The endothelium of 20 cases of rabbit cornea including the normal and postoperated ones (2 weeks and I, 2, 3 months after penetrating keratoplasty) were observed by scanning electron microscope. The photographs of the endothelium in graft-host junction were analysed by computer-assisted image analysis system and the morphometric indexes are as follows: area of the cells, perimeters, density, figure coefficient, long axis, coefficient of variation of the area, and others. After operation the morphology and the density of the endothelial cells were different from the normal ones obviously, but the cells changed from enlargement and irregularity to normal progressively. At the time when the corneas were operated for 3 months, some differences still existed.

Objective To investigate the clinical effects of subemergency treatment of femoral intertrochanteric fractures in elderly patients.Methods From June 2013 through February 2014,47 patients older than 65 years were treated for femoral intertrochanteric fracture at our department and completed full follow-ups.Of them,20 received subemergency operation.They were 9 men and 11 women,with an average age of 72.2 ± 4.8 years.By the Evans-Jensen classification,there were 2 cases of type Ⅰ,5 of type Ⅱ,5 of type Ⅲ,5 of type Ⅳ,and 3 of type Ⅴ.The time from injury to surgery ranged from 0.5 to 1.7 days (average,0.8 days).The other 27 patients underwent selective operation.They were 11 men and 16 women,with an average age of 74.9 ± 5.7 years.By the Evans-Jensen classification,there were 3 cases of type Ⅰ,6 of type Ⅱ,6 of type Ⅲ,7 of type Ⅳ,and 5 of type Ⅴ.The time from injury to surgery ranged from 2 to 5 days (average,3.4 days).We compared the 2 groups in terms of in-hospital complications,fracture healing time,length of hospital stay,and hip scores at the last follow-up.Results All the patients were followed up for 12 to 15 months (mean,13.4 months).The rate of in-hospital complications in the subemergency operation group (35.0％,7/20) was significantly lower than that in the selective operation group (51.9％,14/27),and the length of hospital stay in the former (12.1 ± 1.6 days) was significantly shorter than in the latter (16.1 ± 1.8 days) (P ＜ 0.05).There was no significant difference between the 2 groups in fracture healing time (13.1 ± 1.8 weeks versus 13.6 ± 1.2 weeks) (P ＞ 0.05).According to the hip scores at the last follow-up,the subemergency operation group had 16 excellent,2 good,one fair and one poor cases (with an excellent to good rate of 90.0％) while the selective operation group had 21 excellent,2 good,2 fair and 2 poor cases (with an excellent to good rate of 85.2％),showing no significant difference between groups (P ＞ 0.05).Conclusion Subemergency operation can reduce not only in-hospital complications but also length of hospital stay for old patients with femoral intertrochanteric fracture.

Objective To compare the therapeutic effect and complication of immediate and selective interlocked intramedullary nailing in treatment of open tibial shaft fractures. Methods A total of 123 open tibial shaft fractures of 102 cases were treated with immediate fixation with interlocked intramedullary nailing after debridement (Group A) and with selective fixation with interlocking intramedullary nailing after debridement and closing the wound (Group B). Results The follow up for more than half a year showed that all fractures were healed, with excellent joint function of knee and ankle. Of all, 12 cases with skin necrosis and defect but without deep infection were healed after pedicle flap reconstruction. The result of Group A was much better than that of Group B in regard of total operation time, hospital stay, cost, amount of antibiotics used and partial weight bearing. No statistical difference in therapeutic effects and complications was found between two group. Conclusion Infection is not the contra-indication of interlocked intramedullary nailing in open tibial fractures. Immediate operation can be done after thorough debridement.

Objective Replacement of dexmedetomidine with propofol for maintaining the anes-thesia in elderly patients undergoing laparoscopic cholecystectomy.Methods Ninety patients,over 70 years old,undergoing laparoscopic cholecystectomy were randomly divided into 2 groups,propofol combined with remifentanil (group A),dexmedetomidine combined with remifentanil (group B),45 patients in each group.Group A was not treated with any preoperative medication,while group B was treated with loading dose of 0.5 μg/kg dexmedetomidine intravenously completed within 10 minutes. Induction methods were same in both groups,3 # or 4 # laryngeal mask were inserted after induction in both groups.Maintenance of anesthesia in group A treated with propofol 2.0-3.0 μg/ml + 4.5-5.5 ng/ml TCI;Maintenance of anesthesia in group B treated with dexmedetomidine 0.25 μg·kg-1·h-1 +remifentanil 4.5-5.5 ng/ml (TCI).HR,SBP,DBP,BIS were recorded at inserting the LMA (T1 ), beginning of the surgery (T2 ),dissociate the cholecyst (T3 ),withdrawal of the laparoscope (T4 ), extubate the LMA (T5 ).Postoperative recovery time,Steward awakening score and modified OAA/S score at extubation time were recorded.Results No significant difference was found between BIS val-ue of two groups at different time point.Compared with group A,HR at T1-T5 in group B were sig-nificantly lower,SBP,DBP were significantly decreased (P <0.05).There was no significant differ-ence between Steward awakening score and modified OAA/S score at recovery and extubation time in two groups.Conclusion Dexmedetomidine replacing propofol can be safely used in laparoscopic chole-cystectomy with less hemodynamic changes during maintenance of anesthesia in elderly patients.

This study aims to clarify out the anti-inflammatory mechanism of Qingfei Xiaoyan Wan. Chemical constituents of Qingfei Xiaoyan Wan identified by UPLC Q-TOF, were submit to Molinspiration, PharmMapper and KEGG bioinformatics softwares for predicting their absorption parameters, target proteins and related pathways respectively; and the gene chip and real time-PCR were carried out to investigate the expression of inflammatory genes on lung tissue of guinea pigs or human bronchial epithelial cell lines. The predicted results showed that 19 of the 24 absorbable constituents affected at 9 inflammation-related pathways through 11 protein targets; Qingfei Xiaoyan Wan treatment can significantly reduce the infiltration of cytokines through ERK1 gene and 5 inflammatory pathways (Focal adhesion, Fc epsilon RI, Toll-like receptors, NK cell-mediated cytotoxic, and ERK/MAPK). The results of real time-PCR further confirmed that the anti-inflammatory effects of Qingfei Xiaoyan Wan were due to active ingredients such as arctigenin, cholic acid and sinapic acid intervened focal adhesion, Fc epsilon RI signaling and ERK/MAPK pathways. The novel approach of 'drug-target-pathway' will present an effective strategy for the study of traditional Chinese medicines.

Objective To investigate the effect of microRNA-let-7a on apoptosis in melanoma cell line A375 and its mechanism. Methods The expression of microRNA-let-7a was detected in A375 cells and melanocytes by real-time PCR. Then, microRNA-let-7a mimics was transfected into A375 cells followed by the measurement of apoptosis and caspase-3 protein expression by flow cytometry and Western blotting, respectively. Results The expression level of microRNA-let-7a was reduced by 0.462 folds in A375 cells compared with melanocytes. The apoptosis rate was 47.4% in A375 cells transfected with microRNA-let-7a mimics, significantly higher than that in untransfected A375 cells (16.9%). A significant decline was observed in the expression of caspase-3 protein in A375 cells after transfection. Conclusion microRNA-let-7a can promote the apoptosis and downregulate caspase-3 protein expression, in A375 human malignant melanoma cells.

Objective Through the visual analysis of the literature about the psychological distress in core journals of the Web of Science database for improving the quality of life of clinical patients and providing the reference for formulating targeted nursing measures. Methods CiteSpace V information visualization software was used to visualize and analyze 854 articles on psychological distress in the field of nursing from January 1,2008 to December 31,2017 in core journals of the Web of Science database, and draw knowledge graph about research hotspots and research frontier. Results In the recent decade, the number of psychological distress research in the field of nursing in SCI has generally risen; the research focuses on the key words of depression, stress, breast cancer, anxiety and so on;the United States issued the highest volume of documents, mainland China ranked fifth, China Taiwan ranked seventh in core journals of the Web of Science database. Conclusion Chinese research on psychological distress in the field of nursing is still lagging behind western developed countries, and nursing staff in China should work hard.