AlM: To observe the clinical results of pterygium excision combined with conjunctival autograft transplantation using fibrin glue.METHODS:A total of 60 patients (60 eyes) with primary nasal pterygium were randomly divided into two groups:the fibrin glue group ( experimental group, 30 eyes) and suture group ( control group, 30 eyes ) . All patients underwent pterygium excision combined with conjunctival autograft transplantation. ln the experimental group autograft was attached to sclera with fibrin glue while in control group 10-0 polyamide was used. The patients were followed up for 6mo. The time of operation, post operation comfort, complications and recurrence were evaluated.RESULTS:The average surgical time was 24. 5 ± 6. 5min with fibrin glue group while 35. 2 ± 5. 4min with suture group, with statistically significant difference between two groups (P<0. 05). Pain and foreign body sensation was significantly less with fibrin glue group than that in the control group ( P < 0. 05 ). No severe postoperative complication occurred both in two groups. The incidence of subconjunctival hemorrhage in the experimental group was lower than that in the control group (P<0. 05). 1 case (3%) of fibrin glue group, 3 cases (10%) of suture group had recurrence at the end of follow up 6mo.CONCLUSlON:lt's a safe and effective way to attach conjunctival autograft during pterygium surgery by fibrin glue. lt can reduce surgical time, postoperative complications and relieve postoperative discomfort.

Objective To investigate the clinical, electrophysiological and pathological features of critical illness polyneuropathy and myopathy (CIPNM). Methods The clinical outcomes, electromyogram Results as well as pathological features in nerves and muscles of 3 patients with CIPNM were investigated and analyzed. Results 3 patients were all provided with assisted respiration after tracheal intubation. 7～10 d after intubation, all the patients emerged muscle strength and tendon reflexes of extremities weakening; while 14 days after that, 2 patients appeared amyotrophy of extremities. Electromyogram showed that the conduction of many motor and sensory nerves for extremities decreased, while the amplitude of compound muscle action potential (CMAP) of part of motor nerves decreased. Biopsy for nerves revealed decreased medullated nerve fibers and regeneration phenomenon of auxiliary fibers; while that for muscles showed neuralgic damage and myopathy-like changes. Conclusion CIPNM can complicate after tracheal intubation. The electrophysiological and pathological examinations for nerves and muscles can be helpful for the diagnosis.

Hepatitis B is a serious infectious disease worldwide, and hepatitis B virus (HBV) is the direct cause of this disease. In recent years, as an essential part of its evolutionary process, HBV mutation has been extensively studied domestically and globally. However, the study on the conserved sequences in HBV sequences is still in its infancy. In this study, we applied multiple EM for motif elicitation (MEME) algorithm to discover HBV motif and proposed a new metric, conservative index (CI), to carry out phylogenetic analysis based on HBV sequences. Then, the constructed phylogenetic tree was subjected to reliability assessment. The results demonstrated that the new metric CI combined with the MEME algorithm can effectively help to discover motifs in HBV sequences and construct a phylogenetic tree based on them and to analyze the evolutionary relationship between HBV sequences; in addition, the possible ancestral sequences of samples may be obtained by conservative analysis. The proposed method is valuable for the exploratory study on large HBV sequence data sets.
Computational Biology ; Conserved Sequence ; Evolution, Molecular ; Hepatitis B virus ; genetics ; Humans ; Nucleotide Motifs ; Phylogeny ; Reproducibility of Results

Objective To explore the sensitivity of contrast-enhanced ultrasound (CEUS) and ultrasonic elastography(UE) in detecting different sizes of thyroid papillary carcinoma.Methods 64 cases of thyroid papillary carcinoma were divided into two groups according to the diameter size(group 1,≤1 cm;group 2,＞ 1 cm) and examined by the contrast-enhanced ultrasound and elastography,then the features were analyzed and the sensitivity for detecting of the two methods in different groups were compared.Results The sensitivity for detecting in CEUS was higher than in UE,which had significant difference between two methods.CEUS and UE were valuable for detecting and they had no difference in sensitivity for detecting in group 1.There was a significant difference in sensitivity for detecting between two methods in group 2.Conclusions Both CEUS and UE were valuable in diagnosis of thyroid papillary carcinoma and the sensitivity for detecting in CEUS is higher than in UE in group 2.

Objective To improve lesion detection of the radial head with adjusted elbow joint lateral position on X-ray.Methods (1)20 subjects underwent elbow joint CT three-dimensional reconstruction (average intensity projection),which was as X-ray radio-graphy image.The tilt angle of the humerus and the projection direction for fully display of the radial head in projection images and the tilt angle of the humerus against detector in X-ray radiography were measured.(2)20 subjects (patients and volunteers)with el-bow joint disease underwent routine and improved elbow joint lateral position were enrolled.And assessed the bare blocking rate of the radial head articular surface of the two positions.Results (1)The angle between the the humerus and the direction of projection were 49°-60°and 30°-41°in CT and X-ray,respectively.The average angle was (35.5±1)°.(2).The blocking rate and bare bloc-king rate of the radial head articular surface in routine elbow joint lateral position were 71.6%-100% and 0%-28.4%,respective-ly.The average rate of bare blocking was 14.2%.Fracture 13 cases and 5 cases of suspected fractures.The blocking rate and bare blocking rate of the radial head articular surface in improved elbow joint lateral position were 4.8%-25% and 75%-95.2%,re-spectively.The average rate of bare blocking was 85.1%.Fracture 1 7 cases and 1 case of suspectet fractures.Conclusion The im-proved elbow joint lateral position of X-ray can display the radial head articular surface better than the routine position.

Objective:To detect the value of utilizing bpMRI in prostate biopsy in the detection of prostate cancer with PSA≤20ng/ml.Methods:The clinical data of 394 patients who underwent prostate biopsy in the First Affiliated Hospital of Nanjing Medical University from November 2017 to October 2019 were retrospectively analyzed. Of all the patients, 177 underwent modified systematic biopsy, named TRUS group, 217 patients accepted pre-biopsy bpMRI examination, undergoing modified systematic biopsy if Prostate Imaging Reporting and Data System (PI-RADS) score < 3 or MRI-TRUS cognitive fusion targeted prostate + systematic biopsy if PI-RADS score ≥ 3, named MRI group. The median age of TRUS group was 66 (61, 74) years old, prostate specific antigen (PSA) was 9.52 (7.26, 12.30) ng / ml, and prostate volume (PV) was 36.84 (28.95, 57.72)ml. The median age of MRI group was 66 (59, 72) years old, PSA was 8.84 (6.65, 12.16) ng/ml, and PV was 39.45 (29.25, 58.69)ml. There was no difference in above parameters between the two groups. The χ 2 test was used to compare the detection rate of prostate cancer and clinically significant prostate cancer (CsPCa) between the two groups. Results:There was no significant difference in the detection rates of prostate cancer between TRUS group and MRI group [51.41% (91/177) vs. 48.39% (105/ 217), P = 0.550], but the detection rates of CsPCa were significantly different [26.55% (47/177) vs. 36.41% (79/217), P = 0.037]. In patients with PSA ≤ 10 ng / ml, there was no significant difference in the detection rates of prostate cancer between the two groups [43.62% (41/94) vs. 43.08% (56/130), P = 0.936], but there was a significant difference in the detection rates of CsPCa [17.02% (16/94) vs. 28.46% (37/130), P = 0.047]. There was no significant difference in the detection rates of prostate cancer [60.24% (50/83) and 56.17% (48/87), P= 0.504] and the detection rates of CsPCa [37.35% (31/83) vs. 48.28% (42/87), P = 0.150] between the two groups. The total detection rates of the last two needles in TRUS group and MRI group were 23.16% (41/177) and 36.63% (86/217), respectively, with significant difference ( P=0.001); the detection rates of CsPCa in the last two needles were 11.86% (26/177) and 29.03% (63/ 217), respectively, with significant difference ( P < 0.001). In MRI group, the detection rates of prostate cancer in patients with PI-RADS score <3, 3, 4, 5 were 21.21% (7/33), 25.84% (23/89), 73.24% (52/71), 95.83% (23/24), respectively; the detection rates of CsPCa were 12.12% (4/33), 17.98% (16/89), 54.93% (39/71), 83.33% (23/24), respectively. Conclusions:In patients with PSA ≤ 20 ng / ml, prostate biopsy based on bpMRI may improve the detection of CsPCa, especially in patients with PSA ≤ 10 ng/ml.

AIM: To analyze the influence factors of high intraocular pressure after laser epithelial keratomileusis(LASEK), and to discuss the clinical treatment and prognosis of the high intraocular pressure patients.

METHODS: A retrospective study was used. From August 2013 to February 2016, 160 LASEK patients(160 eyes)in our hospital were selected. Visual acuity after operation was recorded. The incidence and influence factors of high intraocular pressure were investigated. The treatment method and prognosis of high intraocular pressure were recorded.

RESULTS: In the 160 patients, all patients had complete epithelial flap and different degree of photophobia. There were 19 patients with postoperative photophobia, conjunctival hyperemia and foreign body sensation significantly. At postoperative 3mo, average intraocular pressure were 18.40±4.98mmHg, which was higher than that of preoperative, 16.27±2.24mmHg(P<0.05), and at postoperative 3mo, visual acuity was significantly higher than preoperative(P<0.05). There were 9 patients with postoperative steroid induced ocular hypertension, the incidence rate was 5.6%; Multiple linear regression analysis showed that the cutting depth(OR=3.209), maximum diameter of curvature(OR=3.071)and fundus C/D(OR=9.224)value were the main risk factors leading to postoperative steroid induced ocular hypertension(P<0.05).

CONCLUSION: The postoperative steroid induced ocular hypertension in LASEK is common, but has no obvious effect on visual acuity. The cutting depth, maximum diameter, curvature fundus C/D value were the main influencing factors, so we should careful use the hormone drugs in treatment and prevention. Periodic review and detection for change of intraocular pressure are needed.

AIM: To investigate the effects of Aflibercept on the K+ channel of retinal Müller cell membrane cultured in vitro.

METHODS: Human Müller cells were divided into 3 groups(control group, high glucose group and experimental group). The control group were cultured in conventional DMEM medium; the high glucose group were cultured in high glucose DMEM medium; the experimental group were cultured with high glucose DMEM medium and 100μmol/L Aflibercept, and the K+ concentration of the cells were detected by MQAE, and the cell survival were detected by MTT assay, the flow cytometry were used to detect apoptosis rates, Western blot analysis were used to detect the Müller cell caspase-3 protein levels.

RESULTS: The Müller cells were positive for glutamine synthetase(GS)after 48h of culture, and the purification degree were above 90%. The relative concentrations of K+ in the control group, high glucose group and experimental group were(2.14±0.44)%,(23.11±4.39)%,(5.20±0.92)%, and cell viability were(100.00±0.00)%, respectively(73.24±4.13)%,(85.22±5.33)%, the apoptosis rates were(5.03±1.91)%,(26.73±3.14)%,(16.63±2.73)%, and compared the differences between two groups were statistically significant(P<0.05). Compared with the control group, the level of caspase-3 protein in the high glucose group Müller cells were increased significantly(P<0.05); compared with the high glucose group Müller cells, the caspase-3 protein level in the experimental group Müller cells were decreased significantly(P<0.05).

CONCLUSION: Aflibercept can inhibit the K+ channel of retinal Müller cells in vitro, inhibit the apoptosis of Müller cells induced by high glucose, decrease the expression of caspase-3 protein, and promote cell proliferation.

AIM: To investigate the effect of aflibercept on the expression of signal transducers and activators of transcription 3(STAT3)in rat retinal Müller cells.

METHODS: The rat retinal Müller cells treated with different concentrations of Aflibercept 100 μL(diluted concentrations of 400, 200, 100 pg/mL, respectively). MTT assay were used to detect cell proliferation, flow cytometry. Apoptosis were detected by the instrument, cell invasion were detected by transwell chamber method, and protein(AKT, STAT3, GAPDH)expression were detected by Western-blot method.

RESULTS: The proliferation activity of Müller cells were decreased with the increased of aflibercept concentration, and compared the difference were statistically significant(P<0.05). After treatment for 48h, the apoptotic rate of Müller cells were gradually increased with the increased of aflibercept concentration, and the invasion and penetration index of Müller cells gradually were decreased, and compared the difference were statistically significant(P<0.05). After 48 h of transfection, the relative expression of AKT protein in Müller cells were not change significantly with the increased of Aflibercept concentration(P>0.05), and the relative expression of STAT3 protein decreased gradually, and compared the difference were statistically significant(P<0.05).

CONCLUSION: Aflibercept can inhibit the expression of STAT3 protein in rat retinal Müller cells, thereby inhibit cell proliferation and invasion and promote apoptosis.

AIM: To make a contrast and then analyze the difference of optical coherence tomography (OCT) before and after vitreomacular traction syndrome (VTS) was performed.METHODS: The clinical date of 11 evaluable eyes of 11 patients with VTS who were diagnosed by OCT and underwent 25G vitreous surgery from January 2013 to January 2014 were retrospectively analyzed.Patients were followed up for an average of 6mo, to observe the visual acuity and OCT examination of the patient before and after operation.We compared the changes of retinal thickness and local morphology before and after operation.RESULTS: After vitreous retraction, 6 eyes improved, 2 eyes do not improve.One eye received macular membrane traction, in the operation the macular epiretinal membrane peeling, retrial membrane stripping and the triamcinolone acetonide intravitreal injection were given, but after the operation, the vision does not improve.Two eyes received vitreous combined with retinal macular membrane traction.In the operation, macular epiretinal membrane stripping was given, after the operation, visual acuity improved.The proportion of those with visual acuity of 0.1 or more increased from 46% before to 73% after the operation.Before operations, the mean central macular thickness was 619.27±195.13μm, 239.12±143.84μm after, which decreased significantly (P<0.05).CONCLUSION: Vitrectomy can effectively relieve the vitreous traction of the macula, and can prevent further decline in visual acuity and reduce macular edema as well as improve the visual acuity of some patients.So, OCT has important guiding significance on the diagnosis and prognosis of this group.