AIM:To investigate the effect of small incision lenticule extraction(SMILE)on the treatment of myopia patients, and the impact on corneal biomechanics.METHODS:Retrospective study. A total of 120 myopic patients(240 eyes)who were scheduled to undergo corneal refractive surgery in Anyang Eye Hospital from January 2020 to December 2021 were selected. The patients were divided into SMILE group(64 patients, 128 eyes)and transepithelial photorefractive keratectomy(TransPRK)group(56 patients, 112 eyes)according to the surgical treatment method. The two groups were compared in terms of uncorrected visual acuity, corneal biomechanics, corneal endothelial cell count, posterior corneal surface height and corneal surface regularity index at 1, 7 d, 1, 3, 6 mo and 1 a after surgery, and surgical complications.RESULTS:The uncorrected visual acuity of the SMILE group at 1, 7 d and 1 mo after surgery was better than that of the TransPRK group(all P<0.001), but there was no statistically significant difference between the groups at 3, 6 mo and 1 a after surgery(all P>0.05). Compared with preoperative values, corneal-compensated intraocular pressure, Goldmann-correlated intraocular pressure, corneal resistance factor, and corneal hysteresis in both groups showed a first decreasing and then increasing trend after surgery. The corneal-compensated intraocular pressure, Goldmann-correlated intraocular pressure, corneal resistance factor, and corneal hysteresis in the SMILE group at 1, 7 d and 1 mo after surgery were higher than those in the TransPRK group(all P<0.05), but there was no statistically significant difference between the groups at 3, 6 mo and 1 a after surgery(all P>0.05). There were no significant changes of corneal endothelial cell count and corneal posterior surface height in the two groups after surgery(all P>0.05). Furthermore, corneal surface regularity index of the two groups showed a first increasing and then decreasing trend after surgery, with no statistically significant difference between the groups(P>0.05), and there was no statistically significant difference in the incidence of postoperative complications between the groups(P>0.05).CONCLUSION:Compared with TransPRK, SMILE has less influence on corneal biomechanics, and better visual recovery in the early stage. There is no difference in long-term visual acuity between the two surgeries, and both have good safety and effectiveness.

Rotator cuff injury often leads to shoulder pain and dysfunction. For the injured rotator cuff tendon without continuous interruption, conservative treatment is often used. However, the shoulder is used frequent in daily life, which makes that the rotator cuff injury generally shows gradual aggravation and eventually progresses to complete tear due to poor blood supply of the rotator cuff tendon tissue and weak repair ability. In order to reverse the pathophysiological changes after rotator cuff injury and promote the repair of injured rotator cuff tendon, a series of conservative treatments for rotator cuff injury have been explored. Extracorporeal shock wave therapy (ESWT) is one of the representative treatments, but its molecular biological mechanism in promoting rotator cuff repair is still unclear. Therefore, the authors review the progress of ESWT for rotator cuff injury from aspects of the molecular biological mechanism and clinical application status, so as to provide a reference for future researches and clinical application of ESWT.

The spatiotemporal distribution of growth factors in bone tissue-engineered repair and reconstruction is critical. Growth factors can be used in bone tissue engineering through different encapsulation methods. Different encapsulation methods make growth factors have different release kinetics. At present, the common physical entrapment, easily degradable carrier and simple spatial structure usually result in poor sustained release of growth factors by burst release. The optimization of release methods of growth factors enables their release at different times and spaces in a biomimetric manner, which is conducive to improving the effect of tissue repair and avoiding the adverse effects of excessive factors. Starting from the necessity of spatiotemporal sustained release of growth factors, the authors summarize growth factors can attain spatiotemporal sustained release by being directly immobilized on the surface of the carrier, encapsulated in the carrier, encapsulated in the microparticles and encapsulated in the carrier by the microparticles and review the spatiotemporal sustained release of growth factors in different encapsulation methods, so as to provide a reference for optimizing spatiotemporal release of growth factor in bone tissue engineering.

Objective:To investigate the clinical effect of early arthroscopic shoulder treatment of moderate full-thickness tear of the supraspinatus tendon.Methods:A retrospective case control study was conducted to analyze the clinical data of 43 patients with moderate full-thickness supraspinatus tendon tear admitted to First Affiliated Hospital of Xi 'an Jiaotong University from January 2018 to June 2020，including 17 males and 26 females，aged from 41 to 68 years［（55.9±8.2）years］. All patients had arthroscopic shoulder supraspinatus tendon suture and acromioplasty，including 22 patients underwent surgery within 1 month after persistent shoulder pain and motion limitation in early group and 21 patients between 1 month and 3 months in late group. The duration of operation and intraoperative blood loss were recorded. The visual analogue scale（VAS），American Shoulder and Elbow Society（ASES）score and Constant-Murley score were assessed before operation and at postoperative 3 weeks，6 weeks，3 months and 6 months. The complications were detected with 6 months after operation. Results:All patients were followed up for 6-7 months［（6.4±0.4）months］. There was no statistical significance in operation duration and intraoperative blood loss between the two groups（ P>0.05）. At 3 weeks，6 weeks，3 months and 6 months after operation，there showed significant decrease of VAS but significant increase of ASES and Constant-Murley scores compared to preoperation（ P<0.05）. At 3 weeks and 6 weeks after operation，the VAS in early group［（4.4±0.9）points，（3.7±0.8）points］was lower than that in late group［（5.5±1.0）points，（4.8±1.1）points］；while the ASES score［（49.1±4.6）points，（56.8±4.1）points］and Constant-Murley score［（54.1±4.8）points，（64.1±4.4）points］in early group were higher than those in late group［ASES score：（45.2±5.4）points，（50.3±5.4）points；Constant-Murley score：（50.5±3.3）points，（58.2±3.9）points］（ P<0.05）. At 3 months and 6 months after operation，the two groups showed no statistical significance in these scores. There were no postoperative complications such as infection or nerve injury in both group within 6 months. Conclusion:For moderate full-thickness tear of the supraspinatus tendon，arthroscopic shoulder surgery performed within 1 month after persistent shoulder pain and motion limitation can achieve better pain relief and faster functional rehabilitation in the short term compared with surgery performed 1-3 months later.

The rotator cuff injury is a kind of chronic tendon disease related to overuse injury. The main clinical manifestations of this disease include shoulder pain and dysfunction，which seriously affects people 's life quality and work capability. Although previous studies have shown that inflammation and de- generation of collagen matrix are closely related to the occurrence and development of this disease，the pathogenesis of the disease is still unclear. In this study，the authors review the pathologic mechanisms of rotator cuff injuries from aspects of oxidative stress，inflammation，macrophage and non-coding RNA so as to provide a reference for subsequent research and treatment.

Objective:To investigate the expression and clinical significance of histone acetyltransferase P300 in hepatocellular carcinoma.Methods:From January 2013 to December 2017, surgical specimens of 100 patients with hepatocellular carcinoma were collected from the Department of General Surgery of Sichuan Mianyang 404 Hospital. The expressions of P300, CD90, alpha fetoprotein (AFP), Ki-67 and CD34 in hepatocellular carcinoma tissue were detected. At the same time, 42 hepatic hemangioma specimens and 56 liver tissue specimens with moderate to severe liver cirrhosis were collected, and the positive expression rate of P300 in tissues was detected. The correlations between the expression of P300 and clinicopathological features and prognosis of patients with hepatocellular carcinoma were analyzed.Results:The positive expression rates of P300 in normal liver tissue, liver cirrhosis tissue and hepatocellular carcinoma tissue increased gradually, which were 11.9% (5/42), 32.1% (18/56) and 57.0% (57/100) respectively, with a statistically significant difference ( χ2=27.192, P<0.001). Tumor grade ( χ2=9.337, P=0.009), T stage ( χ2=8.794, P=0.032), clinical TNM stage ( χ2=6.121, P=0.013), AFP ( χ2=11.040, P=0.001), CD90 ( χ2=9.903, P=0.002), CD34 ( χ2=4.066, P=0.044) significantly affected the expression of P300. Spearman rank correlation analysis showed that the abnormal expression of P300 was positively correlated with the expression of AFP ( r=0.335, P=0.001), CD90 ( r=0.328, P=0.002) and CD34 ( r=0.264, P=0.047) , but had no significant correlation with the expression of Ki-67 ( P>0.05). Survival analysis showed that the 5-year survival rate of patients with P300 positive expression was 17.6%, and that of patients with P300 negative expression was 62.5%, and there was a statistically significant difference ( χ2=10.596, P<0.001). Cox multivariate analysis showed that P300 positive expression ( RR=2.554, 95% CI: 1.261-4.502, P=0.009), CD90 positive expression ( RR=3.574, 95% CI: 1.021-11.980, P=0.030) and TNM Ⅱ-Ⅳ stage ( RR=0.332, 95% CI: 0.105-0.596, P=0.002) were independent risk factors for poor prognosis of patients with hepatocellular carcinoma. Conclusion:The positive expression of P300 is closely related to the occurrence of hepatocellular carcinoma and can be used as an independent factor to judge the poor prognosis of patients with hepatocellular carcinoma.

Objective:To evaluate the effect of adductor canal block(ACB)and local infiltration anesthesia(LIA)around the knee joint on inflammatory responses in the patients undergoing total knee arthroplasty(TKA).Methods:Sixty American Society of Anesthesiologists physical status Ⅱor Ⅲ patients of both sexes, aged 54-76 yr, scheduled for elective TKA, were divided into 2 groups ( n=30 each) using a random number table method: ACB group (group A) and ACB combined with LIA around knee joint group (group AL). ACB was performed with 0.5% ropivacaine 15 ml after endotracheal intubation in group A and group AL, and in addition LIA was performed around the knee joint after the osteotomy was completed during surgery in group AL.The patient-controlled ACB analgesia was applied at the end of surgery in both groups.The analgesic solution contained ropivacaine 400 ml (in 0.9% normal saline 200 ml), and the analgesic pump was set up to deliver a 5 ml bolus dose with a 30-min lockout interval and background infusion at 5 ml/h.When visual analog scale score>4, and pain was still not relived at 30 min after pressing by patients, pethidine hydrochloride 100 mg was intramuscularly injected as rescue analgesic.Peripheral venous blood samples were collected immediately before surgery (T 0) and at 24, 48 and 72 h after surgery (T 1-3) for determination of serum interleukin-6 (IL-6) and IL-10 concentrations by enzyme-linked immunosorbent assay.The muscle strength on the affected side was assessed at T 1-3.The patients′ satisfaction score, requirement for rescue analgesia, and adverse effects were recorded. Results:Compare with group A, the serum IL-6 concentrations were significantly decreased and serum IL-10 concentrations were increased at each time point after surgery, postoperative patients′ satisfaction scores were increased, the requirement for rescue analgesia was decreased ( P<0.05), and no significant change was found in the quadriceps strength of the affected limb and incidence of adverse reactions after surgery in group AL ( P>0.05). Conclusion:ACB and LIA around the knee joint can mitigate postoperative inflammatory responses in the patients undergoing TKA.

Objective:To explore the efficacy of flow diversion combined with coil embolization in treatment of intracranial aneurysms.Methods:The clinical data of 110 patients with intracranial aneurysms treated by flow diversion in our hospital from April 2015 to September 2019 were retrospectively analyzed. In these patients, 48 were treated by flow diversion combined with coil embolization and 62 were treated by flow diversion alone; the efficacy and safety of patients from the two groups were compared.Results:Blood flow diversion was successfully implanted into all 110 patients, with technical success rate of 100%. Immediate complete occlusion rate in the flow diversion combined with coil embolization group (16.7%) was significantly higher than that in the flow diversion group (1.6%, P<0.05). There was no significant difference in the incidence of perioperative complications between flow diversion combined with coil embolization group and flow diversion group (4.17% vs. 4.84%, P>0.05). During the mean follow-up of 6.72±3.80 months, modified Rankin scale (mRS) scores of patients in the flow diversion combined with coil embolization group were all 0; one patient had mRS score of 1, one patients had mRS scores of 2, and 60 patients had mRS score of 0 in patients from the flow diversion group; no significant difference was noted between the two groups ( P>0.05). Patients in the flow diversion combined with coil embolization group had significantly higher rate of complete aneurysm occlusion than those in the flow diversion group (88.3% vs. 66.1%, P<0.05). Conclusions:Flow diversion is an effective and safe strategy in treatment of intracranial aneurysms. Flow diversion combined with coil embolization can effectively promote early healing of aneurysms in selective patients.

Objective To investigate the relationship between inflammatory response and depth of propofol sedation during cardiac valve replacement with cardiopulmonary bypass (CPB).Methods Fifty patients undergoing cardiac valve replacement with CPB were randomly divided into low Bispectral index (BIS)group(30≤BIS<45)and high BIS group(45≤BIS≤60).Each group had 25 cases.The induction of anesthesia in the two groups was in the same way.Anesthesia was maintained in the fol‐lowing way :low BIS group and high BIS group received intravenous infusion of 7 mg/(kg · h) and 3 mg/(kg · h) propofol ,re‐spectively.In operation ,the propofol infusion rate was adjusted to maintain each group in the corresponding BIS value range.Before induction of anesthesia(T0 ) ,at the end of the CPB(T1 ) ,the end of operation(T2 )and 1 h after operation(T3 ) ,re‐spectively ,6 mL of jugular vein blood samples were collected.The concentrations of IL‐6 ,TNF‐αand S100βprotein in the serum were detected by ELISA method.At T0 ,T1 and T2 ,respectively ,arterial blood was collected ,the pH of blood and the concentra‐tions of blood glucose and lactate were determined.Results At T1 ,T2 and T3 ,the concentrations of IL‐6 and TNF‐αin serum in low BIS group were all lower than those in the high BIS group(all P<0.05).At T2 and T3 ,the S100βprotein concentrations in serum in the low BIS group were all lower than those in the high BIS group (both P< 0.05).Compared with the high BIS group ,the concentrations of blood glucose and lactate in low group at T 1 and T2 were all lower(all P<0.05).Conclusion Ap‐propriately enhancing the depth of sedation could help relieve the inflammatory reaction of patients during cardiac valve replace‐ment with CPB.It can help protect brain tissue and reduce the incidence of brain injury.

objective To understand the baseline data of mortality from malignant tumor from 2006 to 2009 around Hongyanhe Nuclear Power Plant in Wafangdian City,Liaoning Province,so as to provide scientific basis for evaluating the impact of normal operation of nuclear power plant on the health of the residents nearby.Methods Thirty small towns near Hongyanhe Nuclear Power Plant were divided into 5 investigated areas according to the distances away therefrom(0.,10.,20-,30-,and 40-km).The data about from malignant tumor were obtained from the Center for Disease Control and Prevention of Wafangdian.The mortality distribution of difierent malignant tumors was analyzed,including the radiosensitive malignant tumors,especially leukemia,breast cancer,and thyroid gland cancer in different area,gender,and age groups.Results The mortality from malignant tumor was 151.97/105,and the standardized mortality rate(SMR)was 97.76/105.The mortality from malignant tumor among the males was 188.28/105(with the SMR of 116.76/105),and that among the females was 113.47/105(with the SMR of 75.89/105).with a sex ratio of 1.71.The first five cancers in the rank of death causes were lung,liver,stomach,colorectal,and esophageal cancers with mortality of 46.19/105,23.51/105,20.30/105,8.06/105 and 5.45/105,respectively.The mortality from mal.ignant tumor in the areas around the nuclear power plant from the near to the distant were 99.85/105, 137.40/105,138.73/105,156.30/105,and 154.16/105,respectively.The mortality from radiosensitive malignant tumors,leukemia,breast cancer,and thyroid gland cancer were 4.57/105,4.06/105,and 0.26/105,respectively.Conclusions Lung cancer and digestive tract malignant tumors are the main causes of death from malignant tumors in Wafangdian area before the nuclear power plant began to operate.There are no significant differences in the mortality distribution of malignant tumors among different areas,genders,and age groups.There are not significant differences in the mortality distribution of leukemia and breast cancer among different areas and age groups.