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Objective:To evaluate the effect of transcutaneous electrical acupoint stimulation (TEAS) on postoperative pulmonary function in the patients undergoing robot-assisted radical resection of colon cancer.Method:Ninety-four patients of either sex, aged 50-80 yr, with body mass index of 18-25 kg/m 2, of American Society of Anesthesiologists physical status Ⅰ-Ⅲ, with ARISCAT grade of medium risk, undergoing elective robot-assisted radical resection of colon cancer, were enrolled in this study. The patients were divided into TEAS group (group T, n=47) and sham-TEAS group (group S, n=47) using a random number table method. In group T, patients received 30 min of TEAS at Hegu (LI4), Quchi (LI11), Zusanli (ST36) and Feishu (BL13) between 5: 00 and 7: 00 a. m. from 1st day before operation to 3rd day after operation, with disperse-dense wave 2/100 Hz, and the stimulation intensity was the maximum intensity that the patient could tolerate. Patients in group S were also connected to the device without electrical stimulation. Both groups adopted lung-protective ventilation strategy during operation. The oxygenation index was calculated at the time of entering the operating room (T 0), 5 min after anesthesia induction (T 1), 5 min of pneumoperitoneum (T 2), 5 min after changing to Trendelenburg position (T 3) and immediately after the end of pneumoperitoneum (T 4). Peak airway pressure, plateau airway pressure, driving pressure and dynamic lung compliance were recorded at T 0-T 4. The serum concentration of lung Clara cell 16 kDa protein was recorded using enzyme-linked immunosorbent assay at T 0, T 4 and 2 h after extubation (T 5). On 1 day before operation and 1, 3 and 7 days after operation, the forced expiratory volume in the first second (FEV 1) and forced vital capacity (FVC) were measured, and the FEV 1/FVC was calculated, and the concentrations of serum tumor necrosis factor-alpha, interleukin-6 and cardiopulmonary resuscitation were simultaneously determined using enzyme-linked immunosorbent assay. The occurrence of pulmonary complications within 7 days after operation was recorded. Results:There was no significant difference in pH values, PaCO 2, oxygenation index, peak airway pressure, plateau airway pressure, driving pressure, and dynamic lung compliance at each time point between the two groups ( P>0.05). Compared with S group, the serum Clara cell 16 kDa protein concentrations were significantly decreased at T 5, FEV 1 and FVC were increased at 3 and 7 days after operation, the serum tumor necrosis factor-alpha, interleukin-6 and cardiopulmonary resuscitation concentrations were decreased at 1, 3 and 7 days after operation, the incidence of unexpected oxygen supply and total incidence of postoperative pulmonary complications were decreased ( P<0.05), and no significant change was found in FEV 1/FVC at each time point in T group ( P>0.05). Conclusions:TEAS can improve lung function in the patients undergoing robot-assisted radical resection of colon cancer.
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Objective:To investigate the differences in refractive astigmatism, the anterior corneal surface astigmatism and ocular residual astigmatism between dominant and non-dominant eyes in myopia.Methods:A corss-sectional study was conducted.Two hundred and seventy-six eyes from 138 patients with myopia who were to receive corneal refractive surgery in the Refractive Surgery Center of Tianjin Eye Hospital from January to March 2018 were included.Ocular dominance was assessed with the hole-in-the-card test.The manifest refraction and corneal topography were performed in order to measure the sphericity, spherical equivalent, the astigmatism of anterior corneal surface and total cornea.Vector analysis was used to calculate the value of the ocular residual astigmatism and the components of astigmatism, including J0 and J45 of both the refractive astigmatism and the astigmatism of anterior corneal surface.This study adhered to the Declaration of Helsinki.The study protocol was approved by the Ethics Committee of Tianjin Eye Hospital (No.201909).Results:It was found that 61.6%(85/138) of the subjects was right-eye dominant.There was no significant difference in sphericity and spherical equivalent, J0 and J45 of the refractive astigmatism and the astigmatism of anterior corneal surface between dominant and non-dominant eyes (all at P>0.05). The magnitude of the ocular residual astigmatism of the dominant eye was 0.607(0.451, 0.808)D, which was lower than 0.701(0.497, 0.901)D of the non-dominant eye, showing a statistically significant difference ( Z=-2.52, P=0.01). Conclusions:In the myopic population with no significant difference in the sphericity and spherical equivalent between the dominant and non-dominant eyes, the magnitude of the ocular residual astigmatism of the dominant eye is significantly lower than that of the non-dominant eye, which may play an important role in the ocular dominance formation.
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Objective:To evaluate the effect of trans-nasal humidified rapid insufflation ventilatory exchange (THRIVE) on reflux and micro-aspiration during induction of general anesthesia in the patients undergoing laparoscopic cholecystectomy.Methods:A total of 60 patients, regardless of gender, aged 18-60 yr, with body mass index of 18-28 kg/m 2, of American Society of Anesthesiologists Physical Status classification Ⅰ or Ⅱ, scheduled for elective laparoscopic cholecystectomy, were divided into 2 groups ( n=30 each) using a random number table method: routine mask ventilation group (group C) and trans-nasal humidified rapid insufflation ventilatory exchange group (group H). Patients in group C were pre-oxygenated with a mask for 5 min, oxygen flow of 6 L/min and FiO 2 100%, after the induction of anesthesia, the pressure mask was used to artificially assist positive pressure ventilation for 2 min when the patient′s consciousness disappeared, and 2 min later endotracheal intubation was performed.Patients in group H were pre-oxygenated with THRIVE for 5 min, oxygen flow of 30 L/min and FiO 2 100%.The oxygen flow was increased to 50 L/min during anesthesia induction.After anesthesia induction, the oxygen flow was increased to 70 L/min when the patient′s consciousness disappeared, and chin lift and/or jaw thrust was used during apnoea to maintain an open airway, the patient′s mouth was kept closed during the whole process, and 2 min later endotracheal intubation was performed.Ultrasound was used to measure the cross-sectional area (CSA) of the gastric antrum and to monitor the occurrence of gastric insufflation, and the incidence of CSA greater than >3.4 cm 2 was recorded on admission to the operating room and immediately after tracheal intubation.Supraglottic and subglottic secretions were collected at the time of tracheal intubation using visual laryngoscopy after exposing the glottis, and the pepsin content was determined using enzyme-linked immunosorbent assay to assess reflux (content of pepsin in supraglottic secretion >216 ng/ml) and micro-aspiration (content of pepsinin subglottic secretion >200 ng/ml), and arterial blood gas analysis was simultaneously performed.The apnoea time was recorded, and P ETCO 2 at the first mechanical ventilation after tracheal intubation were recorded. Results:Compared with group C, PaO 2 was significantly increased and CSA was decreased immediately after tracheal intubation, and the incidence of CSA greater than >3.4 cm 2 immediately after tracheal intubation was decreased, and the incidence of gastric insufflation, reflux and micro-spiration was decreased, apnoea time was prolonged, and P ETCO 2 at first mechanical ventilation was increased in group H ( P<0.05). Conclusions:THRIVE applied during induction of general anesthesia can reduce the occurrence of reflux and micro-aspiration while ensuring oxygenation in the patients undergoing laparoscopic cholecystectomy.
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Objective:To investigate the changes, distribution and influencing factors of ocular dominance after small incision lenticule extraction (SMILE).Methods:A retrospective observational case series study was conducted.One hundred and twelve patients (224 eyes) with an average age of 25.1±5.4 years who underwent SMILE surgery at Tianjin Eye Hospital from November 2017 to February 2018 were enrolled.There were 42 male and 70 female patients.The dominant eye was determined using the hole-in-the-card test before and after the surgery.Subjective and objective refraction and uncorrected visual acuity examination were performed before operation, and 1 day, 1 week, 1 month and 3 months after operation.The subjects were divided into switch group and non-switch group based on whether the dominant eye changed after surgery.Binary logistic regression was used to analyze the main influencing factors of dominant eye switches.This study adhered to the Declaration of Helsinki.The study protocol was approved by the Ethics Committee of Tianjin Eye Hospital (No.201905). Written informed consent was obtained from each patient before any medical examination.Results:There were 18 patients (16.1%) in the switch group including 7 males (38.9%) and 11 females (61.1%), and 94 patients (83.9%) in the non-switch group including 35 males (37.2%) and 59 females (62.8%). No statistically significant difference was found in sex between the two groups ( χ2=0.02, P=0.89). At 1 month and 3 months after the surgery, there was a statistically significant difference in the cylindrical power between the dominant and non-dominant eye ( t=2.31, 1.95; both at P<0.05). Binary logistic regression equation showed that spherical equivalent[odds ratio ( OR)=0.47, 95%confidence interval ( CI): 0.35-0.66]and refractive error difference ( OR=3.04, 95% CI: 2.12-4.36) were significantly related to the eye dominance switches. Conclusions:There were 16.1% of patients having eye dominance switches after SMILE.The dominant eye transfomation is associated with higher spherical equivalent and anisometropia difference before surgery.
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Objective:To investigate the changes of circulating tumor DNA (ctDNA), circulating B cell-specific Moloney leukemia virus insertion site 1 mRNA (Bmi-1 mRNA) and microRNA-21 (miR-21) before and after treatment with epidermal growth factor receptor (EGFR) monoclonal antibody in advanced colorectal cancer, and analyze their association with treatment response.Methods:The clinical data of 98 patients with advanced colorectal cancer from March 2019 to March 2021 in Yantai Yuhuangding Hospital were retrospectively analyzed. After treatment with cetuximab, complete remission was in 4 cases, partial remission in 26 cases, stable disease in 39 cases, and progressive disease in 29 cases. The patients with complete remission and partial remission were classified as remission group (30 cases), the stable disease and progressive disease were classified as non-remission group (68 cases). Before treatment and after 2 cycles of treatment, the plasma level of ctDNA was detected by high-throughput sequencing; the levels of Bmi-1mRNA and miR-21 were detected by real-time fluorescence quantitative polymerase chain reaction. Spearman correlation was used to analyze the relationship between ctDNA, Bmi-1mRNA, miR-21 and treatment responsiveness after 2 cycles of treatment; multivariate Logistic regression was used to analyze the independent risk factors affecting treatment responsiveness; receiver operating characteristic (ROC) curve was drawn to evaluate the value of ctDNA, Bmi-1mRNA and miR-21 in predicting remission after 2 cycles of treatment.Results:There were no significant differences in ctDNA, Bmi-1mRNA and miR-21 before treatment between 2 groups ( P>0.05); the ctDNA, Bmi-1mRNA and miR-21 after 2 cycles of treatment in remission group were significantly lower than those in non-remission group: (10.03 ± 3.32) μg/L vs. (15.33 ± 5.14) μg/L, 0.13 ± 0.04 vs. 0.19 ± 0.05 and 0.81 ± 0.26 vs. 1.08 ± 0.24, and there were statistical differences ( P<0.01). Spearman correlation analysis result showed that ctDNA, Bmi-1mRNA and miR-21 were negatively correlated with treatment response ( r = -0.500, -0.506 and -0.531; P<0.01). Multivariate Logistic regression analysis result showed that, after controlling for the number of distant metastatic organs and clinical stage, ctDNA, Bmi-1mRNA and miR-21 were still independent risk factors for treatment response in patients with advanced colorectal cancer ( OR = 3.342, 2.725 and 1.838; 95% CI 3.116 to 3.584, 2.647 to 2.805 and 1.768 to 1.911; P<0.01). ROC curve analysis result showed that the area under the curve (AUC) of ctDNA, Bmi-1mRNA combined with miR-21 after 2 cycles of treatment to predict the treatment response was the largest with 0.922. Conclusions:The changes of ctDNA, Bmi-1mRNA and miR-21 in patients with advanced colorectal cancer before and after treatment with EGFR monoclonal antibody are related to the treatment response. Combined detection is helpful for screening patients sensitive to EGFR-targeted therapy, and can provide reference for new targets of molecular intervention.
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Xiaoer-Feire-Kechuan (XFK) is an 11-herb Chinese medicine formula to treat cough and pulmonary inflammation.The complicated composition rendered its chemical analysis and effective-component elucidation.In this study,we combined quantitative analysis and bioactivity test to reveal the anti-inflammatory constituents of XFK.First,UPLC-DAD and UHPLC/Q-Orbitrap-MS methods were estab-lished and validated to quantify 35 analytes (covering 9 out of 11 herbs) in different XFK formulations.Parallel reaction monitoring mode built in Q-Orbitrap-MS was used to improve the sensitivity and selectivity.Then,anti-inflammatory activities of the 35 analytes were analyzed using in vitro COX-2 inhibition assay.Finally,major analytes forsythosides H,I,A (8-10),and baicalin (15) (total contents varied from 21.79 to 91.20 mg/dose in different formulations) with significant activities (inhibitory rate ≥ 80％) were proposed as the anti-inflammatory constituents of XFK.The present study provided an effective strategy to discover effective constituents of multi-herb formulas.
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Objective:To evaluate the efficacy of radiofrequency thermocoagulation with CT-guided transforaminal puncture of intervertebral foramen through the superior margin of costotransverse joint for refractory post-herpetic neuralgia (PHN) in the upper thoracic segment.Methods:Thirty patients with PHN in the upper thoracic segment underwent radiofrequency thermocoagulation with CT-guided intervertebral foramen puncture. The visual analogue scale and self-rating depression scale were used to evaluate the degree of postoperative pain and mental state before and after treatment, and patients were followed by telephone or outpatient visit.Results:No infection occurred after radiofrequency thermocoagulation in all 31 PHN patients. After operation, all patients had hypoesthesia in skin of the original pain area, the pain was significantly relieved, and the mental state improved significantly. The VAS scores were 5.94±0.93, 2.74±0.69, 2.68±0.70 and 2.45±0.51 before and 3 hours, 1 week, 1 month after treatment( t=18.80, t=18.80, t=16.44, all P<0.01). The SDS scores were 58.6±12.2, 47.7±4.4, 48.1±4.8 before and 1 week, 1 month after treatment( t=6.75, t=5.86, all P<0.01). There were 13 patients with moderate or severe depression before treatment, while no patients with moderate or severe depression after treatment; only 5 patients had mild depression one month after surgery. There was no hypoxemia under nasal catheter during the operation. Intraoperative hypertension was found in 19 cases; after treatment with Urapidil (12.5 - 50.0 mg), the blood pressure was not higher by 20% of the basal blood pressure and<180/100 mmHg (1 mmHg=0.133 kPa). No pneumothorax, perioperative cardiovascular and cerebrovascular accidents occurred. Conclusion:Radiofrequency thermocoagulation with CT-guided intervertebral foramen puncture through the superior margin of costotransverse joint can effectively relieve refractory PHN of the upper thoracic segment with safety.
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Objective To evaluate changes in corneal high-order aberrations after the wearing of orthokeratology contact lenses and to study the factors influencing those changes.Methods A series of case-observational method was used.Data on 46 right myopic eyes of 46 children fitted for orthokeratology were continuously collected from January to April 2018.The corneal morphology,the e values of the anterior and posterior corneal surface in the nasal,temporal,superior and inferior zones within 6 mm were measured with Pentacam Anterion Segment Analysis System before and one month after the wearing of orthokeratology contact lens.Zernike Analysis System was used to calculate the values of Z33,Z3-3,Z31,Z3-1,and Z40 on the anterior and posterior surfaces and on the total cornea within a diameter of 6 mm.This study conformed to the tenets of the Declaration of Helsinki.The study protocol was approved by the Ethics Committee of Baoding Yinghua Eye Hospital (No.YKLL-2018-1-01).Written informed consent was obtained from each child and their guardians prior to entering the study cohort.Results Compared to the values recorded prior to orthokeratology contact lens wear,the horizontal coma,vertical coma,and spherical aberration of the total cornea and anterior corneal surface were drifted positively after lens wear;the horizontal coma and spherical aberration of the posterior corneal surface were drifted negatively after lens wear;and the differences were statistically significant (all at P＜0.05).Before wearing orthokeratology contact lenses,eNf,eTf,eIf,eSf and eMf values were 0.580(0.450,0.670),0.455 (0.378,0.513),0.485 (0.268,0.553),0.665(0.578,0.740) and 0.505±0.015,respectively,and after wearing orthokeratology contact lenses,eNf,eTf,eIr,eSf and eMf values were 0.285(-0.635,0.665),-0.605 (-0.813,-0.335),-0.545 (-0.765,0.305),-0.335 (-0.705,0.423) and -0.247±0.058,respectively.Compared with the conditions prior to wearing orthokeratology contact lens,the anterior corneal surface in all parts changed from steep to fiat after lens wear,with statistically significant differences between them (all at P＜0.05).The results of multiple stepwise linear regression showed that after wearing orthokeratology contact lens,the spherical aberration of the total cornea was moderately negatively correlated with the corneal e value and the initial diopter (rs =-0.626,-0.450;both at P＜0.05),the horizontal coma of the total cornea was moderately negatively correlated with the temporal e value (rs =-0.391,P =0.004);the spherical aberration of the anterior corneal surface was moderately negatively correlated with the corneal e value and the initial diopter (rs =-0.612,-0.432;both at P＜0.05);the horizontal coma of the anterior corneal surface was moderately negatively correlated with the temporal e value (rs =-0.400,P =0.003);and the horizontal coma of the posterior corneal surface was negatively correlated with the horizontal coma of the anterior corneal surface (rs =-0.380,P =0.009).Conclusions The spherical aberration and coma of the total cornea and anterior corneal surface drift positively after wearing orthokeratology contact lens,and the spherical aberration and horizontal coma of the posterior corneal surface drift negatively.The refraction and deformation of the anterior surface of the cornea are important factors affecting variation in corneal high-order aberrations.
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Objective@#To evaluate changes in corneal high-order aberrations after the wearing of orthokeratology contact lenses and to study the factors influencing those changes.@*Methods@#A series of case-observational method was used.Data on 46 right myopic eyes of 46 children fitted for orthokeratology were continuously collected from January to April 2018.The corneal morphology, the e values of the anterior and posterior corneal surface in the nasal, temporal, superior and inferior zones within 6 mm were measured with Pentacam Anterion Segment Analysis System before and one month after the wearing of orthokeratology contact lens.Zernike Analysis System was used to calculate the values of Z33, Z3-3, Z31, Z3-1, and Z40 on the anterior and posterior surfaces and on the total cornea within a diameter of 6 mm.This study conformed to the tenets of the Declaration of Helsinki.The study protocol was approved by the Ethics Committee of Baoding Yinghua Eye Hospital (No.YKLL-2018-1-01). Written informed consent was obtained from each child and their guardians prior to entering the study cohort.@*Results@#Compared to the values recorded prior to orthokeratology contact lens wear, the horizontal coma, vertical coma, and spherical aberration of the total cornea and anterior corneal surface were drifted positively after lens wear; the horizontal coma and spherical aberration of the posterior corneal surface were drifted negatively after lens wear; and the differences were statistically significant (all at P<0.05). Before wearing orthokeratology contact lenses, eNf, eTf, eIf, eSf and eMf values were 0.580(0.450, 0.670), 0.455(0.378, 0.513), 0.485(0.268, 0.553), 0.665(0.578, 0.740) and 0.505±0.015, respectively, and after wearing orthokeratology contact lenses, eNf, eTf, eIf, eSf and eMf values were 0.285(-0.635, 0.665), -0.605(-0.813, -0.335), -0.545(-0.765, 0.305), -0.335(-0.705, 0.423) and -0.247±0.058, respectively.Compared with the conditions prior to wearing orthokeratology contact lens, the anterior corneal surface in all parts changed from steep to flat after lens wear, with statistically significant differences between them (all at P<0.05). The results of multiple stepwise linear regression showed that after wearing orthokeratology contact lens, the spherical aberration of the total cornea was moderately negatively correlated with the corneal e value and the initial diopter (rs=-0.626, -0.450; both at P<0.05), the horizontal coma of the total cornea was moderately negatively correlated with the temporal e value (rs=-0.391, P=0.004); the spherical aberration of the anterior corneal surface was moderately negatively correlated with the corneal e value and the initial diopter (rs=-0.612, -0.432; both at P<0.05); the horizontal coma of the anterior corneal surface was moderately negatively correlated with the temporal e value (rs=-0.400, P=0.003); and the horizontal coma of the posterior corneal surface was negatively correlated with the horizontal coma of the anterior corneal surface (rs=-0.380, P=0.009).@*Conclusions@#The spherical aberration and coma of the total cornea and anterior corneal surface drift positively after wearing orthokeratology contact lens, and the spherical aberration and horizontal coma of the posterior corneal surface drift negatively.The refraction and deformation of the anterior surface of the cornea are important factors affecting variation in corneal high-order aberrations.
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Objective To explore the feasibility of the Star-VIBE sequence in esophageal MRI,and compare it with the conventional VIBE sequence.Methods Fifteen healthy volunteers underwent Star-VIBE and VIBE sequences scanning after injecting MRI contrast agent.Two groups of MR images were independently scored in the ability to display esophageal wall,respiratory motion artifacts,cardiovascular pulsation artifacts,overall motion artifacts and overall image quality by the two radiologists,respectively.SNR of esophagus,CNR between esophagus and paravertebral muscles were measured and compared.Results Star-VIBE was superior to VIBE in the ability to display esophageal wall,respiratory motion artifacts,cardiovascular pulsation artifacts,overall motion artifacts and overall image quality (the ability to display esophageal wall:Z＝－3.268,P＝0.001;respiratory motion artifacts:Z＝－3.205,P＝0.001;cardiovascular pulsation artifacts:Z＝－4.644, P＝0.000;overall motion artifacts:Z＝－3.904,P＝0.000;overall image quality:Z＝－2.808,P＝0.005),while no significant differences were found on SNR and CNR between the two sequences (SNR:t＝－1.5 3 9 ,P＝0.1 3 5 ;CNR:t＝－0.874,P＝0.3 89 ).Conclusion The Star-VIBE sequence is insensitive to the physiological motion artifacts,and it can provide better image quality than the conventional VIBE sequence in esophageal MRI.
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Objective To investigate value of ultrasmall superparamagnetic iron oxide (USPIO)-enhanced MRI in diagnosis of lymph node metastasis from abdominal and pelvic malignancies with Meta-analysis.Methods A systematic search was conducted in PubMed,Embase,Cochrane Library,Wanfang,VIP and CNKI databases.The literature were screened according to inclusion and exclusion criteria,and four tabular data were extracted.With Meta Disc version 1.4 and STATA 11.0 software,statistical analysis was performed and heterogeneity of the included articles was tested.Based on the result of heterogeneity test,proper effect model was selected to calculate the pooled sensitivity and specificity.Summary receiver operating characteristics curve was obtained,and the area under curve (AUC) was calculated.Results Totally 20 English literature were enrolled,including 1 211 patients and 3 583 lymph nodes.The pooled sensitivity and specificity for USPIO-enhanced MRI in diagnosis of lymph node metastasis was 0.89 (95％CI [0.86,0.91]) and 0.96 (95 ％CI [0.95,0.96]),and AUC was 0.98,respectively.Regression analysis revealed that the heterogeneity may result from the location of tumors,and subgroup analysis showed that pooled sensitivity in diagnosis of lymph node metastasis in abdominal malignancies was good.Conclusion USPIO-enhanced MRI has good diagnostic efficacy in diagnosis of lymph node metastasis from abdominal and pelvic malignancies.
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Background The current evaluation of corneal optical quality after small incision lenticule extraction (SMILE) is based on the single factor,such as scattering,diffraction or aberration,and all of them are not comprehensive and objective methods.Modulation transfer function (MTF) and Strehl ratio (ST) are novel parameters of corneal optical quality,which can be used to assess the optical quality comprehensively.Objective This study was to evaluate the change of MTF and SR under the photopic and scotopic environment (3 mm and 6 mm pupil size,respectively) after SMILE procedure.Methods The study protocol was approved by Ethic Committee of Tianjin Eye Hospital,and written informed consent was obtained from each patient before any medical procedure.A series cases-observational study with self-control design was carried out.Sixty-three eyes of 32 myopia or myopic astigmatism patients who underwent SMILE surgery in Tianjin Eye Hospital were included from December 2013 to March 2014.The uncorrected visual acuity (UCVA),best corrected visual acuity (BCVA) (LogMAR),the effective index (postoperative UCVA/preoperative BCVA) and refractive diopter were examined,and the MTF,SR and root mean square (RMS) on the anterior corneal surface were measured under the 3 mm and 6 mm pupil size at different spatial frequencies (10,20,30,40,50 and 60 c/d) by Sirius anterior analyzer before surgery and 1 week,1 month and 3 months after surgery,respectively.Results UCVA was ≥0.8 in 59,62 and 63 eyes in 1 week,1 month and 3 months after SMILE,with the percentage of 93.65％,98.41％ and 100％,and the effective index was 1.104± 0.128,1.126±0.145 and 1.158±0.208,respectively.The refractive diopter was normal in the eyes at postoperative 3 months.The MTFs of various spatial frequencies on the vertical and horizontal meridian under the 3 mm pupil size after SMILE were significantly higher than those before SMILE,while under the 6 mm pupil size,the MTFs were higher only on vertical meridian and 10,20,30 and 40 e/d,and there were not significant differences on the horizontal meridian (all at P＜0.05).The SRs under the 3 mm and 6 mm pupil size showed increasing softly after surgery in comparison with before surgery,and the SRs were higher under the 3 mm pupil size than those under the 6 mm pupil size at various time points (all at P＜0.05).There were not significant differences in RMS among different time points under both 3 mm pupil size and 6 mm pupil size (3 mm pupil size:F =1.348,P =0.184;6 mm pupil size:F=1.990,P=0.137).Conclusions SMILE provides a great improvement in corneal optical quality for myopia or myopic astigmatism patients,which is more distinct in photopic condition than that in scotopic condition.
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Background The visual quality and corneal biomechanical change are two major sides for evaluating the outcomes of cornea refractive surgery.It was determined that small incision lenticule extraction (SMILE) can improve the visual outcomes,but its long-term effects on corneal biomechanical are not known clearly.Objective This study was to investigate the change of corneal biomechanics and influence factors following SMILE.Methods A serial cases-observional study was performed.One hundred eyes of 58 patients with a mean spherical diopter (-5.00 ± 1.55) D and cylindrical diopter (-0.98 ± 0.87) D were included in Tianjin Eye Hospital from August 2011 to July 2013 under the informed consent.Corneal biomechanical parameters,including corneal resistance factor (CRF) and cornea hysteresis (CH) were measured using the ocular response analyzer (ORA) in preoperation and postoperative 1,3,6 and 12 months,respectively.The patients were grouped based on different lenticule thickness ratio (LTR),preoperative CRF values and residual stromal thickness (RST) separately,and the correlations of LTR,preoperative CRF and RST with ΔCRF and ΔCH were assessed.In addition,the associations between ΔCRF or ΔCH and related preoperation parameters were evaluated.Results The CRF and CH values at postoperative 1 month were (7.12 ± 1.20) mmHg and (7.90 ± 0.97) mmHg,which were significantly lower than preoperative (10.17±1.46) mmHg and (10.00±1.16) mmHg,respectively (t=15.552,P=0.000;t =13.411,P=0.000).The CRF values at postoperative 3,6 and 12 months were (7.06±0.90),(6.98 ± 1.11) and (6.87 ± 1.07) mmHg,and those of CH were (8.12 ±0.84),(8.12 ±0.97) and (8.14 ±0.86) mmHg,and no significant differences were found in CRF and CH between the adjacent time points (CRF:P =0.848,0.992,0.270;CH:P =0.370,0.791,0.777).Positive correlations were seen between the ΔCRF or ΔCH and LT/preoperative central corneal thickness (CCT) (LTR),preoperative CRF or preoperative CH values,respectively (LTR:r =0.468,P =0.000;r =0.299,P =0.004;preoperative CRF:r =0.696,P =0.000;r =0.590,P =0.000;preoperative CH:r =0.576,P =0.000;r =0.690,P =0.000).ΔCRF and ΔCH were negatively correlated with preoperative spherical equivalent diopter (r =-0.496,P =0.000;r =-0.292,P =0.010),the sum of preoperative spherical diopter and cylindrical diopter (r =-0.484,P =0.000;r =-0.293,P =0.005) or RST/preoperative CCT (r =-0.362,P =0.000;r =-0.243,P =0.019) and were positively correlated with lenticule (r =0.495,P =0.000;r =0.325,P =0.002).No significant association was found between ΔCRF or ΔCH and age,preoperative CCT and preoperative mean keratometry (all at P＞0.05).Conclusions Corneal biomechanical strength is decreased at the early stage after SMILE.However,biomechanical strength gradually enhances 1 month after surgery and tends to stability.The large RST/preoperative CCT can improve postoperative CRF and CH.The another main factor affecting the corneal biomechanics after SMILE is corrected-diopter.
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Background Small incision lenticule extraction (SMILE) is lack of eye-tracking system and there is controversy in the treatment of astigmatism.It is very important to understand its correction effctiveness for myopic astigmatism.Objective This study was to evaluate the clinical outcomes in the correction of myopic astigmatism between SMILE and femtosecond laser assisted laser in situ keratomileusis (FS-LASIK).Methods In this retrospective study,95 eyes of 51 patients and 69 eyes of 40 patients with myopic astigmatism underwent the SMILE surgery and FS-LASIK surgery respectively in Tianjin Eye Hospital from December 2013 to July 2014 under the informed consent.No significant differences were found in spherical power,astigmatic power and spherical equivalent (SE) between the SMILE group and FS-LASIK group before surgery (all at P＞0.05).The uncorrected visual acuity (UCVA),best corrected visual acuity (BCVA),manifest refraction,slit-lamp microscopy,intraocular pressure and corneal topography were measured before surgery and 1 day,1 week,1 month,3 months after surgery.Vector analysis was used to calculate the components of astigmatism before and after surgery.Correction index (CI),index of success (IOS),angle of error (AofE) and flattening index (FI) were used to evaluate the correction effectiveness of astigmatism.Safety index and efficacy index were used to evaluate the recovery status of visual acuity.The corrected effectiveness was compared between the two groups,and the correlations of kappa angle with measured parameter were assessed by Spearman rank correlation analysis.Results The mean spherical power,astigmatic power and SE were (0.003±0.106),(-0.063 ± 0.126) and (-0.029 ± 0.101) D in the SMILE group,which were significantly lower than (0.112 ± 0.212),(-0.091 ± 0.142) and (0.067 ± 0.198)D in the FS-LASIK group (Z =-4.328,-3.197,both at P＜0.05).Vector analysis showed the postoperative with-the-rule astigmatism in the SMILE group and oblique astigmatism in the FS-LASIK group respectively,and the CI and F1 in the SMILE group were significantly lower than those in the FS-LASIK group (Z =-3.051,-3.126,both at P ＜ 0.05).The insignificant reduce in IOS and AofE were seen in the SMILE group compared with the FS-LASIK group (Z=-1.557,P=0.119;Z =-1.923,P =0.054).In addition,the safety index and efficacy index were not significantly different between the two groups (both at P ＞ 0.05).Negative correlations were found between safety index or efficacy index and preoperative kappa angle in the SMILE group (r =-0.258,-0.257,both at P＜0.05).Conclusions Both SMILE and FS-LASIK surgeries are effective and safe in correcting myopic astigmatism with good postoperative visual acuity.SMILE surgery shows less axis rotation and higher accuracy than FS-LASIK because of small incision and flapless procedure.The correction of cylinder can adjust based on experience of surgeon.
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Background Small incision lenticule extraction (SMILE) was a new procedure which is miniinvasion and flapless,but few attentions were paid to the visual quality after SMILE.To understand the changes of intraocular straylight after SMILE is of important significance for the assession of the visual quality after the procedure.Objective This study was to compare the characteristic of straylight between SMILE and femtosecond laser assisted laser in situ keratomileusis (FS-LAISK) after surgery.Methods A retrospective study was designed.Written informed consent was obtained from each patient prior to accepting the surgery.One hundred and twenty-seven eyes of 68 patients with myopia and myopic astigmatism were included in Tianjin Eye Hospital from January 2011 to July 2013.SMILE was performed on 64 eyes of 35 patients and FS-LASIK was carried out in 63 eyes of 33 patients at the same period.Stray light was detected with C-Quant stray light meter before and 1 week,1 month and 6 months after surgery.The changes of stray light values following the surgery were compared between the two groups,and the correlations between postoperative stray light values with operative parameters were analyzed.Results The mean stray light values were (1.03 ±0.19)D and (0.95±0.16)D at 1 week and 1 month after surgery,which were higher than (0.88 ±0.18)D at preoperation in the FS-LASIK group (P =0.000,0.012).The stray light values were (0.98±0.16),(0.95±0.14) and (0.94±0.16)D at 1 week,1 month or 6 months after surgery,and no statistically significant differences were found in comparison with (0.91 ±0.15)D in preoperation in the SMILE group (all at P＞0.05).No significant intergroup difference was seen in the stray light values (Fgroup =0.077,P=0.781).The stray light differences of various time points after surgery and before surgery were increased in the FS-LASIK group compared with SMILE group (Fgroup =14.798,P＜0.001),with the significant difference in postoperative 1 week between the two groups (P＜0.01).The negative correlations were found between stray light values at 1 week,1 month and 6 months after SMILE with the lenticule thickness/central corneal thickness (CCT) (R2=0.123,0.145,0.098,all at P＜0.05) or between stray light change.Conclusions Intraocular stray light appears less change in operative eyes after SMILE.However,intraocular stray light increases in the eyes received FS-LASIK,especially at early stage after operation.The stray light shifts return to normal with the lapse of postoperative time.
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<p><b>OBJECTIVE</b>To investigate the effects of orthodontic treatment of skeletal crossbite adults with mandibular deviation.</p><p><b>METHODS</b>Eighteen skeletal Class III adult patients with borderline skeletal crossbite and mandibular deviation were selected (5 males, 13 females). The mean age was 25 years. All cases were treated with straight-wire appliance in upper arch and occlusal plate in the lower arch.Elastics were applied to correct mandibular deviation. Cephalometric analysis was carried out before and after treatment. Paired t-test was performed.</p><p><b>RESULTS</b>After treatment, the anterior crossbite was corrected and Class I molar and canine relationships were achieved. The inclination of upper incisors was increased significantly.</p><p><b>CONCLUSIONS</b>Straight-wire appliance combined with occlusal plate was effective on correcting adult patients with mild, moderate skeletal crossbite and mandibular deviation.</p>
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Adulto , Feminino , Humanos , Masculino , Cefalometria , Incisivo , Má Oclusão , Terapêutica , Dente Molar , Fios OrtodônticosRESUMO
<p><b>OBJECTIVE</b>To investigate the cytogenetic differences between children and adults with acute lymphoblastic leukemia (ALL) using eight-probe fluorescence in situ hybridization and karyotype analysis.</p><p><b>METHODS</b>Eight-probe (MYC, P16, E2A, TEL/AML1, BCR/ABL , MLL , IGH, and hyperdiploidy) fluorescence in situ hybridization and karyotype analysis were performed for 86 adults and 39 children with acute lymphoblastic leukemia.</p><p><b>RESULTS</b>Eight-probe fluorescence in situ hybridization showed significant differences in the positivity rate of TEL/AML1, BCR/ABL, and hyperdiploidy between adult patients and children with ALL. By karyotype analysis, the positivity rate of t(9;22) and hyperdiploidy differed significantly between the children and adult patients (P<0.05).</p><p><b>CONCLUSION</b>Adults and children with ALL have different expression profiles of the fusion genes. Eight-probe fluorescence in situ hybridization is time-saving, accurate and efficient in detecting common genetic abnormalities in ALL patients, and can be well complementary to karyotype analysis in clinical diagnosis of ALL.</p>
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Adolescente , Adulto , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Adulto Jovem , Citogenética , Hibridização in Situ Fluorescente , Métodos , Cariótipo , Cariotipagem , Leucemia-Linfoma Linfoblástico de Células Precursoras , Diagnóstico , GenéticaRESUMO
<p><b>OBJECTIVE</b>To identify differentially expressed genes between chronic phase and blast crisis in chronic myeloid leukemia, explore the mechanism and screen potential biomarkers of disease progression.</p><p><b>METHODS</b>The differences in the gene expression profiles of bone marrow mononuclear cells between chronic phase and blastic crisis were examined using DNA microarray. PANTHER database, Genomatix database and Bibliosphere software were used to analyze and predict the critical genes or transcription factors during disease progression. Some of the genes or transcription factors were selected for verification by semi-quantitative RT-PCR.</p><p><b>RESULTS</b>In blastic crisis, 68 of the 1176 tested genes were obviously up-regulated. Sixteen of these differential genes were selectively expressed in leukocyte membranes. CD40, CCR3, LGALS3, RGS3, CEACAM3 and the related transcription factors RAC1, CTNNB1, TP53, and NF-κB, all as the nodes of the entire regulatory network, were presumed to play key roles in disease progression. The results of RT-PCR were consistent with the microarray data and showed high expression of CEACAM3, RGS3, CTNNB1 and RAC1 in blastic crisis.</p><p><b>CONCLUSION</b>A group of genes have been identified to very likely play key roles or serve as biomarkers in the transition from the chronic phase to blastic crisis in chronic myeloid leukemia.</p>
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Humanos , Crise Blástica , Genética , Biologia Computacional , Perfilação da Expressão Gênica , Regulação Leucêmica da Expressão Gênica , Leucemia Mielogênica Crônica BCR-ABL Positiva , Genética , Análise de Sequência com Séries de Oligonucleotídeos , TranscriptomaRESUMO
With the change of people's concept of marriage and family changes,the divorce rate of our country has presented an obvious rising tendency,thus students from divorced family have become a large group gradually.The study focuses on the passive effects that divorced family have on the interpersonal communication of student from these families and analyzes the reasons and puts forward the countermeasures of the problem.
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Objective:To construct the eukaryotic vector of human DC-SIGN and EGFP fusion protein,and to identify the protein in cell line COS7.Methods:RT-PCR,T-vector and pEGFP-C1 vector were used to construct the recombinant expressing plasmid encoding for the fusion protein of DC-SIGN and EGFP.COS7 cells were transfected with the plasmid.Real-time PCR and laser scanning confocal microscope were used to quantificate expression of the fusion protein and cell function of uptaking BCG.Results:DC-SIGN cDNA was successfully cloned into the eukaryotic vector pEGFP-C1.The recombinant vector was transfected into COS7,real-time PCR test showed the amount of mRNA encoding for the fusion protein was 4.52?1011 copies/ml and laser scanning confocal microscope confirmed that the cells could uptake BCG.Conclusion:We have constructed a recombinant vector expressing DC-SIGN and EGFP fusion protein.