Age-related macular degeneration (AMD) and cataract are the most common causes of low vision worldwide.Nowadays, there is still a controversy about whether cataract surgery should be taken in patients combined with AMD and when should the surgery be taken.The aim of this review is to assess the influence of cataract surgery on the occurrence and development of AMD, to analyze the risk factors, to explore the occasion of cataract surgery in patients with AMD, and joint with anti-vascular endothelial growth factor (VEGF) treatment, also including the development and application of intraocular lens.It helps to avoid and postpone the development and progression of macular degeneration after cataract surgery and get good visual outcome.

Carcinoma in Situ ; diagnosis ; pathology ; surgery ; Carcinoma, Transitional Cell ; diagnosis ; pathology ; surgery ; Cystectomy ; Humans ; Neoplasm Invasiveness ; Neoplasm Staging ; methods ; Urinary Bladder ; pathology ; surgery ; Urinary Bladder Neoplasms ; diagnosis ; pathology ; surgery

Antineoplastic Agents ; therapeutic use ; Apoptosis ; drug effects ; Caspases ; metabolism ; physiology ; Enzyme Activation ; Fas Ligand Protein ; metabolism ; Humans ; NF-kappa B ; metabolism ; Neoplasms ; metabolism ; therapy ; Neovascularization, Pathologic ; Proto-Oncogene Proteins c-bcl-2 ; metabolism ; Signal Transduction

OBJECTIVETo investigate the causes and managements of postoperative neurological complications in pedicle screw internal fixation for the treatment of degenerative scoliosis (DS).

METHODSThe data of 325 patients with degenerative scoliosis underwent pedicle screw internal fixation was retrospectively analyzed from February 2000 to April 2013. There were 22 patients with postoperative neurological complications. Of them, 16 cases complicated with numbness or pain of lower limb and 6 cases with obvious sensation and motor function decreasing in lower limb. The patients were treated with trophic nerve, dehydration, glucocorticoids, reoperation according to the causes of disease. Postoperative at 3, 6 months and 1 year later, according to VAS scoring and muscule power improvement,the recovery of nerve injury was assessed.

RESULTSPostoperative at 3,6 months and 1 year later,VAS scoring of 16 patients with slightly nerve injury was 2.81 +/- 0.66, 1.94 +/- 0.77, 0.63 +/- 0.62, respectively, and the symptoms had obviously improved than 1 week after operation (P < 0.05). Postoperative at 3 months, among 6 patients with severe nerve injury,muscule power improved in 2 cases and no-improved in 4 cases, with VAS scoring of 4.83 +/- 1.17; postoperative at 6 months,muscule power still had not improved in 3 cases,with VAS scoring of 4.17 +/- 0.75; both of the VAS scoring had not significant difference than 1 week after operation (P > 0.05). One year later, there was no muscule power improvement in 2 cases,with VAS scoring of 3.00 +/- 1.26, there was significant difference than 1 week after operation (P < 0.05).

CONCLUSIONThe causes of postoperative neurological complication in internal fixation for the treatment of dengenerative scoliosis includes: dragging and torsion injury of spinal marrow and nerve root because of excessive orthopedic of scoliosis; inderect injury of nerve root because of malposition of pedicle screw; nerve functional impairment caused by spinal cord ischemia. Avoiding the above factors could decrease the complication and early discovery and treatment could decrease the adverse outcomes.

Aged ; Aged, 80 and over ; Bone Nails ; adverse effects ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Nervous System Diseases ; etiology ; Postoperative Complications ; etiology ; Retrospective Studies ; Scoliosis ; diagnostic imaging ; surgery ; Tomography, X-Ray Computed

ObjectiveTo study the characteristic of apoptosis and the expression of interleukin-1β(IL-1β)and caspase-3, as well as the relation among them after spinal cord injury(SCI) in rats.MethodsAdult SD rats were divided into two groups randomly: sham group and spinal cord injury group. The rats were killed at 1 h, 8 h, 24 h, and 72h after surgery. The expression of IL-1β and caspase-3 was determined with immunohistochemistry and the apoptosis was labeled by TUNEL.ResultsThere was only a few cells that expressed low level IL-1β and caspase-3 in sham group, but they both enhanced in SCI group within 8 h after operation, and then decreased to the level similar to sham group 72 h after operation. The rates of TUNEL-positive cells were similar with that of IL-1β and caspase-3 after SCI. There was positive correlation among expression of IL-1β and caspase-3 and apoptosis index.ConclusionExpression of IL-1β and caspase-3 increase and a large number of TUNEL-positive cells present after SCI in rats, and there is positive correlation among them.

Objective To explore the application value of plastic biliary stent and fully covered self-expandable metallic stent (FCSEMS) in endoscopic retrograde cholangio pancreatography (ERCP) for treatment of benign biliary stricture after liver transplantation.Methods The retrospective cross-sectional study was conducted.The clinical data of 54 patients with benign biliary stricture after liver transplantation undergoing ERCP treatment who were admitted to the First Affiliated Hospital of Xi'an Jiaotong University between January 2010 and August 2016 were collected.Among 54 patients,44 had simple anastomotic stricture and 10 had non-anastomotic stricture.All the patients underwent stent implantation by ERCP.Patients with stricture within 1 month postoperatively initially selected single plastic stent or endoscopic nasobiliary drainage (ENBD),and then changed into multiple plastic stents at the second stent replacement.Patients with stricture after 1 month postoperatively selected multiple plastic stents,multiple plastic stents after balloon dilation or FCSEMS.Observation indicators:ERCP situations,stent implantation,time of stent indwelling,postoperative complications,stent dislocation,treatment outcome and follow-up situations.Patients were followed up by outpatient examination and telephone interview up to November 2016.Clinical symptoms of patients were observed within 1 month postoperatively and liver function and abdominal ultrasound were retested.Liver function and remission degree of biliary stricture were monitored regularly once every 3 months.Measurement data were described as average (range).Results All the patients underwent successful ERCP,of which 53 completed the process of ERCP and 1 rejected treatment due to economic problems.All the 54 patients received 140 times ERCPs with an average of 2.59 times per person,21 times ENBDs,11 times FCSEMSs and 108 times plastic stent implantations (including 35 times single stent implantations,46 times double stents implantations,23 times 3-stents implantations and 4 times 4-stents implantations).All the 54 patients were followed up for 3-143 months,with an average time of 73 months.Of 44 with anastomotic stricture,34 received plastic stent implantation and 98 times ERCPs,with an average number of stent implantation of 2 (range,1-4) and an average time of stent indwelling of 10.7 months (range,9.0-13.0months);the postoperative acute pancreatitis,biliary infection,hyperamylasemia and adverse stent implantation or dislocation were detected in 4 persons every time,7 persons every time,10 persons every time and 3 persons every time,respectively;26 patients were cured and 5 were improved,with an effective rate of 91.2％ (31/34);3 patients with noneffective treatment continued to undergo ERCP and 3 patients had recurrence of anastomotic stricture.Among 10 patients with initial FCSEMS implantation,12 times ERCPs were performed,with an average time of stent indwelling of 7.6 months (range,6.0-12.0 months);postoperative biliary infection,hyperamylasemia and stent dislocation were detected in 1 person every time,1 person every time and 1 person every time,respectively;8 patients were cured,with an effective rate of 8/10;of 2 patients with persistent stricture,1 patient received contrast examination after stent removal,showing a comparative stricture in level 1 branch of intrahepatic duct and considering combined ischaemia,and then underwent the second implantation using multiple plastic stents;the other patient had elevated level of jaundice at 3 months after stents removal and received ERCP,showing anastomotic inflammatory polyp,and then underwent FCSEMS implantation again.Ten patients with non-anastomotic stricture received plastic stent implantation and 30 times ERCPs,with an average number of stent implantation of 3 (range,2-4) and an average time of stent indwelling of 11.3 months (range,10.0-14.0 months);the postoperative acute pancreatitis,biliary infection,hyperamylasemia and adverse stent implantation or dislocation were detected in 2 persons every time,5 persons every time,2 persons every time and 1 person every time,respectively;3 patients were cured and 3 were improved,with an effective rate of 6/10;of 4 patients with noneffective treatment,2 died of gradually deteriorating liver function and 2 underwent the second liver transplantation.Conclusions Stent implantation in ERCP is safe and effective for treatment of benign biliary stricture after liver transplantation,single plastic stent should be used in the early period (within 1 month) and multiple plastic stents should be used in the later period.Although FCSEMS has a higher displacement rate,it should be recommended due to a better clinical effect,lower incidence of complications and simple operation.For patients with non-anastomotic stricture,plastic stent should be used for extrahepatic biliary stricture,with a good clinical effect,and there is worse effect in stent implantation through ERCP for multiple intrahepatic biliary strictures.

Objective To evaluate left ventricular rotation and torsion and its early recovery after percutaneous coronary intervention (PCI) in patients with coronary heart disease and normal left ventricular ejection fraction (LVEF) using two dimensional speckle tracking echocardiography.Methods Twenty three consecutive patients with coronary heart disease and normal LVEF were divided into group B (with coronary stenosis ＜70％) and group C (with coronary stenosis ＞70％ and with PCI).Along with 11 healthy controls(group A),indices including basal rotation (BR),apical rotation (AR),left ventricular torsion (LVT) and normalized time to peak were compared among groups,correlative analysis was made between LVT and each indices mentioned above,indices of group C before and 24 hours after PCI were compared.Results AR,LVT in group B and C reduced relative to group A (P ＜0.05),meanwhile time to peak of BR in group C shortened relative to other groups.BR,AR and normalized time to peak of BR were correlated to LVT respectively.BR and LVT in group C increased after PCI(P ＜0.05).Conclusions AR was sensitive to ischemia,the reduction of time to peak of BR in group C might be restriction and compensation.Sensitive to early recovery of left ventricular function after reperfusion,BR could be a predictive index of early effect of percutaneous coronary intervention.

This study was aimed to observe different forms of β-amyloid peptide (Aβ) and insulin degrading enzyme (IDE) in the hippocampus and cortex in order to further explore the role of Aβ and IDE on spleen yin deficiency di-abetes-associated cognitive decline (DACD), and the effect of Zi-Bu Pi-Y in method. The rats were randomly divided into five groups, which were the blank control (Cont) group, diabetes (DM) group, spleen yin deficiency (pi) group, spleen yin deficiency diabetes (piDM) group and Zi-Bu Pi-Y in recipe (ZBPYR) group. Soluble and insoluble Aβ in the hippocampus and cortex of rats were extracted by gradient centrifugation, and then measured by ELISA. The ex-pression of IDE was observed by western blot. The results showed that the content of soluble and insoluble Aβ1-42 in the hippocampus and cortex of the DM group and piDM group were higher than the Cont group. The soluble and in-soluble Aβ1-42 content in the hippocampus and cortex of the ZBPYR group were reduced compared with the DM group and the piDM group. The soluble Aβ1-40 in the cortex of the DM group, pi group and piDM group were in-creased compared with the Cont group (P < 0.05). The soluble Aβ1-40 content of the ZBPYR group was decreased compared with the DM group and the piDM group (P < 0.05). The expression of IDE protein was decreased in the hippocampus of the DM group and the piDM group compared with the Cont group (P< 0.05), and the IDE protein level in the hippocampus of the ZBPYR group was increased compared with the DM group and the piDM group (P<0.05). The expression of IDE protein in the cortex of the DM group, pi group and piDM group was lower than the Cont group (P< 0.05). The IDE protein level in the cortex of the ZBPYR group was reduced compared to the DM group (P< 0.05). It was concluded that the increased Aβ1-42 in brain may be a major pathological change of DACD and spleen yin deficiency DACD. The decreased IDE expression may be one of the reasons to induce increasing of Aβ1-42 level. The Zi-Bu Pi-Y in method may decrease the Aβ1-42 content by upregulating IDE protein expression.

Objective To investigate the combination application of the intracranial buried electrode and electrical stimulation techniques in excising the epileptogenic zone in the central zone.Methods Seven patients with epileptogenic zone located close to or in the central zone of brain were recruited in the present study.The lone term ECoG monitoring and electrical stimulation of the codex were performed to identify the epileptogenic zone and the central zone of the brain after patients received intracranial electrode implants.The epileptogenic zone was excised with maximum preservation of the cen-tral zone.The patients were follow-up for 6 to 12 months,the outcomes were evaluated based on the Engel's scale and the Karnofsky(KPS)score.Results Seven patients did not experience any seizures and their Engei's and KPS scores were markedly improve after operation.Conclusions Intracranial buried electrodes and cortical electrical stimulation can guide the resection of epileptogenic zone in the central zone.Patients have no seizure and no serious dysfunction after operation and their quality of life was improved markedly.

A series of novel N-acyl-thiochromenothiazol-2-amine derivatives were designed and synthesized, furthermore, their inhibition effect on acetylcholinesterase was investigated. N-Acyl-thiochromenothiazol-2-amines were prepared from thiophenol by Hantzsch reaction, acylation reaction and substitution reaction. Moreover, their bioactivities as AChE inhibitors in vitro were measured with Ellman spectrophotometry. The results showed that most of them had a certain inhibition activity on AChE, and the compound 10a was the best in them. The IC50 of 10a to AChE is 7.92 μmol x L(-1), and the value is better than that of rivastigmine. N-Acyl-thiochromenothiazol-2-amine derivatives showed a certain bioactivity in vitro, which were worth further investigation.
Acetylcholinesterase ; metabolism ; Amines ; chemical synthesis ; pharmacology ; Benzopyrans ; chemical synthesis ; pharmacology ; Cholinesterase Inhibitors ; chemical synthesis ; pharmacology ; Rivastigmine ; Structure-Activity Relationship ; Thiazoles ; chemical synthesis ; pharmacology