· AlM:To compare the therapeutic effects of different surgical methods in treating pterygium patients and to observe tear film stability.
· METHODS: A total of 120 pterygium patients ( 120 eyes) were divided into three groups, each 40 cases (40 eyes).Data including SchirmerⅠtest (SⅠt), tear break-up time ( BUT) , corneal fluorescein staining ( CFS) were recorded preoperatively and postoperatively to evaluate the clinical efficacy of surgery and the effects of tear function changes.
·RESULTS:There were no significant differences in BUT in group A before the operation and one month after operation.Groups B and C showed significant difference before and after operation, but differences were not statistically significant ( all P<0.05 ); One month after operation, there was significant difference in CFS among group A, B and C (P<0.05), but the difference was not satistically significant between groups B and C; After 3mo, BUT in group A was not significant difference compared with the preoperative; but there was significant difference in groups B and C (P<0.05).When
compared it between groups B and C, there showed no significant difference; Group A showed no significant difference in SⅠt compared with preoperative, SⅠt of groups B and C were significant differences compared with preoperative (P<0.05), but no significant difference between the two groups;After 3mo, CFS of preoperative group A and group B and group C had no significant difference. After 10mo follow - up, there was axsignificant difference ( P<0.05 ) in recurrence rate in group A comparing with groups B and C, there were differences between groups B and C, but no statistically significant.Surgery is more likely to relapse in summer than in winter.
·CONCLUSlON: Pterygium excision combined with self-corneal limbal stem cell transplantation and Tenon capsule closed is an ideal surgical to reduce the recurrence and improve tear film function to some extent.

Objective To evaluate clinical curative effect of levosimendan therapy on patients with refractory heart failure.Methods A total of 84 patients with refractory heart failure were randomly and equally divided into le-vosimendan group and routine treatment group.Both groups received routine antiheart failure medication,levosimendan group received levosimendan therapy while routine treatment received milrinone injection therapy additionally.Changes of left ventricular ejection fraction(LVEF)and plasma level of N terminal pro type B natriuretic peptide(NT -proB-NP)were compared between two groups before and after treatment.Results Compared with routine treatment group, there were significant increase in total effective rate of LVEF[(0.36 ±0.18)% vs.(0.42 ±0.36)%],and in NT -proBNP[(975.14 ±247.01)ng/mL vs.(832.14 ±224.78)ng/mL].The effect before and after treatment of levosi-mendan group were more obviously (NT -proBNP:t =2.3 -230.2,P <0.02;LVEF:t =2.29 -215.2,P <0.01). Conclusion Levosimendan can significantly improve heart function,decrease NT -proBNP level in patients with re-fractory heart failure.

Background The visual system of animal have to optimally adjust in various environmental conditions in order to obtain stable and effective visual funetion.However,the color vision system of animals which encounter uncertainty of spectral signals should be plastic.Whether the densities of various cones and expression of opsins change with long-time spectral deprivation is unclear.Objective This study was to investigate the changes of cone density as well as the expression of corresponding opsin and mRNA following the long-term illumination of monochromatic light.Methods Thirty 3-day-old guinea pigs were randomized into 3 groups and exposed tO the 530 nm green light,400 nm purple light and white light for consecutive 8 weeks respectively.The flat-mounted retinal sample was prepared and divided into dorsal zone,ventral zone and mixed zone anatomically according to the distribution of difierent light-sensitive cone.The changes in density of cone cells sensitivited to different colored light were detected by single-1abel or double-label immunocytochemistry.The levels of opsin and its mRNA were determined using Western-blot and real-time PCR respectively.Results The density of green-sensitivity cones was significantly different in the dorsal zone of retina among green light group,purple light group and white light group (F=234.28,P<0.01).Compared with white light group,the density of green-sensitive cones in dorsal retina of green light group was obviously higher but that of purple light group wag evidently lower(q=389.68,P<0.01；q=67.11,P<0.01).No significant difference was found in the density of purple-sensitive cones in the ventral zone of retina among green light group,purple light group and white light group(F=3.14,P>0.05).The density of coexpression of the mixed cone cells was increased in green light group(q=157.55,P<0.01)but decreased in purple light roup (q=254.85,P<0.01)in comparison with white light group.The expression levels of green-opsin and green-opsin mRNA in green light group was significantly elevated(q=184.45,P<0.01；q=4.71,P<0.05),but those of purple light group were evidently declined(q=5.87,P<0.05；q=346.66,P<0.01)in comparison with white light group.There was no statistically significant differences were found in the expression of purple-opsin and its mRNA among all the groups(F=1.24,P>0.05；F=3.27,P>0.05).Conclusion After the exposure of long-time monochromatic light illumination,monochromatic cones density and its opsin in guinea pig occur the corresponding alteration to gain good spatial vision as a compensatory reaction.These outcomes imply that there is some plasticity during the development of color vision.The increase of green-sensitive cones might be from the differentiation of coexpression cones in transition region.

OBJECTIVE:To optimize the preparation technology of Ginkgo biloba extracts-hydroxyprop-?-cyclodextrin(GBE-HP-?-CD) inclusion compounds and to identify this inclusion compound.METHODS:The optimum preparation condition was studied by orthogonal test with encapsulation rate as the index of evaluation.The inclusion compounds were prepared with solution-agitating technique.The inclusion compounds were identified by phase solubility diagra-m,differential scanning calorimetry(DSC) and infrared spectroscopy methods,respectively.RESULTS:The optimum inclusion condition was as follows:the ratio of GBE to HP-?-CD=1.5∶1;agitating time=6 h;inclusion temperature=50 ℃.CONCLUSION:It has been preliminarily proved that it is possible for Ginkgo biloba extracts and hydroxyprop-?-cyclodextrin to be made into inclusion compounds.HP-?-CD has satisfactory solublization on Ginkgo biloba extracts.

OBJECTIVE:To study the preparative methods of the long-circulating solid lipid nanoparticles(LSLN)carrying ginkgolides A and B(GAB)and to study the physicochemical characteristics of the GAB-LSLN.METHODS:GAB-LSLN was prepared by ultrasonication or high pressure homogenization.Transmission electron microscopy was employed to study its shape.Particle size,zeta potential,and entrapment efficiency of GAB-LSLN were determined,and its stability after storage under room temperature for 4 weeks was determined as well.RESULTS:The GAB-LSLN prepared by ultrasonication was platelet-shaped and irregular,and that prepared by high pressure homogenization was spherical and regular in shape.The particle diameters of GAB-L SLN prepared by ultrasonication and high pressure homogenization were(219.6?14.3)nm and(173.9?10.4)nm respectively(P0.05).CONCLUSION:High pressure homogenization is superior to ultrasonication in that the prepared GAB-LSLN has small particle size,high stability and high entrapment efficiency.

Objective To review the experience of perioperative management and effect of valve replacement combined with renal dysfunction.Methods 536 cases of valve replacement.According to preoperative glomerular filtration rate(GFR),renal dysfunction was classified as normal in 322 cases,mild in 162,moderate in 40 and severe in 12.Logistic regression analysis was used to assess the effect of preoperative renal dysfunction on operative mortality and morbidity.Results Patients with a lower GFR were older and more likely to have hypertention.They also tended to have larger left ventricular end-diastolic diameter and worse left ventricular ejection factor.Operative mortality rose inversely with declining renal function,from 2％ for those with normal renal function to 17％ for patients with severe renal dysfunction.Renal dysfunction was significantly associated with a large blood transfusions,re-intubation,longer mechanical ventilation,intensive care unit stay and hospital stay.Conclusion Preoperative renal dysfunction is an important factor of postoperative mortality and morbidity for valve replacement.We must pay more attention to perioperative management.

ObjectiveTo determine the levels of type Ⅳ collagen and matrix metalloproteinase-9 ( MMP-9 ) in the serum and kidney of rats with the multiple organ dysfunction syndrome ( MODS ) and investigate the mechanism of extracellular matrix damage in renal failure of MODS.MethodsForty adult male Sprague- Dawley (SD) rats were randomly (ramdom number) divided into two groups,namely the normal control group ( n =8 ) and the MODS model group ( n =32 ).The rats of model group were further divided into four sub-groups as per different intervals,6 h,12 h,24 h and 48 h,after modeling (n =8 in each).The animal models of MODS were established by two hits,the left eyeball of each model rat was removed to bleed to 2 ml bloocd/100 g body weight and lipopolysaccharide ( LPS,5 mg/kg) was injected into intraperitoneal cavity of model rats four hours later. The same volume of saline instead was injected intraperitoneally into rats of control group.All rats were sacrificed at different intervals.Creatinine (Cr)and blood urea nitrogen (BUN) were determined by using a Hitachi Automatic Biochemical Analyzer.The histological changes in renal tissue were observed under light microscope and transmission electronic microscope.The levels of serum type Ⅳ collagen and MMP - 9 protein were measured by using enzyme linked immunosorbent assay (ELISA).Type Ⅳ collagen and MMP- 9 protein levels in renal tissue were detected by western blot.One - way ANOVA was used for comparison among multiple groups.Results Compared with the control group,Cr and BUN were significantly higher in MODS group ( P ＜0.05 ).There were no histopathological changes in kidney of rats in control group,and the renal injury was serious in rats with MODS.The remarkable edema of basement membrane and defect of collagen fibers in renal tissue were observed in MODS group.Compared with the control group,the levels of MMP-9 in serum increased 6-48 hours after modeling and peaking at interval of 12 hours after modeling ( P ＜ 0.05 ).The protein levels of type Ⅳ collagen increased not significantly in 6 h group and 12 h group in comparison with control group (P ＞ 0.05 ),while those in 24 h group and 48 h group significantly increased ( P ＜ 0.01 ).The levels of MMP -9 in renal tissue of rats with MODS increased in 6 h group and 12 h group (P＜0.05),peaked in 24 h group ( P ＜ 0.05 ),and decreased in 48 hours.However,the level of Ⅳ collagen in serum of rats with MODS decreased significantly 6-48 hours after modeling (P ＜ 0.05 ) Conclusions The injury of extracellular matrix is an important factor to the kidney damage in MODS and it may he used for early diagnose and as a treatment target for kidney injury in MODS.

Contents in orthopaedic are independent relatively and finding out the internal relations during them is helpful to improving the effect of orthopaedic teaching.Transfer theory is important tools for clinical teaching practice,and finding out the common characteristics between the orthopaedic chapters is primary for the theory.This research focuses on the following fields:fractures,nerve injury,infection,tumor and deformity.After the common characteristics between these chapters were analyzed and discussed,we concluded that the transfer theory is helpful in orthopaedic teaching practice,especially for students' comprehension and memory,but still we should avoid some negative effects in teaching process.

OBJECTIVE: To investigate the preservation of the structure and function of the trachea and larynx, the management of laryngotracheal defect when trachea and larynx was involved. METHOD: To review the management and clinical results of 13 cases of thyroid papillary carcinoma with larynx and trachea involvement, the preservation of laryngotracheal structure and relative defect reconstruction of our department from 2007-2014. Those patients being performed total laryngectomy was excluded. 3 males and 10 females, aged from 46 to 67 years old with median age of 53 were included. Among them 8 cases were recurrent. The extent of the tumor foci was estimated with the help of computed tomography and laryngofiberoscope before surgery. Selective neck dissection, total thyroidectomy and related laryngotracheal resection was performed for the first time operation patient, while selective neck dissection, recurrent foci and related larynx and trachea resection was performed for those recurrent patients. Three kinds of modalities were applied to manage the laryngotracheal defect including to reconstruct with pedicled sternocleidomastoid clavicular periosteocutaneous flap, pedicled trapizius muscular flap and to preserve the remaining larynx and trachea and perform a stoma of larynx and trachea which repaired by a second-stage procedure. The patients were followed-up from half an year to 3 years. RESULT: Ten patients out of 13 decannulated while another 3 cases, 2 of which were performed local flap to reduce the stoma, wore tracheal tubes all time. CONCLUSION Either flap transfer or laryngotracheal stoma before second stage repair might preserve partial laryngotacheal anatomy and function in selected cases thus improve the life quality of the patients.
Aged ; Carcinoma ; surgery ; Carcinoma, Papillary ; surgery ; Female ; Humans ; Laryngectomy ; Larynx ; surgery ; Male ; Middle Aged ; Neck Dissection ; Reconstructive Surgical Procedures ; Surgical Flaps ; Thyroid Cancer, Papillary ; Thyroid Neoplasms ; surgery ; Thyroidectomy ; Trachea ; surgery

Objective To observe the biological role and the underlying mechanisms of miR-132 in liver cancer on invasion and metastasis.Methods Real-time quantitative polymerase chain reaction (RT-qPCR) analysis was used to examine the expression of miR-132 in four liver cancer cell lines (MHCC97H,HCCLYH,MHCC97L and SMMC-7721),a normal liver cell line HL-7702,and in liver tumor tissues with or without metastases.The biological effects of miR-132 transfection on human liver can-cer cells were assessed by wound assay,matrigel counting and in vivo experiments in nude mice.Western blotting was used to detect the expression of E-cadherin,α-cadherin,vimentin,fibronectin and ZEB2 in li-ver cancer cells.Immunohistochemistry was used to detect positive expression of ZEB2 in xenograft tumors.Results The expressions of miR-132 were downregulated in the four liver cancer cell lines when compared with the normal liver cell line (P ＜ 0.05),and in the liver cancer tissues with distant metastases when compared with the tissues without metastases (P ＜ 0.05).After transfection,ectopic expressions of miR-132 markedly inhibited cell migration and invasion in liver cancer cells.When compared with the control group,the expressions of E-cadherin and α-cadherin in the miR-132 transfection group were significantly increased,but the expressions of vimentin,fibronectin and ZEB2 were decreased.In addition,the numbers of metastatic lung lesions in nude mice in the miR-132 transfection group was markedly decreased when compared with the control group.The expressions of ZEB2 in the miR-132 transfection group was also significantly decreased when compared with the control group.Conclusions Transfection of miR-132 effectively inhibited invasion and metastasis of liver cancer cells in vitro and in vivo.miR-132 may become a new target for regulation of gene expression in liver cancer.