Background Fungal keratitis has a high incidence in China and its clinical treatment is very difficult,and its etiology diagnosis and appraisal is the premise to improve the prognosis of disease.With the changes of regional environment and climate in recent years,whether the spectrum of fungal keratitis change in South China is remarkable.Objective The purpose of this study was to investigate recent pathogenic distribution of fungal keratitis in South China area.Methods The consecutive fungal culture resuhs of 3 350 purulent keratitis at Zhongshan Ophthalmic Center from January 2009 to December 2014 were retrospectively reviewed.The positive rate of fungal culture,genus or species distribution,seasonal distribution and different term distribution were analyzed.Results The culture-positive rate was 31.34％ in this study (1 050/3 350),and the average culture-positive number was 175 strains per year.In the positive fungus,the highest positive rate was Fusarium SP (32.10％,337/1 050),and followed by Aspergillus SP (25.71％,270/1 050),Heminthosporium SP (14.29 ％,150/1 050) and Mucor SP (9.14％,96/1 050).The fungal culture-positive rate was 36.05％ (367/1 018) in 2009 to 2010,32.45％ (324/1 014) in 2011 to 2012,and 26.86％ (354/1 318) in 2013 to 2014,respectively,with a significant difference among the three periods (x2 =22.37,P＜0.01),showing a decreasing tendency of incidence.Two hundreds and sixtyone strains were isolated from January to March (31.15 ％,261/838),182 strains from April to June (25.53 ％,182/713),237 strains from July to September (30.00％,237/790),370 strains from October to December (36.67％,370/1 009),showing a statistically significant difference among them (x2 =25.19,P ＜ 0.01).The number of infectious strains was most during October to December and fewest during April to June.Conclusions The leading pathogenic fungi of fungal keratitis is Fusarium SP and followed by Aspergillus SP,Helminthosporium SP,Mucor SP in turn.Fungal keratitis is usually prevalent from October to December,and its incidence is still rising in Chinese mainland recently.However,the increasing tendency in South China has been prevented in recent six years.

Objective To investigate the value of using gonadotropin-releasing hormone agonist (GnRH-a) pretreatment in adenomyosis patients before adenomyomectomy. Methods From May 2012 to September 2015, 87 patients with adenomyosis who were non-effective to conservative therapy in Renmin Hospital of Wuhan University were enrolled in this study. According to the principle of randomized control, 41 patients were in the treatment group who were treated with GnRH-a 2-3 cycles before adenomyomectomy, while 46 patients in the control group. The control group paients were operated without any pretreatments. The blood loss, the number of penetrating into uterine cavity, duration of operation, duation of peritoneal drainage and the amount of drainage fluid, the difference of hemoglobin value before and after operation, total white blood cell count, duration of hospitalization, the maximum diameter of uterus and other indicators between the two groups were compared. Results In the treatment group, before and after treatment with GnRH-a, the uterus size, blood hemoglobinand CA125 value were statistically different (all P<0.05);between the treatment group of GnRH-a treated for 2 cycles and for 3 cycles, there were statistical differences of blood hemoglobin value [(108 ± 20) versus (118 ± 24) g/L], CA125 value [(26 ± 11) versus(19 ± 4) kU/L; all P<0.05]. There were statistical differences of blood loss in operation [(113 ± 32) versus (194 ± 42) ml], ratio of penetrating into uterine cavity [12%(5/41) versus 12%(8/46)], duration of operation[(79±23) versus (91±25) minutes], duration of peritoneal drainage after operation [(2.1±0.9) versus (3.0±1.2) days] and the amount of drainage fluid [(152±43) versus (232±32) ml], the difference of hemoglobin value before and after surgery [(-15.6±2.9) versus (-23.7±3.5) g/L], white blood cell count after 2-3 days of operation [(11.4±4.2)×109/L versus (13.5 ± 3.2) × 109/L], ratio of peri-operative blood transfusion [5% (2/41) versus 20% (9/46)] and duration of hospitalization [(11.2±1.9) versus (13.6±3.1) days] between the treatment group and the control group (all P<0.05). Conclusion The pretreatment of using GnRH-a before adenomyomectomy in adenomyosis patients has benefits for implementation of surgery and reducing peri-operative and postoperative complications.

OBJECTIVE:To observe the clinical efficacy of Shenkang injection,a new compound preparation for chronic renal failure(CRF).METHODS:A total of 84 CRF patients were randomly divided into two groups:the treatment group(n=54)was given routine antihypertensive therapy and infused(iv gtt)with Shenkang injection 60～ 100mL(dissolved in 10% GS 300mL or NS 300mL)q.d for 30d;the control group(n=30)was infused(iv gtt)with Compound danshen injection 250mL q.d for 30d.RESULTS:As compared with the control group,serum levels of creatinine and urea nitrogen(UN)in treatment group had a greater reduction(P

Objective To investigate which is better for gastroduodenal endoscopic ultrasound (EUS) between right lateral position and left lateral position of patients guided by nurses. Methods A total of 79 patients were randomly assigned to the left and right lateral position groups. Each patient received EUS examination in three parts, which were sinuses ventriculi, duodenal bulb and descendant duodenum. The operating time and the water volume of each patient were recorded in the procedure of EUS. Results Operating time in sinuses ventriculi, duodenal bulb and descendant duodenum of left lateral position group was (9.0±4.0) min, (6.5±3.2) min and (13.6±10.9) min, while (5.7±3.0) min, (3.6± 1.7) min and ( 6.6±5.7) min in right lateral position group, the differences were significant (t=3.098, 2.190, 3.210, P<0.05) . In the meantime, water volume was (892.0±169.5) ml, (898.6±145.9) ml and (1 012.0± 333.2) ml in sinuses ventriculi, duodenal bulb and descendant duodenum of left lateral position group, while (327.1±79.3) ml, (260.6±30.4) ml and (263.8±17.7) ml in three parts of right lateral position group, respectively. Significant differences were found in water volume among subgroups (t=13.798, 11.290, 4.930, P<0.01 or 0.05). Conclusions In the process of EUS for submucosal lesions at gastric antrum and duodenum, right lateral position instructed by nurses can shorten the operating time and make the procedure easier. This might reduce risks of regurgitation, aspiration, and other related complications.

Adult ; Aged ; Carbon Monoxide Poisoning ; blood ; pathology ; Creatine Kinase ; blood ; Female ; Humans ; Male ; Middle Aged ; Myocardium ; pathology ; Natriuretic Peptide, Brain ; blood ; Peptide Fragments ; blood ; Troponin I ; blood ; Young Adult

[ABSTRACT]OBJECTIVEThe purpose of the study is to put forward some ideas and suggestions for the future research of allergic rhinitis.METHODSThe experimental animal species, strains, methods of replicating animal model and the judging standard of allergic rhinitis in China from January 1998 to December 2014 were reviewed and analyzed.RESULTSThe experimental animal species, strains, methods of replicating animal model and the judging standard of allergic rhinitis used in 137 articles were different.CONCLUSIONOnly standardized and unified experimental animal model can ensure the implementation of scientific research successfully and the reliability of the experimental results.

Objective To investigate the impact of down-regulation of histone methyltransferase enhancer of zeste homolog 2 (EZH2) on RUNX3 expressions,proliferation and apoptosis in human pancreatic cancer.Methods The expressions of EZH2 and RUNX3 in 38 pancreatic cancer patients and human pancreatic cancer AsPC-1,PANC-1 and BxPC-3 cells were detected by immunohistochemistry and western blot,respectively.Cells were transfected with siEZH2 by lipofectamin 2000.Real time-PCR and western blot were used to detect EZH2 and RUNX3 expressions.Cell growth and apoptosis in vitro and vivo were assessed by MTT,flow cytometry and nude mice experiments,respectively.The correlation among the expressions of EZH2,clinical pathological features and overall survival rate were analyzed.Results Elevated EZH2 and decreased RUNX3 expressions were observed in human pancreatic cancer tissues and cells (P ＜ 0.05).Knockdown of EZH2 reduced cell growth and induced apoptosis in vitro and vivo by upregulating RUNX3 protein expression (P ＜ 0.05).In addition,the EZH2 expressions were correlated with tumor stage,lymph node metastasis and poor prognosis (P ＜ 0.05).Conclusions EZH2 expressions were correlated with malignancy and poor prognosis in pancreatic cancer.Tumor cell proliferation was promoted by EZH2 through down-regulation of RUNX3.EZH2 may be a potential therapeutic target for pancreatic cancer.

Objective To identify whether the branches of cervical nerve roots joined into the accessory nerve trunk or not.Methods In 10 adult cadavers (7 males and 3 females, including 20 laterals of brachial plexus nerves), we observe source of cervical plexus branches to the accessory nerve anatomically.In 10 clinical cases of males with brachial plexus nerve injures, in the supraclavicular approach of brachial plexus exploration, the part of the supraclavicular cutaneous nerve for histological specimen were cut off;in the posterior approach, electrical stimulation of the trunk and branches of cervical plexus were performed to observed istaltrapezius muscle contraction.After accessory nerve transfer, the residual terminal accessory nerve and branch of cervical plexus were taked for histological specimens;and observed and judged of each nerve sample by acetylcholinesterase (AchE) immunohistochemical staining.Results In 10 of 20 lateral cases, cervical plexus communicating branches were derived from the fourth cervical nerve root.The intraoperative electrical stimulation of the accessory nerve trunk, 10 cases of distal trapezius muscle were significantly shrink;electrical stimulation of the cervical plexus branch, 2 cases after stimulation of the mild distal trapezius contraction, the remaining 8 cases without trapezius muscle contraction.10 cases of supraclavicular nerve staining for AchE were negative, 10 cases of accessory nerve terminal branches of AchE staining were mixed,10 cases of branch AchE cervical plexus to the accessory nerve staining were negative.Conclusion The branches of the fourth cervical nerve root constantly joins into the accessory nerve, participating in the trapezius muscle inner vation, the fibers of the branches are sensorial fibers.

Objective To discuss with micro-tympanoplastic operation with osteo retention on treating cholesteatomatous otitismedis. Methods Choose 33 cases cholesteatomatous otitis medis patients who toke the tympanoplastic with osteo retention operation,then analyze the postulate and method of the operation, curative effect and complication after operation. Results Follow up with those patients by 12-72 months, and when 3-4 months after operation we endoscopiced the ears, could see that 43 cases of patients ear mastoid process and tympanic sinus were covered with epithelium, those mastoid cavity were well epithelial metaplasia;and the middle ear was separate from mastoid cavity; 39 cases patient of transplant eardrums are heal up (39/43, 90.7%). 2 cases have perforation of the tympanic membrane toke place after 4 months and 6 months with the operation, and it will heal up by anti-inflammatory drug and laser burning, 1 case had tympanic sinus hyperplasia with granulation tissue, and also had grassery juice; after taken anti-inflammatory drug and change bandage for 15 weeks, the symptom disappear. 1 case had grassery juice of operation cavity, after taking anti-inflammatory drug and physiotherapy, the symptom disappear in 24 weeks. After operation the pure tone audiometry shows that air conduction raise (16.8±6.8) dB HL, hearing raise up to:79.1%(34/43). Conclusion Base on right indication of operation choose, taken combined therapy of ambi-operation period, focus of infection are thoroughly cleaning up. Tympanoplastic with osteo retention are treating well with patients of cholesteatomatous otitismedis.

BACKGROUND: Rehabilitation exercise and conservative treatment do not bring about good therapeutic effect for severe obstructive emphysema.And lung volume reduction surgery (LVRS) is an effective method for this kind of disease. How much emphysematous tissue should be resected in LVRS to achieve the best curative effect has been a concern.OBJECTIVE: To evaluate the pulmonary functional and alveolar morphologic changes in emphysematous rabbits after unilateral LVRS, and to compare the effects of different resection volumes.DESIGN: A completely randomized and controlled trial.SETTING: Thoracic Surgery Center of Daping Hospital of the Third Military Medical University of Chinese PLA.MATERIALS: This study was completed at the Laboratory of Thoracic Surgery Center of Daping Hospital of the Third Military Medical University of Chinese PLA from Frebruary 2003 to August 2003. Totally 50 New Zealand white male rabbits of cleaning grade were involved. These animals were divided randomly into groups of emphysema (A), less volume LVRS (B), middle volume LVRS (C), larger volume LVRS (D), and shame operation (E) .METHODS: Making of the rabbit emphysema model: Rabbits were put into an organic glass box and they inhaled passively smog produced from the cigarettes. Within seven weeks, 15 cigarettes (Yinxiang .Brand) were lighted for about 30 minutes every time, once per day and five times a week. Elastase for 3 mL(2000 U/kg) from porcine pancreas (SERVA Co.,Ltd) was injected into the rabbits' trachea in the fourth week. Intervention for different groups: Rabbits in Group A received no operation at all. Animals in other four groups were given general anesthesia by muscular injec tion of Sumianxin Ⅱ and they were then fixed supinely on the operation table. The rabbits were intubated with a 3-mm endotracheal tube and mechanically ventilated (HX-200 ventilator) with a tidal volume of 12 mL/kg and a respiratory rate of 40-50/minute. Thoracotomy was conducted through anterolateral incision of the fourth right intercostals area. The upper and lateral pulmonary tissues of the first lobe of the right lung were resected in Group B. For group C, the upper and lateral pulmonary tissues of the first and the second lobes of the lung were resected. For Group D, the upper and lateral pulmonary tissues of the first, second and the third lobes of the right lung were resected. The pulmonary removal was about a half of the total volume of the lobe. The specimens were removed, followed by 3-0 mattress suture of the wounds. Then, fibrin sealant was insufflated to avoid air leakage after the operation. Thoracotomies without any resection of lung parenchyma were carried out in Group E. Histologic inspection and quantitatively morphologic analysis of the left lung was postoperatively carried out eight weeks later.MAIN OUTCOME MEASURES: Quantitative analysis of pulmonary functions and alveolar morphology in rabbits with emphysema after lung volume reduction surgery with different resection volumes RESULTS: All the fifty rabbits were analyzed, and there were ten animals in each group. ① Comparison of ventilation volume in each group: In Group C, vital volume (VT), forced expiratory volume in 0.3 s (FEV0.3),FEV0.3/forced expiratory capacity (FVC) were all higher than those of Group A [(6.69±0.83) mL, (6.39±1.35) mL, (64.5±16.1)％; (5.76±0.84) mL,(5.23±1.37)mL, (50.2±15.6)％, P＜ 0.05], while functional residual capacity (FRC) was lower than that in group A [(14.3±1.9)mL; (19.3±3.1)mL, P＜ 0.05].Compared with Group A, no obvious difference in the above lung functions of Groups B, D and E was observed (P ＞0.05). ② Histopathological observation results: In group C, obvious repairs to dilatation and destruction of alveolar ducts or cyst were observed and the aggregation of macrophage and neutrophils in the end-terminal bronchiole decreased. In Group D, the inflammatory cells decreased, but alveolar destruction and dilatation became more marked. ③Comparison of the total lung capacity (TLC): TLC of Group C was less than that of group A [(42.1 ±5.8)mL, (58.5±7.6)mL, P＜ 0.05].Compared with group A, no obvious difference in the above lung functions of Groups B, D and E was observed (P ＞0.05). ④ Quantitative analysis result of alveolar morphology: The number of alveoli (Na) and density of alveolar septum (Ds) in Group C were much larger than those of group A [(17.6±3.1)/field, (18.6±2.1)％; (11.3±2.7)/field, (15.2±3.6)％, P＜ 0.05] while the diameter of the alveoli (Da) in Group C was significantly lower than those of Group A[(78.1±7.1),(93.4±10.2)μm, P ＜ 0.05].CONCLUSION: Combination of smog and elastase successfully induced rabbit model of obstructive emphysema. Unilateral LVRS could improve emphysematous rabbits' pulmonary functions. Improved in pulmonary functions was not obvious by LVRS with less (12.5％) or larger (37.5％) resection volume of lung parenchyma. LVRS with appropriate resection volume (25％) could effectively eliminate airway inflammation, alleviate alveolar dilatation and destruction of the residual lung parenchyma, and thus improve pulmonary ventilation function.