AIM: To compare and contrast different operation after cataract patients with refractive change rules. To analyze the patients with refractive stability after cataract surgery, and to provide a reference for cataract patients with clinical surgery after visual quality.
●METHODS: Retrospective study. A total of 126 cases (150 eyes) were selected from Jan. 2014 to Dec. 2015 in Changzhou First People′s Hospital of cataract extraction combined with foldable intraocular lens implantation for cataract patients as the research samples. According to the different operation for three groups, the first group of 42 patients ( 50 eyes ) underwent above 3 mm clear corneal incision;52 cases in group 2 (60 eyes) underwent temporal side 3 mm clear corneal incision. The third group, 32 cases (40 eyes) underwent 3 corner above the scleral tunnel incision. All the cases were measured at different time point in patients with naked eyes far visual acuity, best corrected visual acuity, spherical degree, the degree of astigmatism and astigmatic axial, comparative analysis of after cataract surgery in patients with refractive change regularity and stability of refraction.
●RESULTS: The uncorrected distance visual comparison within the group, and each time point after preoperative differences were significant ( P< 0. 01 ), and the early postoperative period after 1, 3mo significantly different (P<0. 05). Three groups of patients after surgery compared with preoperative uncorrected distance visual acuity improved significantly, and were stable after 1mo. Compare the best corrected distance vision within the group, and each time point after preoperative differences were significant (P<0. 01), postoperative 1wk and after 1, 3d significantly different (P<0. 05), after 1wk and after 1, 3mo was not significantly different ( P > 0. 05 ), three groups of patients were compared with the preoperative best corrected distance visual acuity were increased significantly, and were in stable after 1wk; relatively spherical degree within the array, after 1d and 3d was not significantly different (P>0. 05), hyperopia drift, after 1wk and 1, 3d was significantly different (P<0. 05), after 1wk and 1, 3mo was not significantly different ( P>0. 05 ). Three groups of patients′spherical degrees after 1wk were stabilized. Comparative degree of astigmatism within the array, postoperative compared with preoperative corneal astigmatism were increased 1d after surgery. Corneal astigmatism in each group reached the maximum, and then decreases 1wk and 1d after surgery, compared with postoperative 3d was significantly different ( P<0. 05 ). After 1wk and 1, 3mo was not significantly different ( P>0. 05 ) . Three groups of patients were compared with preoperative astigmatism were significantly increased, and in operation after 1wk were stabilized;astigmatic axis were three groups in the preoperative astigmatism against the rule, the first and third group after 1d, three Tianshun rule astigmatism proportional were increased, and then decreased. Group 2 the- rule astigmatism proportion, after 1wk, 1 and 3mo, the first and third group gradually reduced the proportion of cis regulatory astigmatism, and compared with preoperative increased, increasing the-rule astigmatism group 2 ratio, and increased compared with preoperative.
●CONCLUSION: Above 3 mm the transparent corneal incision, temporal clear corneal incision and above the scleral tunnel incision different surgical postoperative visual acuity are good. lt can be used as a routine surgical procedure in treatment of cataract;phacoemulsification in cataract patients with former majority against the rule astigmatism. After cataract surgery, early refractive state is a state of mild hyperopia and stabilized about 1wk, combined with clinical guide glasses.

Objective To improve the efficiency of donated organs and to investigate the possi- bility and operation protocol of heart and lung transplantation from the same donor to different reci- pients.Methods The organs of heart and lung were obtained from three donors through the method of orthotopic lavage and whole cutting,and transplanted to end-stage patients with heart diseases or lung diseases.First,the donor was subjected to mechanical ventilation,thoracotomy and lavage of heart and lung.The heart and lung were cut in whole and separated.The recipients were subjected the re- trograde lavage of heart and lung.In the patients receiving unilateral lung transcription,the left and right lungs were isolated.Among 3 recipients of lung transcription,one underwent left unilateral lung transplantation and 2 bilateral lung transplantation.Three cases received orthotopic cardiac transplan- tation by using bicaval orthotopic heart transplantation (BOHT) anastomosis method.Results One recipient of left unilateral lung transplantation recovered well after operation.In one recipient under- going bilateral lung transplantation,right upper lung embolism occurred.After re-operation of cutting the right upper lung on the 9th day of the first one,he recovered from the illness.In another recipient receiving bilateral lung transplantation,anastomotic stenosis of trathea and pulmonary infection occurred after operation.After expectant treatment,he recovered from the illness,but died from serious infection 7 months after operation.One of the heart recipients was found having renal failure of first stage,and recovered from disease after hemodialysis treatment.Quality of life was good in all 3 heart recipients after operation and their heart function achieved the restoration of 0-Ⅰstage.Conclusion The treatment protocol of transplantation from the same donor to different recipients at the same time, which can make full use of the organs from donors,is feasible and has good effect.

Abstract: Objective　To analyze the drug resistance of Staphylococcus aureus in blood samples of children and adults from 50 hospitals in Shandong Province, and to understand the drug sensitivity characteristics of Staphylococcus aureus bloodstream infection (BSI), so as to provide reference for clinical experience. Methods　The distribution and drug resistance of Staphylococcus aureus isolated from blood samples from 50 hospitals in Shandong province from 2017 to 2020 were analyzed based on the Cooperative Research Network of Pediatric Bacterial and Fungal Resistance Monitoring in Shandong Province. Meanwhile, the drug sensitivity characteristics of Staphylococcus aureus were divided into children group (<14 years old) and adult group (≥14 years old). The data were analyzed by Whonet 5.6 and SPSS 22.0 with reference to CLSI 2021 M100 document standard judgment results. Results　A total of 3 661 Staphylococcus aureus strains were collected from 50 medical institutions in Shandong Province, including 675 in 2017, 870 in 2018, 1 080 in 2019, and 1 036 in 2020. The drug resistance rates of multiple antibiotics in blood culture methicillin-resistant Staphylococcus aureus (MRSA) group and methicillin-sensitive Staphylococcus aureus (MSSA) group were significantly different (P<0.05). There were significant differences in antibiotic resistance rates between adult group and children group (P<0.05). The overall detection rate of MRSA was 27.5%, and no staphylococcus aureus strains resistant to vancomycin, linezolid and tigecycline were found. Conclusion　The detection rate of MRSA strains decreased continuously and increased by 2020. The detection rate of MRSA in adult group was lower than that in children group, suggesting that we should pay attention to the monitoring of bacterial resistance in children group, to the management of multiple resistant bacteria and rational use of antibacterial drugs.

ObjectiveTo investigate left ventricular (LV) radial dyssynchrony and LV rotational change of isolated complete left bundle branch block (CLBBB) and CLBBB with heart failure (HF).Methods Twenty-six isolated CLBBB patients,twenty-four CLBBB patients with HF and twenty healthy controls were studied.Two-dimensional speckle tracking imaging (2D-STI) was applied to short-axis views to calculate LV radial dyssynchrony and LV rotational and twist degree and time to peak rotational and twist degree.ResultsLV radial dyssynchrony and LV rotation and twist degree were intermediately damaged in isolated CLBBB patients and was significantly damaged in CLBBB patients with HF,compared with healthy controls.ConclusionsFor isolated CLBBB patients,even if LV ejection fraction was in the normal range,another parameters of cardiac mechanic had changed and 2DSTI could be used to evaluate these alterations.

Objective To evaluate the characteristics and treatment of ovary torsion after controlled ovarian hyperstimulation.Methods Between Jan.2008 and Dec.2011,5 cases with ovary torsion who underwent ovarian hyperstimulation were retrospectively studied.Results Five cases presented intermittent lower abdominal from I to 38 days after oocyte retrieval.Enlargement of ovary and decreased or absent venous and/or arterial flow were demonstrated by Doppler sonography.Two torsions at left side,two torsions at right side,and one on bilateral side were observed.Three cases give up embryo transplantation,2 cases were pregnant after surgical treatment.One case with partial torsion was successfully treated with simple conservative treatment.Two cases with complete torsion were performed adnexectomy by laparotomy.One case with complete torsion with early pregnancy was managed by laparoscopic adnexectomy.One case with chemical pregnancy was managed by laparoscopic detorsion for left side and excision for right side.Postoperative pathology of ovary tissue all confirmed haemorrhage and necrosis.Conclusions Ovary torsion might occur after controlled ovarian hyperstimulation.The early management on ovary torsion will be benefit for preserving ovarian function.

The regulative role of extracellular signal-regulated kinase(ERK)signaling pathway on proliferation and apoptosis in rats' airway smooth muscle cells(ASMCs)was investigated.Primary cultures of ASMCs were established and cells between passages 4 and 7 were used for experiments.ASMCs were U-eated with ERK activator epidermal growth factor(EGF)and inhibitor PD98059.The expressions of ERK mRNA and protein were detected by RT-PCR and immunofluorescence staining.Proliferation of ASMCs were detected by MTT eolorimetric assay and [3H] thymidine incorporation.Apoptosis of ASMCs were detected by Hoechst staining and Annexin-V FITC PI donble staining.The levels of ERK1/2,phosphorylated forms of ERK1/2(p-ERK1/2) and proeaspase-3 protein were detected by Western blotting.The expressions of ERK mRNA and ERK protein were obviously observed in ASMCs. Compared with control,the absorbanee(A490) value and DNA synthesis index of PD-treated ASMCs were significantly decreased(P＜0.05).The apoptotic index and the percentage of the early apoptotic cells were significantly increased(P＜0.05).The expressions of ERK1/2 and pERK1/2 protein were significantly down-regulated.The expressions of procaspase-3 protein was significantly increased.Compared with c,ontrol,the A490 value and DNA synthesis index were significantly increased(P＜0.05)in EGF-treated cells.Apoptotic index and the percentage of the early apoptotic cells were significantly decreased(P＜0.05).The levels of ERK1/2 and pERK1/2 protein were significantly increased,and the levels of procaspase-3 protein were significantly decreased, There were no significant differences between control and P+E group(P＞0.05).ERK signaling pathway may play an important role in regulating ASMCs proliferation and apoptosis and ERK regulating the apoptosis of ASMCs possibly relates to the expressions of procaspase-3 protein. The finding will help to understand the mechanisms of asthmatic ASMCs involved in abnormal proliferation.

Objective To explore the relationship between body composition and arterial function index,especially augmentation index(AI),and make clear the impacts of gender and age on the relationship.Methotis A total of 3859 health adults were enrolled in this study.Boay composition was measured by bioelectrical impedance,and AI and pulse wave velocity(PWV) were viewed as indictors for arterial function.Correlation analysis and liner regression analysis were used for data comparison.Results Both body mass index(BMI) and body fat rate positively changed with PWV(r=0.114,both P<0.01).However,BMI showed no relation to AI(r=0.022,P>0.05).Body fat rate was positively and independently associated with AI(r=0.263, P<0.01),which was gender-dependent(female:r=0.219,P<0.01;male:r=0.033,P>0.05).When age was concerned,above relationship was more stronger in participants ≤50 years(β=0.479 vs β=0.321,P<0.01).Conclusion Body fat mass may be a predicting factor of changes in AI.Gender and age could affect the relationship between body fat and rtery function.

Objective To investigate the effect on free portal pressure (FPP), postoperative complications and rebleeding of devascularization procedure with intact portasystemic collateral shunts. Methods The clinical data of 121 patients with portal hypertension undergoing devascularization in our hospital from 1994 to 2004 were retrospectively analyzed. Patients were divided into two groups(96 cases and 25 cases) , respectively according to whether or not the portasystemic collateral shunts were reserved during operation. Results (1) Free portal pressure (FPP) decreased significantly after devascularization in both two groups [(47?8) cmH2O vs. (37?5) cmH2O, (41?7) cmH2O vs. (37?6) cmH2O; P

Objective To study the effect of glucagon-like peptide-1 agonist(exendin-4)on insulin signaling pathway in skeletal muscle of mice with insulin resistance(IR). Methods Thirty male KM mice were divided into normal control group(NC group, n=10)and IR group(n=20). The mice in NC group and IR group were fed with routine diet and high-fat diet for 16 weeks, respectively. After IR models were successfully established, 10 mice in IR group were treated with exendin-4(Ex group, 3μg·kg-1·d-1)for 4 weeks. NC group and IR group were given the same dose of normal saline. Body weight, fasting blood glucose(FBG), and fasting insulin(FINS)were measured before and after the intervention, and homeostasis model assessment for insulin resistance ( HOMA-IR ) was calculated . The muscle glycogen content were measured by Periodic Acid-Schiff Stain ( PAS ) . The expressions of insulinreceptor(IRC), insulin receptor substrate-1(IRS-1), and phosphatidylinositol 3-kinase(PI3K)in the skeletal muscle were measured by Western blot and immunohistochemistry. Results Before intervention, the body weight, FBG, and HOMA-IR of IR group and Ex group were higher compared with NC group(all P<0. 05), but FINS did not rise significantly(P>0. 05). Compared with before intervention, the body weight of three groups after intervention were all increased, but increased more significantly in the IR group. After intervention, the FBG and HOMA-IR in Ex group decreased, compared with IR group and Ex group of non-intervention (all P<0. 05), but FINS did not decrease significantly(P>0. 05). The skeletal muscle cells in NC control were colored extensively and more colored granules, while IR group were less colored, and Ex group were between NC group and IR group. Compared with NC group, the expressions of IRC, IRS-1, and PI3K in the skeletal muscle of IR group were significantly decreased(P<0. 05), not in Ex group(P>0. 05). Compared with IR group, the expressions of IRC, IRS-1 and PI3K in Ex group were higher(P<0. 05). Conclusions Exendin-4 improves insulin resistance by up-regulating the expressions of IRC, IRS-1, and PI3K in the skeletal muscle and promoting the synthesis of muscle glycogen.

Effect and safety of repeated embryo aspiration for reduction of muhifetal cervical pregnancy Was retrospectively evaluated.Three women with muhifetal cervical pregnancy successfully received conservative treatment of repeated embryo aspiration under the guidance of transvaginal ultrasound,and the gestational sac contents were aspirated completely.Local(2.5～5.0 mg injectable methotrexate,MTX) or systemic medication was used.Our findings showed that repeated embryo aspiration for reduction of cervical multifetal pregnancy could improve the coupe of disease,decrease systemic medication of MTX,and discontinue a cervical pregnancy within 8 weeks effectively and safely.However,the mminimum therapeutic dose of MTX remained to be explored.