AIM: To observe the efficacy and safety of small incision manual nuncleofragmentation technology in hard-nucleus cataract.METHODS: Fifty-four patients (54 eyes) were performed with small incision manual nucleofragmentation and intraocular lens implantation.Uncorrected-visual acuity,corrected-visual acuity and astigmatism were measured before and after surgery.Anterior segment of eye,retina,surgical complications were observed.RESULTS: Preoperative uncorrected vision(LogMAR) was 1.095±0.171,corrected vision (LogMAR) was 0.994±0.158.Postoperative uncorrected vision(LogMAR) was 0.321±0.214 and corrected vision(LogMAR) was 0.276±0.179 at 1wk after operation.Both had statistical significance compared with uncorrected vision(LogMAR) (t=27.052,P<0.01) and corrected vision (LogMAR)(t=29.211,P<0.01) after cataract operation.Average preoprative corneal astigmatism was 0.93±0.34D,average postoprative astigmatism was 0.95±0.29D at 3mo,there was no statistical significance of astigmatism before and after surgery(t=1.048,P>0.05).No severe complications occurred in all cases.CONCLUSION: The technology of small incision manual nuncleofragmentation in hard-nucleus cataract is proved to be safe and effective.

To evaluate the clinical effect of small incision cataract extraction with a manual nucleus division technique combined with intraocular lens implantation in cataract operation of large quantities.
●METHODS: Totally 105 patients (105 eyes) underwent small incision cataract extraction surgery. Visual acuity was observed, eye condition, fundus and intraocular pressure were examined by slit lamp at postoperative 1wk; 1mo.
●RESULTS: The visual acuity improved significantly at postoperative 1mo, 89 cases (89 eyes) with better than 0. 3( 85%), 101 cases ( 101 eyes) with 0. 1 and above (96%). lt had short operation time, fewer complications and good anesthetic effect.
● CONCLUSlON: This operation is suitable for primary hospitals, which visual acuity improved obviously, without serious complications, and economic and feasible.

Objective: To compare short-term efficacy of enhanced phase-I cardiac rehabilitation and ordinary phase-Ⅰ cardiac rehabilitation in patients after coronary artery bypass grafting (CABG). Methods: A total of 254 patients received CABG in our hospital from 2015-07 to 2015-10 were enrolled including 196 male and 58 female at the mean age of (59.92±7.80) years. Relevant health education was conducted and echocardiography, emotion, grip strength were assessed before operation. Based on personal aspiration, the patients were assigned to 2 groups at the 1st day after CABG: Enhanced phase-I cardiac rehabilitation (Enhanced) group, the patients received every day one to one training by physical therapist for 7 days and Ordinary phase-I cardiac rehabilitation (Ordinary) group, the patients received unified instruction by physical therapist prior operation. Relevant parameters were compared between 2 groups at 1 week post-operation which were mainly focused on left ventricular ejection fraction (LVEF), emotional assessment as health questionnaire 9-items (PHQ-9), generalized anxiety disorder 7-items (GAD-7) and grip strength. Results: Before operation: LVEF, PHQ-9 scores, GAD-7 scores and grip strength were similar between 2 groups.1 week post-operation: compared with Ordinary group, Enhanced group had the higher LVEF (62.88±5.21) % vs (59.00±9.83) %, P<0.05; Enhanced group showed slightly lower PHQ-9, GAD-7 scores and slightly higher grip strength without statistic meaning. Conclusion: Enhanced phase-I cardiac rehabilitation presented slight superiority as improved LVEF which implied that even 1 week specific training may benefit CABG patients.

Objective To analyze the correlation of interleukin(IL)-12B gene single nucleotide polymorphism(SNP)rs6887695 with clinical phenotypes(including age at onset,family history,clinical types,gender)of psoriasis vulgaris in Chinese Han population.Methods This study recruited 575 patients with psoriasis vulgaris and 1403 healthy controls.DNA samples were obtained from these subjects.PCR with Taqman fluorescent probe(ABI 7900 system)was performed to analyze the genotype of SNP rs6887695 in IL-12B gene.Statistical analysis was carried out by using the software SPSS 14.0,and Chi-square test was conducted to compare the frequency of the SNP rs6887695 genotypes and alleles between the patients and controls as well as between patients with different clinical phenotypes of psoriasis.Results The frequency of GG,GC and CC genotype of the SNP rs6887695 was 42.61％,45.39％ and 12.0％ respectively in the patients,compared to 34.42％,47.83％ and 17.75％ in the healthy controls(x2 =16.31,P ＜ 0.01);the frequency of G and C allele of the SNP rs6887695 was 65.30％ and 34.70％ respectively in the patients,compared to 58.34％ and 41.66％ respectively in the healthy controls(x2 =16.54,P＜0.01).Significant differences were observed in the distribution of genotypes and alleles of the SNP rs6887695 between patients with chronic plaque psoriasis(n =543)and those with acute guttate psoriasis(n =32,x2 =18.11,12.19,both P ＜ 0.01).Increased frequency of G allele and GG genotype of the SNP rs6887695 were noted in the patients with psoriasis vulgaris compared with the healthy controls,and in the patients with plaque psoriasis compared with those with guttate psoriasis.However,there was no statistical difference in the distribution of SNP rs6887695 genotypes or alleles between 540 patients with adult onset psoriasis and 35 patients with child onset psoriasis,between 102 patients with family history and 440 patients without family history,or between 341 male patients and 234 female patients(all P ＞ 0.05).Conclusions The IL-12B SNP rs6887695 may be associated with the susceptibility to psoriasis vulgaris in Chinese Han population,especially with the susceptibility to plaque psoriasis,but seems unassociated with the age at onset,family history or gender of patients.

Objective To explore the efficacy and safety of recombinant human brain natriuretic peptide (rhBNP) in the patients with severe heart failure (HF). Methods A prospective multicenter study was conducted. Patients whose age > 18 years old, and with the New York Heart Association (NYHA) cardiac function grade overⅢ - Ⅳ , acute cardiac insufficiency and the acute exacerbation of chronic cardiac insufficiency admitted to intensive care unit/cardiovascular care unit (ICU/CCU) of 58 Hospitals in China were enrolled. On the basis of the conventional treatment, all patients would be given rhBNP (neo adjuvant) with a loading dose of 1.5 μg/kg for 3-5 minutes, and followed by a maintenance dose of 0.010-0.015 μg·kg-1·min-1 for 3-7 days. Before the treatment and 1, 3, 7 days after treatment, researchers detected indexes of cardiac and renal function, the levels of N-terminal B-type natriuretic peptide (NT-proBNP), left ventricular ejection fraction (LVEF), cardiac output (CO), pulmonary capillary wedge pressure (PCWP), central venous pressure (CVP), urea nitrogen (BUN), serum creatinine (SCr), and urine output; the renal function index was re-evaluated at 30 days after administration, and the time entering ICU again, re-admission, cardiovascular events were recorded. Results 408 patients were enrolled, with 241 males and 167 females. Age range was 28-95 years, the average age was (63.0±15.8) years, and 50-70 years old accounted for 46.8%. Compared with the data before treatment, NT-proBNP, PCWP and CVP significantly decreased at 6 hours after treatment [NT-proBNP (μg·kg-1·min-1): 4378.58±4082.29 vs. 6403.41±5759.48, PCWP (mmHg, 1 mmHg = 0.133 kPa):12.41±2.21 vs. 14.26±2.85 , CVP (mmHg): 10.63±2.62 vs. 11.45±3.45, all P < 0.05], and with the prolongation of injection, NT-proBNP, PCWP and CVP were gradually declined; CO 1 day after treatment (mL: 4.89±0.81 vs. 4.40±0.92) and LVEF 3 days after treatment (0.465±0.100 vs. 0.431±0.107) were significantly increased (both P < 0.05), and with the prolongation of injection, CO and LVEF were gradually increased. There were no obvious changes in BUN and SCr during the treatment, but 30 days after treatment, SCr was significantly lower than that pre-treatment (μmol/L: 110.98±47.40 vs. 132.62±75.60, P < 0.01). Compared with the data pre-treatment, urine output per hour was significantly increased at 3 hours after treatment (mL: 129.59±82.16 vs. 89.60±53.49, P =0.000); urine output every 24 hours was significantly increased at day 1 and day 2 after administration (mL: 2676.54± 1006.83, 2678.74±975.97 vs. 2150.36±283.76, both P < 0.01). In 7 days, the re-entry ICU rate was 2.7%, and the re-hospitalization rate was 2.88% within 30 days, re-cardiac failure rate was 1.43% in 30 days, and the overall fatality rate was 9.55% in 30 days. Conclusions The rhBNP can significantly improve heart function in patients with HF. And, it has a certain effect on renal function. The rhBNP is effective and safe for the treatment of cardiac insufficiency.

Objective To investigate the indications and methods of retaining only portal vein for the hilar cholangiocarcinoma radical resection to improve the therapeutic efficacy. Methods Six patients with hilar cholangiocarcinoma underwent left hepatectomy and extrahepatic bile duct excision. Tumor invaded hepatic artery was resected and fight hepatic duct-jejunum anastomosis was made during July 2006 to December 2007. Results There was no mortality. Bile leakage developed in one case and was cured by drainage. No liver failure developed postoperatively. All 6 cases were followed up for 10 - 23 months, and all were still alive. Conclusions Retaining only portal vein for the treatment of hilar cholangiocarcinoma radical resection under definite indications is safe.

Objective:To summarize the clinical characteristics, diagnosis and treatment of caspase recruitment domain-containing protein 9 (CARD9) gene deficiency associated invasive candidiasis, and report a novel mutation in CARD9 gene.Methods:The clinical characteristics, laboratory tests, treatment and the outcome of follow-up in a boy with invasive candidiasis were described. The boy′s main clinical manifestations were central nervous system infection and retroperitoneal mass. Whole-exome sequencing was performed and Sanger sequencing was verified to identify the CARD9 gene mutations in the patient and his parents. A literature search for “CARD9”and “invasive candidiasis”was conducted in PubMed, Wanfang and CNKI databases from their establishment to May 2020.Results:A 10-year-old boy suffered onset symptom of chronic diarrhea, which lasted for two months. The symptom was followed by progressive neurological symptoms such as headache, vomiting, seizures and disorder of consciousness. His unusual medical history was absent. Candida albicans were cultured several times in cerebrospinal fluid and blood, and yeast-like fungi were found in the stool high power field of vision. Cerebral magnetic resonance imaging indicated obstructive hydrocephalus and abdominal CT scan showed retroperitoneal mass and thickening of the intestinal wall. The whole-exome sequencing analyses of blood samples from the boy and his parents were performed. The results showed that there was a homozygous mutation of c.952-12_956delinsAG in the CARD9 gene, which was an unreported pathogenic mutation. This was confirmed by Sanger sequencing. There was no significant relief from intravenous combined antifungal medications. After lateral ventricular drainage surgery and injection of amphotericin B into the lateral ventricle, improvement of clinical symptoms and cerebral spinal fluid abnormalities was observed after nine weeks, and the retroperitoneal mass shrank. At follow-up after four-month oral combined antifungal medications, the child had no complaint except fatigue. However, cerebral spinal fluid analysis showed increased protein level and decreased glucose. Persistent hydrocephalus and periventricular white matter abnormal signals were revealed on the brain magnetic resonance imaging and the smaller retroperitoneal mass than before on the abdominal CT scan. In addition to this case, totally 21 cases with CARD9 gene deficiency associated invasive candidiasis have been reported worldwide, most of which featured central nervous system infections.Conclusions:CARD9 gene deficiency is an autosomal recessive primary immunodeficiency that confers human susceptibility to fungal disease. The associated invasive candidiasis often affects the central nervous system and makes the patient severely ill. Adequate systemic antifungal therapies should be given, and patients with hydrocephalus need surgical treatment. A novel mutation is reported that expands the variant diversity of CARD9 gene. For patients with unexplained invasive candidiasis, including those without a history of previous recurrent infection, genetic testing is recommended for primary immunodeficiency including CARD9 gene deficiency.

The theoretical basis of the alcohol precipitation process control was provided, the alcohol precipitation was optimized and the relationship equation was got. The monod glycoside, loganin and paeoniflorin were used as the evaluation indexes to determine the impact factors of alcohol precipitation techniques of Liuwei Dihuang decoction by the Plackett-Burman experimental design and the levels of non-significant factors were identified. Then, Box-Behnken response surface methodology was used to research and discuss the critical process parameters influence the effect of alcohol precipitation and draw interaction between key process parameters and the correlation equation with index components. Through the establishment and solving the quadratic regression model of composite score, the optimum preparation conditions of alcohol precipitation techniques of liuwei were as follows: stirring speed was 580 r x min(-1), standing time was 17 hours, alcohol concentration was 34%, the density of Liuwei Dihuang decoction was 1.13. The response surface methodology for optimized alcohol precipitation techniques of Liuwei Dihuang decoction is. reasonable and feasible.
Chemical Precipitation ; Chemistry, Pharmaceutical ; methods ; Drugs, Chinese Herbal ; chemistry ; Ethanol ; chemistry

Mean hemoglobin (Hb) concentration of about 3 500 subjects derived from 17 studies of Himalayan highlanders (Tibetans, Sherpas, and Ladakhis) was compared with lowlanders (Chinese Han, Indian Tamils) lived in the Himalayas, and European climbers during Everest expeditions as well as Andean natives. The results found that Hb concentration in Himalayan highlanders was systemically lower than those reported for Andean natives and lowland immigrants. These comparative data demonstrated that a healthy native population may successfully reside at high altitude without a significant elevation in Hb, and the lower Hb levels of Himalayan highlanders than those of migrated lowlanders and Andean natives are an example of favourable adaptation over the generations. In addition, excessive polycythemia has frequently been used as a marker of chronic mountain sickness (CMS). Altitude populations who have a higher Hb concentration also have a higher incidence of CMS. The low Hb in Himalayans suggested as showing adaptation over many generations in Tibetan stock. Recent work in Tibet, suggested that Tibetans there may have adapted to high altitude as a result of evolutionary pressure selecting for genes which give an advantage at altitude. All of the population genomic and statistical analysis indicated that EPAS1 and EGLN1 are mostly likely responsible for high altitude adaptation and closely related to low Hb concentration in Tibetans. These data supported the hypothesis that Himalayan highlanders have evolved a genetically different erythropoietic response to chronic hypoxia by virtue of their much longer exposure to high altitude.
Adaptation, Physiological ; Altitude ; Asian Continental Ancestry Group ; genetics ; Basic Helix-Loop-Helix Transcription Factors ; genetics ; Evolution, Molecular ; Hemoglobins ; genetics ; Humans ; Hypoxia-Inducible Factor-Proline Dioxygenases ; genetics ; Tibet

Objective To study the effect of different approach on myocardial contractile force, angiogenesis and collagen renovation in acute myocardial infarct site by implantation of bone marrow mesenchymal stem cells (MSCs). Methods 32 Gui-zbou Xiang porcine were randomly divided into control group (group C), intra-coronary arterial injection group (group A) ,topical injection group (group T) and intra-coronary arterial + topical injection group( group A + T). 3 ml bone marrow was extracted. MSCs were cultured according to the methods of Wakitani's. After being co-cultured with 5-azacytidine for 24 hours, these cells were labelled with bromodeoxyuridine ( BrdU ). Autologus MSCs were implanted into the acute myocardial infarct site via the distal segment of the ligated left anterior descending artery (LAD) ,topical injection and both. Specimens and muscle strip were harvested in 3 and 6 weeks after MSCs implantation for microvessel count, P Ⅲ NP activity and contractile force measurement. Results The contractile force(48.6±5.9) %, (42.1±6.2 ) %, ( 56.9±5.1 ) %, microvessel count ( 19.6±4.3,17.1±4.0, 23.2±5.5 ) and collagen renovation (4.6±0.5 ) μg/L, ( 5.9±0.7 ) μg/L, ( 3.9±0.3 ) μg/L in the cell implant groups was better than that in the control group(37.9±5.4)% ,13.2±3.8,(8.7±0.8) μg/L,(P <0.01) ,espe-cially in group A + T. Conclusions Implantation of MSCs through intra-coronary arterial plus topical injection of MSCs maybe an ideal approach for infracted myocardium.