?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.

BACKGROUND:Intramedulary nail with rigid biomechanics was firstly selected for proximal femoral fracture. Proximal femoral intramedulary nail can effectively control the shortening and rotation of the fracture, alow patients to do early exercise and weight bearing, and promote the improvement of joint function. OBJECTIVE:To investigate the effects of proximal femoral intramedulary nail for treating intertrochanteric fractures on the recovery of joint function in young patients. METHODS:80 young patients with intertrochanteric fractures were randomly divided into the treatment group and the control group, with 40 cases in each group. The control group received dynamic hip screw fixation, and the treatment group received proximal femoral nail fixation. Perioperative index, complications and functional recovery of knee joint after 3 months of treatment were compared between the two groups. RESULTS AND CONCLUSION:Compared with the control group, length of incision, intraoperative blood loss, operative time, fracture healing time and postoperative ambulation time were significantly reduced in the treatment group (P< 0.05). Complications such as postoperative nonunion, hip varus, limb shortening and deep vein thrombosis were significantly less in the treatment group than in the control group (P < 0.05). After folow-up at 3 months post treatment, the excelent and good rate of hip function was significantly higher in the treatment group than in the control group (93%, 80%;P < 0.05). These results suggest that proximal femoral nail for treating intertrochanteric fractures in young patients folows the principle of biomechanics, reflects the characteristics of minimal invasion, and has few complications, and promotes the recovery of hip function.

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 explore the value of MSCT enhanced scanner in diagnosis and differential diagnosis of spleen tumor. Methods The MSCT enhanced feautures of 23 cases of spleen tumor proved by imaging examination,follow-up and pathologically were anlayzed retrospectively,the features of MSCT enhanced scanner in spleen tumor were analyzed.Results All cases included 12 benign tumor (5 cysts,6 hemangiomas,1 lymphangioma).1 1 malignant tumor(2 primary lymphomas,3 secondary lymphomas,6 metastatic tumors).Conclusion MSCT enhanced scanning for the qualitative diagnosis of spleen tumors with high value.

Objective Clinical features of primary biliary cirrhosis (PBC) were reviewed in order to improve its diagnosis in our clinical practice. Methods Clinical data of 70 patients with PBC were reviewed including the clinical manifestation, laboratory tests, pathological findings and the response to therapy. Results Sixty-two patients were females (88.6%), eight patients were males (11.4%), and the mean age at diagnosis was (53.1?10.4) years. The most frequently complained symptoms were pruitus (60.0%), fatigue (42.9%), anorexia (41.4%) and jaundice (45.7%). Serum alkaline phosphatase (ALP) and ? glutamyl transpeptidase (GGT) levels were markedly elevated in all patients, while alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels were mildly elevated. The serum total bilirubin level increased in sixty-five patients (92.9%). Forty-four patients (62.9%) had elevated serum immunoglobin M (IgM), and 98.6% of patients (69/70) were antimitochondrial antibody (AMA) /AMA-M2 positive. Forty-one patients underwent pathological examinations, 82.9% in early stage (Ⅰ,Ⅱ stage) and 17.1% in advanced stage (Ⅲ,Ⅳ stage).Conclusions PBC most frequently affects middle-aged women and the main clinical manifestations are pruritus, fatigue, anorexia and jaundice. The elevated level of ALP, GGT, IgM and positive AMA/AMA-M2 may be crucial to diagnosis of PBC.

Objective To investigate the effects of seed quality on the using value of Akebia trifoliata. Methods The seed net weight and plumpness were determined by electric balance, the moisture content was determined by moisture meter and the germination rate were determined through germination test. Results The seed net weight degree, 100-grain weight, 1 000 -grain weight, moisture content, viability, germination rate, and germination potential of A. trifotiata fresh seed were 98.7%, 6.64 g, 66.6 g, 43.1%, 94.5%, 82.6%, and 52.8%, respectively. Being made air-dried for 10 d or 60 d, the moisture content of A. trifoliata seeds were 28.5% and 7.8%, respectively, the germination rate were 64.3% and 14.7% respectively. Conclusion It is suitable to put the A. trifoliata seeds into the 30 ℃ clear water for 24 h and make them sprout or be buried in the wet sand at a room temperature of 5-12 ℃. When the moisture content of seed is lower than 8%, it will lose the value to be cultivated.

OBJECTIVE To investigate pathogen distribution and drug resistance in infection of operative incision and provide the reference for clinical prevention and cure.METHODS Referring to National Rules of Operation in Clinical Laboratory,strains were isolated and identified,and drug-sensitivity test was performed by DADE BEHRING panel.RESULTS Among total 140 strains of pathogenic bacteria,the most were Gram-negative bacilli that accounted for 58.6%(82 strains),followed by Gram-positive cocci that accounted for 41.4%(58 strains).Staphylococcus aureus and Pseudomonas aeruginosa had the higher detection rate.The former was 29.3% and the latter was 27.1%.Among the total S.aureus,meticillin-resistant S.aureus(MRSA) accounted for 31.7%.Detection rate of extended-spectrum beta-lactamases(ESBLs) producing Escherichia coli and Klebsiella pneumoniae was 40.9%.CONCLUSIONS Effective measurement should be taken to prevent and control infection of operative incision.

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.