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

ObjectiveTo investigate key techniques and intervention in reducing birth defects. Method Down's syndrome (DS), trisomy-18 (Edwards syndrome, ES), neural tube defects (NTD), Duchenne muscular dystrophy (DMD), spinal muscular atrophy (SMA), thalassemia, and glucose-6-phosphate dehydrogenase deficiency (G6PD) were chosen as target disease. From Jan. 2007 to Dec. 2009, the condition of intake folie acid were investigated in 5004 pregnant women in Panlong District and Wuhua District of Kunming City. All of the 27 660 pregnant women undergoing prenatal examination were enrolled into the study from the First People's Hospital of Yunnan Province, the Second People's Hospital of Yunnan Province, the First People's Hospital of Qujing City, the Second People's of Qujing City, Qujing Women and Children's Hospital, People's Hospital of Lincang City, Kunming Maria Women's Hospital, Maternal and Infant's Care Unit of Panlong District of Kunming City, Maternal and Infant's Hospital of Dali City. The screening was performed on serum of those pregnant women at 8 -20 +6 gestational weeks. Prenatal cytogenetic analysis and fetal ultrasonogrspy were performed on the high risk or indicated women after genetic counseling. DNA analysis was administered on those women with family or childbearing history of DMD,SMA,thalassemia,orG6PD. Outcomeof pregnancywasfolloweduptoevaluatetheeffectof intervention. ResultsApproximately 30. 10％ (1506/5004) of pregnant women were administered by oral folic acid during perinatal period. Two thousand three hundred and thirteen women with high risks of DS,ES, or NTD fetuses were observed among 27 660 undergoing maternal serum screening. Two thousand and ninety-six pregnant women including two twins pregnant women were performed cytogenetic analysis. Other 67 pregnant women at high risk of DMD, SMA, thalassemia, and G6PD accepted genetic counseling and prenatal gene analysis. Two thousand one hundred and sixty-three pregnant women (2165 fetuses) underwent prenatal examination. One hundred and two cases chromosome abnormalities, 17 cases NTD, 4 cases DMD, 1 cases α-thalassemia major were found. All of the 91 fetuses with major birth defects were terminated after genetic counseling. Another affected DS fetus in a twin pregnancy dead intrauterine at 24 gestational weeks. Thirty-two women bearing fetuseswithbalancedtranslocations orinversionscontinuedtheir pregnancies. Totally 2071 normal term fetuses were born in the prenatal diagnosis group. Two fetuses with normal chromosome were lost within 1 week after amniocentesis. Four affected DS fetuses were born from their high risk mothers who refused further prenatal diagnosis service. In a random sampling follow-up cohort of 5000 mothers at low risk, none of affected child suffering target diseases was found. The DS detection rate of maternal serum screening was 84％ (27/32), with the false positive rate was 6. 153％ (1702/27 660).ConclusionsFolic acid intake before conception and in the first trimester would reduce the risk of birth defects, only 1/3 reproductive women took folie acid actively. Maternal serum screening could effectively detect high risk of DS, ES and NTD. The genetic counseling is critical in women at high risk or who had family history of inherited disorders. The prenatal screening and diagnosis combined with routine obstetric care could reduce the incidence of major birth defects, which should become prenatal care strategy in our country.

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 compare brain lead accumulation and neurotoxicity induced by lead under drinking purified water and tap water on rat.

METHODSAll 104 male weaning SD rats were randomly divided into eight groups, matched-four pairs according to drinking water: tap water, purified water, tap water with lead 50 mg/L(lead acetate water-solution), purified water with lead 50 mg/L, tap water with lead 200 mg/L, purified water with lead 200 mg/L, tap water with lead 800 mg/L. All were fed with normal food and environmental cognitions kept consistent Morris water maze(including Place Navigation, Spatial Probe Test, Visible Platform Trial) was measured to test rat spatial learning at the 12 and 24 week. At the end of the experiment (28 week), rats were killed and the lead of brain and blood was measured by Graphite furnace atomic absorption spectrometric method; the NR1, NR2A, NR2B of NMDAR (N-methyl-D-aspartame receptor) in hippocampus were analyzed by RT-PCR.

RESULTSUnder the same lead exposure, no significant differences were observed in blood lead, however, brain lead level showed higher in drinking purified water group than that in tap water group. Expression of NR1, NR2A and NR2B in hippocampus of the rats drinking purified water was lower than those drinking tap water, especially at low lead exposure (50 mg/L) (P < 0.05). In the 24 week Morris water maze, place navigation test's escape latency showed significantly prolonged at the rats drinking purified water as compared with those drinking tap water on the pairs of 50 mg/L and 200 mg/L pb2+ groups (P < 0.05), and the differences occurred in early 1-2 days.

CONCLUSIONCompared with drinking tap water, drinking purified water might increase the accumulation of brain lead, lower NR1, NR2A, NR2B expression and delay the spatial learning and memory ability under chronic lead exposure in water.

Animals ; Drinking ; Intelligence ; drug effects ; Lead ; toxicity ; Male ; Maze Learning ; drug effects ; Memory ; drug effects ; N-Methylaspartate ; Rats ; Rats, Sprague-Dawley ; Receptors, N-Methyl-D-Aspartate ; drug effects