Objective To investigate the key points in the nursing work of esophageal waterperfused high-resolution manometry (WHRM).Methods Summarized the nursing experiences before,during and after WHRM of 153 patients.Results Only 5 cases could not finish the test due to failure of intubation.23 cases complained about nasopharyngeal discomfort but follow-up monitoring was unremarkable.Conclusion In order to ensure the completion of WHRM,nursing cooperation requires serious assessment and preparation before manometry,intimate observation of patients' condition during manometry,and keep the catheter disinfection after manometry.

Background Panretinal photocoagulation (PRP) is an effective method for diabetic retinopathy (DR).However,PRP causes macular edema and visual impairment.The application of compound anisodine,a vascular dynamic drug can alleviate the adverse effect of PRP,but its effectiveness is not verified yet.Objective This study aimed to investigate the clinical therapeutic effect of compound anisodine on retinal functional damage following PRP in the eyes with non-proliferative diabetic retinopathy (NPDR).Methods A prospective cohort study was carried out from August 2013 to February 2014 in Beijing Tongren Hospital.One hundred and ten eyes with NPDR were included and PRP were performed.The operative eyes were randomized into the compound anisodine group (64 eyes) and control group (46 eyes).Compound anisodine solution of 2 ml was injected via temporal subcutaneous tissue since the second day after photocoagulation,and the injection was performed once per day for 4 courses in 3-day interval between each course (1 course for 14 days) in the compound anisodine group,and no any drug was used in the control group.The visual acuity,30° to 60° ring visual field and flash electroretinaogram (F-ERG) were examined before photocoagulation and 1 day,1 month and 2 months after photocoagulation to compare the retinal function between the two groups.ResultsThe vision acuity improved in 55 eyes in the compound anisodine group with the rate 85.94％,and that in the control group was 11 eyes with the rate 23.91％,showing a significant difference between the two groups (x2 =15.425,P =0.000).The mean sensitivities of visual field were (4.15 ± 1.42),(3.94 ± 1.40) and (4.81 ± 1.41) dB in 1 day,1 month and 2 months after photocoagulation in the compound anisodine group,which were significantly higher than (3.76± 1.52),(3.53± 1.55) and (3.64 ± 1.50) dB of the control group (t =1.39,1.44,1.15,all at P＜0.05).The amplitudes of a-wave and b-wave of F-ERG were all higher in the compound anisodine group than those in the control group in various time points after photocoagulation (all at P＜0.05).Conclusions The injection of compound anisodine via temporal subcutaneous tissue can relieve visual functional damage caused by PRP in NPDR eyes.

Objective To study the effect of diabetes on spatial memory ability and spatial associative memory ability in rats. Methods 70 SD rats( 180±20 g) were randomly divided into 3 groups: control group,type1 diabetes group and type2 diabetes group. Type1 and type2 diabetic rat models were set up by streptozocin (STZ) intraperitoneal injection and high fat forage raise. The blood glucose was determined. After rat diabetic model established 1 month and 3 months, respectively, the Morris water maze experiments were implemented,including 4 days' place swimming and 1 day's space exploration. Results After 1 month, diabetic rats' spatial memory ability and spatial associative memory ability were not affected. After 3 months, in place swimming test,the escape latency of two diabetic rat groups was obviously longer than that of the control group (P＜0.05). From the second day of the experiment, escape latency of the control descended sharply, while that of the diabetic group descended slowly. There was no difference between type 1 and type2 diabetic groups in escape latency (P＞0.05). After 3 months, in the space exploration test, when rats were put into the maze from I quadrant which already trained, swimming time in the platform quadrant was shorter, the other parameter scores were lower of the two diabetic model groups, contrast to the control group (P＜0.05). The parameter scores of type2 diabetic group were lower slightly than type1 diabetic group. When rats were put into the maze from IV quadrant for which never trained, the parameter scores of two diabetic groups were lower than that of the control group (P＜0.05) and the total score of type 1 group was lower than that of type2 group. Conclusion The spatial memory ability and spatial associative memory ability of type 1 and type2 diabetic rats descended. In the experiment, the spatial memory ability of type2 diabetic rats was more significantly affected than that of type1 diabetic rats. By contrast,type 1 diabetic rats' spatial associative memory ability descended greatly than that of type2 diabetic rats.

Objective To analyse the detection of The Heidelberg Retina Tomograph Ⅱ (HRT-II ) for macular diseases. Design Retrospective observational case series. Participants 110 patients(201 eyes). Methods Fifty-two normal eyes, 74 eyes with macular edema, 23 eyes with macular hole, 31 eyes with macular premembrane and 21 eyes with choroidal neovascularization were examined with macular edema module(MEM) of HRT-Ⅱ. Main Outcome Measures Edema index (E value), signal width value (W value) and features of reflectance pictures. Results In normal eyes, E value and W value of some areas in macula were partly associated with age(r=0.207-0.359). E value and W value in macular diseases were significantly different from normal eyes (P=0.000). HRT-II could display macular edema cysts, configuration and size of macular holes, extension of macular premembrane and its relationship with retina and druen or subretinal neovascularization in age-related degeneration. Conclusion The reflectance pictures of HRT-Ⅱ have characteristic appearances in different macular diseases, and the measurements of E value and W value altered in pathologic stage of macular diseases. Especially E value of central zone can reflect changes of retinal thickness and light reflectance in macula, and it is obviously different in macular edema.

Objective To evaluate the application value of scanning laser angiography with a wide-field contact lens system in the diagnosis of choroidal melanoma. Methods Twenty-four patients with choroidal melanoma were randomly divided into two groups, who underwent fundus fluorescein angiography and indocyanine green angiography scanning with the wide-field contact and non-contact lens system respectively in order to acquire the 150? wide-field and 30? view image data. The quality of the images was comprehensively evaluated. Results Satisfying images were acquired from all of the 24 patients. Wide-field contact lens system indicated the accurate adjacent relation between the lesion position and the other dissection mechanisms, and also provided the general information about the size of the tumor and the perfusion of fluorescien or indocyanine green in the blood vessels. At the same time, it enlarged the view scope 3-5 times, which make for the screening of the peripheral lesions. Conclusions Scanning laser angiography with a wide-field contact lens system has important application value in the diagnosis of choroidal melanoma.

Objective To compare the therapeutic effects of 577 nm laser and 532 nm laser panretinal photocoagulation (PRP) in the treatment of non-proliferative diabetic retinopathy (NPDR).Methods This is a prospective controlled study.A total of 23 patients (41 eyes) with clinically diagnosed severe NPDR were randomly divided into two groups including 577 nm group (11 patients,20 eyes) and the 532 nm group (12 patients,21 eyes).577 nm group and 532 nm group received 3-4 times PRP with single-point mode.The laser energy and the number of laser spots were compared,and the laser energy density was calculated.Before treatment and 1 day,1,3,6 and 12 months after treatment,the changes of best corrected visual acuity (BCVA),average threshold sensitivity,a/b-wave amplitude of flash ERG (F-ERG) in the 30°-60° visual field,and fundus fluorescein angiography (FFA) were compared between two groups.Results The response rate was 85.0％ and 23.8％,respectively in the 577 nm and 532 nm group,the difference was statistically significant (x2 =15.43,P ＜ 0.05).Compare to the pre-treatment measurement,the average threshold sensitivity,a/b wave amplitude of F-ERG and the 30°-60°visual field were reduced at 1 day after treatment both in the 577 nm and 532 nm group,the difference were statistically significant (F =8.68,7.57,4.52;P＜0.05).The average threshold sensitivity (t=2.41,3.48,1.23),a/b wave amplitude (a wave:t=5.82,4.45,7.83;b wave:t=5.40,3.23,4.67) of F-ERG were different between 577 nm and 532 nm group at 3,6 and 12 months after treatment (P＜0.05).There was no retinal neovascularization and non-perfusion region in two groups at 6 months after treatment.The average laser power were (436.25 ±54.65) and (446.43 ± 35.61) mW,number of laser spots were (1952.95 ± 299.09) and (2119.05 ± 302.69) spots,energy density were (7.60±1.30) and (7.60±3.00) mW× ms/μm2 in the 577 nm group and 532 nm group,respectively.There was no difference in average laser power (t=1.35),number of laser spots (t=2.85) and energy density (t=1.99) between two groups (P＞0.05).Conclusion Compared with the 532 nm laser,577 nm laser treatment has better visual outcomes for NPDR patients.

Objective To compare the therapeutic effects of 577 nm laser panretinal photocoagulation (PRP) between one time multi-point scanning mode and multiple time single-point mode in the treatment of eyes with non-proliferative diabetic retinopathy (NPDR).Methods This is a prospective controlled study from August 2013 to February 2014.A total of 29 patients (46 eyes) with clinically diagnosed severe NPDR were randomly divided into two groups including the treatment group (12 patients,22 eyes) and the control group (17 patients,224 eyes).The treatment group received one time PRP of multi-point scanning mode,and the control group received 3-4 times of PRP with single-point mode.In order to evaluate its efficacy,the best corrected visual acuity was measured before treatment,and 1 day,1,2,6 and 12 months after treatment.The average threshold sensitivity,a/b-wave amplitude of flash ERG (F-ERG) in the 30 °-60 ° visual field,and fundus fluorescein angiography (FFA) of the change were also compared between the 2 groups.The laser energy and the number of laser spots were compared,and the laser energy density was calculated.Results The response rate was 86.4％ and 79.2％,respectively in the treatment and control group,the difference was not statistically significant (x2 =0.414,P＞0.05).Compare to the pre-treatment measurement,the average threshold sensitivity,a/b-wave amplitude of F-ERG in the 30 °-60 ° visual field were reduced at 1 day after treatment both in treatment and control group,the differences were statistically significant (P＜0.05).The average threshold sensitivity,a/b-wave amplitude of F-ERG were no difference between treatment and control group at 2m,6m and 12m after treatment (P＞0.05).The average laser power,number of laser spots and energy density were (537.50 ± 64.69) mW and (339.09 ± 132.09) mW,(1934.32 ± 426.38) points and (2061.42 ± 375.49) points,(0.35±0.12) mW o ms/μm2 and (1.95 ± 0.86) mW · ms/μm2 in the treatment group and the control group,respectively.The average laser power and energy density was statistically different between the 2 groups (P＜0.05),while the number of laser spots was no difference (P＞0.05).Conclusions 577 nm multi-point scanning laser can complete the PRP at one time,and achieve the same therapeutic outcomes with the single-point mode which need several times to complete the PRP in the eyes with severe NPDR,and have lower energy density,and thus relative minor function damage.

Objective To study the effects of diabetes on hippocampal synaptic plasticity in perforant path-dentate gyrus pathway (PP-DG) in rats. Methods 70 SD rats( 180±20) g were divided into 3 groups at random: control group, type1 diabetes group (DM1)and type2 diabetes group (DM2). After Morris water maze test, 15 rats that showed worse spatial memory ability were selected in each model group to investigate the variation of paired-pulse facilitation (PPF) and the range of synaptic plasticity. Field potentials were recorded in the dentate gyrus of the dorsal hippocampus by stimulating the perforant path. Results Contrast to the control group, diabetic rats' hippocampal LTP were depressed (P<0.05), and type1 diabetic rats' LTP reduced much more. Diabetic rats' PPF ratio was reduced contrast to the control group (P<0.05). Conclusion Type1 and type2 diabetes impaired synaptic plasticity of hippocampal PP-DG pathway in rats, which conformed the results of water maze test.

Aim To investigate the role of autophagy and its mechanism in Raji cell death induced by arse-nic trioxide. Methods Transmission electron micros-copy ( SEM) and MDC fluorescence staining were used to observe autophagy. MTT colorimetry was employed to assay the cellular proliferating activity. Cell apopto-sis and cell cycle analysis were performed using FITC-Annexin-V/PI double staining and flow cytometry ( FCM) . The expressions of LC3 and the conversion of LC3-I to LC3-II were measured by western bloting. The expression of bcl-2 mRNA and p53 mRNA were detected by reverse transcription-polymerase chain re-action ( RT-PCR ) . Results Arsenic trioxide could obviously inhibit the proliferation of Raji cells, arrest the cells at G2/M phase and induce apoptosis. Mean-while, arsenic trioxide markedly inhibited the expres-sion of bcl-2 mRNA and enhanced the expression of p53 mRNA in Raji cells. Arsenic trioxide also induced autophagy synchronously which paralleled with the in-duction of apoptosis in Raji cells, and 3-MA, an auto-phagy inhibitor, was able to reverse the arsenic triox-ide-activated autophagic activity, up-regulate bcl-2, down-regulated p53 expression and suppress the lethal effect of arsenic trioxide on Raji cells to reduce their sensitivity to arsenic trioxide. In contrast, the Rapamy-cin, an autophagy inducer, possessed the completely opposite effects on Raji cells compared with 3-MA. Conclusions The apoptosis and autophagic cell death are coexistent in arsenic trioxide-triggered death of Raji lymphoma cells, and Bcl-2 and p53 may play a key regulating role in this process.

To investigate whether accelerated blood clearance (ABC) phenomenon could be induced after repeated injection of mitoxantrone thermosensitive liposomes, LC-MS/MS and enzyme linked immunosorbent assay (ELISA) were used to measure the concentration of mitoxantrone and the anti-polyethylene glycol (PEG) IgM levels in rat plasma, separately. The drug was rapidly cleared away after the second administration. The anti-PEG IgM was detected after the first dose which was neutralized quickly after the second dose. It is proved that repeated administration of mitoxantrone thermosensitive liposomes in rat caused the ABC phenomenon.
Animals ; Antineoplastic Agents ; administration & dosage ; blood ; pharmacokinetics ; Chromatography, High Pressure Liquid ; Immunoglobulin M ; blood ; Liposomes ; administration & dosage ; blood ; pharmacokinetics ; Male ; Metabolic Clearance Rate ; Mitoxantrone ; administration & dosage ; blood ; pharmacokinetics ; Polyethylene Glycols ; administration & dosage ; chemistry ; pharmacokinetics ; Rats ; Rats, Wistar ; Spectrometry, Mass, Electrospray Ionization ; Tandem Mass Spectrometry