Objective To analyze the corneal flap thickness in laser in situ keratomileusis(LASIK) using Moria M2 microkeratome and to identify the related factors. Methods Sixty patients with LASIK were divided into two groups: M2 90 group,using the Moria M2 90 microkeratome,n=30;M2 110 group,using the Moria M2 110 microkeratome,n=30.All were performed on both eyes with the right one treated first.Subtraction pachymetry was used to measure corneal flap thickness which was analyzed statistically with the data including age,preoperative corneal diameter,curvature,corneal thickness and refraction. Results In the 30 patients of M2 90 group,the mean corneal flap thickness of right eye and left eyes were(128.03?12.03)?m(105~156 ?m) and(123.40?12.38) ?m(92~147 ?m),respectively,and the corneal flap thickness were statistically different between the right and left eyes(P

Objective To research the effect of ulinastatin on T-cytoimmunity in patients with infertility undergoing laparoscopic surgery. Methods Forty patients scheduled for receiving laparoscopic surgery were equally randomized into two groups, ulinastatin group (Group U) and control group (Group C). Ulinastatin was given to patients in the Group U at a dose of 20 × 104 U before anesthetic. No ulinastatin was given to patients in the Group C. Patients′venous blood samples for T-lymphocyte subset (CD3+,CD3+CD4+,CD3+CD8+) and CD3+CD4+/ CD3+CD8+ ratio calculation were collected before the surgery (T0) and at 0 h (T1),1st day (T2),3rd day (T3) after the surgery. Results CD3+ had less difference at T1~3 compared with T0 in the Group C but raised obviously at T2~3 in the Group U. CD3+CD4+ were only raised at T3 compared with T0 but raised obviously at T2~3 in the Group U. CD3+CD8+ were raised obviously at T2~3 compared with T0 in the Group C but had less difference in the Group U. CD3+CD4+/CD3+CD8+ had less difference at T1~3 compared with T0 in the Group C but raised obviously at T3 in the Group U. Conclusion The application of ulinastatin in laparoscopic surgery could significantly produce protective effect on T-cytoimmunity.

Adenocarcinoma ; diagnosis ; pathology ; Carcinoma, Squamous Cell ; diagnosis ; pathology ; Cytodiagnosis ; methods ; Cytological Techniques ; methods ; Female ; Humans ; Lung Neoplasms ; diagnosis ; pathology ; Male ; Middle Aged ; Small Cell Lung Carcinoma ; diagnosis ; pathology ; Sputum

Objective To determine the levels and significance of Krebs von den lungen-6(KL-6), pulmonary surfactant protein A (SP-A), SP-D and interleukin (IL)-6 in patients with connective tissue disease interstitial lung disease (CTD-ILD). Methods The serum KL-6, SP-A, SP-D and IL-6 in all subjects were detected and the imaging and pulmonary function were recorded t test, χ2 test, non-parametric test, ANOVA and correlation analysis were used for data analysis. Results ① The levels of serum KL-6, SP-A, SP-D, IL-6 in the CTD-ILD group [551.4 (428.2, 883.5) U/ml, 938.4(435.2, 2324.7) pg/ml, 90.7 (80.7, 100.3) ng/ml and 30.4 (22.9, 41.7) pg/ml; P all<0.05] was significantly higher than that in the CTD group [192.9 (139.2, 266.2) U/ml; 458.0 (372.6, 529.0) pg/ml; 80.0 (71.2, 98.3) ng/ml; 18.6 (4.9, 31.0) pg/ml, Z=-5.383, -3.76, -2.123,-3.903, P all <0.05]; and higher than healthy controls (n=30) [183.2(141.9, 216.6) U/ml; 229.0(162.0, 248.0) pg/ml;50.8(26.1, 96.4) ng/ml;7.1(3.7, 8.7) pg/ml, Z=-5.801,-8.13, 2.272, 3.266;P all<0.05].②The levels of KL-6 in pulmonary HRCT for active ILD group was significantly higher than the non-active ILD group [998.5 (640.3, 1293.3) U/ml vs 565.0(434.0, 799.5) U/ml, Z=2.182, P=0.023], there was no statistical difference in the levels of SP-A, SP-D, IL-6 between the 2 groups. ③ Spearman correlation analysis showed that KL-6 was negatively correlated with forced vital capacity (FVC%);SP-D, IL-6 and diffusing capacity of carbon monoxide (DLCO %). ④ Logistic multiple regression analysis showed that KL-6 [OR=1.017, P=0.002, 95%CI (1.006, 1.028)], SP-A [OR=1.023, P=0.009, 95%CI (1.006, 1.041)], SP-D [OR=1.175, P=0.009, 95%CI (1.075, 1.264)], IL-6[OR=1.213, P=0.001, 95%CI(1.088, 1.354)] were the risk factors for ILD. Conclusion Serum KL-6, SP-A, SP-D and IL-6 are significantly increased and correlate with CTD-ILD. KL-6 is related to the pulmonary inflammatory disease and vital capacity, while SP-D and IL-6 are related to diffusion function.

0.05).Expressions of IL-2 in tears significantly decreased 1 d,1 week and 1 month after LASIK(P0.05).Compared with the expression of NGF in tears before operation,those of 1 d,1 week,1 month and 3 months after LASIK were significantly increased(P

OBJECTIVETo observe the effect of Kangxin Capsule (KXC) on the expression of nerve growth factor (NGF) as well as the morphology and amount of nerve synapse in the cortical parietal lobe and hippocampus CA, area of vascular dementia ( VD) model rats.

METHODSThe model rats of VD made by photochemical reaction technique were randomly divided into five groups: the model group (MG), the high-dose, middle-dose and low-dose KXC groups (HDG, MDG and LDG), and the Western medicine hydergin control group (WMG). They were treated respectively with distilled water, high, middle and low dosage of KXC suspended liquid, and hydergin for a month. Besides, a blank group consisting of normal (non-model) rats was set up for control (CG). The ultrastructure of nerve synapse in the cortical parietal lobe and hippocampus CA1 area of the rats were observed and its density estimated. The condition of NGF positive neurons in the above-mentioned two regions were also observed by immunohistochemical stain.

RESULTSAll the KXC or hydergin treated groups demonstrated a normal amount of nerve synapse with integral structure in the cortical parietal lobe and hippocampus CA, area, which approached that in the CG and was superior to that in the MG. Also, the NGF positive neuron in all the treated groups was much more than that in MG with significant difference ( P<0.01), approaching to that in the CG.

CONCLUSIONKXC could elevate the expression of NGF in the cortical parietal lobe and hippocampus CA, area, preserve the number and morphology of synapse, thus to protect the function of nerve system from ischemic injury.

Animals ; Capsules ; Dementia, Vascular ; drug therapy ; metabolism ; pathology ; Disease Models, Animal ; Female ; Hippocampus ; chemistry ; Immunohistochemistry ; Male ; Medicine, Chinese Traditional ; Microscopy, Electron ; Nerve Growth Factors ; analysis ; Neurons ; ultrastructure ; Parietal Lobe ; chemistry ; Rats ; Rats, Wistar ; Synapses ; ultrastructure

BACKGROUNDThe evoked electromyography (EMG) is frequently used to identify facial nerve in order to prevent its damage during surgeries. Partial neuromuscular blockade (NMB) has been suggested to favor EMG activity and insure patients' safety. The aim of this study was to determine an adequate level of NMB correspondent to sensible facial nerve identification by evaluating the relationship between facial EMG responses and peripheral NMB levels during the middle ear surgeries.

METHODSFacial nerve evoked EMG and NMB monitoring were performed simultaneously in 40 patients who underwent tympanoplasty. Facial electromyographic responses were recorded by insertion of needle electrodes into the orbicularis oris and orbicularis oculi muscles after electrical stimulation on facial nerve. The NMB was observed objectively with the hypothenar muscle's twitching after electrical stimulation of ulnar nerve, and the intensity of blockade was adjusted at levels of 0, 25%, 50%, 75%, 90%, and 100% respectively with increased intravenous infusion of Rocuronium (muscle relaxant).

RESULTSAll of the patients had detectable EMG responses at the levels of NMB or= 75%. A significant linear positive correlation was present between stimulation thresholds and NMB levels while a linear negative correlation was present between EMG amplitudes and NMB levels.

CONCLUSIONSThe facial nerve monitoring via facial electromyographic responses can be obtained when an intraoperative partial neuromuscular blockade is induced to provide an adequate immobilization of the patient. The 50% NMB should be considered as the choice of anesthetic management for facial nerve monitoring in otologic microsurgery based on the relationship of correlation.

Adult ; Ear, Middle ; surgery ; Electromyography ; methods ; Facial Nerve ; physiology ; Female ; Humans ; Male ; Middle Aged ; Monitoring, Intraoperative ; methods ; Neuromuscular Blockade ; methods ; Otologic Surgical Procedures ; methods ; Young Adult

Objective :To explore correlation among serum levels of high sensitive C reactive protein (hsCRP) ,homocys-teine (Hcy) and severity of ischemic stroke in patients with ischemic stroke .Methods :A total of 131 patients with ischemic stroke were enrolled as stroke group .According to neurologic impairment score ,they were divided into mild group (n＝59) ,medium group (n＝41) and severe group (n＝31) ;according to infarct size ,they were divided into lacunar infarction group (n＝55) ,small infarction group (n＝46) and large infarction group (n＝30).Another 98 healthy subjects undergoing physical examination during the same period were selected as healthy control group .Serum levels of hsCRP and Hcy were measured in all groups ,and their correlation with clinic neurologic impairment degree and infarct size in patients with ische-mic stroke were analyzed .Results :Compared with healthy control group ,there were significant rise in serum levels of hsCRP and Hcy in stroke group ,P＝0.001 both .Compared with mild group ,there were significant rise in serum levels of hsCRP [ (4.43 ± 0.42) mg/L vs.(6.78 ± 1.48) mg/L vs.(9.52 ± 1.73) mg/L] and Hcy [ (17.49 ± 1.32) μmol/L vs. (22.18 ± 1.83) μmol/L vs.(26.01 ± 2.37) μmol/L] in medium group and severe group ,and those of severe group were significantly higher than those of medium group , P＝0.001 all ;compared with lacunar infarction group ,there were signif-icant rise in serum levels of hsCRP [ (4.13 ± 0.53) mg/L vs.(7.61 ± 1.47) mg/L vs.(9.49 ± 2.18 ) mg/L] and Hcy [ (18.49 ± 3.27) μmol/L vs.(22.53 ± 4.28) μmol/L vs.(27.38 ± 5.12) μmol/L] in small infarction group and large in-farction group ,and those of large infarction group were significantly higher than those of small infarction group (P＝0.001 all).Pearson correlation analysis indicated that serum serum levels of hsCRP and Hcy were significant positively correlated with clinic neurologic impairment score and infarct size in patients with ischemic stroke (r＝0.253～0.641 ,P＜0.01 all). Conclusion :Serum levels of hsCRP and Hcy are important indexes assessing severity of ischemic stroke .

Objective To explore the nursing measures of patients complicated with esophago-tracheal fistula treated by the implantation of self-expansion membrane-covered esophageal stent. Methods Observed postoperative complications of 62 patients with advanced carcinoma of middle third of esophagus after the implantation surgery of self-expansion membrane-covered esophageal stent under direct vision of gastroscopy.Results The incidence of postoperative complications was higher in patients complicated with esophago-tracheal fistula than in the others. Conclusions The enhancement of postoperative nursing measures, especially the instruction of cough, could decrease the incidence of postoperative complications effectively.

Objective To study the clinical features, therapy and prognosis of neurosyphilis typically manifested as dementia to improve its diagnosis and treatment. Methods A retrospective analysis of patients with neurosyphilis typically manifested as dementia, searched in Medline and Chinese Biomedical Literature Datebase (CBM) from 1989 to 2010, was performed. Results Forty-four studies involving 62 patients (61 cases of general paresis and 1 case of syphilitic psychoneurosis) were evaluated;the clinical features of them included the follows: male are more common;most of them had insidious onset;memory impairment and personality changes were the first common symptoms;diffuse cerebral atrophy was found in MRI and CT;serum and cerebrospinal fluid (CSF) syphilis antibody reaction was positive with some exceptional case;definite diagnosis was difficult;after anti-syphilitic therapy, symptoms could be improved more or less in a short time;and evidence of long-term prognosis was insufficient. Conclusion Both general paresis and syphilitic psychoneurosis could cause dementia. Dementia patients should be given serum and CSF syphilis antibody examination routinely if the causes of dementia are unknown. Anti-syphilitic and symptomatic treatments mostly enjoy good curative effects in a short term. Close follow-up is necessary in observing the forward effects.