AIM:To observe the effect of phacoemulsification and intraocular lens ( IOL ) implantation combined with goniosynechialysis on corneal endothelial cells for the treatment of primary angle closure glaucoma ( PACG ) combined cataract, and to analyze the relative factors.METHODS: Ninety-five eyes of 95 patients with PACG combined cataract were documented in this study. Twenty-two patients were male, and 73 were female. The age ranged from 46 to 85y old with a mean of(66±7) y. All patients were examined for endothelial cell count ( ECC ) , intraocular pressure ( IOP ) and best corrected visual acuity ( BCVA ) 1wk, 1, 2, 3 and 6mo after operation. Meanwhile, the range of anterior chamber closure and anterior chamber depth ( ACD ) were recorded before operation and postoperative 6mo.
RESULTS: The mean IOP was 36. 1±4. 3mmHg ( 28-42mmHg) preoperatively and 15. 8±3. 5mmHg ( 8-28 mmHg)(1mmHg=0. 133kPa) 6mo after operation. There was a decreasing trend in IOP after operation( t=17. 173, P<0. 01). There was an increased trend in BCVA after operation(Z=-8. 351, P<0. 01). The mean ACD was 1. 95±0. 34mm preoperatively and 3. 11±0. 33mm 6mo after operation. There was an increased trend in ACD after operation(t=11. 483, P<0. 01). There were 74 eyes in the range from 90o to 180o of anterior chamber and 21 eyes less than 90o before operation. There were 12 eyes in the range from 90o to 180o of anterior chamber and 83 eyes less than 90o postoperatively. The most of anterior chamber were open(Z=-9. 013, P<0. 01). ECC was 2304±135 cells/mm2 before operation and 2 243±152 cells/mm2 , 2 135±177 cells/mm2 , 2 028±172 cells/mm2 , 2 017±181 cells/mm2 , 2 006±143 cells/mm2 1wk, 1, 2, 3 and 6mo after operation respectively. ECC loss rates were 2. 6%, 7. 3%, 12. 0%, 12. 5% and 13. 0%. ECC had a decreased trend 2mo after operation(F=5. 568, P<0. 01) and then kept stable(P3mo=0. 067, P6mo=0. 073).
CONCLUSION: Phacoemulsification and IOL -implantation combined with goniosynechialysis is an effective method to treat PACG combined cataract. It can increase BCVA and decrease IOP. ECC decreases after operation, but it is in the normal range. It is a safe and effective operation mode.

BACKGROUND: In the clinical therapy for orthopedic diseases, the traditional administration easily induces the great fluctuation of drug concentration and side effect, and implanted drug carrier material hydroxyapatite (Hap) cannot be used in human's load bearing parts due to its poor mechanical performances, and poly-L-lactic acid (PLLA) is effortlessly degraded to acid byproducts. Drug carriers made from Hap/PLLA are supposed to not only persist releasing drug onto the lesion and reduce the side effect,but also obtain strength enhancement and eliminate tissue inflammatory reaction in favor of bone regeneration.OBJECTIVE: To observe the preparation of absorbable target control-release drug carrier and simulate the application of drugs.DESIGN: Observation trial.SETTING: Chongqing Institute of Technology and Wuhan University of Technology.MATERIALS: Tails of albino rats and PLLA (offered by Biological Center of Wuhan University of Technology), pepsin (1:10 000, Sigma company), Ca(OH)2, strong phosphoric, NaOH, glacial acetic acid, phosphate buffer (pH=7.4), 1,4-dioxane, absolute alcohol (Analytical reagent available on market).METHODS: The experiment was carried out in Chongqing Institute of Technology and Wuhan University of Technology. ①Type Ⅰ collagen (Col)was prepared by acid dissolution and alkali purification methods. Hap/Col bone-like biomimetic composite was synthesized through self-assembly mechanism of materials simulating in vitro biomineralization process of nature bone. X ray diffraction analysis and transmission electron microscope were applied to observe the characterization of composite's structure and morphology. ②The resultant product of HAP/Col composite was further synthesized with PLLA to prepare the three-dimensional porous reservoir type carrier for controlled release of drug employing thermal-induced phase separation technique. Scanning electron microscope, material test machine and specific gravity test method were used to investigate the pore structure and mechanical property of carrier material. ③The prepared Hap/Col/PLLA drug carrier was loaded with bromothymol blue to investigate in vitro control-release characteristic in simulated body fluid.MAIN OUTCOME MEASURES: ①Characterization of structure and morphology of Hap/Col bone-like biomimetic composite; ②Evaluation on the property and preparation technique of Hap/Col/PLLA drug carrier; ③Assessment on results of in vitro control-release trail of model composite.RESULTS: ①Hap nanocrystals formed as slender needles aligning with its crystalline c-axis preferentially oriented.②Hap/Col/PLLA drug carrier possessed apt pore configuration and physical properties for drug controlrelease.③In vitro release test by model compound revealed an approximate zero-orderslow release prior to its 80% release percentage.CONCLUSION: Hap/Col composite material is similar with natural bone, and Hap/Col/PLLA reservoir carrier can control drug release.

Objective To compare the clinical value of nerve stimulator-versus ultrasound-guided continuous femoral nerve block for analgesia after laparoscopic surgery.Methods Forty patients,aged 18-60 yr,with body mass index of 18-30 kg/m2,of ASA physical status Ⅰ or Ⅱ,scheduled for elective laparoscopic surgery,were randomly assigned into 2 groups (n =20 each) using a random number table:nerve stimulator group (group S) and ultrasound group (group U).Epidural anesthesia was performed with 1.73 ％ carbonated lidocaine in both groups.0.2％ ropivacaine 5 ml/h was infused continuously after surgery to perform femoral nerve block for analgesia.VAS score at rest was assessed at 2,6,24 and 48 h after surgery.At 24 and 48 h after surgery,VAS scores during active and passive movement were assessed.The time for catheter placement near the femoral nerve and development of subcutaneous hematoma at the puncture site,local anesthetic intoxication and nausea and vomiting were recorded.The postoperative requirement for analgesics was also recorded.Results There was no significant difference in the VAS scores and puncture for femoral nerve block-and local anesthetics-related adverse events between the two groups.The time for catheter placement near the femoral nerve was 8.0 ± 1.4 and (6.7 ± 0.9) min in S and U groups,respectively,and the time was significantly longer in group S than in group U.No patients required rescue analgesic after surgery in both groups.Conclusion Nerve stimulator-guided continuous femoral nerve block provides higher clinical value than ultrasound-guided continuous femoral nerve block for analgesia after laparoscopic surgery and it is more suitable for clinical application.

Objective To address angiotensin Ⅱ type 1 receptor (AT 1R) gene polymorphism and its relationship with plasma endothelin (ET) in PIH. Methods Gene polymorphism of AT 1R at site 1166 was detected with polymerase chain reaction (PCR), digestion of restriction enzyme and electrophoresis. Plasma ET was measured by radioimmunoassay. Results 1. The frequencies of genotype(AC and CC) at 1166 of AT 1R gene and C allele in PIH individuals were significantly higher than those of control group, (? 2=11.06, 9.73, respectively, P0.05). Conclusions 1. The variant (A→C) of 1166 polymorphism site of AT 1R is associated with the generation of PIH, and C allele may be a susceptible gene to PIH. 2.There is relationship between AT 1R gene and plasma ET level in PIH patients.

Objective To investigate the relationship between hepatocyte growth factor (HGF) and vascular endothelial cells (VEC) in pregnancy induced hypertension (PIH) Methods Twenty women with PIH (6 mild, and 14 moderate or severe PIH ) and 20 women with normal pregnancy were recruited as study group and control group, respectively The two groups were matched in maternal age, parity and gestational age Flow cytometer was used for counting the number of peripheral blood circulating endothelial cells (CEC), while enzyme linked immunoadsordent assay (ELISA) was used to measure the concentration of serum HGF Results In the study group, the concentration of HGF was (1395?512) ng/L, and the number of CEC was (109 360?24 070) /L In the control group, the concentration of HGF was (1565 ?399) ng/L, and the number of CEC was (21 800?4420)/L The differences both in the concentration of HGF and the number of CEC between the two groups were statistically significant ( P

Objective To study a wavelet method for acquiring the characters of pulse wave based on the principle of wavelet transform which can effectively solve the problem of inaccuracy of the conventional methods. Method The method of wavelet module maximum was used to divide the pulse wave according to periods and basically decomposed it, by arranging in time order and symbolizing the module maximum character points of pulse wave signal at the ascending and descending edges as well as the crest and trough. Result Through the method, the unobvious dicrotism, trail wave and the anomalistic wave appearing at the ascending and descending edge of the main wave, and multi-scale characters and all kinds of characters in time domain of pulse signal were further acquired more accurately. Conclusion Simplicity, quickness and accuracy are achieved by focusing on the character points of pulse signals. It provides a new means for further studies of classification and identification of pulse signals.

Objective To assess the influence of host factors on the progression to cirrhosis in patients with chronic hepatitis C virus (HCV) infection. Methods Duration of 121 patients from HCV infection developing to liver cirrhosis was compared according to age at which HCV was infected, having the history of acute hepatopathy or not, infection pathway and sex. Patients with other hepatitis virus infection were excluded. Age, at which HCV was infected, was identified as that at blood transfusion or acute episode in non-transfusion patients. No patients had applied to any drugs. Results It took mean (27.17?6.78) years for the patients of age range 0-20 at which HCV was infected to develop to cirrhosis, while only (10.16?5.84) years for those of age range 41～50. There were significant differences between them (P0.05). Conclusion Our data show that patients with older age at which HCV was infected, with history of acute hepatopathy or HCV infection through blood transfusion developed into liver cirrhosis in shorter time. Sex was not found to have significant influence on the progression to cirrhosis.

OBJECTIVE To investigate distribution status and drug-resistance pathogens from infected urinary tract and offer scientific evidence for reasonably clinical usage of antibiotics.METHODS A total of 286 strains of pathogenic bacteria isolated from urinary tract were identified by common methods.Antibiotic susceptibility tests were performed by K-B methods.RESULTS Escherichia coli rated the top one,accounting for 62.2%.Results of susceptibility test showed that all pathogens were resistant to the many antibiotics in different degrees except for 100.0% sensitive to vancomycin in Gram-positive cocci and to imipenem in Gram-negative bacilli.The detection rate of extensive-spectrum beta-lactamases(ESBLs) producers in E.coli and Klebsiella pneumoniae was 36.5% and 40.9%,respectively.The average detection rate of meticillin-resistant staphylococci(MRS) was 35.7%.CONCLUSIONS The drug-resistance of pathogenic bacteria from infected urinary tract is quite serious in the local area.We should adopt effective measurement to control its prevalence.

Objective To observe the effect of bromodomain4 (brd4) inhibitor JQ1 on proliferation inhibition and apoptosis of Ph positive acute lymphocytic leukemia (Ph+ ALL) cells, and to explore the influence on the expression of brd4 and its downstream genes (myc and p53), and the reverse effect on bcr-abl.Methods Different concentrations of JQ1 were used on SUP-B15 cells.The proliferation inhibition rate was detected by MTT, the apoptosis rate was determined by flow cytometry (FCM), and the expressions of bcr-abl mRNA, brd4 mRNA, myc mRNA and p53 mRNA were detected by real-time fluorescent quantitative PCR (RT-PCR).Results Different concentrations of JQ1 inhibited SUP-B15 cells proliferation and induced cell apoptosis.The apoptosis rate was significantly increased compared with that in control group with a time-dose dependent manner.Median inhibitory concentration at 72 h was 1.0 pmol/L.At the same time, JQ1 decreased the transcription levels of bcr-abl mRNA, brd4 mRNA and myc mRNA, and increased the transcription level of p53 mRNA.Conclusions As a brd4 inhibitor, JQ1 can decrease the expression of brd4 to affect the expression of its downstream genes myc and p53, meanwhile, it can change the over expression of bcr-abl to suppress the proliferation of Ph+ ALL cells and induce apoptosis.

Objective To investigate the lymph node micrometastasis and its clinicopathologic features on 5-year disease free survival rate for patients with pT1-3N0 gastric cancer.Methods One hundred and twenty patients with stage pT1-3N0 gastric tumors were included,and 2 106 lymph nodes were harvested and examined in all the specimens.There were 9-28 lymph nodes with average 18 lymph nodes from each patient.All the lymph nodes were negative by HE staining.The CK20 expression of lymph nodes was tested by immunohistochemistry.The relationships between clinicopathologic features or CK positive expression and 5-year disease free survival were analyzed.Results The positive expression rate of CK20 was 9.07%(191/2 106)in lymph nodes and 26.67%(32/120)in patients with pT1-3N0 gastric cancer by immunohistochemistry.Eleven cases were with micriometastasis,21 cases were isolated tumor cells(ITC).The average postoperative follow-up was 66.35(range 24-121)months.Five-year disease free survival rates were 87.4%,78.3%,and 40.9% for the lymph node negative,ITC,and micrometastasis groups,respectively.Five-year disease free survival rate in the micrometastasis group was lower than that in the lymph node negative group(P=0.000)and ITC group(P=0.046).However,there was no significant difference between the lymph node negative group and ITC group(P=0.253).Multivariate analysis identified tumor diameter(P=0.011),depth of tumor invasion(P=0.043),and lymphatic vessel invasion(P=0.002)were related with CK20 positive expression.There was no significant relationship between the pathologic parameters and the 5-year disease free survival rates.Lymph node micrometastasis of gastric cancer was detected in 11 patients who should belong to stage pN1(Mi),the restage rate was 9.17%.While the lymph node negative(88 patients)and ITC(21 patients)were recorded pN0(i-)and pN0(i+),respectively,and were not recommended restage(stage pN0).Conclusion Patients with stage pT1-3N0 gastric cancer and micrometastasis in lymph node are with high-risk and low 5-year disease free survival rate,for whom adjuvant therapies may be justified and effective.