Intra-operative optical coherence tomography in corneal lamellar graft reinforcement for Boston type I keratoprosthesis corneal melt

Corneal melt is a sight-threatening complication of Boston type 1 keratoprosthesis (KPro). Severe corneal melt may result in hypotony, choroidal hemorrhage, and even spontaneous extrusion of the KPro, which may lead to a poor visual prognosis. Lamellar keratoplasty is one surgical option for the management of mild corneal melt, especially when a new KPro is not available. Herein, we present a new surgical technique application, intra-operative optical coherence tomography (iOCT) for the management of cornea graft melt after Boston type 1 KPro implantation. The visual acuity and the intra-ocular maintained stable at 6 months post-operatively, and the KPro remained in place without corneal melting, epithelial ingrowth, or infection. iOCT may prove to be a real-time, non-invasive, and accurate treatment for corneal lamellar dissection and suturing beneath the anterior plate of the KPro, which can effectively help the surgeon to make surgical decisions and reduce post-operative complications.

Prognosis of patients with secondary organ dysfunction caused by intra-abdominal infections / 中国实用外科杂志

OBJECTIVE: To analyze the clinical characteristics and prognosis of patients with organ dysfunction secondary to intra-abdominal infections(IAIs).METHODS: 606 patients with organ dysfunction secondary to IAIs who admitted to the First Affiliated Hospital of Xi' an Jiaotong University from January 2014 to December 2017 were recruited for retrospective analysis.Demographic,treatment and outcome data of all patients were collected.Incidence,mortality,treatment and risk factors were adopted for reveal the prevalence of organ dysfunction secondary to IAIs.RESULTS: The morbidity and mortality of patients with organ dysfunction secondary to IAIs were 40.6% and 14.7%,respectively.The mortality rate increased with the number of dysfunctional organs.The univariate analysis results indicated that the number of dysfunctional organs,location of primary infection,continuous renal replacement therapy(CRRT) treatment,artificial liver support,presence of comorbidities,acute physiology and chronic health status(APACHEII)score,sequential organ failure(SOFA)score were associated with the prognosis.The multivariate analysis results showed that the number of dysfunctional organs,artificial liver support,APACHE Ⅱ score and SOFA score were risk factors for the prognosis of patients with organ dysfunction secondary to IAIs.CONCLUSION: The morbidity and mortality of organ dysfunction in IAIs were high.The number of dysfunctional organs,artificial liver support,APACHE Ⅱscore and SOFA score were risk factors for the prognosis of patients with organ dysfunction secondary to IAIs.

The predictive value of PNI for post-operative intra-abdominal infections in gerontal liver cancer patients / 中国实用外科杂志

OBJECTIVE: To investigate the predictive significance of prognostic nutritional index(PNI)for intraabdominal infections(IAIs)in gerontal liver cancer patients who received hepatectomy.METHODS: The clinical data of270 gerontal(age≥60 y)patients with primary liver cancer(PLC)who received hepatectomy in the First Affiliated Hospital of Xi' an Jiaotong University were retrospectively analyzed.Receiver operating characteristic curve(ROC),multivariate analysis and survival curve were used to conduct the predictive significance of preoperative PNI for IAIs.RESULTS: The incidence of IAIs was 12.59%(34/270)in this cohort.The cut-off value of preoperative PNI for the prediction of postoperative IAIs was 47.58(P0.05).CONCLUSION: Preoperative PNI determination has predictive value for postoperative IAIs in gerontal liver cancer patients who received hepatectomy.

Progress in the combined application of bone morphogenetic protein-2 and basic fibroblast growth factor in bone tissue engineering / 口腔疾病防治

@#Bone morphogenetic protein-2 (BMP-2) and basic fibroblast growth factor (bFGF) are two important signaling molecules for natural bone repair that are widely applied in the field of bone tissue engineering. BMP-2 accelerates the maturation and mineralization of osteoblasts, and bFGF exhibits significant effects on the promotion of cell division and angiogenesis. The osteogenesis mechanism of BMP-2 differs from that of bFGF, leading to a potentially complementary role between the two proteins. The use of a suitable dose of bFGF in combination with BMP-2 in bone tissue engineering synergistically promotes the formation of new bone and exhibits a better repair effect than either single growth factor. However, the suitable dose range of BMP-2 and bFGF in combination should be further clarified. The mechanism of the synergism and antagonism between BMP-2 and bFGF must be further delineated, and a drug delivery system that better simulates the growth factor release pattern during natural bone repair remains to be designed.

Waist Circumference-dependent Peripheral Monocytes Change after Gliclazide Treatment for Chinese Type 2 Diabetic Patients / 华中科技大学学报（医学）（英德文版）

Gliclazide used for the treatment of type 2 diabetes mellitus (T2DM) stimulates insulin secretion and influences peripheral blood monocytes.The roles of gliclazide in peripheral monocytes of newly diagnosed T2DM patients were investigated in this study.A total of 105 newly diagnosed T2DM patients with no history of antihyperglycemic medication were treated with gliclazide-modified release for 16 weeks.The total and differential leukocyte profiles of peripheral blood were measured at baseline and week 16.The peripheral blood monocyte count at week 16 was significantly lower than that at baseline (P=0.019).Peripheral monocytes level at baseline was positively correlated with waist circumference.After gliclazide treatment,the peripheral monocytes were decreased [(320.09±15.13)×106/L vs.(294.19±14.22)×106/L] in non-abdominal obesity group,but increased in abdominal obesity group [(344.36±17.24)×106/L vs.(351.87±16.93)×106/L].Compared with non-abdominal obese patients,abdominal obese patients showed higher Amonocytes (P=0.046) and Aacute insulin secretion (P=0.049),but lower AHbAlc (P=0.047).There was significantly positive correlation between Amonocytes and Aacute insulin secretion (P=0.015),which disappeared after adjusting for age,waist circumference and dosage at baseline.In conclusion,waist circumference is correlated with peripheral monocyte change after gliclazide treatment in Chinese newly diagnosed T2DM patients.Peripheral monocytes are decreased in non-abdominal obesity group and increased in abdominal obesity group after gliclazide treatment.

Survival Analysis of Hepatocellular Carcinoma: A Comparison Between Young Patients and Aged Patients / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>To compare the clinicopathological features and prognosis between younger and aged patients with hepatocellular carcinoma (HCC).</p><p><b>METHODS</b>We analyzed the outcome of 451 HCC patients underwent liver resection, transcatheter arterial chemoembolization and radiofrequency ablation, respectively. Then risk factors for aged and younger patients' survival were evaluated by multivariate analysis, respectively.</p><p><b>RESULTS</b>The patients who were older than 55 years old were defined as the older group. The overall survival for aged patients was significantly worse than those younger patients. The younger patients had similar liver functional reserve but more aggressive tumor factors than aged patients. Cox regression analysis showed that the elevated levels of aspartate aminotransferase (AST) (Wald χ2 = 3.963, P = 0.047, hazard ratio [HR] =1.453, 95% confidence interval [CI]: 1.006-2.098), lower albumin (Wald χ2 = 12.213, P < 0.001, HR = 1.982, 95% CI: 1.351-2.910), tumor size (Wald χ2 = 8.179, P = 0.004, HR = 1.841, 95% CI: 1.212-2.797), and higher alpha-fetoprotein level (Wald χ2 = 4.044, P = 0.044, HR = 1.465, 95% CI: 1.010-2.126) were independent prognostic factors for aged patients, while only elevated levels of AST (Wald χ2 = 14.491, P < 0.001, HR = 2.285, 95% CI: 1.493-3.496) and tumor size (Wald χ2 = 21.662, P < 0.001, HR = 2.928, 95% CI: 1.863-4.604) were independent prognostic factors for younger patients.</p><p><b>CONCLUSIONS</b>Age is a risk factor to determine the prognosis of patients with HCC. Aged patients who have good liver functional reserve are still encouraged to receive curative therapy.</p>

Single-port laparoscopic ligation with suture silk for varicocele: a report of 20 cases / 中华男科学杂志

<p><b>OBJECTIVE</b>To evaluate the clinical effect of single-port laparoscopic ligation (SPLL) with suture silk for the management of varicocele.</p><p><b>METHODS</b>We analyzed the clinical effects of SPLL with suture silk in the treatment of 20 cases of varicocele, and compared them with those of conventional three-port laparoscopic ligation (TPLL) for another 24 varicocele patients.</p><p><b>RESULTS</b>All the operations were successful. The operation time was 20-35 (mean 28) minutes and the hospital stay was 2 days for SPLL, as compared with 15-28 (mean 20) minutes and 3 days for TPLL. The cure rate was 75% for the former, and 67% for the latter, with no signification difference between the two groups (P > 0.05).</p><p><b>CONCLUSION</b>SPLL with suture silk for the treatment of varicocele has more advantages over TPLL for minimal invasiveness, faster recovery, and less scarring and extraneous residual.</p>

Expression of Toll-like Receptor 9 in Peripheral Blood Mononuclear Cells from Patients with Different Hepatitis B and C Viral Loads / 华中科技大学学报（医学）（英德文版）

e negatively corre-lated with serum viral copies and play an important role in detecting viral replication of HBV and HCV.

The Effect of Gankang Suppository on Duck Hepatitis B Virus, Serum Biochemistry and Liver Histology in Ducklings / 华中科技大学学报（医学）（英德文版）

To examine the effect of Gankang Suppository on duck hepatitis B virus (DHBV), the serum biochemistry and hepatic histology in an animal model of DHBV infection, a model of DHBV infection was established by infecting 1-day-old Yingtaogu ducklings with DHBV-positive serum.The successful model was confirmed by PCR assay and 48 ducklings infected with DHBV were randomly divided into 3 groups: a Gankang Suppository treatment group, an acyclovir (ACV) group and a DHBV model group (control), with each group having 16 animals. All the animals were .given the medicines for 4 weeks in a row. The serum of the animals was taken 14 and 28 days after the medication and 7 days after drug discontinuation. Real-time PCR was performed to detect the copy numbers of DHBV DNA in the serum. ALT and AST were dynamically monitored. The ducklings were sacrificed on the 7th day after the discontinuation of the treatment and livers were harvested and examined for inflammation and degeneration of liver cells by using HE staining. The results showed that on day14, 28 after the treatment and day 7 after the withdrawal, the logarithmic values (log) of DHBV DNA copy numbers in ducklings of Gankang Suppository treatment group were significantly lower than that before the treatment (P=0.0092, P=0.0070, P=0.0080, respectively). Compared with DHBV model control group, the ALT level was significantly decreased (P=0.0020, P=0.0019, respectively)on day 28 after the treatment and on day 7 after the withdrawal. The AST level was also reduced on day 14 after the treatment (P=0.0298). Compared with the ACV control group, the level of ALT was lower on day 7 after the withdrawal (P=0.0016). Histologically, the hepatocyte swelling, vacuolous degeneration and acidophilic degeneration in Gankang Suppository treatment group were alleviated 7days after the withdrawal as compared with model control group(P=0.0282, P=0.0084, P=0.0195,respectively). It is concluded that Gankang Suppository can effectively suppress DHBV replication,reduce the levels of serum ALT and AST and improve hepatic histology.

Effects of Endotoxin on Liver Smac Apoptosis Channel / 华中科技大学学报（医学）（英德文版）

To study the effect of endotoxin on liver apoptosis, LO2 liver ceils were cultured and passaged in vitro, and then stimulated by endotoxin at 10 mg/mL for 4, 8, 16 and 24 h respectively. Liver apoptosis was flow cytometrically and fluorescently detected. Immunohistochemistry was used to detect the delivery of smac and caspase9. The delivery of liver cell smac and the activity of caspase3 were measured by caspase3 assay kit. The hepatic failure models of rats were established by using D-galactosamine. The blood serum and liver tissues were collected for the detection of the liver function, the level of endotoxin and the activity of caspase3 by using chromogenic substrate limulus amebocyte lysate method (LAL) and caspase3 active assay kit. The expression of smac and caspase9 in liver ceils was detected by Western blotting. With in vitro study, the LO2 cells stimulated by LPS condensed into conglobation and formed apoptotic bodies. After those cells were stained.by hoechst,the apoptotic cells displayed blue color under the fluorescent microscope. The apoptosis rate was increased over time and the apoptosis was mainly of advanced stage. Meanwhile, the rate of smac delivery and activity of caspase9 and caspase3 were increased on LO2 cell membrane. In vivo, hepatic failure and obvious endotoxemia were induced by injection of more than 200 mg/kg D-GaIN. Hepatic mitochondria smac was reduced with dosage of D-GaIN and, on the contrary, the activity of caspase3 was increased. D-GaIN at 200 mg/kg increased Caspase9 while D-GaIN at 300 mg/kg decreased caspase9. Mitochondria signal channel plays an important role in the endotoxin-induced apoptosis of hepatic cells by promoting the release of smac from mitochondria to cytoplasm and activating caspase9 and caspase3 in its low-level channel.