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 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 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 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 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.

Humans ; Hypertension, Pulmonary ; metabolism ; Inhibitor of Apoptosis Proteins ; Microtubule-Associated Proteins ; metabolism

Objective To investigate the relationship among age,menopausal status,serum 25 (OH)VD and skeletal metabolism index as PTH (Parathyroid Hormone),CA(Calcium),P (Phosphorus) and boned mineral density (BMD) of climacteric female in Xi'an.Methods 352 cases of healthy women at the age of 40～60 were collected who did routine examination in outpatient building of the First Affiliated Hospital of Xi'an Jiaotong University from January 2016 to April 2016.According to the results of skeletal density test,all subjects were divided into 3 groups as the normal group (T＞-1),the reduction group (-2.5＜T＜-1),the osteoporosis group (T＜-2.5).Electrochemiluminescent immunoassay (ECLIA) was used to detect levels of serum 25 (OH)VD,PTH,CA and P.Kruskal-Wallis test and chi-square test were used to analyze differences of age,serum 25(OH)VD,PTH,CA and P in different levels of bone mineral density groups.Results Compared with bone density normal group 2.24(2.18～2.29)mmol/L,serum CA levels of bone mineral density reduction group 2.27 (2.20 ～ 2.32)mmol/L and osteoporosis group 2.27(2.23～2.33)mmol/L were significantly higher (Z=9.669,P＜0.01).Serum P levels of bone mineral density reduction group 1.15 (1.09～ 1.23)mmol/L and osteoporosis group 1.18 (1.09～ 1.25)mmol/L were obviously higher than bone density normal group,1.11 (0.99 ～ 1.23) mmol/L (Z =13.64,P＜ 0.01).Ages of osteoporosis group 54(50～57) years and bone mineral density reduction group 51 (47～ 54) years were significantly older than Bone density normal group 47(43～50) years (Z=73.08,P＜0.01).The rate of menopause in osteoporosis group and bone mineral density reduction group were significantly higher than in bone density normal group (x2 =13.81,P＜ 0.01).There was no statistical difference in serum 25(OH)VD and PTH between groups.Conclusion This study found boned density of climacteric women is more likely correlated with age,menopause status and levels of serum CA and P.There was not enough evidence to prove that 25 (OH)VD and PTH have effect on skeletal density.Therefore,to monitor and detect the menopause status and levels of serum CA and P of climacteric female is critical for the prevention and treatment on osteoporosis of women.

Objective:To investigate the effect of enteral nutrition support by CT-guided percutaneous gastrostomyon the nutritional status of patients with esophageal cancer complicated with dysphagia during radiotherapy.Methods:Therewere46 cases of esophageal cancer patients with dysphagia treated with CT-guided percutaneousgastrostomy.Others 43 cases of esophageal cancer by oral feeding in patients with dysphagia as control groupduringthe sametimein our hospital radiotherapy center.Patients in the observation group were ingested daily through the gastrostomy,and the nutritional intake of the control group included oral ingestion and intravenous infusion.All patients were measuredthe body height,body weight (BW).body mass index (BMI),Serum levels of serum albumin (ALB),pre-albumin (PA) and hemoglobin (HB) before and after radiotherapy.We also observed the incidence of acute radiation esophagitis and the completion of the treatment plan during radiotherapy in both groups,and to observe the two groups of patients the incidence rate of radiotherapy and treatment plan during the completion of acute radiation esophagitis.Results:There was no significant difference in BW,BMI,ALB,PA,HB before radiotherapy between the two groups (t =0.84,0.63,-1.07,-0.81,1.48,P ＞ 0.05).The BW,BMI,ALB,PA and HB of the observation group were significantly higher than those of the control group at the end of radiotherapy,which werestatistically significant (t=3.30,4.65,6.82,43.56,31.91,P ＜ 0.01).During the radiotherapy,the total incidence of acute radiation esophagitis in the observation group was significantly lower than that in the control group,(x2=3.971,P＜ 0.05).In addition,the completion rate of the observationgroup was significantly higher than that of the control group (x2 =6.811,P ＜ 0.01).Conclusion:To the Patients with dysphagia of esophageal cancer,enteral nutrition byCT guided percutaneous gastrostomy,can improve the malnutrition,the immune function of the patients and reduce the acute radiation esophagitis during radiotherapy and ensure the successful completion of the treatment plan.

Staphylococcus aureus,an important foodborne pathogen,can contaminate foods through variety of ways and produce enterotoxin that may cause Staphylococcal food poisoning.In addition to food safety problems,Staphylococcus aureus could also cause clinical infection.The study of its pathogenicity is not only beneficial to prevent and control foodborne diseases,but also provide a new point for clinical treatment.This paper analyzes the types and characteristics of common strains of Staphylococcus aureus in food,and summaries the effect of food processing on pathogenicity and the methods for pathogenicity research in order to provide reference for the related study on pathogenicity of Staphylococcus aureus.