AIM:To observe the clinical effects of 23-gauge (23G) transconjunctival sutureless vitrectomy for idiopathic macular hole.
METHODS: In this retrospective study, 28 eyes of 28 consecutive patients who underwent 23 - gauge transconjunctival sutureless vitrectomy for idiopathic macular hole between January 2013 and October 2013 in our hospital were evaluated. The follow-up time was 3-12mo. The operation effects were analyzed.
RESULTS:The macular hole was closed in 27 eyes of 28 eyes which underwent 23G transconjunctival sutureless vitrectomy and not closed in 1 eye after surgery. Best-corrected visual acuity at postoperative 1, 3mo was significantly improved compared to pre-operation (χ2=8-65, P=0. 003;χ2=10. 33, P=0. 001). The macular hole was closed as shown by OCT. Intraoperative incision was sutured in 5 cases ( 18%) . There was no statistically significant difference in intraocular pressure between pre-operation and post - operation. No post - operative complications such as endophthalmitis, retinal detachment, vitreous hemorrhage came up.
CONCLUSION: 23G transconjunctival sutureless vitrectomy is observed to be safe and effective technique in the treatment of macular hole. It is therefore our preferred system for straightforward macular surgery.

Activins ; administration & dosage ; pharmacology ; Animals ; Animals, Newborn ; Apoptosis ; drug effects ; Cerebral Cortex ; drug effects ; pathology ; ultrastructure ; Disease Models, Animal ; Dose-Response Relationship, Drug ; Female ; Hippocampus ; pathology ; ultrastructure ; Hypoxia-Ischemia, Brain ; drug therapy ; pathology ; Injections, Intraperitoneal ; Male ; Microscopy, Electron ; Neuroprotective Agents ; administration & dosage ; pharmacology ; Rats ; Rats, Wistar ; Treatment Outcome

Objective To systematically review the evaluation tools for walking ability of lower limb amputees wearing prostheses. Methods A computer-based search of PubMed, Wanfang Data and CNKI.net was performed for articles related to the evaluation of walking ability of lower limb amputees wearing prostheses published from January, 1995 to December, 2015. Results and Conclusion A total of 20 papers were selected, including 18 foreign literatures and 2 Chinese articles. There were many evaluation tools for walking ability of lower limb amputees wearing prostheses, and should be chosen according to the actual situation.

Objective To investigate walking ability of amputees with unilateral transtibial prosthesis. Methods From April to Decem-ber, 2016, 20 unilateral transtibial amputees (patients) and 20 healthy adults (controls) were tested with L test, balance test, 6-minute walk test (6MWT) and 1000 m walking outdoor on various terrain. Results There was no significant difference in time of L test between the am-putees wearing Solid Ankle Cushion Heel (SACH) and Storage Foot (t=0.675, P>0.05). In balance tests, there was no significant difference in the total track length, confidence ellipse area, maximum horizontal deviation and maximum vertical deviation between the patients and the controls (t<0.803, P>0.05). Each parameter was significantly different in 6MWT between them (t>2.774, P<0.01), as well as the time and energy expenditure of outdoor 1000 m walk test (t>4.130, P<0.001). Conclusion The walking ability of the unilateral transtibial ampu-tees wearing prostheses is different from normal people. The transtibial prosthetic feet that the amputees wear may impact their walking abil-ity.

Objective To evaluate the effect of alveolar recruitment maneuver on the perioperative pulmonary function in the morbidly obese patients undergoing laparoscopic sleeve gastrectomy.Methods Forty morbidly obese patients of both sexes,of American Society of Anesthesiologists physical status Ⅰ or Ⅱ,aged 18-64 yr,with body mass index ≥ 40 kg/m2,scheduled for elective laparoscopic sleeve gastrectomy,were randomly divided into either control group (group C) or alveolar recruitment maneuver group (group R) using a random number table,with 20 patients in each group.Patients in group C were treated with volume-or pressure-controlled ventilation after creation of pneumoperitoneum,maintaining the peak inspiratory pressure (Ppeak) ≤ 30 cmH2O and partial pressure of end-tidal CO2 35-40 mmHg.Patients in group R received alveolar recruitment maneuver once every 30 min starting from creation of pneumoperitoneum until the end of surgery.Patients were transfered to post-anesthesia care unit (PACU) with endotracheal tube which was extubated when the unified extubation standard was achieved in PACU.The patients who stayed in PACU for 2 h showing no indications for extubation were transfered to intensive care unit for continuous ventilation support.Immediately after intubation,immediately after creation of pneumoperitoneum,at 30,60 and 90 min of pneumoperitoneum,and at the end of pneumoperitoneum,blood samples were collected from the radial artery for blood gas analysis.Immediately after intubation,immediately after creation of pneumoperitoneum,at 30,60 and 90 min of pneumoperitoneum,at the end of surgery,and immediately before discharge from PACU,Ppeak,plateau pressure (Peat),and dynamic lung compliance were recorded.The time for achieving extubation standard and time for achieving the standard for discharge from PACU were recorded.Patients were followed up until discharge,and the feeding time and duration of hospital stay were recorded.Results Compared with group C,PaO2 and oxygenation index were significantly increased at 90 min of pneumoperitoneum,at the end of surgery,and immediately before discharge from PACU,Ppeak was decreased at 60 and 90 min of pneumoperitoneum and immediately after the end of pneumoperitoneum,Pplat was decreased at 60 and 90 min of pneumoperitoneum,the dynamic lung compliance was increased at 30,60 and 90 min of pneumoperitoneum and immediately after the end of pneumoperitoneum,and the time for achieving extubation standard,time for achieving the standard for discharge from PACU,feeding time,and duration of hospital stay were shortened in group R (P＜0.05 or 0.01).In group C,one patient did not present with indications for extubation and were transfered to intensive care unit for continuous ventilation support.Conclusion Intraoperative alveolar recruitment maneuver can effectively improve the intraoperative pulmonary function and promote the recovery of postoperative pulmonary function in the morbidly obese patients undergoing laparoscopic sleeve gastrectomy.

OBJECTIVE To enhance the rational usage of antimicrobial agents in hospitalized patients by comprehensive interventional measures in clinics.METHODS The selected indictors recommended by WHO were applied to evaluate the use of antimicrobial agents in hospitalized patients.The hospital information was gained from hospital administration section.The prescription and treatment data were collected from the discharged patients′ medical history.Intervention was involved in managerial and educational strategies.RESULTS After intervention,the average number of antimicrobial agents prescribed per inpatient fell from 2.13 to 1.97.The average cost of antimicrobial agents prescribed per inpatient fell from 1765.23 yuan to 1136.18 yuan(P

Background Optic neuritis is closely associated with multiple sclerosis (MS).Its pathogenesis is uncompletely clear,and less basic researches are carried out at home and abroad. Objective This study was to reveal the expression of myelin basic protein (MBP) in the optic nerve of rat with experimental allergic encephalomyelitis (EAE) and to provide a theoretical evidence for the research of the relationship of optic neuritis with MS. Methods Fifty clean Wistar rats were randomized into the control group and immune 8,12,18 and 25 days groups.Myelencephalon was collected from 5 guinea pigs to prepare the homogenate and mixed with the isovolumetric complete Freud' s adjuvant (CFA).The 0.5 ml mixed antigen emulsifier was subcutancously injected into the 4 maps together with Bordetella pertussis 0.2 ml under the cutancous of dorsalis pedis at 0 and 48 hours to induce the EAE.Behavior of the rats was evaluated to score the neurological function.The optical nerve sections were prepared 8,12,18 and 25 days after immunology for the histopathological examination,and immunochemistry and Western blot were used to detect the expression of MBP in optic nerve.The use of the animals complied with the Regulation for the Administration of Affairs Concerning Experimental Animals by State Science and Technology Commission. Results The disorder of motor nerve was seen 12 days following the immune,and the clinical neural functional scores were significantly higher 12 day and peaked on 18 days myelination and then gradually reduced.The histopathological examination showed that the irregular alignment of neural fiber was found at 12 days,and changes of cellular structure,edema of neural shaft bunch were observed at 18 days.However,the abnormal cells were significantly less 25 days following the immune.Immunochemistry showed that the MBP was expressed mainly in the myelination of optic nerve fibers.The numbers of positive cells for MBP were (115.75±26.49)cells/5 fields at the 12th day,showing a significant lowing in comparison with (167.44±22.49)cells/5 fields of control group (t=4.537,P＜0.05 ).The positive cells were lest at the 18th day with the values ( 75.57 ± 34.54) cells/5 fields ( t =6.362,P＜0.01 ).At the 25th day,positive cells increased to ( 117.63 ± 13.78) cells/5 fields,which still was lower than those of the control group ( t =4.068,P＜0.05 ).Western blot assay illuminated that with the prolong of immune time,MBP/β-actin ratio in optic nerve was gradually reduced and followed the same pattern at the 12th day( t =4.639,P＜0.05 ).At 18 days after immune in comparison with the control group,the expression of MBP/β-actin ratio in optic nerve was the least (t=8.427,P＜0.01). Conclusions MBP can be degraded in rat optic nerve.This is a further evidence that optic neuritis is a severe demyelination disease.It is clearly related to MS.

Objective To investigate the role of autophagy and synaptophysin (SYP) in cognitive impairment in de?pressed rats receiving electroconvulsive shock (ECS). Methods Clean and healthy adult male Sprague-Dawley rats were acclimatized to a standard laboratory environment for 7 days. The chronic unpredictable mild stress (CUMS) was used to establish the rat model of depression. Behavior tests were conducted before and after CUMS to evaluate the depression and cognition level of rats. After establishment of the model, 24 rats were randomly divided into ESC group (group E) and depression group (group D) with 12 rats in each group. The rats in group E were administered 80 mg/kg of propofol (10 mg/mL) by intraperitoneal injection, followed by ECS treatment. The rats in group D were administered propofol by intra?peritoneal injection, followed by sham-ECS treatments. The above interventions were conducted daily for 7 consecutive days. After the interventions, rats underwent behavior tests as before. Subsequently, rats were killed and specimens were collected for measurements. Immunohistochemistry was performed to examine autophagy markers such as Beclin 1 and LC3Ⅱand ELISA was used to detect SYP in the hippocampus. Results Group E after ECS significantly increased the percentage of sucrose preference (68.2%±8.7%), rearing times (7.0±1.9), total horizontal distance [(569.5±70.0) cm], es? cape latency [(21.9±5.3)s] and space exploration time [(20.5±3.9)s] compared with group D or group E before ECS. There was no significant difference in these index between groups before ECS or in group E between before and after ECS(P>0.05). Compared with group D, group E had upregulated protein expression levels of Beclin 1 and LC3Ⅱin CA1, CA3, DG as well as the area near the hippocampus and increased SYP contents (P<0.05). Conclusions Cognitive impairment in depression rats following ECS correlates with activated autophagy and increased SYP by ECS.

Objective To investiagate cell apoptosis and expressions of Bax,Bcl-2 andCaspase-3 in gambogic acid-treated colorectal cancer cells. Methods SW480/LOVO colorectal cancer cells were treated by gambogic acid. Cell Counting Kit-8 assay (CCK-8) was used to test cell proliferation. Microscopy was used to check the morphological changes. Immunofluorescence staining technique was used to detect cell apoptosis. Expressions of Bax,Bcl-2 and Caspase-3 protein were detected by Western blot assay. Results Gambogic acid inhibited the proliferation of SW480/LOVO in a dose and time-dependent manner. Gambogic acid could induce cell apoptosis. Gambogic acid increased expressions of Caspase-3 and Bax, increased the ratio of Bax/Bcl-2, and decreased Bcl-2 protein expression. Conclusion Gambogic acid can inhibit proliferation and induce apoptosis of SW480LOVO cells, with the mechanism of up-regulation of Bax/Bcl-2 and activation of Caspase-3.

Objective To evaluate the changes in the expression of CXCR3 in regulatory T cells (Tregs) in the renal tissues of mice with renal ischemia-reperfusion (I/R) injury .Methods Forty-eight SPF male C57BL/6J mice ,aged 8-12 yr ,weighing 20-25 g ,were randomly divided into 3 groups ( n=16 each ) using a random number table:sham operation group (group S) ,group I/R and CD25 monoclonal antibody PC61 group (group P) . Bilateral kidneys were exposed and their pedicles were occluded for 45 min with atraumatic mini-clamp followed by 72 h reperfusion .PC61 250 μg was injected intraperitoneally at 24 h before the model was established .Blood samples were collected from the inferior vena cava at 24 and 72 h of reperfusion (T1 ,2 ) for determination of serum blood urea nitrogen (BUN) and creatinine (Cr) concentrations .Bilateral kidneys were obtained for determination of CD4+ CD25+ Foxp3+ Treg count and CXCR3+ CD4+ CD25+ Foxp3+ Treg count in renal tissues and the pathological changes of the kidney were scored .Results Compared with group S , the serum BUN and Cr concentrations and pathological scores were significantly increased at T1 ,2 in I/R and P groups ,and the number of CD4+ CD25+ Foxp3+ Treg and CXCR3+ CD4+ CD25+ Foxp3+ Treg was increased at T2 in I/R group ( P<0.05) .Compared with group I/R ,the serum BUN and Cr concentrations and pathological scores were significantly increased at T2 ,and the number of CD4+ CD25+ Foxp3+ Treg and CXCR3+ CD4+ CD25+ Foxp3+ Treg was decreased at T2 in P group ( P<0.05 ) .Conclusion Up-regulation of CXCR3 is helpful in migration of Tregs into the renal tissues of mice with renal I/R injury .