Background Wearing of soft contact lens,as one of the important methods to correct ametropia,has been widely applied at present.The clinically deleterious effects of soft contact lens have been reported,but researches about influence of apoptosis of corneal epithelial cells are scant.Objective This study was to detect and compare the ratio of apoptosis of corneal epithelial cells between the patients with contact lens wearing and without contact lens wearing,and explore the influence of soft contact lens wearing for long term on growth of corneal epithelial cells after injury.Methods A retrospective nest case-controlled study was designed.Forty eyes of 20 myopic patients with wearing of soft contact lens for ≥5 years and 40 eyes of 20 myopic patients without wearing of soft contact lens were included in Affiliated Hospital of Guiyang Medical College.All the patients received the off-flap epipolis laser in situ keratomileusis (Epi-LASIK) from 2010 October to 2011 June.The corneal flaps were collected during the surgery.The apoptosis of corneal epithelial cells was detected by flow cytometry(FCM),and the difference of apoptotic proportion between the two groups was compared using independent sample t test.Results The FCM scatter plot showed that compared to the without contact lens wearing group,the early stage of apoptotic cells with high staining annexin V and low staining proaium iodide (PI) were much more,and survival cells with low staining annexin V and PI were less,and necrotic and late stage of apoptotic cells with high staining of annexin V/PI were more in the with contact lens wearing group.The early stage of apoptosis proportion of corneal epithelial cells was (11.23 ± 5.31)％ in the with contact lens wearing group,and that in the without contact lens wearing group was (7.31± 5.43)％,showing a significant difference between them (t=2.754,P=0.008).Conclusions A long term wearing of contact lens induce more apoptosis of corneal epithelial cells,which can result in a disorder of structure and function of ocular surface during the wound healing stage.

Background Epipolis laser in situ keratomihusis(Epi-LASIK) is an potential surgery for myopia because it synthesize advantages of LASEK and LASIK. But its clinical effectiveness and safeness is remarkable.Objective This study was to evaluate the clinical curative effects and safeness of Epi-LASIK for myopia in different diopter of population. Methods Retrospective study was designed for 208 eyes of 104 patients who underwent EpiLASIK for the correction of myopia. The patients were divided into two groups according to preoperative diopter:lower myopia group( ≤ -6.00 D, 111 eyes) and high myopia group ( ＞-6.00 D,97 eyes). The time of epithelial healing, postoperative syndrome, postoperative visual acuity, refraction, intraocular pressure (IOP) , the safe index, the efficacy index and haze were evaluated at 1,3,6,12 months postoperatively. The written informed consent was obtained from each individual before surgery. Results After operation, 20 eyes ( 18.02% ) of lower myopia group and 29 eyes (29.90%) of high myopia group had obvious pain, presenting statistically significant difference between two groups (X2 = 4. 060, P＜0.05 ). The mean time of epithelial healing was (5.49±0. 83 )days in lower myopia group and (5.85± 0.68 )days in high myopia group with a delayed epithelial healing time in high myopia group( u= 3. 377 ,P＜0.05 ).One year after the treatment,the uncorrected visual acuity( UCVA ) ≥ 1. 0 was 90. 99% ( 101 eyes) in lower myopia group and 75.26% ( 73 eyes) in high myopia group, and 9.91% ( 11 eyes) and 15.46% ( 16 eyes) of the eyes improved byl line or more in best spectacle corrected visual acuity(BCVA) ;whereas 3.60% (4 eyes)and 6. 18% (6 eyes)lost a line or more. 91.89% ( 102 eyes) and 85.57% (83 eyes) in both groups gained within 1.00 D of the attempted correction. The safety index and efficacy index were 1.04 and 0. 98 in lower myopia group,and 1. 01 and 0. 96 in high myopia group without statistically significant difference( P＞0. 05 ). haze occurred in 6 eyes in lower myopia group and 9 eyes in high myopia group and the difference in haze grading was not statistically significant between two groups ( P＞0. 05 ). The high intraocular pressure appeared in 10 eyes and 9 eyes in low myopia group and high myopia group respectively during the fellow up duration and back to normal after topical use of timolol. Conclusion Epi-LASIK is an effective and safe method for correction of different diopters of myopia because of its mild symptom and lower incidence of haze.

Child ; Echocardiography ; Humans ; Male ; Myocardial Infarction ; diagnosis ; Myocarditis ; diagnosis ; virology

Purpose To investigate the effect of subcellular location of tumor BRCA1 on the sensitivity to ionizing radiation (IR) and PARP inhibitor.Methods siRNA of BRCA1 were first used to inhibit endougenous BRCA1 expression in MCF7 cells.Then,plasmids of pCMV-3xFlag-WT-BRCA1,pCMV-3xFlag-NES-BRCA1 and pCMV-3xFlag-NLS-BRCA1 were transfected in MCF7 cells.Immunofluorescence staining was used to detect BRCA1 subcellular location as well as the formation of Rad51 and γ-H2AX foci.Apoptotic cells were analyzed by flow cytometry,and colony formation assay was performed to evaluate the survival of cells.Results There were 47％ cells with nuclear BRCA1,23％ cells with cytoplasmic BRCA1 and 30％ cell with mixed nuclear and cytoplasmic BRCA1 expression in WT-BRCA1 transfected cell.There were 87％ cells with nuclear BRCA1 in NES-BRCA1 transfected cell,and 82％ cells with cytoplasmic BRCA1 in NLS-BRCA1 transfected cell.There were 87％,84％ and 13％ Rad51 foci positive cells at 2 hours after 4 Gy radiation treatment and 22％,25％ and 59％ γ-H2AX foci positive cells at 24 hours after 4Gy radiation treatment in WT-BRCA1,NES-BRCA1 mutant and NLS-BRCA1 mutant transfected cell respectively.ABT-888 and radiation treatment induced more apoptosis and fewer colonies in NLS-BRCA1 transfected cell than WT-BRCA1,NES-BRCA1 mutant transfected cell.Conclusion Subcellular location of BRCA1 might affect homologous recombination repair of DNA double strand breaks and can be used to predict sensitivity to IR and PARP inhibitor.

Informed consent right is not just for basic ethical consideration, but is important for protecting patient's right by law, which is expressed through informed consent contract. The appraised individuals of forensic clinical examination have the similar legal status as the patients in medical system. However, the law does not require informed consent right for the appraised individuals. I recommend giving certain informed consent right to the appraised individuals in the forensic clinical examination. Under the contracted relationship with the institution, the appraised individuals could participate in the examination process, know the necessary information, and make a selected consent on the examination results, which can assure the justice and fairness of judicial examination procedure.
Forensic Medicine ; Humans ; Informed Consent ; Patient Participation

Objective To investigate the early diagnostic value of plasma D-dimer level in acute aortic dissection (AAD) . Method A total of 80 patients with chest pain were enrolled from January 2006 to March 2009, and 40 patients of them were confirmed to be AAD with computerized tomographic angiography (CTA), and these patients were matched with 40 controls presenting suspected dissection, which were ruled out later. The D-dimer test was performed in all patients within 12 hours after onset of chest pain,and plasma D-dimer concentrations were compared between two groups. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of D-dimer used for diagnosing AAD were analyzed. The receiver operating characteristic (ROC) curve was also established. The statistical analysis of data was carried out by using Mann-Whitney test with SPSS 11.5 software. Results The plasma D-dimer oncentrations in AAD were significantly higher than those in controls [(5.48±7.95) vs. (0.64±0.75), P <0.0l]. Receiver operating characteristic curve analysis showed that D-dimer ( > 0.5 μg/mL) was predictive in the diagnosis of AAD, and the area under ROC curve was 0.848 ± 0.042, (95% CI: 0.766-0.930) with 87.5% sensitivity, 62.5% specificity,70% PPV and 83.3% NPV. Conclu-sions D-dimer may be a valuable biomarker in early diagnosis of AAD.

Objective To evaluate the efficacy and safety of hydroxychloroquine combined with butyli flufenamatum ointment and other drugs for the treatment of polymorphous light eruption (PLE).Methods A total of 48 patients with PLE were randomly and equally classified into group 1 and group 2.Both groups took hydroxychloroquine 200 mg twice a day and loratadine 10 mg per day for the initial 4 weeks,then took hydroxychloroquine 100 mg twice a day alone for another 4 weeks.Group 1 also topically applied butyli flufenamatum ointment twice a day during the 8 weeks,while group 2 applied mometasone furoate cream twice a day for the first 2 weeks followed by butyli flufenamatum ointment twice a day for another 6 weeks.Each treatment cycle lasted 2 weeks,and both groups received 4 cycles of treatment.Patients were evaluated for the response rate at the end of each cycle,and for the total symptom score and erythema score before and after the 8-week treatment.Statistical analysis was carried out using t test,chi-square test,Fisher's exact test and repeated-measures analysis of variance with the SPSS17.0 software.Results On day 14,28,42 and 56,the total score improved in 0,3,12 and 19 patients in group 1 respectively,and in 1,4,12 and 20 patients in group 2 respectively;the erythema score improved in 1,5,13 and 18 patients in group 1 respectively,and in 0,5,11 and 17 patients in group 2 respectively.No significant difference was observed between the two groups in response rates at any of the above four time points (P ＞ 0.05).Both the total score and erythema score significantly decreased after the 8-week treatment in both groups compared with the pretreatment scores (both P ＜ 0.05).No serious adverse reaction was observed in either of the two groups.Conclusions Hydroxychloroquine combined with loratadine and butyli flufenamatum ointment shows high efficacy and safety for the treatment of PLE.Topical butyli flufenamatum ointment is highly effective for the treatment of PLE,especially for PLE cases mainly presenting with erythema.

Objective To investigate various types and quantities of fetal cells getting into peripheral blood of pregnant women and immune status related to pregnancy induced hypertension syndrome (PIH) and analyze the etiology of PIH.Methods (1) Three markers of fetal nucleated red blood cells (fNRBCs) in normal pregnant women(n=43)and PIH patients (n=39)were measured by flow cytometry: CD71,HbF/iAg and HbF/CA.(2)We detected the levels of sub-groups of lymphocytes and some plasma cytokines.such as TNF-α and IL-6.The blood samples were from normal pregnant subjects and patients of PIH.Results In the peripheral blood of patients of PIH and normal pregnant subjects,(1) The quantities of fetal cells using three different methods in PIH [6.56(11.37)%、0.09(0.16)%、0.06(0.11)%]were significantly different from normal pregnant subjects[1.58(3.35)%、0.04(0.08)%、0.02(0.06)%],Z= -5.31,-2.97,-4.13 respectively,P＜0.01.(2)Except CD8,the levels of CD3 (76.4±8.5)%,CD4(42.6±6.4)%,CD4/CD8(1.5±0.4)%,CD19(10.5±3.9)%,CD16/CD56 (12.2±7.7)%,TNF-α (1.4 ±0.6)μg/L and IL-6(89.6±12.9)μg/L in PIH were significantly different from normal pregnant subjects[CD3(70.4±8.3)%,CD4(35.3±6.9)%,CD4/CD8(1.2±0.4)%,CD19(8.2±2.8)%,CD16/CD56(20.5±8.9)%,TNF-α(0.5±0.2)μg/L and IL-6(22.0±5.7)μg/L,respectively,P＜0.001].There were no significant differences observed in the level of CD8(P＞0.05).Conclusion The increment of fNRBCs getting into peripheral blood of pregnant women and associated immune status were implicated in the development of PIH.

Objective To analyze the cost of capsule endoscopy in diagnosing small bowel bleeding and to compare it with traditional diagnostic methods.Methods The patients suspected with small bowel bleeding were divided into group A(n=58,collected during 1998 to 2005)diagnosed with traditional processes and group B (n=93,collected during 2002 to January 2005)diagnosed with capsule endoscopy.The diagnostic yield,specific treatments,examination costs and other accumulated costs of two groups was compared.The examination cost ratio and the integration cost ratio were evaluated.The sensitivity analysis was performed.Results The diagnostic yield of small bowel bleeding in group A and group B were 22.4%(13/58) and 86%(80/93),respectively.The total of examination costs were 133 750 RMB and 790 500 RMB,respectively.The examination costs in group B(RMB 9881.3/each) was slightly lower than group A(RMB 10 288.5/each).Furthermore,as the diagnostic yield of group B was significantly higher than group A(P=0.001).The specific treatments based on the results of the diagnosis was 37.4% higher in group B(49.5%) than group A(12.1%).That means the cost of repeat- ed consultations,emergencies room visit,examinations,supporting treatments and hospitalizations in group B were significantly decreased.After the adjustment,the cost in group B(RMB 9881/patient) was lower than group A(16 361.5 RMB in one month—97 424.0 over 5 years/patient).The total cost of each patient in group A was 6480.2—87 542.7 RMB more than group B,which represented 1.7—9.9 folds increase.Conclusions The patients who suspected with small bowel bleeding and had a negative results of gastroscopy and colonoscopy were recommended to have capsule endoscopy which yields early diagnosis and less cost.

Animals ; Cytokines ; blood ; Endotoxemia ; blood ; therapy ; Endotoxins ; blood ; toxicity ; Enzyme-Linked Immunosorbent Assay ; Hemofiltration ; Interleukin-1 ; blood ; Interleukin-10 ; blood ; Models, Animal ; Swine ; Time Factors ; Tumor Necrosis Factor-alpha ; analysis