Background Cataract surgery can induce the occurrence of dry eye because of the influence of incision on corneal nerve fibers and the change of corneal regularity derived by surgery.Objective This study was to investigate the change of regularity of anterior corneal surface,tear film and astigmatism caused by the process of manual small-incision cataract surgery (manual SICS) and phacoemulsification (Phaco).Methods A prospective non-randomized controlled study was designed.Fifty eyes of 46 age-related cataract patients were included in this clinical study.Thirty eyes of 30 patients received the manual SICS,and other 20 eyes of 16 patients underwent Phaco.Corneal irregularity measurement (CIM),shape factor (SF) and corneal astigmatism were assessed by the corneal tomography examination,the subjective symptoms were scored and tear film break up time (BUT),Schirmer Ⅰ test (S Ⅰ t) were examined before surgery and 1 day,1 week,1 month after surgery.The examined parameters were compared among different time points and two groups.This study was approved by Ethic Committee of Affiliated Eye Hospital of Wenzhou Medical College,and written informed consent was obtained prior to operation.Results The CIM values were gradually increased with the prolong of time after operation,showing a statistically significant difference dependent on time (Ftime =22.864,P =0.000),and CIM value of 1 day,1 week and 1 month after operation was higher than that of before operation (P＜0.01).However,no significant difference was found in CIM value between two groups in different time points (Fgroup =0.062,P =0.804).There was no significant difference in SF values with time prolong (Ftime =4.600,P =0.428) and different groups (Fgroup =0.009,P =0.925).The BUT was gradually reduced with the time prolongs with the considerably difference (Ftime =39.384,P=0.000).Obviously decreases of BUT values were seen in 1 week and 1 month in comparison with 1 day after operation (both P=0.000).But no significant change was found in BUT between two groups in various time points (Fgroup =0.000,P=0.983).In the manual SICS group,the difference was found in S Ⅰ t values between before operation and 1 week or 1 month after surgery(P＜0.01).Surgery associated astigmatism (SIA) was existed in the operative eyes in various time points after operation.With time lapse,SIA value was declined with a significant difference (Ftime =21.479,P =0.000),the difference also was found in different groups (Fgroup =8.709,P =0.005),and SIA value in the Phaco was significantly lower than that in the manual SICS group (P＜0.01).Conclusions In the present study,in the early stage after manual SICS and Phaco,SIA appears due to the irregular change of the anterior corneal surface increases and stability of tear film worsens.

Objective The difficulty of full thoracoscopic Ivor-Lewis is the lack of a safe and low cost anastomosis.By improving the surgical process,to explore the application of circular stapler in the intrathoracic esophagogastric anastomosis.The thoracoscopic operation mode of esophageal cancer changes from simply following the McKoewn procedure to Ivor-Lewis and McKoewn procedure.Methods Retrospective analysis 123 cases of implementation thoracoscopic esophageal cancer from July 2009 to February 2013,which including the cases of intrathoracic anastomosis and cervical anastomosis.Divided it into two groups:intrathoracic anastomosis groups,which including thoracoscopic esophagectomy resection,gastroesophageal anastomosis and anastomotic pedicled omentum embedding,the cervical anastomosis groups,which including thoracoscopic esophageal free and gastroesophageal neck anastomosis.To comparing the incidence of ARDS,postoperative hoarseness,anastomotic complications (Anastomotic leakage and anastomotic strictures within two months after surgery),guardianship time of ICU and postoperative hospital stay between the two groups.Results All the patients were no deaths.The cervical anastomosis group operative time was significantly lower than the intrathoracic anastomosis group.The incidence of anastomotic fistula and anastomotic stricture of intrathoracic anastomosis group was significantly lower than that of the cervical anastomosis group,total hospitalization time of the intrathoracic anastomosis group were significantly lower than that of the cervical anastomosis group,there is no significant differences in postoperative hoarseness and ARDS incidence between the two groups.Conclusion For the lower esophageal carcinoma,it is technically mature and safe to apply the circular stapler for Ivor-Lewis surgery and sleeve omentumembedding anastomotic technique in full thoracoscopic,and the technology should be widely applied; for the upper esophagealcarcinoma,McKoewn procedure should be applied.

Objective To compare the changes of blood coagulation system and the clinical interventional effect of low molecular weight heparin (LMWH) in elderly patients who had received thoracic surgery. Methods Ninety-six thoracic surgery patients (age≥70 years) were divided into control group ( 54 cases ) and experimental group ( 42 cases ) ( postoperative 1-7 days, subcutaneous injection with LMWH ) from September 2007 to December 2009 by random digits table. Observed perioperative changes in prothrombin time (PT),activated partial thromboplastin time (APTT),platelet (Plt),D-dimer (D-D),fibrinogen (Fib), anti- X a activity, and clinical performances. Also observed the influence of diabetes mellitus of surgery coagulation function. Results The preoperative indexes of coagulation function were no significant (P ＞ 0.05 ). In control group PT prolonged, Fib and D-D increased, the differences between preoperative and postoperative each time were significant (P ＜ 0.05 ). Fib and D-D in control group increased than those in experimental group postoperative each time (P ＜ 0.05 ). In experimental group anti- X a activity increased postoperative each time (P ＜ 0.05 ),compared with control group was also significant (P ＜ 0.05 ). Diabetes mellitus had no significant influence on coagulation function. One patient appeared pulmonary thromboembolism in control group,and no one appeared venous thromboembelism and bleeding adverse reactions in experimental group. Conclusion Thoracic surgery in elderly patients have high blood coagulation state, prone to venous thromboembolism, LMWH given early postoperative prophylactic treatment is beneficial to improve the hypercoagulable state and have better security.

Objective To investigate the clinical efficacy of shoulder-three-points warm needling moxibustion plus conventional rehabilitation in recovery from arthroscopic rotator cuff repair.Method Seventy patients who had undergone arthroscopic rotator cuff repair for rotator cuff injury were enrolled and randomly allocated to groups A and B, 35 cases each. Group A received conventional rehabilitation and group B, shoulder-three-points warm needling moxibustion in addition. Functional activity and pain in the affected shoulder were scored using the American Shoulder Elbow Scale (ASES), the University of California at Los Angeles (UCLA) Shoulder Scale and the Constant-Murley Shoulder Outcome Score in the two groups before and after treatment.Result There were statistically significant pre-/post-treatment differences in the ASES, UCLA and Constant-Murley scores in the two groups (P<0.01). After treatment, the scores were higher in group B than in group A, but there was no significant difference in the UCLA function subscore (P>0.05) and a significant difference in the UCLA pain subscore (P<0.01) between groups A and B. Conclusion shoulder-three-points warm needling moxibustion plus conventional rehabilitation training can markedly promote postoperative rehabilitation and especially relieve postoperative pain in patients with rotator cuff injury. It provides a new idea for clinical shoulder rehabilitation in the future.

0.05). Conclusion This method is sensitive, accurate, stabile and is applicable to the determination of inorganic arsenic in groundwater samples.

[Objective]To evaluate the role of Southwick angle and Klein line in the diagnosis of slipped capital femoral epiphysis (SCFE). [Methods]Forty-two cases of SCFE were treated by Russell traction and screw or pins fixation in situ from 1995 to 2006. The hip anteroposterior and frog-lateral radiographs were reviewed to measure the occurrence of metaphyseal change,the Southwick angle and the Klein line.[Results]The metaphyseal changes occurred in all cases. The Southwick angles were reduced with the severity of SCFE. The positive ratio of Klein line was higher in the lateral radiographs,but lower in the anteroposterior radiographys.[Conclusion]The Southwick angle and Klein line play an important role in the diagnosis of SCFE. The lateral radiography should be emphasized in the diagnosis of SCFE.

AIM: To investigate the effect of yigu capsule drug-containing serum on proliferation, ALP activity and expression of interleukin-11 mRNA in Sprague-Dawley rat osteobalsts in the co-culture system. METHODS: (1) Osteoblasts and osteoclasts were isolated from 1 and 5-day-old Sprague-Dawley rats, respectively. The osteoblasts-osteoclasts co-culture system was built to prevent the two kinds of cells from contact and allow the media to exchange. The experiment included two groups, drug-containing sera group and control group. (2) The osteoblasts proliferation, ALP activity and expression of interleukin-11 mRNA were detected by the MTT, 4-aminoantipyrine spectrometric methods and FQ-PCR,respectively. RESULTS: In drug-containing sera group, the osteoblasts proliferation, ALP activity, expression of IL-11 mRNA were higher than those of control group (P

AIM:To observe the effect of TNF-? and Yigu capsule drug-containing sera on osteoblasts apoptosis in osteoblasts-osteoclasts coculture system.METHODS:(1)Twenty female Sprague-Dawley rats,10 months old,were randomly assigned into 2 groups,NS and Yigu capsule groups,to prepare blank sera and drug-containing sera.(2)The DNA gel electrophoresis method was used to detect apoptosis of osteoblasts treated with different concentration of TNF-? in order to determine the best dosage in the co-culture system.(3)The cells were divided into four groups,TNF-? group,normal group,TNF-? + blank serum group and TNF-? + drug-containing serum group.DNA gel electrophoresis,acridine orange staining and flow cytometry were used to observe osteoblast apoptosis in these groups.RESULTS:(1)After induced by TNF-? for 72 h at a concentration of 60 ?g/L,relatively typical DNA ladder appeared in TNF-? group.(2)Only two DNA brands appeared and most of cells were well-proportioned stained in TNF-? + drug-containing serum group,the rate of osteoblasts apoptosis in TNF-? + drug-containing serum group(9.60%?0.26%)was obviously lower than that in the TNF-? group(26.90%?0.06%)and TNF-? + blank serum group(18.10%?0.06%).CONCLUSION:TNF-? induces osteoblast apoptosis in the co-culture system,and Yigu capsule drug-containing serum prevents osteoblast apoptosis induced by TNF-?.

This experiment was done to compare the effects of antegrade and retrograde cold cardioplegic solutions on myoeardium in the presence of coronary obstruction. Twelve mongrel dogs were anesthetized with intravenous pentobarbital, and immediately after the left anterior descending of coronary artery (LAD) was tied off, all subjects were randomly allocated to receiving antegrade cardioplegic solution (4 C) through arotic root at initial dose of 20ml?kg~(-1) and supplemental dose of 10ml?kg~(-1) with perfusion pressure being 10.7kPa every 20 minutes (group n=6), or antegrade cardioplegic solution in the same way as mentioned above at initial dose of 10ml?kg~(-1) and retrograde cardioplegic solution at initial dose 10ml?kg~(-1) and supplemental dose of 10ml?kg~(-1) with perfusion pressure being 5.3kPa every 20 minutes (group Ⅱ, n=6), respectively. The occlusion of LAD lasted 60 minutes. As compared with the values of group Ⅰ, in group Ⅱ, there was a lower hypothermia in the myocardial re gion supplied by LAD during ischemia (P

AIM: To study the effect of proliferating cell nuclear antigen (PCNA) expression on alveolar macrophages (AM) and Fas/FasL expression on alveolar type Ⅱ epithelial cells induced by lipopolysaccharide (LPS) in smoking rats. METHODS: Immunohistochemistry SABC and immunofluorescence techniques were used to examine PCNA expression on AM and Fas/FasL system expression on alveolar type Ⅱ epithelial cells in smoking rats of different stages induced by LPS. RESULTS: The AM PCNA expression in smoking rats reached the highest level after 3 or 4 months. The AM PCNA expression in every groups stimulated by LPS significantly increased ( P