Objective To evaluate the effectiveness of orthokeratology (Ortho-k) in treatment of myopia. Method Using Better Vision Contact lenses to treat 98 patients with myopia(192 eyes). The visual, the diopter of myopia and the corneal curvature were observed.Results Three monthes after treatment the myopia degree was reduced by-5 75D,astigmatism with rale was decreased by-2 75D,respectively,96 47% of low myopia (≤-3 00D),64 49% moderate-high myopia (-3 00D～-7 25D) were recovered to emmetropia. A positive correlation was found between the spherical equivalent and the corneal curvature (?=0 993,P

Objective To study the changes rule of serum procalcitonin (PCT) and PCT clearance rate (PCTc) in patients with severe craniocerebral injury complicated with pulmonary infection and analyze the values of PCT and PCTc in the patients' therapeutic effect and prognosis.Methods A retrospective controlled analysis was conducted, the clinical data of 58 patients with severe craniocerebral injury complicated with pulmonary infection admitted into the Department of Neurology of the Forth Hospital of Tianjin from December 2012 to December 2016 were collected, and within 24 hours after definite diagnosis (before treatment) and after treatment for 1, 3, 7 days, the levels of PCT and percentages of PCTc were measured by rapid semi quantitative method. According to the therapeutic results of treatments, including antibiotics, airway management, nutritional support, etc., the patients were divided into an effective group and a deteriorative group. The changes rule of levels of serum PCT and percentages of PCTc before treatment and 1, 3, 7 days after treatment were dynamically evaluated. The receiver operating characteristic curve (ROC curve) was drawn and the area under the ROC curve (AUC) was calculated, and the sensitivity, specificity and diagnostic accordance rate of the combined treatment were assessed.Results Of 58 cases 32 (55.2%) after active treatment had promising therapeutic results or better prognosis (effective group), and the disease situations in 26 patients (44.8%) were deteriorating(deteriorative group). With prolonged treatment in effective group, the serum level of PCT was decreased gradually, while the deteriorative group showed a tendency firstly decreased and then increased, reaching to the valley on the 1st day after treatment, on the 3rd day beginning to increase and reaching the peak on the 7th day; the levels of PCT in effective group were significantly lower than those in deteriorative group at each time point after treatment on 1, 3, 7 days (μg/L: 1 day was 2.67±0.77 vs. 3.24±0.90, 3 days was 1.38±0.63 vs. 3.31±0.85, 7 days was 0.61±0.16 vs. 3.82±1.05, allP < 0.05); The PCTc rates in the effective group were significantly higher than those in the deteriorative group at each time point on 1, 3 and 7 d [1 day was (17.53±9.94)% vs. (12.31±7.55)%, 3 days was (60.34±13.55)% vs. (8.31±4.69)%, 7 days was (82.47±15.11)% vs. (-5.82±9.60)%, allP < 0.05]. After treatment for 3 days, 7 days, the AUC of PCT were 0.532 and 0.688, and the diagnosis cut-off values were 2.42 and 1.86 respectively; on 1, 3, 7 days after treatment, the AUC of PCTc were 0.529, 0.547, 0.775, and the diagnostic cut-off values were 15.67, 35.94 and 70.55 respectively. Further the final outcome was recognized as the gold standard: after treatment for 7 days, the PCT sensitivity was 80.1%, specificity 75%, the coincidence rate 77.6%; 7 days after treatment, the sensitivity of PCTc was 92.3%, the specificity 87.5%, the coincidencerate 89.7%.Conclusion The dynamic observations on serum PCT and PCTc have relatively good evaluation values on the therapeutic effect and prognosis of patients with severe craniocerebral injury complicated with pulmonary infection.

A capillary electrophoretic method was developed for the separation of enantiomers of naphthylgly-cidic ether(NGE). Several cyclodextrins(CDs) were applied as the chiral selectors and it was found that the ionic modified highly sulfated cyclodextrin(HS-β-CD) could give satisfactory enantioselectivity. In addition,the effects of the pH value of the buffer system,the concentration of the HS-β-CD,capillary temperature and the running voltage on the chiral separation were investigated systematically. The result showed that under the optimized conditions of pH 2. 5,20 mmol/L H_3PO_4-triethanolamine buffer containing 2% highly sulfated cyclodextrin ( HS-β-CD) at capillary temperature 20℃ in the reversed polarity voltage of - 18 kV,the enantiomers of naphthylglycidic ether were baseline separated. This method is simple,precise and can be applied to the chiral separation of naphthylglycidic ether enantiomers and determination of enantiomers excess(ee,% ).

Objective To explore the diagnostic performance of 64-slice spiral CT combined with exercise treadmill test for coronary artery disease ( CAD). Methods Eighty-six patients suspected of CAD were divided into low risk group, intermediate risk group and high risk group according to estimated pretest probabilities of CAD. All patients underwent coronary angiography, 64-slice spiral CT and exercise treadmill test. With coronary artery stenosis rate >50% as positive findings, the sensitivity, specificity, positive predictive value ( PPV), negative predictive value ( NPV) and accuracy of 64-slice spiral CT and 64-slice spiral CT combined with exercise treadmill test in diagnosis of CAD were calculated. Results With coronary angiography as the "golden criteria", the sensitivity, specificity, PPV, NPV and accuracy of 64-slice spiral CT in diagnosis of CAD were 95.2% , 88.6% , 88.9% , 95.1% and 91.9% , respectively. The sensitivity of low risk group, intermediate risk group and high risk group was 100% , 100% and 92.6%, specificity was 94.4% , 94.1% and 66.7%, PPV was 80.0%, 91.7% and 89.3%, NPV was 100% , 100% and 75.0%, and accuracy was 95.5% , 96.4% and 86.1%, respectively. The sensitivity, specificity, PPV, NPV and accuracy of 64-slice spiral CT combined with exercise treadmill test in diagnosis of CAD were 97.6%, 97.7%, 97.6%, 97.7% and 97.7%, respectively. Conclusion 64-slice spiral CT combined with exercise treadmill test works well in screening CAD, especially for those with a low or intermediate estimated pretest probability.

Objective To investigate the effect of allicin on the development of atherosclerosis in apoE-/-mice and explore its underlying mechanism from the perspective of protein S-nitrosylation.Methods Thirty male apoE-/- mice were randomly divided into 3 groups:control group (saline,ig),low-dose group (allicin,9 mg/kg·d, ig)and high-dose group (allicin,18 mg/kg·d,ig).They were fed with high cholesterol diet for 12 weeks.The levels of plasma lipids,oxidized-LDL (ox-LDL),malondialdehyde,tumor necrosis factor-alpha and nitric oxide (NO)were measured.The atherosclerotic lesions in aortic root were evaluated after hematoxylin and eosin staining and elastica van Gieson and immunohistochemical staining,respectively.Furthermore,in vitro experiments were performed using human umbilical vein endothelial cells (HUVECs).The HUVECs were treated with allicin (10μmol/L or 20 μmol/L)for 24 hours in the presence of ox-LDL (50 μg/mL).The level of NO in supernatant was measured by a nitrate/nitrite assay. The protein S-nitrosylation of the HUVECs was detected through immunofluorescence.Results The histological analysis revealed that allicin treatment not only significantly decreased the areas of the atherosclerotic lesion (all P <0.05)but also suppressed the macrophage accumulation and smooth muscle cell proliferation in the lesion.There was no significant difference in the levels of plasma lipids between control and treated groups.However,allicin exerted obvious anti-oxidative and anti-inflammatory effects. Interestingly,the allicin treatment led to marked increase of the plasma NO level (P <0.05)and aortic protein S-nitrosylation.The experiments in vitro further proved that the allicin up-regulated the levels of NO and protein S-nitrosylation in HUVECs treated with ox-LDL (P < 0.01 ).Conclusion Allicin can inhibit the development of atherosclerosis.The mechanism is associated with the up-regulation of protein S-nitrosylation in endothelial cells, which plays an important role in anti-oxidization and anti-inflammation.

Objective:To explore the clinico-pathological characteristics and risk factors affecting prognosis in elderly patients with gastric cancer.Methods:A retrospective study was used to retrospectively analyze 2386 patients with gastric cancer undergoing radical surgery in Surgery Department of the Fourth Hospital of Hebei Medical University from 1 January 2012 to 1 January 2015.Patients aged 70 years and older were screened so as to analyze clinical characteristics and influencing factors for the prognosis.Results:A total of 2386 patients with gastric cancer were divided into the elderly group aged 70 years and older(342 of 2386 cases, 14.3%). There were statistically significant differences between the two groups in gender, number of concomitant diseases, NRS2002 score, PG-SGA score, tumor location, tumor diameter, histological type, Borrmann classification, tumor invasion depth staging(pT), lymph node metastasis staging(pN), the anatomic extent of tumor staging(TNM, pTNM), and Lauren classifications( P<0.05). The 981 of 2386 cases(41.4%)had postoperative complications, accompanied by 413 cases(17.3%)of surgery-related complications and 568 cases(24.0%)of non-surgery-related complications.A multivariate logistic analysis showed that the number of preoperative co-existing diseases ≥ 2 was an independent influencing factor for postoperative complications in elderly gastric cancer patients( HR=4.478, 95% CI: 1.121-7.918, P=0.006). The 5-year OS and DSS was 21.10% and 62.73% in the ≥70 years gastric cancer group, and was 54.1% and 70.0% in the <70 years gastric cancer group, respectively.The difference in the 5-year OS between the two groups was statistically significant( P<0.05), while the difference in the 5-year DSS between the two groups was not statistically significant( P>0.05). Multivariate analysis by the Cox proportional hazard model showed that the independent risk factors for the prognosis of elderly patients with gastric cancer included the low-undifferentiated histological type of the tumor( P=0.004), the depth of tumor invasion pT stage of pT4a-pT4b( P=0.007), lymph node metastasis( P=0.034), tumor pTNM stage ⅢA-ⅢC( P=0.002)and vascular tumor thrombus( P=0.034). Conclusions:Elderly patients with gastric cancer have many preoperative co-existing diseases, which increases the risk of postoperative non-surgical complications.Therefore, we should focus on the peri-operative management of their comorbid diseases so as to improve the safety and efficacy of surgery.The advanced age is not the independent risk factors for the prognosis.

Objective:To investigate the risk factors of pancreatic fistula after radical resection of gastric cancer, and to establish a risk prediction scoring model for pancreatic fistula.Methods:The clinico-pathological data of 312 patients with gastric cancer admitted to the Fourth Hospital of Hebei Medical University from January 2019 to January 2020 were retrospectively analyzed. Multiple factor logistic regression model was used to analyze the risk factors of pancreatic fistula after radical resection of gastric cancer, and a risk prediction scoring model based on the risk factors was established. Hosmer-Lemeshow test was used to detect the goodness of fit of regression equation, and receiver operating characteristics (ROC) curve was used to evaluate the distinction degree of regression equation.Results:Among 312 patients with gastric cancer, 27 cases (8.65%) had pancreatic fistula after radical resection of gastric cancer. Multiple factor logistic regression analysis showed that male patients ( OR = 5.312, 95% CI 1.532-18.420, P = 0.008), age ≥ 60 years old ( OR = 4.928, 95% CI 1.493-16.250, P = 0.009), preoperative diabetes mellitus ( OR = 3.062, 95% CI 1.091-8.589, P = 0.034), lesion location in the gastric body-gastric antrum ( OR = 3.121, 95% CI 1.052-9.251, P = 0.040), intraoperative omental bursa resection ( OR = 6.209, 95% CI 2.084-18.478, P = 0.001), intraoperative lymph node dissection at D2+ station ( OR = 3.114, 95% CI 1.044-9.281, P = 0.042), intraoperative combined organ resection ( OR = 5.063, 95% CI 1.473-17.400, P = 0.010), preoperative TNM stage Ⅲ ( OR = 4.973, 95% CI 1.189-20.792, P = 0.028) were independent risk factors for pancreatic fistula after radical resection of gastric cancer. A risk prediction equation of pancreatic fistula after radical resection of patients with gastric cancer was established: P = -8.619+1.670X 1+1.595X 2+1.119X 3+1.138X 4+1.826X 5+1.136X 6+1.622X 7+1.604X 8; factor X was set as a binomial assignment (0 or 1); X1-X8 were listed as follows respectively: gender (the male was 1), age (≥60 years old was 1), preoperative diabetes history (yes was 1), lesion location (gastric body-gastric antrum was 1), intraoperative resection of omental bursa or not (yes was 1), intraoperative lymph node dissection at D2+ station or not (yes was 1), intraoperative combined organ resection or not (yes was 1), preoperative TNM stage (stage Ⅲ was 1). The goodness of fit of regression equation was high ( P = 0.395). The area under the curve of ROC by using risk prediction scoring model to judge pancreatic fistula was 0.916 (95% CI 0.872-0.960, P<0.01). The probability of pancreatic fistula in patients with score ≥ 5 was 40.90%, and the probability of pancreatic fistula in patients with score < 5 was 3.35%. Conclusions:The occurrence of pancreatic fistula after radical resection of gastric cancer is closely related to a variety of risk factors. By establishing a risk prediction scoring model for pancreatic fistula after radical resection of gastric cancer, it is helpful to effectively identify patients with high risk of pancreatic fistula after radical surgery during the perioperative period.

Objective To investigate the effect and mechanism of metformin on inflammatory cytokines after cerebral ischemia-reperfusion injury in rats.Methods A rat model of middle cerebral artery occlusion (MCAO)was established by suture method.The neurological function was evaluated by modified neurological function score (mNSS).The apoptosis was detected by TUNEL method.The levels of interleukin-6 (IL-6),interleukin-8(IL-8) and tumor necrosis factor alpha (TNF-α) in serum were detected by enzyme-linked immunosorbent assay (ELISA).The expression levels of hypoxia inducible factor-1α(HIF-1α),BAX and BCL-2 protein in brain tissue was detected by Western Blot.Results Compared with the control group,the neurological function scores and the tissue cell apoptosis of the rats with cerebral ischemia injury was both significantly increased (all P＜0.01).Compared with the model group,metformin could alleviate the rats' neurological damage after cerebral ischemia-reperfusion,and the expression of IL-6,IL-8 and TNF-α in serum were significantly decreased (all P＜0.01).The expression of HIF-1α and BAX proteins were significantly down-regulated and the BCL-2 protein was up-regulated by metformin in rat brain tissue so as to regulate the expression of apoptosis-related proteins and reduce the apoptosis of brain tissue cells.Conclusions Metformin can reduce the expression of inflammatory cytokines and inhibit the apoptosis,which may play a protective role for cerebral ischemia-reperfusion injury.The mechanism may be related to the regulation of apoptosis-related protein expression,inhibition of HIF-1α expression,and inhibition of the release of related inflammatory factors TNF-α,IL-6 and IL-8.

Objective To evaluate the safety of biodegradable flow-diverting devices (FDs) for treatment of intracranial aneurysms in rabbits.Methods Biodegradable polyglycolic acid FDs (PGA-FDs) were implanted into the abdominal aorta in 12 New Zealand rabbits,covering the ostium of a lumbar artery.Animals underwent angiography at 3,6,and 12 weeks after device implantation;and 3 animals were sacrificed at 3 and 6 weeks for pathology by HE staining,Veigert resorcinol (VG) staining,and CD34,CD68 and α smooth muscle actin (αSMA) immunohistochemistry.The diameter of abdomen arota and the patency of side branches covered by the devices were assessed.All animals were sacrificed after angiography for pathology at 12 weeks.Results No side branch occlusions were noted,either immediately after implantation or at follow-ups.Abdominal aorta neointimal hyperplasia was minimal,and there were no differences immediately after device implantation,or at 3,6,and 12 weeks after device implantation (abdominal aorta diameter:[3.35±0.24] mm,[3.33 ±0.12] mm,[3.23±0.16] mm,[3.12±0.10] mm and [3.30±0.11] mm).Pathology results showed the neointima covered the strips of PGA-FD,and minial inflammation was abserved around the strips.The PGA strips were obsorbed completely at 12 weeks follow up with no apparent inflammation.The neointima predominantly comprised of smooth muscle cells and collagen fibers.Conclusion The PGA-FD is safe for abdominal aorta and normal side branches at short-term follow-up.

Objective To evaluate the feasibility of biodegradable flow-diverting stent for treatment of intracranial wide-neck aneurysm.Methods Twenty adult New Zealand rabbits were used to induce wide-neck aneurysm models by elastase,and then,these models were divided into 3 groups:in group one (n=7),biodegradable polyglycolic acid flow-diverting stents (PGA-FDs) were implanted into parent arteries and covered the necks of aneurysms;in group 2 (n=7),the bare metal FDs replaced PGA-FDs;the observation period of animals in group one and group 2 was 3 months;in group 3 (n=6),the PGA-FDs were implanted into parent arteries with 6 weeks of observation period.The status of aneurysm occlusion and patency of side branches covered by the stent were assessed,and all animals were sacrificed:HE staining was used to observe the thrombosis in the aneurysms,Elastic fiber staining was used to observe the neointimal thickness of parent arteries,and immuohistochemical staining was employed to detect the expressions of CD34,CD68 and alpha-actin (αSMA) in the parent arteries.Results Complete aneurysm occlusion rate in groups one,2 and 3 was 83.3％ (5/6),0％ (0/6) and 66.7％ (4/6),respectively.The neointimal thickness in parent artery of groups one,2 and 3 was (111±69) μm,(70±48) μm and (190±52) μm,respectively;that in group 3 was significantly higher than that in group one and 2 (P＜0.05).The neointima comprised predominantly smooth muscle cells and collagen fibers.Some CD34 positive vascular endothelial cells could be seen in the neointima of parent arteries of groups one and 2.Conclusion The PGA-FD is an effective device to occlude aneurysms without inducing obvious neointimal thickness and side branch stenosis in the 3-month follow-up.