?AlM:To compare the effect of iris location guided sub-bowman keratomileusis ( SBK ) and iris location guided thin - flap laser in situ keratomileusis ( LASlK ) for extremely high myopia treatment.
?METHODS:lris location guided SBK was performed in 64 eyes of 32 patients with extremely high myopia and 42 eyes of 84 patients were received iris location guided thin-flap LASlK. All the patients’ spherical refraction was-9. 00D ~ - 11. 00D and the age was 22 ~ 35 years. Uncorrected visual acuity ( UCVA) , refraction, split-lamp examination, topography examination, central corneal stroma thickness, thickness of central corneal flap, thickness of peripheral corneal flap and complication was examined in these patients and follow-up was 6mo.
?RESULTS:At 6mo after surgery, 93. 8% of the patients received iris location guided SBK and 92. 9% received iris location guided thin-flap LASlK achieved a UCVA better than 20/20. There was no significant difference between two groups. Refraction between ±0. 5D was 89. 1% of SBK group and 84. 5% of LASlK group. There was no significant difference. Corneal rear surface height of SBK was 0. 046±0. 012μm and LASlK was 0. 056±0. 015μm. Thickness of corneal stroma after surgery was 328. 6±14. 7μm in SBK group, while it was 301. 2±21. 6μm in LASlK group and there was significant difference ( t =3. 127, P=0. 001). BUT was 11. 38±4. 02s and 17. 81±4. 89s in SBK and LASlK group respectively, with no statistical difference. There was no serious complication in two groups.?CONCLUTlON:Both iris location guided SBK and thin-flap LASlK are effective for extremely high myopia, but SBK is safer and more predictive than thin-flap LASlK.

Objective To analyze the risk factors for healthcare-associated pneumonia (HAP) in patients with orthopedic injury,provide the basis for making prevention and control measures.Methods HAP occurred in patients with orthopedic injury and admitted to the department of orthopedics of a hospital from June 2011 to May 2015 were investigated retrospectively,risk factors were analyzed by univariate and multivariate logistic regression methods.Results A total of 2 578 patients with orthopedic injury were investigated,92 patients developed HAI,incidence of HAP was 3.57％.107 strains of pathogens were detected,the major were Klebsiella pneumoniae (n =22,20.56％),Escherichia coli (n =14,13.08％),and Acinetobacter baumannii (n =13,12.15％).Risk factors for HAP in patients with orthopedic injury were length of hospital stay≥15 days,smoking history≥3 years,bedridden ≥7 days,associated with underlying diseases,complications,indwelling catheter≥7 days,surgical operation,mechanical ventilation,admitted to intensive care unit,open injury,blood sugar≥11 mmol/L,plasma albumin＜30 g/ L,hemoglobin concentration＜90 g/L,and use of glucocorticoid≥4 days (all P＜0.05).Multivariate logistic regression analysis showed that smoking,bedridden,surgery,mechanical ventilation,glucocorticoid use,and anaemia were independent risk factors for HAP in patients with orthopedic injury.Conclusion The occurrence of HAP in patients with orthopedic injury is related with multiple factors,the major are surgical operation,mechanical ventilation,glucocorticoid use,long term smoking,bedridden,and anaemia.

Objective:To observe the pulmonary apoptosis resulted from ischemia reperfusion lung injury in rats. Methods: Forty male SD rats, weighing 300 350 g,were randomly divided into 8 groups: 6 ischemia reperfusion group,simple ischemia group and control group( n =5).An in situ ischemia reperfusion lung injury rat model was established. Apoptotic cells were detected by the terminal deoxynucleotidyl transferase mediate dUTP nick end labelling (TUNEL) technique and the apoptotic DNA fragments by pulmonary DNA electrophoresis. Electron microscopy was performed to verify the morphologic changes of apoptosis. Results: Obvious apoptosis of pneumocytes occurred early after(30 min) ischemia reperfusion lung injury, with the peak on 2 h after reperfusion, and there were no significant differences 12 h after reperfusion compared with control group. There was a slight but no statistically significant elevation of apoptotic pneumocytes number in simple ischemia group compared with controls. Conclusion: The result indicates that apoptosis may contribute significantly to ischemia reperfusion lung injury.

Objective To comparie the effects of pre-dilution with post-dilution continuous renal replacement therapy (CRRT) for patients with MODS. Method Thirty-two MODS patients admitted to ICU (Intensive Care Unit ) were randomized and treated with different modes of CRRT. The results of creatinine clearance, acid-base equilibrium, haemodynamic variables before and post therapy were recorded.The maximal pre-filter pressure, the duration of filter unworn out and mortality of patients treated with different modes of CRRT were also recorded. Results Seventeen patients were treated with pre-dilution mode of CRRT and 15 patients treated with post-dilution mode of CRRT. After 24 hours of pre- and postdilution modes of CRRT, the net increase in Ccr (namely the rate of replacement creatinine clearance) were (15.6±4.6) vs. (22.7 ±4. 1) mL/min respectively (P＜0.01); after 48-hour, they were (14.9±3.3)vs. ( 18. 9 ±2. 3) mL/min (p ＜0. 05) . Both dilution modes could improve the blood PH、 HCO3- and BE( P ＜ 0. 05 ) without significant differences between two groups after CRRT therapy ( P ＞ 0. 05 ) . The MAP of patients treated with pre-dilution modes of CRRT therapy for 24 hours and the MAP of patients before therapy were 69. 2 ± 4. 6 and 56. 7 + 9. 1 mmHg respectively ( P ＜ 0. 05 ), and dosage of dopamine used in patients before CRRT therapy and that after CRRT for 24 hours were ( 11.20 +3.45 ) vs (6. 12 +3.41 ) μg ·kg-1 min -1(P＜0.05).The maximal pre-filter pressures of pre-and post-dilution modes were (82.23+9.11) cm H2O, (110.56 +28. 14) cmH2O respectively (P＜0.05), and the durations of lasting effect of filter used in two modes of CRRT were ( 39 + 28. 12 ) vs. ( 25 + 14. 45 ) h respectively ( P ＜0. 05) . Both dilution modes could improve APACHE Scores. There were no significant differences in APACHE Scores and mortalities between two groups after CRRT therapy. Conclusions Post-dilution mode of CRRT has higher filtration rate, but have higher maximal pre-filter pressure and shorter longevity of filter.Pre-dilution mode of CRRT has better effect on improving hemodynamics, reducing usage of vasopressor.Both modes of CRRT can correct acid base equilibrium disorder rapidly. There are no differences in the results of blood gas analysis improved、 APACHE scores and mortality between the two groups.

Objective To investigate the change of inflammatory factor and blood coagulation in patients with laparo?scopic gastric cancer radical surgery. Methods Data of seventy-seven stomach cancer patients hospitalized in our hospital and received the surgical treatment from June 2012 to June 2014 were retrospectively analyzed. Thirty-eight of these pa?tients underwent laparoscopic treatment (laparoscopic group) and 39 cases received laparotomy treatment (laparotomy group). The values of interleukin-6 (IL-6), IL-8 and tumor necrosis factor alpha (TNF-α) were analyzed at the time points of preop?eration and 6 h, 24 h after the surgery in two groups. The levels of activated partial thromboplastin time (APTT), prothrombin time (PT), international standardization ration (INR), fibrinogen (FIB) and D dimer (D-D) were also analyzed at the same time points in two groups. The postoperative thrombosis and tumor recurrence rate were also analyzed in two groups of pa?tients. Results There were no significant differences in the gender, age, the size of tumor, differentiation degree and TNM staging between two groups of patients. The serum levels of IL-6, IL-8 and TNF-αwere significantly increased after surgery in two groups (P < 0.01), and which were significantly higher in laparotomy group than those of laparoscopic group (P<0.01). The levels of APTT, PT and INR were significantly lower after surgery in two groups of patients, and which were signifi?cantly lower in laparoscopic group than those of laparotomy group (P<0.05). The levels of FIB and D-D were significantly increased after operation in two groups of patients (P<0.05), which were significantly higher in laparoscopic group than those of laparotomy group (P<0.05). The postoperative recurrence of cancer was less in laparoscopic group than that of lapa?rotomy group. But, the postoperative thrombosis was more in laparoscopic group than that of laparotomy group. Conclusion There was less release of inflammatory mediators and less effect on the body’s immune function in patients with laparoscopic gastric cancer radical surgery. But, the surgery has a large influence in blood coagulation, we should pay attention to it in the clinical treatment.

Objective To search for clinical appearance and fungal resistance of candidemia in ICU.Methods Thirty-four cases of candidemia in ICU during 2003and 2006 were analyzed retrospectively.Results Twelve of 34 cases of candidemia were C.albicans,and 22 of 34 cases were non-C.albicans,which were 64.71% in candida monilia.Fever and chill of candidemia were 100% and 70.59% differently.Conclusion If there is high risk factor of fungous infection in clinic,at the same time fever and chill appear,and antibiotics treat is inefficacy not effective,it is possible to consider candidemia.

[Objective] To determine dormancy mechanism of Taxus mairei(Lemee et Levl.) S.Y.Hu ex Liu Seeds,the best method of dormancy breaking.[Method]The seeds were handled by lotic water or excitatory autacoid or cold-warm-cold stratification treatment or cold-warm-cold stratification treatment with excitatory autacoid,then compare withgermination inhibition of Brassica campestris seeds handling with water solution from the seeds after four dormancy breaking methods,to dertemine the best dormancy breaking method.[Conclusion] The best damancy breaking method was cold(4℃)—warm(23℃)—cold(4℃) stratification treatment with 0.05% gibberellic acid for 120 days.

Objective To investigate the effects of propofol on the whole-cell excitatory postsynaptic currents (EPSC) and spontaneous excitatory postsynaptic current (sEPSC) in hippocampal CAl neurons.Methods Wistar rats (13-19 days old) weighing 40-60 g were decapitated and the hippocampi were immediately removed and placed in 0-4℃ artificial CSF aerated with 95% O2 and 5% CO2 . The hippocampi were sliced (400 ?m thick) . EPSCs were recorded in hippocampal CA1 neurons by stimulating the Schaffer collateral / commissural pathway. The 50 slices were divided into 5 groups (n = 10 each): group Ⅰ intralipid-1; group Ⅱ propofol-1; group Ⅲ SR95531 + propofol; group Ⅳ intralipid-2 and group Ⅴ propofol-2. In group Ⅰ, Ⅱ and Ⅲ after EPSCs were recorded for 10 min, 10% intralipid 90 ?l, 1% propofol 90 ?l (final concentration was 100 ?mol?L-1 and SR95531 10 ?mol?L-1 + propofol 100 ?mol?L-1 were added to the perfusate and again EPSCs were recorded for 40min. The changes in amplitude of EPSC were analyzed. In group Ⅳ and Ⅴ after the cell membrane was perforated and being stabilized for 10-15 min 10% intralipid 90 ?l and 1 % propofol (100 ?mol?L-1) was added to the perfusate and sEPSCs were recorded without stimulation. The holding potential was - 70 mV. Results Intralipid didn't affect EPSC but propfol 100 ?mol?L-1 reduced EPSC to 47.7% of the baseline value. SR95531 could reverse the effect of propofol on EPSCs. The frequency, amplitude and decay time of sEPSC in group propofol-2 were reduced to 31. 9% , 70. 9% and 50. 7% of those in group Ⅳ (intralipid-2) (P

Objective To reproduce a simple and practicable animal model of rheumatoid arthritis(RA)for evaluating the therapeutic effects of recombinant human interleukin-1 receptor antagonist(rhIL-1Ra).Methods The animal model of RA was reproduced in Wistar rats by intradermic injection of an admixture of bovine type Ⅱcollagen and Freund's complete adjuvant on the foot pad,tail,and back of the rats and the injections were repeated 7 days later.Results Two weeks after the second injection,all the extremities were markedly swollen.The diameter of ankle joints,the level of TNF-? in serum,and the size of the paws were increased obviously.There was destruction and absorption of the bone trabeculae of distal end of the tibia.There was also necrosis and fibrosis of cartilage of the joints.The articular space was narrowed.Thus RA model was successfully reproduced in rat.Conclusion Bovine type Ⅱcollagen and Freund's complete adjuvant were a favorable agent for the reproduction of RA model in rats.