Retinal anatomic structure and physiology function are very complex.Electroretinogram (ERG) is currently the only objective assessment for retinal function.There are groups of devastating diseases characterized by affecting the inner retinal functions.However,compared with its advantages in evaluating the outer retina function,ERG is less sensitive in judging the inner retinal function.The decrease of sensitivity is mainly associated with the crosstalk between the rod and cone systems in the longer visual signal pathways.In the past twenty years,new recording techniques in ERG analysis including oscillatory potentials,ON-OFF responses,photopic negative responses and scotopic threshold response have been developed.These ERG components are generated from the bipolar cells,amacrine cells or retinal ganglion cells and are becoming novel tools to assess the function of the inner retina.Ophthalmologists should fully understand the clinical significance of these ERG components in assessing inner retinal function to better guide the diagnosis and treatment of retinal diseases.

Objective: To investigate the diagnostic value of salivary gland scintigraphy for primary Sj?gren’s syndrome (pSS). Methods:This study took 50 pSS patients and 50 healthy women as the control group. All of them were performed salivary gland scintigraphy. We observed the imaging of salivary gland scintigraphy for two groups, and evaluated their salivary gland function. Results: In 50 patients with pSS, eight patients (16.0%) of bilateral parotid and submandibular glands were functioned well. While the function of bilateral parotid function and/or bilateral submandibular gland were observed reduction in other patients with pSS. The uptaking function decreased obviously in the typical patients with pSS, who are with bilateral parotid and submandibular glands. The uptake of 99TcmO4-was decreased in salivary glands, and the uptake of the oral cavity was lessened. After taken vitamin C tablets, there was no obvious concentration of 99TcmO4-. The time-radioactive type curve has continued to rise. The UR, S/T, SR and V of pSS patients were significantly lower than the control group, and the differences were statistically significant (P<0.01). Conclusion: Salivary gland scintigraphy is a non-invasive diagnosis with high-value for primary Sj?gren’s syndrome patients.

Dizziness ; classification ; epidemiology ; Humans ; Vertigo ; classification ; epidemiology

Arytenoid Cartilage ; pathology ; Humans ; Laryngeal Neoplasms ; diagnosis ; pathology ; Neoplasm Invasiveness ; diagnosis ; Neoplasm Staging

The indigenous populations of high altitude, physiologically with lower concentration of hemoglobin and higher level of nitric oxide, can be well-adapted to hypoxia and cold environment. Recent studies have revealed that these adaptive highland population possessed genetic bases, which involved a number of genes, such as EPAS1, EGLN1, CBARA1, VAV3, PPARA, and eNOS, associating with hypoxia-inducible pathway, production of red blood cells and vasodilator substances, etc. These findings provided new insights and strategies from genetics to uncover the unique natural environment selection, to understand the mechanisms of plateau diseases, finally to better prevent and treat them.

Objective To observe the postoperative analgesic effects of ultrasound-guided transversus abdominis plane block after cesarean section. Methods Forty patients having underwent cesarean section under intraspinal anesthesia were selected, and they were divided into experiment group and control group by random digits table method with 20 cases each. All the patients were given ultrasound-guided transversus abdominis plane blocks when surgery finished. The patients in experiment group were injected 0.25%ropivacaine 20 ml, and the patients in control group were injected 0.9% sodium chloride 20 ml. All the patients received patient controlled intravenous analgesia (PCIA) pump after surgery. The movement and resting visual analog score (VAS), incision VAS at 4, 8, 12 and 24 h after surgery, and the compression time of analgesis pump were compared between 2 groups. The correlated adverse reaction of transversus abdominis plane block were recorded. Results The movement VAS at 4 and 8 h after surgery in experiment group were (4.1±1.7) and (5.3±1.8)scores, and in control group were (6.3±2.0) and (7.0±1.2) scores, and there were statistical differences (P<0.05). The incision VAS at 4 and 8 h after surgery in experiment group were (0.9±0.4) and (1.2±0.8) scores, and in control group were (3.6±2.1) and (6.8±2.4) scores, and there were statistical differences (P<0.05). The compression time of analgesis pump in experiment group was significantly lower than that in control group: (2.8± 1.4) times vs. (4.0±1.9) times, and there was statistical difference (P<0.05). The using dose of tramadol in experiment group was significantly lower than that in control group:(214±12) mg vs. (224±15) mg, and there was statistical difference (P<0.05). All the patients did not appear the correlated adverse reaction of transversus abdominis plane block. Conclusions Ultrasound-guided transversus abdominis plane block is accurate and easy. It provides effectual post-cesarean section analgesia with lower adverse reaction, which is a better choice of multimodal analgesia for cesarean section.

ObjectiveTo evaluate and compare long-term clinical outcomes of arthroscopic anterior cruciate ligament (ACL) reconstruction with remnant preservation versus remnant resection.MethodsFrom October 1999 to May 2005,standard ACL reconstruction with autogenous quadrupled hamstring tendons under arthroscopy using remnant resection with transtibial techniques was conducted in 87 patients.From June 2005 to May 2010,ACL reconstruction with autogenous quadrupled hamstring tendons using outside-in bone tunnel establishment and remnant preservation was performed in 221 patients.Only the patients who underwent simple ACL reconstruction together with more than three years follow-up records were enrolled in the study,including 66 patients in remnant preservation group and 39in remnant resection group.ResultsPatients of both groups were all followed up for 36-60 months,which showed insignificant difference between groups ( P ＞ 0.05).Compared with the preoperative data,the latest follow up data demonstrated satisfactory outcomes in both groups.The two groups showed no significant differences regarding the preoperative data including age and gender distribution,average time from injury to surgery,joint instability extent and functional score of the affected knee ( P ＞ 0.05 ).There was no statistical difference in regards of the thigh muscle atrophy and Lachman test between groups ( P ＞0.05).However,the remnant preservation group was superior to the remnant resection group in aspects of the range of motion of the affected knee,Lysholm score,stability in anterior drawer test,stability in pivot shift test and international knee documentation committee (IKDC) grade ( all P ＜ 0.05 ). ConclusionCompared with standard ACL reconstruction using remnant resection with transtibial techniques,the ACL reconstruction using outside-in bone tunnel establishment and remnant preservation has better longterm clinical outcomes including stability and function of the affected knee.

Objective To evaluate the different effects of the treatment of thoracolumbar fractures by pedicle of vertebral arch Tenor system and Harrington device.Methods The clinical data of 35 cases of thoracolumbar fractures were analyzed retrospectively, 23 of them were operated with Harrington device and 12 with Tenor system.Results These cases were followed up for 6 months to 2 years. The fractures treated with Tenor system got satisfied reduction, reached about 96 7% of normal vertebral height. The deformities were completely corrected and complications were significant lower than those derived from Harrington device treatment, and no delayed neurologic damage was found. Most cases got reduction with one to three Frankel grades of neurologic recovery.Conclusion The Tenor pedicle system is more effective in treatment of thoracolumbar fracture than non-pedicle device. It can get satisfied fracture reduction , reliable fixation and less complications.

Objective To evaluate the effect of ?-lipoic acid(ALA)as a antioxidant on the histomorphologic changes of the kidney in type 2 diabetic Goto Kakisaki rats.Methods Four healthy Wistar rats(normal control group)and 10 GK rats were divided randomly into two groups:diabetic control group and lipoic acid-treatment diabetic group(?-lipoic acid 35 mg/kg intraperitoneal injection qd alt),who were both fed for 12 weeks.Indexes of oxidative stress of kidney were measured.Sections of renal tissue were evaluated using both a light and electron microscope to assess histomorphologic changes.Paraffin sections of the left kidneys were prepared and stained with H&E,PAS and Masson stains to compare the histomorphologic changes.The image analysis software of Motic Image Advanced 3.1 was used to measure the area of glomerulus and mesangial region,and the thickness of the glomerular basement membrane(GBM).Results Compared with normal control group,there were significant decreases in GSH,SOD,VitC and VitE levels in diabetic control group.The kidneys of the normal control group exhibited normal cortical morphology as determined by light microscope.Mild glomerulosclerosis,characterized by widening of the mesangial region,mesangial expansion and intercapillary cells proliferation,and GBM thickening under electron microscope were observed in the diabetic control group.In the ALA-treatment group,all the above pathological changes were alleviated.Conclusion In the kidney of type 2 diabetic rat,there exists oxidative stress which is associated with diabetic nephropathy.?-Lipoic acid can alleviate the abnormal histomorphologic changes of the kidney via antioxidative effects.

Objective To observe pathological process of intestinal epithelial cells subjected to ischemia,ischemia/reperfusion injury and inflammation simulated hypoxia/reoxygenation (H/R) and lipopolysaccharide (LPS) challenged human fetal normal colonic cell (FHC) line in vivo,and to observe the changes when the assaulted intestinal epithelial cells were treated with emodin,in order to explore the possible intervention targets of emodin.Methods Normoxia group:the FHC cells were cultured in 95％ air and 5％ CO2 at 37 ℃.Hypoxia (H) group:the cells were cultured with a mixed anaerobic gas of 1％ O2,5％ CO2 and 94％ N2 at 37 ℃ for 1,2,3,4 hours.H + LPS group:the cells were cultured in hypoxic condition as H group with simultaneous challenge of LPS (1 mg/L).H/R group:the cells were cultured in hypoxia for 3 hours followed by reoxygenation for 1,2,3 and 4 hours,respectively.H/R + LPS group:the cells were cultured in H/R as H/R group and LPS (1 mg/L) simultaneously.Emodin intervention group:the cells were cultured in H3 h/R2 h + LPS and emodin (20,40,60,80 μmol/L) simultaneously.The variation trends of phosphorylation nuclear factor-κB profilin-o (pIκB-α),phosphorylation NF-κBp65 (pNF-κBp65) and their downstream target gene cyclooxygenase-2 (COX-2),and hypoxia-inducible factor-1α (HIF-1 α) were determined by Western Blot.The morphological changes in intestinal epithelium in different groups were observed using light microscope.The effect of emodin on the proliferation of intestinal epithelial cell was measured by methyl thiazolyl tetrazolium (MTT) assay.Results ① H group:the expressions of pIκB-α,pNF-κBp65 and COX-2 were upregulated,peaking at H1 h (0.350 ± 0.018,1.083 ± 0.054,0.903 ± 0.045),and then they gradually lowered (F value was 3.011,7.247,5.754,P value was 0.013,0.000,0.005,respectively).The expression of HIF-1 α peaked at H3 h (1.511 ± 0.076),but there was no significant difference among different groups (F=1.881,P=0.062).H + LPS group:the expressions of pIκB-α,pNF-κBp65,COX-2,HIF-1α were increased with elongation of duration of hypoxia,and a maximal induction was observed at H3 h (0.504 ± 0.025,1.255 ± 0.063,0.812 ± 0.041,1.209 ± 0.075,F value was 2.683,8.774,9.765,2.432,and P value was 0.011,0.000,0.000,0.026,respectively).H/R group:with the prolonged duration of reoxygenation,the expressions of NF-κB signaling pathway proteins (pIκB-α,pNF-κBp65,COX-2) were decreased and dropped to nadir at H3 h/R4 h (0.712 ± 0.034,1.202 ± 0.048,0.691 ± 0.042,F value was 1.923,6.765,2.719,and P value was 0.063,0.000,0.016,respectively).Compared with H group,HIF-1α was decreased with a prolonged duration of reoxygenation in H/R group,but there was no significant difference in value among different time points (F=1.280,P=0.081).H/R + LPS group:pIκB-o,pNF-κBp65,COX-2,HIF-1α showed no sign of degradation with the prolonged duration of reoxygenation,and their expression increased to maximum analogously at R2-3 h (3.302 ± 0.061,2.315 ± 0.055,2.017 ± 0.043,2.413 ± 0.098,Fvalue was 4.614,1.652,5.970,2.076,and Pvalue was 0.001,0.067,0.000,0.037,respectively).Emodin group:emodin when co-treated with H/R + LPS inhibited the expression of HIF-1o and NF-κB pathways with a dose-effect relationship (P＜0.05 or P＜0.01).Emodin at the dose of 80 μmol/L showed most marked inhibition (2.599 ± 0.130,1.772 ± 0.089,2.590 ± 0.129,2.518 ± 0.125).However,after treatment of emodin did not show such effect.② After treatment with H/R + LPS,there were morphological changes in cells:vacuoles,deformation and fusion.The speed of cell growth became much slower compared with H group.③ Emodin (20-80 μmol/L) had no significant effect on cell proliferation.Although emodin produced biological effect in this concentration range,it had no cellular toxicity.Conclusions Both hypoxia and inflammation can activate the hypoxia pathway of HIF-1α and the pro-inflammatory pathway of NF-κB,but different stimuli cause varying degrees of activation in these two pathways.In H/R group,both pathways were weakened during reoxygenation.However,in H/R + LPS group,the proteins remained to show a relatively high expression during the process of reoxygenation.This may be related to the pathophysiological mechanism of intestinal ischemia/reperfusion injury:hypoxia/reperfusion injury and LPS act together to destroy the intestinal epithelial cells and induce gut-derived sepsis.Emodin may inhibit inflammation by blocking HIF-1α/NF-κB-COX-2 signaling pathways.