Macular hole is a retinal hole locates in macular fovea, and can be idiopathic, traumatic and high myopic. Although its etiology, disease course, treatment and prognosis varied from case to case,enforcing macular-hole closure and retinal reattachment are challenges to all cases. Completely removal of premacular vitreous cortex is the key to successful repair, and inner limiting membrane (ILM) staining and peeling can greatly help the removal of those cortexes. Selections and usages of different dyes, methods of ILM peeling, and strategies to promote macular retina-choroidal adhesion warrant further study to improve treatment and prognosis of macular holes.

About 50-70% patients will have secondary cardiac damage after subarachnoid hemorrhage (SAH),and the cardiac damage will aggravate cerebral ischemia and hypoxia,which may also promote the occurrence of delayed hypoxic-ischemic encephalopathy. By means of the detections of electrocardiogram,echocardiography,and serum myocardial enzymes,many researchers observe the clinical features and duration of this change and its relationship with the prognosis. This article reviews the advance in research on the causes of early cardiac damage after SAH,as well as the clinical features of the changes of electrocardiogram,echocardiography,and myocardial enzymes.

A differential diagnosis between primary and metastatic cancers is required in lung cancer patients with a history of breast cancer, However, the limited morphological findings are not enough to differentiate many atypical cases. Essential immunohistochemical and molecular markers are helpful for differential diagnosis. Combined markers currently specific and sensitive to lung or breast carcinomas can improve the efficacy of differential diagnosis between primary lung cancers and metastatic breast cancers.

Objective To construct DNA vaccine expressing HIV-1 AE2f gp145-tat-rev-nef fusion gene( AE-Gp145TRN) and to compare the immunogenicities of DNA vaccines expressing Tat, Rev and Nef in gene fusion formulations of tat-rev-integrase(c-half)-vif-nef( AE-TRIVN) and AE-Gpl45TRN. Methods DNA vaccine was constructed by inserting the codon optimized HIV-1 AE2( gp145-tat-rev-nef fusion gene into mammalian expression DNA vector. In vitro expression efficiency of the constructed DNA vaccine was determined by Western blot and the immunogenicities of AE-Gpl45TRN and AE-TRIVN were compared by immunizing female BALB/c mice. IFN-r ELISPOT assay was used to read out the specific T cell immunity. Results Western blot assay showed the constructed DNA vaccine could be expressed efficiently in vitro. After vaccination, AE-TRIVN mounted significantly higher T cell responses against Tat, Rev and Nef[(148±91)SFCs/106 splenocytes]than Gpl45TRN[(55±28) SFCs/106 splenocytes]. Specific T cell responses elicited by AE-TRIVN predominantly targeting Rev, whereas Gpl45TRN could significantly enhance T cell responses against Nef. Conclusion AE-TRIVN and Gpl45TRN induced distinct T cell response modalities, which implied different gene fusion formulations may affect the immunogenicity of specific DNA vaccines.

BACKGROUND: As the damage caused by protein glycation is one of the mechanisms of diabetes, it is helpful to treat diabetes related diseases with the understanding of the inhibition of berberine on protein glycation and the protection to the brain damage caused by protein glycation.OBJECTIVE: To observe the effects of berberine on glycated brain damages induced by D-galactose in model rats.DESIGN: Randomly grouping paralleled control study.SETTING: Department of Ophthalmology, Xiamen Traditional Chinese Medicine Hospital.MATERIALS: The experiment was conducted in the Department of Pharmacology, Pharmacy College of Jinan University from June to October 2005. Ninety SD rats (6 weeks old) were selected and divided into 6 groups: control group, model group, hydrochloride aminoguanidine group and high (300 mg/kg), middle (150 mg/kg) and low (75 mg/kg) doses berberine groups with 15 rats in each group. The glycated models were established by intraperitoneal injection of D-galactose. The main drugs:berberine was from Guangzhou Wanji Drugs Limited Company; D-galactose was from Shanghai Yuanju Bioscience Technology Limited Company.METHODS: The rats in the control group were intraperitoneally injected the normal saline for 8 weeks; rats in other groups were injected 5%D-galactose (150 mg/kg) for 8 weeks. From the 3rd week, the hydrochloride aminoguanidine group was infused hydrochloride aminoganidine (150 mg/kg); the three doses berberine groups were given corresponding doses berberine; the control group and model group were given distilled water for 6 weeks with the volume of 10 mL/kg. At the end of the 8th week, the erythrocyte aldose reductase activity was determined by coomassie brilliant blue method; the level of plasma glycohemoglobin was measured by thio-barbituric acid colorimetry and the fructosamine in serum was measured by nitroblue tetrazolium colorimetry. The quantity of advanced glycation end products (AGEs) in serum, and AGEs, malondialdehyde (MDA), and activity of superoxide edismutase (SOD) in brain tissue and calcium ion in neurons were also dertermined. Moreover, the changes of mitochondria in brain hippocampus cells were observed under electronic microscope.MAIN OUTCOME MEASURES: ① The AGEs, plasma glycohemoglobin, serum fructosamine and aldose reductase activity. ②AGEs in brain tissues. ③Calcium level in brain. ④MDA content and SOD activity in brain tissues. ⑤Changes of mitochondria in hippocampus neurons.RESULTS: All 90 animals were involved in the result analysis. ①Aldose reductase activity and glycated product content in serum: After the rats were treated with D-galactose for 8 weeks, the aldose reductase activity in red blood cells and the content of fructosamine in serum, glycohemoglobin,AGEs in the model group were significantly higher than those in the normal control group (P ＜ 0.01); After treated by high and middle doses berberine for 6 weeks, the activity of aldose reductase and content of fructosamine in serum (absorbancevalue of hemoglobin every 10 g), glycohemoglobin, and AGEs were obviously lower than those in the control group [(1.07±0.39), (1.22±0.47), (1.76±0.30) nkat/g, t=5.052, 5.484, P ＜ 0.01;(0.740±0.142), (0.862±0.131), (0.958±0.083) mmol/L, t=7.829, P ＜ 0.01,t=2.404, P ＜ 0.05; 58.434±12.135, 64.614±13.418, 83.747±7.990,t=4.922, 6.748, P ＜ 0.01; (3.104±0.814), (2.937±0.514), (4.156±0.860) U/mg,t=4.104, 3.440, P ＜ 0.05]; the aldose reductase activity of the low dose berberine group was lower than the model group (P ＜ 0.05), which had no obvious effect on glycated products. ②AGEs in brain tissues: The contents in the hydrochloride aminoganidine group, high and middle doses berberine groups were lower than the model group [(10.52±1.22), (10.95±1.75),(11.95±2.27), (14.26±3.51) U/mg, t=-3.892, -3.263, P ＜ 0.01, t=-2.139,P ＜ 0.05], and the low dose berberine had little effect (P ＞ 0.05). ③Calcium level in neurons: The levels in the hydrochloride aminoganidine group,and high dose berberine groups were lower than the model group.[(271.52±32.71), (293.84±31.58), (337.15±58.49) nmol/L, t=-3.421, P＜ 0.01, t=-2.275, P ＜ 0.05], the low dose berberine group had no obvious effect (P ＞ 0.05). ④MDA content and SOD activity in brain tissues: MDA contents in the hydrochloride aminoganidine group, high and middle doses berberine groups were lower than the model group, and the SOD activity was markedly higher than the model group [(2.09±0.16), (2.12±0.22),(2.41±0.12), (2.54±0.21) μmol/g, t=6.601, 5.348, P ＜ 0.01, t=2.082, P＜ 0.05; (8.79±1.09), (8.80±1.52), (7.90±1.48), (6.48±1.34) mkat/g, t=4.571,4.254, P ＜ 0.01, t=2.226, P ＜ 0.05]. ⑤Mitochondria structure in brain hippocampus cells: Under the electronic microscope, mitochondria in brain hippocampus cells of the model group appeared obvious swelling with broken crests and disorganized structure, even obvious big vacuoles were observed. In the hydrochloride aminoganidine, and high and middle doses berberine groups, no obvious swelling was observed with vacuoles only in a few mitochondria. Nevertheless, obvious swelling appeared in mitochondria of low dose berberine group with broken crest and disorganized structure,and vacuoles were observed.CONCLUSION: D-galactose-induced damage in mitochondria may be related to AGEs formation in brain tissue, maladjustment of calcium ions in neurons and oxidative stress in rat models. Berberine can inhibit glycation induced by D-galactose and protect rat brain tissues from glycated damage.

Objective To evaluate the pattern of development of fetal cerebral sulei by prenatal ultrasound and its clinical significance. Methods Sixty hundred and ninety-two fetuses at age from 17 to 40 weeks were observed for the development and depth of cerebral sulci (parietal-occipital sulcus, calcarine suleus, central sulcus, eingulate sulcus, cingulate gyrus, and sylvian fissure) by transabdominal ultrasonography. Results Parietal-occipital sulcus,calcarine sulcus,and sylvian fissure were visible at about 19 weeks of gestation, central sulcus was at about 25 weeks, cingulate sulcus and cingulate gyrus were at about 26 weeks. One case of them was considered as cerebral sulei growth retardation due to the signs of invisible parietal-occipital sulcus and sylvian fissure at 24 weeks of gestation. Two cases were considered as cerebral sulci growth retardation due to the signs of invisible parietal occipital sulcus and central sulcus and the shallow blunt shape of sylvian fissure at 29 weeks of gestation. There were positive correlations between the depths of fetal cerebral sulci and gestational weeks, and negative correlations between their relative depths and gestational weeks(all P <0.05), Conclusions Transabdominal ultrasonography can be use to observe the development of fetal cerebral sulci (parietal-occipital sulcus, calcarine sulcus, central sulcus, eingulate sulcus,cingulate gyrus,and sylvian fissure). The depth of cerebral sulci is relative to gestational weeks,and would be considered for prenatal assessment of cerebral sulci maldevelopment, such as cerebral sulci growth retardation and lissencephalia.

Objective To detect the normal values of fetal cerebellar vermis using transabdominal ultrasonography and assess its clinical significance in the diagnosis of vermal hypoplasia(agenesis). Methods A total of 111 fetuses were evaluated by transabdominal sonography between 20 and 40 weeks of gestation.The mid-sagittal antero-posterior(AP) and cranio-caudal(CC) vermian diameters were measured. A second group of 15 fetuses with cisterns magna were assessed and compared with the value of normal fetuses.0.05) and correlated linearly with gestational age ( AP = - 5.406 + 0. 761 GA, r = 0.97 ; CC = - 5.795 +fissure, second fissure and fastigium may help identify developmental anomalies. Conclusions Transabdominal ultrasonography is a valuable tool in the study of fetal vermis during the second half of pregnancy.

Functional dyspepsia is a common functional gastrointestinal disease , however , the cause of functional dyspepsia has not been fully elucidated .Ghrelin is braingut petide , secreted by major endocrine cells of the stomach ( x/A like cells ) .Its recep-tor is widely distributed in the body .It has many kinds of biological effects , such as regulating growth hormone secretion , feeding and energy balance , affecting neuroendocrine and gastrointestinal function and so on .A growing number of studies have shown that Ghrelin in FD has a positive role in increasing the improvement of food intake and generating hunger , promoting gastric emptying .Ghrelin is a new hot spot in the research of FD .

BACKGROUND: More and more psychiatric problems require liaison consultation in specific clinical departments of general hospital.OBJECTIVE: To enhance the recognition of physicians in non-psychiatric departments on psychiatric illness by carrying on psychiatric liaison consultation in general hospital.DESIGN: Case analysis.SETTING: Department of Psychology in the affiliated hospital to Guangdong Medical College.PARTICIPANTS: Totally 154 inpatients for the consultation in Department of Psychology were selected in the Affiliated Hospital of Guangdong Medical College from April 2003 to April 2004, of either sex and different age and educational backgrounds.METHODS: It was to investigate the distributions of departments and diseases with consultation-liaison psychiatry (CLP) in general hospital in 154 cases based on statistics.RESULTS: Totally 154 cases were employed and were all in result analydepartments applying for consultation, the department of internal nedicine occupies the top, 57 cases (37.0%) involved, followed by department of emergency, with 26 cases (16.8%), department of infection, with 17 cases illness: The most common diseases in consultation were neurotic disorders due to brain disease (31.1%), psychiatric disorder (25.3%) and psychiatric disorder due to body disease (13.6%).CONCLUSION: Psychiatric problem happens in every clinical department of general hospital. It is necessary to enhance liaison psychiatric consultation in general hospital.

Objective To introduce cause-tracing technique in the static state of Qigong to enrich modem clinic psychotherapy. Methods Based on previous therapeutic experience, we reduced resistance from patients through interview.Then the cause of diseases was detected by analyzing implicit memory. Results Cause-tracing technique in the static state of Qigong could get important relevant information by excavating implicit memory. It was a cause-tracing method characterized by low-resistance and high-speed. Conclusion Cause-tracing technique in the static state of Qigong had great clinical value.