AIM: To observe the clinical effect of amniotic membrane transplantation and penetrating keratoplasty in the treatment of atheromatous corneal ulcer.
METHODS: Thirteen patients ( 13 eyes ) diagnosed atheromatous corneal ulcer from February 2009 to May 2014 in our hospital were retrospectively analyzed. Surgical treatment including amniotic membrane transplantation and penetrating keratoplasty were used to deal the patients with no effects of drugs. All patients were followed up for 4mo to 2a ( mean 8mo ) after surgery. Visual acuity, healing and recipient of ulcer were examined.
RESULTS:There patients were treated conservatively with corneal ulcer slowly healing, healing time was 14~35 ( 21±12. 1 ) d. Seven cases were treated with amniotic membrane transplantation, 2 cases were treated with penetrating keratoplasty, 1 case of corneal ulcer perforation and lost light perception received enucleation of eyeball. Corneal ulcer were cured in patients performed amniotic membrane transplantation and penetrating keratoplasty. All patients had no recurrence during the follow-up period.
CONCLUSION:Atheromatous corneal ulcer is difficult to be cured by conservative treatment. Most patients need operation treatment. Amniotic membrane transplantation and penetrating keratoplasty can be performed to deal with atheromatous corneal ulcer and abtain satisfactory effect. But amniotic membrane transplantation is relatively simple and easy, and it is suitable for promotion in primary hospitals.

AIM: To investigate the preliminary clinical observation of excimer laser phototherapeutic keratectomy ( PTK ) assisted by anterior segment optical coherence tomography ( OCT ) in the treatment of non II type granular corneal dystrophy.
METHODS: A retrospective case series were studied. Totally 8 patients ( 12 eyes ) who were diagnosed as granular corneal dystrophy underwent PTK from April 2011 to January 2013 in our hospital. All patients were excluded from the II type granular corneal dystrophy ( Avellino corneal dystrophy ) by the Avellino corneal dystrophy rapid diagnostic kit and underwent preoperative anterior segment OCT examination, so as to determine the lesion morphology and depth, and used to guide the setting of PTK parameters. They were followed up for the complications after operation, postoperative recurrence, the recovery of visual acuity.
RESULTS: All patients were followed up for 6-12mo, average 9mo after operation. All patients' best corrected visual acuity were significantly improved, superficial corneal opacity lesions were effectively removed, and the corneal opacity recurrence or serious Haze were not found during the follow-up period after operation.
CONCLUSION: In patients with non type II granular corneal dystrophy, PTK assisted by anterior segment OCT can be accurate, effective removal of corneal lesions, obtain good effect after operation.

OBJECTIVE:To provide reference for rational use of drugs in hospital under the condition of the separation of drug and medical care. METHODS:The volumes of business,income from drug and income condition of medical staff were compared before and after implementation of separation of drug and medical care. The chance for pharmaceutical work under the condition of the separation of drug and medical care were analyzed to put forward advice for improvement of drug use in medical institutions. RESULTS & CONCLUSION:After conducting Wuhu model in 8 medical institutions,some achievement and experience have been obtained. It should be propelled to implement effective administration for rational use of drugs to resolve the problems on over expensive medical service.

Objective To investigate the correlation between atherosclerotic renal artery stenosis and hypertension.Methods One hundred and seventy-nine patients underwent renal artery angiography after coronary artery angiography. Results Among the 179 patients, 56.4% patients were detected as renal artery normal, 24% as renal artery disease, and 19.6% as renal artery stenosis. Compared with hypertensive patients with normal renal artery, ARAS patients had higher systolic blood pressure (148?23 mm?Hg vs 136?18 mm?Hg, P

Objective To investigate whether lamivudine antiviral treatment after radical surgery can prolong disease-free survival of patients with hepatitis B virus-related liver cancer.Methods A total of 120 patients with hepatitis B virus-related liver cancer who underwent conventional radical surgery in Dongfeng Hospital Affiliated to Hubei Medical College from March 2014 to March 2016 were enrolled,and among these patients,60 were given conventional treatment (group A) and 60 were given lamivudine antiviral treatment (group B).ELISA was used to measure serum HBV DNA level.The t-test was used for comparison of continuous data between groups,the chi-square test was used for comparison of categorical data between groups,the Kaplan-Meier method was used to compare disease-free survival rate and recurrence rate between groups,and the Spearman method was used to investigate the correlation between serum HBV DNA level and survival time.Results According to the results of the 3-year follow-up,71 patients (59.17％) died (group A:46 patients died of tumor and 4 died of hepatic encephalopathy;group B:20 died of tumor and 1 died of hepatic encephalopathy).Compared with group A,group B had significantly lower recurrence rate (48.33％ vs 90.00％,x2 =16.98,P ＜0.001) and mortality rate within 3 years (35.00％ vs 83.33％,x2 =10.34,P ＜ 0.001).Group B had significantly higher mean disease-free survival time and 1-,2-,and 3-year dis-ease-free survival rates than group A(t =9.82,x2 =7.87,11.43,and 7.98,all P ＜ 0.001).After surgery,group B had a significantly lower serum HBV DNA load than group A [(0.008 1 ±0.003 2) × 105 copies/ml vs (0.014 3 ±0.008 9) × 105 copies/ml,t =18.54,P ＜ 0.001].In group A,there were significant differences in 1-,2-,and 3-year disease-free survival rates between patients with serum HBV DNA load ≥ 1.0 × 105 copies/ml and those with serum HBV DNA load ＜ 1.0 × 105 copies/ml (x2 =8.57,P ＜ 0.05),and further analysis showed that there were significant differences in 1-,2-,and 3-year disease-free survival rates (x2 =4.36,5.36,and 9.53,P ＜ 0.05);in group B,there were no significant differences in 1-,2-,and 3-year disease-free survival rates between these two groups of patients (P ＞ 0.05).Serum HBV DNA expression was positively correlated with patients' survival time (r =0.67,P ＜ 0.001).Conclusion Lamivudine antiviral therapy after radical surgery can effectively reduce serum HBV DNA level,and helps to prolong the disease-free survival time of patients with hepatitis B virus-related liver cancer.

Objective To study the intracellular calcium ([Ca2+ ]i) in myocardial cell of obesity rats induced by high-fat diet. Methods Male Sprague-Dawley (SD) rats were divided into obesity resistant (OR, n=15), normal (Nor, n=15) and obesity prone (OP, n=15) group after fed with high-fat diet for 10 weeks. Their body fat and serum lipids were measured. Myocardial cells were isolated with Langendorff perfusion and [Ca2+]i was measured with calcium indicator Fluo-3/AM and laser scanning confocal microscope after KCl depolarization and caffeine- induced. Results Compared with those in Nor and OR rats, the epididymal fat, perirenal fat, omental fat and body fat increased in OP rats (P<0.05), as well as the the level of total cholesterol, triglyceride and low density lipoprotein (P<0.05); the vary of [Ca2+]i elevation and restoration were lower (P<0.05). Conclusion The vary of [Ca2+ ]i elevation decreases in OP rats after KCl depolarization and caffeine-induced, that may associated with arrhythmia in obesity rats.

OBJECTIVEThis study aims to test the accuracy and precision of iWitness photogrammetry for measuring the facial tissues of mannequin head.

METHODSUnder ideal circumstances, the 3D landmark coordinates were repeatedly obtained from a mannequin head using iWitness photogrammetric system with different parameters, to examine the precision of this system. The differences between the 3D data and their true distance values of mannequin head were computed.

RESULTSOperator error of 3D system in non-zoom and zoom status were 0.20 mm and 0.09 mm, and the difference was significant (P 0.05). Image captured error of 3D system was 0.283 mm, and there was no significant difference compared with the same group of images (P>0.05). Error of 3D systen with recalibration was 0.251 mm, and the difference was not statistically significant compared with image captured error (P>0.05). Good congruence was observed between means derived from the 3D photos and direct anthropometry, with difference ranging from -0.4 mm to +0.4 mm.

CONCLUSIONThis study provides further evidence of the high reliability of iWitness photogrammetry for several craniofacial measurements, including landmarks and inter-landmark distances. The evaluated system can be recommended for the evaluation and documentation of the facial surface.

Objective To investigate the guidance of a new classification on the treatment methods selection for cystic dilation of bile duct (CDBD).Methods The clinical data of 213 patients with CDBD who received treatment according to the Todani 2003 classification at the Peking Union medical College Hospital from September 1968 to July 2013 were retrospectively analyzed.The CDBD was reclassified with a new classification proposed by Dong Jiahong et al,and the guidance of the new classification on the treatment methods selection for CDBD was analyzed.Patients were followed up via out-patient examination and telephone interview till August 2013.Results Of the 213 patients,139 were with Todani type Ⅰ CDBD (type C CDBD of the new classification) ; 3 were with Todani type Ⅱ CDBD (type C1 CDBD of the new classification) ; 1 was with Todani type Ⅲ CDBD (type E CDBD of the new classification); 52 were with Todani type Ⅳa CDBD (35 with type D1 and 17 with type D2 CDBD of the new classification) ; 1 was with Todani type Ⅳb CDBD (type C CDBD of the new classification) ; 8 were with Todani typeⅤ-Ⅰ CDBD (type B CDBD of the new classification) ; 9 were with Todani type Ⅴ-Ⅱ CDBD (type A CDBD of the new classification).Eighteen patients did not receive the surgical treatment.Of the 195 patients who received surgical treatment,patients with type C and D CDBD of the new classification took a large proportion.Patients with type C CDBD of the new classification received cystectomy,biliary cyst resection,Rouxen-Y cholangiojejunostomy or internal drainage.Patients with type D CDBD of the new classification received extrahepatic biliary cyst resection,Roux-en-Y cholangiojejunostomy.Patients with severe intrahepatic disease and with type D1 CDBD of the new classification received concomitant left hemihepatectomy or pancreaticoduodenectomy.Patients with type A1 CDBD of the new classification received right hemihepatectomy.Patients with type A2 CDBD of the new classification were cured by conservative treatment after split liver transplantation.Patients with type B1 CDBD of the new classification received left hemihepatectomy and Roux-en-Y cholangiojejunostomy.Patients with type B2 CDBD of the new classification received bile duct stone extraction.There was 1 patient with type E CDBD,and partial resection of the CDBD ± bile duct reconstruction was carried out.Pancreatic fistula,biliary fistula,reflux cholangitis,cholangitis and anastomotic stricture were detected on 74 patients,and they were cured by conservative treatment or lithotomy.A total of 187 patients were followed up with the median time of 85 months (range,1-432 months).One hundred of seventy-five patients recovered well,and 12 patients with canceration of the bile duct died of tumor metastasis at postoperative 1-282 months.Conclusion This new classification simplifies the typing of extrahepatic bile duct dilation,refines the typing of intrahepatic bile duct dilation,and has better guidance for surgical treatment.

Insulin resistance, lipid metabolism disorders, independent autonomic neuropathy are high risk factors for gallstone formation in type 2 diabetic patients. In recent years, there have been a lot of new developments on the relationship between type 2 diabetes and gallstones, such as adiponectin, leptin and metabolic syndrome, etc. Based on these studies, the risk factors of type 2 diabetes complicated with gallstones are summarized in this paper.

Objective To determine the risk factors of gallstones. Methods A case-control study was conducted on 4087 patients with gallstones (the study group) and 20435 individuals without gallstones (the control group) at the Health Center of Peking Union Medical College Hospital (PUMCH) between January 2007 to May 2010. Using age and sex, the study and the control groups were matched in 1 : 5 ratio. Data were statistically analyzed using Chi-square test and conditional logistic regression.Results Univariate analysis showed significant differences in diabetic mellitus (DM), systolic blood pressure (SBP), diastalic blood pressure (DBP), triglyceride (TG), high density lipoprotein cholesterol (HDL-CH) and body mass index (BMI) between the study and the control groups (P＜0.05). Multivariate analysis confirmed that DM, SBP, HDL-CH and BMI were associated with gallstones, and their adjusted odds ratio (95％ confidence interval) were 0. 825 (0. 736 ～0. 925), 0. 908 (0. 828～0. 996), 1. 211 (1. 056～1. 389) and 0. 746 (0. 691～0. 805), respectively.The incidences of total cholesterol (TCH) and low deasity dipoprotein cholesterol (LDL-CH) were not significantly different between the two groups (P＞0.05). ConclusionsDM、SBP、HDL-CH and BMI were found to be the risk factors for gallstones. To prevent gallstones, weight reduction, blood pressure control and normalization of blood lipid are important measures.