Adult ; Coke ; adverse effects ; DNA Damage ; drug effects ; Female ; Humans ; Male ; Monitoring, Physiologic ; Occupational Exposure ; adverse effects

Objective To present and summarize the data concerning the treatment and prognosis of acute limb arterial embolism in West China Hospital.Methods Forty three patients with 52 limbs of acute arterial embolism were treated in West China Hospital from January 2003 to March 2006.There were 15 males and 28 females,aging from 26 years to 77 years 〔(58.88?13.90) years〕.The diagnosis was based on clinical manifestations and results of color Doppler sonography or DSA.The follow-up ranged from 1 month to 39 months.The following factors,which might influence the prognosis,were analysed through multiple linear regression of SPSS 10.0:age,sex,uper limb or lower limb,location of embolus,ischemic time,clinical categories of acute limb ischemia,history of smoking,atherosclerosis and other combined diseases,pervious history of acute limb arterial embolism,operative or nonoperative treatment,and postoperative complications.Results Clinical categories of acute limb ischemia include:Ⅰ(n=0),Ⅱa(n=16),Ⅱb(n=29),Ⅲ(n=7).The ischemic time varied from 3 h to 2 weeks.The sources of embolus:heart(n=39),vessle(n=7),iatrogenic origin(n=1),unidentidied origin(n=5).The therapies included embolectomy(n=38),catheter-directed thrombolysis(n=2) and medical treatment(n=12).The following postoperative complications occured:compartment syndrome(n=12),respiratory failure(n=3),alkalolsis(n=3),acute renal failure(n=2),wound infection(n=2) and pulmonary infection(n=1).Two patients died of cerebral infarction in hospital and one patient died of heart failure 3 months after discharge.Thirty-eight patients with 45 diseased limbs were followed up.The results were excellent in 13 limbs,good in 15 ones,fair in 8 ones and poor in 9 ones.The statistically significant influencing factors of prognosis include ischemic time,clinical categories of acute limb ischemia and history of smoking(P

AIM: To compare the visual acuity and contrast sensitivity of eyes with different corneal spherical aberration implanted with the same aspherical IOL and evaluate the effect of different ocular spherical aberration on visual performance after phacoemulsification.
METHODS:It was a prospective case series study. Forty-six eyes of thirty-nine age-related cataract patients in our department were included. The patients were divided into 3 groups according to the value of preoperative corneal spherical aberration. Eyes with corneal spherical aberration≤0. 2μm were assigned to group A, those with corneal spherical aberration >0. 2μm and ≤0. 3μm to group B, and those with corneal spherical aberration≥ 0. 3μm to group C. All patients underwent phacoemulcification and recieved AcrySof IQ aspheric IOL. Uncorrected visual acuity ( UCVA ) , best-corrected visual acuity( BCVA) , contrast sensitivity, and total ocular higher - order aberrations for a 6. 0mm pupil were recorded 3mo postoperatively. ANOVA were used to analyze the data.
RESULTS: There were no significant differences in UCVA and BCVA between the 3 groups (P=0. 287, 0. 115). Contrast sensitivity was no statistically significant difference between the 3 groups at any spatial frequency under photopic、 mesopic, and mesopic with glare conditions (P>0. 05). With a 6. 0mm pupil diameter, root mean square values for total ocular higher - order aberrations were lower in groups A and B than that in group C (P=0. 000). The difference of total ocular spherical aberration was statistically significant between the 3 groups (P=0. 000). Coma and trefoil were similar between the groups (P=0. 788,0. 590), with no statistically significant differences.CONCLUSION:Implantation of the same aspherical IOL in eyes with different corneal spherical aberration results in similar visual acuity and contrast sensitivity. Small differences of ocular spherical aberration after phacoemulsification have no effect on visual performance.

Objective To evaluate the relationship between changes in B-type natriuretic peptide(BNP) and cardiac troponin I(cTnI)levels and prognosis of critically ill patients with sepsis. Methods This study retrospectively reviewed the clinical data of 75 patients with severe sepsis and septic shock admitted into Emergency Intensive Care Unit(EICU)of the First Affiliated Hospital of Wenzhou Medical University in Zhejiang Province. According to the severity of the cases,they were divided into two groups:severe sepsis group(34 cases)and septic shock group(41 cases),and based on the difference in prognosis,they were divide into survivor group(32 cases) and non-survivor group(43 cases). Electrocardiogram(ECG)was performed within 24 hours after admission in all the patients. Acute physiology and chronic health evaluation Ⅱ(APACHEⅡ)score and biochemical markers showing organ dysfunctions as BNP, cTnI, creatine kinase (CK), creatine kinase MB mass(CK-MB), and lactate were compared between severe sepsis and septic shock groups and between survivor and non-survivor groups. Results The septic shock group had significantly higher baseline BNP,cTnI,lactate and APACHE Ⅱscore and mortality rate than those in severe sepsis group〔BNP(μg/L):1.90(1.08,2.79)vs. 0.41(0.31,0.75),cTnI (μg/L):1.15(0.92,1.28)vs. 0.58(0.40,0.79),lactate(mmol/L):6.63±3.72 vs. 3.28±1.66,APACHEⅡscore:26.00(24.00,28.00)vs. 21.50(20.00,29.25),mortality rate:70.73%vs. 41.18%,P<0.05 or P<0.01〕. Compared with survivor group,the ages of non-survivor group were older with more males and higher BNP,cTnI,lactate and APACHEⅡscore〔males(cases):30 vs. 13,age(years old):66.49±14.97 vs. 58.19±17.05,BNP:1.60(0.62, 2.51)vs. 0.57(0.37,1.79),lactate:4.10(3.00,9.00)vs. 3.10(2.13,4.18),cTnI:1.02±0.49 vs. 0.62±0.37, APACHE Ⅱ score:28.00(25.00,30.00)vs. 21.00(20.00,25.75),P<0.05 or P<0.01〕. However,there were no statistically significant differences in the levels of CK and CK-MB between the above compared groups(both P>0.05). The patients' ECGs had no obvious changes. Conclusions High plasma BNP and cTnI levels in patients with sepsis may suggest myocardial damage and relatively bad prognosis. The examination of BNP and cTnI levels may help clinicians to early detect the high-risk patients with septic cardiac dysfunction and assess their prognoses.

· AlM: To observe the characteristic of choroidal circulation in diabetics and investigate its changes as well as the relationship between it and the development and progression of diabetic retinopathy ( DR) .
·METHODS:All 45 diabetics were divided into 3 groups:no diabetic retinopathy ( NDR), nonproliferative diabetic retinopathy ( NPDR ) , proliferative diabetic retinopathy ( PDR);and 20 health people were selected to be control group.All subjects were examined by FFA and indocyaine green angiography ( lCGA ) ( Heidelberg retina tomography, Germany ) at the same time. The characteristics of angiograph results were comparatively observed and the feature of diabetic choroidapathy were analyzed.
· RESULTS: ( 1 ) There were no significant differences between DR groups and control group in the central retinal artery ( CRA ) filling time.There were significant decreases of the choroidal artery filling time in DR groups, compared to the control group (P<0.05).(2) ln all DR groups, the more serious DR, the bigger proportion of reverse filling.( 3 ) With more serious DR, the ratio increased gradually in early phase of choroidal filling deficiency angiograph and in the late phase of spot hyperfluorescence.
·CONCLUSlON:lCGA may be a useful adjunct to FFA in the evaluation of choroidal vascular changes in DR.The research provides that the diabetic choroidal circulation was abnormal before the occurrence of DR, which fully proved the presence of diabetic choroidopathy.

Heat shock protein 27 ( HSP27 ) is an endogenous protein that plays an important role in a great variety of physio-logical and pathological processes. It can express a large number under body stress conditions. Recent studies have shown estro-gen upregulates the expression of HSP27 through a number of ways, playing a perfect “triple protection” role. In the early stage of atherosclerosis, estrogen induces the phosphorylation of HSP27 via PI3K/Akt signaling pathway. Phosphorylation of HSP27 can resist the injury of vascular endothelial cells( VECs) through an antioxidant and anti-apoptotic pathway as well as the inhibition of cytochrome C. In the stage of forming foam cells, estrogen induces the expression and release of HSP27 from mac-rophages by stimulating the estrogen receptor β ( ERβ) , then HSP27 inhibits the LDL uptake and the release of proinflammato-ry cytokine by binding scavenger receptor A ( SR-A) . During the proliferation and migration of vascular smooth muscle cells ( VSMCs) , estrogen induces estrogen receptor α ( ERα) and protein phosphatase 2 ( PP2A) to form a complex that enhances the activity of PP2A, then it can lead to the dephosphorylation of HSP27 and finally inhibit cells proliferation and migration. In summary, the anti-atherosclerotic effect of estrogen is closely re-lated to the role of HSP27. Given the side effects of estrogen re-placement therapy( MHT) , regulating HSP27 may provide a no-vel therapy for the prevention and treatment of cardiovascular dis-eases in menopausal women clinically.

OBJECTIVETo investigate the dynamic changes of the epididymal size 1 year after vasectomy.

METHODSFifty male volunteers received vasoligation. Before and at 1, 2, 3, 6, and 12 months after operation, we measured the size and detected the internal echoes of the epididymis using color Doppler ultrasonography.

RESULTSThe bilateral epididymides were both thickened post-operatively in all the 50 cases, with statistically significant differences between the baseline and the 1st month, the 1st and the 2nd month, the 2nd and the 3rd month, or the 3rd and the 6th month after surgery (all P < 0.01), but not between the 6th and the 12th month (P > 0.05).

CONCLUSIONWithin 6 months after vasectomy, the bilateral epididymides manifested a progressive thickening, but basically restored their balance of secretion-absorption after 6 months.

Epididymis ; diagnostic imaging ; pathology ; physiology ; Humans ; Male ; Organ Size ; Postoperative Period ; Time Factors ; Ultrasonography, Doppler, Color ; Vasectomy

As the ubiquitous nucleic acids recognizing motif, Zinc finger protein play important role in regulation of gene expression. The study of recognization specific will greatly facilitate understanding the delicate interaction of Zinc finger protein and DNA. By the choice of expression vector, the induction and culture conditions, the DNA binding domain of Zif268 was expressed in Escherichia coli partly solubly. The gel mobility shift assay shows that purified DNA binding domain can bind its natural target sequence specifically, which indicates the DNA binding domain remains its DNA binding activity in Escherichia coli. The functional expression of DNA binding domain of Zif268 will greatly facilitate the development of in vivo genetic selection assay for the study of Zinc fingers-DNA interaction.
DNA-Binding Proteins ; genetics ; Electrophoretic Mobility Shift Assay ; Escherichia coli ; genetics ; metabolism ; Gene Expression ; Genetic Vectors ; genetics ; Zinc Fingers ; genetics

OBJECTIVETo study the anatomy of angular nerve (AN), so as to provide safe approach for the denervation surgery of corrugator supercilii, depressor supercilii and procerus.

METHODS10 fresh cadaver (20 sides)were perfused and fixed with formalin. Dissection was performed in the 10 x operating microscope. The plexus of the zygomatic branch and the buccal branch were detected to confirm the AN. The relationship of AN with the surrounding blood vessels was observed. We tracked AN until it entered corrugator supercilii, depressor supercilii and procerus.

RESULTS(1) AN was classified into I, II, III type according to its formation pattern. Type I (20%, 4/20 sides) AN is single, which is mainly from the plexus of buccal branch plus the zygomatic branch from the orbicularis oculi muscle. In type II (20%, 4/20 sides), the single AN was formed by buccal branch plexus and zygomatic branch plexus in the "Four Muscle Gap". In type III (60%, 12/20 sides), the AN had two branches in the "Four Muscle Gap". (2) The three types AN passed inferior to the support ligament at the suborbital part, and then transversed medial to the support ligament at the medial canthus, along the vessels of medial canthus. (3) The branch of AN enters the depressor supercilii or procerus 2.19 to 4.28 mm above the medial canthus ligament. The backward branch enters the levator labii superioris alaeque nasi 6.89 to 9.38 mm below the medial canthus ligament.

CONCLUSIONSThe approach of denervation surgery for AN should be performed medial to the support ligation, between 2.19 mm above the medial canthus and 6.89 mm below the medial canthus.

Adult ; Cadaver ; Denervation ; Facial Muscles ; innervation ; Facial Nerve ; anatomy & histology ; surgery ; Female ; Humans ; Male

Objective To optimize the nasal examination procedures for preliminary medical selection of pilot cadets,to reduce the use of medicine for nasal congestion,to simplify the workflow and to improve the efficiency.Methods In the course of recruiting pilots,all the 306 candidates in seven districts of a province were selected and randomly divided into the exercise-first group (n =166) and the spraying-first group (n =140).In the exercise-first group,the nasal cavity of the students was observed under the anterior rhinoscope at three time points:before exercise/spraying,after simple exercise,and after exercise/spraying(exercise first).In the second group,the nasal cavity was observed under the anterior rhinoscope at three time points:before exercise/spraying,after simple spraying,and after exercise/spraying(spraying first).Conclusions were drawn after nasal examination,and the percentage of clear conclusions in each group was statistically analyzed.Results In the case of simple exercise or simple nasal spraying,clear conclusions could be drawn about most of the candidates.There was no significant difference between the simple nasal spraying group and simple exercise group in the rate of clear conclusions.Conclusion During the preliminary recruitment of pilot students,the exercise method can be used to shrink the nasal cavity.For a few candidates whose conclusions cannot be drawn after exercise,nasal spray can be added to reduce congestion improve efficiency,and reduce the use of nasal congestion,thus reducing the indireet damage to candidates.During the re-check and final check,the nasal spray agent can be used to reduce the congestion and at the same time fast squatting 50 times in two minutes can be used as a the nasal cavity contraction method.