Objective To discuss the X-knife radiosurgery (XKS) in the treatment of brain metastasis of lung carcinoma. Methods A total of 100 patients with similar prognostic factors were divided into two groups with 50 patients in each group, receiving either whole-brain radiotherapy alone (30~40 Gy/3~4 weeks) (Radiotherapy Group) or XKS combined with radiotherapy (Combination Group). In the Combination Group, 27 patients received XKS with single fraction of radiation, with a median prescription dose of 14.2 Gy, and the other 23 patients received multiple fractions of radiation (5~10 Gy/f, 3 times weekly), with a total dose of 15~30 Gy. Results In the Combination Group and the Radiotherapy Group, the median survival time was 16.4 and 10 months, respectively (P=0.0064), the 2-year local tumor control rate was 88% (44/50) and 44% (22/50), respectively (?2=21.569,P=0.000), and the effective rate under CT or MRI scanning at 1~3 months after treatment was 87.5% (35/40) and 52.2% (24/46), respectively (?2=16.497,P=0.001). An analysis on the cause of death showed that 11.9% of patients (5/42) in the Combination Group died from brain metastasis, which was significantly lower than that in the Radiotherapy Group (55.6%, 25/45) (?2=25.908,P=0.000). The incidence of complications was not significantly different between the Combination Group (8%, 4/50) and the Radiotherapy Group (4%, 2/50) (?2=0.709,P=0.400). Conclusions Combined use of X-knife radiosurgery and routine radiotherapy has better therapeutic effects than radiotherapy alone for treating brain metastatic tumor.

Objective To evaluate the sleep characteristics of the Korean children,and explore the measurement of improving the sleep qua-lity of minority nationality children.Methods The sleep time of 1 183 from 3 to 12 years age Korean children were investigated with questionnaire The sleep time of korean children in different ages and cities were compared.Results The mean time of total sleep time in Korean children was(10.06?1.29) h,which was decreasing with the age′s increasing.The difference in different ages groups was remarkable(Pa

Cerebral Infarction ; drug therapy ; etiology ; Female ; Humans ; Infant, Newborn ; Intracranial Hemorrhages ; drug therapy ; etiology ; Male ; Vitamin K Deficiency ; complications ; drug therapy

Objective To explore the clinical manifestations of toxic epidermal necrolysis(TEN) and its rare pulmonary complications.Methods Clinical symptoms,treatment and prognosis of 1 child with TEN caused by carbamazepine were analyzed.Radiological images were reviewed to evaluate the manifestations and the outcome of chronic pulmonary complications associated with TEN.Results The patient had high fever shortly after a dosage increment of carbamazepine.A confluent erythematous exanthema developed rapidly into painful blistering with skin erosion,denudation and involvement of conjunctive and oropharyngeal mucosa.The diagnosis of TEN was made.The mucocutaneous damage was gradually recovered with steroid plus intravenous immunoglobulin for 3 weeks.However,the patient presented with respiratory failure in the recovery phase of TEN.The computer tomography revealed pulmonary bullae and pneumothorax in the right lung.Lung parenchyma was squeezed and pulmonary bullae ruptured with pneumothorax and atelectasis,which were absorbed gradually through thoracic drainages.The patient′s lung function and pulmonary bullae were partly improved during a 7-month follow-up.Conclusions TEN is a severe form of blistering skin di-sease which is characterized by an extensive loss of epidermis and mucous membrane.Chronic pulmonary complications may occur in recovery phase of TEN.Pulmonary bullae,which might be caused by mucous damage and respiratory obstruction,is a rare complication of TEN.

To obtain a number of extracellular penicillinase,the gene(penp)encoding penicillinse of Bacillus cereus ATCC10987 was cloned into expression vector in Bacillus subtilis,transformed into Bacillus subtilis DB104 deficient in two proteases.When recombinant bacteria was cultured in LB medium for 24 hours,the result of SDS-PAGE showed that the molecular weight of the protein was 28kDa and the penicillinase activity reached 339U/ml.By screening seven different fermentation media,the result showed that 4# medium is favorable to producing penicillinase by the recombinant cells than the others,with the yield of the enzyme being 1580U/ml.When the recombinant cells was cultured in 7 liter fermentor for 24h,the penicillinase activity reached 1255.8U/ml.

AIM: To observe the effect of Ahmed glaucoma valve implantation intravitreal bevacizumab in the treatment of neovascular glaucoma ( NVG) .
METHODS:Twenty-two cases (22 eyes) who presented with NVG were first treated with intravitreal bevacizumab 0. 1mL ( 2. 5mg ), then with Ahmed glaucoma valve implantation after regression of iris neovessels. Cases were followed - up for 6 - 36 ( mean 24 ) mo with observation on visual acuity, IOP control, regression of iris neovessels, and complications during or after surgery.
RESULTS: Iris neovessels was regressed in different degree after injection within 1wk in 22 eyes. At final follow-up, the IOP of 18 eyes were all less than 21mmHg without any drugs and of 3 eyes with 1-3 kinds of anti-glaucoma drugs after combined Ahmed glaucoma valve implantation. The IOP of one eye was controlled after cryotherapy. The mean IOP dropped from 45. 36 ±8.13mmHg preoperatively to 15. 59 ± 3. 21mmHg postoperatively. IOP reduction was statistically significance between preoperative and postoperative ( P<0. 05) at final follow-up. Visual acuity was improved in 9 eyes (41%) and was no changed in 13 eyes. No serious complications were observed during or after intravitreous bevacizumab injection and Ahmed glaucoma valve implantation.
CONCLUSION: Ahmed glaucoma valve implantation and intravitreal bevacizumab in the treatment of NVG is useful and safe. It improves the success rate of surgery and preserves visual function, furthermore its complications are less.

AlM:To observe the relationship between axial length and complications of phacoemulsification with intraocular lens ( lOL) implantation in high axial myopia eyes and normal axis eyes.
METHODS: A retrospective review of 843 consecutive patients ( 1 042 eyes ) of cataract extraction with phacoemulsification and lOL implantation in our hospital from February 2012 to February 2013 was performed. The patients were divided into two groups according to the axial length: 853 eyes were in normal axis group ( 21-24mm) and 189 eyes were in high axial myopia group (≥26mm). The two groups were compared regarding surgical complications, such as vitreous loss, posterior capsular rupture, nucleolus drop, and abnormal location of lOL.
RESULTS:Age was a risk factor in both groups. There was positive correlation between age and surgical complications, and between axial length and surgical complications, especially for complications with posterior capsular rupture and vitreous loss.
CONCLUSlON:As the results illustrate, in this survey, age and high axial lengthare statistically significant risk factors for incidence of complications of phacoemulsification. Anticipation of these complications and also preparation and prophylactic measures may decrease incidence of these complications.

To investigate the anticancer effects of ring C in 18β-glycyrrhetinic acid (GA), a series of GA derivatives featured with 9(11)-ene moiety in ring C were designed and synthesized. The structures were confirmed by IR, LC-MS and 1H NMR. Their inhibitory effects towards human prostate cancer PC-3 and leukemia HL-60 cell lines were determined. Most of the derivatives displayed stronger antiproliferative activities than GA. Particularly, compound 14 showed promising anticancer activity with the GI50 values of 4.48 µmol · L(-1) and 1.2 µmol · L(-1) against PC-3 and HL-60 cells respectively, which is worth further study.
Antineoplastic Agents ; chemistry ; pharmacology ; Cell Line, Tumor ; drug effects ; Cell Proliferation ; drug effects ; Drug Design ; Glycyrrhetinic Acid ; analogs & derivatives ; chemistry ; HL-60 Cells ; drug effects ; Humans ; Male ; Prostatic Neoplasms ; pathology

To evaluate the visual performance of the patients with traumatic corneal astigmatism, after the treatment of topography guided off-flap epipolis laser in situ keratomileusi (off-flap Epi-LASlK).
●METHODS: This prospective clinical study was comprised of 21 eyes of 21 patients with irregular corneal astigmatism caused by trauma, they were treated by off-flap Epi - LASlK from July 2012 to December 2013. The data included uncorrected visual acuity ( UCVA), best spectacle - corrected visual acuity ( BSCVA ), contrast sensitivity 1, 6mo before and after surgery; the healing area percentage of corneal epithelia, the healing time of corneal epithelia and pain score at 3d after surgery.
●RESULTS: Postoperative 1mo both UCVA and BSCVA were improved significantly than that before surgery (t =15. 703, 4. 351, P< 0. 05); Compared with the 1mo after surgery, UCVA at 6mo after surgery raised significantly (t= 6. 867, P <0. 05). There was no statistical significance between 6 and 1mo after surgery about BSCVA (t= 1. 497, P = 0. 140 ). After surgery, mean spherical equivalent (SE) was reduced from -2. 43±3. 02D to -0. 23±0. 49D (P<0. 05), and the mean cylinder was reduced from -1. 86± 2. 23D to - 0. 46 ± 1. 03D (P< 0. 05). Postoperative 1mo,4 kinds of spatial frequency and contrast sensitivity had no significant difference compared with the preoperative (P>0. 05 ). Postoperative 6mo except the 3c/ d spatial frequency, the remaining 3 spatial frequency contrast sensitivity compared with those before operation were significantly improved ( P < 0. 05 ). The healing area percentage of corneal epithelia was 92. 46% ±8. 24% (80% -100%) at 3d after surgery; The healing time of corneal epithelia was 3. 50 ± 1. 56d; Pain scores at 3 and 7d after surgery was 1. 54±1. 32 and 0. 04±0. 64, respectively.
●CONCLUSlON: Topography-guided off-flap Epi-LASlK is safe and effective in treating the patients with traumatic corneal irregular astigmatism. The operation can improve both the contrast sensitivity and the visual performance.

Objective To measure the serum selenium levels in patient with Keshan disease(KSD)and in healthy controls in Shandong,Sichuan and Inner Mongolia KSD areas,to monitor the long-term dynamic changes of hair and serum selenium levels in Shandong KSD areas,and to provide scientific basis for preventing KSD.Methods A cross-sectional survey was carried out in KSD areas of Shandong,Sichuan and Inner Mongolia in 2009.The research subjects which come from KSD areas were 77 cases and 63 healthy controls from Shandong;35 patients and 36 healthy controls from Sichuan;and 17 patients and 18 healthy controls from Inner Mongolia.Additional 33 healthy people from Jinan city were selected as controls of non-KSD areas.Blood and hair samples were collected and selenium levels were measured by 2,3-diaminonaphthalene fluorescence spectrometry.Retrospective method was used to analyze the hair and serum selenium data collected between 1976 and 2004 in Shandong KSD areas.and these data were eompard with the data of 2009 to observe the long-term dynamic changes.Results ① The serum selenium levels of KSD patients in Shandong and Inner Mongolia were significantly lower than that of healthy subjects of KSD areas[(0.0773±0.0113)vs(0.0895±0.0256),(0.0347±0.0107)vs(0.0469±0.0161),t=3.52,3.87,all P<0.01].No significant difference was found between KSD patients and healthy people in Sichuan[(0.0792±0.0162)vs(0.0774±0.0103),t=0.55,P>0.05].②The serum selenium levels of KSD patients in Shandong,Sichuan and Inner Mongolia KSD areas were lower than that of non-KSD area[(0.0988±0.0231)mg/L,q=6.74,5.83,19.47,all P<0.01].The serum selenium levels of healthy people in Sichuan and Inner Mongoha KSD areas were significantly lower than that of non-KSD area(q=6.68,16.36,all P<0.01).The serum selenium levels of healthy controls in Inner Mongolia were lower than that of in Shandong and Sichuan(q=13.63,14.74,13.62,1.46,all P<0.01).③From 1976 to 2009,the hair and serum selenium levels of Shandong resident were increased 1.68 times(0.343/0.128-1)for hair and 0.98 times(0.091/0.046-1)for serum,respectively.But there was no significant difference between the average growth rate of hair and serum selenium levels(χ2=1.38,P>0.05).Conclusions ①The hair and serum selenium levels of KSD patients are lower than that of healthy controls in non-KSD area.②The serum selenium levels of Shandong,Sichuan and Inner Mongolia are different between KSD patients and healthy controls in the diseased areas.③The hair and serum selenium data of Shandong resident show an upward vend over the past 30 years.We suggest to continue the comprehensive measures of adding selenium in KSD areas.