AIM: To investigate the possible impact of conductive keratoplasty(CK)on intraocular pressure( IOP ).METHODS: 36 eyes of 20 patients with hyperopia underwent IOP measurement with non-contact tonometer (NCT), Goldmann applanation tonometer (GAT) and Schiotz tonometer before and after CK.RESULTS: After CK, a significant decrease was observed by NCT, GAT and Schiotz measurements. The change in IOP readings was not correlated with age, sex,keratometric readings, or attempted correction.CONCLUSION: The applanation tonometer atend to underestimate the true IOP after CK.

Pancreatic cancer has a bad curative effect because of low rate of early diagnosis.Plasma cancer marker becomes the most ideal screening method for the special advantages.With the development of proteomics,many new plasma cancer markers,such as apolipoprotei A-Ⅱ,apolipoprotei C-Ⅰ,MBL2、ML-CK2,REG4 and so on,have been detected.The article describes the research progress of plasma tumor marker.

Objective:To investigate the non-thymoma thymic morphology in patients with Myasthenia Gravis(MG), and provide the theoretical basis for extended thymectomy.Methods:From September 2008 to March 2018, extended thymectomy had been performed for 150 patients with MG in our department. In order to achieve maximal benefit, combined thoracoscopic and mediastinoscopic approach had been adopted to completely remove both thymus and ectopic thymic tissue in the neck and the anterior mediastinum. Cervical and mediastinal tissue including fat from the thyroid isthmus to the diaphragm was swept away from above the phrenic nerve. The regions containing mediastinal fat were divided into 12 stations.Results:There was no mortality. Pathology reports revealed 126(84.0%) patients with MG had hyperplastic thymus, 17(11.3%)cases with involuted thymus and 7 (4.7%)cases with normal thymus. 98 (65.3%)cases had more than two superior horns, and 59(39.3%) patients had ectopic thymic tissue in the mediastinum and in the neck. Positive rates of ectopic thymic tissue in the 12 cervical-mediastinal fat stations were 7.8%, 10.0%, 8.8%, 3.8%, 3.0%, 2.5%, 0, 0, 0.7%, 13.3%, 12.3% and 9.1%, respectively. After a follow-up period of 2-12 years, the rate of complete stable remission was 44.7%(59/132), and the effective rate was 89.4%(118/132).Conclusion:It is very meaningful to study non-thymoma thymic morphology in patients with MG in order to guide the performance of extended thymectomy and improve its outcome. For the purpose of minimally invasion, one side of mediastinal pleural should be carefully protected.

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Objective:To explore the role of peripheral blood monocyte subsets in the pathogenesis of rheumatoid arthritis (RA),we therefore decided to compare the percentage of monocyte subpopulations in peripheral blood,as well as cytokines secretion function,to that of healthy controls. Methods:22 patients with RA and 22 cases of healthy controls ( HC) were drew 3 ml fresh venous blood into a tube containing heparin. The percentage of monocyte subsets,expression of Toll-like receptor(TLR)2,HLA-DR,triggering receptor expressed on myeloid cells-1(TREM-1) on intermediate monocyte and mean fluorescence intensity(MFI) of intracellular tumor necrosis factor-α ( TNF-α) were evaluated with the methods of flow cytometry ( FCM ) . The correlation between percentage of monocyte subsets and serum cytokines was explored. Statistical significance between parametric data was determined by the students't-test. Results:Compared to HC controls, the percentages of intermediate monocytes were significant higher in RA patients [ ( 11. 7 ± 1. 6)% vs (4. 6±1. 2)%,P<0. 05],as well as the expression(MFI) of TLR2 (750. 2±110. 3 vs 526. 8±98. 6) and TREM-1 (58. 4± 12. 1 vs 40. 3±10. 2) on intermediate monocytes (P<0. 05). The expression of HLA-DR on intermediate monocytes of RA patients had no difference with HC controls (P>0. 05),while MFI of intracellular TNF-αin intermediate monocytes of RA patients were significant higher than that of HC controls (46. 3±6. 4 vs 36. 7±8. 3,P<0. 05). In addition,RA patients showed a positive correlation between the percentage of CD14highCD16+ monocytes and DAS28 scores(r=0. 538,P=0. 009),as well as the serum levels of TNF-α,IL-17 ( r=0. 471,P=0. 027;r=0. 593,P=0. 003). Conclusion:Monocyte subpopulations from RA patients are abnormally skewed toward to in-termediate monocytes which has high expression of TLR2 , TREM-1 and the function of TNF-α secretion. Therefore, intermediate monocytes may play a role in the pathophysiology of RA. By modulating polarization or blocking monocyte cell surface receptors could be a new treatment of RA.

Objective To detect the routine coagulation indicators in breast cancer patients receiving the trastuzumab treatment and to analyze the influence of the coagulation indicators on clinical treatment response .Methods Totally 67 hospitalized breast cancer patients receiving the trastuzumab treatment in 401 Hospital of PLA from Jan .2006 to Dec .2012 were collected and divided into the effective group(47 cases) and ineffective group(20 cases) according to the curative effect .The levels of PT ,APTT ,TT ,Fib and D‐D were statistically analyzed .The differences of coagulation indicators were compared between the two groups .The correla‐tion between the coagulation indicators with the curative effect was analyzed .Results Compared with the effective group ,PT , APTT and TT in the ineffective group were slightly extended ,while the D‐D level was slightly increased ,the differences were not statistically significant(P> 0 .05);but the Fib level was significantly increased with statistical difference(P< 0 .05) .Conclusion The breast cancer patients with ineffectiveness in the trastuzumab treatment are easily appear the high Fib status .Determining its plas‐ma concentration is conducive to judge the prognosis of the trastuzumab treatment in breast cancer patients .

AIM:To observe the effects on human keratocytes by cationic liposome LipofectamineTM 2000(LF2000).to investigate the efficiency and safe range applied in human keratocytes,and establish basis for gene therapy of human keratocytes.METHODS: Human keratocytes cultured in vivo within 3 to 5 passages were used in experiment after being identified.The effects on proliferation of cultured human keratocytes by LF2000 with different concentrations and time were evaluated By MTT:the effects of LF2000 on the survival rate and its relation with 5,10,20,40.80mg/L concentration and time were detected by trypan blue staining.related with concentration and time.The cellular proliferation and survival rate declined when concentration of LF2000 was above certain level,and this effect increased as time became longer.LF2000 had no effect with concentration under 40mg/L for 24 hours. CONCLUSION:LF2000 did ont cause cytotoxicity during a concentration range"tested",and it is hoped to play an important role in gene therapy of human keratocytes.

AIM:To observe and compare clinical effects of coaxial 1. 8mm microincision phacoemulsification and 3. 2mm small incision phacoemulsification.
●METHODS:A total of 117 eyes of 85 patients with age-related cataract in our hospital were divided randomly into two groups:43 patients (59 eyes) in the coaxial 1. 8 mm microincision cataract surgery group ( C - MlCS ) , 42 patients (58 eyes) in the coaxial 3. 2 mm traditional small incision cataract surgery group (C-SlCS). A total of 117 eyes were received phacoemulsification with intraocular lens implantation. Uncorrected visual acuity was recorded preoperatively and postoperatively at 1, 7, 30 and 90d. The effective phacoemulsification time and average ultrasound energy were recorded in surgery. Corneal endothelial cell and corneal topography were recorded preoperatively and postoperatively at 90 d.
●RESULTS:Uncorrected visual acuity ( logMAR) was no overall statistical significance difference between C-MlCS group and C-SlCS group (P>0. 05), but was significant statistical difference in different time-point within both groups(P<0. 05). Uncorrected visual acuity in different time-point had nothing to do with corneal wound size in cataract surgery(P>0. 05). On the 1 day after surgery, uncorrected visual acuity was 0. 16±0. 11 in C-MlCS group and 0. 22±0. 18 in C-SlCS group(P<0. 05). AVE was (7. 00± 2.72)% in C-MlCS group and (6. 16±3. 16)% in C-SlCS group (P>0. 05). EPT was (3. 09±1. 61)s in C-MlCS group and (3. 20±1. 92)s in C-SlCS group (P>0. 05). At 90 d after surgery, corneal endothelial cell loss percentage was (5. 81±2. 28)% in C-MlCS group and (5. 69±2. 38)% in C-SlCS group (P>0.05), SlA was (0.35±0.11) Din C-MlCS group and (0. 61±0. 13) D in C-SlCS group (P<0. 05).
● CONCLUSION: Compared with coaxial 3. 2mm traditional small incision cataract surgery, 1. 8mm coaxial microincision cataract surgery can get earlier visual rehabilitation and significantly reduce SlA. The coaxial 1. 8mm microincision cataract surgery is safe, effective and deserves further clinical applications.

Objective To evaluate the differences, including clinical symptoms, endoscopic and histopathologic findings, status of Helicobacter pylori (Hp) infection and cytokeratin (CK) expressions, be-tween Barrett esophagus (BE) and heterotopic gastric mucosa (HGM) in upper esophagus. Methods Clinical data of 152 patients with BE and 52 patients with HGM in upper esophagus diagnosed from February 2004 to September 2005 were retrospectively studied. The parameters being compared include-ed clinical manifestations, conventional and magnifying endoscopic findings, histopathological findings, Hp infection determined by rapid urease test and Warthin-Starry staining and expression of CK phenotypes detec-ted by immunohistochemistry. Results Gastro-esophngeal reflux was observed in 64. 5% of patients with BE (98/152), higher than that in patients with HGM ( 13.5%, 7/52, χ2 = 40. 36, P < 0. 01 ). Endoscopic faveolus of BE mucosa included 46 cases of spot pattern, 65 striations and 41 villiform patterns, while those of HGM were all striation patterns. The histologic classification in BE included 56 cases of fundic type, 39 junction type and 57 specialized intestinal metaplasia, while in HGM mucesa, 31 cases of fundic type, 16 junction type and 5 antrum type were diagnosed, and no goblet cells were found. Moderate and severe infil-tration of inflammatory cells in BE mucosa was 63.2% (96/152), which was significantly higher than that in HGM mucosa (15/52, 28. 8%, P<0. 01). However, no difference was found in gastric antrum inflam-mation between the two groups (44.7%, 68/152, vs. 51.9%, 27/52, P>0.05). No difference was ob-served in prevalence of Hp infection between BE and HGM groups (P >0. 05 ), either in involved mucosa or in antrum. CK7 was not expressed in HGM or normal squamons mucosa, but was expressed in BE. CK20 and CK19 were expressed in both HGM and BE, and CK13 expression was found in some BE nmcosa including gas-tric metaplesia (55/95) and intestinal metaplasia (29/57) but not in HGM mucosa. Conclusion There are differences between HGM and BE, in regarding of reflux symptoms, magnifying endoscopic findings, histo-logical types and CKs expressions, which may be indicators to make differential diagnosis.

Objective:To standardize the clinical information of the nose.Methods:Based on the 1034 descriptions on the clinical manifestation of nose in the database of the clinical records of Chinese medicine in the past dynasties,according to the hypothesis of symptomatic unit,the symptomatic units,the second-level clinical characteristics and the limiting factors were summarized in the paper.Results:All the descriptions on the clinical manifestation of nose include 11 symptomatic units,7 second-level clinical characteristics and 1 limiting factor.Conclusion:Comparing with the symptoms in the authoritative works of Chinese medicine,cold-feeling of the nose while breathing was the new fi nding,nares flaring and ozena recorded in the authoritative works were the second-level clinical characteristics of polypnea and rhinorrhoea respectively.Nose diseases,such as nasal eczema,were usually diagnosed by several symptomatic units,so they were not symptomatic units.