Objective To investigate the effect and changes of IL -18 and IL -35 in patients with recurrent Hp positive gastric ulcer by treating with leibeirazole quadruple therapy.Methods 180 patients with recurrent Hp positive gastric ulcer were divided into two groups.The control group(90 cases)was applied amoxicillin,clarithromy-cin and colloidal bismuth pectin.The observation group was added leibeirazole.The effect and changes of IL -18 and IL -35 were observed before and after treatment in the two groups.Results The effective rate (86.67% vs. 73.33%,χ2 =5.000,P =0.025),inflammatory reaction rate(26.67% vs.51.11%,χ2 =11.314,P =0.008)and Hp positive rate(16.67 % vs.31.11%,χ2 =5.163,P =0.023)were higher in the observation group than in the control group.Expression of IL -18 was decreased after treatment[(70.80 ±11.21)ng/L vs.(88.83 ±7.13)ng/L, t =8.27,P =0.0210]in the observation group,but no change in the control group[(85.62 ±10.84)ng/L vs. (87.64 ±9.28)ng/L,t =0.78,P =0.4512).Expression of IL -35 didn't change after treatment in the two group (P >0.05).Conclusion Leibeirazole quadruple can increase the clinical effect,decrease the expression of IL -18 in patients with recurrent Hp positive gastric ulcer,it is worthy to be applied in clinical treatment.

Background Researches showed that femtosecond laser corneal small incision lenticule extraction (SMILE) was used in the correction of myopia and myopic astigmatism due to its fast recovery,good shortterm efficacy and few complications.However,few research focused on its long-term efficacy.Objective Thisstudy was to evaluate the effectiveness,safety,predictability,stability and complications of SMILE.Methods A serial cases-observational study was carried out under the approval of Ethic Committee of Henan Eye Institute and informed consent of patients.Sixty-seven eyes of 34 patients with myopia and myopic astigmatism were included in Henan Eye Institute from January to June 2013.All the patients received SMILE and followed-up for 2-year duration.The uncorrected visual acuity (UCVA),best corrected visual acuity (BCVA),automatic optometry,intraocular pressure and corneal topography were examined before surgery and 1 day,1 week,1 month,3 months,1 year and 2 years after surgery and calculated the spherical equivalent (SE).The long-term efficacy of SMILE included effective index (preoperative BCVA/postoperative UCVA),safety index (postoperative BCVA/ preoperative BCVA),predictability (linear regression analysis between actual SE and attempted SE) and refractive stability (SE changes at postoperative time points).Results The preoperative BCVA was ≥ 20/20 in 60 eyes with the percentage of 89.55％.UCVA≥ 20/20 were found in 61 eyes and 60 eyes in postoperative 3 months and 2 years respectively (91.04％ and 89.55％).The effective index was 1.038±0.182 and 1.029±0.231 in postoperative 3 months and 2 years respectively,showing an insignificant difference between them (t =0.400,P ＞ 0.05).Compared with the preoperative BCVA,8.96％ (6/67) and 10.45％ (7/67) eyes lost 1 line at 3 months and 2 years after surgery,respectively.The safety indexes were 1.141±0.193 and 1.312±0.242 at 3 months and 2 years after surgery,with no significant difference between them (t =0.414,P＞0.05).A linear correlation was found between actual SE and attempted SE both at postoperative 3 months and 2 years,with the linear regression equations of Y=0.897 1X-0.440 8 (R2 =0.914 2,P＜0.05) and Y =0.893 7X-0.382 3 (R2 =0.915 7,P＜0.05),respectively.The SE was (0.013±0.578),(-0.033±0.489),(-0.106±0.508),(-0.103±0.375),(-0.154±0.518) and (-0.147±0.366)D 1 day,1 week,1 month,3 months,1 year and 2 years after surgery,respectively,and there were no significant difference among different time points (F =0.185,P =0.176).Eighteen in the 67 eyes occurred opaque bubble layer after surgery.Diffuse lamellar keratitis appeared in 6 eyes and punctate keratitis was in 2 eyes.These complications were cured 1 month after administration of drugs.Conclusions SMILE is good in effectiveness,safety,predictability and refreactive stability and has fewer complications during 2-year following-up.

Objective To observe the effect of enteral nutrition emulsion (fresubin diabetes) on inflammatory factors and prognosis in patients with diabetes and mechanical ventilation (MV). Methods Sixty-six patients with diabetes and MV admitted to Lishui Hospital of Traditional Chinese Medicine from June 2014 to December 2016 were enrolled, and they were divided into an observation group and a control group according to random number table, 33 cases in each group. Active treatment of the primary disease, maintenance of water and electrolyte balance, active control of infection, protamine biosynthesis of human insulin injection to control blood glucose and other treatment were given to both groups. After 24 hours of MV, enteral nutrition suspension (nutrison fibre) was evenly dripped into the control group through a nasogastric tube, and fresubin diabetes was evenly dripped with the same method as above into the observation group. After treatment for 2 weeks, the average values of daily blood glucose, of blood glucose fluctuation and daily total insulin dosage of two groups were calculated; the differences in procalcitonin (PCT), high-sensitivity C-reactive protein (hs-CRP) and serum albumin (ALB), prealbumin (PA) and transferrin (TF) were compared before and after treatment in the two groups; the duration of MV, stay time in ICU, and 2-week MV withdrawal rate were observed in the two groups. Results During nutritional therapy, there was no significant difference in the average daily blood glucose level between observation group and control group (mmol/L: 8.62±2.65 vs. 9.70±3.43, P > 0.05), however, in the observation group, the average daily blood glucose fluctuation value (mmol/L: 3.13±1.09 vs. 5.68±1.40), and the daily total insulin dosage (U/d: 31.93±4.93 vs. 43.50±5.31) were significantly lower than those of the control group (both P < 0.05). After treatment, PCT and hs-CRP in both groups were significantly lower than those before treatment, and the degrees of decrease in observation group were more significant than those in the control group [PCT (μg/L):2.81±1.03 vs. 5.95±1.57, hs-CRP (mg/L): 4.41±2.01 vs. 11.46±4.05, all P < 0.05]. After treatment, the levels of ALB, PA and TF were significantly higher than those before treatment [ALB (g/L): the control group was 37.98±3.49 vs. 30.50±3.44, the observation group was 37.88±3.47 vs. 30.48±3.34; PA (mg/L): the control group was 188.60±12.66 vs. 130.22±11.33, the observation group was 184.42±12.95 and 133.50±11.91; TF (mg/L): the control group was 2.71±1.01 vs. 2.07±0.86, the observation group was 2.69±1.02 vs. 2.08±0.90, all P < 0.05]; however, there were no statistical significant differences between the two groups (all P > 0.05). The MV time (days: 7.29±3.65 vs. 10.70±4.43) and ICU stay (days: 11.13±3.09 vs. 15.48±4.40) in the observation group were significantly lower than those in the control group (both P < 0.05), and 2-week MV withdrawal rate was significantly higher than that of the control group [69.70% (23/33) vs. 39.39% (13/33), P < 0.05]. Conclusion Fresubin diabetes can meet the nutritional needs of diabetic patients with MV, in the aspects of controlling blood sugar, maintaining stable blood sugar levels and reducing inflammation, the therapeutic effect of fresubin diabetes is better than that of nutrison fibre, thus fresubin diabetes may better improve the prognosis of patients with diabetes.

OBJECTIVESTo observe the synthesis of Toll-like receptor (TLR) 4 protein and its mRNA expression in Kupffer cells (KCs) and evaluate the role of TLR 4 in liver injury to rats through alcohol-induced liver disease.

METHODSTwenty-eight Wistar rats were divided into two groups: ethanol-fed (group E) and control (group C). Group E rats were given ethanol at a dose of 5 - 12 g x kg(-1) x d(-1), while group C received dextrose. Animals from both groups were killed at 4 and 8 weeks. The KCs were isolated and synthesis of TLR 4 protein was determined by laser scanning confocal microscopy. TLR 4 mRNA expression in KCs was determined by reverse transcription polymerase chain reaction (RT-PCR) analysis. The levels of endotoxin, tumor necrosis factor-alpha (TNF-alpha) and interleukin-6 (IL-6) in plasma were determined. Changes in liver pathology were observed.

RESULTSLaser scanning confocal microscopy showed that the intensity of fluorescence of TLR 4 protein in group E was stronger than group C. Ethanol administration led to a significant increase in TLR 4 mRNA expression in group E compared with group C (P < 0.05). The concentrations of plasma endotoxin, TNF-alpha and IL-6 were higher in group E than in group C (P < 0.05). Liver sections from rats in group E demonstrated marked pathological changes.

CONCLUSIONEthanol administration can lead to the synthesis of TLR 4 protein and its gene expression in KCs, indicating that TLR 4 may play a major role in the development of alcohol-induced liver injury.

Animals ; Drosophila Proteins ; Female ; Interleukin-6 ; blood ; Kupffer Cells ; physiology ; Lipopolysaccharide Receptors ; physiology ; Liver Diseases, Alcoholic ; etiology ; pathology ; Membrane Glycoproteins ; genetics ; physiology ; RNA, Messenger ; analysis ; Rats ; Rats, Wistar ; Receptors, Cell Surface ; genetics ; physiology ; Toll-Like Receptor 4 ; Toll-Like Receptors ; Tumor Necrosis Factor-alpha ; analysis

Objective To study the sensitivity and specificity of parameter Corvis biomechanical index (CBI)— a new biomechanical index of Corvis ST in the diagnosis of keratoconus and evaluate the role of CBI in the diagnosis of keratoconus and the change of biomechanic.Methods A diagnostic trial study was adopted,and 66 eyes from 49 keratoconic patients (keratoconus group) and 91 right eyes from 91 myopic patients (control group) from April in 2018 to August in 2018 in Henan Eye Hospital were enrolled.Pentacam and Corvis ST examinations were performed by the same operator after the basic eye examinations.Using the evaluation of diagnostic test,consistency test,and receiver operating characteristic (ROC) curve analysis,gain the outcome of the sensitivity,specificity,consistency,Youden index,and area under the ROC curve of the parameter CBI.This study protocol was approved by Ethic Committee of Henan Eye Hospital and followed the Declaration of Helsinki.Written informed consent was obtained from each patient prior to any medical examination.Results Sixty eyes were diagnosed as keratoconus by the parameter CBI of Corvis ST.Evaluation of diagnosis test:the sensitivity was 97.0％,and the specificity was 97.8％;consistency check:Kappa =0.948,P＜0.05.ROC curve analysis:the sensitivity was 98.5％,the specificity was 96.8％,Youden index was 96.3％,P＜0.000 1 and AUC was 0.996.Conclusions CBI can separate healthy eyes from keratoconic eyes with highly sensitivity and specificity,which was highly consistency with results of Rabinowitz keratoconus diagnostic criteria.CBI could be used as a new biomechanical indicator for the diagnosis of keratoconus.

Objective:To evaluate the safety and effectiveness of Kangduo endoscopic surgical robot system for partial nephrectomy.Methods:Consecutive patients with stage T 1 renal tumor meeting the inclusion criteria from the Department of Urology, Peking University First Hospital from December 2020 to February 2021 were prospectively enrolled. All patients underwent partial nephrectomy with the Kangduo endoscopic surgical robot system after signing the informed consent. Clinical data including preoperative, perioperative and postoperative pathology and follow-up were collected. Results:Among the 26 patients, there were 16 males and 10 females, with a median age of 53(33-74) years, and a median body mass index of 25.99(20.90-32.91) kg/m 2. There were 12 cases of left kidney tumor and 14 cases of right kidney tumor. The median tumor diameter was 2.2(1.0-3.5) cm. The median time of warm ischemia was 17.7(7.1-29.2) minutes, and all of them were less than 30 minutes. The median docking time was 4.7(2.3-9.9) minutes, and the median time of robotic arm operation was 65.0 (37.0-155.0) minutes. The median National Aeronautics and Space Administration Task Load Index (NASA-TLX) score was 5.3 (2.0-28.0), and no instrument-related adverse events occurred intraoperatively. The median postoperative hospital stay was 4 (4-5) days. All tumor margins were negative on pathologic reports. No Clavien Ⅱ stage operative complications occurred in all patients during perioperative period and 1 month after the surgery. Conclusions:The partial nephrectomy using the kangduo endoscopic surgical robot system were completed successfully, and no instrument-related adverse events and complications occurred, showing that this surgical system used for partial nephrectomy is safe and effective.

The anterior cruciate ligament (ACL) injury is a common sports injury that has a significant impact on knee function and patients′ mobility. With the popularity of national fitness campaign in China, the incidence of ACL injury is increasing year by year. Currently, there still lacks clinical standards or guidelines on how to choose appropriate treatment methods, surgical plans and rehabilitation protocols for ACL injury. In order to timely reflect the new treatment concept of ACL injury, standardize its diagnosis and treatment and improve the curative effect, the Sports Medicine Society of Chinese Research Hospital Association and the Editorial Board of Chinese Journal of Trauma organized domestic orthopedic and sports medicine experts to formulate the "clinical evidence-based guideline for the diagnosis and treatment of anterior cruciate ligament injury (2022 version)" based on the level of evidence-based medicine and in compliance with the principle of scientificity, practicability and advancement. The present guideline includes 12 recommendations for the diagnosis, treatment and rehabilitation of ACL injury in order to provide guidance and assistance for the clinical diagnosis and treatment of ACL injury in China.