Objective To discuss the effects and influence of preoperative and postoperative adjunctive intravitreal conbercept in 23G vitrectomy for proliferative diabetic retinopathy (PDR).Methods A retrospective research was performed on 42 PDR eyes from January 2015 to February 2016 in the Second Affiliated Hospital of Nanchang University,who received either intravitreal 0.05 mL conbercept injection 7 days before 23G vitrectomy (group A,n =22) or intravitreal 0.05 mL conbercept injection at the end of 23 G vitrectomy (group B,n =20).The operative time,postoperative vitreous hemorrhage (VH),intraoperative and postoperative other differences of clinical indicators and postoperative best-corrected visual acuity (BCVA) between the two groups were compared.Results The average operation time,intraoperative electric coagulation hemostasis rate,iatrogenic hiatal incidence and intraoperative hemorrhage rate of group A were lower than those of group B (all P ＜ 0.05).BCVA at 6 months after surgery did not differ significantly between two groups (P ＞ 0.05),but the difference was statistically significant between pre-operation and post-operation (P ＜ 0.05).The incidences of early (≤ 1 month) postoperative VH were 18.2％ (4 eyes) and 15.0％ (3 eyes) in group A and B,respectively (P ＞ 0.05).The incidences of later (＞ 1 month) postoperative VH were 27.3％ (6 eyes) and 0 in group A and B,respectively,the difference was statistically significant (P ＜0.05).The percentages of reoperation were 13.6％ (3eyes with postoperative VH) and 10.0％ (2 eyes with traction retinal detachment) respectively in group A and B.The average times of supplementary laser photocoagulation were (2.3 ± 1.0) times and (1.4 ±0.6) times in group A and B,respectively in follow-up period (P ＜ 0.05).Conclusion The adjunctive use of intraoperative intravitreal injection of conbercept can prevent effectively postoperative VH and decrease conveniently the time of supplementary laser photocoagulation in 23G vitrectomy for PDR,as well as the preoperative adjunctive use can decrease the operation time,intraoperative complications and incidences of early postoperative VH.

Objective:To observe the expression of chemokine receptor CCR7 and CXCR4 in human colorectal carcinoma and its significance,so as to assess their expression with the metastasis and prognosis of colorectal carcinoma. Methods:Immunohistochemistry was used to detect the expression of chemokine receptor CCR7 and CXCR4 in 110 patients with colon cancer.The relationship between the CCR7 and CXCR4 expression and the clinic pathological characters was statistically analyzed. Results:CCR7 and CXCR4 expression were positively expressed in 59.1% and 45.5%of the patients. The high expression rate of CCR7 and CXCR4 in lymph node metastasis positive cases was 81. 5% and 60.0% respectively,but the without lymph node metastasis positive cases were 26.7% and 24.4% respectively. The positive expression was significantely higher in the patients with lymph node metastasis than those non-lymph node metastasis(P

We present an algorithm for numerical solution of transport equation in diffusive regimes, in which the transport equation is nearly singular and its solution becomes a solution of a diffusion equation. This algorithm, which is based on the Least-squares FEM in combination with a scaling transformation, presents a good approximation of a diffusion operator in diffusive regimes and guarantees an accurate discrete solution. The numerical experiments in 2D and 3D case are given, and the numerical results show that this algorithm is correct and efficient.

ObjectiveTo investigate the unfavorable factors of intestinal mucosa repair after the intestinal epithelial injury in vivo in a mouse model of sepsis. MethodsThe method of cecal ligature and puncture (CLP) was used to induce sepsis and then the intestinal mucosa damage, epithelial cell apoptosis and the number of transformed goblet cells were observed, and the concentrations of serum TNF-αt, IL-1 and TGF-β1 and TFF3 ( trefoil factor 3) in small intestinal mucosa were determined. All above various laboratory examinations were made by different assays including H-E staining, western blot, ELISA and immunohistochemistry respectively. The experimental mice were divided into sepsis group and sham operation control group. The mice with sepsis were separately sacrificed 6 hours ( n = 7 ), 24 hours ( n = 7) and 48 hours ( n = 7) after CLP. Results In septic mice group, the injured intestinal mucosa was found 6 hours after CLP. The damage scores in mice 24 h and 48 h after CLP were higher than those 6 h after CLP, but there was no significant difference between those 24 h and 48 h after CLP. Moreover, a few goblet cells or other epithelial cells adjacent to the injured surface migrated onto the wound to cover the denuded area. The number of goblet cells was substantially decreased in mice of sepsis group 6 hours after CLP compared with sham operation control group. Compared with sham operation control group, levels of IL-1 and TNF-α significantly increased 3-4 times in mice of sepsis group at all intervals, and the phosphorylated caspase-3 increased 4 times. Although TFF3 assayed by using Western blot showed modest increase 6 h after CLP and it declined 24 h and 48 h later. A similar change was found in TGF-β1, it modestly increased 6h after CLP, but it didn't elevate 24 h and 48 h later. ConclusionsSevere sepsis keeps on the inflammatory reaction and epithelial cell apoptosis, preventing the repair of intestinal mucosa from injury.

Objective To compare with the efficiency between X-ray or B ultrasound guided puncture target calyces of treatment of upper urinary calculi in MPCNL.Methods From October 2010 to October 2012,we have a retrospective analysis of the 116 cases in urological department in the second affiliated hospital of Kunming Medical University,it had the sugery that was MPCNL.Selected 116 cases as the research object,(8 patients were lost to follow-up).With X-ray locating (48 cases),B ultrasound locating (53 cases),and compared with preoperative,intraoperative and postoperative clinical objective indicators of two different methods.Results X-ray locating (48 cases),the mean age was (44.86 ± 12.84) years; the mean Stone diameter(1.43 ±0.70) cm; Stone is located in the upper calyx in 1 case,the middle of calyx in 23 cases,under the calyx in 8 cases,the upper ureter in 16 cases.B ultrasonic locating (53 cases),the mean age was(46.36 ± 14.29) years; the mean Stone diameter (1.34 ±0.62) cm; Stone is located in the upper calyx in 2 cases,the middle of calyx in 24 cases,under the calyx in 8 cases,the upper ureter in 16 cases.Compared with preoperative general data of two groups,there was no statistically significant difference (P ＞ 0.05).X-ray group,the mean operation time (130.43 ± 31.63) min ; Intraoperative blood loss(80.42 ± 43.75) mL; Postoperative hospital stay (6.20 ± 2.08) d; Infected with 8 cases (17％) of postoperative,hemorrhage in 2 cases (4％) ; and calculi exhausted rate was 90％ (43/47).B Ultrasound group,the mean operation time(102.45 ± 36.32) min.Intraoperative blood loss(160.07 ± 52.33) mL;Postoperative hospital stay(5.62 ±2.37) d; Infected with 16 cases (30％) of postoperative,bleeding in 9 cases (17％) ; and calculi exhausted rate was 83％ (46/53).By comparison,X-ray and B ultrasound group in operation time,intraoperative blood loss,postoperative infection,a stone exhausted rate was statistically significant (P ＜0.05),and postoperative hospital stay,no statistical significance (P ＞ 0.05).Conclusion X-ray positioning compared with B ultrasound,X-ray is longer than B ultrasonic of operation time,but,blood much less,calculi exhausted rate is higher,and infected rate is lower.

Obiective:To evaluate the effects of various surgical procedures on liver carcinoma accompanied by portal hypertension.Methods:Combined surgical procedures which were performed in 26 patients with liver carcinoma accompanied by portal hypertension in our department between Aug,2002 and Aug,2008 were analysed retrospectively.Results:There was no operative mortality.The postoperative complications developed in 50%(13/26) patients.The postoperative survival rates of 1,2 and 3 years were 84.6%(22/26),57.7%(15/26),34.6%(9/26),respectively.Postoperative upper digestive tract hemorrhage developed in 10 cases.Fifteen patients died during follow-up period,of whom 7 cases died of recurrence of liver carcinoma,2 cases died of liver failure,6 cases died of upper digestive tract hemorrhage.Conclusion:The survival time can be prolonged and the postoperative complications can be reduced through perioperative cares and prudent selection of surgical procedures in patients suffering from concurrent liver cancer and portal hypertension.Combined operation is safe and feasible.

Objective To investigate the security and efficacy of one stage and bilateral resection of thymic tissue and clearance of mediastinal fat by uniportal-video-assisted thoracic surgery(VATS) to cure patients with myasthenia gravis(MG).Methods A number of 131 patients with MG who underwent resection of thymic tissue and clearance of mediastinal fat by VATS in one single center from February 2009 to December 2013 were selected in this retrospective study.76 patients underwent unilateral resection of thymic tissue and clearance of mediastinal fat by three portal VATS from February 2009 to March 2012 and 55 patients underwent one stage and bilateral resection of thymic tissue and clearance of mediastinal fat by small uniportal-VATS from April 2012 to December 2013.The time for operation,the bleeding volume during operation,the volume of postoperative drainage and drainage time,the improvement of symptoms,the postoperative pain,hospital stays and the occurrence of myasthenia gravis crisis were compared between the two groups.Results The general condition and pathological type did not have significant statistical differences between the two groups.The operating time in the uniportal-VATS group was significantly longer than that in three portal VATS group,but the pain was lighter,and the hospital stay was shorter.There were no significant differences between groups in terms of blood loss,postoperative drainage time,and volume of drainage.The follow-up was from 32 to 90 months,and 118 (90.08％)patients completed the follow up.94.5 ％ of the patients in uniportalVATS group acquired complete stable remission(CSR),while it was 84.2％ in three portal VATS group(P ＜ 0.05),and the uniportal-VATS group had lower rate of myasthenic crisis (P ＜0.05).Conclusion One stage and bilateral resection of thymic tissue and clearance of mediastinal fat by small uniportal-VATS is safe and effective with shorter hospital stay and less pain,and it can get higher CSR and less myasthenic crisis,its efficacy is superior to traditional three portal VATS.

This paper is to establish a three-dimensional finite element model (3D-FEM) of pelvic floor levator ani muscles in an old healthy women. We acquired the image data of the pelvic bones and pelvic floor muscles from CT and MRI scanning in a non-pregnant old healthy female volunteers. The 3-D reconstruction and mesh optimization of the whole pelvic bones and muscles with application of image processing software Mimics12.0 and Geomagic9.0 were obtained. Then we built the 3D-FEM of the musculoskeletal system of the pelvic bones and levator ani muscles with Ansys11.0 software. We obtained an accurate 3D-FEM of pelvic bones and levator ani muscles in the older healthy woman. The results showed that it was reliable to build 3D-FEM with CT and MRI scanning data and this model could vividly reflect the huge space anatomy of the real pelvic floor levator ani muscles. It avoids the defects to gain the model from the body of anatomical specimens in the past. The image data of model are closer to vivisection, and the model is more conducive to the latter finite element analysis.
Female ; Finite Element Analysis ; Humans ; Imaging, Three-Dimensional ; Magnetic Resonance Imaging ; Middle Aged ; Muscle, Skeletal ; anatomy & histology ; diagnostic imaging ; Pelvic Floor ; anatomy & histology ; diagnostic imaging ; Tomography, X-Ray Computed ; methods

Objective To research the application of "Z" chest drainage and modified incision and closure techniques for single-incision VATS.Methods 422 patients by uniportal VATS were divided into three groups:282 in experimental group("Z" Chest drainage with 16 F stomach tube),male 156,female 126,median age is 55 years old;100 in control group 1 (traditional chest drainage with 16 F stomach tube),male 58,female 42,median age is 53 years old;40 in control group 2 (traditional chest drainage with 34 F chest tube),male 24,female 16,median age is 52 years old.To compare the incidence rate of incision exudating、poor healing of incision and debridement between the 3 groups.Results The age,sex and surgical method of the three groups has no statistical significance.Incidence rate of incision exudating of experimental group,control group 1 and control group 2:5 (1.8％,5/282),5 (5.0％,5/100) and 6 (15.0％,6/40);Poor healing of incision of the three groups:0,1 (1.0％,1/100) and 3(7.5％,3/40);debridement of the three groups:0,0 and 3(7.5％,3/40).For the healing of incision,control group 1 was better than control group 2;and experimental group was better than control group 1.Conclusion "Z" chest drainage and modified incision and closure techniques decreased the incidence rate of incision exudate 、poor healing of incision and debridement,it could be useful to obtain a better cosmetic effect after single-incision VATS.

Objective To explore the effects of aripiprazole on clinical symptoms and neurotrophic factor levels in patients with schizophrenia. Methods Forty patients with schizophrenia and 40 normal controls were included in the study. The clinical symptoms of patients receiving aripiprazole only for 12 weeks were evaluated by using the Positive and Negative Syndrome Scale (PANSS). Stroop Color-Word Test (SCWT), Continuous Performance Test, Digit-Symbol Coding Test and Trail Making Test-A were used to evaluate the cognitive function both in patients and controls. Serum levels of Nerve Growth Factor (NGF), Brain Derived Neurotrophic Factor (BDNF) and Neurotrophin 3 (NT-3) were measured using enzyme linked immunosorbent assay. Results The clinical scores, cognitive function and levels of neurotrophic factors were different before and after treatment (P<0.01). And those were significantly lower in patients than in control group (P<0.05). Before treatment, BDNF was negatively correlated with PANSS negative symptom score (r=-0.362, P=0.022);NGF was related to the total score of PANSS (r=0.332, P=0.037) and positive symptoms (r=0.401, P=0.010); NT-3 was associated with negative symptom scores (r=-0.376, P=0.017) and SCWT-color words (r=0.332, P=0.037) in patient group. After treatment, the increase in BDNF was correlated with the reduction in PANSS total score (r=0.371, P=0.018), negative symptom score (r=0.345, P=0.029) and general pathology score (r=0.342, P=0.031). There was a correlation of the increase of NGF with the decrease of PANSS total scores (r=0.437, P=0.005) and with positive symptom scores (r=0.357, P=0.024). Conclusion Treatment with Aripiprazole can improve the clinical symptoms and cognitive functiona impairments in patients with schizophrenia, which may be related to the increase in serum levels of BDNF, NGF and NT-3.