AIM: To discuss the effect of Smart Plug canalicular plug on aqueous-deficient dryeye.
METHODS:Forty-eight cases of aqueous-deficient dry eye patients in our hospital from May 2012 to April 2013 were selected for the study. After treated by Smart Plug canalicular plug, postoperative clinical efficacy, foundation Schirmer I test ( SIt) , tear film break-up time ( BUT ) , corneal fluorescein staining ( FL ) changes were observed.
RESULTS: Forty-eight patients were cured, 31 cases were markedly effective(65%), effective 14 cases (29%), invalid in 3 cases (6%), the total effective rate was 94%. Before treatment, SⅠt, BUT, and FL was ( 3. 49±1. 24 ) mm/5min, ( 3. 15±1. 07 ) s, and ( 2. 52±0. 11 ) points, respectively. After treatment, SIt, BUT, FL were significantly improved compared with before treatment, the difference was statistically significant (P<0. 05). One patient had postoperative foreign body sensation, 8h after shedding emboli; One patient granulation tissue after surgery 8mo, canalicular plug off. The remaining cases had no inferior lacrimal duct infection or granuloma.
CONCLUSION: Smart Plug canalicular plug is an effective treatment for aqueous-deficient dry eye, can effectively relieve symptoms, worthy of promotion.

The regulation mechanism of arecoline on rat hepatic CYP2E1 was studied in vivo. After oral administration of arecoline hydrobromide (AH; 4, 20 and 100 mg x kg(-1) x d(-1)) to rats for one week, the hepatic CYP2E1 mRNA level remained unchanged, but the hepatic CYP2E1 protein content was dose-dependently increased. Additionally, although the hepatic CYP2E1 activity was induced by AH treatment, the induction was attenuated with the increase in dosage. The results indicate that the effect of arecoline on rat hepaticdoes not involve transcriptional activation of the gene, but largely involves the stabilization of CYP2E1 protein against degradation or increased efficiency of CYP2E1 mRNA translation, and additionally involve the post- ranslational modification of CYP2E1 protein. Furthermore, the CYP2E1 response is fairly equal among the different species, the induction of rat hepatic CYP2E1 by arecoline suggests that there is a risk of metabolic interaction among the substrate drugs of CYP2E1 in betel-quid use human.
Animals ; Arecoline ; pharmacology ; Cytochrome P-450 CYP2E1 ; metabolism ; Cytochrome P-450 CYP2E1 Inducers ; pharmacology ; Humans ; Liver ; drug effects ; metabolism ; RNA, Messenger ; Rats

objective To observe the distribution of vitamin D receptor(VDR)gene polymorphisms in children of Han nationality and investigate the relationship between VDR gene polymorphisms and the susceptibility to children's dental fluorosis of Han nationality.Methods From October of 2008 to March of 2009,a case-control study was conducted among children between 8 and 12 years old with(n=101)and without(n=102)dental fluorosis using Dean method in Guandian countyside of Fengtai county in Anhui province.DNA was extracted from blood samples ofthese children.The Apa I,Bsm I,Fok I and raq I polymorphisms in the VDR gene were genotyped using polymerase chain reaction-restriction fragment length polymorphism(PCR-RFLP).The distribution of the genotypes in patients and the control group were analyzed. Results Different genotypes of the VDR gene existed in children of Han nationality with the highest distribution frequency of Aa, bb, Ff, TT, which respectively was 51.7% ( 105/203 ), 89.7% (182/203), 52.7% (107/203), 93.1% (189/203), followed by genotype distribution frequency of aa, Bb, FF, Tt, being 39.9% (81/203),7.9% (16/203),31.5% (64/203) ,6.9% (14/203), respectively. AA,BB, ff, tt distribution frequency was the lowest as follows, 8.4% ( 17/203 ), 2.4% (5/203), 15.8% (32/203),0 (0/203). The frequency distribution of VDR Apa I genotype was AA 7.9% (8/101), Aa 55.4% (56/101), aa 36.7%(37/101) in children with fluorosis, and AA 8.8% (9/102), Aa 48.0% (49/102), aa 43.3% (44/102) in children without fluorosis, respectively. There were no significant differences in the two groups(χ2= 1.13, P > 0.05).The frequency distribution of VDR Bsm I genotype was BB 3.0%(3/101), Bb 5.9%(6/101 ), bb 91.1% (92/101) in children with fluorosis, and BB 2.0% (2/102), Bb 9.8% (10/102), bb 88.2% (90/102) in children without fluorosis, respectively. There were no significant differences in the two groups(χ2 = 0.55, P > 0.05). The frequency distribution of VDR Fok I genotype was FF 28.7%(29/101), Ff 56.4% (57/101), ff 14.9%(15/101) in children with fluorosis, and FF 34.3% (35/102), Ff 49.0% (50/102), ff 16.7% (17/102) in children without fluorosis,respectively. There were no significant differences in the two groups(χ2 = 1.14, P > 0.05). The frequency distribution of VDR Taq I genotype was TT 93.1%(94/101), Tt 6.9%(7/101) in children with fluorosis, and TT 93.1% (95/102), Tt 6.9%(7/102) in children without fluorosis, respectively. The tt genotype was not found. There were no significant differences in the two groups (χ2 = 0.00, P > 0.05 ). Conclusions Different genotypes of the VDR gene existed in children of Han nationality. There were no correlation between VDR Apa I , Bsm I , Fok I , Taq I gene polymorphisms and children's dental fluorosis of Han nationality in this area.

OBJECTIVE: To investigate the correlation between RFCA catheter cumulative energy and autonomic nerve injury. METHODS: Forty-one patients with paroxysmal supraventricular tachycardia were enrolled, Patients were excluded if they had Diabetes, Hypertension, Congestive Heart Failure or other organic heart disease. HRV and biochemical markers were measured before and after the RFCA. RESULTS: Compared with pre-ablation values,there was significantly decrease in post-ablation low frequency (LF) and high frequency (HF). This was noted in both the septal group (AVNRT and septal pathway) and free wall group (free wall accessory pathway).Post-procedure,the sensitivity of cardiac troponin I(cTnI) for myocardial injury detection was 58.3%, AST was 41.7%. This was significantly higher than other markers(CK:4.2%, CK-MB:10.4%, LDH:20.8%). The post-ablation sensitivity of cTnI was 54.2%, 6.3% and 52.1%at 1 hour, 12 hours, and 24 hours respectively. A significant correlation between cumulative energy and delta HF(r=0.688,P=0.01) or delta LF (r=0.462, P<0.05).was noted in free wall group.(delta HF=pre-ablation HF-post-ablation HF/pre-ablation HF x 100%). There was no significant correlation between biochemical markers and either delta HF or delta LF. CONCLUSION: RFCA induced injury on cardiac autonomic nerves related to both cumulative energy and ablation site,but not size of myocardial injury as determined by cTnI measurement. cTnI is an excellent biochemical marker of myocardial injury.

OBJECTIVETo investigate the effects of the novel proteasome subunit Adrm1 knockdown by RNA interference on proliferation of colorectal cancer cells.

METHODSThe shRNA eukaryotic expression vector against Adrm1 was constructed and transfected into colon cancer RKO cells. The Adrm1-shRNA stable transfected clones were selected. Experimental cells were divided into 3 groups: the experimental group containing stable Adrm1-shRNA transfected cells, the control group containing only RKO colon cancer cells and stable empty vector transfected control group. The Adrm1 protein expression level was analyzed by Western blot. The colony-forming ability of the three groups was assessed by soft agar assay. The cell proliferation and apoptosis were analyzed by methyl thiazolyl tetrazolium (MTT) method and in situ end labeling (TUNEL) assay. Cell cycle changes were assayed by flow cytometry.

RESULTSAdrm1-shRNA effectively suppressed Adrm1 expression in the experimental group. Silencing of Adrm1 in RKO cells significantly inhibited their anchorage-independent growth, only occasional individual colonies were formed. The apoptosis rate of experimental group was (12.4 +/- 1.1)%, significantly higher than that of the stable empty vector transfected control group. The proportion of G(0)/G(1) and S/G(2) phase cells in the experimental group was (41.2 +/- 1.1)% and (58.8 +/- 1.1)%, respectively. The cells were arrested at G(1) phase. In addition, Adrm1 RNA interference combined with 5-Fu treatment significantly suppressed colorectal cancer cell growth in vitro.

CONCLUSIONSilencing of Adrm1 by RNA interference can significantly suppress proliferation of RKO cells through inducing apoptosis and arresting the cell cycle. The combined application of Adrm1 RNA interference and chemotherapy may become as a novel therapeutic strategy for Adrm1 overexpressed colorectal cancer.

Antimetabolites, Antineoplastic ; pharmacology ; Apoptosis ; Cell Cycle ; Cell Line, Tumor ; Cell Proliferation ; Colorectal Neoplasms ; metabolism ; pathology ; Drug Resistance, Neoplasm ; Fluorouracil ; pharmacology ; Genetic Vectors ; Humans ; Membrane Glycoproteins ; genetics ; metabolism ; Plasmids ; RNA Interference ; RNA, Small Interfering ; genetics ; Transfection

OBJECTIVETo explore the feasibility of single-incision laparoscopic totally extraperitoneal hernioplasty (SILS-TEP) with self-made port for repairing of inguinal hernia.

METHODSSILS-TEP was performed in 7 inguinal hernia patients (9 sides) with conventional laparoscopic instruments and self-made port, which composed of a wound retractor, surgical gloves and 3 ordinary trocars. The clinical data and follow-up results of 7 cases were retrospectively collected and analyzed.

RESULTSThe self-made port was applied for SILS-TEP uneventfully without the need of additional ports in all 7 patients (9 inguinal hernias). The median operating time was 90. 0 (70-125) min, intraoperative blood loss was 10. 0 (5. 0-20. 0) mL and postoperative hospital stay was 2.0 (2. 0-4. 0) d. The median pain scores of visual analog scale (VAS) at 6 h,12 h, 24 h and 14 d were 3(2~4), 2(1~2), 1(0~2) and 0(0~1), respectively. There were no intraoperative complications reported, and all patients were satisfied with wound healing. No hernia recurrence was observed during the 3-months of follow-up.

CONCLUSIONOur initial experiences show that SILS-TEP with self-made port is a safe and feasible surgery, which can simplify the procedure with available equipments and reduce the cost, therefore can be applied in grass-root hospitals.

Hernia, Inguinal ; surgery ; Herniorrhaphy ; methods ; Humans ; Laparoscopy ; methods ; Length of Stay ; Retrospective Studies

OBJECTIVETo analyze the prognostic factors of pancreatic neuroendocrine neoplasms (PNEN).

METHODSClinical data of 61 patients with PNEN from March 1992 to December 2012 was retrospectively analyzed. There were 23 male and 38 female patients, with a median age of 52 years (ranged from 22 to 68 years). Forty-one patients were non-functional tumors, and 20 patients were functional tumors. Fifty-nine patients received operation, 13 (22.0%) patients underwent laparoscopic operation, 2 patients underwent puncture biopsy under CT guidance. Survival was analyzed with the Kaplan-Meier method.

RESULTSAmong these patients, 53 (86.9%) patients underwent curative resection. The cases of grade G1, G2, G3 were 41 (67.2%), 9 (14.8%), 11 (18.0%), respectively. The cases of stageI, II, III, IV were 47 (77.0%), 7 (11.5%), 2 (3.3%), 5 (8.2%), respectively. Liver metastasis, neural invasion were found in 5 cases (8.2%), 5 cases (8.2%), respectively. The median follow-up period was 40 months (ranged from 3 to 209 months). The overall 1-, 3-, 5-year survival rates were 92.0%, 89.7%, 86.3%, respectively. Univariate analysis showed WHO classification (χ(2) = 18.503), TNM staging system (χ(2) = 23.401), liver metastasis (χ(2) = 18.606), neural invasion (χ(2) = 10.091), resection status (χ(2) = 25.514) were prognostic factors of PNEN (all P = 0.000).

CONCLUSIONSSurgical resection in PNEN results in long-term survival. WHO classification, TNM staging, resection status are effective in predicting the prognosis of PNEN. Liver metastasis, neural invasion predicted poor prognosis.

Humans ; Neoplasm Staging ; Pancreatectomy ; Pancreatic Neoplasms ; surgery ; Prognosis ; Survival Rate

OBJECTIVETo compare the safety and efficacy of totally laparoscopic distal gastrectomy (TLDG) with laparoscopic assisted distal gastrectomy (LADG) for gastric cancer by meta-analysis.

METHODSThe literature on comparative studies of TLDG and LADG up to June 2014 were extensively retrieved from database PubMed, Cochrane library, Web of Science, and Biosis Previews. The operation time, blood loss, time to flatus, time to first oral intake, postoperative hospital stay, postoperative morbidity, times of analgestic requirement, pain score, and the level of C-reactive protein (CRP) on postoperative day 1 and 7 were analyzed. The statistical analysis was performed with RevMan 5.1 software.

RESULTSSeven studies met the inclusion criteria for meta-analysis. A total of 1783 Patients were included for meta-analysis, among whom 727 cases underwent TLDG and 1056 underwent LADG. Comparing with LADG, TLDG experienced less blood loss [weighted mean difference (WMD)=22.86 ml，95% confidence interval (CI): 12.0-33.72, P<0.01)], less times of analgesic requirement (WMD=0.58, 95% CI: 0.35-0.81, P< 0.01)，less pain score on postoperative day 1 and day 3 (day1: WMD=0.60, 95% CI: 0.20-0.99, P < 0.01; day3: WMD=0.36, 95% CI: 0.24-0.48, P < 0.01), earlier beginning to take diet (WMD=0.66, 95% CI: 0.13-1.19, P=0.01). The operation time, postoperative hospital stay, overall morbidity and anastomosis-related morbidity, and the level of CRP on postoperative day 1 and 7 were similar between two groups (Ps>0.05).

CONCLUSIONTLDG is a safe and feasible procedure with less blood loss, less pain, and quicker recovery than those of LADG.

Aged ; C-Reactive Protein ; Gastrectomy ; methods ; Humans ; Laparoscopy ; methods ; Length of Stay ; Stomach Neoplasms ; surgery

OBJECTIVE: To compare accuracy of anterior cervical pedicle screws between assist of rapid prototyping 3D guide plate and free-hand insertion, and evaluate the safety of two methods. METHODS: Eight adult cervical cadaver specimens after formaldehyde immersion, including 4 males and 4 females, aged 32 to 65(40.3±5.6) years old. After X-ray examination to exclude bone damage and deformity, 4 of them (3D guide plate group) randomly selected were for CT scan to obtain DICOM format data, and the data was imported into Mimics software for model, designed the ideal entry point and nail path for anterior cervicaltranspedicular screw (ATPS). After obtaining the personalized guide plate of the nail channel, it was exported as STL data, and the individual guide plate was printed by rapid prototyping and 3D printing technology. In turn, with the assistance of 3D guide plates, one-to-one personalized ATPS screws were placed on the four lower cervical cadaver specimens. Another 4 (free-hand group) lower cervical cadaver specimens were implanted with ATPS screws using free-hand technique. All specimens were performed CT thin-layer scanning and three-dimensional reconstruction after operation. The Tomasino method was used to evaluate the safety of the screws on the CT cross-sectional and sagittal images, to determine whether there was a cortical puncture of the lower and inner edges of the pedicle. According to the CT rating results, gradeⅠandⅡwere safe, and grade Ⅲ- Ⅴ were dangerous.And the accuracy of screws was recorded and analyzed between two groups. RESULTS: Two screws were inserted in each segment from C CONCLUSION The 3D printing rapid prototyping guide plate assisted insertion of the anterior cervical pedicle screw can significantly improve the accuracy and safety, and provide a theoretical basis for further clinical application.
Adult ; Aged ; Bone Plates ; Cervical Vertebrae/surgery* ; Cross-Sectional Studies ; Female ; Humans ; Male ; Middle Aged ; Pedicle Screws ; Printing, Three-Dimensional

Adolescent ; Anti-Glomerular Basement Membrane Disease ; pathology ; Diagnosis, Differential ; Granulomatosis with Polyangiitis ; pathology ; Humans ; Kidney ; pathology ; Lung ; pathology ; Lupus Erythematosus, Systemic ; pathology ; Male