Background The situation of zonule is very important for determining the cataract surgery.Ultrasound biomicroscopy (UBM) is an important method to observe the situation of zonule before cataract surgery.Objective This study was to evaluate the accuracy and clinical significance of observing the zonule of cataract patients by UBM.Methods A series cases-observational study was performed.One hundred and thirty eyes of 130 cataract patients who were to receive extracapsular cataract enucleation were enrolled in Tianjin Eye Hospital from January to June 2015,including 59 eyes with cataract associated with primary angle-closure glaucoma (PACG) and 71 eyes with traumatic cataract.UBM examination was carried out before surgery,and the abnormalities of zonule were recorded and compared between UBM and surgery findings.This study was approved by the Ethic Committee of Tianjin Eye Hospital and informed consent was obtained from all subjects.Results A large space between lens and cilliary was exhibited and the echo of zonule was clear on the UBM image in the eyes with traumatic cataract.The typical anatomic findings of the anterior eye segment were displayed,and lens equator came into contact with cilliary on the UBM image,and the echo of zonule was blurry in the eyes with cataract associated with PACG.The eye number of abnormal zonule was consistent between UBM and surgery findings (Kappa=O.952),and no significant difference in the eye number of abnormal zonule between UBM and surgery findings (P =0.250).In 75 zonule abnormal eyes diagnosed by both UBM and surgery findings,zonule abnormal range could not be compared in 1 eye (1/130,0.77％),and exactly consistent in 8 eyes (8/130,6.15％) between the two methods.The difference of zonule abnormal range between the two methods was 1 clock in 35 eyes (35/130,26.92％),and 2 clock in 27 eyes (27/130,20.77％),3 clock in 4 eyes (4/130,3.08％).In 74 zonule abnormal eyes,the mean difference of zonule abnormal meridian between the two methods was (1.36 ± 1.29) clock,an those in 28 traumatic cataract eyes and 36 cataract with PACG eyes were (1.14±1.10) clock and (1.64-± 1.48) clock,respectively.Conclusions UBM is able to observe zonule accurately,the observation effectiveness of UBM for traumatic cataract is better than that of cataract combined with PACG.These results are of clinical valueable for surgical strategy of cataract and prediction of surgical complications.

OBJECTIVETo evaluate the clinical efficacy and safety of phosphodiesterase 5 (PDE-5) inhibitors for erectile dysfunction (ED) in patients with diabetes mellitus and provide some evidence for the clinical treatment of the disease.

METHODSWe searched MedMed, EMbase, Cochrane Library, CNKI, Wan Fang Data, VIP and ZADL for randomized controlled trials on PDE-5 inhibitors for ED in diabetic men and evaluated the methodology of the included trials with the Jadad scale. We used the erectile function domain in the IIEF (IIEF-EF), IIEF questions (IIEF-Q) 3 and 4, SEP-2 and -3, and Global Assessment Questions (GAQ) as the main evaluation indexes and employed the Review Manager 5. 1. 0 software for meta analysis.

RESULTSA total of 13 studies were included, which were all high quality trials with Jadad score > 3. The IIEF-EF scores in 10 of the included studies were subjected to meta analysis using the random-effect model (REM), with a weighted mean difference (WMD) of 5.64 (95% CI 4.41 - 6.83, P < 0.001). The fixed-effect model (FEM) analysis of the IIEF-Q scores in 6 of the studies showed the WMD to be 0.96 (95% CI 0.83 -1.08, P < 0.001) for IIEF-Q3 and 1.11 (95% CI 0.98 - 1.25, P < 0.001) for IIEF-Q4. FEM analysis of the SEP-2 scores showed WMD = 17.67 (95% CI 12. 38 - 22. 97, P < 0.001) in 2 of the studies, and that of the SEP-3 scores WMD = 23.64 (95% CI 17. 49 - 29.79, P < 0.001) in 5 of the studies. The GAQ scores in 11 of the studies were subjected to REM analysis, with OR = 6. 20 and 95% CI 3.65 - 10.52 (P < 0.001). REM analysis was performed on the adverse reactions in 11 of the studies, with OR = 7.43 and 95% CI 4.11 - 13.44 (P < 0.001).

CONCLUSIONPDE-5 inhibitors can effectively and safely improve erectile function in patients with diabetes mellitus.

Objective To assess alternations in left ventricular volume and systolic synchrony in patients with frequent premature ventricular complexes(PVCs) from the right ventricular outflow tract(RVOT).Methods Twenty-nine patients with frequent isolated PVCs from RVOT were included and 30 healthy subjects as control.Instantaneous full-volume imaging(IFI) was performed to evaluate left ventricle volumetric parameters,including end-systolic volume (ESV),end-diastolic volume (EDV),stroke volume (SV),ejection fraction (EF),and systolic synchrony parameters,including systolic dyssynchrony index (SDI),dispersion end-systole (DISPES),mean end-systolic time (MES),pre-contraction time volume (PreContr) and post-contraction time volume (PostContr).Contraction front mapping was performed to visualize volumetric contraction sequence.All values of patients with PVCs were recorded during sinus beats (PVC-S) and premature ventricular beats (PVC-V) respectively.Results Significant differences were observed in left ventricular systolic volumetric and synchrony parameters between PVC-V and control subjects (P＜0.01),as well as in MES and PreContr between PVC-S and control subjects (P＜0.01).Conclusions Left ventricular systolic dysynchrony was demonstrated in patients with PVCs from RVOT.IFI was a novel tool to analyze left ventricular global and regional volumetric alternations.

Objective To summarize the experience of treating the end stage of liver disease complicated with renal failure using combined liver-kidney transplantation.Methods The clinical data of 28 cases receiving combined liver-kidney transplantation were retrospectively analyzed, including the inclusion criteria of surgical indications, modus operandi, protocol of immunosuppression and the prognosis post-operation.Results Among these 28 cases in our study, 22 cases suffered from liver and renal failure, accounting for 78.6%; 4 cases were diagnosed as having hepatorenal syndrome, accounting for 14.3%; and 1 case had hyperoxaluria and polycystic liver with polycystic kidney. As for the modus operandi we used, piggy-back procedure was adopted for 4 patients and classic procedure without bypass was used for the rest. Donor kidneys were all put in the right iliac fossa. During the follow-up period of 5 months to 7 years, one-and 3-year survival rate of the recipients was 92.9% and 78.3% respectively. Among these 28 recipients, 4 cases had the graft renal dysfunction early post-operation: One died and 3 recovered through consecutive therapy. One case received re-transplantation of the liver 3 months after the first due to the relevant complications and then recovered. During this period, no impact on the renal function occurred. Eleven cases had pulmonary infection post-operation, and 1 died. No acute rejection occurred.Conclusion Combined liver-kidney transplantation is the effective treatment to the patients with end stage liver disease complicated with renal dysfunction. Suitable case selection and perfect operation timing were the key points to the success of combined liver-kidney transplantation.

BACKGROUND: Studies demonstrated that small intestinal submucosa (SIS) had no immunogenicity, which can not lead to rejection following transplantation, thus, this is an ideal skin substitutes for natural skin.OBJECTIVE: Basic fibroblast growth factor (bFGF) gene was transfected into bone marrow mesenchymal stem cells (BMSCs),and combined the cells with SIS to construct tissue-engineered skin.METHODS: BMSCs were obtained from Japanese big-earad rabbits, and in vitro cultured. Then the subculturad BMSCs were transfected by pCDNA3.1 plasmid, followed by incubation on swine SIS to construct the tissue-engineered skin. The growth of cells and phenotype of BMSCs were detected by flow cytometry. In addition, the result of transfecting BMSCs with pCDNA-bFGF vector was measured by Western blot, and the structure of tissue-engineered skin was observed.RESULTS AND CONCLUSION: After passaged, BMSCs were grown quickly with Iong-fusiform shape. The cells were positive expressed CD90 and CD44, but negative expressed CD45. bFGF had been transfected into BMSCs, and stable expressed. The transfected BMSCs grew well in SIS. By this method, tissue-engineered skin can be constructed in vitro.

BACKGROUND: Basic fibroblast growth factor (bFGF) has significant promotion effects on repair in trauma, but local application cannot play a role for a long time.OBJECTIVE: To observe expression of bFGF gene in rabbit bone marrow mesenchymai stem cells (BMSCs) following transfection.DESIGN, TIME AND SETTING: The cytogene in vitro observation was performed at the College of Life Science, Yunnan University from March to August 2009.MATERIALS: One Japan flap-eared rabbit was purchased from the Department of Animal, Kunming Medical College. pCDNA3.1plasmid (Invitrogen, USA) was used in this study.METHODS: Bone marrow was extracted from rabbit anterior superior iliac spine. BMSCs were harvested by the adherent method.Cells were digested and subcultured when 80% confluent. According to GeneBank bFGF cDNA sequence, gene was designed and synthesized. Following electropherosis, the gel was retrieved using xhol I, BamH I enzyme digestion. Restriction enzyme was used to perform enzyme digestion, electropherosis and gene recovery in PcDNA Vector plasmid. bFGF DNA was connected with PcDNA Vector plasmid. PcDNA-bFGF eukaryotic expression vector was constructed. Recombinant was transfected into rabbit BMSCs using liposome infection protocol, and stable transfected line was screened.MAIN OUTCOME MEASURES: BMSC surface antigen expression was measured. Western blot was utilized to determine the expression of target protein.RESULTS: Results of flow cytometry showed that cultured cells were positive for CD90 and CD44, but negative for CD45.Results of immunohistochemistry demonstrated that vessel-derived BMSCs were negative for CD34, but positive for CD44. In cell disruption liquid of bFGF-transfected BMSCs, a significant positive zone of hybridization was visible at M, 23 000. However, no positive band was found in protein from pCDNA3.1(-) blank vector-transfected BMSCs.CONCLUSION: The bFGF gene was successfully transfected into BMSCs, and this target gene can stably express.

Cervical spondylotic myelopathy (CSM) is a common cause of spinal cord dysfunction clinical disease. Surgery is the main therapeutic tool for CSM. However, there are obvious differences in clinical functional recovery after operation. For the past few years, the influence factors of prognosis in cervical spondylosis myelopathic has been widely concerned. Age, nerve function, course of desease, imaging findings,surgical method and related factors became the investigative point for prognosis of cervical spondylotic myelopathy. Present viewpoint showed that the older patient, preoperative worse nerve function, longer the course of disease would result in worse outcomes. Imaging examination maybe can indicate the prognosis, but the correlation is unclear. Selection of surgical method and approach should be based on the principles of sufficient decompression, stabilize the alignment of the cervical spine, keeping backward extension of cervical spine, maintain effective decompression, preventing complications. Therefore, the treatment of cervical spondylotic myelopathy should be on the basis of pathogenic condition and imaging examination at early stage and a suitable usrgical procedure should be performed to obtain a better prognosis.
Cervical Vertebrae ; surgery ; Humans ; Magnetic Resonance Imaging ; Prognosis ; Radiography ; Spinal Cord Diseases ; diagnosis ; diagnostic imaging ; surgery ; Spondylosis ; diagnosis ; diagnostic imaging ; surgery

Objective To induce bone marrow mesenchymal stem cells(BMSCs) or bone marrow stroma stem cell(MSCs) to differentiate directionally towards chondrocytes in vitro and then identify the differentiated cells.Methods Bone marrow was harvested from the iliac bone of 16-week-old Japanese white rabbits.After gradient centrifugation,cultivation,amplification,the 3rd-passaged BMSC were implanted in six-hole-plate according to a certain proportion and induced by chondrogenic inducers including transforming growth factor-?1,dexamethasone and vitamin C.Chondrocytes were selected and fixed at different time.The features of chondrocytes were identified by toluidine blue staining and collagen types II immunohistochemical assay.Results The structure of cellular cartilage from BMSCs was uniformly positive of toluidine blue staining and collagen types II immunohistochemical staining.Conclusion Rabbit BMSC,obtained under the experimental conditions,develops stably,proliferates rapidly and is differentiated successfully into chondrocytes by induction in vitro.

Objective To study the consumption rate of qualified iodized salt at household level based on the salt surveillance results from 2004 to 2011,and to provide a scientific basis for setting up appropriate control strategies to iodine deficiency disorders.Methods Iodized salt monitoring results in Hainan Province from 2004 to 2011 were collected with retrospective method.Coverage rate of iodized salt,qualified rate of iodized salt and consumption rate of qualified iodized salt were calculated at the provincial,city(county) levels and on geographic distribution (coastal,plains and mountains).Qualified iodized salt criteria was set as (35 ± 15)mg/kg,unqualified iodized salt criteria was set as 5 to ＜ 20 mg/kg or ＞ 50 mg/kg,and criteria of non-iodized salt was set as ＜ 5 mg/kg.Results From 2004 to 2011,at provincial level,the median of iodized salt was raised from 30.25 mg/kg to 32.14 mg/kg; the iodized salt coverage rate,the qualified rate of iodized salt and the consumption rate of qualified iodized salt was raised from 77.81％ (4780/6143) to 96.06％ (5890/6132),90.48％ (4325/4780) to 98.72％(5815/5890),and 70.41％(4325/6143) to 94.83％(5815/6132),respectively.From 2004 to 2011,at city (county) level,the proportion of iodized salt coverage rate that higher than 90.00％,of qualified rate of iodized salt that higher than 95.00％ and of consumption rate of qualified iodized salt that higher than 90.00％ was raised from 44.45％(8/18) to 88.89％(16/18),16.67％(3/18) to 100.00％(18/18),and 22.22％(4/19) to 88.89％(16/18),respectively.The iodized salt coverage rate in the coastal and plain townships was raised from 70.55％(1440/2041) to 95.02％(1869/1967),and 75.36％ (1762/2338) to 96.24％(2331/2422),respectively.The iodized salt coverage rate in mountainous townships maintained at 89.46％ (1578/1764)-97.46％ (1690/1734) in the 8 years.There were 2 counties where the iodized salt coverage rate was less than 90％.There were 9 and 4 townships,where the iodized salt coverage rate was less than 90％ in coastal and plain townships,respectively,in 2011.Conclusions The rate of qualified iodized salt has been raised in Hainan Province,but part of coastal and plain townships (towns) are still serious in non-iodized salt problem.Comprehensive intervention on iodine deficiency disorders should be strengthened in these areas.

Objective:To study the combined use of endoscopic balloon dilation with endoscopic biliary brushings in diagnosis of bile duct strictures.Methods:A prospective single center study was conducted at the Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology. All patients with suspected malignant bile duct strictures shown on CT or MRI imaging from January 2018 to January 2020 were reviewed. All patients gave informed consent to the endascopic retrograde cholangiopancreatography procedures. Their clinical and follow-up data were analyzed. All patients underwent endoscopic balloon dilation of bile duct strictures. Before and after balloon dilation, biliary brush cytology was performed, and the results were used to classify the patients into the control group and the experimental group. Pathological examination of the brush cytology samples was carried out by a single chief pathologist. Presence of cancer cells or significant heterogeneous cells indicated a positive brush cytology test. Negative patients who still highly consider cholangiocarcinoma and agree to surgery and whose gross specimen is confirmed to be malignant after surgery should be considered as false negative by brush examination; it is difficult to judge that patients with cholangiocarcinoma have progress after 2 months of follow-up should be considered as false negative by brush examination. Any progression of disease indicated that the brush test was wrong and the test was again classified as false negative. Only when there was no progression of strictures was the possibility of a benign biliary stricture being considered. The advantage test (McNemar test) was used to analyze the difference between the two diagnostic methods.Results:Of 39 patients who were included in this study, there were 26 males and 13 females, with an age of (68.0 ± 5.2) years. Cholangiocarcinoma was diagnosed by histopathology, surgery or at 2 months follow-up in 35 patients. In the control group, 17 patients had a positive brush test (sensitivity rate was 48.6%, 17/35). In the experimental group, 26 patients had a positive brush test (sensitivity rate was 74.2%, 26/35). In addition, 2 patients in the control group had a positive brush test, while in the experimental group, a negative brush test. A total of 28 patients were positive in the two groups. The sensitivity rate of the brush test was 80.0% (28/35). There were significant differences between the two groups ( P<0.05). Conclusion:Endoscopic balloon dilation combined with endoscopic biliary brushings improved the sensitivity of pathological diagnosis of cholangiocarcinoma, and endoscopic biliary brushings before and after balloon dilation improved the sensitivity of diagnosis.