Background Nd: YAG laser posterior capsulotomy is an important way for after cataract.Usually the patient will use glucocorticoid eye drops to treat the anterior chamber inflammation after operation,but there is potential risk of elevating intraocular pressure (IOP).Objective This study was to compare the clinical effectiveness and safety of loteprednol etabonate ophthalmic suspension,tobramycin+ dexamethasone eye drops and fluorometholone eye drops following Nd: YAG laser posterior capsulotomy.Methods A randomized-controlled clinical trail was performed.One hundrcd and seventy-onc cycs of 127 paticnts who received Nd: YAG laser posterior capsulotomy for after cataract were randomly divided into four groups.Loteprednol etabonate ophthalmic suspension,fluorometholone eye drops,tobramycin+dexamethasone eye drops and systane eye drops was topically administered respectively in the four groups after laser posterior capsulotomy and 6 times per day for 5 days.IOP was measured with Goldmann tomometer 1 hour before operation and 1 hour,1 day,3 days and 7 days after operation.The ocular anterior segment inflammatory response was examined under the slit lamp and scored based on the Peizeng criteria.Written informed consent was obtained from each patient before any relevant medical procedure.Results The IOP was (18.2 ±4.7),(20.1 ±5.7),(18.7±5.5),(19.0 ±4.1),(19.5 ±3.5) mmHg in various time points in the loteprednol etabonate group; (18.7 ±5.3),(20.9±5.7),(21.3±4.5),(21.0±4.9),(22.5±6.5) mmHg in the fluorometholone eye drops group ; (17.9± 6.3),(20.3 ± 6.1),(23.0 ± 3.7),(24.7 ± 4.9),(24.5 ± 6.5) mmHg in the tobramycin +dexamethasone group and(18.4±6.3),(20.7±3.7),(22.7±6.5),(19.6±4.8),(18.5±3.5) mmHg in the systane group,showing a significant difference among the 4 groups (Fgroup =3.876,P =0.023).With the time lapse,the IOP was gradually reduced in the loteprednol etabonate group and systane group,but that in the fluorometholone group and tobramycin+dexamethasone group was elevated,showing a significant difference among them (Ftime =3.801,P =0.031).No any ocular and systemic adverse effect was found in various groups.The percentage of grade 1 and 2 of aqueous inflammatory cells was lower in the loteprednol etabonate group and tobramycin+dexamethasone group than the fluorometholone group and fluorometholone group and systane group(H =8.276,P =0.012).The percentage of Ⅰgrade of aqueous flare was 8％ in the loteprednol etabonate group,22％ in the fluorometholone group,18％ in the tobramycin+dexamethasone group and 30％ in the systane group,with a significant difference among them (H=9.305,P=0.000).Conclusions The use of corticosteroid eye drops can relieve the inflammatory response of ocular anterior chamber after Nd: YAG laser posterior capsulotomy.Loteprednol etabonate ophthalmic suspension has a better anti-inflammatory effect and less influence on IOP.

Background Currently,the recommendation when treating acute biliary or pancreatic disease during pregnancy is to perform endoscopic retrograde cholangiopancreatography (ERCP) without radiation exposure,either empirically (with no radiographic guidance) or with ultrasound guidance.However,few published studies compared these two ways.This study aimed to compare ultrasound-guided ERCP with the procedure without radiographic guidance in the treatment of acute pancreaticobiliary disease in pregnant patients.Methods The clinical data of 68 pregnant patients with acute pancreaticobiliary disease admitted to our hospital between January 2004 and May 2010 were reviewed retrospectively.ERCP was performed without radiographic guidance in 36 cases (group A) and with ultrasound guidance in 32 cases (group B).Data on the following variables were compared between the two groups:surgical success rate,rate of complete stone removal,time to resolution of clinical manifestations and laboratory indicators,length of hospital stay,complications,outcome and differences in efficacy of ERCP during different stages of pregnancy.Results In group A,the rates of surgical success and complete removal of stones were 69％ and 60％,respectively; the corresponding values were 91％ and 89％ in group B (P ＜0.05).Postoperatively,clinical manifestations improved rapidly in all patients; there was no statistically significant difference between the groups (P ＞0.05).Leukocyte counts and liver function had improved significantly after one week in all patients; they recovered more quickly in group B ((8.64±1.83)days vs.(14.57±3.74) days,(14.29±4.64) days vs.(20.00±5.40) days,P ＜0.01).The hospital stay was shorter in group B ((16.28±7.25) days vs.(28.00±6.83) days,P＜0.001).The complication rate was 14％ in group A and 3％ in group B (P ＜0.05).There were no significant differences between the two groups in the procedure's efficacy during different stages of pregnancy.Conclusions In the treatment of acute pancreaticobiliary disease during pregnancy,ultrasound-guided ERCP is safer and more effective than performing the procedure empirically without radiographic guidance when performed by experienced practitioners.Its more widespread use is recommended.

Objective To investigated the effects of combined arsenic trioxide(ATO) and resveratrol(Res)on the viability of NB4 human leukemia cells. Methods NB4 human leukemia cell was used in this experiment.Cells were cultured in ATO (0,0.1875,0.3750,0.7500, 1.1250, 1.5000,2.2500,3.0000,5.0000 μmol/L) and Res (0, 1.5625,3.1250,6.2500, 12.5000, 18.7500,25.0000,37.5000,50.0000 μmol/L). Cell viabilities were measured by MTT in different treatment groups. Half inhibitory concentration(IC50) was calculated. The ratio of concentration of ATO and Res 1.5∶ 18,1.5∶ 25,1.5∶ 35 was added to cells, and the combination index(CI) was calculated. The level of ROS in control, ATO( 1.5000 μmol/L), Res(25.0000 μmol/L) and ATO(0.9000 μmol/L) + Res( 12.5000μmol/L) groups was measured by chemiluminescence assay. Results ①ATO( ≥0.7500 μmol/L) reduced the viability of NB4 cells in a concentration-dependent manner(P ＜ 0.05 ), and IC50 was (1.78 ± 0.11 )μmol/L. ②)Res (≥18.7500 μ mol/L) dose-dependently decreased the viability of NB4 cells (P ＜ 0.05 ), and IC50 was ( 18.71 ±0.18)μ mol/L. ③Combination of ATO and Res showed an antagonistic effect on NB4 cells viability. ④The ROS in Res group( 1670.55 ± 13.97) was significantly lower than that in control group(2345.88 ± 14.48,P ＜ 0.05). The ROS in ATO group (3092.42 ± 94.84) was significantly higher than that in control group(P ＜ 0.05). The ROS in ATO + Res group (1860.27 ± 15.99) was significantly lower than that in ATO group(P ＜ 0.05). Conclusions NB4 cell survival rate can be decreased by ATO and Res. The combination of arsenic trioxide and Res presents an antagonistic effect on NB4 cell viability, in part by reducing intracellular ROS formation.

Background Surgery is regarded as the most effective treatment to relieve pain and reduce complications in chronic pancreatitis (CP).Two major strategies exist:duodenum-preserving pancreatic head resection (DPPHR) and pancreatoduodenectomy (PD).Many studies suggest that DPPHR offers advantages during surgery and in the short-term; however,the long-term effects have not been thoroughly investigated.We analyzed the long-term outcomes of DPPHR and PD,over follow-up times of at least 1 year,to determine the optimal surgical treatment for CP.Methods We systemically reviewed all CP surgical treatment reports,and only included randomized controlled trials (RCT) comparing DPPHR and PD,excluding unqualified studies using several pre-specified criteria.When multiple publications of a single trial were found,the most comprehensive current data were selected.Characteristics of the study populations and long-term postoperative outcome parameters were collected.The quality of the studies and data was analyzed using RevMan 4.2 software.Results Five trials were qualified for meta-analysis,with 261 participants in total (114 in the DPPHR group and 147 in the PD group).There were no significant differences in the age,gender,or indications for surgery of each group.At the mean of 5.7-year (1-14 years) follow-up examination,DPPHR and PD resulted in equally effective pain relief,exocrine and endocrine function,and similar mortality rates (P ＞0.05); however,DPPHR patients had improved global quality of life and weight gain,and reduced diarrhea and fatigue (P ＜0.05).Conclusion DPPHR and PD result in equal pain relief,mortality,and pancreatic function; however,DPPHR provides superior long-term outcomes.

Objective To study the infection of MP-Ab IgM (MP) in serum,bronchial lavage fluid,pleural effusion and cere brospinal from pediatric patients with Mycoplasma Pneumoniae Pneumonia (MPP).Methods From March to June 2013,278 cases of patients suspected MP infection in Children's Hospital Affiliated to Capital Medical University were selected and the MP-Ab IgM of thcire serum,bronchial lavage fluid,pleural effusion and ccrebrospinal fluid specimens were detected with the method of particle agglutination test.Results 181 cases (104 cases of boys,77 cases of girls) of different specimens in (MP) were positive.All the serum samples,278 cases were detected positive serum specimen of 170 cases,the overall detection rate was 61.2％ (170/278),144 cases of bronchial lavage fluid was investigated at the same time,check out the posi rive 62 cases,and the detection rate was 43.1％ (62/144).19 cases for pleural effusion samples at the same time,checked out the positive 13 cases,and detection rate was 68.4％ (13/19).15 cases of cerebrospinal fluid specimens was investigated at the same time,checked out the positive in 1 case,and the detection rate was 6.7％ (1/ 15).Positive rate between different age groups was respectively:6 months～1 year group 29.0％ (9/31),～3 year group 51.0％ (25/49),～5 year group 56.1％ (23/41),～16 year group 79.0％ (124/157),6 months～1 year witb other age groups was statistically significant difference (P＜0.05).In 0.5～1 year,～3 year,～5 year,16 year～four age groups,different types of MP-Ab IgM positive specimens of the same patients,the corresponding results for A:serum type (111 cases) 7,21,13,70.B:serum and bronchoalveolar lavage fluid type (45 cases) 0,2,5,38.C:Serum pleural effusion (7 cases) 0,1,2,4.D:serum and cerebrospinal fluid (1 cases) 0,0,0,1;E:serum and bronchoalveolar lavage fluid and pleural effusion type (6 cases):0,0,2,4.F:bronchoalveolar lavage fluid type (11) 2,1,1,7.Conclusion MP infection varied,have atrend of younger age,and has a tendency to increase year by year,and the patient's infection rates have different characteristics.Positive serum of different age groups was gradually increased with age,infants and young children positive detection rate increased significantlychildren with severe multiple in older children.

Objective To investigate the effects of simvastatin(Sim) and losartan(Los) on cardiac fibrosis and myocardial expression of MMP-2 mRNA, MMP-9 mRNA and TIMP-1 mRNA, TIMP-2 mRNA in pressure overloaded rat hearts. Methods The pressure overload model was induced by descending aortic constriction (DAC) in rats. SD rats were randomized into 6 groups (n=20 each) : normol control group, control sham group, DAC group, Los group (DAC+Los, 5 mg/kg), Sire group ( DAC + Sire, 2 mg/kg), Los + Sire group (DAC+Los+Sire, Los 5 mg/kg, Sire 2 mg/kg). Water, Los or Sire drug was administrated by garage daily beginning from day 5 after operation for 30 days. Collagen was measured on Masson stained myocardial sections, and the level of MMP-2 mRNA, MMP-9 mRNA and TIMP-1 mRNA, TIMP-2 mRNA in left ventricle were detected by RT-PCR. Results Collagen volume fraction (CVF) in DAC group was significantly higher than the normal control and sham groups (P<0.01) which could be significantly reduced by Los and Sire (P<0.05), especially in DAC + Los + Sire group (P<0.01). The levels of myocardial MMP-2 mRNA, MMP-9 mRNA and TIMP-1 mRNA, TIMP-2 mRNA were also significantly higher in DAC group than in normal control and sham groups (P<0.01). Treatment Sim and Los alone and especially in combination significantly decreased the TIMP-1 mRNA, TIMP-2 mRNA expressions (P<0.01) while MMP-2 mRNA, MMP-9 mRNA levels remained unchanged (P>0.05). Conclusion Upregulation of myocardial MMP-2 mRNA, MMP-9 mRNA and TIMP-1 mRNA, TIMP-2 mRNA expressions might contribute to myocardial fibrosis in this model, Sire and Los significantly inhibited myocardial fibrosis possibly by downregulating myocardial TIMP-1 mRNA, TIMP-2 mRNA expressions in this model.

Background Precise evaluation of the live donor's liver is the most important factor for the donor's safety and the recipient's prognosis in living donor liver transplantation (LDLT).Our study assessed the clinical value of computer-assisted three-dimensional quantitative assessment and a surgical planning tool for donor evaluation in LDLT.Methods Computer-assisted three-dimensional (3D) quantitative assessment was used to prospectively provide quantitative assessment of the graft volume for 123 consecutive donors of LDLT and its accuracy and efficiency were compared with that of the standard manual-traced method.A case of reduced monosegmental LDLT was also assessed and a surgical planning tool displayed the precise surgical plan to avoid large-for-size syndrome.Results There was no statistically significant difference between the detected graft volumes with computer-assisted 3D quantitative assessment and manual-traced approaches ((856.76±162.18) cm3 vs.(870.64±172.54) cm3,P=0.796).Estimated volumes by either method had good correlation with the actual graft weight (r-manual-traced method:0.921,r-3D quantitative assessment method:0.896,both P ＜0.001).However,the computer-assisted 3D quantitative assessment approach was significantly more efficient taking half the time of the manual-traced method ((16.91±1.375) minutes vs.(39.27±2.102) minutes,P ＜0.01) to estimate graft volume.We performed the reduced monosegmental LDLT,a pediatric case,with the surgical planning tool (188 g graft in the operation,which was estimated at 208 cm3 pre-operation).The recipient recovered without large-for-size syndrome.Conclusions Computer-assisted 3D quantitative assessment provided precise evaluation of the graft volume.It also assisted surgeons with a better understanding of the hepatic 3D anatomy and was useful for the individual surgical planning tool.

Objective To observe the intake of minocycline and its amount in mature rat mandibular oateoblasts(MRMOB)in vitro,and to identify the feasibility of intracellular anti-bacterial activity of minocycline.Methods Four groups of MRMOB were incubated in 100 mg/L minocycline for 15,30,45 and 60 minutes respectively,and the accumulation of minocycline within MRMOB was measured using a fluorescence spectrophotometer.Results The intracellular accumulation amount of minocycline in the four groups of MRMOB was(17.29±1.49),(16.87±1.57),(16.96±1.67)and(17.94±1.63)mg/g respectively after osteoblasts were cultured in Dulbecco's modified Eagle's medium(DMEM)which contained minocycline for 15,30,45 and 60 min.There was no significant difference in amount of minocycline among the four groups of MRMOB.Conclusions The mature rat mandibular ostoeblasts can ingest minocycline.and the accumulation amount of minocycline in MRMOB is irrelevant with the exposure time of MRMOB to minocycline.

Objective To analyze the related pathogenicity gene mutations in a sudden death of hypertrophic cardiomyopathy (HCM) on whole exome level.Methods Whole exome sequencing (WES) was been performed on a sudden death case sample with pathological features of HCM by Illumina(R) Hiseq 2500 platform.Using hgl9 as the reference sequences,the sequencing data were analyzed.Suspicious single nucleotide variants (SNV) were screened,and the conservatism and function were analyzed by the software such as PhyloP,PolyPhen-2,SIFT,etc.Results After screening,a heterozygous mutation C719R was finally identified in the gene MYBPC3 of this case.Conclusion The molecular anatomy on whole exome level by second generation sequencing technology can help to define the molecular mechanism of HCM and provide a new mothed and thought for analysis of death cause.

Objective To investigate the expression changes of myeloid-related protein-8 (MRP-8) and myeloid-related protein-14 (MRP-14) in children with Kawasaki disease (KD) and to obtain laboratory diagnostic serum markers and new targets for its drug therapy.Methods A total of 46 patients with KD(KD group) were enrolled from Jul.2009 to Dec.2010 and divided into the coronary artery dilatation(CAD) group(n =15) and the normal coronary artery group(n =31) ;Meanwhile,25 febrile patients with acute respiratory tract infection but without disease in the circulatory,blood,immune systems formed the non-KD febrile group.Twenty healthy children from the out-patient department formed the healthy control group.Peripheral venous blood was collected in the acute and subacute stage of KD.Levels of MRP-8/MRP-14 were detected with enzyme-linked immunosorbnent assay (ELISA).Gene expressions of MRP-8,MRP-14 in leukocytes were analyzed by semi-quantitative reverse transcription-polymerase chain reaction(RTPCR).Results The serum levels of MRP-8/MRP-14 along with mRNA expressions of MRP-8 and MRP-14 in the leukocytes in the out-patient acute and subacute stage of KD were significantly higher than those in the non-KD febrile group and the healthy control group(all P ＜ 0.05) ;There was no significant difference between non-KD febrile group and healthy control group (P ＞ 0.05).The serum levels of MRP-8/MRP-14 along with mRNA expressions of MRP-8 and MRP-14 in leukocyte in actue stage of KD were significantly higher than those in subacute stage(all P ＜ 0.001).The serum levels of MRP-8/MRP-14 as well as mRNA expressions of MRP-8 and MRP-14 in the acute and the subacute stage of CAD group were significantly higher than those in the normal coronary artery group(P ＜ 0.05).Conclusions MRP-8/MRP-14 may probably play a role in the pathogenesis of KD and can be used as a diagnostic indicator for KD;MRP-8/MRP-14 may be involved in the formation of coronary artery lesion and can be used as an effective predictor for the coronary artery lesion.