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Corneal refractive surgery and intraocular collamer lens(ICL)implantation are the mainstream refractive surgery methods at present. Many studies have proved that ICL implantation can effectively improve the postoperative visual acuity of patients. ICL implantation has gained favor among refractive doctors and patients because of its multiple advantages. Excellent postoperative visual acuity and visual quality are the key factors to improve patients' satisfaction. In order to evaluate the subjective and objective visual quality of patients after operation and avoid complications, this article reviews the visual quality and postoperative complications after ICL implantation.
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Objective: To investigate the clinicopathological features, immunophenotypes and molecular genetics of EWSR1-SMAD3 positive fibroblastic tumor (ESFT) with an emphasis on differential diagnosis. Methods: The clinicopathological data, immunohistochemical profiles and molecular profiles of 3 ESFT cases diagnosed at the Department of Pathology, Fudan University Shanghai Cancer Center from 2018 to 2021were analyzed. The related literature was also reviewed. Results: There were two males and one female. The patients were 24, 12 and 36 years old, respectively. All three tumors occurred in the subcutis of the foot with the disease duration of 6 months to 2 years. The tumors were presented with a slowly growing mass or nodule, accompanied with pain in 1 patient. The tumors ranged in size from 0.1 to 1.6 cm (mean, 1.0 cm). Microscopically, the tumors were located in the subcutaneous tissue with a nodular or plexiform growth pattern. They were composed of cellular fascicles of bland spindle cells with elongated nuclei and fine chromatin. One of the tumors infiltrated into adjacent adipose tissue. There was no nuclear atypia or mitotic activities. All three tumors showed prominent stromal hyalinization with zonal pattern present in one case. Focal punctate calcification was noted in two cases. The immunohistochemical studies showed that tumor cells were diffusely positive for ERG and negative for CD31 and CD34, with Ki-67 index less than 2%. Fluorescence in situ hybridization on the two tested cases identified EWSR1 gene rearrangement. The next generation sequencing analysis demonstrated EWSR1-SMAD3 fusion in all three cases. During the follow up, one patient developed local recurrence 24 months after the surgery. Conclusions: ESFT is a benign fibroblastic neoplasm and has a predilection for the foot, characterized by ERG immunoreactivity and EWSR1-SMAD3 fusion. Local recurrence might occur when incompletely excised. Familiarity with its clinicopathological features is helpful in distinguishing it from other spindle cell neoplasms that tend to occur at acral sites.
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Adult , Child , Female , Humans , Male , Biomarkers, Tumor/analysis , China , In Situ Hybridization, Fluorescence , Neoplasms, Fibrous Tissue/pathology , RNA-Binding Protein EWS/genetics , Smad3 Protein/genetics , Soft Tissue Neoplasms/surgeryABSTRACT
@#AIM:To assess the clinical application of confocal microscopy combined with corneal scraping in the diagnosis and treatment of fungal keratitis.<p>METHODS: Totally 56 eyes of 56 patients with fungal keratitis from our hospital were included. All patients underwent confocal microscopy and cornea scraping for smear microscopy and fungal culture. The diagnostic yield was analyzed.<p>RESULTS: The positive diagnostic rates of confocal microscopy and cornea scraping were 91% and 54% respectively,whereas in combination the positive diagnostic rate increased to 95%. 44 eyes(79%)were clinically cured with drugs alone while 12 eyes(21%)also required surgery. <p>CONCLUSION: Confocal microscopy examination is non-invasive, with rapid detection and strong repeatability. When combined with corneal scraping it can be used to improve diagnostic yield and guide clinical therapy.
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Objective To explore the effect of PM2.5 on the mortality of cardio-cerebrovascular disease in Suzhou, China. Methods The death data, air pollutant data and meteorological data from January 1, 2016 to December 31, 2017 in Suzhou were collected. The general additive Poisson regression model was used to analyse the association of exposure to PM2.5 with the daily deaths due to cardio-cerebrovascular disease, and to calculate the relative risk (RR) and 95% confidence intervals (95%CI) for an interquartile range (IQR) increase in PM2.5. Results The number of deaths from cardio-cerebrovascular disease was 30 200. On average, there were approximately 41 deaths per day. The daily median concentration of PM2.5 was 37.13 μg/m3 and IQR was 30.75 μg/m3. The RR values of single-day death and average death from cardio-cerebrovascular disease were 1.017(1.001-1.034) and 1.055(1.019-1.093)with an IQR increase of PM2.5 concentration, respectively. Stratified by gender and age, female and the elderly aged over 65 had higher risks of death from the cardio-cerebrovascular disease. Conclusion The elevated level of ambient PM2.5was positively associated with the increase of mortality of cardio-cerebrovascular disease.
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Umbilicus application to treat ascites caused by cirrhosis is a simple and effective characteristic therapy. This article analyzed the regularity of application traditional Chinese medicine (TCM) herbs on umbilicus to treat ascites caused by cirrhosis through TCM inherited auxiliary system. This study chose academic literatures related to TCM dressing umbilicus to treat ascites caused by cirrhosis in CNKI database, VIP database, Wanfang database over the past 20 years as the data source, and established database to analyze the core drugs and their channel tropism, property and flavor, compatibility law, and core composition,by means of frequency statistics, and association rules (Apriori method, complicated system entropy clustering). Finally, 92 prescription to treat ascites caused by cirrhosiss were screened out. These prescription includes 109 traditional Chinese medicines. And the analysis showed that there are 14 drugs with usage frequency of 10 and more than 10, 19 common drug pairs, 12 core drug combination. The drugs with high usage frequency include Kansui Radix, Borneolum Syntheticum, Pharbitidis Semen, Rhei Radix et Rhizoma, Moschus, Euphorbiae Pekinensis Radix, Natrii Sulfas, Cinnamomi Cortex, Genkwa Flos, Phytolaccae Radix, Arecae Semen. And the channel which are mostly invoivet includ lung meridian, spleen meridian and kidney meridian; while the property and flavor of the herbs used have the properties of cold and acrid; the common drug pairs include Pharbitidis Semen-Kansui Radix, Borneolum Syntheticum-Kansui Radix, Kansui Radix-Euphorbiae Pekinensis Radix, Kansui Radix-Moschus, Rhei Radix et Rhizome-Kansui Radix, Kansui Radix-Genkwa Flos, Borneolum Syntheticum-Pharbitidis Semen, Borneolum Syntheticum-Pharbitidis Semen-Kansui Radix, Kansui Radix-Arecae Semen; herbs with the function of expelling water and purgation used as main conponents, and resuscitation, promoting the circulation of Qi, and increaseing Yang used as auxilizy conponents.
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Humans , Ascites , Drugs, Chinese Herbal , Liver Cirrhosis , Medicine, Chinese Traditional , Meridians , UmbilicusABSTRACT
Thymus,a main organ for T cell development,plays a pivotal role in adaptive immune response and dealing with the threaten from pathogens and tumors.With the deep understanding of the thymus,people have been realizing that the thymus is extremely sensitive to acute and chronic injuries as well as involution with age.Thymus regeneration can recover its function to a certain level.Up to now,these methods including adoptive thymic epithelial progenitor cells immunotherapy,injection of IL-2 and angiogenesis factor and regulation of c-Met signal are able to promote thymus recovery and T cell regeneration.
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Objective To investigate the prevalence of and risk factors for neurosyphilis in syphilitic patients with persistently positive nontreponemal serological tests after regular therapy.Methods Clinical data were collected from 248 syphilitic patients with persistently positive nontreponemal serological tests after regular therapy,and analyzed retrospectively.Univariate analysis,multivariate logistic regression analysis and receiver operating characteristic (ROC) curve analysis were performed to assess factors associated with neurosyphilis.Results Of the 248 patients,25 (10.1％) were diagnosed with neurosyphilis.As univariate analysis showed,the occurrence of neurosyphilis was associated with the degree of decline in serum toluidine red unheated serum test (TRUST) titers (x2 =20.663,P ＜ 0.05) and persistent positive serum TRUST titers (Z =-7.021,P ＜ 0.05),but not with gender,age,stage of syphilis,treatment protocols,initial serum TRUST titers,or the presence or obsence of neurological symptoms (P ＞ 0.05).Multivariate logistic regression analysis revealed that persistent positive serum TRUST titers were a risk factor for neurosyphilis (OR =4.685,95％ CI =2.552-8.601,P ＜ 0.05).ROC curve analysis showed that the best cut-off point of persistent positive serum TRUST titer was 1 ∶ 8 for predicting neurosyphilis,with the area under the curve (AUC) being 0.907.Conclusion Serum TRUST titers are somewhat valuable for predicting neurosyphilis in syphilitic patients after regular therapy.
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Objective:To study the dissolution behavior of panax notoginseng saponins R1 , ginseng saponin Rg1 and ginseng sapo-nin Rb1 in Xuesaitong soft capsules in two different dissolution media. Methods:The dissolution test conditions were confirmed accord-ing to“quality of medical drugs information set” of Japan and the dissolution media were chosen in accordance with the physicochemi-cal properties of Xuesaitong soft capsules, the in vitro dissolution of Xuesaitong soft capsules was inspected respectively in pH 6. 8 phosphate buffer and water. The dissolution rate was determined by HPLC-ELSD, and the similarity of the release curves for the three components was compared with similarity factors ( f2 ) method. Results: The assay displayed a good linearity over the concentration range of 0. 8-16. 0 mg·L-1(r=0. 999 6), 3. 0-60. 0 mg·L-1(r=0. 999 8) and 4. 0-80. 0 mg·L-1(r=0. 999 7) for panax notog-inseng saponins R1 , ginseng saponin Rg1 and ginseng saponin Rb1 , respectively. In pH 6. 8 phosphate buffer and water, f2 of ginseng saponin Rg1 and ginseng saponin Rb1 were both above 50 when compared with panax notoginseng saponins R1 . Conclusion:The meth-od is simple, accurate and reproducible in the dissolution determination of the soft capsules. The dissolution of ginseng saponin Rg1 and ginseng saponin Rb1 has similar characteristics with that of panax notoginseng saponins R1 in Xuesaitong soft capsules.
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Objective:To investigate the ethical significance of the extracorporeal circulation membrane oxy-genation ( ECMO) in the donation organ transplantation .Methods: Analyzing the data of ECMO protected to the organ in 13 donors after brain death , Accounting the rising costs which caused by ECMO and make the interview to the patients and family members .Results:In the period of ECMO flow , the hemodynamic of the DBD donors be-come stable gradually , the medications reduced significantly or stop , the function of organs was restored .There were 38 organs can be used for the transplantation which were proven by the pathological biopsy .Twenty six kid-neys were transplanted to 26 recipients and liver transplantation was performed in 12 recipients.All transplantations were successfully completed .Medical cost of this patients increase 5.3%, all of the family members and patients can accept the intervention of ECMO .Conclusion:ECMO is an effective method to protect and improve the utili-zation rate of the organ .the improvement of the related technical standards , legal, laws and ethics of staff will pro-mote to the development of organ transplantation .
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<p><b>OBJECTIVE</b>To study the changes to surfactant proteins in the serum and bronchoalveolar lavage fluids (BALF) of children with Mycoplasma pneumoniae pneumonia (MPP) and their significance.</p><p><b>METHODS</b>Self-control method was used in the study. Forty-seven MPP children were divided into single lung infected (n=32) and bilateral lung infected groups (n=15) according to lung CT results. Surfactant proteins SP-A, B, C and D were measured using ELISA in the serum and BALF in the two groups. The correlations between SP-A, B, C and D content in the serum and BALF were evaluated by Spearman correlation analysis.</p><p><b>RESULTS</b>SP-A, B, C and D content in BALF from the majorly infected or infected lung were significantly higher than from the opposite lung and serum (P<0.01). SP-A, B and C content in serum was significantly lower than in BALF from the non-infected lung in the single-side infected lung group (P<0.01 or 0.05), but there was no significant difference between serum SP-D content and BALF SP-D content from the non-infected lung. There were no significant differences in SP-A, B, C and D content in serum and BALF from the minorly infected lung in the bilateral lung infected group. Serum SP-D content was positively correlated with BALF SP-D content from the majorly infected lung in the bilateral lung infected group (P<0.01).</p><p><b>CONCLUSIONS</b>Serum SP-D content may serve as a biomarker for evaluating the severity of pulmonary infection in children with community-acquired pneumonia.</p>
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Child , Child, Preschool , Female , Humans , Infant , Male , Bronchoalveolar Lavage Fluid , Chemistry , Pneumonia, Mycoplasma , Metabolism , Pulmonary Surfactants , BloodABSTRACT
<p><b>OBJECTIVE</b>To assess the inhibitory modulation of blood pressure by stimulation of the deep peroneal nerve (DPN) and to determine the involvement of nociceptive fibers in the modulation.</p><p><b>METHODS</b>All the animals were divided into six groups (A-F). The rats in groups A and B received no pretreatment. The rats in groups C and D received subcutaneous injection of capsaicin or control vehicle, respectively, near the DPN for 2 days. Those in groups E and F had the DPN exposed to capsaicin or control vehicle, respectively, for 20 min. Subsequently, pressor responses were induced by stimulation of paraventricular nucleus (PVN) either electrically (groups A and C C-F) or chemically via injection of glutamate (group B). After two stable pressor responses (baseline), all groups were subject to 5-min DPN stimulation followed by PVN stimulation for 10 s. Arterial blood pressure, heart rate, and electrocardiogram were recorded. The pressor response was calculated as the difference in the mean arterial pressure (MAP) before and after PVN stimulation, and changes from baseline in pressor response after DPN stimulation were compared between the groups.</p><p><b>RESULTS</b>Increases of MAP of 22.88±2.18 mm Hg and 20.32±5.25 mm Hg were induced by electrical (group A) or chemical (group B) stimulation of the PVN, respectively. These pressor responses were inhibited by stimulation of the DPN, and the MAP was reduced to 12.00±2.10 mm Hg in group A (n=6, P<0.01) and 7.00±2.85 mm Hg in group B (n=6, P<0.01). Subcutaneous injection of capsaicin (125 mg/kg) near the DPN in group C (n=7) had no effect on the inhibitory effect of DPN stimulation compared with the group D (n=9), and neither did blockade of nociceptive fibers with capsaicin in group E (n=6) compared with group F (n=8).</p><p><b>CONCLUSION</b>Stimulation of the DPN mimicking acupuncture has an inhibitory effect on the pressor response, and the effect is mediated by capsaicin-insensitive afferent fibers in the DPN.</p>
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Animals , Male , Rats , Acupuncture Therapy , Anesthesia , Blood Pressure , Capsaicin , Pharmacology , Electric Stimulation , Injections, Subcutaneous , Paraventricular Hypothalamic Nucleus , Cell Biology , Peroneal Nerve , Physiology , Pressoreceptors , Physiology , Rats, Sprague-DawleyABSTRACT
The study was aimed to evaluate the impact of disease status on the outcomes of allogeneic hematopoietic stem cell transplantation (allo-HSCT) in patients with refractory and relapsed acute myeloid leukemia (AML). 32 patients with refractory and relapsed AML received allo-HSCT after myeloablative conditioning regimen, including 17 patients in no-remission (NR) and 15 patients in complete remission (CR) at the time of transplant. Treatment related adverse events, relapse rate and leukemia free survival (LFS) were analyzed. The results showed that the parameters of sex, age, cytogenetic risk and transplant procedures were comparable between the two groups. 30 patients had successful engraftment, except one had graft failure and one died from severe veno-occlusive disease in the NR group. The incidences of aGVHD in NR group and CR group were 47.1% (8 patients) and 33.5% (5 patients) respectively. Out of comparable patients, 5 from 9 patients in NR group developed with cGVHD, and 4 from 11 patients in CR group were subjected to cGVHD. There were no statistic difference in incidences of aGVHD and cGVHD between two group. Compa-red with CR group, NR group had a higher treatment-related mortality (29.4% vs 14.3%, P = 0.392) and relapse rate (42.9% vs 26.7% P = 0.300), but there was no significant difference. With a median follow-up of 13 (1 - 124) months, 6 patients remained alive in both of the two groups, and the 2 year LFS of them were parallel (35.3% vs 40.0%, P = 0.267). Among these 32 patients, overall survival (OS) was better in patients with age < 35 years (P = 0.044) and with the appearance of cGVHD (P = 0.046). It is concluded that allo-HSCT is an effective salvage therapy for patients with refractory and relapsed AML, and the overall outcome seems unrelated to the disease status (NR or CR) before transplantation. As such, for refractory and relapsed AML patients in non-remission, performance of allo-HSCT to achieve long-term survival is feasible.
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Adolescent , Adult , Child , Female , Humans , Male , Young Adult , Hematopoietic Stem Cell Transplantation , Leukemia, Myeloid, Acute , Diagnosis , Pathology , General Surgery , Prognosis , Recurrence , Salvage Therapy , Methods , Transplantation, HomologousABSTRACT
Objective To examine the benefits of ECMO for potential organ donors with hemodynamic instability after brain death.Methods Three brain-dead potential donors who presented with hemodynamic instability despite maximal medical management,finished a declaration of brain death,that were supported by extracorporeal circulation membrane oxygenation (ECMO).Results Donor organs,including six kidneys,and two livers,were harvested from the three donors under ECMO support,leading to 8 successful transplantations.The organs functioned well and the recipients made full recoveries.Conclusion Our experience indicates that ECMO allows for the maintenance of abdominal organ tissue perfusion without warm ischemia before organ procurement,providing sufficient time for safe organ donation procedures and reducing the risk of unpredictable cardiac arrest that could result in the donor death and graft loss.
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dy for public hospitals.Discussions in relation were made on these subjects in an effort to offer references for the financial subsidy system for public hospitals.
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<p><b>OBJECTIVE</b>To investigate the role of nitric oxide in the inhibitory effect of somatic afferent input on the pressor response caused by electrical stimulation of the paraventricular nucleus of the hypothalamus (PVN).</p><p><b>METHODS</b>SD rats anesthetized by urethane were used in the study. Bipolar stainless stimulating electrode was inserted into PVN for electrical stimulation. Multi-barreled micropipettes were used for microinjection of L-NAME or normal saline into the lateral ventricle or amygdala. Deep peroneal nerve (DPN) was stimulated with electrical current pulses of 0.4 mA with duration of 0.5 ms at 4 Hz for 5 min. PVN was stimulated by electrical current pulses of 0.3 mA with duration of 0.5 ms at 80 Hz for 10 sec.</p><p><b>RESULT</b>Electrical stimulation of PVN increased mean arterial pressure. Stimulation of DPN significantly inhibited the pressor response induced by stimulation of PVN (P<0.01), with the inhibitory percentage of 43.27%. Microinjection of L-NAME (0.5 mol/L,10 microl) into the lateral ventricle of brain attenuated the inhibitory effect of DPN. The inhibitory percentage decreased from 47.73% to 12.49% (P<0.05). Microinjection of L-NAME (2 mol/L,100 nl) into amygdala reduced the inhibitory effect of DPN. The inhibitory percentage of stimulating DPN on the pressor response decreased from 50.71% to 25.30% (P<0.05).</p><p><b>CONCLUSION</b>Nitric oxide in the brain and amygdala are involved in the inhibitory effect of somatic afferent input on central pressor response.</p>
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Animals , Rats , Afferent Pathways , Physiology , Amygdala , Physiology , Blood Pressure , Physiology , Electric Stimulation , Enzyme Inhibitors , Pharmacology , NG-Nitroarginine Methyl Ester , Pharmacology , Nitric Oxide , Physiology , Nitric Oxide Synthase , Paraventricular Hypothalamic Nucleus , Physiology , Peroneal Nerve , Physiology , Pressoreceptors , Physiology , Rats, Sprague-DawleyABSTRACT
Objectives:To investigate the characteristics of clinical changes during maintenance therapy of chronic periodontitis.Methods:22 patients with chronic periodontitis were enrolled in a 9-month maintenance care program after non-surgical periodontal therapy.Oral hygiene instructions together with supra-and sub-gingival scaling and root planing were carried out every 3 months.Clinical parameters including probing pocket depth(PPD),probing attachment level(PAL),and bleeding on probing(BOP) were recorded at baseline and each re-examination point.Results:The mean PPD decreased by 0.44 mm,PAL increased by 0.38 mm and BOP point number decreased by 18.94%.The recoveries were mainly observed during the first 3 months.Sites with ≥4 mm pocket at baseline exhibited a greater percentage of pocket deepening than those with initial shallow pocket.The incidence of the sites with PPD deeping of posterior teeth increased more than that of anterior teeth(P
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An antibiotic-producing bacterium, which was numbered as 20 #-5, was separated from the soil in Chongqing. It was identified as the member of pseudomonas. Gram positive bacteria are badly suppressed by it. The antibiotic secreted by 20 #-5 can endure 100℃ for half an hour, and it can also go through the ultrafiltration membrane with pores of 0.22?m.