AIM: To discuss the clinical efficacy of fresh amniotic membrane ( AM ) during the microscopic adjustable suture surgery in children's intercommunity strabismus, in order to guide clinical treatment.
METHODS: With the clinical randomized control study (RCT), 60 (112 eyes) cases of patients in childhood who received microscopic strabismus surgery in our hospital were divided them into two different groups from Jan. 2010 to Oct. 2015. According to the application of AM on the basis of ophthalmology outpatient number, 30 cases (58 eyes) in group A were treated with rectus muscle recession surgery combined adjustable suture combined with AM. The other 30 cases (54 eyes) in group B were treated with rectus muscle recession surgery combined adjustable suture only. All patients in two groups were followed-up over 6mo after the strabismus surgery.
RESULTS:Twenty-seven cases ( 48 eyes ) of all the strabismus patients must be adjusted after strabismus surgery, and the eye position adjustment rate was 42.9%. At 1mo after surgery, eye position of 18 cases (29 eyes) can be adjusted in all patients, and 44. 8% (16 cases, 26 eyes ) in group A with the average of adjustment lengths was 2. 56±0. 64mm, and 5. 6% ( 2 cases, 3 eyes ) in group B, with the average of adjustment lengths was 0. 52±0. 28mm, the differences of the adjustment rate and the average of adjustment amount were both high statistically significant (χ2 =22.477, P<0. 01; t=16. 502, P<0. 01 ) between the two groups. Except of 3 cases who couldn't cooperate with eye position adjustment, they all received eye position adjustment in different degrees in one month after strabismus surgery,and after eye position adjustment, 27 cases (53 eyes) in group A got normal eye position, and the correction rate of eye position was 91. 4%, and 16 cases (28 eyes) in group B got normal eye position after eye position adjustment, the correction rate was 51. 9%, the differences of the correction rate were statistically significant (χ2=21. 827, P<0. 01) between the two groups.
CONCLUSION: The application of fresh AM in the microscopic adjustable suture strabismus surgery is exactly effective in treatment of children's intercommunity strabismus. It can significantly extend the adjustment time and increase the adjustment amount, and it also can statistically improve the controllability and achievement ratio for children's strabismus surgery.

Objective To evaluate the value of ultrasound elastography in the diagnosis of breast tumor ,and compared with imaging analysis .Methods To collect the image data of 160 patients ,confirmed by pathology ,a total of 182 ,preoperative ultra-sound elasticity imaging and DWI ,ultra sonic elastography diagnosis by five points method ,DWI on the basis of the measured ADC value in the diagnosis of lesions ,respectively compared with pathology .Results Ultrasound elastography diagnosis of 89 malignant tumors ,of which the correct diagnosis of 78 malignant tumors ,7 misdiagnosis ,11 benign misdiagnosed as malignant diagnosis;93 benign tumors ,86 of correct diagnosis ,11 misdiagnosis ,7 malignant misdiagnosed as benign ,sensitivity was 87 .6% ,specificity of 92 .5% ,the Accuracy was 93 .9% ;ultrasound elastography and DWI combined imaging diagnosis of 86 malignant tumors ,81 correct diagnosis of malignant tumors ,4 misdiagnosis ,5 from the benign misdiagnosed as malignant diagnosis ,96 benign tumors ,92 correct diagnosis ,5 misdiagnosis ,the sensitivity was 94 .1% ,specificity of 95 .8% ,the accuracy was 97 .2% .Conclusion Ultrasound elas-tography in breast benign and malignant tumor diagnosis with higher sensitivity and specificity ,accuracy ,joint DWI can significantly improve the sensitivity and specificity of breast benign and malignant tumor diagnosis ,accuracy .

OBJECTIVETo explore the feasibility of multi-dimensional and comprehensive evaluation on the quality of life among rural elderly population in Anhui province.

METHODS5652 rural elderly people aged above 65 in Anhui province were selected by cluster sampling method and were studied by cross-sectional study through a questionnaire on health information. The quality of life was evaluated by comprehensive evaluation method.

RESULTSThe total score of satisfactory quality of life in the studied rural elderly people was 0.1432 +/- 0.5170, while not satisfied was -0.2521 +/- 0.6081, with significant difference between the two groups (F = 666.221, P < 0.0001). There was positive correlation between subjective satisfaction and total score of quality of life, with r(s) = 0.345 (P < 0.0001). The results of logistic regression analysis between comprehensive index of quality of life and subjective satisfaction indicated that filial piety, income, sleeping condition, chronic disease, nutrition status, economic dominance in the family, amusement activities etc. were important factors influencing the quality of life.

CONCLUSIONIt was feasible to evaluation on the quality of life by comprehensive evaluation method.

Activities of Daily Living ; Aged ; Aged, 80 and over ; China ; Evaluation Studies as Topic ; Female ; Health Status ; Humans ; Male ; Personal Satisfaction ; Quality of Life ; Regression Analysis ; Rural Health ; standards ; statistics & numerical data ; Socioeconomic Factors ; Surveys and Questionnaires

Objective To choose a better version of Rivermead Behavioral Memory Test(RBMT)to assess memory function of patients with mild traumatic brain injury(TBI).Methods From April,2015 to Febrary,2017,40 mild TBI patients and 40 healthy people were re-cruited as TBI group and control group respectively.Both groups completed the Chinese version of RBMT-II first,and 24 hours to 48 hours later,completed the Chinese version of RBMT-III.The raw score of each test and the number of perfect scores and floor performance were scored and compared.Results Compared with the control group,TBI group got lower scores in six subtests of RBMT-II(F>2.131,P<0.05) and twelve subtests of RBMT-III(F>2.035,P<0.05).Administration of the RBMT-III resulted in less participants performing at or near indi-vidual subtest's ceiling than RBMT-II,mainly in the picture recognition,face recognition,the line instant memories,the line delay memo-ries,letters delayed recall and orientation date(Z>2.117,P<0.05).Also administration of the RBMT-III resulted in less floor performance than those of RBMT-II,mainly in remembering the name and the appointment(Z>2.138,P<0.05).Conclusion RBMT-III has substantial im-provement over the original RBMT-II,as it reduces the problem of ceiling and floor performance and the number of misclassifications.

In this study, 1 065 infants and young children aged 24 months below in ethnic minorities gathering in poor rural areas in poor rural areas of Liangshan Yi Autonomous Prefecture of Sichuan Province and Gannan Tibetan Autonomous Prefecture of Gansu Province were investigated for their anemia status from October to November 2014, and the association between anemia and the utilization of maternal and child health services was analyzed. The prevalence of anemia in this area was 52.68%(561/1 065). After the adjustment of socio-demographic characteristics of mothers and infants, compared with infants aged 2-5 months, Han ethnic group, and infants whose mother was not anemic, the OR(95%CI) values of infant anemia for infants aged 6-12 months, 13-8 months, 19-24 months, ethnic minorities group, and infants whose mother was anemic were 11.65 (7.09-19.14), 9.91 (5.99-16.38), 5.87 (3.39-10.16), 1.55 (1.10-2.18) and 1.52 (1.14-2.04), respectively; Compared with infants whose child examination times not up to standard, and who were not only non-hospital delivered but also received inadequate number of inoculation, the OR (95%CI) values of infant anemia for infants whose child examination times up to standard, and who were not only hospital delivered but also received adequate number of inoculation were 0.60 (0.38-0.94) and 0.71 (0.52-0.98), respectively. The infants anemia is associated with the utilization of maternal and child health services.

Objective To explore an assessment tool for releasing physical restraints of patients in neurosurgical intensive care unit (NICU).Methods Totally 70 patients in NICU with physical restraints whose Glasgow Coma Scale (GCS)scores were 13 to 15 were assessed by Johns Hopkins Adapted Cognitive Exam (ACE).After assessment,patients were divided into the normal orientation group and the abnormal orientation group according to the results.Then we removed physical constraints of patients in the normal orientation group.We analyzed occurrence of unplanned extubation and overall cognitive function of two groups.Results There was no unplanned extubation after removal of physical restraints in the normal orientation group,whereas there were five cases of unplanned extubation in the abnormal orientation group (P＜0.05).With regards to overall cognitive function,scores of other subtests and total scores in the normal orientation group were significantly higher than those in the abnormal orientation group (P＜0.05).Conclusion ACE can be used as assessment tool for orientation among patients in NICU,and normal orientation can serve as an indication of removal of physical restraints in patients with GCS scores of 13 to 15 in NICU.

Objective To investigate the molecular basis of pathogenicity of Japanese encephalitis virus (JEV) by sequencing of complete nucleotide sequence and analyze the characteristics of full-length genome of genotype Ⅰ Japanese encephalitis virus strains ( GZ56 ) which was isolated from the first cerebrospinal fluid (CSF) of Japanese encephalitis patients.Methods The complete nucleotide sequence was obtained by RT-PCR and sequencing was performed directly.Bioinformatics was used to analyze the nucleic acid data,deduced amino acid sequence and phylogenetic trees.Results The result of sequence analysis showed that the genome of GZ56 strains had 10 965 nucleotides,which coded for a 3432-amino acid polyprotein.Phyolngenetic analysis based on full-length genome showed that GZ56 strains and M-28 strains which were the first isolated from mosquitoes in Yunnan in 1977 were in the same evolutionary branch.GZ56 strains belongs to genotype Ⅰ of Japanese encephalitis virus,the homology of genome ranged from 96.2％ to 98.6％ in nucleotide and from 98.2％ to 99.7％ in amino acid sequences respectively when compared with selected genotype Ⅰ of JEV strains in GenBank.There were 11 amino acid divergences in E protein when compared with the JEV inactivated P3 strain but they are not the key virulence sites.However,there were 14 amino acid divergences in E protein when compared with the JEV live attenuated vaccine SA14-14-2 strain and 8 amino acid divergences were the key virulence sites.Conclusion This study indicated that the full length of genome GZ56 strains had no ignificant change.It can be hypothesized from genomic level that the currently available JEV vaccines( inactivated and live attenuated) can protect against GZ56 strains infection,meanwhile,the JEV live attenuated vaccine(SA14-14-2) formulation conferred higher levels of protection.

BACKGROUNDPrevious studies reported interleukin-27 (IL-27), interferon-γ (IFN-γ), or adenosine deaminase (ADA) alone plays a helpful role in diagnosing tuberculous pleural effusion (TPE). The present study aims at comparing the diagnostic accuracy of pleural IL-27, IFN-γ, and ADA, and investigate the diagnostic accuracy of the combination of IL-27, IFN-γ, or/and ADA for differentiating TPE from pleural effusions with the other etiologies.

METHODSThe concentrations of IL-27, IFN-γ and ADA were simultaneously determined in pleural fluids and sera from 40 patients with TPE; 26 with malignant pleural effusion, seven with infectious pleural effusion, and eight with transudative pleural effusion by enzyme linked immunosorbent assay and colorimetric method. The corresponding biochemical indexs were also simultaneously determined.

RESULTSThe concentrations of pleural IL-27 and IFN-γ in the tuberculous group were significantly higher than those in the malignant, infectious, and transudative groups. The concentrations of ADA in TPE were significantly higher than those in MPE or transudative effusions, while much lower than those in infectious effusions. Among these three biomarkers, IL-27 was the most effective for TPE diagnosis, with the cut off value of 900.8 ng/L. IL-27 had a high sensitivity of 95% and specificity of 97.6% for differential diagnosis of TPE from non-TPEs. Combinations of IL-27, IFN-γ and ADA measurements further increased the sensitivity or specificity up to 100%.

CONCLUSIONSCompared to non-TPEs, IL-27, IFN-γ and ADA all simultaneously increased in TPE; and among these three rapid detection methods, IL-27 appeared to be the best for distinguishing tuberculous from non-TPEs, especially from MPE. Combinations of the three markers (IL-27, IFN-γ and ADA) yielded the highest sensitivity and specificity. These findings suggest that the applications of a new biomarker, IL-27, alone or with IFN-γ and ADA, may contribute to more efficient diagnosis strategies in the management of tuberculous pleurisy.

Adenosine Deaminase ; blood ; metabolism ; Aged ; Female ; Humans ; Interferon-gamma ; blood ; metabolism ; Interleukin-27 ; blood ; metabolism ; Male ; Middle Aged ; Pleural Effusion ; blood ; metabolism ; Tuberculosis, Pleural ; blood ; diagnosis ; metabolism

OBJECTIVETo explore whether ischemic postconditioning can attenuate the myocardial injury induced by ischemia/reperfusion (I/R) in hypercholesteremic rats and whether hypoxia inducible factor-1alpha (HIF-1alpha) play a role in the protection.

METHODSAdult male Wistar rats received a high fat diet for 8 weeks to prepare the hypercholesteremic models. Myocardial damage induced by ischemia/reperfusion was evaluated by infarct size, creatine kinase (CK) activity and myocardial apoptosis. HIF-1alpha mRNA level was detected by real time-RT-PCR and the protein level was detected by Western blot.

RESULTSMyocardial infarct size, CK activity, and caspase-3 activity induced by I/R were markedly increased in hypercholesteremic rats compared with those in normal rats. Ischemic postconditioning attenuated the myocardial injury in both normal rats and hypercholesteremic rats, and increased HIF-1alpha protein level. There was a significant linear inverse relationship between HIF-1alpha protein level and infarct size (r = -0.802, P <0.01).

CONCLUSIONHypercholesteremia enhanced the susceptibility of myocardia to ischemia/reperfusion injury. While ischemic postconditioning markedly attenuated the increase of myocardial susceptibility to I/R induced by hypercholesteremia. HIF-1alpha might be one of the mechanisms of protection by ischemic postconditioning.

Animals ; Apoptosis ; Caspase 3 ; metabolism ; Creatine Kinase ; metabolism ; Disease Susceptibility ; Hypercholesterolemia ; metabolism ; Hypoxia-Inducible Factor 1, alpha Subunit ; metabolism ; Ischemic Postconditioning ; Male ; Myocardial Reperfusion Injury ; prevention & control ; Rats ; Rats, Wistar

OBJECTIVETo construct a rheumatoid arthritis-specific full-length fully human mammalian display antibody libraries.

METHODSPeripheral blood lymphocytes were isolated from patients with rheumatoid arthritis. The repertoires of kappa light chain (LCκ) and heavy chain variable region (VH) of the antibodies were amplified by RT-PCR. The amplified LCκ and VH genes were inserted into the vector pDGB-HC-TM separately, and the ligated libraries were transformed into competent E.coli TOPO-10 strain to construct the rheumatoid arthritis-specific antibody heavy and light chain libraries. 293T cells were co-transfected with the libraries and the full-length fully human antibody expressed on the surface of 293T cells were analyzed by flow cytometry.

RESULTSThe libraries of rheumatoid arthritis-specific antibody LCκ and heavy chain (IgG1) were constructed. The expression of full-length fully human antibody on the surface of 293T cells was confirmed by flow cytometry. With the rates of correct LCκ and heavy chain sequence insertion reaching 80% and 60%, respectively, as shown by DNA sequence analysis of the randomly selected clones, the libraries showed an expressible combinatory diversity of 6.13×10(10).

CONCLUSIONThe constructed libraries provide a useful platform for screening rheumatoid arthritis-specific antibodies.

Amino Acid Sequence ; Animals ; Antibodies ; genetics ; immunology ; Antibody Specificity ; Arthritis, Rheumatoid ; immunology ; Cell Surface Display Techniques ; Cloning, Molecular ; Escherichia coli ; genetics ; metabolism ; Genetic Vectors ; genetics ; HEK293 Cells ; Humans ; Immunoglobulin G ; biosynthesis ; genetics ; Immunoglobulin Heavy Chains ; biosynthesis ; genetics ; Immunoglobulin kappa-Chains ; biosynthesis ; genetics ; Lymphocytes ; immunology ; metabolism ; Molecular Sequence Data ; Peptide Library ; Recombinant Proteins ; biosynthesis ; genetics ; immunology ; Transfection