loop diuretic on renal function in patients with chronic heart failure.Methods Data were of 211 impatients diagnosed as HF collected in a nested case-control study.The association of application of loop diuretic with renal function was assessed to identify whether loop diuretic was an independent risk factor of worsening renal function(WRF).To identify WRF,we defined serum creatinine level as a rise ≥26.5 μmol/L compared to the level at admission.Therefore,the subjects were divided into case group(serum creatinine level ≥ 26.5 μmol/L,n =66)and control group(serum creatinine level ＜ 26.5μmol/L,n =145).Results The doses of loop diuretic were higher in the case group([385.17 ± 49.37]mg)than the control group([244.50 ± 34.82]ag)(P ＜ 0.05),but it was not independent risk factor of WRF (P＞0.05).Creatinine level and NYHA class at admission were independent risk factor for WRF,with OR of 2.248(95 ％ CI:1.088-4.647)and 2.485(95 ％ CI:1.385-4.459)respectively(Ps ＜ 0.05).Conclusion The doses ofloop diuretic were not independent risk factor of WRF,creatinine level and severity of HF at admission are the most important predictors of the occurrence of WRF.

BACKGROUND: Hydroxyapatite/chitosan (HA/CS) complex may act as a drug carrier for drug release, but little is reported about the release amount and antibacterial effect of minocycline-HA/CS (Mino-HA/CS) complex. OBJECTIVE: To investigate the in vitro release and antibacterial property of Mino-HA/CS complex. METHODS: HA/CS and Mino-HA/CS were prepared using co-precipitation method. The surface and cross-section features of the complexes were observed under scanning electron microscopy. The porosities were measured according to Archimedes Principle. The release of minocycline hydrochloride was measured by high performance liquid chromatography with the simulated saliva as drug release media. In vitro antibacterial effect on Porphyromonas gingivalis and Staphylococcus aureus were measured by bacteria-inhibiting ring method. Biological toxicities were evaluated via cel counting kit-8cel proliferation assay. RESULTS AND CONCLUSION: The porosity of Mino-HA/CS was larger than that of HA/CS, with the average porosity of 53.99%. Single-day release amount of Mino-HA/CS could maintain at the level of 0.5-1 μg per day for a long-term. Bacteriostatic rings of Porphyromonas gingivalis and Staphylococcus aureus stil existed clearly after 7 days. Cel proliferation assays showed that Mino-HA/CS extract had the significant effect on promoting cel proliferation. These findings indicate that the Mino-HA/CS sustains the release of minocycline at a relatively stable level within a longer period, shows good inhibitory effect on Porphyromonas gingivalis and Staphylococcus aureus and promotes the proliferation of periodontal ligament cel s.

BackgroundEndostatin (ES) is currently the strongest endogenous angiognesis inhibitor,and it can inhibit the occurrence of neovascularization.Various studies demonstrated that the poly RGD sequence can enhance the function of the ES gene.ObjectiveThis study was to evaluate the use of gene therapy of modified ES for alkaline burn-induced corneal neovascularization (CNV).MethodsOne hundred and two clean SD rats were randomly divided into the normal control group,the pCI empty vector group,the pCI-ES group,and the pCI-RGDRGDES group.Corneal neovascularization models were established by placing a piece of 3 mm filter paper with 1 mol/L NaOH at the central cornea for 40 seconds.3 μg of the pCI blank vector,ES-tranfected pCI blank vector,or RGDRGD-ES-transfected pCI vector was injected into the superior bulbar conjunctiva after the alkali burn twice at 1-week intervals.Area of CNV and edema of the cornea in the various groups of rats were examined daily under the slit lamp biomicroscope.1,4,7 and 14 days after operation,the rats were sacrificed by the excessive anesthesia method and corneal tissues were obtained to evaluate pathological changes.The expression of CD34 in vascular endothelial cells was detected by immunochemistry to calculate the corneal neovascular density.The expressions of VEGF mRNA and Flk-1 protein in the corneas were detected by reverse transcription polymerase chain reaction (RT-PCR) and Western blot analysis.The use and maintenance of animals followed the Statement of ARVO.Results Seven to fourteen days after corneal alkali-burning,the corneal neovascular area was smaller in the pCI-ES group and pCI-RGDRGD-ES group compared with the normal control group and pCI blank vector group (P＜0.05,P＜0.01 ),and nevascular area in the pCI-RGDRGD-ES group was smaller than that in the pCI-ES group (P＜0.05).The expression level of CD34 was significantly lower in the pCI-ES group and pCI-RGDRGD-ES group than that in the normal control group and pCI blank vector group (P＜0.05,P＜0.01 ),and the expression level of CD34 was further declined in the pCI-RGDRGD-ES group compared with the pCI-ES group (P＜0.05 ).Compared with the normal control group and pCI vector group,the expressions of the Flk-1 protein and VEGF mRNA were decreased in the pCI-ES group and pCI-RGDRGD-ES group on the fourth day after corneal alkali-burning (P＜0.01,P＜0.05 ),and those in the pCI-RGDRGD-ES group were less than the pCI-ES group (P＜ 0.05,P＜ 0.05 ).Conclusions Subconjunctival injection of both ES and modified RGDRGD-ES genes result in significant suppression of CNV in vivo,and modified RGDRGD-ES appears to be more effective than native ES.The main mechanism of ES in inhibiting neovascularization is to downregulate the expression of VEGF and Flk-1.

Objective To explore the diagnostic value of morphology in patients with blastic plasmacytoid dendritic cell leukemiafrom bone marrow cell.Methods Clinical data of 5 patients with BPDCN leukemia in Peking Union Medical College Hospital from 2011 to 2016were collected.The morphological characteristics of the cell size,nuclei,chromatin and cytoplasm of the BPDCNtumor cells in the bone marrow smears were observed under the microscope.Results The clinical manifestation of the 5 cases involved skin lesions (5/5,100％),lymphadenopathy (4/5,80％),hepatomegaly (3/5,60％),splenomegaly (4/5,80％).Immunophenotype showed all cases were positive for CD4,CD56 and CD123.The morphologiesof BPDCN cell characterized by heterogenous clls,were frequent,including,frequent mediumsized cells with a round or irregular nucleus,lacy chromatin,basophilic cytoplasm with lack of granules,marked large pseudopodia and vacuolation which may arranged as pearl necklace along the cytoplasmic outline.They might mimicking pseudomonoblast,Pseudolymphoblast or Pseudolymphoma cell.Conclusions Plasmacytoid dendritic cells had some peculiar morphological features,the patients suffered from the clinical manifestation of skin lesion may highly suggested the diagnosis of BPDCN,Flow cytometry and pathological biopsy are necessary for the final diagnosis of BPDCN.

OBJECTIVETo investigate the comparison method on internal control of hematology analyzer by using fresh blood.

METHODSThe hematology analyzer with well function was selected as the reference analyzer, fresh blood samples from healthy subjects were measured by reference analyzer and the values were used to calibrate compared hematology analyzers. The acceptable limits of relative deviation of WBC,RBC, HGB,HCT, PLT were established by comparative experiments during three months. The results of fresh blood samples from patients with low/medium/high levels measured by compared analyzer were compared with those from reference analyzer, the relative deviation of WBC, RBC, HGB, HCT, PLT was calculated respectively. The internal quality control charts in laboratory information system were established, with date as x-axis, relative deviation as y-axis. The acceptable relative deviation limits were set to be +/-2 s, and to be used for laboratory quality control.

RESULTThe relative deviation of WBC, RBC, HGB, HCT, PLT with high, medium, low levels were(0.75+/-2.964)%, (1.19+/-2.488)%,(1.43+/-2.439)%; (-0.39+/-1.327)%, (-0.26+/-1.297)%, (-0.35+/-1.095)%û(-0.43+/-1.393)%, (-0.17+/-1.139)%, (0.24+/-1.166)%û(-.43+/-1.362)%, (-0.36+/-1.381)%, (-0.57+/-1.299)%û(-0.93+/-4.330)%,(0.04+/-4.118)%, (-0.41+/-4.149)%, respectively in 2006. As the second instrument, the compared analyzer was involved in College of American Pathologists Proficiency Testing with satisfactory results, the bias of WBC,RBC, HGB, HCT, PLT were within (-0.5 approximately 5.1)%, (-1.0 approximately 1.6)%, (-1.7 approximately 1.4)%, (-1.5 approximately 1.3)%, (-4.5 approximately 7.4)%, respectively.

CONCLUSIONThe quality control on compared hematology analyzer can be effectively, conveniently and economically performed using this method.

Autoanalysis ; methods ; Blood ; Erythrocyte Count ; instrumentation ; Hematology ; instrumentation ; methods ; standards ; Hemoglobins ; analysis ; Humans ; Leukocyte Count ; instrumentation ; Platelet Count ; instrumentation ; Quality Control ; Reference Standards ; Weights and Measures

OBJECTIVETo explore the clinical characteristics and risk factors of refracture in patients suffering from osteoporosis-related fractures as well as effective interventions.

METHODSFrom January 2006 to January 2008, both out-patients and in-patients in our hospital who were over 50 years old and suffered from osteoporosis-related fractures were selected for this research. They were divided into fracture group and refracture group. The refracture rate was followed up for 2 years, during which 11 patients developed refracture, thus were included in the refracture group. Therefore, 273 patients, 225 first-fracture cases, aged (67.7+/-8.5) years, and 48 refracture cases, aged (72.7+/-9.5) years, were included in this study. General data including age and sex, fracture types, femoral neck bone mineral density (BMD) T-scores tested by dual-energy X-rays absorptiometry (DEXA), Charlson index, time-frame between two fractures as well as mobility skill assessment were collected and analyzed by single-factor and multivariate statistical methods.

RESULTSFemales accounted for 70.2% of the fracture group and 77.1% of the refracture group. The most common refracture type was vertebral fracture for the first time and femoral neck fracture for the second time during the follow-up. The second fracture happened 3.7 years after the first one on average. The refracture rate was 2.12% within one year, and 4.66% within two years. Risk factors for a second fracture in osteoporotic fracture patients included age (larger than 75 years, HR equal to 1.23, 95%CI 1.18-1.29; larger than 85 years, HR equal to 1.68, 95% CI 1.60-1.76), female sex (HR equal to 1.36, 95%CI 1.32-1.40), prior vertebral fractures (HR equal to 1.62, 95%CI 1.01-2.07), prior hip fractures (HR equal to 1.27, 95%CI 0.89-2.42), BMD T-score less than -3.5 (HR equal to 1.38, 95%CI 1.17-1.72) and weakened motor skills (HR equal to 1.27, 95%CI 1.09-1.40).

CONCLUSIONSThe risks of second fracture among patients with initial brittle fracture are substantial. There is adequate time between the first and second fractures for interventions to reduce the risks of refracture, especially for the old women with a vertebral or hip fracture. Medication, motor functional rehabilitation and fall-down prevention training are helpful.

Age Factors ; Aged ; Aged, 80 and over ; Bone Density ; Female ; Humans ; Male ; Middle Aged ; Motor Skills ; Multivariate Analysis ; Osteoporotic Fractures ; etiology ; Risk Factors

The Tibetan antelope, a prototype mammal, has developed a unique adaptation to extreme high altitude-associated hypoxia. To investigate the role of the endocrine system in adaptation to high altitude in the Tibetan antelope, comparisons of endocrine hormones levels between Tibetan antelope (n = 9) and Tibetan sheep (n = 10) were performed. Both two kinds of animals were captured at an altitude of 4 300 m and then transported to experimental base at 2 800 m altitude. The blood samples were drawn from right external jugular vein in the next morning, and the 20 hormones in hypothalamus-adenohypophysis-peripheral hormonal axis were measured with radioimmunoassay or enzyme-linked immunosorbent assay. Heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP) and mean pulmonary arterial pressure (mPAP) were recorded using catheterization. Moreover, hemoglobin (Hb) content was measured by blood analyser. The results showed that, the levels of FT(3), FT(4) and Ang II in Tibetan antelope were significantly lower than those in Tibetan sheep, whereas TRH, CRH, GHRH, F, E(2), Ald, ACTH and CGRP levels were significantly greater in Tibetan antelope than those in the Tibetan sheep. Compared with Tibetan sheep, Tibetan antelope showed lower HR, mPAP, SBP, DBP and Hb content. In Tibetan antelope and Tibetan sheep, both Hb and Ang II were correlated positively with respective mPAP. In Tibetan antelope, FT(3) level was correlated positively with GH and negatively with ACTH. These results suggest that the endocrine system of Tibetan antelope is characterized by low energy expenditure and high stress, which may be one of the mechanisms underlying the Tibetan antelope adaptation to chronic hypoxia.
Adaptation, Physiological ; physiology ; Altitude ; Animals ; Antelopes ; blood ; Hormones ; blood ; Hypothalamo-Hypophyseal System ; metabolism ; physiology ; Male ; Sheep ; blood ; Tibet

OBJECTIVETo measure the effect of laser fluence and scanning velocity on ablation efficiency of enamel and dentin.

METHODSTwo extracted human incisors and two molars were cut transversely along the axial plane with a diamond saw to obtain dentin and enamel slices with thickness of about 1 mm. Samples were fixed on a motorized translation stage, the linear reciprocating movement in the plane perpendicular to the direction of laser incident was programmed by the controller, and the laser focused on the tooth surface, then 36 ablation lines on enamel and 48 ablation lines on dentin were produced. A femtosecond laser system with wavelength of 800 nm, pulse width 30 fs, repetition frequency 1000 Hz was used, and the diameter of the focused spot was approximately 25 µm. A group of different fluence (1.33, 1.77, 2.21, 4.42, 8.85, 17.69 J/cm(2) for enamel and 0.44, 0.66, 0.88, 1.33, 1.77, 2.21, 4.42, 6.63 J/cm(2) for dentin) and two scanning velocity (10 mm/s and 20 mm/s) were tested. Confocal laser scanning microscope was used to measure the ablation volume.Ablation efficiency for enamel and dentin was then calculated.

RESULTSUnder the fluence of 8.85 J/cm(2) there was the highest ablation efficiency for enamel, 18.703×10(-3) mm(3)/J (20 mm/s), and the highest ablation efficiency for dentin was found under the fluence of 2.21 J/cm(2), ie.223.458×10(-3) mm(3)/J (20 mm/s).

CONCLUSIONSFluence and scanning speed of this femtosecond laser can affect ablation efficiency for both enamel and dentin, and this suggests that with appropriate choice of fluence and scanning speed we can improve the ablation efficiency for enamel and dentin.

Dental Enamel ; radiation effects ; Dentin ; radiation effects ; Humans ; Incisor ; anatomy & histology ; Lasers ; Molar ; anatomy & histology

OBJECTIVETo study the clinical characteristics and outcomes of the hereditary medullary thyroid carcinoma (HMTC) and the sporadic medullary thyroid carcinoma (SMTC).

METHODSThe clinical data of 78 patients with medullary thyroid carcinoma who underwent surgery in our hospital between July 1980 and May 2011 were retrospectively analyzed.

RESULTSOf these 78 patients, there were 23 HMTC cases and 55 SMTC cases. The HMTC group was significantly younger age of onset [(36.4±13.5) years vs. (46.6±11.2) years, P<0.01] and a lower pre/post-operative serum calcitonin levels [(850.4±110.20) ng/L vs. (1450.4±118.3) ng/L, P<0.01 and (410.8±133.2) ng/L vs. (1585.4±129.5) ng/L, P<0.01] than the SMTC group. In addition, the mean tumor diameter was also significantly smaller in the HMTC group (14.3 mm vs. 21.0 mm in SMTC group, P<0.05). Tumor multifocality was seen in a significantly higher proportion of HMTC cases compared with the SMTC cases (56.6% vs. 29.1%, P<0.05). The overall 10-year survival was 100% in HMTC group and 80.2% in SMTC group (P<0.05).

CONCLUSIONHMTC has a better prognosis than SMTC.

Adolescent ; Adult ; Age of Onset ; Aged ; Carcinoma, Medullary ; classification ; genetics ; pathology ; Carcinoma, Neuroendocrine ; Female ; Genetic Diseases, Inborn ; pathology ; Humans ; Male ; Middle Aged ; Prognosis ; Retrospective Studies ; Survival Rate ; Thyroid Neoplasms ; classification ; genetics ; pathology ; Young Adult