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Objective:To evaluate the application efficacy of enhanced recovery after surgery(ERAS)in laparoscopic colorectal cancer surgery in primary hospitals.Methods:A total of 116 patients who underwent laparoscopic colorectal cancer surgery from January 2017 to December 2018 at our hospital were enrolled in this study.According to the perioperative rehabilitation program, 116 patients were divided into the group A(n=67, receiving enhanced recovery after surgery)and the group B(n=49, receiving traditional recovery after surgery).Results:The incidences of preoperative thirst and hunger were lower in the group A than in the group B(11.9% vs.53.1%, 16.4% vs.51.0%, χ2=23.10 and 15.83, respectively, P<0.001). The levels of CRP and blood glucose in the two groups were significantly higher after operation than before operation, and reached the peak values on the 3rd day after the operation.At different time points after operation, CRP levels and blood glucose levels were higher in the group B than in the group A(all P<0.05). On the 7th day after operation, blood glucose level was recovered to the preoperative level in the group A, while it was not so in the group B. The incidence of complication in the group A was similar to the group B(7.46% vs.12.2%, χ2=0.75, P>0.05). The hospitalization period was shorter and the hospitalization cost was less in the group A than in the group B(8.16±1.33)d vs.(15.39±2.81)d, (46100±1800)yuan vs.(56900±5600)yuan, t=10.98 and 9.96, P=0.000). Conclusions:The application of enhanced recovery after surgery is beneficial for perioperative safety, can reduce surgical stress response, promote postoperative recovery, shorten hospitalization time after surgery and reduce hospitalization costs in laparoscopic colorectal cancer surgery.
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Objective To synthesize a dual-function nanodrug with immunosuppression of tacrolimus (FK506) and lubrication of artificial tear carboxymethylcellulose sodium (CMC), and provide a basis for the clinical treatment of dry eye syndrome. Methods The FK506 nanocrystals were prepared by ultrasonic method, and polyallylamine hydrochloride (PAH) and CMC were deposited alternatively on the surface of FK506 nanocrystals using layer-by-layer (LbL) self-assembly technology to prepare the bifunctional nanodrug. The morphology, particle size, surface charge, and composition of the nanodrug were analyzed. Results The particle size of FK506 nanocrystals was uniform, and the FK506-(PAH/CMC)3 was approximately spherical with uneven surface. Zeta potential detection results showed that the charge changed alternatively with the increasing of layer number. The results of laser scanning confocal imaging and infrared spectroscopy showed that PAH and CMC were successfully modified on the surface of FK506 nanocrystals. Conclusion The prepared FK506-(PAH/CMC)3 nanodrug is expected to provide a scientific basis for the combined treatment of dry eye.
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Background Obstructive meibomian gland dysfunction (OMGD) is due to the meibomian gland duct obstruction and/or meibum abnormal secretion.Meibomian gland morphological change is important to clinical observation.Objective This study aimed to image the meibomian gland structures and the morphological changes in eyes with OMGD using a non-contact infrared meibography system (Keratograph 5M).Methods A case-control study was performed in Tianjin Medical University Eye Hospital from January to June in 2015.Sixty OMGD patients and 60 age-matched healthy controls were recruited.Ocular Surface Disease Index (OSDI) questionnaire was employed for the assess of ocular surface symptoms,and slit-lamp examination was performed for the observation of lid margin and meibomian gland orifices.Meibomian gland secretion scores and Keratograph 5M examination the morphological changes of the meibomian glands.According to OSDI questionnaire,the patients of OMGD were classified into mild group (12.0 ＜ OSDI ≤ 22.0) (23 eyes),moderate group (22.0 ＜ OSDI ≤ 32.0) (21 eyes) and severe group (32.0 ＜ OSDI ≤ 100.0) (16 eyes).Partial or complete loss of the meibomian glands (meibomian dropout) was scored from grade 0 (no loss) through out grade 3 (lost area was ＞2/3 of the total meibomian gland area).Written informed consent was obtained from all subjects before the examination.Results The OSDI,meibomian gland orifices,meibomian gland secretion scores and meibomian gland dropout scores were significantly higher,and BUT was dramatically shorter in the OMGD group than those in the normal group,showing significant differences between the two groups (Z =-9.425,-8.954,-7.781,all at P＜0.05).The BUT was (6.10± 1.91) s and (10.67-±2.11)s,and meibomian gland dropout scores were 1.35±0.90 and 0.88±0.64 in the OMGD group and normal control group,showing significant differences between the two groups (t=3.276,-12.418,both at P＜0.05).OSDI,meibomian gland secretion scores and meibomian gland dropout scores were significantly in three intergroups (H=52.121,13.642,37.180,all at P＜0.05).BUT,meibomian gland orifices were significantly different among the mild,moderate and severe OMGD (F=58.191,8.474,both at P＜0.05).OSDI showed a significantly high positive correlation with meibomian gland orifices,meibomian gland secretion scores and meibomian gland dropout scores (r =0.708,P =0.000;r =0.759,P =0.000;r =0.270,P =0.003).BUT showed negative correlation with meibomian parameters (r=-0.692,P=0.000;r=-0.691,P=0.000;r=-0.192,P=0.036).Conclusions Keratograph 5M provides an effective noninvasive method in assessing the image of the meibomian gland structures and meibomian gland dropout.There are differences in the ocular surface and meibomian glands between the OMGD patients and normal persons.
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Objective To assess the optical quality after implantation of the intraocular contact lens with and without a central hole for high myopia.Methods A total of 23 patients (41eyes),including 11 patients (21 eyes) implanted with V4 ICL (V4 ICL group) and 12 patients (20 eyes) with V4 c ICL implantation (V4 c ICL group) were enrolled in this research.Six months after operation,slit lamp microscope was used to check the anterior segment,and LogMAR chart was to test uncorrected visual acuity (UCVA) and best corrected visual acuity (BCVA).Moreover,automatic refractometer was to measure the spherical equivalent (SE) and astigmatic diopter before and after the operation.OQAS parameters included objective scattering index (OSI),modulation transfer function (MTF),Stryrby (SR),OQAS values (OV100％,OV20％,OV9％) at different contrast level were examined.Results In both groups,the parameters of UCVA (logMAR),BCVA (logMAR),SE and astigmatic diopter at 6 months after operation were significantly improved compared with before operation,with significant difference (all P ＜ 0.05).There was no siguificant difference in the UCVA,BCVA,SE and astigmatic diopter between the two groups before operation and 6 months after operation (all P ＞ 0.05).Moreover,the values of MTFcutoff,SR,and OQAS visual parameters (OV100％,OV20％ and OV9％) at 6 months after operation were significantly higher than those before operation between the two groups,and the difference was statistically significant (all P ＜ 0.05),while OSI was lower than preoperative data,but there was no significant difference in OSI between the two groups (P ＜ 0.05).There was no significant difference in OQAS visual quality parameters,including OSI,MTFcutoff,SR,and OV100％,OV20％ and OV9％,between the two groups (all P ＞ 0.05).Conclusion It is safe and effective of the two types of intraocular contact lens implantation for correction of high myopia,and V4 c ICL can achieve the similar visual quality to the traditional V4 ICL.
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Background phacoemulsification combined with limbal relaxing incision (LRI) is reported to be effective for the management of coexisting cataract astigmatism,but the influence of after phacoemulsification with LRI on corneal high-order aberration is still rarely reported.Objective This study was to evaluate the effect of cataract surgery with LRI for preoperative astigmatism or on corneal high-order aberration.Methods A selfcontrolled serial cases observational study was designed.A total of 35 cataractous eyes of 35 patients with astigmatism ≥ 1.0 D before cataract surgery were enrolled in Tianjin Medical University Eye Hospital from August 2014 to April 2015 under the informed consent of patients.LRIs were performed on the eyes during the phacoemulsification and IOL implantation.The uncorrected visual acuity (UCVA),BCVA and optometry were recorded before operation and 1 day,1 week,1 month,3 months after operation.Pentacam was employed to measure the maximal and minimal diopters,astigmatism and high-order aberrations within 3 mm of the anterior corneal surface at above-mentioned time points.All the results were compared among different time points.The optometry outcomes and the anterior corneal surface astigmatism change were analyzed using vector analysis method.Results The UCVA was 0.34 ±0.22,0.38 ± 0.25,0.43±0.27,0.42±0.28 in 1 day,1 week,1 month and 3 months after operation,which was significantly higher than 0.08 ±0.09 before operation;and the BCVA was 0.54 ± 0.27,0.64 ± 0.29,0.67 ± 0.29,0.71 ± 0.32 in 1 day,1 week,1 month and 3 months after operation,showing a significant increase in comparison with 0.22±0.51 before operation(F=54.457,P=0.000;F =62.653,P =0.000).The refractive cylindrical error and corneal astigmatism were significantly decreased after operation in comparison with before operation (F =31.061,P =0.000;F =113.043,P=0.000).High order aberrations (HOA) at postoperative 1 day,1 week,1 month,3 months were all higher than those in preoperation (F =11.189,P =0.000) under the 4 mm pupil diameter.Compared with preoperation,the vertical coma,secondary vertical coma and three leaf clover were significantly increased(all at P＜0.05),but the horizontal coma and primary spherical aberration were not significantly changed (all at P＞0.05) under the 6 mm pupil diameter.Conclusions Phacoemulsification combined with LRI can reduce the corneal astigmatism effectively and steadily,and the increase of corneal aberrations does not affect visual acuity.
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Objective To compare and analysis clinical characteristics ,Dppler ultrasonography and CT imaging features of War‐thin′s tumor and pleomorphic adenoma of the parotid gland .Methods Thirty‐eight cases of Warthin′s tumor and 107 cases of pleo‐morphic adenoma of the parotid gland in our hospital were selected and divided into Warthin′s tumor group and pleomorphic adeno‐ma group .Average age ,gender ,position of onset ,mean course of disease ,smoking rates and Doppler ultrasonography and CT ima‐ging features of 2 groups were compared and analyzed .Results Compared with pleomorphic adenoma group ,the average age ,per‐centage of males ,smoking rates were higher in Warthin′s tumor group but the mean course of disease was short ,which showed sig‐nificant difference(P<0 .05) .The site of Warthin′s tumor mostly occurred in lower posterior polar of the parotid gland .Doppler re‐sults indicated more abundant blood supply in Warthin′s tumors group .CT imagine results also indicated higher density in Warthin′s tumors group than in pleomorphic adenomas group .Conclusion According to the group constituent ratio of disease ,average age , gender ,mean course of disease combined with Doppler ultrasonography and CT imaging features ,the tumor could be diagnosed be‐fore surgery ,which could be helpful to make the correct surgical plan .
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To clone overexpressed gene from human gastric carcinoma cell SGC-7901, DDRT-PCR technique is used with human gastric epithelial cell GES-1 as control. After cloned into pGEM -T vector, YA61, one of the overexpressed genes, was analyzed by dot blot and was sequenced then. The sequence gotten was then compared to GenBank data and analyzed by NCBI ORF Finder. Dot blot results showed that the gene YA61 was overexpressed in human gastric carcinoma cell SGC-7901. NCBI's sequence similarity search indicated that the gene YA61 was a new gene sequence. Open reading frame analysis demonstrated that the gene YA61 had one complete open reading frame. In conclusion, the gene YA61 was a new gene sequence that was overexpressed in human gastric carcinoma cell SGC-7901.