· AIM: To discuss the cause and management of complications during the manual small incision cataract surgery (MSICS).combined with intraocular lens implant (MSICS-IOL) were done in 160 patietns with cataract. In this paper, we reviewed the clinical data of the intraoperative complications.injury, posterior capsule rupture, iris prolapse and hyphema, were mainly caused by inexpert skill and lacking of experience.techniques, careful operation could decrease the incidence of complications during MSICS operation. By proper management, the intraoperative complications could be solved satisfactorily.

Objective To evaluate the impact of the Blumgart anastomosis in pancreaticojejunostomy on the incidence of postoperative pancreatic fistula (POPF) after pancreaticoduodeneetomy (PD),and to study its safety and efficacy.Methods A total of 205 patients who underwent PD between January 2011 and February 2013 were retrospectively studied.The patients were divided into three groups depending on the pancreaticoenteric reconstruction:the Blumgart anastomosis group (n=37),the duct-to-mucosa anastomosis group (n =39) and the traditional invagination group (n=129).Postoperative morbidity were analyzed.Results The incidences of POPF after the Blumgart anastomosis (8.1％) was significantly lower than the duct-to-mucosa anastomosis group (23.1％ ; P=0.037) and the traditional invagination anastomosis group (30.2％ ; P=0.012).Multivariate analysis revealed soft pancreatic texture,pancreatic duct diameter ＜3 mm and non-Blumgart anastomosis were independent risk factors of POPF.On subgroup analysis,the Blumgart anastomosis was superior to the duct-to-mucosa anastomosis in patients with pancreatic duct diameter ＜ 3 mm (P=0.038),and showed advantages over the traditional invagination anastomosis in patients with soft pancreatic texture (P =0.001),as well as in patients with pancreatic duct diameter ＜ 3 mm (P=0.011).Conclusions The Blumgart anastomosis is a safe technique,and it could significantly reduced the rate of POPF.It should be routinely used for pancreatoenteric reconstruction after PD.

Objective To explore incidence of child obesity in Zhengzhou area and intervention measures.Methods In 2001, spot check was conducted on 5688 cases of high and primary school students ,including 2848 boys and 2840 girls at the age of 7-18.Child obesity was diagnosed by meeting reference BMI value published by Cole et al,conducted comprehensive treatment consisting of massage intervention along channel of traditional Chinese medicine, behavior modification, dietetic and sport adjustment for 22 cases of simple obesity children (7-15 years old, 18 boys, 4 girls) selected for one month, and follow-up survey 6 months after treatment.Results Five thousands,six hundreds and eighty-eight high and primary school students investigated had an overweight incidence of 15.4%, an obesity incidence of 3.2%,boys' overweight incidence and obesity incidence(19.2%,4.6%) were remarkably higher than those of girls (11.5%,1.7% P<0.001). Overweight incidence of various age groups evidently differed(χ2=42.88 P<0.001) with the group of 8-15 years old children as popular. Incidence of various age groups also differed(χ2=21.28 P<0.05) with 7-10 years old and 14-15 years old children as popular. After one-month treatment, weight of all the 22 cases of fat children decreased from (76.45±19.87) kg upon hospitalized to (69.06±17.98) kg with a decrease of (7.43±2.58)kg, BMI value decreased from (31.05±3.96) before treatment to (27.72±3.54).Weight and BMI value before and after treatment differed evidently (t=13.6,12.88 P<0.01), and weight and BMI value decrease were remarkably related with those upon hospitalized (r=0.77 P<0.01;r=0.49 P<0.05).Conclusions Incidence of child obesity has been increasing in recent years, comprehensive treatment consisting of massage intervention along channel of traditional Chinese medicine, behavior modification, dietetic and sport adjustment have good curative effect and are comfortable, well received by children and suitable to promote and apply.

Auxiliary liver transplantation reserves whole or part of recipient' native liver while implanting the graft. It call be classified as auxiliary heterotopic liver transplantation and auxiliary orthotopic liver transplantation according to the location of the graft. On the basis of graft volume. it can be categorized as whole liver auxiliary liver transplantation and partial liver auxiliary liver transplantation. Either cadaveric or living donor is available. Because auxiliarg orthotopic liver transplantation is only the partial liver transplantation, so it is also called aunliry orthotopic partial liver transplantation. The. technique of auxiliary liver transplantation progresses with the devehopment of liver transplantation. Great attention is paid to auxiliary liver transplantation because of its special superiority, in spite of some unresolved problems.

Objective To detect the nodal occult micrometastasis in stage Ⅰ non-small-cell lung cancer(NSCLC),and further investigate the main factor of affecting the nodal occult micrometastasis and the rule of micrometastasis in stage Ⅰ NSCLC. Methods Occult micrometastatic tumor cells by in hilar and subcarinal lymph nodes(LN)were detected immunohistochemistry (SP method),which were removed from 91patients with completely resected stage Ⅰ NSCLC.The monoclonal antibody muhicytokeratin(MCK)was used as a micrometastatic marker.Another 45 hilar LN removed from benign pulmonary lesion patients and 45 hilar LN removed from Ⅱ and Ⅲ stage NSCLC were detected, respectively by conventional histopathologic examination as negative and positive control.Results Micrometastasis was detected in all lymph nodes that were removed from stageⅡand Ⅲ NSCLC.but no one was detected in lymph nodes that were removed from benign pulmonary lesion patients.There were 45 positive cases in 91 patients.The rate of micrometastasis in stage Ⅰ NSCLC was 49%(45/91).among them 39 subcarinal lymph nodes and 11 hilar lymph nodes were detected as positive,5 cases were detected as positive both in subcrinal and hilar lymph nodes.Logistic regression analysis indicated that tumor size,stage and differentiation affected micrometastasis significantly,odd ratios(OR) were 8.444,6.946 and 14.566 respectively.The multivariate analysis indicated that cell difierentiation and T stage may be the adverse factors for nodal micrometastasis,odd ratios(OR)were 7.028and 14.509 respectively.Conclusion There is nodal micrometastasis in completely resected stage Ⅰ NSCLC patients.The micrometastasis frequency of stage ⅠB is significantly higher than stage ⅠA;It is necessary for stage ⅠB NSCLC to be given chemotherapy after operation;cell differentiation and T stage may be the adverse factors for nodal micrometastasis.The method of lymph node micrometastasis is from hilum to mediastinum.The skip micrometastasis may be taken place in adenocarcinoma.

Diagnosis, Differential ; Esophageal Neoplasms ; pathology ; surgery ; Granuloma, Pyogenic ; pathology ; surgery ; Hemangioma, Capillary ; pathology ; Hemangiosarcoma ; pathology ; Humans ; Male ; Middle Aged ; Sarcoma, Kaposi ; pathology

Objective To investigate the expressions and effects of interleukin-4(IL-4) and its alternative spliced variant(IL-4?2) in patients with atopic asthma.Methods The expressions of IL-4 and IL-4?2 were detected in 10 cases of patients with atopic asthma using a quantitative nested reverse-transcription polymerase chain reaction(RT-PCR) protocol.Result The expression level of IL-4 was higher in the patients with atopic asthma than that of the healthy controls.The median ratio of IL-4 to IL-4?2 was much higher in the patients with atopic asthma compared with that of the healthy controls.Conclusion The relative expression of IL-4 and IL-4?2 may play an important role in the mechanism of the pulmonary pathology in patients with atopic asthma,and may be one of the reason for the functional diversity of Th2 cells in different clinical conditions.

Liver is the most common metastatic organ in patients with advanced colorectal cancer. Once colorectal cancer liver metastasis (CRLM) occurs, the prognosis will be poor. Therefore early detection of CRLM has a great clinical significance for improving the prognosis of CRLM patients. Surgical resection of primary and metastatic lesion is the only possible curable option for CRLM, translational therapy, interventional therapy and multidisciplinary team also provide more treatment ideas. Long non-coding RNA, cancer stem cells and phosphatidylinositide-3-kinases/protein kinase B signaling pathway reveal the main mechanism of CRLM from different aspects. This article reviews the recent advances in the early diagnosis, treatments and main mechanisms of CRLM.

Objective To evaluate the effects of medical residency training program in postgraduate-year-one (PGY-1) residents at Peking Union Medical College (PUMC) Hospital.Methods PGY-I medical residents at PUMC Hospital were surveyed by a self-administered questionnaire after they completed their first year residency.Results Forty-nine residents who completed their first year residency training participated in the survey with a 100％ response rate.Before training,only a few had bedside (n =18) and on-call experiences (n =10).At the end of the one-year-training,all the residents (100％) considered themselves being improved to certain degrees,especially in clinical practice capability,and passed all the examinations.However,53.1％ and 8.2％ of all the residents agreed that they need to improve their abilities in teaching (n =26) and doctor-patient communication (n =4),respectively.All residents hoped to get further improved by taking part in various forms of teaching activities,including experience summary/sharing and basic skills training.During the first year,95.9％ of them participated in all teaching activities in medicine actively.Conclusions The tradition and current models of medical residency training program at PUMC Hospital had a significant impact on professional development of the 1st year resident physicians.It is critical to focus on basic skill training and multi-level teaching to improve residents' clinical competency.

OBJECTIVETo study the expression of microRNAs (miRNAs) in extranodal NK/T cell lymphoma, nasal type (EN-NK/T-NT).

METHODSTaqMan low density arrays were used to assess the expression level of 665 miRNAs in one case of EN-NK/T-NT and one normal nasopharyngeal tissue. Ninety-five miRNAs were found to be aberrantly expressed (86 being up-regulated and 9 being down-regulated) in EN-NK/T-NT, compared with normal nasopharyngeal tissue. The aberrant expression was found to be most significant in 8 miRNAs. According to the literature and miRNA database, the expression patterns of these 8 miRNAs were further analyzed in 15 cases of EN-NK/T-NT and 3 normal nasopharyngeal specimens, using the single tube TaqMan microRNA assays.

RESULTSThree of the 8 miRNAs showed statistically significant difference in the expression in EN-NK/T-NT and normal nasopharyngeal specimens. These 3 miRNAs (miR-223, 886-3p and 34c-5p) were considered to play crucial roles in hemopoiesis, cellular proliferation and apoptosis. MiR-223 and miR-886-3p were significantly over-expressed in EN-NK/T-NT (P = 0.002, P = 0.010) while miR-34c-5p was significantly under-expressed (P = 0.017).

CONCLUSIONSCertain types of miRNAs, especially those related to hemopoiesis, cellular proliferation and apoptosis, are aberrantly expressed in EN-NK/T-NT. The potential role of miRNAs in the molecular genetics of EN-NK/T-NT requires further investigation.

Adult ; Aged ; CD56 Antigen ; metabolism ; Female ; Gene Expression Profiling ; Gene Expression Regulation, Neoplastic ; Herpesvirus 4, Human ; isolation & purification ; Humans ; Lymphoma, Extranodal NK-T-Cell ; genetics ; metabolism ; pathology ; virology ; Male ; MicroRNAs ; genetics ; metabolism ; Middle Aged ; Nasal Mucosa ; metabolism ; Young Adult