Objective To seak a available way of evaluating morphology of filtering blebs after trabeculectomy is very important for forecasting the successful rate of surgery.At the present time,filtering blebs were commonly evaluated by using the slim lamp microscope,but it did not to exactly reflect the filtering passage.This study aimed to evaluate the morphology of filtering blebs after trabeculectomy with anterior segment optical coherence tomography (AS-OCT).MethodsThis was a prospective study.Sixty-nine eyes of 53 patients who had previously undergone trabeculectomy were selected in this study,including 25 eyes with open-angle glaucoma,38 eyes with close-angle glaucoma and 6 eyes with secondary glaucoma.These filtering blebs were classified into functional type (typeⅠandⅡ) and nonfunction type (type Ⅲ and Ⅳ) under the slit lamp microscope based on the van Buskirk grading scales.Intra-bleb morphology and structure were characterized as diffuse-like,cystic-like,encapsulating-like and flatten-like by AS-OCT in reference to the Leung method.The consistency between the two methods was evaluated by the Chi-Square test.Written informed consent was obtained from all the patients before surgery.ResultsThe average follow-up time was 10.78±11.0 months.All the patients finished the examination during the follow-up duration.The average intraocular pressure was(14.9±4.5)mmHg during the observation period.There were 38/69 (55.1%) functioning blebs and 31/69 (44.9%) non-function blebs under the slim lamp microscope.AS-OCT imaging showed diffuse-like blebs in 26 eyes (15.9%),cystic-like blebs in 11 eyes (27.5%),encapsulating-like blebs in 19 eyes (18.8%) and flatten-like in 13 eyes with the intraocular pressure of(13.16±3.77)mmHg,(15.36±2.92)mmHg,(15.77±5.07)mmHg and (16.62±5.33)mmHg,respectively,showing a significant difference among them (F=3.32,P＜0.05).These patterns of different OCT presented a good consistency with the clinical outcome (χ~2=0.03,P=0.86).ConclusionAS-OCT allows the observation of filtering blebs after glaucoma surgery.It is probably to visualize the internal structure of filtering bleb and deep sclerectomy.Functional and dysfunctional filtering blebs delivery gives different OCT patterns.This could be a new way to assess the postoperative healing process.

Cerebellum ; surgery ; Cystadenoma, Papillary ; complications ; pathology ; surgery ; Epididymis ; pathology ; surgery ; Follow-Up Studies ; Genital Neoplasms, Male ; complications ; pathology ; surgery ; Humans ; Keratin-7 ; metabolism ; Kidney ; surgery ; Male ; Middle Aged ; Mucin-1 ; metabolism ; Vimentin ; metabolism ; von Hippel-Lindau Disease ; complications ; metabolism ; pathology ; surgery

Objective To investigate the molecular mechanism of miR-139-5p targeting transforming growth factor-β1 (TGF-β1) in the regulation of epithelial mesenchymal transition (EMT),thus inhibiting invasion and metastasis of hepatoma cells.Methods Bioinformatics methods were used to determine whether miR-139-5p was the best binding miRNA of TGF-β1.Correlation between the TGF-β1 expression as detected by immunohistochemistry and Western blot,and the miR-139-5p level by qRT-PCR in 56 hepatoma tissues and 20 normal tissues,respectively,was analyzed.The relationship between the miR-139-5p level as detected by qRT-PCR,and TGF-β1,E-cadherin and Vimentin by Western blot in the high and low metastatic hepatoma cell lines were investigated.In recombinant cell lines,whether miR-139-5p could bind to the 3'UTR site of TGF-β1 was evaluated,and the effect on invasive ability after modulating miR-139-5p level was also tested by the transwell method.Results A total of 20 miRNAs were found to be able to bind with TGF-β1 by bioinformatics methods and among these mRNAs,miR-139-5p was the best target miRNA with the highest specificity and strongest stability to bind TGF-β1.The positive expression rates of TGF-β1 in hepatoma tissues and adjacent normal liver tissues were 80.4％ (45/56) and 15.0％ (3/20),respectively,(P ＜0.05).There were significant differences on the expressions of TGF-β1,E-cadherin and Vimentin among the different metastatic cell lines (all P ＜ 0.05).After miR-139-5p was transfected into hepatoma cells,miR-139-5p could bind to the 3'UTR site of TGF-β1,resulting in downregulating TGF-β1 expression.When compared to the other three groups,the cell line with a high expression of miR-139-5p had a significantly lower count of invasive cells (53 ± 4/high magnification field) (P ＜ 0.05).Conclusion miRNA139-5p could specifically bind to the 3'UTR site of TGF-β1 and regulate the EMT signaling pathway,thus suppressing invasion and metastasis of hepatoma cells.

The reconstructive method and layout of medical train is studied,especially in reconstruction of the sick and wounded ward,medical room and train carriage.Safe protection for the wounded and methods for equipment constancy are introduced.It is expected to serve as a reference for enhancing medical treatment efficiency and quality.

Objective To study the effect of annexin A1 on cardiac function,tumor necrosis factorα(TNF?α),and interleukin 1β(IL?1β)in diabetic rats. Methods Twenty?four SD rats were randomly divided into normal control and diabetic groups. The type 2 diabetes model was in?duced with a high?glucose and high?fat diet and administration of low?dose streptozotocin.Left ventricular end?diastolic volume(LVEDV),left ven?tricular end?systolic volume(LVESV),peak velocity of early diastolic mitral?to?late diastolic peak velocity(e/a)ratio,left ventricular ejection frac?tion(LVEF),and stroke volume(SV)were measured by using color Doppler ultrasonography at the end of week 8. The expression levels of TNF?αand IL?1βin blood were measured by using enzyme?linked immunosorbent assay,and the expression level of annexin A1 in blood was measured at weeks 0,4,and 8 by using real?time polymerase chain reaction. Results Compared with the normal control group,the diabetic group had de?creased LVEDV,e/a,and SV(P<0.05).The annexin A1 expression level in the diabetic group decreased significantly after 8 weeks(P<0.01). The TNF?αand IL?1βlevels in the diabetic group were significantly higher than those in the normal control group(P<0.05)and increased signifi?cantly after 8 weeks(P<0.01). Annexin A1 level correlated with the TNF?αand IL?1βlevels in the diabetic group(P<0.01). Conclusion Annexin A1 expression shows an anti?inflammatory effect that improved the cardiac function of diabetic rats.

Objective To investigate the usefulness of HC visual laryngoscope designed for unskilled junior emergency resident doctors in respect of increasing the efficiency and success rate of emergency tracheal intubation.Methods A total of 80 patients needed the emergency tracheal intubation were at first divided into two groups randomly (random number).Patients in group A were operated by junior emergency resident doctors and patients in group B were operated by well experienced attending doctors.Then,the two groups of patients above were divided into two groups randomly (random number).Patients in group N were operated with conventional laryngoscope and patients in group HC were managed with HC visual laryngoscope.Then comparisons of the success rate of glottis exposure,the one-time success rate of tracheal intubation,the success rate of tracheal intubation,the complications,the number of attempt in successful intubation cases and the operative time consumed for successful intubation cases among the groups were done.Results (1)The success rate of glottis exposure,the one-time success rate and the success rate of tracheal intubation in group A-HC were 90%,70% and 90%,respectively which were significantly higher than those (50%,20% and 45%)in group A-N (P <0.05).The rate of complication,the number of attempt and operative time consumed for intubation cases in group A-HC were respectively 15%,(1.28 ± 0.43)and (31.44 ±5.06 ) s,which were significantly less than those [45%,(1.89 ±0.79 )and (45.89 ±4.99) s in group A-N (P <0.05 ).(2)The success rate of glottis exposure,the one-time success rate and the success rate of tracheal intubation in group B-N were 80%,65% and 80%, respectively which were significantly higher than those (50%,20% and 45%)in group A-N (P <0.05). The rate of complication,the number of attempt and operative time consumed for successful intubation cases in group B-N were 15%,(1.25 ±0.41)and (39.31 ±4.23)s,respectively which were significantly less than those [45%,(1.89 ±0.79)and (45.89 ±4.99)s]in group A-N (P <0.05).(3)There were no significant statistical differences in above results between group A-HC and group B-HC (P >0.05 ). Conclusions HC visual laryngoscope used by unskilled junior emergency resident doctors for emergency tracheal intubation,could increase success rate of glottis exposure,decrease the number of attempt of intubation,decrease rate of complication,shorten operative time required for intubation thus improving efficiency and success rate of emergency tracheal intubation,and maybe narrow the skill gap between unskilled junior resident doctors and well experienced attending doctors in respect of emergency tracheal intubation.

Objective To analyze the correlation between emphysema extent measured by high resolution computed tomography (HRCT) and pulmonary function tests, symptom score in patients with chronic obstructive pulmonary disease ( COPD ) , and to study the value of HRCT in the emphysema quantification in the clinical evaluation of COPD patients. Methods 78 patients with stable COPD were recruited to take the HRCT scan , and emphysema extent was qualified by measuring the proportion of low attenuation area in the whole lung (LAA%). Correlations between LAA% and indices of pulmonary function test, bronchial dilation test, mMRC scale, CAT score and six minutes walking distance (6MWD) were assessed. Results LAA% was negatively correlated with FEV1/FVC and DLCO%pred, and the correlation coefficients were -0.759 and -0.589 (P <0.01), respectively. LAA% was positively related to mMRC score (r = 0.342, P < 0.01), and negatively asso-ciated with 6MWD (r = -0.365,P< 0.01). There was no association between LAA% and indices of bronchodila-tion test (⊿FVC, ⊿FVC%, ⊿FEV1, ⊿FEV1%) (P > 0.05). Conclusions The severity of emphysema measured by HRCT is well correlated with the clinical symptoms , pulmonary function tests and exercise capacity in COPD patients. It can be used to diagnose emphysema early and to evaluate the severity of the disease com-prehensively. Thus, the risk factors of COPD can be controlled and the prognosis of the patients can be im-proved.

Objective To evaluate the application value of bedside lung ultrasound in diagnosis of neonatal severe pneumonia.Methods Bedside lung ultrasound and chest X-ray were performed in 59 the newborn patients admitted to the newborn department for suspected severe pneumonia,from October 2015 to March 2016.According to the characteristics of the chest X-ray,patients were divided into consolidation group (widely spot shadow in double lung and airbronchograms) and the unconsolidation group (enlargement,fuzzy texture in double lung or small patch sample changes) Differences in ultrasonic characteristics were compared between the two groups.Results Ultrasonic image characteristics were pulmonary consolidation with air bronchograms,A-line disappearance,pleural line abnormalities.Among 23 patients with chest X-ray,21 patients were found pulmonary consolidation by lung ultrasound,and all 36 patients in unconsolidation group were not found pulmonary consolidation by lung ultrasound,and there was no significant difference in the detection rate by lung ultrasound between the two groups (P＞0.05) The pulmonary ultrasound results of 20 cases in the consolidation group showed A-line disappearance,37 cases in the unconsolidation group showed A-line disappearance.There was no statistical significant differences between the two groups (P＞0.05).The pulmonary ultrasound results showed 11 cases in the consolidation group and 15 cases in the unconsolidation group with pleural line abnormalities,there was no statistically significant differences between the two groups (P＞O.05).Conclusions Ultrasound image characteristics of neonatal severe pneumonia include pulmonary consolidation and air bronchograms,A-line disappearance,pleural line abnormalities.Compared lung ultrasound and chest X-ray result,there was no difference between consolidation group and unconsolidation group.Both of the two methods can be used for evaluating the diagnosis of pneumonia.

The paper identified bottlenecks in establishing general practice departments at tertiary hospitals.With analysis of the importance of general practice education,medical service and research,as well as complete disciplinary building at such hospitals,the authors explored strategies and measures for talent training and development of general practice.

This article was aimed to explain the distribution of syndrome and study the change of pathogenesis in patients of acute exacerbation of chronic obstructive pulmonary disease risk-window (AECOPD-RW) based on clini-cal investigation. The data of the traditional Chinese medicine (TCM) syndrome of patients diagnosed as AECOPD into AECOPD-RW were collected from 8 hospitals. The database was established. Data was analyzed with SPSS 13.0 software. The results showed that among 15 basic syndromes, the syndrome of lung-qi deficiency was with the high-est frequency, which was followed by the syndrome of kidney-qi deficiency and syndrome of phlegm-dampness. A-mong 14 combined syndromes, the syndrome of lung-kidney qi deficiency and the syndrome of phlegm-dampness ac-cumulated in the lung were with the highest frequency. The common syndromes of AECOPD-RW were the syndrome of lung-kidney qi deficiency combined with the syndrome of phlegm-dampness accumulated in the lung, the syn-drome of lung-kidney qi deficiency, the syndrome of lung-spleen qi deficiency combined with the syndrome of phlegm-dampness accumulated in the lung, the syndrome of lung-spleen qi deficiency, the syndrome of lung-kidney qi-yin deficiency combined with the syndrome of phlegm-dampness accumulated in the lung, the syndrome of lung-kidney qi-yin deficiency, the syndrome of lung-kidney qi deficiency combined with the syndrome of phlegm-stasis accumulated in the lung, and the syndrome of lung-kidney qi-yin deficiency combined with the syndrome of phlegm-stasis accumulated in the lung. It was concluded that the main common syndromes of AECOPD-RW was the mixture of deficiency and excess. There was relatively less pure deficiency and excess syndrome.