With increasing age, more and more patients with posterior chamber intraocular lens (ICL) implantation are facing the threat of cataracts to their visual acuity.When examining the eyes of cataract patients after ICL surgery, attention should be paid to whether the density of corneal endothelial cells is greater than 2 000 cells/mm 2, the state of the anterior chamber angle, and whether there are fundus abnormalities such as retinal detachment and choroidal neovascularization.When conducting eye biometry measurement, attention should be paid to the measurement starting and ending lines of anterior chamber depth and lens thickness.If patients undergo ICL combined with corneal refractive surgery, they should be examined with two or more devices to obtain corneal refractive power according to the examination requirements after corneal laser vision correction.When selecting the type of intraocular lens, consideration should be given to the histological characteristics of high myopia.Compared to C- and L- loops, plate-haptic is relatively more stable in patients with high myopia accompanied by large capsules and larger diameters of continuous curvilinear capsulorhexis.Kane, Barrett Universal Ⅱ, Olsen, Hill-RBF formulas for calculating the refractive power of intraocular lenses are more accurate in people with long axial length.It is recommended to perform ICL removal simultaneously with phacoemulsification and intraocular lens implantation, preferably with a surgical incision greater than 2.6 mm.Femtosecond laser assisted cataract extraction surgery, although superior to traditional phacoemulsification in reducing corneal endothelial cell loss, reducing corneal edema, and high-quality capsulorhexis, can cause incomplete capsulorhexis and fragmentation due to the cavitation bubbles, manual adjustment of location, and the impact of lower vault.It is recommended to use it with caution.Ophthalmologists should fully understand and pay attention to the characteristics and difficulties of cataract surgery after ICL surgery, communicate fully with patients, and make personalized surgery to achieve better visual outcomes.

Objective To investigate the serum levels of homocysteine(HCY)and cystatin C(Cys-C)in patients with antineutrophil cytoplasmic antibody(ANCA)-associated vasculitis(AAV)associated renal injury,and to explore the diagnostic value of combined detection of HCY and Cys-C in ANCA-associated renal injury.Methods We selected 70 ANCA-positive patients with renal injury admitted to the Department of Nephrology in our hospital from January 2016 to January 2019.Another 48 patients with ANCA-positive but not complicated with renal injury were in simple ANCA positive group while 50 patients with physical examination who came to the hospital during the same period were in control group.Healthy patients served as the control group.By comparing the differences in the test results of different groups,the area under the curve(AUC)of each test index for ANCA-positive renal injury was determined,and the correlation and diagnostic value of combined detection of HCY and Cys-C for ANCA-related renal injury were calculated.Results The levels of HCY and Cys-C in the ANCA positive combined with renal injury group,the pure ANCA positive group,and the control group differed significantly(P＜0.05).The positive rates of HCY and Cys-C in the two groups were significantly different(P＜0.05).The sensitivity and specificity of HCY and Cys-C in combination for the diagnosis of ANCA-positive related renal injury were significantly higher than those of the above indicators alone(P＜0.05).ROC curve results showed that HCY combined with Cys-C had a better diagnosis for patients with positive ANCA and associated renal injury and a higher correlation.Conclusion HCY combined with Cys-C is closely correlated to ANCA-related renal injury,and the combined detection has a positive effect on the diagnosis of patients with ANCA-positive related renal injury,and has guiding value for the treatment of patients.

ObjectiveTo explore the effects of phillygenin （PHI） on the inflammation in L02 cells induced by lipopolysaccharide （LPS） and adenosine triphosphate （ATP） and the expression of purinergic 2X7 receptor （P2X7R）， NOD-like receptor family pyrin domain containing 3 （NLRP3）， and nuclear factor kappa B （NF-κB） expression. MethodIn this study， the inflammation model was induced in L02 cells by 100 μg·L^-1 LPS treatment for 24 h and 5 mmoL·L^-1 ATP treatment for 5 h. The cells in the PHI groups were cultured with PHI （100， 50， 25 mg·L^-1） for 6 h in the LPS treatment period， followed by LPS treatment for another 18 h. After ATP treatment for 5 h， the mRNA and protein expression of interleukin-1β （IL-1β）， interleukin-18 （IL-18）， P2X7R， NLRP3， Caspase-1 precursor （pro-Caspase-1）， cleaved Caspase-1， NF-κB， and NF-κB inhibitor protein α （IκBα） in L02 cells was detected by real-time fluorescence quantitative polymerase chain reaction （Real-time PCR） and Western blot， respectively. Molecular docking was used to predict whether P2X7R could bind to PHI， and DCFH-DA was employed to detect the accumulation of reactive oxygen species （ROS） in cells. P2X7R was silenced by small interfering ribonucleic acid （siRNA）， and then the mRNA expression of IL-1β， IL-18， P2X7R， NLRP3， Caspase-1， NF-κB， and IκBα was detected by Real-time PCR. ResultReal-time PCR and Western blot showed that compared with the normal group， the model group showed increased expression of IL-1β and IL-18 （P<0.05）， and compared with the model group， the PHI groups showed down-regulated IL-1β， IL-18 mRNA and protein expression （P<0.05）. Molecular docking suggested a good binding effect of PHI to P2X7R. Real-time PCR and Western blot analysis showed that the expression of P2X7R in the model group was significantly up-regulated compared with that in the normal group （P<0.05）， and compared with the model group， the PHI groups showed down-regulated mRNA and protein expression of P2X7R （P<0.05）. DCFH-DA results showed that compared with the normal group， the model group showed increased content of ROS （P<0.05）， and compared with the model group， the PHI groups decreased the accumulation of ROS （P<0.05）. As demonstrated by Real-time PCR and Western blot， compared with the normal group， the model group showed increased expression of NLRP3 inflammasome and NF-κB （P<0.05）， and compared with the model group， the PHI groups significantly decreased the mRNA and protein expression of NLRP3 and cleaved Caspase-1， and up-regulated the mRNA and protein expression of NF-κB and IκBα （P<0.05）. Real-time PCR analysis showed that compared with the results in the model group， after silencing P2X7R by siRNA， the mRNA expression of IL-1β， IL-18， P2X7R， NLRP3， Caspase-1， NF-κB， and IκBα was decreased （P<0.05）. PHI exerted the same effect， and the mRNA expression was further reduced after the combination of them. ConclusionPHI is presumed to suppress the expression of the NLRP3/NF-κB signaling pathway by down-regulating upstream P2X7R to alleviate the LPS/ATP-induced inflammation in L02 cells， suggesting that P2X7R may be the target of PHI against inflammation.

Objective: To observe the clinical efficacy of electroacupuncture (EA) in controlling myopia in children and its effect on retinal blood flow. Methods: Sixty-eight myopic children were randomly divided into an observation group and a control group, with 34 cases in each group. The control group was given auricular acupressure treatment alone, and the observation group was treated with EA once a week in addition to the treatment used in the control group. The spherical equivalent refraction (SER) and axial length (AL) were measured at baseline, and after 3 months and 6 months of treatment. Optical coherence tomography angiography was used to measure the vessel density (VD) and perfusion density (PD) in the surface layer of the retina. Results: After 3 months and 6 months of treatment, the changes in SER between the two groups were not statistically significant (P>0.05). After 3 months of treatment, the changes in AL between the two groups were not statistically significant (P>0.05); after 6 months of treatment, the change amount of AL in the observation group was smaller than that in the control group (P<0.05); after 3 months and 6 months of treatment, the changes in VD and PD in the surface layer of the retina in the observation group were significantly greater than those in the control group (P<0.01). Conclusion: EA treatment once a week for 6 months can delay the increase of AL and improve the retinal surface blood flow in myopic children.

In the study of oral orthodontics, the dental tissue models play an important role in finite element analysis results. Currently, the commonly used alveolar bone models mainly have two kinds: the uniform and the non-uniform models. The material of the uniform model was defined with the whole alveolar bone, and each mesh element has a uniform mechanical property. While the material of the elements in non-uniform model was differently determined by the Hounsfield unit (HU) value of computed tomography (CT) images where the element was located. To investigate the effects of different alveolar bone models on the biomechanical responses of periodontal ligament (PDL), a clinical patient was chosen as the research object, his mandibular canine, PDL and two kinds of alveolar bone models were constructed, and intrusive force of 1 N and moment of 2 Nmm were exerted on the canine along its root direction, respectively, which were used to analyze the hydrostatic stress and the maximal logarithmic principal strain of PDL under different loads. Research results indicated that the mechanical responses of PDL had been affected by alveolar bone models, no matter the canine translation or rotation. Compared to the uniform model, if the alveolar bone was defined as the non-uniform model, the maximal stress and strain of PDL were decreased by 13.13% and 35.57%, respectively, when the canine translation along its root direction; while the maximal stress and strain of PDL were decreased by 19.55% and 35.64%, respectively, when the canine rotation along its root direction. The uniform alveolar bone model will induce orthodontists to choose a smaller orthodontic force. The non-uniform alveolar bone model can better reflect the differences of bone characteristics in the real alveolar bone, and more conducive to obtain accurate analysis results.
Biomechanical Phenomena ; Computer Simulation ; Finite Element Analysis ; Humans ; Models, Biological ; Periodontal Ligament ; Stress, Mechanical ; Tooth Movement Techniques

Mandible is an important bone of the head and neck. Mandibular defects not only affect patient's face, but also impede patient's daily functions, such as chewing, speech, and so on. Fibular transplantation for mandibular reconstruction is the common method, which requests high accuracy of bone positioning and posture adjustment. Therefore, a robotic system for mandibular reconstruction surgery with fibula flaps was designed to assist surgeons to hold and locate bones, and the model comparison experiments were conducted. The results showed that the robotic system can assist surgeons for mandibular reconstruction to improve quality of surgery.
Bone Transplantation ; methods ; standards ; Fibula ; transplantation ; Humans ; Mandible ; surgery ; Mandibular Reconstruction ; methods ; Robotics ; standards ; Surgery, Computer-Assisted

Objective To integrate the best available evidence of preoperative care for ophthalmic patients undergoing day surgery into clinical practice,so as to improve the quality of nursing.Methods This project was performed in an ophthalmic day surgery ward,guided by the Joanna Briggs Institute(JBI)Practice Application of Clinical Evidence System (PACES) program which includes 3 procedures:baseline audit,evidence implementation,and re-audit.Eight audit criteria were made based on evidences from JBI.Twelve nurses and 267 patients were enrolled in baseline audit,and 12 nurses and 234 patients were recruited for re-audit after evidence implementation.Results Six of the audit criteria that nurses showed poor compliance in the baseline audit(0％～28.5％),such as providing preoperative telephone screening and reducing preoperative waiting time through better preparation and planning,were significantly improved in the re-audit(71.43％～100％).The preoperative waiting time was shortened from 109.70±18.34 minutes to 88.22±9.91 minutes;the correct rates of operation-related knowledge in patients increased from 63.0％ to 85.09％;the patients' satisfaction scored 84.23±17.01 in baseline audit and 95.02±7.32 in the re-audit(P＜0.001).Conclusion Application of evidence-based preoperative care of ophthalmic patients undergoing day surgery can improve nurse's behavior and compliance with the implementation of evidence into clinical practice,and increase patient satisfaction.Continuous audits are needed to continuously improve clinical nursing quality.

Background and purpose: At present, the treatment of elderly patients with ovarian cancer, espe-cially advanced ovarian cancer, tends to be conservative, and elderly patients often can not receive standard treatment. There are few treatment experiences and research data. This study aimed to investigate the treatment outcome, survival and prognostic factors of elderly patients with advanced epithelial ovarian cancer. Methods: This study retrospectively analyzed the clinical data for women older than 65 years diagnosed with stage Ⅲ and Ⅳ epithelial ovarian cancer between Apr. 2008 to Dec. 2012 in Chongqing Cancer Hospital. Results: Of the 181 women who met study criteria, 8.8％ received no treatment, 12.7％ underwent surgery alone, 15.5％ received chemotherapy alone, 33.2％ underwent non-standard treatment, 29.8％ underwent standard treatment. Baseline comparison of different treatment methods showed that the proportion of patients with cardiovascular and cerebrovascular diseases was lower in the standard treatment group. After Correcting the effect of cardio-cerebrovascular diseases, the median survival time of standard treatment (48 months) and the median survival time of non-standard treatment (47 months) were significantly longer than that of the other treatment groups (P<0.001). The median survival time of chemotherapy alone (26 months) was significantly longer than that of the surgery alone and untreated group (P<0.001), while the median survival time of surgery alone was similar to untreated group (9 months vs 8 months, P=0.269). Multivariate analysis using Cox model showed that treatment, residual lesion size, cardio-cerebrovascular diseases significantly impacted on survival time. Conclusion: Standard treatment was still the key factor for the best survival of elderly women with advanced ovarian cancer. When this is not offered or possible, chemother-apy alone offers better survival than surgery alone. However, surgery alone does not improve prognosis.

Objective To study the changes of resting-state brain activity in knee osteoarthritis(KOA)patients with chronic pain.Methods The data of 21 KOA patients (KOA group) and 21 healthy controls (HC group) who underwent standard resting-state fMRI scan were analyzed with regional homogeneity (ReHo) method to observe the changes in the patients in contrast to the controls.Results Compared to HC group,patients of the KOA group showed ReHo changes in bilateral frontal lobe,bilateral parietal lobe,bilateral temporal lobe,bilateral cerebellum,limbic system and default-mode network.Conclusion Patients with chronic pain demonstrate abnormal neuron activities in the brain regions, and control loops not only related with pain but also related with emotive function disorder and cognitive impairment.

Objective To study the effect and mechanisms of TW-37 on cell proliferation,apoptosis,invasion and angiogenesis in pancreatic cancer cells in vitro and further explore the potential mechanism.Methods BxPC3 and HPAC cells were pretreated with TW-37 using untransfected or transfected with NF-κB p65 cDNA(p65 cDNA)or NF-κB p65 siRNA(siRNA-p65)cells as controls.Cell viability was determined by MrTT assay.Cell apoptosis was assessed by enzyme-linked immunosorbent assay (ELISA).Cell invasion and angiogenesis was detected by Transwell and endothelial tube formation assay of HUVECs.ELISA assay was used to measure the activity of NF-κB,and its target proteins of MMP-9 and VEGF were detected by western blot.Results TW-37 suppressed cell growth and induced apoptosis (A405:1.29 ± 0.21 vs 0.09 ± 0.01,1.07 s0.18 vs 0.08 ± 0.01),inhibited NF-κB activity and protein expression of NF-κB p65,VEGF and MMP-9(all P ＜0.05)in a dose-and time-dependent manner.The number of cells that invaded across the matrigel in the transwell chamber was (46.7 ±5.24) and (10.3 ± 1.26)/×200 in BxPC3 control and 0.75 μmol/L TW-37 group (P=0.001).The number of tube formation was (39.4 ±4.36) and (7.84 ± 1.25)/×200,(P =0.001).NF-κB activity was increased by p65 cDNA transfection,and decreased by TW-37 treatment in both of the two cell lines (P ＜0.05).However,NF-κB activity was decreased by p65 siRNA transfection,and greatly decreased by TW-37 treatment in both two cell lines (P ＜0.05 or P ＜0.01).Transfection of p65 cDNA did not significantly affect cell apoptosis.Transfection of p65 siRNA increased cell apoptosis,and greatly increased by TW-37 treatment in both two cell lines (all P ＜ 0.01).Conclusions TW-37 could inhibit the proliferation,invasion and angiogenesis in pancreatic cancer cells by regulating NF-κB signal pathway.