AIM: To evaluate the accuracy of central conreal thickness ( CCT ) using EX500 Excimer Laser workstation (EX500) in laser in situ keratomileusis (LASIK) patients.METHODS:The CCT of 120 eyes (63 patients) who had LASIK between January 2013 and June 2013 were measured by A- scan and EX500. Three groups were classified: >550μm, 500 ~550μm, <500μm according the CCT value of A-scan. The CCT were measured again by corneal flap creating by moria SBK microkeratome. The thickness of the corneal bed stroma were measured by A-scan and EX500 after keratomileusis. All outcomes were analyzed with paired t test.
RESULTS: The average preoperative CCT value was 527. 9±34. 3μm measured by A-scan, 528. 5±34. 6μm measured by EX500. There was no significant difference between these two measurements (t=1. 736, P=0. 085). In group which CCT >550μm, the average preoperative CCT value was 571. 4±17. 3μm measured by A-scan, 572.7±15. 7μm measured by EX500. There was no significant difference between these two measurements (t=1. 857, P=0. 072). In group which CCT 500 ~ 550μm, the average preoperative CCT value was 523. 4±13. 1μm measured by A-scan, 524. 2±12. 4μm measured by EX500. There was no significant difference between these two measurements ( t=1. 934, P = 0. 058 ). In group which CCT <500μm, the average preoperative CCT value 484. 5±9.8μm measured by A-scan, 483. 7±8. 9μm measured by EX500. There was no significant difference between these two measurements (t=1. 395, P=0. 174). The average CCT value after corneal flap lifting was 401. 3 ± 34. 2μm measured by A-scan, 393. 4±38. 9μm measured by EX500. There was a significant difference between these two measurements ( t = 6. 669, P = 0. 000 ). The average thickness of the corneal bed stroma value after keratomileusis was 332. 6±38. 3μm measured by A-scan, 307. 3 ± 37. 1μm measured by EX500. There was a significant difference between these two measurements ( t=17. 165, P=0. 000).
CONCLUSION: There is no significant difference between preoperative CCT value measured by A-scan and EX500. After corneal flap lifting and keratomileusis, the CCT value measured by EX500 is smaller than measured by A-scan.

Adult ; Foot Diseases ; diagnostic imaging ; Humans ; Male ; Melorheostosis ; diagnostic imaging ; Radiography ; X-Rays

AIM: To evaluate the changes of corneal high - order aberration (including Coma, Spab, RMSh) after laser in situ keratomileusis (LASIK) with femtosecond laser, sub- Bowman keratomileusis ( SBK ) and laser epithelial keratomileusis (LASEK). METHODS: Of 82 myopic patients ( 164 eyes ), 31 patients (62 eyes) were treated by FS-LASIK, 31 patients (62 eyes) were treated by SBK, 20 patients (40 eyes) were treated by LASEK. Sirius system was used for measuring the coma aberration, spherical aberration, and high order aberration at 1, 15d,1, 3mo after surgery. RESULTS: 1) Vision: The uncorrected visual acuity of the three groups had no differences (P>0. 05). 2) Corneal aberrations: Three kinds of surgical procedure for patients with corneal aberration had significant impact. The C7, C8, C12 and RMSh of three groups were increased significantly (P<0. 05). The C7, C8, C12 and RMSh were not recovered to preoperative levels after 3mo. But the increase of patients after FS- LASIK was smaller than the other two groups, with statistical significance (P<0. 05). CONCLUSION: Compared with SBK and LASEK, FS - LASIK has better visual acuity in the early postoperative and corneal higher-order aberrations increase is relatively small.

OBJECTIVETo investigate the effects of total flavonoids of Litsea Coreana (TFLC) on the gap junction (GJ) intercellular communication in TM3 testicular Leydig cells and whether TFLC can reduce the cytotoxicity of oxaliplatin (OHP) in vitro.

METHODSWe detected the effect of TFLC on the dye spread of the in vitro cultured TM3 cells by parachute assay, observed changes in the expression of connexin 43 (Cx43) total protein in the TFLC-treated TM3 cells by Western blot, and determined the effects of TFLC on the expression of Cx43 on the membrane of the TM3 cells by immunofluorescence assay and on the cytotoxicity of OHP by MTT assay.

RESULTSTFLC obviously enhanced the GJ function with the increasing of the TFLC concentration in the TM3 cells. Western blot and immunofluorescence assay confirmed that TFLC significantly enhanced the expression of Cx43 total protein and Cx43 expression on the membrane of the TM3 cells. MTT assay showed that at a high cell density (confluent with GJ formation), 20 microg/ml TFLC enhanced the GJ function of the TM3 cells and reduced the cytotoxicity of OHP (P < 0.05), while at a low density (preconfluent with no GJ formation), TFLC exhibited no effect on the cytotoxicity of OHP (P > 0.05).

CONCLUSIONTFLC increases the Cx43 expression and GJ function in normal TM3 Leydig cells, and the enhancement of GJ function reduces the cytotoxicity of OHP.

Antineoplastic Agents ; toxicity ; Cell Communication ; drug effects ; physiology ; Cell Count ; Connexin 43 ; metabolism ; Flavonoids ; pharmacology ; Gap Junctions ; drug effects ; Humans ; In Vitro Techniques ; Leydig Cells ; drug effects ; ultrastructure ; Litsea ; chemistry ; Male ; Organoplatinum Compounds ; antagonists & inhibitors ; toxicity ; Proteins ; metabolism

Chemical constituents from the acetone extract of twigs of Manglietia hookeri were isolated and purified by various column chromatographic methods over silica gel and sephadex LH-20, and preparative TLC. The structures of these compounds were identified on the basis of physicochemical properties and spectral analysis, including NMR and MS spectra. Six eudesmane sesquiterpenes were obtained and their structures were identified as trans-eudesmane-4, 11-diol(1), β-eudesmol(2), (-) -10-epi-5β-hydroxy-β-eudesmol (3), epi-carrisone (4), 6-hydroxy-eudesm-4(14) -ene(5) and gynurenol(6). All the compounds were isolated from this plant for the first time. Furthermore, the 13C-NMR data of compound 3 were reported for the first time.
Drugs, Chinese Herbal ; chemistry ; isolation & purification ; Magnetic Resonance Spectroscopy ; Magnolia ; chemistry ; Molecular Structure ; Plant Stems ; chemistry ; Sesquiterpenes, Eudesmane ; chemistry ; isolation & purification ; Spectrometry, Mass, Electrospray Ionization

Objective • To investigate the correlation between blood pressure and catecholamine levels in children with obstructive sleep apnea hypopnea syndrome (OSAHS). Methods • From January 2014 to December 2014, children and adolescents aged 2 to 12 years old who complained mainly of snoring during sleep were admitted to Department of Otolaryngology-Head and Neck Surgery, Shanghai Children's Hospital and underwent surgery. Allnight polysomnography (PSG) was used to monitor and measure the systolic blood pressure (SBP) and diastolic blood pressure (DBP) in conscious state. According to the blood pressure reference standard of Chinese children and adolescents in 2010, the children with OSAHS were divided into normal blood pressure group, SBP increased group, DBP increased group, and SBP and DBP increased group. The children with OSAHS were divided into light, moderate and severe OSAHS subgroups according to the apnea hypopnea index (AHI) and the lowest oxygen saturation (LSpO2). The correlation between blood pressure and the level of catecholamine was analyzed in the children with OSAHS. Results • Two hundred and twenty-three subjects were included in the analysis. The average SBP was (100.3±9.8) mmHg (1 mmHg=0.133 kPa) and the average DBP was (63.0±9.8) mmHg. There were 50 cases (22.42%) diagnosed as hypertension, in which 20 cases (8.97%) were severe hypertension. The 223 children with OSAHS were divided into mild OSAHS subgroup (n=59), moderate OSAHS subgroup (n=127) and severe OSAHS subgroup (n=37) according to OSAHS grades. The difference of adrenaline level between the normal blood pressure group and the DBP increased group was statistically significant (P=0.032). The difference of LSpO2 between the DBP increased group and the SBP and DBP increased group was statistically significant (P=0.031). There were no significant differences in dopamine and noradrenaline levels among the four groups. There were significant differences in SBP and adrenaline level between OSAHS mild subgroup and moderate subgroup (P=0.038, P=0.000), but there were no significant differences between the moderate OSAHS subgroup and the severe OSAHS subgroup. There were no significant differences in dopamine and noradrenaline levels among the three OSAHS subgroups. Conclusion • The increase of plasma catecholamine level in children with OSAHS can lead to the increase of SBP, which will increase with the development of OSAHS. Therefore, early diagnosis and treatment of OSAHS should be taken into consideration.

BACKGROUNDPhakic intraocular lens (pIOL) implantation has been a popular means for the treatment of high ametropia. Measurements of ciliary sulcus diameter is important for pIOL size determining. But till now, no perfect system can directly measure it. The present study was to evaluate the accuracy, repeatability and reproducibility of direct sulcus diameter measurements obtained by a full-scale 50-megahertz (MHz) ultrasound biomicroscopy (UBM).

METHODSA fresh cadaver human eye with a scale marker inserted through the posterior chamber plane from 3 o'clock to 9 o'clock meridian and 30 randomly selected eyes from 30 normal subjects were scanned by full-scale 50-MHz UBM in horizontal meridional scan plane. The distance between the scales and the whole length of the marker inside the cadaver eye were measured by the same observer using the "built-in" measurement tools and the indicating error of instrument was calculated. Reproducibility of the measurement was evaluated in 30 eyes by 2 operators using Blander and Altman plot test. Repeatability was evaluated from 10 successive eyes randomly selected from the 30 eyes by one operator.

RESULTSOn a scale of 1 mm, the greatest indicating error was 40 microm; the mean largest indicating error of 1 mm scale from the 10 images was (26 +/- 14) microm; on a scale of 11 mm, the greatest indicating error was 70 microm; the error rate was 0.64%. The mean length of the needle inside the eye of the 10 images was 11.05 mm, with the mean indicating error of 47 microm, the average error rate was 0.43%. For ciliary sulcus diameter measurements in vivo, the coefficient of variation was 0.38%; the coefficients of repeatability for intra-observer and inter-observer measurements were 1.99% and 2.55%, respectively. The limits of agreement for intra-observer and inter-observer measurement were -0.41 mm to 0.48 mm and -0.59 mm to 0.58 mm, respectively.

CONCLUSIONThe full-scale 50-MHz UBM can be a high accuracy and good repeatability means for direct measuring the ciliary sulcus diameter and useful for size determining of posterior chamber pIOL.

Ciliary Body ; diagnostic imaging ; Humans ; In Vitro Techniques ; Lenses, Intraocular ; Microscopy, Acoustic ; methods ; standards ; Reproducibility of Results

Objective To evaluate the efficacy of ultrasound-guided modified anterior approach to sciatic nerve block ( SNB) for orthopedic surgery with general anesthesia. Methods Ninety American So-ciety of Anesthesiology physical status Ⅰ or Ⅱpatients of both sexes, aged 18-64 yr, weighing 19-28 kg∕m2 , scheduled for elective knee joint or distal orthopedic surgery, were divided into 3 groups ( n=30 each) using a random number table method: modified anterior approach ( the puncture needle was almost perpendicular to the ultrasound beam) group, anterior approach group and posterior approach group. SNB ( injecting 0. 5％ ropivacaine 20 ml) combined with femoral nerve block ( injecting 0. 5％ ropivacaine 15-20 ml) was performed under ultrasound guidance. Surgery was completed under combination of the laryngeal mask and combined intravenous-inhalational anesthesia. When the respiratory rate ≥20 beats∕min and∕or the increase in heart rate was more than 20％ of the baseline value, sufentanil 1μg∕time was intravenously injected. When visual analog scale ( VAS) score ≥4 within 24 h after surgery, celecoxib capsules 0. 2 g was taken orally for analgesia. The depth of sciatic nerve, needling depth, sharpness score of needle ima-ging under ultrasound, and operation time and duration of SNB were recorded. VAS scores at rest and dur-ing activity were recorded at 6, 8, 10, 12 and 24 h after surgery. The amount of sufentanil consumed dur-ing surgery and use of celecoxib capsules within 24 h after surgery were recorded. The development of ad-verse reactions such as hematoma at the puncture site, nausea and vomiting was also recorded after surgery. Results Compared with posterior approach group, the depth of sciatic nerve and needling depth were sig-nificantly increased, the operation time of SNB was prolonged, the duration of SNB was shortened, the in-traoperative consumption of sufentanil was increased, VAS scores at rest and during activity were increased at 10 h after surgery, and the sharpness score of needle imaging was increased in modified anterior approach and anterior approach groups (P<0. 05). Compared with anterior approach group, the sharpness score of needle imaging was significantly increased, and VAS scores during activity were decreased at 24 h after sur-gery in modified anterior approach group ( P<0. 05) . There was no significant difference in the requirement for celecoxib capsules within 24 h after surgery or occurrence of adverse reactions among the three groups ( P>0. 05) . Conclusion Although ultrasound-guided modified anterior approach to SNB provides compara-ble efficacy with anterior approach to SNB and is not as good as posterior approach to SNB when used for or-thopedic surgery with general anesthesia, modified anterior approach to SNB is easy to operate, with clear images under ultrasound.

OBJECTIVEDuring recent years several changes have occurred in the clinical characteristics of infective endocarditis (IE) which has made a new challenge in the management of this disease. This study aimed to understand current practice pattern in the management of pediatric IE in China.

METHODSThis retrospective, multicenter study was conducted in 13 hospitals. Clinical data of 268 patients diagnosed as IE according to the new IE criteria (trial) between 2000 and 2006 were analysed, focusing particularly on management and outcome of patients. The mean age of patients was 8.94 years (18 d - 18 years).

RESULTSExcept for one patient who died after admission without treatment, 56 antimicrobial agents were used in the management of this disease in the 267 patients, including cephalosporin group (15), penicillin group (8), beta-lactamase inhibitor combination (8), aminoglycosides (4), glycopeptide agents (3) etc. The most commonly used antibiotics were as follows: penicillin G (125 cases/times), cefotaxime (113), vancomycin (78), ceftriaxone (73), ampicillin (66), cefuroxime (56), piperacillin (48), amikacin (39) etc. For management of this disease, only one antibiotic agent was used in 33 (12.3%) patients, two antibiotic agents in 83 (31.1%) patients, 3 antibiotic agents in 44 (16.5%) patients, 4 antibiotic agents in 57 (21.3%) patients, 5 antibiotic agents in 25 (9.4%) patients, 6 or more antibiotic agents in 25 (9.4%) patients. The most commonly used antibiotic agents in patients with streptococci detected in blood culture were penicillin G, cephalosporins, vancomycin, beta-lactamase inhibitor combination, and aminoglycoside, in patients with staphylococcus detected in blood culture were cephalosporins, oxacillin, vancomycin, aminoglycoside, and quinolones. Duration of antibiotic treatment was from 1 day to 98 days, less than 2 weeks in 19 (7%) patients, 2 weeks to less than 4 weeks in 74 (27.7%) patients, 4-6 weeks in 122 (45.7%) patients, more than 6 weeks in 52 (19.4%) patients; 123 patients simultaneously underwent surgical management (for removal of vegetations and intracardiac defects or residual shunt repair 105, and valve repair 8, valve replacement 6, intracardiac defect repair 4 ) Of the 268 patients, 186 patients were cured, 4 patients were referred to surgery, 18 patients died and 60 patients refused medical advice. In antibiotics and surgical treatment group (123 patients), 111 patients were cured, 4 patients were referred to surgery, 5 patients died, 3 patients refused medical advice, in antibiotics treatment group (145 patients), 75 patients were cured, 13 patients died, 57 patients refused medical advice. The outcomes were significantly different between the two groups (chi2 = 61.7, P = 0.000). The results of multivariate logistic regression analysis showed that Staphylococcus aureus as a pathogen (chi2 = 4.40, P = 0.036, OR = 9.78, 95% CI 1.16-82.26), children with repaired congenital heart disease (chi2 = 9.4, P = 0.002, OR = 9.8, 95% CI 2.28-42.16), and complicated with heart failure (chi2 = 10.36, P = 0.001, OR = 0.075, 95% CI 0.16-0.36) were risk factors related to death.

CONCLUSIONThis study revealed the current status in the management of pediatric IE in China Wide range antibiotic agents and diverse regimens are used to manage children with IE. For improving management of pediatric IE, there is an urgent need for guidelines or recommendations or consensus for management of pediatric IE stipulated by multidiscipline specialists, and randomized controlled clinical trials are required to provide evidences.

Adolescent ; Child ; Child, Preschool ; Endocarditis, Bacterial ; therapy ; Female ; Humans ; Infant ; Infant, Newborn ; Logistic Models ; Male ; Retrospective Studies ; Treatment Outcome

OBJECTIVETo evaluate the effects of different vibration frequency on the back muscle fatigue during simulated driving.

METHODSThirty-six subjects performed three simulated driving experiments under three vertical vibration frequencies which were 1.8, 4.0, 6.0 Hz respectively and the driving time was 90 minutes. At the same time the electromyography of low back was recorded.

RESULTSThe median frequencies calculated from the power spectrum were decreased exponentially under three vertical vibration frequencies, especially under 4.0 Hz vibration frequency.

CONCLUSIONThe 4.0 Hz vibration frequency has the most important effect on the back muscle fatigue under simulated driving condition.

Adult ; Automobile Driving ; Electromyography ; methods ; Humans ; Low Back Pain ; etiology ; physiopathology ; Male ; Models, Biological ; Muscle Fatigue ; physiology ; Muscles ; physiology ; Posture ; physiology