Objective To observe the concentration of the inflammatory cytokines in vitreous of severe proliferative diabetic retinopathy (PDR) after intravitreal ranibizumab injection (IVR).Methods A total of 80 PDR patients (80 eyes) were enrolled in this study.The patients were randomly divided into vitrectomy group (group A) and IVR combined with vitrectomy group (group B),40 eyes in each group.The differences of sex(x2=0.05),age (t=0.59),duration of diabetes (t=0.36),HbA1c (t=0.13) and intraocular pressure (F=0.81) between two groups were not significant (P＞0.05).The eyes in group B received 0.5 mg (0.05 ml) ranibizumab injection at 7 days before operation.The vitreous samples (0.4 ml)were obtained before operation.The concentration of vascular endothelial growth factor (VEGF),interleukin (IL)-6,IL-8,intercellular adhesion molecule-1 (ICAM-1) and connective tissue growth factor (CTGF) were measured by enzyme-linked immunosorbent assays.Results The concentration of VEGF and ICAM-1 were (10.70±3.60),(224.64±90.32) pg/L in group B and (72.38±23.59),(665.61±203.34)pg/L in group A.The differences of VEGF and ICAM-1 concentration between two groups was significant (t=16.34,12.53 ; P＜ 0.001).The concentration of IL-6 and IL-8 were (210.64 ± 80.27),(156.00±57.74) pg/L in group B and (45.78±33.82),(41.07±13.82) pg/L in group A.The differences of IL-6 and IL-8 concentration between two groups was significant (t=11.97,12.24; P＜0.001).There was no difference of CTGF concentration between two groups (t=1.39,P=0.17).The CTGF/VEGF in group B was higher than that in group A (t=14.75,P＜0.001).Conclusions One week after IVR,the concentration of VEGF and ICAM-1 are decreased,while IL-6 and IL-8 increased.There is no obvious change in CTGF,but CTGF/VEGF is increased.

Objective:To introduce a novel method of endoscopic forehead lift and its follow-up results.Methods:In the past 7 years, 119 patients underwent endoscopic forehead lift. The parallel incisions were made on the frontalis muscle to relieve the wrinkles of the forehead. Glabella muscles were partially bluntly bitten by minimally invasive forceps. No fixator or suture was applied during the operation. Postoperative FACE-Q scales were issued to patients, and the changes of eyebrow position before and after operation were measured.Results:One week postoperatively, glabella frown and forehead wrinkles were relieved or eliminated as the swell gone. The eyebrow measurement outcome showed that the eyebrows of the patients were definitely raised after the operation. The results of FACE-Q scales showed that patients were highly satisfied with the improvement of frontal wrinkles and glabella frown wrinkles, and with the surgical outcomes and decisions. The patients thought they were averagely 7 years younger after operation. The most common complication was temporary frontal skin numbness, followed by hairline regression.Conclusions:The endoscopic forehead lift can effectively improve the forehead wrinkles and the glabella frown wrinkles which meets the demands of Chinese patients.

Objective To evaluate ligation of the intersphincteric fistula tract plus core-out fistulectomy for complex cryptoglandular anal fistulas.Methods Forty-one patients were divided into ligation and control group randomly.In ligation group (20 cases),patients underwent ligation of the intersphincteric fistula tract plus core-out fistulectomy procedure.While in control group (21 cases) fistulotomy on low sphincter with cutting-seton on high sphincter procedure was performed.The primary end points of the study were healing rate and continence by using the Wexner score.Secondary end points were postoperative pain in the third and seventh day with the use of the visual analog scale,length of hospital stay and followed measures for a recurrent fistula.Comparison of measurement data using independent samples t-test or paired samples t-test,compared with the count data using Fisher's exact test.Results There was no statistical difference in the healing rate between ligation group (90％) and control group (95％) (P ＞0.05).Postoperatively,one case in ligation group reported incontinence for gas,compared to 7 cases in control group,among these 7 cases 2 cases also had incontinence for watery stool.Statistical differences were found between two groups in Wexner scores,visual analog scale scores and length of hospital stay (P ＜0.05).Conclusion Ligation of the intersphincteric fistula tract plus core-out fistulectomy is an economical,safe,little painful,recovery enhanced and minimally invasive technique to treat complex anal fistulas.

Silver nanoparticles ( AgNP) , the metallic silver par-ticles with the diameter of 1 ~100 nm are now widely used in many fields. Many researches show that the smaller size of Ag-NP, the stronger toxicity it shows. Generally speaking, AgNP with 20 nm shows strongest toxicity. After entering the body, they are distributed in different organs in the body, and the dis-tribution in the kidney shows a certain gender difference. They also produce some toxic effects after entering body organs. AgNP often exhibit dose effect on the toxicity in vitro cells,while in vivo experiments, their toxic effects change with the different objects and ways of acting. In addition, AgNP can produce toxic effects on reproduction, and may cause parental reproductive activity to deteriorate, and pass the toxic effects to offspring through the placenta to exert a negative influence on the growth and develop-ment of the offspring. The toxicity mechanisms of AgNP are oxi-dative stress injury caused by producing free radicals;metabolic disorders caused by reducing of drug metabolic enzyme activity;and also related gene expression defects and certain molecules, such as transcription factor NF-E2-related factor 2(Nrf2) prote-ase caused by abnormal expression. In short, AgNP can be toxic to organisms, and we must evaluate their biological safety when we use it, to minimize or even avoid the danger it brings about.

Objective To evaluate the various patterns of hepatic perfusion disorders with multi-slice spiral CT and to emphasize the significance of recognition for them . Methods In a period of 1 year, the all CT images of 1568 patients received multi-slice spiral CT examination of upper abdomen were analyzed retrospectively. The CT findings, etiologies and mechanisms of different pattens of hepatic perfusion disorders were investigated. Results 103 cases were demonstrated to have hepatic perfusion disorders. 69 cases were associated with tumors and the other 34 cases were non-tumor associated. The etiologies of various hepatic perfusion disorders were classified as (1)arterioportal fistulae(41.7%), (2) portal venous inflow obstruction(23.3%), (3) inflammartory hyperemic changes(17.5%), (4) steal phenomenon by hypervascular tumors(6.8%), (5) hepatic venous outflow obstruction(4.9%), (6) aberrant hepatic blood supply (3.9%) and (7) uncertain causes(1.9%). There was significant correlation between the CT images of perfusion disorders in shape and distribution and the causes of them. Conclusion Multi-slice spiral CT provides a new effective technique for demonstrating and understanding various hepatic perfusion disorders. Familiarity with the spiral CT appearances of these perfusion disorders will result in more accurate evaluation for various pathologic or physiologic states reflected by them.

No abstract available.
Claudin-1 ; Immunohistochemistry

Polyacrylamide resin was synthesized via surface-initiated atom transfer radical polymerization ( SI-ATRP) method. Acrylic amide ( AM) was grafted onto the surface of the chloromethyl polystyrene resin via SI-ATRP in the CuBr/2, 2'-bipyridine ( Bpy) system as catalyst at room temperature. The compositions of polyacrylamide resin were determined by means of elementary analysis, FT-IR analysis and scanning electron microscopy ( SEM) . The adsorption properties, the parameters of kinetics and the thermodynamics of the resin were evaluated in details, respectively. As the results, adsorption capacity of 2,4-dichlorophenoxyacetic acid (2,4-D) increased with the initial concentrations of solution increasing at room temperature, and its highest adsorption capacity was 111. 0 mg/g with solution concentration of 8 mmol/L. Adsorption isotherm at room temperature was determined and modeled with Langmuir and Freundlich equations. The thermodynamic equilibrium functions were calculated to be ΔG<0,ΔH=268. 2 kJ/mol, ΔS>0, hence, the adsorption was spontaneous, endothermic and entropy increasing. The kinetics fitted the pseudo-second-order well. The polyacrylamide-chloromethyl polystyrene (PAM-CMCPS) resin was used for the adsorption of 2,4-D in orange sample, and good results were obtained.

Objective To study the plasma metabolomics features of SD rats with wei-qi deficiency respectively in spring, summer, autumn and winter; To seek the potential markers related to wei-qi deficiency; To discuss the essence of wei-qi deficiency.MethodsTwenty male SD rats were adaptively fed 7 days before Chinese Vernal Equinox Day, Summer Solstice, Autumn Equinox and Winter Solstice, synchronous controled with temporal condition. The rats were randomly divided into experimental and control groups according to random number method. Rats in the experimental groupwere made into wei-qi deficiency models through fatigue stimulation alternately with cold and heat stimulation. Blood was collected at 12:00 each solar term. High performance liquid chromatography- mass spectrometry instrument was used to detect plasma metabolites. Partial least squates-discriminant analysis was used to process statistical analysis of the data to compared the original data of plasma metabolomics between the two groups of each season, and explore the difference metabolic markers between each two groups, then speculate the potential biomakers of wei-qi differency.ResultsWith the changes of spring, summer, autumn and winter, significant differences were showed in metabolic profile between the experimental and control groups. Homocysteine showed a significant difference in spring, summer and autumn; Ceramide showed a significant difference in summer and winter; Testosterone showed a significant difference in spring and summer; Cyclic guanosine monophosphate showed a significant difference in autumn and winter; Sarcosine showed a significant difference in spring, summer and winter. The physiological functions of these substances related to lipid metabolism, amino acid metabolism, neurotransmitter and hormone regulation.ConclusionPotential biomakers of wei-qi deficiency changed along with the seasonal variation, which mainly reflected in lipid metabolism, amino acid metabolism, neurotransmitter and hormone regulation.

Objective To use metabonomics method to study the change of the basic materials of month rhythm of wei qi deficiency syndrome; To find the potential markers so as to provides a new way for the essence of the wei qi deficiency syndrome research.Methods Based on the autumnal equinox in lunar calendar month, the beginning of a month (the first day of lunar August), the middle of a month (the 15th day of lunar August), and the end of a month (the 30th day of lunar August) were set as the three days to draw experimental materials. Two weeks before drawing materials, 20 rats were randomly divided into control group and model group, 10 rats in each group. The model rats were modeled by the stimulus of fatigue combined with coldness and hotness. Control group rats received conventional breeding. The rats in the both groups during the three experiments received decollation and the blood was taken at the 12 o’clock at noon. HPLC-MS was used to detect plasma metabolites, and partial least squares were used to make statistical analysis on the data for comparing plasma metabonomics original data of control group and model group. Possible metabolic markers of wei qi deficiency syndrome were explored, and the potential makers of month rhythm change of wei qi deficiency syndrome were deduced.Results Oleamide, phosphatidyl glycerol, cortisol, proline, dimethyl fumarate, and eicosapentaenoic acid may be potential markers of wei qi deficiency syndrome in the beginning of a month. Sphingosine-1-phosphate, malic acid, cortisol, oleamide, carnitine, eicosapentaenoic acid and dimethyl fumarate may be potential markers of wei qi deficiency syndrome in the middle of a month. Cholesteryl acetate, threonine, cortisol, dimethyl fumarate, oleamide, eicosapentaenoic acid and pyroglutamate may be potential markers of wei qi deficiency syndrome in the end of a month.Conclusion Month rhythm change of wei qi deficiency syndrome may be influenced by oleamide, cortisol, eicosapentaenoic acid, dimethyl fumarate, and aconitic acid, and may be closely related to energy metabolism, meanwhile accompanied by regulation of cell, hormone and nerves.

Objective To investigate the treatment effection of cranial decompression under temporal muscle in very-low position with large bone flap for severe cranial trauma.Methods 53 cases of severs cranial traumatic brain herniation were derided into two groups.22 cases with unilateral dilated pupil,and 31 cases of bilateral dilated pupil,all the patients were treated with cranial decompression under temporal muscle in very low position with large bone-flap.The ICP,appearance rate of cisternal,pupil contraction rate and GCS evaluation were observed,recorded and statistiely analysised.Results According to the intraeranial pressure monitoring,the rate of 24h ICP＜20mmHg was increased significantly,and the rate of 72h ICP＞40mmHg was decreased in both groups.The occurance rate of cisternal:81.82% in unilateral dilated pupil group,and 51.61% in bilateral dilated pupil group.The recoverance rate of pupil in 24h:77.2% in unilateral dilated pupil group,and 32.26% in bilateral dilated pupil group.GCS evaluation:All of the patient's average mark of GCS after operation wag(8.02±3.03)which increased(3.92±2.21)compared with the mark of GCS before operation,which was(4.10±0.82),with a significant difference(P＜0.01).Treat outcome:well/moderate disability:64.15%,severe/long-term coma:7.55%,and death:28.30%.Conclusion Cranial decompression under temporal muscle in very-low position with large bone-flap for severe cranial trauma can enlarge the cranial capacity effectively,increase the decompression space in dorsolateral cranium,which can alleviate the intracranial pressure in axial centre of brain truak,promote the effeetion of the brain herniation restore and the recover of the brain trauma.