With the development of corneal refractive surgery, especially the application of femtosecond laser, and the lack of corneal donor, corneal stromal lenticules produced in refractive surgery have gradually attracted the attention of ophthalmologists.Most fresh corneal stromal lenticules are difficult to put into use immediately, so how to better preserve and treat the lenticules is a problem that ophthalmologists need to solve.Corneal stromal lenticules can be used in the treatment of many kinds of ophthalmic diseases.In this article, the preservation and treatment of corneal stromal lenticules, as well as its application and prospects in treating hyperopia and presbyopia, keratoconus, corneal ulcer, corneal dystrophy, dermoid tumors and recurrent pterygium, corneal thinning after laser in situ keratomileusis, and covering glaucoma drainage valve to prevent exposure were reviewed to provide reference for further clinical research and application.

OBJECTIVETo explore the effect of electroacupuncture (EA) on the expression of Ghrelin and mRNA expression of its receptor in functional dyspepsia (FD) rats.

METHODSTotally 80 rats were divided into the normal group, the model group, the drug therapy group, and the EA group according to random digit table, 20 in each group. FD model was duplicated by clipping tail modeling. Drug containing cisapride [2 mL/100 g, 0.09 g/(kg x d)] was administered to rats in the drug therapy group from the 3rd day after successful modeling, once per day. EA at Zusanli (ST36) (0.3-0.5 cun) and Taichong (LR3) (0.1-0.2 cun) was performed in the EA group. The twirling of needle was performed to the subsidence of needle, and then the needle was connected to HANS-200A Acupoint Nerve Stimulating Device using disperse-dense wave at 2 Hz, 2 mA, 30 min each time, once per day. Six days consisted of one therapeutic course, two courses in total with an interval of one day. The intestinal propulsive rate of ink was observed. Ghrelin protein expression in gastric tissue was detected by Western blot. mRNA expression of growth hormone secretagogue receptor (GHS-R) in stomach, hypothalamus, and hippocampus was detected using Real-time PCR respectively.

RESULTSCompared with the normal group, the intestinal propulsive rate of ink, Ghrelin protein expression in gastric tissue, mRNA expression of GHS-R in stomach, hypothalamus, and hippocampus decreased in the model group (P < 0.05, P < 0.01). Compared with the model group, the intestinal propulsive rate of ink, Ghrelin protein expression in gastric tissue, mRNA expression of GHS-R in stomach, hypothalamus, and hippocampus increased in the EA group (P < 0.01); mRNA expression of GHS-R in stomach, hypothalamus, and hippocampus increased in the drug therapy group (P < 0.01). Compared with the drug therapy group, Ghrelin protein expression in gastric tissue, mRNA expression of GHS-R in hypothalamus increased in the EA group (P < 0.05, P < 0.01).

CONCLUSIONEA could regulate Ghrelin content and GHS-R mRNA expression of FD rat hypothalamus, hippocampus, and gastric tissue, and promote the intestinal propulsive rate of ink.

Acupuncture Points ; Animals ; Dyspepsia ; metabolism ; therapy ; Electroacupuncture ; Ghrelin ; metabolism ; Hippocampus ; metabolism ; Hypothalamus ; metabolism ; RNA, Messenger ; metabolism ; Random Allocation ; Rats ; Receptors, Ghrelin ; metabolism ; Stomach ; metabolism

Objective To develop a non-invasive method for diagnosis of esophageal varices in patients with cirrhosis induced by viral hepatitis.Methods The clinical data,including results of blood routine,liver function,blood coagulation and color ultrasonography,of patients with cirrhosis induced by viral hepatitis from the First Affiliated Hospital of Zhengzhou University during December 2011 and December 2012 were retrospectively analyzed.Patients with hematopoietic diseases and portal vein thrombosis were excluded,and no patients received beta-blocker,endoscope band ligation,and splenectomy treatment.According to gastroscopic results,all patients were divided into no/mild group and mid/serious group.Correlations between clinical data and esophageal varices were analyzed by Logistic regression method,and receiver operating characteristic (ROC) curve was used to evaluate their values for diagnosis of esophageal varices.Results Totally 96 patients were enrolled in the study,30 without or with mild esophageal varices,and 66 with mid/serious esophageal varices.There were significant differences on platelet (PLT),plateletcrit (PCT),platelet distribution width (PDW),alanine aminotransferase (ALT),aspartate aminotransferase (AST),spleen thickness (ST) and PLT/ST between no/mild group and mid/ serious group (Z/t =-2.842,-3.151,-2.549,-3.463,-3.601,-4.360and 11.877,P＜0.05 or P ＜ 0.01).Multivariate logistic regression analysis showed that only ST was statistically different between two groups (OR =1.127,OR 95％ confidence interval (CI):1.012-1.256,P =0.030).The area under the curve (AUC) was 0.728,and 95％ CI:0.628-0.827.With the cut off value of 52.5 mm,the sensitivity,specificity,and Youden index of ST in diagnosis of esophageal varices were 53.0％,90.0％ and 0.43,respectively.Conclusion ST measured by color ultrosonography can be used for early diagnosis of mid/serious esophageal varices.

Objective To explore and analyze perioperative psychological care and its effect in craniotomy patients under sober state.Methods 10 patients with cerebral tumor of functional zone undergoing craniotomy under conscious state were given pertinent psychological nursing and psychological counsehng,besides,perioperative comprehensive nursing wag given in order to reach the aim of effective psychological nursing.Results The perioperative behavioral control of patients wag better,they could cooperate with the operation as requested and reached the anticipated aim.All patients rehabilitated at discharge.Conclusions Effective psychological care plays a very important role to ensure the success of sober craniotomy and rehabilitation of patients.

Objective To investigate the role of nucleotide-binding oligomerization domain-containing protein 1 (NOD1) in inducing insulin resistance in differentiated human adipocytes.Methods Human preadipocytes obtained via liposuction were induced to differentiate into mature adipocytes.iE-DAP,a specific ligand for NOD1,was administered to human adipocytes in culture.NF-κB transcriptional activity and proinflammatory cytokines production were determined by luciferase assay and enzyme-linked immunosorbent assay.Glucose uptake in adipocytes was measured by 2-deoxy-D-[3 H] glucose uptake (P＜0.05).The expression of phosphatidylinositol-3-kinase p85 (PI-3K p85),insulin receptor substrate-1 (IRS-1) and Akt phosphorylations were detected by Western blotting.Results NF-κB transcriptional activity and cytokines such as interleukin (IL)-6,IL-8,and monocyte chemotactic protein 1 secretion were markedly increased after stimulation with iE-DAP (P＜0.05 or P＜0.01).Insulin-induced glucose uptake was decreased with the activation of NOD1 in a dose-and time-dependent fashion.NOD1 activation weakened insulin signal transduction as being revealed by increasing IRS-1 Ser307phosphorylation,reducing protein expression of PI-3K p85,and attenuating insulin-induced phosphorylation of Akt on Ser473 and Thr308in human adipocytes.Conclusion These results indicate that NOD1 activation induces inflammatory response and insulin resistance via IRS-1/PI3-K/Akt signaling pathway in human adipocytes.

Objective To investigate early nasogastric nutrition on patients with acute decompensated chronic heart failure,and observe its influence on patient's disease outcome.Methods From January 2012 to December 2013,100 cases with acute decompensated chronic heart failure were used as the research subjects,were randomly divided into experimental and control groups with 50 cases each group.Patients of two groups adopt expansion of blood vessels,strong heart,diuresis,and routine anti-infection treatment;Based on this scheme,experimental group adopt early nasogastric nutrition.The cardiac function index,the change of nutritional status and clinical curative effect and the result of follow-up within 1 year after discharge of two groups were compared.Results Left ventricular end-diastolic dimension (LVEDD) and left ventricular end-systolic dimension (LVESD) in two groups after treatment were decreased,and the descender of experimental group was superior to that of the control group with statistically significant difference (P ＜ 0.05).After treatment,left ventricular ejection fractions (LVEF) of two groups were improved,and the rise of experimental group was superior to that of control group with statistically significant difference (P ＜0.05).In the two groups after treatment,the serum brain natriuretic peptide (BNP) levels were significantly decreased,and the descender of the experimental group was more than that of control group with statistically significant difference (P ＜ 0.05).After treatment,body mass index (BMI),the level of serum prealbumin (PA),transferrin (TRF),and the total number of lymphocytes of two groups were increased significantly (P ＜ 0.05);and BMI,the level of serum PA and TRF,and the total number of lymphocytes of the experimental group were significantly better than those of the control group (P ＜ 0.05).The total effective rate of the experimental group was significantly higher than that of the control group (P ＜ 0.05).The exacerbation rates,readmission and mortality rate of experimental group follow-up within 1 year after discharge were significantly lower than that of the control group (P ＜ 0.05).Conclusions The early nasogastric nutrition on the patients with acute decompensated chronic heart failure was better able to improve patients' nutrition state,more conducive to patients with cardiac function recovery,improve the clinical curative effect,and reduce the exacerbation rates,and readmission and mortality rate.

Objective To evaluate the application of serological detection of Chlamydia pneumonia (Cpn) in patients with acute coronary syndrome (ACS) .Methods From Oct .2012 to Oct .2013 ,80 patients with ACS (ACS group) and 80 healthy subjects (control group) were enrolled and detected for Cpn DNA .According to the detected results ,ACS patients were divided to chlamydia group and non‐chlamydia group .Serum levels of tumor necrosis factor α(TNF‐α) ,C reaction protein (CRP) ,intercellular cell adhe‐sion molecule‐1 (ICAM‐1) and lipoprotein were also detected .Results In ACS group ,53 cases were Cpn positive and 27 cases were Cpn negative ,and in control group ,7 cases were Cpn positive and 83 cases were Cpn negative ,which were with statistical difference between the two groups (P<0 .05) .Serum levels of TNF‐α,CRP ,ICAM‐1 ,total cholesterol ,triacylglycerol and low density lipo‐protein cholesterol were higher in chlamydia group and that of high density lipoprotein cholesterol was lower than non‐chlamydia group (P<0 .05) .Conclusion Chlamydia pneumoniae infection might be correlated with ACS .Chlamydia pneumoniae infection could be involved in disease development by increasing levels of inflammatory cytokines in ACS patients ,and further improve serum lipid levels .

Objective To discuss the effect and clinical value of serum sialic acid (SA) and lactadherin(MFG-E8) in the coronary atherosclerotic heart disease(CHD).Methods Selected 295 patients who visited to Wuhan University Renmin's Hospital cardiovascular medicine (from January to June, 2014), and then according to the results of coronary angiography divide the subjects into control group (n =78, the result of coronary angiography completely normal)and coronary heart disease group(n =217, the results of coronary angiography showed that one major coronary stenosis was more than 30％).Detected their serum level of lipid, SA, MFG-E8, hs-CRP index.At last, analyze the differences of SA and MFG-E8 between these groups, and the correlation with the severity of coronary stenosis (symbolize with Gensini score), use the binary logistic regression analysis to research the relationship among the serum level of SA, MFG-E8 and the risk of CHD.Results Compared with the control group, the patients with CHD have a higher level of serum SA and a lower level of MFG-E8 (U =4 402.5, 2 736.0 respectively,P ＜0.001);the AMI group has a higher level of serum SA than the StA and UA groups (U =1 329.0,957.5 respectively, P ＜0.001);the AMI group has a lower level of serum MFG-E8 than the StA groups (U =1517.0, P ＜ 0.001).The spearman correlation analysis showed that the serum SA has a positively correlation with the level of TG, hsCRP and Gensini score, and has a negatively correlated with the level of MFG-E8 (r =0.214, 0.462, 0.378,-0.322 respectively,P ＜0.01);the MFG-E8 has a negatively correlated with the level of TG, hsCRP and Gensini score (r =-0.18,-0.425,-0.564 respectively, P ＜0.01).Binary logistic regression analysis showed that there was a positive correlation between the serum SA and the risk of CHD (OD =4.782, 5.319, 4.179 3.832, 3.648 respectively, P ＜0.001), and the was a negative correlation between the serum MFG-E8 and the risk of CHD (OD =O.118, 0.112, 0.127, 0.135, 0.134 respectively, P ＜ 0.001).Conclusion With the serum SA rised and the MFG-E8 reduced, the risk of coronary heart disease was higher, combined detection these two indexes may be able to diagnose the CHD and assess the degree of stenosis and the risk of CHD.

Objective To investigate the molecular types and related clinical features of methicillin-resistant Staphylococcus aureus (MRSA) in Jingzhou area, Hubei Province.Methods A total of 80 MRSA strains confirmed by mecA gene were isolated from inpatients in Jingzhou Central Hospital of Hubei province during January and December 2014. Vitek 2 Compact was used for antibiotic susceptibility test . Staphylococcus protein A (SPA) types and Staphylococcal cassette chromosome mec (SCCmec) genotypes were detected by multiplex polymerase chain reaction ( PCR ) and gene sequencing . Panton-valentine leucocidin ( pvl) gene of the strains was detected by PCR .Chi-square test and Wilcoxon test were used for data analysis .Results There were 16 spa types in 80 MRSA isolates , in which t030 and t437 were the most prevalent ones accounting for 50.0% ( 40 strains ) and 28.8% ( 23 strains ) of the total strains, respectively.There were 77 strains of SCCmec type Ⅰ-Ⅴ, in which SCCmecⅢ and SCCmecⅣ were the most prevalent ones accounting for 45.0% (36 strains) and 35.0% (28 strains), respectively.t030 was the main spa type in isolates of SCCmecⅢ(33/36, 91.7%), while t437 was the main spa type in isolates of SCCmecⅣ(20/28, 71.4%).Patients infected with t030/SCCmecⅢMRSAs were with higher ages than those infected with t437/SCCmecⅣMRSAs (T=446.500 and 607.500, P<0.01).Patients infected with t030/SCCmecⅢ MRSAs were mainly from surgical wards and intensive care unit ( ICU ) , while those infected with t437/SCCmecⅣ MRSAs were mainly from pediatrics wards , and there were significant differences in ward distribution between two groups (χ2 =33.724 and 29.768, P <0.01).Seventy percent and above strains of t030/SCCmec type Ⅲ were resistant to rifampin, erythromycin, clindamycin, tetracycline, levofloxacin, moxifloxacin, ciprofloxacin and gentamicin .Strains of t437/SCCmec type Ⅳwere resistant to erythromycin , clindamycin and tetracycline , but were sensitive to most non-β-lactam antimicrobial drugs (with resistance rates <20%).Virulence gene pvl was found in 11 strains (13.8%), in which 7 were strains of t437-SCCmec typeⅣ.Conclusions MRSAs in Jinzhou are of various genotypes , in which t030-SCCmecⅢand t437-SCCmecⅣare the most prevalent ones .Strains of t030-SCCmec typeⅢare usually multiple-drug resistant , mainly seen in elderly patients in surgical wards and ICU .Strains of t437-SCCmecⅣare sensitive to most non-β-lactam antimicrobial drugs , and its infection is mainly seen in children and young people .

Objective To investigate the epidemiology and antibiotic resistance of communityassociated and hospital-associated meticillin-resistant Staphylococcus aureus (CA-MRSA and HA-MRSA) in Jingzhou.Methods A total of 159 MRSA isolates were successively collected from patients in Jingzhou Central Hospital during January 2012 and December 2013.The minimum inhibitory concentrations of 16 antimicrobial agents against 159 MRSA isolates were detected.SCCmec types of the strains were detected by multiplex PCR,and the homology of the strains was analyzed using pulsed field gel electrophoresis (PFGE) and cluster analysis of antibiogram.WHONET 5.6 and SPSS 19.0 were used for data analysis.Results Among 159 MRSA strains,131 were hospital-associated,and 28 were community-associated,which accounted for 82.4％ and 17.6％,respectively.There were significant differences in the age of patients,ward distribution,specimen type,length of stay,length of anti-infection treatment,type of infection and underlying diseases between patients with CA-MRSA or HA-MRSA infections (x2 =19.103,31.372,59.756,71.703,54.153,59.756 and 54.232,all P ＜ 0.01).No vancomycin,linezolid,tigecyeline and nitrofurantoin resistant strains were found,but all strains were resistant to penicillin,cefoxitin and oxacillin.HA-MRSA had higher resistance rates to moxifloxacin,levofloxacin,rifampicin,ciprofloxacin and gentamicin than CA-MRSA (x2 =30.179,27.352,28.523,28.523 and 25.987,all P ＜ 0.01),but its resistance rates to erythromycin and clindamycin were lower (x2 =13.106 and 11.743,both P ＜ 0.01).Among 159 MRSA strains,12 (7.5％) were of SCCmec type Ⅱ,113 (71.1％) were of SCCmec type Ⅲ,26 (16.4％) were of SCCmec type Ⅳ,and 8 were of undifferentiated type.The predominant SCCmec types were type Ⅳ for CA-MRSA (26/28,92.9％) and type Ⅲ for HA-MRSA (113/131,86.3％),respectively.Six PFGE patters were found in 49 HA-MRSA isolates from ICU,and the predominant patters were A1 (24,49.0％),A2 (9,18.4％) and B (9,18.4％).Cluster analysis of antibiogram showed that three groups of HA-MRSA were of high correlations,and they were of PFGE patter A1,A2 and B,respectively.Conclusions HA-MRSA is the predominant MRSA in Jingzhou area,and it is different from CA-MRSA in the age of patients,ward distribution,type of infection and antibiotic resistance.Most HA-MRSA strains are of type SCCmec Ⅲ,and may cause epidemic outbreak in ICU.