AIM: To evaluate the effects of glycemic control on refraction in diabetic patients. METHODS: Twenty newly diagnosed diabetic patients were included in this study. The random blood glucose, HbA1c levels, fasting C-peptide and postprandial 2h C-peptide were measured before treatment. The patients with random blood glucose higher than 12.0mmol/L and HbA1c level higher than 10.0% were selected. Refraction, intraocular pressure, radius of the anterior corneal curvature, depth of the anterior chamber, lens thickness, vitreous length, and axial length were measured on admission and at the end of week 1, 2, 3 and 4 during glycemic control.RESULTS: A transient hyperopic change occurred in all the patients receiving glycemic control. The maximum hyperopic change was 1.60D (range 0.50±3.20D). Recovery of the previous refraction occurred between two and four weeks after insulin treatment. There was a positive correlation between the maximum hyperopic changes and the HbA1c levels on admission (r=0.84, P<0.05). There was a positive correlation between the maximum hyperopic changes and the daily rate of blood glucose reduction over the first 7 days of the treatment (r=0.53, P<0.05). During transient hyperopia, no significant changes were observed in the intraocular pressure, radius of the anterior corneal curvature, depth of the anterior chamber, lens thickness, vitreous length and axial length.CONCLUSION: Transient hyperopic changes occur after glycemic control in diabetic patients with severe hyperglycemia. The degrees of transient hyperopia are highly dependent on HbA1c levels before treatment and the rate of reduction of the blood glucose level.

Objective To evaluate effects of glycemic control on refraction in diabetic patients.Methods Twenty newly diagnosed diabetic patients were included in this study. The random blood glucose,glycosylated hemoglobin A1c( HbA1c) levels, fasting C-peptide and postprandial 2 h C-peptide levels were measured before treatment. The patients with random blood glucose ≥ 12. 0 mmol/L and HbA1c ≥ 10. 0%were selected. Refraction, intraocular pressure, radius of the anterior corneal curvature, depth of the anterior chamber, lens thickness, vitreous length, and axial length were measured on admission and at the end of week 1,2, 3 and 4 during glycaemic control. Results A transient hyperopic change occurred in all the patients receiving glycemic control with a mean maximum hyperopic changes of 1.6 D ( 0. 50 D ～ 3.20 D). There was a positive correlation between the magnitude of the maximum hyperopic changes and the HbA1 c levels on admission ( r = 0.84, P ＜ 0.05 ). There was a positive correlation between the magnitude of the maximum hyperopic changes and the daily rate of blood glucose reduction over the first 7 days of the treatment ( r = 0.53, P ＜ 0.05 ). There was no significant correlation between the magnitude of the maximum hyperopic changes and the levels of random blood glucose on admission. No significant correlation was observed between the maximum hyperopic changes and fasting C-peptide or postprandial 2 h C-peptide.There were no significant correlations between the magnitude of the maximum hyperopic changes and age,blood press, body mass index, triglyceride, total cholesterol, low-density lipoprotein or high-density lipoprotein. No significant changes were observed in the intraocular pressure, radius of the anterior corneal curvature, depth of the anterior chamber, lens thickness, vitreous length and axial length during glycemic control. Conclusions Transient hyperopic changes occur after glycemic control in diabetic patients with severe hyperglycaemia. The degrees of transient hyperopia are highly dependent on HbA1c levels before treatment and the rate of reduction of glucose level over the first 7 days of treatment. This is probably due to the decrease of refractive power by lens hydration, not morphological change of lens.

Adenoidectomy ; Female ; Humans ; Infant ; Male ; Retrospective Studies ; Sleep Apnea, Obstructive ; surgery

Adenocarcinoma ; diagnosis ; metabolism ; pathology ; Carcinoma, Signet Ring Cell ; diagnosis ; metabolism ; pathology ; Gene Expression Regulation, Neoplastic ; Humans ; Male ; Neoplasm, Residual ; metabolism ; Prostatic Hyperplasia ; metabolism ; Prostatic Intraepithelial Neoplasia ; metabolism ; Prostatic Neoplasms ; diagnosis ; metabolism ; pathology ; Racemases and Epimerases ; metabolism ; Sensitivity and Specificity

Objective To investigate the imaging characteristic of DWI in rabbit models of hepatic VX2 tumors after three-dimensional stereotactic conformal radiation therapy, and the characteristics of apoptosis after radiotherapy. Methods Sixty hepatic VX2 tumor models were successfully created. After the tumor grew to more than 1 cm in diameter, 40 tumor models were treated with SCRT and then divided into four groups using random number table. The remaining 20 tumor models were used as controls and randomly assigned to each group. MR scanning were performed at different time points ( 1 st day, 5 th day, 10 th day, 15 th day) for each group respectively. ROIs of the VX2 tumor tissues and normal liver tissue were taken and ADC values were measured to calculate their ratios. Cell apoptesis were determined by using TUNEL method. ADC values with their ratios and the apoptotic index were analyzed using one-way analysis of variance and SNK test was used for comparison among different time points of groups, while two sample t test was used for comparison between the groups. Results On the 1 st day, 5 th day, 10 th day, and the 15 th day, the ADC ratios of the radiotherapy groups were 0.74 ±0. 15(n =8), 1.04 ±0.09(n =7), 1.43 ±0. 12 (n = 7 ), 1.25 ± 0. 23 (n = 8 ) (F = 24. 221, P ＜ 0. 01 ), the corresponding ADC ratios of control groups were 0. 78 ±0.07(n =5), 0.79 ±0.07(n=4), 0.83 ±0. 14(n =4), 0.97 ±0. 19(n =4). The ratios of ADC values for radiotherapy groups and control group were compared, and the t value was 0. 569 ( P ＞0.05), 4.417(P＜0.05), 7.259(P ＜0.01), 1.957(P＞0.05) respectively for each time point. On the 1 st day, 5 th day, 10 th day, 15 th day, the apoptotic index of the radiotherapy groups were 0. 39 ±0. 13(n=8), 0.29 ±0.08(n=7), 0.28 ±0.07(n=7), 0.58 ±0. 19(n=8,F=8. 128,P＜0.05), while the corresponding apoptotic index of control groups were 0. 26 ±0. 13(n =5), 0. 18 ±0. 03(n =4), 0. 16 ±0. 06(n =4), 0. 18 ±0. 08(n =4,F= 1. 006,P ＞0. 05). The apoptotic index value for radiotherapy groups and control group were compared, with t value of 1. 716 ( P ＞ 0.05 ), 2. 348 ( P ＜ 0. 05 ), 2. 386 ( P ＜0. 05 ), 3. 756( P ＜0.01 ) respectively. Conclusion DWI ADC values can reflect the dynamic changes of cell apoptosis in hepatic VX2 tumors after radiotherapy at different time points.

Objective To explore the clinical the efficacy of large diameter esophagogastric internal fistula combined with fundoplication and modified Heller surgery for treatment of achalasia.Methods From June 2008 to March 2014,18 patients diagnosed as achalasia were se-lected into this suty,and they were divided into the observation group (8 cases)and the control group (10 cases).Patients of the observation group were received large diameter esophagogastric internal fistula combined with fundoplication while patients of the control group received modified Heller surgery.Compared the surgical curative effect and complications between the two groups.Results All the 18 patients suc-cessfully completed the arranged surgical treatment.The imaging examination 3 months after the operation showed that the contrast agent suc-cessfully passed through the esophagus,cardia and the anastomosis,and then went into the gastric lumen.The total effective rate was 100% in the observation group 12 months after operation,while it was 60% in the control group,and the difference between the two groups was statisti-cally significant (P =0.014).The incidence of complications in the observation group was lower than that of the control group,the difference was statistically significant (P =0.026).Conclusion Large diameter esophagogastric internal fistula combined with fundoplication for treat-ment of achalasia is safer,and there is a possibiltiy to cure the achalasia.

Objective To investigate the feasibility and the perioperative treatments of repairing atrial septal defects and bilateral lung transplantation in treatment of ASD with Eisenmenger's syndrome.Methods On May 24th,2016,one case of atrial septal defect with Eisenmenger's syndrome underwent repair for the atrial septal defect with bilateral sequential lung transplantation aided by extracorporeal circulation ECMO in Zhongshan People's Hospital.In strict accordance to the procedure,the lung was collected and preserved with the HTK solution.The operation went smoothly,the cold ischemic time for the right lung was 120 min and that for the left lung was 260 min.Postoperatively,Tacrolimus (FK506) + Mycophenolate Mofetil (MMF) + adrenal cortical hormone Sanlian immunosuppression was used.Results At 60th h post-operation the patient was hemodynamically stable,with good oxygenation after removal of the ECMO.At 7th day post-operation the patient was extubated.At 12th-20th day post-operation bacterial culture of the sputum was found to be positive and the patient was treated with the corresponding sensitive antibiotics and recovered.Cardiac ultrasound before discharge showed that there was no residual shunt.One month after discharge the cardiopulmonary function of the patient was quite good,chest X-ray showed that the bilateral transplanted lungs were clear and the patient's quality of life was much better.Conclusion Cardiac malformation repairs with bilateral lung transplantation is a feasible treatment for patients with end-stage Eisenmenger's syndrome with bi-directional shunts.The key to success is sufficient preoperative preparation,and a smooth operation with the timely and effective treatment of postoperative complications.

Objective To analyze the clinical features of infantile cytomegalovirus(CMV) hepatitis with cholestasis and investigate intrahepatic cholestasis due to hepatocytic impairment caused by CMV infection.Methods Forty-seven children with CMV cholestatic he-patitis were divided into 2 groups according to the level of total bilirubin(TB):22 cases with serum TB lower than 136.8 ?mol/L(groupⅠ),and 25 cases with serum TB higher than 136.8 ?mol/L(groupⅡ).All children were treated with both gangciclovir and routine met-hods,and serum biochemistry were checked before and after treatment.SPSS 13.0 software was used to analyze the data.Results Forty-seven cases of infantile CMV cholestatic hepatitis had different degrees of jaundice,hepatosplenomegaly and abnormal liver functions.The differences of serum ALT and AST between the 2 groups had statistical significance,the levels of serum gamma glutamy transferase(GGT) and alkaline phosphatase(ALP) were lightly higher in groupⅡcompared with those in groupⅠ,but there were no statistical significance.TB,direct bilirubin(DB),ALT and AST were decreased in the 2 groups after treatment,GGT and ALP hadn′t decreased significantly after treatment.Conclusions CMV infection can injure hepatocytes and epithelials on each grade of bile duct,thus CMV hepatitis causes intrahepatic cholestasis.Cholestasis due to hepatocytic impairment deserves emphasis and intervention should be done as early as possible.Gangciclovir therapy for CMV infection manifest effective and safe in short-term.

Objective:To investigate the therapeutic effect of carbon dioxide laser tonsillectomy.Method:In this prospective,randomized study, One hundred and two patients were divided into laser group or control group. Patients of laser group were cured with carbon dioxide laser tonsillectom,and the control group was cured with routine method. All operations are executed by one person. Observation index included operation time, hemorrhage in operation, ache after operation, inflammatory reaction of raw surface, repair time of raw surface, rehaemorrhagia and scar.Result:Laser group had advantages of less operation time, less hemorrhage, less ache and less inflammatory reaction of raw surface. Laser group have hemorrhage in operation (7.2±2.1)ml, while control group have hemorrhage in operation (92.0±35.0)ml. Laser group have pseudomembrane early but desquamate late.Conclusion:Carbon dioxide laser tonsillectomy is effective to relieve pain, inflammatory reaction and with less time ,it's an safe , efficient and mini-trauma operation.

Objective To discuss the imaging technology and characteristic of perfusion-weighted imaging in rabbit models of hepatic VX2 tumors. Methods Twenty-eight New Zealand rabbits were implanted in liver with VX2 tumor by tissue block. After routine scans were performed on 1.5 T MR scanner, 28 New Zealand white rabbits with VX2 carcinoma were divided randomly into treatment group and control group. Treatment group was divided randomly into group A, group B and group C, 7 animals per group. Perfusion weighted imaging(PWI) was performed in day 14, 25 and 35, respectively, after tumor implantation in all animals. Select the regions of interest (ROI) of the VX2 tumor center, tumor border and pars-tumor parenchyma. Maximal signal reduction slope ( SRSmax ) of the signal intensity versus time curves were created as quantitative variable, and the parameters were calculated and compared in all groups. Results Maximal signal reduction slope ( SRSmax ) of the signal intensity versus time curves were studied in 4 groups, 23 VX2 rabbits,7,5 and 6 in group A , B and C, respectively. The SRSmax of tumor center were ( 12. 6 ± 3.4), ( 9. 8 ± 2. 6 ) and ( 1.0 ± 0. 4 ), the difference was significant ( F = 10. 855, P < 0. 05 ). The SRSmax of tumor border were(48. 3 ± 2.4), (46. 2 ± 1.5 ) and (43. 6 ± 1.8 ) ( P > 0. 05 ). The SRSmax of para-tumor parenchyma were ( 14.4 ± 3.0 ), ( 12. 2 ± 1. 4 ) and ( 14. 8 ± 5.0 ) ( P > 0. 05 ). The difference was significant in different ROI in treatment groups( F value was 7. 435,8. 625 and 12. 595, respectively, P < 0. 05 ). Conclusion PWI can be used in evaluating the liver tumor angiogenesis and angio-degeneration with the treatment of HIFU. It will be possible for qualitative analysis of rabbit models of hepatic VX2 tumors by different treatments.