AIM: To observe the clinical effect of phacoemulsification and posterior chamber intraocular lens ( IOL) implantation in the treatment of unilateral high myopia combined with age-related cataract.
METHODS: A retrospective clinical study was carried out in a single ophthalmology center. All patients diagnosed of unilateral high myopia with age- related cataract were performed phacoemulsification and posterior chamber IOL implantation. The axial length of operation eye was ≥27mm, and the axial length of unoperated fellow eye was≤25mm. Visual acuity and complications were followed up for 1, 7d, 1, 3mo postoperative.
RESULTS:Thirty-three patients with average age 68. 8±9. 26 (41-87) y were enrolled in this study, 7 cases were men, 26 cases were women. The mean axial length of operation eyes was 29. 44±1. 80(27. 1-32. 71) mm and the mean axial length of unoperated fellow eyes was 23. 39±0.92 ( 21. 72 - 24. 90 ) mm. The average axial length difference of binocular eyes was 6. 06±1. 97(2. 78-9. 92) mm. The best corrected visual acuity ( BCVA ) increased from 0. 02±0. 02(light perception~0. 12) preoperatively to 0. 20±0. 20 ( 0. 02 - 0. 8 ) at 3mo postoperatively. There was statistically significant difference (t= -5. 278, P<0. 05). Among the 10 patients whose axial length difference of binocular eyes was 2. 01 - 5. 00mm, 60% of their postoperative BCVA were >0. 3. Among the 13 patients with binocular axial length difference of 5. 01-7. 00mm, 46.2% of BCVA were >0. 3,46.2% achieved 0. 05-0. 25. Another 10 patients of binocular axial length difference between 7. 01-9. 99mm, 90% of BCVA were <0. 3, of which 40% were<0. 05. No complications occurred during operative and postoperative .
CONCLUSION: Phacoemulsification and posterior chamber IOL implantation can effectively improve the postoperative visual acuity and it is safe for unilateral high myopic patients combined with age-related cataract. The recovery of visual acuity is related with binocular axial length difference.

To assess the postoperative outcomes of piggyback implantation using Acrysof Toric intraocular lens ( lOL ) in high myopia combined with corneal astigmatism.
●METHODS: Sixty patients who had phacoemulsification with lOL implantation due to high myopia, cataract and corneal astigmatism from January 2010 to June 2013 were randomly divided into observation group (piggyback Toric lOL implantation, both an Acrysoft lQ Toric lOL and a minus foldable acrylic three piece lOL were implanted in the capsular bag, n= 30) and control group (foldable lOL implantation, n = 30). Postoperative follow - up went on 6mo. lnformation collected included uncorrected visual acuity ( UCVA), lOL position, residual astigmatism and complications.
● RESULTS: The UCVA increased from 3. 52 ± 0. 03 preoperatively to 4. 78±0. 01 at 6mo postoperatively in the observation group, from 3. 51±0. 03 preoperatively to 4. 30± 0. 13 at 6mo postoperatively in the control group. The observation group's postoperative UCVA was better than that of the control group. There was statistically significant difference ( t = 3. 612, P < 0. 05 ). The preoperative corneal astigmatism was 2. 97 ± 0. 87 (1. 70 -4. 27) D in the observation group and 2. 92 ± 0. 97 (1. 50 -4. 90)D in the control group. The postoperative residual astigmatism was 0. 48 ± 0. 23 ( 0. 25 - 1. 00 ) D in the observation group and 2. 87 ± 1. 11 (1. 00 - 5. 20) D in the control group. There was statistically significant difference postoperatively (t = - 11. 995, P < 0. 05) between the two groups. No complications occurred.
●CONCLUSlON: Piggyback implantation using Toric lOL can help to solve the problem of no matching Toric lOL power for the high myopia combined with corneal astigmatism at the current stage. lt improves the UCVA and reduces the astigmatism after the cataract surgery.

Objective To explore the clinical effect of anteromedial thigh perforator flap for repairing soft tissue defect in lower extremity.Methods From January 2009 to December 2012,12 patients with soft tissue defect of lower extremity were treated with free anteromedial thigh perforator flap.Among them,there were 5 cases of wound in front of tibia,4 cases of dorsal foot wound,3 cases of heel wound;the wound size was 3.0 cm ×3.5 cm-7.0 cm × 9.5 cm;3 cases were repaired with free perforator flap of descending genicular artery,2 cases with free anteromedial thigh perforator flap,and 7 cases with medial vastus muscle perforator flap.Results All the transplants survived.Among them,1 case of anteromedial thigh perforator flap and 1 case of descending genicular artery perforator flap appeared vascular crisis postoperative.After anticoagulation and antispasmodic treatment aggressively,the flaps survived.One case of descending genicular artery perforator flap necrosis in edge,and then were cured by changing dressing.Twelve cases were followed up 6-12 months after operation (average 8.6 months),and the texture of flaps were good,the appearance appropriate ;7 sensation of 5 free flaps after nerve anastomosis came back to S; the donor sites in all cases were sutured directly and healed,leaving only the linear scar,and no effect on function.Conclusion The anatomy of anteromedial thigh perforator flap is constant,and the operation is convenient.The clinical result of repairing soft tissue defect of lower extremity is satisfying.

Objective To investigate the relationship between nutritional status and quality of life ( QOL) in patients with nasopharyngeal carcinoma undergoing concurrent chemoradiotherapy, and to identify the optimal indices of body composition for evaluation of malnutrition. Methods Based on the European Society Parenteral and Enteral Nutrition ( ESPEN) consensus on the diagnosis of malnutrition and patient?generated subjective global assessment (PG?SGA), a prospective study was performed in 48 patients with nasopharyngeal carcinoma who received concurrent chemoradiotherapy in our hospital from 2014 to 2015. Changes in body composition and nutritional status were evaluated in those patients. The relationship between nutritional status and QOL was studied. The predictive factors for nutritional status in patients with nasopharyngeal carcinoma were explored. The correlation between datasets was evaluated by the Pearson correlation coefficient. The influencing factors for nutritional status were analyzed by Logistic regression. Results During concurrent chemoradiotherapy, some indices of body composition, including weight, body mass index ( BMI) , fat mass index ( FMI) , fat?free mass index ( FFMI) , body cell mass ( BCM) , skeletal muscle mass ( SM) , and phase angle ( PA) had different degrees of reduction ( P=0?00) , while the PG?SGA score gradually increased. The incidence of malnutrition in patients with nasopharyngeal carcinoma during radiotherapy was 2?1%?39?6% based on 2015 ESPEN consensus on the diagnosis of malnutrition and 12?5%?41?7% based on PG?SGA. These two methods showed good agreement at the fourth and sixth weeks of radiotherapy ( Kappa=0?911;Kappa=0?957) . The changes in QOL score were correlated with changes in FFMI and weight during radiotherapy ( r= 0?805, P= 0?00;r= 0?777, P= 0?00 ) . Logistic regression indicated that age, FMI, and FFMI were influencing factors for nutritional status ( P= 0?035, 0?013, 0?043) . Conclusions Patients with nasopharyngeal carcinoma have substantial nutritional deterioration during chemoradiotherapy. The nutritional status is closely associated with QOL. A prediction model of nutritional status can provide a comprehensive and accurate judgment of nutritional status in patients.

Animals ; Barbiturates ; Coloring Agents ; Fallopian Tubes ; cytology ; embryology ; physiology ; Female ; Isoxazoles ; Male ; Membrane Potentials ; Mice ; Mice, Inbred Strains

Objective To investigate the clinical effect of the free fibula composite tissue flap transplantation to repair the first metatarsal bone with soft tissue defect on foot.Methods From August, 2008 to August, 2013, 6 patients with the first metatarsal bone and soft tissue defect on foot were treated with transplantation of free fibula composite tissue flap.The causes: 2 cases in traffic accident injury, 4 cases in machine injury;3 cases with traumatic defect, and septic defect in 3 patients.Of the 6 cases, the fibular length with transplantation was 6 cm to 12 cm, and the flap area was 8 cm × 5 cm-18 cm × 16 cm;All the cases were followed-up in 3, 6, 12 months postoperatively to observe the fracture healing, and to assess injured limb function in 1 year postoperatively.Results All cases were followed up 12-24 months, and average of 14 months;All the flaps survived, and the metatarsal bone and fibula healing was good visibly in half a year, The surgery function were assessed according to Maryland's scale, and the excellent were 2 and the good were 4.Conclusion The transplantation of free fibula composite tissue flap to repair the first metatarsal bone with soft tissue defect on foot is a safe and effective strategy, and it has the advantages such as covering the wound at foot approvingly, one-time rebuild repair foot weight bearing area and the surrounding soft tissue defect, shorten the treatment cycle, for small area damage in donor area, and the function postoperative is good, etc.

BACKGROUND: This study was undertaken to investigate the expression of hypoxia-inducible factor-1α (HIF-1α) in rat cerebral cortex and the effects of β-sodium aescinate (SA) administration after return of spontaneous circulation (ROSC).METHODS: Sixty rats were divided into three groups: SA group, injected intraperitoneally with SA instantly after ROSC; control group, injected intraperitoneally with normal saline; and sham-operated group, without cardiac arrest or SA. The cardiac arrest model was established using asphyxiation and intravenous potassium chloride. Blood was sampled 1, 6, 12, and 24 hours after ROSC. Protein and mRNA levels of HIF-1α, VEGF and EPO were detected in the cerebral cortex by immunohistochemistry and real-time RT-PCR; serum levels of NSE and S100β were determined by enzyme-linked immunosorbent assays.RESULTS: Serum S100β and NSE were signifi cantly increased in the control group versus the sham-operated group 1, 6, 12 and 24 hours after ROSC (P<0.05). Protein and mRNA levels of HIF-1α, VEGF and EPO were signifi cantly increased in the control rats (P<0.05). Serum NSE and S100β were significantly decreased in the SA group versus the control group 1, 6, 12 and 24 hours after ROSC (P<0.05). Protein and mRNA levels of HIF-1α, VEGF and EPO were signifi cantly increased in the SA group (P<0.05).CONCLUSIONS: The expression of HIF-1α is increased in rat cerebral cortex after ROSC, and SA up-regulates the expression of HIF-1α. The up-regulation of HIF-1α improves the resistance of the cortex to ischemia and hypoxia and contributes to neuroprotection, possibly because of up-regulation of EPO and VEGF expression.

OBJECTIVETo investigate the synergistic effects of a biotic elicitor yeast extract and different abiotic elicitors (Ag+, Co2+ and alpha-amino isobutyric acid) on the production of tanshinones in Salvia miltiorrhiza hairy root.

METHODDifferent elicitors and their combinations were added to S. miltiorrhiza hairy root culture and the contents of three major tanshinones (crypotanshinone, tanshinone I and tanshinone II A) were analyzed by HPLC.

RESULTThe combinations of yeast extract with different abiotic elicitors had notable synergistic effects on the tanshinone I and tanshinone II A production but not on crypotanshinone. The combination of yeast extract and Ag+ (300 micromol x L(-1)) yielded the highest tanshinone I content, which was nearly 14-fold of the control, and the synergistic elicitation coefficient was 3.0. The combination of yeast extract and Co2+ (100 micromol L(-1)) led to the highest tanshinone IIA content, which was about 14.5-fold of the control, and the synergistic elicitation coefficient was 2.1. Only yeast extract combined with alpha-amino isobutyric acid (200 micromol x L(-1)) increased the crypotanshinone content more effectively than single elicitors. The highest crypotanshinone content was 1.28 mg x g(-1), about 30-fold of the control with a synergistic elicitation coefficient of 1.3.

CONCLUSIONThe elicitation by the combination of a biotic elicitor and an abiotic elicitor can generate a synergistic effect, which is more effective than single elicitors to promote secondary metabolite production in plant tissue cultures.

Aminoisobutyric Acids ; pharmacology ; Bioreactors ; Cobalt ; pharmacology ; Culture Media ; Culture Techniques ; Diterpenes, Abietane ; Drug Synergism ; Phenanthrenes ; metabolism ; Plant Roots ; growth & development ; metabolism ; Plants, Medicinal ; growth & development ; metabolism ; Saccharomyces cerevisiae ; chemistry ; Salvia miltiorrhiza ; growth & development ; metabolism ; Silver ; pharmacology

Objective: To observe the clinical efficacy of acupuncture and moxibustion for functional dyspepsia (FD) due to Yang deficiency of the spleen and stomach.Methods: A total of 90 patients meeting the inclusion criteria of FD due to Yang deficiency of the spleen and stomach were randomized into an acupuncture-moxibustion group, an electroacupuncture (EA) group, and a mosapride group by the random number table method, with 30 cases in each group. The mosapride group was treated with mosapride citrate dispersible tablets. The EA group was treated with EA treatment. The acupuncture-moxibustion group was treated with additional moxibustion therapy based on the treatment in the EA group. All three groups took 10 d as one treatment course and 2 courses in total, with a 2-day interval between two courses. The traditional Chinese medicine (TCM) symptoms score, functional digestive disorder quality of life questionnaire (FDDQL) score, oral-colon transit time (OCTT), and serum glucagon-like peptide-1 (GLP-1) level was compared before and after treatment among the three groups. And the clinical efficacy was evaluated.Results: The total effective rate in the acupuncture-moxibustion group was 96.7％, which was higher than 86.7％ in the EA group and 73.3％ in the mosapride group, and the total effective rate in the EA group was higher than that in the mosapride group; the inter-group differences were all statistically significant (P<0.05). After treatment, the TCM symptom score in the three groups was lower than that before treatment (P<0.05), and the FDDQL score was higher than that before treatment (P<0.05). The change after treatment in the TCM symptom score in the acupuncture- moxibustion group and the EA group was more significant than that in the mosapride group, and the change in the acupuncture-moxibustion group was more significant than that in the EA group; the inter-group differences were statistically significant (P<0.05). The change after treatment in the FDDQL score in the acupuncture-moxibustion group and the EA group was greater than that in the mosapride group, and the change in the acupuncture-moxibustion group was larger than that in the EA group; the inter-group differences were all statistically significant (P<0.05). After treatment, the OCTT in all three groups was lower than that before treatment (P<0.05), and the serum GLP-1 level was higher than that before treatment (P<0.05); the change after treatment in the OCTT in the acupuncture-moxibustion group and the EA group was more significant than that in the mosapride group, and the change in the acupuncture- moxibustion group was more significant than that in the EA group; the inter-group differences were statistically significant (P<0.05). The change after treatment in the serum GLP-1 level in the acupuncture-moxibustion group and the EA group was greater than that in the mosapride group, and the change in the acupuncture-moxibustion group was larger than that in the EA group; the inter-group differences were statistically significant (P<0.05).Conclusion: Acupuncture and moxibustion can improve the clinical symptoms in patients with FD and enhance their quality of life, producing better effects than EA or mosapride alone. Shortening gastrointestinal movement time and increasing gastrointestinal hormone levels may be its mechanism.

Objective To investigate the preoperative psychological requirement of patients undergoing da Viric S Robotic Cardiac Surgery in order to provide scientific data for the effectively nursing interventions.Methods One hundred and six cardiac patients scheduled for Total Robotic operation were selected.They were surveyed on the first day in hospital and 2 hours before operation by self-designed questionnaire.Results Total score of the psychological requirement of patients undergoing total robotic cardiac surgery was 96 to 171 ( 137.52 ±18.54).The amount of items which necessary rate was more than 50％ was 20,they occupied 48 percent of all items.The psychological requirements of patients undergoing total robotic cardiac surgery were various,which mainly embodied in the following:wanting to know the success rate of total robotic cardiac surgery(3.70 ±0.54),wanting to understand the progress and changes of disease(3.68 ±0.51 ),wanting to understand the effect of total robotic operation(3.64 ±0.59),wanting to communicate with the patients underwent total robotic cardiac surgery (3.63 ±0.62).Conclusions The patients have many psychological requirements before to receive total robotic cardiac operation,we should take corresponding nursing countermeasures based on different psychological needs,pay attention to the patient' s health guidance and the preoperative interview in order to promote recovery.