AlM:To compare the effect of different incision in corneal astigmatism after phacoemulsification.
METHODS: Totally 88 cases ( 122 eyes ) with pure cataract were randomly divided into two groups. Forty cases (60 eyes) were clarity corneal incision in group A, and 48 cases ( 62 eyes ) were sclera tunnel incision in group B. Mean corneal astigmatism, surgically induced astigmatism ( SlA ) , uncorrected visual acuity ( UCVA ) and best correct vision acuity ( BCVA ) were observed in pre- and post-operation at 1d;1wk;1mo.
RESULTS: The mean astigmatism had statistically significant difference between two groups at 1d; 1wk;1mo after operation(P<0. 05). The SlA had statistically significant difference at 1d ( P<0. 05 ); The SlA had no statistically significant difference between two groups at 1mo after operation (P>0. 05). UCVA≥0. 5 and BCVA≥0. 8 had statistically significant difference at 1d; 1wk ( P<0. 05) . There had no statistically significant difference at 1mo after operation (P>0. 05).
CONCLUSlON: Phacoemulsification with scleral tunnel incision remove combined intraocular lens ( lOL ) implantation has small changes to corneal astigmatism. By selecting personalized corneal incision according to the corneal topography might be more beneficial.

In order to observe the replication and expression of HGV RNA genome in HepG2 cells and establish a cell model of HGV infection, HGV RNA genome was prepared in vitro and transfected HepG2 cells with lipofec-tamin. HGV RNA-positive supernatants were used to infect fresh HepG2 cells. RT-PCR, immunohistochemistry and Western blot assays were carried out to detect the replication and expression of HGV in HepG2 cells. Both positive and negative strands of HGV RNA could be detectable in cell culture supernatants and cells at 24h post-transfection. During the culture periods of 90 days, the cells were maintained by changing the medium every 3 or 5 days, and cultured for more than 20 passages. Both strands of HGV could be detectable in culture supernatants and cells. Immunohistochemistry and Western blot results also confirmed that HGV E2 protein could be expressed in the infected HepG2 cells. HGV RNA could also be detectable in the frozen-thawed HepG2 cells infected with HGV RNA genome. Therefore, HGV RNA genome can replicate and express in HepG2 cells, this HGV RNA genome transfected cells model could be used as a cell model in the studies of replication and infection of HGV.

Objective To investigate the inhibitory effect and mechanism of rosiglitazone on chemokines secretion in renal tubular epithelial cells (HK-2) stimulated by lipopolysaccharide (LPS). Methods Cells were divided into four groups: control (CON), LPS (1 mg/L),rosiglitazone (10 μmol/L), rosiglitazone (10 μmol/L) +LPS (1 mg/L). MCP-1 and IL-8 expression was measured using real time PCR and ELISA. PPARγ was knockdown by RNAi to investigate whether the inhibitory effect of rosiglitazone was PPARγ-dependent or -independent. The NF-κB in nucleus was detected by Western blotting. The DNA binding activity of NF-κB was determined by electrophoretic mobility shift assay. Results Compared with CON group, the expressions of IL-8 and MCP-1 were increased by (4.30±0.45) and (4.80±1.29) times in mRNA level, (1.39±0.18)and (2.11 ±0.47) times in protein level, respectively, in LPS-stimulated HK-2 cells (P＜0.05).Application of rosiglitazone followed by LPS significantly reduced IL-8 and MCP-1 secretion compared with LPS group (decreasing by 66.37% and 71.88% in mRNA levels, while 41.68% and 47.87% in protein levels) (P＜0.05). In pcDNATM 6.2-GW/EmGFP-miPPARγ transfected cells, IL-8and MCP-1 only were decreased by 18.16% and 16.83% in mRNA level, while 11.39% and 11.86%% in protein level in rosiglitazone pretreated group, showing no significant difference compared with LPS group. Rosiglitazone did not block NF-κB nuclear translocation while significantly inhibiting the DNA binding activity of NF-κB. Conclusions Rosiglitazone inhibits the expressions of MCP-1 and IL-8 via a PPARγ-dependent mechanism in HK-2 cells, resulting from inhibition the DNA binding activity of NF-κB.

Objective To improve detectable rate of gastric schwannoma by endoscopic ultrasonography (EUS). Method Clinical data and endoscopic ultrasonography (EUS) imaging features of 4 cases were retrospectively ana-lyzed which diagnosed as gastric schwannoma pathologically and immunohistochemically while diagnosed as gastric stromal tumor by EUS from May 2008 to June 2015 and reviewed the literature. Results 4 cases of gastric schwan-nomas are female and benign, all 4 lesions are solitary, 3 in gastric body, and 1 in fundus by endoscopic. By EUS, all lesions are originated from muscularis propria, hypoechoic change, even echoes and clear board without calcifica-tion or cystic changes. 2 cases have halo artifacts around the lesion. Literature review found that gastric schwannoma tended to occur in female, halo artifacts could be the feature of gastric schwannoma, calcification or cystic changes were rare in gastric schwannoma which were common in gastric stromal tumors. Conclusion It was difficult to distin-guish gastric schwannoma and gastric stromal tumors that originated from muscularis propria by EUS. For female patients with lesions originated from muscularis propria, originated from muscularis propria and occurred in gastric body, it was necessary to observe lesions whether there was being calcification or cystic and halo artifacts. Integrated all these performance, we should be in consideration of gastric stromal tumors, meanwhile, excluding the possibility of gastric schwannoma.

Objective To investigate the role of IL-2,IFN-? and IL-10 in pemphigus acantholysis. Methods Acantholysis was observed histopathologically in the skin organ culture model of pemphigus after interacting with different concentrations of IL-2, IFN-? and IL-10 for 24 h?48 h and 72 h. Results The acantholysis was promoted by IL-2 and IFN-?, and the severity of acantholysis was related to the concentrations of IL-2 and IFN-?. The effect of IFN-? was weaker than that of IL-2. IL-10 could inhibit the acantholytic effect of IFN-? significantly, and inhibit the acantholytic effect of IL-2 when its concentration was higher than 100 pg/mL. Conclusions Th1 cytokines can promote acantholysis induced by antibody of pemphigus (Pab) while Th2 cytokines can inhibit the acantholysis induced by Pab, and the effect of Th1 cytokines. Th2 lymphocytes may play an important role in the pathogenesis of pemphigus.

OBJECTIVE: Metatarsophalangeal joint is an important joint for daily weight-bearing walking. Osteoarthritis, osteochondrosis of the metatarsal head, rheumatoid arthritis can often cause the destruction of 2-5 metatarsophalangeal joint, leading to pain, limited joint movement and toe deformities, severely affecting the forefoot function. The purpose of this study is to report the results of middle-long term follow-up after performing Swanson double-stem silicon implant arthroplasty in patients with diseases of 2-5 metatarsophalangeal joint. METHODS: From January 2010 to October 2015, 21 patients with 2-5 metatarsophalangeal joint replacement were performed with Swanson double-stem silicone prosthesis. In the study, 16 cases were successfully followed up, 2 men and 14 women with an average age (66.7±5.5) years. There were 9 cases diagnosed with rheumatoid arthritis, 5 cases with severe osteoarthritis and 2 cases with osteochondrosis of the metatarsal head. The American Association of foot and ankle surgery Maryland foot scoring system and visual analogue score (VAS) were used to evaluate the walking function, metatarsophalangeal joint mobility and pain degree before and after surgery. RESULTS: The follow-up time ranged from 17 months to 5 years, with an average of 3.2 years. According to Maryland foot scoring system of the American Association of foot and ankle surgery, the preoperative score was (60.69±6.12) points and postoperative score was (88.13±5.84) points. Range of motion of metatarsophalangeal joint: preoperative: back extension 5.4°±3.1°, plantar flexion 4.4°±2.7°; postoperative: back extension 15.7°±4.5°, plantar flexion 12.2°±4.3°, the motion of 2-5 metatarsophalangeal joint after operation was significantly improved compared with that before operation (P < 0.01). The preoperative VAS was (6.8±0.9) points and the last follow-up was (2.3±0.8) points, the pain symptom of metatarsophalangeal joint was improved obviously after operation. The postoperative score was significantly higher than the preoperative score according to Maryland foot scoring system (P < 0.01), the excellent rate was 81.3%. CONCLUSIONS With the advantages of alleviating pain, preserving the length and alignment of metatarsophalangeal joint, improving the function of walking, and correcting the deformity, Swanson double-stem silicon implant arthroplasty is a reproducible and safe option for the reconstruction of the 2-5 metatarsophalangeal joint. However, there is still some probability of adverse reactions and still room for improvement.
Aged ; Arthritis, Rheumatoid ; Arthroplasty ; Female ; Follow-Up Studies ; Humans ; Joint Prosthesis ; Male ; Metatarsophalangeal Joint/surgery* ; Middle Aged ; Treatment Outcome

Objective To compare the diagnostic yield of endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) for solid pancreatic masses performed with three different needle types through the cytological results.Methods All patients with solid pancreatic masses larger than 2cm from December 2010 to May 2011 were enrolled,and divided into two groups according to different access of EUS-FNA,trans-gastric approach with 19-,22-and 25-gauge needles (n =42) and trans-duodenal approach with 22-and 25-gauge needles (n =10).In both groups,EUS-FNA was performed with randomization of needle types.During the puncture,the suction,the number of movements,and the depth of insertion were fixed.At the end of the puncture,a liquid-based cytological (LBC) preparation was used to fix the specimen.One cytopathologists was assigned to make the diagnosis and comparison.Results Technical success was 100％ and no procedure related complications occurred.No statistically significant differences were observed in different needles in terms of all cytological parameters between two groups (P ＞ 0.05).However,the 25-gauge needle showed a trend towards a higher sensitivity,specificity,positive predictive value,negative predictive value and accuracy.Conclusion There is no significant difference in yield of cytological results between different needle types,although 25-gauge needle shows a relative superiority.

Objective To explore the clinical presentation and management principles of congenital pyriform sinus fistula. Methods Seven sequential cases of congenital pyriform sinus fistula (CPSF) treated between January 2007 and January 2011 were reported. The clinical presentation were recurrent left lower neck abscess or acute suppurative thyroiditis. All of these patients had past histories of misdiagnosis ranged from 3 years to 11 years. All the patients had undergone incision and drainage several times. In acute infection period, these patients received incision and drainage, after inflammation susided, were treated with definitive surgery. Results After barium swallow study and CT examination in the quiescent stage of infection, 5 patients could be seen fistula in the pyriform, all the patients were found scar tissue near the left thyroid lobe, 4 patients received direct laryngoscope examination and 3 of them could be found inner orifice near the apex of pyriform sinus, fistula and the involved lobe of thyroid were successfully excised without permanent recurrent laryngeal nerve injury or hypothroidism. All the patients had an uneventful recovery and remained symptom free from 5 months to 40 months. Conclusions The clinical history of recurrent low neck inflammatory episodes in patients, especially on the left side, should raise the suspicion of CPSF,investigation using barium swallow in combination with CT scanning is useful. CPSF can be treated by excising the fistula and involved lobe of thyroid.

OBJECTIVETo investigate the effect of intranasal administration of low dosage recombinant human erythropoietin (r-HuEPO) on seizure in rats.

METHODSAfter intranasal or intraperitoneal administration of r-HuEPO, the behavioral and electroencephalographic changes were observed in pentylenetetrazol (PTZ) and maximal electroshock (MES) induced seizure or electrical amygdaloid-kindled seizure of rats.

RESULTIntranasal administration of low dosage r-HuEPO increased the seizure latency, and decreased the seizure grade and duration, and the number of convulsive episodes in PTZ induced seizure, with the most potential dosage of 2.4 IU. Intraperitoneal administration of r-HuEPO (3 000, 4 000 IU/kg) only decreased the seizure duration and number of convulsive episodes. The seizure grade, forelimb or hindlimb extension duration were decreased in MES-induced seizure by intranasal administration of 2.4 IU r-HuEPO. In addition, intranasal administration of 2.4 IU r-HuEPO decreased the seizure grade, generalized seizure duration and afterdischarge in electrical amygdaloid-kindled rats stimulated with generalized seizure threshold.

CONCLUSIONIntranasal administration of low dosage r-HuEPO can inhibit the seizure in rats.

Administration, Intranasal ; Animals ; Anticonvulsants ; administration & dosage ; Epilepsy ; chemically induced ; drug therapy ; Erythropoietin ; administration & dosage ; Humans ; Male ; Pentylenetetrazole ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Recombinant Proteins

Objective To study the effect of flumazenil on hypnotic mice induced by diazepam and zolpidem ,and to eval-uate the possibility of flumazenil oral administration .Methods First ,Kunming mice were injected intraperitoneally with nor-mal saline and sodium pentobarbital (S + W) ,diazepam and pentobarbital sodium (D + W) ,zolpidem and pentobarbital sodi-um (Z + W) .The hypnotic effect of diazepam and zolpidem on prolonging the sleep time of pentobarbital sodium would be ver-ified by (D + W) group and (Z + W) group .Then the mice were injected intraperitoneally with flumazenil .The sleep time was used as the evaluation index to evaluate the effect of flumazenil against hypnosis . Finally , the oral administration of flumazenil was observed against hypnosis ,which was evaluated by using sleep time as an index .Results Compared with the control group (S+W) ,the diazepam group (D+W) and the zolpidem group (Z+W) significantly prolonged the sleep time in-duced by pentobarbital sodium (P<0 .001 ,P<0 .05);After Intraperitoneal injection of flumazenil ,compared with the diazepam group (D+W) and the zolpidem group (Z+W) ,the sleep time of the diazepam group [F(ip)+D+W] and the zolpidem group [F(ip)+Z+W] were significantly shorter (P<0 .001 ,P<0 .05);After oral administration of flumazenil ,the sleep time of the diazepam group [F(ig)+ D+ W] and the zolpidem group [F(ig)+ Z+ W] were also significantly shorter (P< 0 .001 ,P<0.05) .Conclusion Flumazenil ,whether intraperitoneal injection or intragastric administration ,could antagonize the hypnotic effect of diazepam and zolpidem .It was proved that oral administration of flumazenil had the same effect compared with intrap-eritoneal injection of flumazenil ,which provided the possibility of preparation of oral administration of flumazenil .