AIM: To observe the effect and safety of applying mitomycin C ( MMC ) in laser - assisted subepithelial keratomileusis ( LASEK) for extreme high myopia.
●METHODS:LASEK with 0. 02% MMC was performed in 364 eyes of 182 patients with extreme high myopia and spherical equivalent was-9. 0 to-10. 25 D. All the patients were divided into four groups according to the applying time of MMC. The time in Group l was 10s, in GroupⅡwas 25s, in Group Ⅲ was 40s and 55s in Group lV. Uncorrected visual acuity ( UCVA ) , residual refraction, Haze, healing time of corneal epithelium, density and variant index of corneal endothelium was examined in these patients and follow-up 6mo.
●RESULTS:At 6mo after surgery, 76. 3%, 94. 0%, 92. 3%and 93. 8% of the patients in Group l, GroupⅡ, GroupⅢ and Group lV respectively achieved the UCVA better than 15/20. There was significant difference of UCVA between Group l and the other three groups (χ2=19. 610, P=0. 000). Proportion of the residual refraction between ± 0. 5D in Group l (78. 8%) was lower than other groups (95. 2% in Group Ⅱ, 93. 3% in Group Ⅲ, and 92. 7% in GroupⅣ) at 6mo and there was significant difference (χ2=16. 329, P=0. 001). Group l had more Haze statistically than the other three groups at 6mo postoperatively ( Hc=50. 110, P=0. 000). The healing time of cornea epithelium seem to be no statistically difference between each group at 6mo (χ2=11. 611, P>0. 05). MMC had no influence on the density of corneal endothelium in each group postoperatively (P>0. 05), there were 3071. 3±284. 4 cells/mm2 in Group l, 3 105. 6 ± 337. 8 cells/mm2 in Group Ⅱ, 2 986. 3 ± 304. 1cells/mm2 in Group Ⅲ and 3 088. 7 ± 372. 5 cells/mm2 in Group lV respectively. The variant index of corneal endothelium calculated in each group at 6mo after surgery was 24. 72 ± 6. 52, 22. 93 ± 6. 74, 24. 38 ± 6. 63 and 23. 14±7. 22 repectively, compare with that preoperatively there were no statistically differences (P>0. 05).
●CONCLUSION: For extreme high myopia LASEK with 0. 02% MMC is effective and safe. The MMC applying time of 25s in LASEK can effectively reduce Haze after surgery and decrease potential complications.

AlM:To make a analysis of visual quality of iris location guided femtosecond laser assisted in situ keratomi ( LASlK) and iris location guided mechanical sub-bowman keratomileusis ( SBK) for high myopia treatment.METHODS:Femtosecond LASlK ( study group ) was performed in 102 eyes of 51 patients with high myopia and 70 eyes of 35 patients were received mechanical SBK ( control group ) from January to October 2013. The spherical refraction of all the patients was from -6. 00 ~-9. 50D. Best corrected visual acuity ( BCVA ) of the patients was ≥1. 0. Uncorrected visual acuity ( UCVA), BCVA, thickness of cornea flap, contrast sensitivity function ( CSF ) and senior ocular aberration were examined in these patients and follow-up was 1a.RESULTS: At 1a after surgery 94. 1% UCVA in study group reached ≥1. 0 and there was 94. 3% in control group. There was no significant difference between two groups (P>0. 05). Residual refraction of study group was-0. 08±0. 10 D and control group was -0. 10±0. 07 D. There was no significant difference of residual refraction between two groups (P>0. 05). C12 , C8 of senior ocular aberration and RMSH in study group was less than control group, amplification:0.1642±0.0519 and 0.2229±0.0382 (t=8. 077, P<0. 05), while C7 was equal in two groups:0. 1583 ±0.1921 and 0. 1436±0. 1536 (t=0. 556, P>0. 05). C8 was 0. 0950±0. 069 and 0. 1858±0. 095 (t=7. 261, P<0. 05). RMSh was 0. 3711 ± 0. 0847 and 0. 5622 ± 0. 1033 ( t= 12. 801, P<0. 05). CSF was no significant difference between study group and control group (P>0. 05). CONCLUSlON: Femtosecond LASlK and mechanical SBK is effective for high myopia. Compared to mechanical SBK, femtosecond LASlK shows more advantages in the senior ocular aberration and visual quality. The cornea flap is more regular from central to peripheral area with femtosecond laser.

Objective To investigate whether velocity vector imaging (VVI) combined with stress echocardiography could detect potential myocardial impairment of the left ventricle(LV) in diabetic rats.Methods DM rats ( n = 18,administered by STZ at 65 mg/kg) and control rats( n = 12) were performed with VVI and M-mode echocardiography both at rest and after dipyridamole stress 12 weeks later. Twodimensional echocardiographic cine loops and M-mode images of three consecutive beats were obtained from the short-axis views at the mid-LV level. The means of segmental peak systolic velocity(Vs), circumferential strain(εc) ,radial strain(εr), systolic circumferential and radial strain rate (SRc, SRr) and the percent wall thickening (WT% ,derived from M-mode) were obtained. After echocardiograms were performed,the hearts were excised and prepared for HE staining and ultrastructural observations under electron microscopy.Results At rest,only SRc in the DM group was significantly lower than that in the control group( P ＜0.05), the other parameters were statistically comparable between the two groups. After dipyridamole stress,all VVI values in the DM group were significantly lower than those in the control group ( P ＜0.05).However,there was no significant difference in WT% between the two groups either at rest or after dipyridamole stress ( P ＞0.05). Conclusions The VVI parameters combined with dipyridamole stress are more effective in evaluating potential myocardial impairment of the LV walls in diabetic rats. SRc might be more sensitive indices that can be used to detect myocardial impairment at rest.

Background and purpose:Methylene tetrahydrofolate reductase (MTHFR) plays an important role in metabolism of folate and DNA methylation. This study aimed to investigate the relationship between methylene tetrahydrofolate reductase (MTHFR) C677T polymorphism and chemotherapy side effects in advanced non-small cell lung cancer (NSCLC) patients. Methods:A total of 100 patients with advanced NSCLC conifrmed by pathology were included into this study in Zhejiang Cancer Hospital from Jun. 2007 to May. 2009. All patients received the combined chemotherapy of platinum drug and gemcitabine. MTHFR genotypes were determined by allele-specific-PCR technology. Results:In the 100 cases, genotype frequency of MTHFR C677T T/T, T/C and C/C were 20%, 44%and 36%, respectively. Compared with patients of T/T and T/C genotype, patients of C/C genotype were correlated with decreased rate of thrombocytopenia to chemotherapy (P=0.039). No signiifcant differences were observed concerning gastrointestinal toxicity. Conclusion:MTHFR C677T gene polymorphism can be used to predict the adverse reactions to platinum-based chemotherapy in patients with advanced NSCLC.

Objective To investigate the relationship between the expression of MMP-7 in peripher- al blood and esophageal cancer.Methods By using Real time RT-PCR, blood samples from 82 cases with postoperative esophageal cancer were detected.Results 37.8 %(32/82)patients were positive for MMP-7 mRNA expression.MMP-7 mRNA positivity significantly correlated with lymph node metastasis,stage,and hematogeneous metastasis.Recurrent disease was found in 28 of 82 cases. Of 28 patients experiencing re- lapse,15 patients were serially follow-up in every three months.The number positive of MMP-7 mRNA be- fore detection by imaging,at the same time of detection by imaging,and after detection by imaging was 5 cas- es,8 cases and 2 cases respectively.Conclusion Examination of MMP-7 mRNA in peripheral blood during follow-up is useful for early detection of occult recurrence.

Objective To study the expression of Gult-1 in cervical adenocarcinoma and prognosis analysis.Methods Gult-1 was detected by immunohistochemistry (EnVision) in cervical adenocarcinoma and cancer adjacent tissue.Results In cancer adjacent tissue and cervical adenocarcinoma,the positive rates of Gult-1 were 2.22 ％ (1/45),58.67 ％ (44/75),respectively,and there was statistical significance between them (x2 =38.23,P =0.00).The expression of Gult-1 was not correlated to age,histological classification and infiltrated depth (all P ＞ 0.05).However,it was correlated to tumor size,histological grade and lymphatic nodes metastasis (all P ＜ 0.05).The survival rate of positive Gult-1 patients was lower than negative Gult-1 patients (x 2 =4.27,P =0.04).Conclusion The over-expression of Guh-1 in cervical adenocarcinoma indicates poorly differentiated cancer,the possibility of lymphatic nodes metastasis and unfavourable prognosis.

Totally 1 360 pregnant women during the first trimesters (4-12 weeks) who visited Ningbo University Affiliated Hospital and Ningbo Jiangbei Maternal Health Hospital from February 2010 to October 2011,and 216 non-pregnant healthy women,who contemporaneous by visited the hospital,were enrolled in this study.The thyroid screening was made by determining urinary iodine and serum free thyroxine,free triiodothyronine,total thyroxine,total triiodothyronine,thyrotropin,and thyroid peroxidase antibody (TPOAb).The median concentration of urinary iodine in the pregnant women was not different from that of non-pregnant women (P＞0.05) ; 1 360 pregnant women were screened,268 (19.71％) of them were identified to suffer from thyroid disorders or with positive thyroid autoantibody.29(13.43％) of non-pregnant women were identified to suffer from thyroid disorders or with positive thyroid autoantibody.There was significant difference between the 2 groups (x2 =4.40,P＜0.05).Prevalence of thyroid dysfunction may increase during early pregnancy.The screening for thyroid function and autoantibody should be recommended in that period.

Objective To discuss the prevalence of non-EV71,non-CA16 virus strains of hand,foot and mouth disease(HFMD) in Guangdong province between 2008 and 2009,and analyze the genetic evolution of these non-EV71,non-CA16 virus strains.Methods Isolated viruses from stool samples collected from outpatient and in-patient cases of HFMD between 2008 and 2009 by human rhabdomyosarcoma(RD) cell and HEp-2 cell,cultures that exhibited a characteristic enterovirus cytopathic effect were evaluated by RT-PCR.Those strains which identified non-EV71,non-CA16 were analyzed by VP1 sequencing and then were identified by BLAST program.A phylogenetic tree was constructed using the Neighor-Joinning method in the MEGA 4.0 software.Results Twenty-two virus strains of non-EV71,non-CA16 were obtained,and nine of the twenty-two virus strains in 2008 were classified into CA2,CA4,and CB3 by BLAST; thirteen of the twenty-two virus strains in 2009 were classified into EV80,Echo13,Echo30,CBS,Echo24,CA10,CA6,and poliovirus 1 by BLAST.The honology of all strains was low,and all the strains belonged to CA,CB,Echoviruses,Enterovirus and poliovirus subgroup.Conclusion Except for EV71 and CA16 was a major causative agent in prevail of HFMD in Guangdong province between 2008 and 2009,there also existed other subgroup Enterovirus.The other twenty-two strains respectively belonged to CA,CB,Echoviruses,Enterovirus and poliovirus subgroup,and none of those strains was predominant.Muti-species Enterovirus occurred concomitantly.

Objective To investigate whether myocardial dysfunction and perfusion impairment had happened in diabetes mellitus(DM)rats,and to assess the relationship between them by using myocardial contrast echocardiography(MCE)and velocity vector imaging(VVI).Methods MCE and VVI were performed from the short-axis views of the mid-left ventricular level both at rest and after dipyridamole stress in control rats and DM rafs(12 weeks after induction with streptozotocin).MCE-derived myocardial blood flow(MBF)and myocardial flow reserve(MFR)and VVI-derived circumferential strain rate(SRc)and SRc reserve were obtained.Results SRc(absolute value)and MBF in the DM group were significantly lower than those in the control group at rest(P =0.03 for SRc and P =0.005 for MBF).SRc reserve and MFR in the DM group were significantly lower than those in the control group after dipyridamole stress (P =0.000 for SRc reserve and P =0.014 for MFR).There was no significant correlation between SRc and MBF at rest in the DM group(r =0.189,P =0.453).However,significant negative correlation existed between SRc reserve and MFR(r =-0.658,P =0.003).Conclusions Both myocardial systolic function and perfusion are impaired in DM rats.The decrease of MBF might not be the predominant determinant of myocardial systolic dysfunction at rest.However,the impairment of MFR could be an important contributor to the decrease of myocardial contractile reserve.

ObjectiveThis study evaluates the feasibility of intensity-modulated radiation therapy (IMRT) to treat patients with 1 -5 brain metastases from non-small cell lung cancer (NSCLC).Methods 30 IMRT patients with brain metastases for NSCLC studied retrospectively.Whole brain radiotherapy plus three-dimensional conformal radiotherapy (WBRT + 3DCRT) and WBRT plus stereotactic radiotherapy ( WBRT + SRT) plans were generated.Planning target volume ( PTV ) and organs at risk dose were measured and compared by dose volume histogram.Differences were analyzed in the three techniques by Wilcoxon Z -test.Results D99％ of the shoulder ( D99％-D90％ ) from IMRT were higher than from WBRT +3DCRT and WBRT+SRT in all cases.From D15％ of slope (D90％-D10％) to D5％ of tail (D10％ -D1％ ),IMRT were lower than WBRT + 3DCRT and WBRT + SRT ( Z =- 4.72,P =0.000 and Z =- 4.72,P =0.000).D10％ and D5％ of IMRT were (35.1 ±1.42) Gy and (37.7 ±2.91) Gy,WBRT +3DCRT were (36.5±2.86) Gy and ( 39.1 ± 3.56) Gy ;WBRT + SRT were (36.2 ± 2.57) Gy and ( 38.7 ± 3.67) Gy.IMRT vs WBRT+ 3DCRT and WBRT + SRT were significant ( Z=-3.18,-3.18,P=0.001,0.001 and Z=- 4.11,- 3.02,P =0.000,0.002) in 13 patients with 3 - 5 brain metastases.The total mean monitor units were 14756.3,9614.8 and 9043.2 for IMRT,WBRT +3DCRT and WBRT + SRT plans,respectively,with a 38.7％ reduction from IMRT to WBRT + SRT (Z =-4.78,-4.78,P =0.000,0.000).The brain doses around metastases were similar in the three techniques with 1 -2 metastases,but IMRT was the best with 3 -5 metastases.ConclusionsIMRT can advance brain metastases dose and improve the planning target minimum dose and spare the dose around brain metastases.Only IMRT is the best choice for just sparing the dose around brain metastases among 3 -5 brain metastases.