To observe the curative effect of treating small -incision cataract extraction by intraocular lens implantation combined with trabeculectomy for primary angle-closure glaucoma with cataract.
●METHODS: Totally 44 cases (52 eyes) of primary angle-closure glaucoma combined with cataract were selected to undergo the combined surgery, in order to observe the patients' pre - and postoperative eyesights, intraocular pressures and the postoperative complications.
●RESULTS: The postoperative eyesight was improved significantly as compared with the preoperative eyesight. The intraocular pressure was declined dramatically. The result was of statistical significance (P<0. 05). All the 52 cases' surgeries were performed by the same surgeon. The surgeries were processed smoothly, with 6 postoperative eyes of anterior chamber inflammation cell response, 3 eyes of anterior chamber fibrinoid exudate, 2 eyes of shallow anterior chamber through mydriasis and treatment with glucocorticoids and non - steroidal eyedrops before absorption, and no complications like malignant glaucoma, cyclodialysis, etc. were reported through mydriasis and pressure bandaging before recovery.
● CONCLUSlON: Treating the primary angle - closure glaucoma combined with cataract through the combined surgery has high reliability and desirable curative effect. The surgical method is simple to learn and applicable for promotion on the basic level.

The strain F12-11-1-2 was isolated from the East China Sea,which had antimitosis activity using Pyricularia oryzae mode.Ac- cording to phenotypical study,salt-aggregation test and 16S rDNA sequence analysis,the strain F12-11-1-2 has been identified to be Bacillus subtilis.

Objective To discuss the combined value of gray-scale ultrasound ( GSUS) and contrast-enhanced ultrasound (CEUS) in the diagnosis of benign and malignant thyroid lesions and to explore the optimal diagnostic point of scoring method .Methods Ultrasound images of 178 thyroid lesions confirmed by pathology were synthetically reviewed by scoring 5 GSUS indicators including shape , orientation, interior echogenicity, halo sign, microcalcification and 6 CEUS indicators including relative arrival time of microbubbles in the periphery and interior, peak periphery and interior echogenicity, peripheral ring-enhancement, and homogeneity of enhancement .One positive indicator scored one point .The optimal diagnostic points and their clinical value were explored according to ROC curves .Results Scores of GSUS, CEUS and the combination of GSUS and CEUS were significantly different (Z =10.188,9.843,10.705,all P <0.001). Areas under ROC curves of GSUS, CEUS and the combination of GSUS and CEUS were 0.936, 0.919 and 0.964, respectively.Three or more positive GSUS indicators of five in a thyroid lesion predicted that the thyroid lesion was malignant , with the sensitivity of 79.6% and the specificity of 91.2%.Two or more positive CEUS indicators of six in a thyroid lesion predicted that the thyroid lesion was malignant , with the sensitivity of 91.8% and the specificity of 81.2%.Five or more positive GSUS and CEUS indicators of eleven in a thyroid lesion predicted that the thyroid lesion was malignant , with the sensitivity of 93.6%and the specificity of 92.3%.The areas under the ROC curve of GSUS and CEUS were 0.936 and 0.919.The area under the ROC curve of the combination of GSUS and CEUS was 0.964, larger than the areas under the GSUS ROC curve and the CEUS ROC curve.Conclusion Ultrasound is valuable in the differential diagnosis of benign and malignant thyroid lesions , and the combination of GSUS and CEUS is the most valuable with 5 points as the optimal diagnostic scoring method .

Objective To evaluate the effect of the difficult embryo transfer on the clinical pregnancy outcome of in vitro fertili-zation-embryo transfer(IVF-ET) .Methods There were 209 fresh cycles of difficultly transferring and 2 489 fresh cycles of easily embryo transferring between January 2011 and December 2012 .The clinical outcome was compared .Results There were statistical-ly significant differences in the catheter blood staining rates (51 .20% vs 27 .68% ,P< 0 .05) ,implantation rate(31 .14% vs 35 . 54% ,P<0 .05) ,and clinical pregnancy rate (46 .41% vs 55 .56% ,P<0 .05)between the two groups .There was no significant difference in the rates of ectopic pregnancy and miscarriage between the two groups (P>0 .05) .Conclusion Difficulty ET will in-fluence the clinical pregnancy .Therefore ,all efforts should be made to avoid the difficult transfer in order to increase the pregnant rate .

Objective To compare the cleaning effect of before and after improvement of P′750 type endoscopic infusion pump sensing infusion. Methods 240 cases of urinary calculi patients were divided into experimental group (120 cases) and control group (120 cases) according to the random number table method. Experimental group made improvements on P′750 type endoscopic infusion pump sensing infusion, Took latex transmission pipe, sampling module, metal fittings and parenteral nutrition infusion bags, disposable connecting pipe connection, and surgery using improved sensing infusion. The control group used unimproved sensing infusion. Results Visual inspection of cleaning pass rate before and after improvement sensing infusion were 85.83% (103/120), 99.17% (119/120), 5 times with light magnifier inspection were 78.33%(94/120), 97.50% (117/120), tampons method inspection were 75.83% (91/120), 95.83% (115/120), ATP bioluminescence monitoring were 70.83% (85/120), 91.67% (110/120), dry pass rate were 90.83%(109/120), 100.00% (120/120), cleaning and drying pass rate were significantly improved (χ2=18.296, 29.159, 32.986, 40.976, 11.528, all P<0.01). Cleaning time before and after improvement sensing infusion were (1 020.40±8.22) s, (539.30±8.70) s. Dry time were (1 199.35±26.70) s, (61.50±5.79) s. Cleaning and drying time were significantly shortened (t=440.340, 456.206, all P<0.01). Conclusion Improvement sensing infusion increased the quality of cleaning and drying, shortened the cleaning and drying time, ensured the quality of surgery using equipment, improved work efficiency, and provided a guarantee for the safe and smooth implementation of the surgery.

Animals ; Brain-Derived Neurotrophic Factor ; metabolism ; Hypothalamus ; metabolism ; Male ; Physical Conditioning, Animal ; physiology ; Rats ; Rats, Sprague-Dawley

Objective: To evaluate narrow-band imaging (NBI) without magnifying in the diagnosis of colorectal lesions by NBI International Colorectal Endoscopic Criteria (NICE classification), and analyze the safety and practicability of "do-not-resect" and "resect and discard" policies in clinical practice. Methods: The patients undergoing screening or surveillance colonoscopy, who were found colorectal lesions in the examination, from May to December in 2017 were enrolled. All the patients were examined by NBI without magnifying by any of the designated two physicians. NICE classification was used to diagnose colorectal lesions, and the diagnostic confidence of each lesion was recorded. The results of endoscopy were compared with those of pathology, and the accuracy rate and the confidence rate of diagnosis were calculated. The sensitivity, specificity, positive predictive value and negative predictive value of the diagnostic method for differentiating superficial tumors from non-tumors were also calculated. Finally, the feasibility, safety and cost savings of using "do-not-resect" and "resect and discard" policies in clinic were analyzed. Results: A total of 764 lesions were detected in the 636 enrolled patients. The overall accuracy of NICE classification was 84.95% and the diagnostic confidence rate was 81.68%. The sensitivity, specificity, positive predictive value and negative predictive value for differentiating tumors from non-tumors were 91.77%, 67.68%, 88.69%, and 74.86%, respectively. The diagnostic accuracy of diminutive colorectal lesions (≤5 mm) with high confidence was 94.98%, and the negative predictive value of diminutive rectosigmoid lesions (≤5 mm) with high confidence was 96.25%. They achieved the criteria of "resect and discard" and "do-not-resect" policies. If "do-not-resect" and "resect and discard" policies had been executed in clinical practice, ¥165 490 could have been saved and the omission diagnostic rates of "do-not-resect" and "resect and discard" policies would have been 3.75% and 0, respectively, in this study. Conclusion: It is feasible to use NBI without magnifying in differentiating tumors from non-tumors. The diminutive colorectal lesions and rectosigmoid lesions with high diagnostic confidence may achieve the criteria of "resect and discard" and "do-not-resect" policies, respectively.

Objective To study the micro-pore architecture and mechanical properties of porous titanium scaffolds with diamond molecule structure produced by 3D print technology, so as to guide the development of 3D-prinited porous titanium orthopedic implants. Methods Selective laser melting (SLM) and electron beam melting (EBM) were used to fabricate porous Ti6Al4V scaffolds with diamond molecule structure. The micro-pore architectures of those scaffolds were observed using optical microscope and scanning electron microscope (SEM), and universal material testing machine was used to conduct compressive test on the scaffolds. Results Both SLM and EBM techniques had machining error and half-melted metal particles were found on the strut surface. The relative error of strut size produced by SLM and EMB was 20.9%-35.8% and －9.1%-46.8%, respectively. The scaffold with strut width of 0.2 mm could not be produced by EBM. The compressive strength and elastic modulus of the scaffold fabricated by SLM was 99.7-192.6 MPa and 2.43-4.23 GPa, respectively. The compressive strength and elastic modulus of the scaffold fabricated by SLM was 39.5-96.9 MPa and 1.44-2.83 GPa, respectively. Conclusions The manufacturing precision of SLM is higher than that of EBM. Porosity is the main factor that affects the compressive strength and elastic modulus of the scaffolds. In the same process, with the increase of porosity, both the compressive strength and elastic modulus decrease. When the porosities are similar, the scaffolds fabricated by SLM possess higher compressive strength and elastic modulus than those by SLM.

Background Following the accelerated speed of population aging in China,the incidence of cataract is rising gradually.Researches indicated that senescenee marker protein-30 ( SMP-30 ) is closely associated with the occurring and developing of cataract. Objective This study was to investigate the expression of SMP-30 in human lens epithelial cells(LECs) of age-related cataract and study the relationship between SMP-30 and apoptosis.Methods Capsulotomy was performed on 80 eyes of 59 patients with simple cortex age-related cataract and 70 eyes of 53 age-matched patients with nucleus age-related cataract.The anterior capsular specimens were obtained by circularly capsulorhexis during the operation.Expressions of the SMP-30 protein and mRNA in the LECs of two types of cataract were detected using immunochemistry and real-time PCR respectively.Apoptosis of the LECs was assayed by TUNEL.The differences of expression of SMP-30 and apoptosis were compared between the two types of cataract.Results Immunochemistry showed that SMP-30 was expressed in cytoplasm of LECs.The expression intensity of SMP-30 was higher in the center zone compared with periphery zone.The apoptosis rate of LECs was significantly higher in the center of the anterior capsule than the periphery in both two types of cataract ( nucleus cataract:19.34％±0.11％ vs 8.32 ％ ± 0.57 ％,P =0.025 ; cortex cataract:42.07 ％ ± 0.86 ％ vs 13.55 ％ ± 0.64 ％,P =0.010 ).The expression amount of SMP-30 mRNA was lower at the periphery than the center of lens in both two types of cataract (nucleus cataract:45.21±2.79 vs 76.42±11.21,P=0.042 ;cortex cataract:108.32±4.32 vs 206.34±15.67,P=0.037 ),and that of nucleus cataract was significantly lower than cortex cataract (60.02±9.08 vs 157.33 ± 13.01,P =0.034),and the apoptosis rate of LECs was declined in the nucleus cataract group compared with the cortex cataract group ( 14.05％ ±0.22％ vs 27.70％ ±0.81％,P =0.007 ). Conclusions LECs apoptosis exists in age-related cataract.SMP-30 probably plays an important role in the formation of cataract.

OBJECTIVETo investigate the hemodynamics evidence of the descending branch of lateral circumflex femoral artery in a reversed way. To explore the clinical result of using the reversed descending branch of the lateral circumflex femoral artery as the receipt artery for free flaps for reconstruction of the leg soft-tissue defect.

METHODSFrom October 2005 to February 2012, 38 patients with severe leg soft-tissue defects were treated. The proximal antegrade and retrograde mean artery pressure of the descending branch of the lateral circumflex femoral artery in 16 of 38 patients were recorded during operation. All wounds had osteomyelitis, bone and tendon exposure requiring coverage reconstruction. And there was no recipient artery in the injured lower leg for free flaps in all 38 patients. Reversed descending branches of lateral femoral circumflex arteries were used as recipient arteries for free flaps (free latissimus dorsi flap, free thoracoumbilical flap, and free anterolateral thigh flap) in all patients. The flap donor site was closed directly or with the skin graft.

RESULTSThe proximal antegrade mean artery pressure of the descending branch of lateral circumflex femoral artery was(81.6 +/- 12.4) mmHg. The proximal retrograde pressure was(48.2 +/- 10.7) mmHg. The proximal retrograde mean artery pressure was 59.07 percent of the proximal antegrade pressure. The donor skin graft survived and wound healed primarily. After operation, 2 flaps had distal partial necrosis and healing was achieved after dressing change. All the other flaps survived completely without vascular problems. All the patients were followed up for 11 months to 2.5 years (mean, 1.6 years). The flap appearance was satisfactory. The texture and color of flaps in all cases were good.

CONCLUSIONSThe reverse descending branch of lateral circumflex femoral artery is a reliable recipient artery for the free flaps. It is an easy and simple technique that can be used for reconstruction of the defects in the lower leg, with the reversed descending branch of lateral circumflex femoral artery as recipient artery.

Adolescent ; Adult ; Blood Pressure ; Female ; Femoral Artery ; physiopathology ; surgery ; Free Tissue Flaps ; blood supply ; Hemodynamics ; Humans ; Lower Extremity ; injuries ; Male ; Middle Aged ; Soft Tissue Injuries ; surgery ; Young Adult