Objective To evaluate the effect on reliability with different sample amount when human corneal endothelial morpho- logic parameters estimated using center by center method analysis.Design Clinical study.Participants Thirty central corneal endothe- lium photo-micrographs for the same eye. Methods Noncontact specular photomicrographs were obtained.Each photo-micrograph was analyzed with center by center method and was analyzed for 9 times by pointing different amount cells,from 10 to 90.Compare the di- versity of corneal endothelial morphometric parameters between different groups. Main Outcome Measures Corneal emtothelium den- sity,coefficient of variation.Results The coefficient of variation decreased and then kept to a same level when sample cell amount were added from 10 to 90.With the sample cell amounts varied from 10,20,30,40,50 to 90,the coefficient of variation was changed from 9.5,6.3,4.6,4.4.,4.3 to 3.8.Corneal endothelium density had significant difference between the first two groups of 10 and 20 cells with the other groups(P

Objective To observe the acute side effects and recent therapeutical effect of cisplatinum/paclitaxe concurrent radiotherapy for patients with advanced nasopharyngeal carcinoma.Methods 87 patients with advanced nasopharygeal carcinoma were enrolled.According to the treatment,87 patients were divided into paclitaxe group (groupA,n =43) and cisplatinum group (group B,n =44).The two groups were treated with 6MV-X ray for radiotherapy.The prescription dose of radiation therapy was PGTV,PGTVnd 6 996 cGy/33F,PTV1 6 006 cGy/33F,PTV2 5 096 cGy/28F.The two groups began concurrent chemotherapy in radiotherapy,specific method:group A paclitaxe 30mg/m2,1 time a week,until the end of radiotherapy,group B cisplatinum 80 ～100 mg/m2,every 21 days.Results The recent therapeutical effect of nasopharyngeal lesions and lymph nodes of neck for group A and group B were 88.4％ and 86.4％ (x2 =0.079,P =0.778),88.4％ and 88.6％ (x2 =0.000,P =1.000),respectively.But the occurrence rate of group B ' oral mucosa reaction (x2 =4.295,P =0.038) and gastrointestinal reaction (x2 =4.482,P =0.028) were higher than that of group A.Conclusion Treated with cisplatin in advanced nasopharyngeal carcinoma after radical radiotherapy combined with docetaxel is similar,and the side effect is low,the tolerance of patients is good,curative effect is satisfied.

Objective To estimate the arterial-to-end-tidal carbon dioxide tension difference (Pa-ET CO 2 )in children with cyanotic or acyanotic congenital heart diseases;evaluate whether hyper-ventilation can reduce the tension difference or not;analyze the effect of sevofleurane on Pa-ET CO 2 . Methods One hundred and twenty patients (male 60 cases,female 60 cases,aged 1 month-6 years, ASA class Ⅱ or Ⅲ)undergoing selective cardiac surgery were randomly divided into 6 groups (n =20 each)based on right-to-left or left-to-right intracardic shunts:group A1,cyanotic with sevoflurane of 0.5 MAC;group A2,cyanotic with sevoflurane of 1.0 MAC;group B1,acyanotic with sevoflurane of 0.5 MAC;group B2,acyanotic with sevoflurane of 1.0 MAC;group C1,cyanotic with no inter-vention factors;group C2,acyanotic with no intervention factors.All the children received general an-aesthesia after placing an intravenous and arterial catheter.The value of PET CO 2 ,SpO 2 ,PaCO 2 , SaO 2 ,Hct and temperature(nasopharyngeal temperature and rectal temperature)were obtained before operation,after hyperventilation(the control groups without hyperventilation)and five minutes before surture sternum.Results The values of Pa-ET CO 2 were more than the normal one in six groups before operation.The value of Pa-ET CO 2 in group B1 was less than that in group A1,that in group B2 was less than that in group A2 and that in group C2 was less than that in group C1 before operation (P <0.01).Compared with the time point before operation,the values of Pa-ET CO 2 in groups A1,A2,B1 and B2 decreased significantly after hyperventilation (P < 0.05 or P < 0.01 ).Moreover, this reduction was more significant in groups B1 and B2.Compared with the time point before operation, the values of Pa-ET CO 2 in groups B1,B2,C2 increased significantly (P <0.01)and that in groups A1, A2,C1 decreased significantly (P <0.05)at 5 minutes before surture sternum.There was no statisti-cal difference at three different time points between group A1 and A2,B1 and B2.Conclusion The value of Pa-ET CO 2 in cyanotic children increased more significantly than that in acyanotic children.Hy-perventilation can reduce the value of Pa-ET CO 2 especially in acynanotic children with pulmonary con-gestion.The concentration (from 0.5 MAC to 1.0 MAC)of sevoflurane had little effect on the value of Pa-ET CO 2 .

Objective To investigate the effect of biofilm cleaning agents and multienzyme cleaning agents in the cleaning of tubular instruments. Methods About 200 pieces of intramedullary nail used in tibial fracture and intramedullary nailing were selected and divided into multienzyme cleaning group and biomembrane cleaning group according to the order of recovery. According to the random number table method, each group had 100 pieces. The biofilm cleaning group was cleaned with biological membrane cleaning agent, and the multienzyme cleaning group was cleaned with multienzyme cleaning agent. The cleaning effect of luminal instruments was observed by means of microscopy, dipstick test and ATP bioluminescence assay. Result The cleaning quality and biofilm removal effect of the biofilm cleaning group were better than those of the multienzyme cleaning group (P<0.05). Conclusion Cleaning the luminal instruments with biomembrane cleaning agent can improve the cleaning quality and prevent the formation of bacterial biofilm.

Objective To explore the effects of examination scores of surgical experiment on introducing simulated vessel(ISV).Method 200 students of clinical medicine were randomly taken out and divided into two groups,namely the experimental group and routine group(n=100),who were respectively tested by the surgical experiment operating and theory after were trained by the ISV and routine surgical experimentation to compare the variability of their scores.Results The scores of the surgical experiment operating and theory of the experimental group were significantly higher than the routine group(P0.05),middle score groups were higher than the routine groups(P

Keratorefractive surgery changes the central corneal thickness (CCT) and corneal curvature, which could influence the Goldmann applanation tonometer (GAT) and non-contact tonometer (NCT) measurements of intraocular pressure (IOP), but not dynamic contour tonometer(DCT). During the procedure of LASIK, there is a transient rise of IOP, which increases the risks of optic nerve damage. Meanwhile, the presence of functioning filtering blebs may affect the choice and outcome of refractive surgery, or even becomes a contraindication of surgery. Steroids are typically used after keratorefractive surgery, which could lead to IOP elevation. Hence it is important to monitor IOP after LASIK and to be aware of inaccurate IOP readings due to corneal flap interface fluid. Treating patients with postoperative elevated IOP after keratorefractive surgery is similar to that for patients with glaucoma. This review will address the issues surrounding the safety, relevant complications and implications of keratorefractive surgeries on glaucoma and relevant diagnostic tests.

OBJECTIVETo compare the efficacy between moving cupping at Hechelu combined with rubbing method and western medication for depression of diabetes mellitus (DM).

METHODSTwo hundred and sixteen patients were randomly divided into an observation group and a control group, 108 cases in each group. Patients in the observation group were treated with moving cupping at Hechelu combined with rubbing method, once every: other day; six treatments were considered as one course, and totally two courses were given with an interval of: 4 days between courses. Patients in the control group were treated with oral administration of fluoxetine hydrochloride capsules, once a day for consecutive 4 weeks. The Hamilton depression scale (HAMD), self-rating depression scale (SDS) and TCM symptom score were measured before treatment, after the treatment and in follow-up visit one and a half months after treatment. The fasting blood glucose was tested before and after treatment. The glycosylated hemoglobin (HbA1c) was tested in the follow-up visit.

RESULTSThe total effective rate was 90.9% (90/99) in the observation group, which was superior to 73.7% (70/95) in the control group (P < 0.05). After the treatment, HAMD, SDS and TCM symptom scores were all reduced apparently in the observation group and the control group (all P < 0.05). After the treatment and the follow-up visit, the TCM symptom score in the observation group was lower than that in the control group (P < 0.05). The levels of HbA1c and GLU were stable in the observation group, and were decreased compared with those before treatment; but the difference between the, two groups was not significant (P > 0.05).

CONCLUSIONThe Hechelu theory-based TCM treatment has better: efficacy for depression of diabetes mellitus than fluoxetine hydrochloride capsule, which has less adverse effects.

Acupuncture Points ; Adult ; Aged ; Blood Glucose ; metabolism ; Combined Modality Therapy ; Depressive Disorder ; etiology ; metabolism ; psychology ; therapy ; Diabetes Mellitus, Type 2 ; complications ; metabolism ; psychology ; Female ; Humans ; Male ; Massage ; Medicine, Chinese Traditional ; methods ; Middle Aged ; Treatment Outcome

BACKGROUND:Currently, bone marrow mesenchymal stem cel s can differentiate into nerve cel s via many approaches. Different methods for inducing bone marrow mesenchymal stem cel s differentiating into nerve cel s have different ratios. OBJECTIVE:To investigate the difference between chemical method and co-culture method to induce the differentiation of rat bone marrow mesenchymal stem cel s into nerve cel s. METHODS:Rat bone marrow mesenchymal stem cel s were isolated and purified using whole bone marrow culture method, and then randomly divided into two groups:chemical group,β-mercaptoethanol was added;co-culture group, co-cultured in a Transwel chamber. RESULTS AND CONCLUSION:Visible protrusions from induced cel s showed radiation growth at 1 week of induced culture, and neuron-specific enolase staining was positive at 2 weeks of culture. Star-like structure of nerve cel s was visible in the co-culture group within 4-5 days of culture, and then more protrusions formed. Meanwhile, the positive rate of neuron-specific enolase was (70.82±2.46)%. After 6-7 days of culture, neuron-like cel s formed and were interconnected in the chemical group;while, the positive rate of neuron-specific enolase was (52.37±1.83)%. These findings suggest that cel microenvironment plays a leading role in the differentiation of bone marrow mesenchymal stem cel s into nerve cel s, and chemical induction method is inferior to the co-culture method.

Objective To assess cognitive impairment of patients with idiopathic Parkinson's disease(PD)of different clinical subgroups. Methods The cluster analysis approach was used to classify PD patients on the basis of their clinical features, and then compare their cognitive function according their Montreal Cognitive Assessment (MoCA)score. Results One-hundred and six patients were divided into 5 groups by means of cluster analysis:A. young-onset(n = 35), B. rapid disease progression(n = 6); C. tremor dominant(n = 36), D. haplo-non-tremor dominant(n =18),E. non-tremor dominant with depression(n = 11). The MoCA score and proportion of abnormal scores differed among the 5 groups significantly,especially between the subgroup E(19.00 ±5.47)and the subgroup A(23. 66 ± 3.51)(P ＜ 0. 05), the former was more seriously impaired in clock drawing task(1.73 ± 1. 01 vs.2. 66 ±0. 59 ,t = -2. 904,P =0. 013), alertness(0. 55 ±0. 52 vs. 0. 91 ±0. 28 ,t = -2. 241 ,P =0. 045),semantic fluency(0. 64 ±0. 51 vs. 0. 97 ±0. 17 ,t = -3. 429,P =0. 001)and orientation domains than the latter(4. 91 ± 1.38 vs. 5.80±0.47,t = -3.321,P =0.020). Conclusions The cognitive impairment in PD patients are common as well as heterogeneous.

Objective To investigate the risk factors of Parkinson's disease(PD)with mild cognitive impairment and mode of cerebral glucose metabolism. Methods One hundred and one non-dementia PD patients were assessed with Montreal Cognitive Assessment(MoCA)and divided into the PD with mild cognitive impairment (PD-MCI)group and the PD non-cognitive impairment(PD-NC)group. The demographic details, clinical features,Unified Pakinson's Disease Rating Scale(UPDRS), Hohen-Yahr rank and Hamilton Depression Scale(HAMD)were compared between the two groups. Patients in Hohen-Yahr stage 1 underwent positron emission tomography(PET)with 18F-fluorodeoxyglucose(18F-FDG)to show glucose metabolism. Results Seventy-seven(74. 3%)PD patients had mild cognitive impairment PD-MCI group had higher score in UPDRS 1st(mentation ,behavior and mood),2nd (activity of daily living)and 3rd(motor examination)subscale(2.48 ± 1.51,10. 71 ± 4. 88,22.31 ± 12.70)than PD-NC group(1.65 ± 1.29,8.15 ±2. 20,15.92 ±7.56,P ＜0.05)respectively. The FDG metabolism ratio of frontal cortex,parietal cortex and occipital cortex decreased more significantly in PD-MCI than in PD-NC(P ＜ 0.05).Conclusions The risk factors of mild cognitive impairment in PD include moter dysfunction, clinical stage and depression. The metabolic dysfunction of cortex may be the mechanism of mild cognitive impairment in PD.