With the increasing perfection and improvement of microsurgery technique in modern ophthalmology, especially the popularization of micro-incision cataract extraction and the rise of femtosecond-laser-assisted cataract extraction, the cataract extraction and intraocular lens implantation is gradually transformed from vision rehabilitation surgery into refractive surgery and people also pursue better postoperative visual experiences. However, the preoperative and postoperative corneal astigmatism is always the main factor affecting the postoperative visual effect. ln recent years, the development of design and materials of the intraocular lens ( lOL) provided necessary basic conditions for clinical application of the Toric lOL. The Toric lOL is primarily characterized by effective correction of cataract patients′postoperative corneal astigmatism, which results in the enhancement of patients′postoperative visual function. ln this paper, the design, classification and clinical application of Toric lOL were analyzed, and current problems and prospect were discussed.

Objective To analysis the clinical characteristics of kidney transplantation for the aged recipients and the influence of quadruple immunosuppressant on treatment result. Methods From 1990 to 2001,of 1251 cases of renal transpantation,the clinical data of 126 cases of the aged recipients over 60 years old were investigated.The aged recipients was divided into two groups;combination of cyclosporine(CsA),azathoprine(Aza) and corticosterioids was given in groupⅠ,In groupⅡ,except for CsA,mycophenolate mofetil(MMF),corticosteroids and Wu-T 3 quadruple therapy in the 47 cases aged recipients, Daclizumab or Basiliximab were injected in prophylaxis of acute rejection within 2 hours prior to transplantation and in someday after transplantation to the 24 aged recipients. The groupⅡ was compared with the groupⅠ in complications, the rate of acute rejection and the one-year-survival rate of patients/allograft.Results The rates of cardiocerebral vascular disease and infection complications in the aged recipients were higher than that in the non-elderly patients. In the groupsⅠ and Ⅱ, the postoperative complications was 74 55%and 38 03%, respectively;the rates of acute rejection were 12 73% and 4 23%,respectively;one year survival rate of patients/allografts was 81 82%/78 18% and 97 18%/95 77% respectively.Conclusions The cardiocerebral vascular disease and infection complications were the main factors affecting the outcome of renal transplantation in the aged recipients. The quadruple immunosuppressant regimens could reduce postoperative complications and acute rejection. At the same time one-year-survival rate of patients/ allografts have been improved in the aged patients.

Acupuncture Therapy ; Adult ; Anal Canal ; surgery ; Anus Diseases ; surgery ; Female ; Humans ; Male ; Middle Aged ; Moxibustion ; Postoperative Complications ; therapy

Sixteen compounds were isolated from the aerial parts of Euphorbia sikkimensis by means of various chromatographic techniques such as silica gel, Sephades LH-20 and RP-18, and their structures were elucidated as naringenin (1), kaempferol (2), quercetin (3), kaempferol-3-O-alpha-L-arabinopyranoside (4), quercetin-3-O-alpha-L-arabinopyranoside (5), quercetin-3-O-(2"-galloyl)-alpha-L-arabinopyranoside (6), 5alpha, 8alpha-epidioxy-(22E, 24R)-ergosta-6,22-dien-3beta-ol (7), stigmast-5-ene-7-one-3beta-ol (8), 3beta-hydroxy4a, 14alpha-dimethyl-5alpha-ergosta-8, 24(28)-dien-7-one(9), beta-sitosterol (10) , 10-cucurbitadienol( 1) , scopoletin(12) , ethyl gallate(13), p-hydroxybenzaldehyde (14), 3 betahydroxybenzeneethanol( 15) ,and 2,4-dihydroxy-6-methoxy-acetophenone (16) on the basis of spectroscopic data analysis. All the compounds are isolated from this plant for the first time, and compounds 1, 4-8, 15 are obtained from Euphorbia species for the first time.
Chromatography ; Euphorbia ; chemistry ; Organic Chemicals ; analysis ; isolation & purification

OBJECTIVETo explore causes of shoulder pain and propose prevention measures in treating acromioclavicular joint dislocation.

METHODSFrom January 2005 to January 2013, 86 patients with acromioclavicular joint dislocation (Tossy III) were treated with hook plate fixation, and were divided into two groups. Bsaed on recovery of shoulder function mostly, the patients who suffered from rest pain, motion pain were named as shoulder pain group, while the patients without pain were named as painless group. In shoulder pain group, there were 21 cases including 15 males and and 6 females ranging the age from 22 to 62 years old with an average of (40.6±11.2) years old. There were 8 cases were on the left side and 13 cases were on the right side. In painless group, there were 65 cases including 36 males and and 29 females ranging the age from 19 to 65 years old with an average of (40.0±11.3) years old. There were 33 cases were on the left side and 32 cases were on the right side. The time from injury to operation ranged from 3 h to 8 d with an average of 34.6 h. Shoulder function of all patients were normal before injuried. Postoperative pain, activity of daily living (ADL), range of motion, deltoid muscle strength were compared. Anteflexion,rear protraction, abduction and upthrow of shoulder joint were also compared. Postoperative complications between two groups were observed and compared.

RESULTSAll patients were followed up from 12 to 48 months with an average of 18.5 months. Constant-Murley score were used to evaluate clinical efficacy at the least following up, and 13 cases got an excellent results, 5 moderate, 2 good and 1 poor in shoulder pain group ; while 61 cases were obtained excellent results, 3 moderate and 1 good in painless group. There were significantly differences between two groups in Constant-Murley score and activity of shoulder joint (P<0.05). In shoulder pain group, 3 cases were disconnected, 1 case occurred stress fracture, 9 cases were subacromial impingement syndrome, 5 cases occurred subluxation, 1 case occurred plate breakage and 11 cases were acromioclavicular arthritis.

CONCLUSIONChosing individual clavicular hook plate, fulfilling anatomic reset, paying attention to the repair of articular capsule ligament, and reducing hook and bone antagonism between stress is the key point of preventing and decreasing postoperative shoulder pain.

Acromioclavicular Joint ; injuries ; physiopathology ; surgery ; Adult ; Bone Plates ; adverse effects ; Case-Control Studies ; Female ; Fracture Fixation, Internal ; instrumentation ; methods ; Humans ; Male ; Middle Aged ; Postoperative Complications ; etiology ; Range of Motion, Articular ; Shoulder Dislocation ; complications ; physiopathology ; surgery ; Shoulder Pain ; etiology ; Treatment Outcome ; Young Adult

Objective To investigate whether RelB-silenced bone marrow-derived dendritic cells (BMDC) pulsed with torpedo acetylcholine receptor (TAChR) immuno-dominant peptide Tα_(146～162) can induce tolerance in T cells primed with TAChR. Methods Recombinant lentivirus that produced RelB siRNA and control lentivirus were prepared and used to infect BMDCs. The infected BMDCs were stimulated with LPS,and the resulting cells were designated as DC-siRelB or DC-control, respectively. The mRNA and protein expression of RelB were examined by quantitative real-time PCR and Western blot. Cell surface markers of DC were evaluated by flow cytometry. IL-12 in the supernatant was detected by ELISA. Mice were randomly divided into 6 groups: A1, A2, A3,K1, K2, and K3. On day 0, group A1, A2, and A3 were primed with TAChR in CFA and group K1, K2 and K3 were primed with KLH+CFA. On day 7, group A2 and K2 were injected with Tα_(146～162) pulsed DC-siRelB, group A3 and K3 were injected with Tα_(146～162) pulsed DC-control, while A1 and K1 group received PBS at the same time. On day 14, lymphocyte proliferative response of the 4 groups were measured. Results Recombinant lentivirus including RelBshRNA genes was successfully constructed. RelB siRNA knocked down RelB expression in BMDCs obviously. Compared with DC-control, DC-siRelB expressed a significantly lower level of CD80, CD86, and MHC class II on their surface, producing lower level of IL-12. Compared with group A1 and A3, lymphocyte proliferative response to TAChR of A2 group was suppressed significantly (P<0.05). No different lymphocyte proliferative responses to KLH and ConA were seen in group A1, A2 and A3 (P>0.05). No different lymphocyte proliferative responses were seen in group K1, K2 and K3 (P>0.05). Conclusion Lentiviral-mediated RelB-silenced BMDCs are maturation resistant and can induce antigen-specific tolerance in TAChR primed C57BL/6 mice,which provides a basis for further study of their therapeutic potential in myasthenia gravis.

Objective To introduce and evaluate the procedure of sling percutaneous bladder neck suspension for female stress urinary incontinence (SUI). Methods A vaginal submucosal tunnel was created between the urethra and the anterior vaginal wall at the level of the bladder neck for later passage of the sling contructed from polypropylene mesh (2.8 cm?1.2 cm).Nineteen cases were treated using bladder neck suspension via percutaneous puncture with the Vesica needle.Cystoscopy was performed to prevent bladder or urethra injury. Results The mean follow up period was 17 months (ranged from 3 to 45 ) with no incontinence in all patients except for only one complaining of voiding difficulty. Conclusions The procedure provides tension free support of the urethra and bladder neck without elevation of the urethra and increased tension on the vaginal wall.The procedure is simple, safe and effective for SUI.

Infection and inflammatory response can induce the brain damage in neonate,but the mechanism involved in it has not been elucidated completely.Proposed mechanisms include inflammatory response,cytokine and free radical-mediated injury,and excitatory amino acids-induced injury.The activation of microglia and selective vulnerability of immature oligodendrocyte play an important role in the whole process.Recent researches show that the fetal inflammatory response and complex gene regulation are also involved in the infection-induced brain damage.

OBJECTIVETo analyze the effect of Chinese herbs used by Prof. LI Tao on peripheral blood T subsets in treating multiple sclerosis (MS) by using association rules and statistical methods, thereby providing evidence for optimizing prescriptions.

METHODSData of MS inpatients and outpatients recorded by data collecting system, Xiyuan Hospital, China Academy of Chinese Medical Sciences were resorted. The relationship between Chinese herbs and T cell subsets were analyzed using SPSS17.0 and Aprior module in SPSS Clementine 12.0.

RESULTSRadix bupleuri, Radix Paeoniae alba, Fructus Aurantii, Atractylodes, and Radix Glycyrrhizae were most commonly used herbal combinations.Radix Aconiti lateralis preparata and Rhizoma Smilacis glabrae were often added. Radix Aconiti lateralis preparata was associated with decreased Th1 cells (confidence level 83.78%, supportive level 36.26%). Decreased Th1 cell was associated with Radix Aconiti lateralis preparata (confidence level 71.26%, supportive level 36.26%).Radix Aconiti lateralis preparata was obviously associated with decreased Th1 cells. Radix Bupleuri, Radix Paeoniae alba, bitter orange, Atractylodes , Radix glycyrrhizae, and Radix Aconiti lateralis preparata could reduce peripheral blood Th1 subsets of MS patients and elevate Th2 subsets (all P < 0.01).

CONCLUSIONSThe herbal combination of Radix Bupleuri, Radix Paeoniae alba, Fructus Aurantii, Atractylodes, Radix Glycyrrhizae, Rhizoma Smilacis glabrae, and Radix Aconiti lateralis preparata could lower peripheral blood Th1 cells and elevate Th2 cells, and prevent the relapse of MS possibly by reducing Th1 cells and elevating Th2 cells. Especially Radix Aconiti lateralis preparata played important roles in aforesaid changes of Th1 and Th2.

Aconitum ; chemistry ; Atractylodes ; chemistry ; Bupleurum ; chemistry ; China ; Drugs, Chinese Herbal ; therapeutic use ; Fruit ; chemistry ; Glycyrrhiza ; chemistry ; Humans ; Multiple Sclerosis ; therapy ; Paeonia ; chemistry ; Plant Roots ; chemistry ; Rhizome ; chemistry ; Smilacaceae ; chemistry ; T-Lymphocyte Subsets ; drug effects