Objective To compare the changes of corneal endothelial cells in early recovery period after 1.8 mm small incision phacoemulsification nucleus chopping and conventional incision phacoemulsification for cataract.Methods Fifty-three patients with cataract were divided into the observation group and control group according to different operation methods.The observation group was treated with 1.8 mm small incision phacoemuisification nucleus chopping while the control group was treated with routine incision phacoemuisification.The visual acuity,degree of astigmatism,corneal endothelial cell indexes and complications were observed.Results The effective ultrasound time and average ultrasonic energy of the observation group were significantly less than those of the control group (all P ＜ 0.05).Compared with 1 day before operation,the visual acuity,degree of astigmatism,corneal endothelial cell area (ECA) and coefficient of variation (CV) were significantly increased at 1 week and 4 weeks after operation,and corneal endothelial cell density (ECD) was significantly decreased (all P ＜ 0.05).The visual acuity and ECD levels of the observation group at 1 day,1 week and 4 weeks after operation were significantly higher than those of the control group,while the degree of astigmatism,ECA and CV were significantly lower than those of the control group (all P ＜ 0.05).Conclusion Compared with the traditional incision phacoemulsification,the damage of 1.8 mm small incision phacoemulsification nucleus chopping to corneal endothelial cells is significantly milder,can reduce the effective ultrasound time and average ultrasonic energy,decrease the degree of astigmatism,improve the visual acuity and decrease the corneal edema.

AIM:To observe the preliminary efficacy of conbercept injected intravitreally for the treatment of wet age-related macular degeneration(wAMD).METHODS:Seventeen wAMD patients (18 eyes) were selected to receive conbercept injection.All patients were given a single conbercept injection every month,3 times.Before and after 1,2,3mo of the injection,the best corrected visual acuity (BCVA),intraocular pressure (IOP,measured by Non-contact tonometer),fundus photography,fundus fluorescein angiography(FFA),indocyanine green angiography(ICG),optical coherence tomography(OCT) examination and the complications incidence were compared.RESULTS:Three months after conbercept injection,the BCVA improved in 15 eyes (83%),stable in 3 eyes (17%).Before treatment,the average central macular thickness was 421.72±54.43μm,at 1 and 2 and 3mo after treatment,the average central macular thickness was 337.89±25.88μm,293.56±26.87μm,266.89±19.10μm respectively.There were significant differences compared with before and after injection(P<0.05).In the final follow up,FFA and ICG showed that the leakage in macular area disappeared in 15 eyes (83%),still existed in 3 eyes (17%),in those 3 eyes the injection was given for one or two times till the leakage disappeared.Elevated intraocular pressure occurred in 2 cases (26mmHg,23mmHg),after 1d down to normal.Another patient showed postoperative envy,given left ofloxacin eye drops after 2d,then back to normal.There was no serious ocular adverse reactions.CONCLUSION:Intravitreal injection conbercept for wAMD can significantly improve the visual function,reduce the macular edema and the leakage with higher safety and less complications.However the prolonged efficacy needs further observation.

Objective: To study the methylation status of PTPRO (protein tyrosine phosphatase receptor-type O) gene as a potential biomarker in the detection of breast cancer, and to analyze its association with clincopathologic features. Methods: The PTPRO gene promoter methylation status in primary human breast tumors, normal breast tissues and peripheral blood were detected by MSP (methylation specific-PCR), and the results were analyzed with corresponding clinico pathological data. Results: The frequency of PTPRO gene mehtylation among 98 breast cancer tissues were 55.1% (54/98), and 33.7% (33/98) in peripheral blood, however no PTPRO gene mehtylation was found in normal breast tissues. PTPRO gene methylation in peripheral blood was significantly correlated to that in tumor tissue (r = 17.083,P = 0.000). PTPRO methylation was associated with tumor stage (r = 9.649,P = 0.001), histological grade (r = 2.476,P = 0.035), lymph node metastasis (r = 3.400, P = 0.003) and ErbB2-positive (r = 4.912,P = 0.000). Patients with ER (estrogen receptor)-negative and PR (progestogen receptor)-negative had more PTPRO methylation, but the difference was not statistically significant. No aberrant methylation of PTPRO gene was found in the plasma samples from healthy control and the patients without gene methylation in tumor tissues. Conclusion: PTPRO gene promoter mehtylation may play an important role in the carcinogenesis and development of breast cancer. It might be used to predict the prognosis of breast cancer patients. Furthermore, this is the first report of methylated PTPRO as a noninvasive tumor biomarker in peripheral blood of breast tumor patients for detection and disease monitoring. Copyright © 2013 by TUMOR.

Objective The paper is to explore the cultivation effect of teachers' scientific research ability in medical vocational college.Methods The proportional stratified sampling method was introduced.108 professional teachers were selected as the research objects in Cangzhou Medical College.The various measures were taken to cultivate teachers' scientific research ability.Comprehensive evaluation of teachers' scientific research ability is divided into subjective and objective quantitative evaluation.The results of the pre-test and post-test were compared.Results After the implementation of cultivation, scientific research ability of teachers significantly increased in medical vocational college.Before and after the cultivation, the total score of comprehensive evaluation had significant difference (P＜0.01).The total score of subjective and objective quantitative evaluation had significant difference (P＜0.01).Conclusions The cultivating measures are actively adopted in medical vocational colleges.It has a positive impact on teachers' scientific research ability.

Objective To evaluate the value of stereotactic core needle biopsy and needle localization biopsy in diagnosis and treatment in the early breast carcinoma .Methods Forty cases with breast micro-lesions detected by radiography underwent stereotactic mammography needle localization biopsy or stereotactic core needle biopsy .Results The biopsies were successful in 27 cases(96.4%),and 1 case of breast cancer was missed diagnosed by stereotactic core needle biopsy.Conclusion Stereotactic mammography needle localization and stereotactic core needle biopsy play important roles in diagnosis and treatment of early breast cancer.

Objective To study dexmedetomidine on the adverse impact of ketamine based anesthesia and sedative effects in indirect inguinal hemia.Methods Eighty children underwent indirect inguinal hemia surgery were randomily divided into two groups after injected muscle with midazolam and ketamine,Group B was injectded with 0.5 μg/kg DEX,but Group A with normal saline,analgesia was with caudal block (lidocaine).The with hemodynamic,level of sedation,recovery time and CHW score were observed.The adverse reactions were recorded.Results Two groups of children have hemodynamically stable,and recovery time had no statistical significance.The two groups of CHW score in Group A (1.6 ± 0.5) points higher than in group B (0.9 ± 0.3) points (P ＜ 0.05).The restlessness rated group (1.52 ± 0.54) points was higher than in group B (0.51 ± 0.48) points (P ＜ 0.05).Compared with Group B,Group A had 12 cases of psychiatric symptoms,10 cases of involuntary movement of limbs,6 cases of severe postoperative agitation nausea,and 8 cases of vomiting (P ＜ 0.05).Conclusion 0.5μg/kg DEX can be safely and effectively used in the pediatric anesthesia,and reduce the adverse reactions caused by ketamine.

Objective To investigate changes of serum silent information regulator 1 (Sirt1) and inflammatory cytokines in type 2 diabetes patients with different stages of diabetic nephropathy.To explore the relationship between serum Sirt1 level and inflammatory cytokines in type 2 diabetic patients with different urinary albumin excretion rates.Methods A total of 436 cases with type 2 diabetes were divided into three groups:normoalbuminuric [D1,n =168],microalbuminuric [D2;n =152],and macroalbuminuric [D3,n =116].Serum Sirt1,hypoxia-inducible factor-1α (HIF-1α),early growth response protein 1 (EGR1),insulin-like growth factors-Ⅰ (IGF-Ⅰ),and monocyte chemotactic protein-1 (MCP-1) were determined by enzyme-linked immunosorbent assay (ELISA).Results The levels of serum Sirt1 in type 2 diabetes patients were significantly lower than that in control group,and with the increase of urinary protein excretion rate,the levels of serum Sirt1 in group D1,D2 and D3 were decreased gradually (P ＜ 0.01).Compared to control,serum inflammatory cytokines (HIF-1α,EGR1,IGF-Ⅰ,and MCP-1) levels were significantly increased in type 2 diabetic patients and gradually increased in the patients of D1,D2 and D3 groups (P ＜0.01).Furthermore,Serum Sirt1 was negatively correlated with the levels of inflammatory cytokines.Age,duration,fasting blood glucose (FBG),fasting insulin (FINS),homeostasis model assessment insulin resistance index (HOMA-IR),glycosylated hemoglobin (HbA1c),low density lipoprotein (LDL),total cholesterol (TC),triglyceride (TG),serum creatinine (Scr),blood urea nitrogen (BUN),uric acid (UA),HIF-1α,EGR1,IGF-Ⅰ,and MCP-1 were positively correlated with Ln Koc of urinary albumin to creatinine ratio [Ln(ACR)] (P ＜ 0.05);and Sirt1 were negatively correlated with Ln(ACR)(P ＜ 0.01).HIF-1α,MCP-1,IGF-Ⅰ,duration,BUN,Sirt1,UA,LDL,and EGR1 were independent factors that significantly influenced Ln (ACR) (P ＜ 0.05).Conclusions Serum Sirt1 might be a new target for the treatment of diabetic nephropathy.Enhancing serum Sirt1 levels might have a role in delaying the progression of diabetic nephropathy.

Objective To discuss the surgical methodology for sunken upper eyelid and its curative effect by eyelid orbital fat reset.Methods 26 patients with the sunken upper eyelid were operated,in which blepharoplasty incision was used to open musculus orbicularis oculi and septum orbitale,dissected levator,displaced orbital fat were extended and replaced to the sunken region of upper eyelid,to mild-to-moderate ptosis evator tendon membrane folding suture was carried out at the same time and the wound was routinely sutured through 7-0 nylon thread.Results All cases were followed up for 12 months after operation.There was no obvious complication occurred,All cases got ideal outcomes,with smooth and symmetry lid folds.Conclusions The postoperative effects of upper eyelid orbital fat reset for correction of eyelid sunken are satisfactory,without inequality complications,and therefore it is worth promoting.

ObjectiveTo explore which body constitution responds the best in the treatment of hyperplasia of mammary glands with mild moxibustion, by differentiating the constitution following the self-rating scale for theClassification of Body Constitution of Traditional Chinese Medicine.MethodTotally 118 patients were intervened by mild moxibustion, majorly at Jianjing (GB21), but assisted by other points according to the nine constitution types (moderate, qi deficiency, blood stagnation, phlegm-dampness, qi stagnation, damp-heat, yin-deficiency, yang-deficiency, and specific constitutions). The mammary lump, pain in breast, and complicated symptoms were observed before and after intervention by following the self-comparison rules.ResultThere were no significant changes in mammary lumps in the 9 constitution types (P>0.05); the phlegm-dampness, qi-deficiency, blood stagnation, qi stagnation, and yang-deficiency constitutions showed significant improvements in the evaluation of breast pain and complicated symptoms (P<0.05), while the changes in other constitutions werestatistically insignificant(P>0.05).ConclusionMild moxibustion can significantly improve the symptoms in some constitutions, but it seems that dry mild moxibustion is impossible to reverse the organic lesions and its efficacy is rather limited.

A total of 175 patients with type 2 diabetes mellitus (T2DM) were composed of 69 with normoalbuminuria,60 with microalbuminuria,and 46 with macroalbuminuria.The control group consisted of 64 healthy individuals.Serum YKL-40 levels were determined with ELISA method and related metabolic data were collected.Serum YKL-40 levels were significantly higher in T2DM group than in control group(P＜0.01).Significant correlations of YKL-40 were found with the ratio of microalbuminuria to uric creatinine(r=0.677,P＜0.01),HbA1C (r =0.562,P＜0.01),systolic blood pressure (r =0.372,P =0.001),HOMA-IR (r =0.460,P =0.001),low density lipoprotein-cholesterol (r=0.304,P=0.012),age(r=0.260,P=0.015),blood uric acid (r=0.329,P=0.018),and high density lipoprotein-cholesterol (r=-0.247,P=0.032).YKL-40 may play a role in the occurrence and development of diabetic nephropathy.