To evaluate the efficacy and safety of limbal relaxing incision ( LRl) for correcting corneal astigmatism during implantable collamer lens ( lCL) surgery.METHODS:A total of 185 eyes of 105 patients with high myopia and corneal keratometric astigmatism were included in the study. lCL surgery with concomitant relaxing incision was performed in 105 eyes of 60 patients in LRls group ( Group A) . Eighty eyes of 45 patients only underwent lCL surgery were in control group ( Group B) . All patients undergone ophthalmic examination that included uncorrected visual acuity ( UCVA ) , best -corrected visual acuity ( BCVA ) , Pentacam analysis system to observe the changes of corneal astigmatism before and 1wk, 1 and 3mo after surgery.RESULTS: Respectively comparing UCVA between two groups in 1 and 3mo postoperatively, the P values were considered statistically significant ( P < 0. 05 ). But, respectively comparing BCVA between two groups in 1wk, 1 and 3mo postoperatively, the P values were considered no statistically significant ( P > 0. 05 ). Preoperative corneal astigmatism was 1. 52 ± 0. 55D in group A and 1. 48 ± 0. 57D in group B, there was no statistically significant difference (P>0. 05). One week postoperatively, the astigmatism was 0. 55 ± 0. 41D in group A and 1. 20 ± 0. 48D in group B. One month postoperatively, the astigmatism was 0. 60 ± 0. 38D in group A and 0. 93 ± 0. 47D. Three months postoperatively, the astigmatism was 0. 51 ± 0. 32D in group A and 0. 96 ± 0. 40D in group B. The difference between the two groups were statistically significant ( P<0. 05 ). The difference value of corned astigmatism before surgery and 1wk, 1 and 3mo after surgery had statistical significance ( P<0. 05). ln LRls group, at preoperative and postoperative time points, the average corneal astigmatism changes were also considered statistically significant difference (P<0. 05). CONCLUSlON: LRls performed during lCL surgery appeared to be an effective and safer procedure to reduce pre-existing corneal astigmatism and improve UCVA as well as the visual quality.

Objective:To investigate the non-thymoma thymic morphology in patients with Myasthenia Gravis(MG), and provide the theoretical basis for extended thymectomy.Methods:From September 2008 to March 2018, extended thymectomy had been performed for 150 patients with MG in our department. In order to achieve maximal benefit, combined thoracoscopic and mediastinoscopic approach had been adopted to completely remove both thymus and ectopic thymic tissue in the neck and the anterior mediastinum. Cervical and mediastinal tissue including fat from the thyroid isthmus to the diaphragm was swept away from above the phrenic nerve. The regions containing mediastinal fat were divided into 12 stations.Results:There was no mortality. Pathology reports revealed 126(84.0%) patients with MG had hyperplastic thymus, 17(11.3%)cases with involuted thymus and 7 (4.7%)cases with normal thymus. 98 (65.3%)cases had more than two superior horns, and 59(39.3%) patients had ectopic thymic tissue in the mediastinum and in the neck. Positive rates of ectopic thymic tissue in the 12 cervical-mediastinal fat stations were 7.8%, 10.0%, 8.8%, 3.8%, 3.0%, 2.5%, 0, 0, 0.7%, 13.3%, 12.3% and 9.1%, respectively. After a follow-up period of 2-12 years, the rate of complete stable remission was 44.7%(59/132), and the effective rate was 89.4%(118/132).Conclusion:It is very meaningful to study non-thymoma thymic morphology in patients with MG in order to guide the performance of extended thymectomy and improve its outcome. For the purpose of minimally invasion, one side of mediastinal pleural should be carefully protected.

Hypertension is one of main risk factors for the occurrence and death of stroke and coronary heart disease. Its prevalence rate is rising year by year. It severely threatens the health of the human beings. The acupuncture method of "activating blood and dispersing wind, harmonizing Gan-Pi" for treating hypertension launched by Academician SHI Xue-min has aroused great attention due to good cur- ative effect and less adverse reactions. In this paper principles of the circular motion covered by the acupuncture method of "activating blood and dispersing wind, harmonizing Gan-Pi" were clarified.
Acupuncture ; Acupuncture Therapy ; methods ; Coronary Artery Disease ; Humans ; Hypertension ; therapy ; Medicine, Chinese Traditional ; Risk Factors ; Stroke ; Wind

Objective To explore the effective measurements of integrated therapy for the ear keloids in the Oriental. Methods Surgical excision was performed for keloid, and the cut then sutured directly or with flap transfer. At early stage of surgery (within 24 hours), X-ray or electron-ray radiotherapy was used for 3-5 times once daily; and steroids injected after cutting lines at 7th day every two weeks and gradually ended. Results A total of 48 patients were treated, and followed, in which 12 patients were lost of follow-up. The total effective rate was 94. 4 % based on the data of follow-up in 36 patients for 1-3 years. Therefore, the curation rate was 83. 3 % (30 cases) and effective rate 11. 1 % (4 cases). Conclusions Surgical cutting combined with early radiotherapy and steroids injection is the effective integrated therapy for the ear keloids in the Oriental.

Objective To explore the methods and effects of improving facial appearance on volume defect and aging,and recovery of aesthetic looks by autologous fat granules graft.Methods We designed the filling areas according to gender,age,individual face characteristics and desire of the case before operation.By liposuction technology with low pressure from the trunk,fats were taken with cleaning and purifying.Then pure fats were injected to the marked areas of the face by multi-level and multi-tunnel injection.It was able to supply the facial volume for lost soft tissue,to improve the aging appearance and to achieve smooth facial contour.Results All cases were followed-up for 3 months to 2 years,facial appearances were satisfied or improved,without fat liquefaction,infection,scleroma and other complications.Only a few cases needed complementary transplantation.The overall results were satisfactory.Conclusions Autologous fat granules graft is a safe and effective facial soft tissue filling technology.It can effectively improve facial aging appearance,restore natural,young and beautiful looks,and be worth for clinical application.

ObjectiveTo investigate the effect of perioperative use of fish oil on post-operative fatigue(POF) of rat.MethodsAfter one week's preoperative behavior training,12 rats presented poor behavior were excluded from 60 healthy adult male SD rats as the normal controls of serum parameters.The remaining 48 rats were randomly divided into model group and fish oil treatment group by random number table.The fish oil treatment group received 10 days' (3 days before surgery and 7 days after surgery) intraperitoneal injection of fish oil [2 ml/( kg · d) ],and the model group with saline.On the 1st,3rd,5th,and 7th post-operative day,rats were assessed by Morris water-maze and tail suspension test.Serum levels of interleukin ( IL)-1β,IL-6,tumor necrosis factor-α (TNF-α),superoxide dismutase (SOD),and glutathione peroxidase (GSH-PX) were measured.ResultsSerum parameters:on the 1st and 3rd post-operative day,the IL-6 level in the fish oil treatment group [ (66.22 ±8.80),(56.03 ± 1.19) pg/ml] was significantly lower than in model group [ (83.30 ± 10.69),(82.72 ± 24.27) pg/ml ] (P =0.034,P =0.038 ) ; on the 1 st,3rd,5th,and 7th post-operative day,the TNF-α level in the fish oil treatment group [ ( 104.36 ±5.02),(84.49 ±7.81 ),(64.47 ±2.89),(39.29 ±2.52)pg/ml ] was significantly lower than in model group [ ( 120.01 ± 14.99 ),( 119.68 ± 8.84),(75.29 ± 2.58 ),(41.96±1.65) pg/ml] (P=0.014,P=0.003,P=0.000,P=0.004); onthe1st,3rd,5th,and 7th postoperative day,the IL-1β level [(155.11 ±9.08),(79.39±5.86),(57.26±16.07),(35.42±1.53) pg/ml]was significantly lower than model group [ (204.87±30.61),(198.82±54.83),(152.12±29.06),(64.35 ± 2.70) pg/ml ] ( P =0.024,P =0.002,P =0.000,P =0.000) ; on the 5th postoperative day,SOD ( 1.08±0.08) μmol/L was significantly higher than model group (0.71±0.06) μmoL/L (P=0.000) ; on the 5th and 7th postoperative day,GSH-PX [ (31.21 ± 1.30), (30.78 ± 1.83) μmol/L] was significantly higher than model group [ (25.03 ±1.74),(27.57±3.57) μ mol/L](P=0.000,P=0.036).Behavior:in tail suspension test,on the 1st and 3rd postoperative day,value of struggle in fish oil treatment group [ (6620 ± 1390),(7011 ± 1472) mv · s] was significantly higher than in model group [ (4739 ± 1040),(4344 ± 1130) mv · s](P=0.048,P=0.043); cumulative fixed time [ (118.42±10.05), (101.02±8.68) s] and single rest time [ (55.39±7.70),(56.60±5.88) s] was lower thanin modelgroup [ (135.08+12.44),(131.02±9.24) s; (65.73±3.78),(64.93±3.25) s] (P=0.042,P=0.012,P=0.043,and P=0.042).In Morris water-maze,on the 3rd and 5th postoperative day,escape latent period of fish oil treatment group [ (48.263 ±1.815),(44.955±2.567) s] was lower than model group [ (51.543±1.990),(49.956±2.888) s] (P=0.035,P=0.035) ; on the 1st,3rd,5th,and 7th postoperative day,the cross platform number (1.04±0.25,1.95±0.49,2.42 ±0.41,3.21 ±0.53) was significantly higher than in model group (0.58 ±0.26,1.20±0.33,1.50±0.39,2.17±0.68) (P=0.002,P=0.003,P=0.018,P=0.035).ConclusionPerioperative use of fish oil can reduce postoperative inflammatory response,enhance antioxidant defense capability,and mitigate post-operative fatigue.

Objective To investigate whether the protein kinase C inhibitor can promote the apopto- sis of multidrug resistance tumor cell lines which are induced by chemotherapy drugs.Methods Choose the KB/S(oral squamous cancer cell line)and KB/VCR(its multidrug resistant cell line)to compare the Adri- amycin-induced apoptosis with or without staurospolin(protein kinase C inhibitor).The apoptosis is stained with acridine orange,tested by flow cytometry,and approved by electron microscope.Results 36 hours after the treatment with 0.04 ?g/ml adriamycin,apoptotic cells of KB/S are 96.68%,and after 48 hours,the apop- totic cells of KB/VCR are 64.99%.When the concentration of adriamycin are augmented to 0.4?g/ml and 2.0?g/ml,the apoptotic cells of KB/VCR are 69.74% and 37.18% respectively.When treated with stau- rospolin together,the apoptotic cells of KB/VCR increased to 72.58%(?~2=4.5,P0.05)respectively.These results were testified by electron microscope and acridine orange-stain.Conclu- sion The resistance to apoptosis may be one of the mechanisms of multidrug resistance and the protein ki- nase C inhibitor may reverse this resistance by promoting the apoptosis of multidrug resistance tumor cells.

Objective To investigate the etiology and clinical characteristics of pediatric pulmonary arterial hypertension(PAH) and improve its early diagnosis and treatment.Methods The clinical and echocardiogram data of all inpatients with PAH in Pediatric Department of Peking University First Hospital between May 1995 and May 2007 were retrospectively analyzed for age,sex,etiology,symptoms and echocardiographic measurement of pulmonary artery pressure.Data were divided into groups according to different etiology and statistics.Pulmonary arterial systolic pressure(sPAP) values estimated from the tricuspid regurgitant velocity by Doppler echocardiography were compared among different groups.Cases who were not belonged to the first category of the Venice Clinical Classification of pulmonary hypertension were not included.Results Totally 276 cases,168 boys and 108 girls were diagnosed to have PAH.Age ranged from 1 month to 17 years,median age was 9 months.Most of pediatric PAH was associated-PAH(267 cases,96.7%),while idiopathic PAH took a small part(9 cases,3.3%).Congenital heart disease-associated PAH(CHD-PAH) was predominant(245 cases,88.7%) and left to right shunt was the main lesion (217 cases,88.6%),while complex lesion-associated PAH comprised 28 cases(11.4%).Connective tissue disease associated PAH(CTD-PAH) was the second common among this group of pediatric PAH patients(19 cases,6.9 %).The incidence of PAH in systemic lupus erythematosus(SLE),juvenile rheumatoid arteritis and takayasu arteritis were 10.3 %(13/126),8.7%(4/46),15.4%(2/13),respectively.The other 3 cases of PAH were associated with portal hypertension(2 cases) and thalassanemia(1 case).The estimated sPAP from tricuspid regurgitant velocity in 8 cases with idiopathic PAH[(74.6?23.9) mmHg(1 mmHg=0.133 kPa)]was higher significantly compared with those of 33 cases of CHD-PAH [(58.0?19.7) mmHg ] and 12 cases of CTD-PAH [(49.6?18.9) mmHg] respectively(t=-2.052,-2.609 Pa

BACKGROUND: Because of complicated physiological environment and difficulty to control experimental conditions, it is difficult to get satisfactory results from in vivo studies of cell mechanics.OBJECTIVE: To study the action and mechanism of p38MAPK signaling pathways on myoblast apoptosis based on successful construction of in vitro mechanical stimulation models.METHODS: The C2C12 cells cultured in vitro were divided into control group and SB203580 treatment group. Cyclic tensile stress was applied on the C2C12 myoblast cells for 0, 6, 12 and 24 hours in each group. The Flexcell Strain Unit-5000T was used to expose C2C12 myoblast cell to an equiaxial cyclic of 15% magnitude and a frequency of 10 cycles/min, each cycle including the 3 s stretch and 3 s relaxation. Hoechst 33258 fluorescent staining and optical microscope were used to detect cell apoptosis. RT-PCR, flow cytometric analysis were used to observe the apoptosis of C2C12 myoblast cells and Western blotting were used to detect the activity of p38MAPK and p-p38MAPK. RESULTS AND CONCLUSION: The optical microscope tested the change in the morphology. Hoechst 33258 staining showed that after treatment with cyclic stress, the cell took the typical appearance of apoptosis with chromatin condensation and apoptotic bodies. RT-PCR and flow cytometry showed that with the extension of time the rate of the apoptosis of C2C12 myoblast cell increased. And cells imposed SB203580 before imposing cyclical tensile stress, the results showed that the apoptosis was markedly affected, and the p-p38MAPK expression declined apparently. These findings demonstrate that p38MAPK signaling pathways in stress mediated into C2C12 myoblast cell apoptosis plays an important role.

Objeetive To analyze the clinical efficacy of liver transplantation (OLT) for patients with hepatopulmonary syndrome (HPS).Methods From 2008 to 2013,420 adult patients underwent liver transplantation in our hospital.There were 91 patients with,and 329 patients without,HPS.The 5-year survival and mortality rates after OLT for the two groups were retrospectively analyzed.Results There were no significant differences between patients without and with HPS in age,primary disease,Child-Pugh score,MELD score,cold ischemia time and warm ischemia time.However,the differences on serum albumin [(29.6 ± 1.2) g/L vs.(26.4 ± 1.6) g/L] and blood oxygen pressure [(61.0 ±9.0) mmHg (1 mmHg =0.133 kPa) vs.(87.0 ± 6.0) mmHg] were significantly different (P ＜ 0.05).The 1-year cure rate was 65.9％ (60/91) in 91 patients with HPS after liver transplantation.The 1,3,5-year cumulative survival rates for patients without HPS were 97.3％,90.9％ and 80.3％,respectively,and the main causes of death were primary graft dysfunction,recurrent cardiovascular events and primary disease recurrence or tumors.The 1,3,5-year cumulative survival rates for patients with HPS were 65.9％,59.3％ and 56.0％,and the main causes of death were multiple-organ failure,pulmonary infection and cerebrovascular events.Kaplan-Meier survival curve analysis showed that the survival of patients with HPS was significantly lower than that of patients without HPS (P ＜ 0.05).Conclusions Liver transplantation is the most effective treatment for patients with HPS,but the short-term mortality rate is relatively high.We still need to learn more about HPS to improve the survival rate of patients with HPS after liver transplantation.