Diabetic retinopathy ( DR ) is one of the most serious microvascular complications of diabetes. It also is a world's major causes of blind eye diseases. Although the injection of anti - vascular endothelial growth factor intraocular drug is becoming a hotspot of current research. Pan retinal photocoagulation (PRP) remains the effective and economical treatment for DR. As a destructive treatment, PRP will inevitably cause some changes on the normal morphology and function of the retinal and cornea. Currently, with the development of the optical coherence tomography, confocal microscopy and other auxiliary examination, we have more accurate and objective research to better understand the laser-neural tissue interaction. This may help us to protect the patient's visual function more efficiently.

Objective To observe the clinical efficacy of sertraline hydrochloride combined with compound alverine citrate in the treatment of irritable bowel syndrome(IBS).Methods 72 patients with IBS were randomly divided into control group and combined treatment group.The control group received a 10 -week course of twice daily 60mg compound alverine citrate singly.The combined treatment group received a 10 -week course of twice daily 60mg compound alverine citrate and thrice daily 50mg sertraline hydrochloride.The change of clinical efficacy and the score of abdominal pain,abdominal bulge,diarrhea,rectal and anal uncomfortableness were assessed before and after the treatment.Results The total clinical efficacy rate was 55.55% in the control group and 88.88% in the combined treatment group,the difference was statistically significant(χ2 =10.225,P <0.05).The scores of abdominal pain, abdominal bulge,diarrhea, rectal and anal uncomfortableness in the control group were (4.91 ±1.12) points, (3.55 ±0.45) points,(1.59 ±0.49) points,(1.86 ±0.26) points,which in the combined treatment group were (0.95 ±0.46)points,(1.08 ±0.51)points,(0.89 ±0.71) points,(1.12 ±0.35) points.The combined treatment group were significantly improved compared with the control group after 8 weeks treatment( t =10.314,10.264, 9.561,9.823,all P <0.05).Conclusion The clinical efficacy of sertraline hydrochloride combined with compound alverine citrate is more efficient on IBS,it is worth to extend and apply in clinic.

Objective:To discuss the distinctive clinical manifestation of primary aspergillus laryngitis.Method:Six cases of primary aspergillus laryngitis in our department were reviewed,among which 3 cases were diabetes patients,and were laryngeal mucosal barrier impairment.2 cases were smoking, 2 cases were over use of voice and 1 case were gastro-pharyngeal reflux . Refractory hoarseness was the main clinical manifestation of all patients. The prophase treatment with antibiotics and glucocorticoid should breakdown the balance of flora and exacerbate the disease.Result:Stop using antibiotics and glucocorticoid and alter to oral administration of itraconazole in 2 to 4 weeks after final diagnosis can effectively cure the disease. No recurrence was found in 6 month to 4 years follow up.Conclusion:Diffuse hyperemia ,pachynsis and scattered lamellar leukasmus of vocal cord were the characteristic physical findings of primary aspergillus laryngitis.Pathology is the major means to get the final diagnosis. Oral administration of itraconazole could be effective.

Objective To establish models of different susceptibility of heroin-induced conditioned place preference (CPP) in rats and investigate the relation between novel environmental response and heroin-dependent susceptibility. Methods After an open-field test, 70 male Sprague-Dawley rats were classified into 2 groups according to the numerical value of heroin-induced CPP, each accounting for 30%. The correlation between open-field test and CPP was analyzed. Results CPP value was much higher than pre-test scores in the rats after exposure to heroin (P<0.01). Compared with the low-CPP group, the high-CPP group had much higher scores in open-field test (P<0.01). The deviation of resident time at natural preference side tested and pre-tested had positive correlation with open-field test (P<0.05). Conclusion Heroin-induced CPP model of different susceptibilities could be successfully established by chronic heroin exposure. The novel environmental response is a reliable predictor for its vulnerability to develop heroin dependence.

Objective To investigate the risk factors related with postoperative complications following radical gnstrectomy for gastric cancer in cirrhotic patients. Methods In this study, 1474 cases underwent radical gastrectomy for gastric carcinoma in the past six years and the postoperative complications were retrospectively reviewed. The risk factors related with postoperative complications of cirrhotic patients were analyzed by Logistic regressive analysis. Results The postoperative morbidity rates of the 2 groups with or without liver cirrhosis were 51.22% and 23.94% (X2 = 15.955, P<0.01), and the mortality rate was 7.32% and 0.91% (P = 0.009), respectively. The main complications of the group with liver cirrhosis were postoperative aseites (5 cases), hepatic failure (4 cases), wound infection or dehiscence (4 cases), intra-abdominal infection (4 cases), etc, and three patients in the group died from extensive bleeding, jejunal fistula and hepatic failure respectively. Univariate Logistic analysis revealed that age (OR = 1.277, 95% CI:0.991 ～ 1.646), preoperative nscites (OR = 20.900,95% CI: 2.349 - 185.933), the albumin level (OR =0.160,95% CI:0.041 ～ 0.629), Child classification (OR = 9.500,95% CI: 1.046 ～ 86.261), portal hypertension (OR = 4.000,95% CI: 1.057 ～ 15.138), esophageal variees (OR = 4.400,95% CI: 1.095 ～ 17.676), transfusion (OR =3.714,95% CI: 1.021 ～ 13.511) and blood loss (OR = 1.442, 95% CI:1.023 ～ 2.034) were the main factors associated with postoperative complications of the group with liver cirrhosis. Muhivariable Logistic analysis showed that preoperative ascites (OR = 19.213,95% CI: 1.569 ～ 231.255), Child classification (OR = 12.661,95% CI: 0.721 ～ 222.458), esophageal varices (OR =6.008,95% CI:0.857 ～42.097) and blood loss (OR = 1.574,95% (7,1:0.938 ～ 2.640) were the independent risk factors. Conclusion Gastrectomy for gastric carcinoma in cirrhotic patients engenders considerably high postoperative mortality and morbidity. Preoperative ascites, Child classifation, esophageal variees and intraoperative blood loss were factors closely related with postoperative complications.

Alzheimers disease is a progressive neurodegeneration disorder that is characterised by the accumulation of ? amyloid deposits and neurofibrillary tangles. It has been long assumed that the disrupted interneuronal communication that occurs in AD brain does not involve widespread changes in postsynaptic receptor function. However, recent evidence suggests that both the neurotransmitter receptor/G protein modulated adenyl cyclase and the phosphatidylinositol hydrolysis signal transduction cascades are disrupted in AD. Such disruption in AD may provide a reason for the relative lack of success of neurotransmitter replacement therapies for the disorder. Moreover it can direct drug research and development for AD treatment.

Nerve growth factor (NGF), one of the most potent growth factors for cholinergic neurons, has generated great interest as a potential target for the treatment of Alzheimers disease (AD). The degeneration of basal forebrain cholinergic neurons, which provides the major source of cholinergic innervation to the cerebral cortex and hippocampus, occurs early and contributes significantly to cognitive decline in AD. Those regions show high level expression of NGF and NGF receptors and depend on NGF for their survival and proper function. NGF executes its effects mainly by binding high affinity receptor TrkA in the remaining neurons of AD. Meanwhile, stimulation of neurons may protect those cells from the deleterious effects of AD, a phenomenon called “use it or lose it.”However, the use of NGF as therapeutic agent is limited by their hindered mobility through the blood brain barrier. Many theoretical and technical issues for NGF delivery to the target region in the brain remain to be solved, before NGF can live up to its potential for the treatment of AD.

Rho(Ras homologue) family play an import ant role in intracellular signal-transduction pathways. Not until recently have they been found to overexpress in many kinds of tumors such as testicular germ cell tumor,colorectal tumor,breast cancer,ductal adenocarcinoma of the pancreas and prostate cancer and been linked to the tumorigenesis and metastasis. So the members of the Rho family of small guanosine triphosphatases would be new marker s for tumor diagnosis、new markers for the prediction of metastatic potential an d new important prognostic factors. Moreover,they have the potential as therape utic targets for the prevention of cancer invasion and metastasis. In this artic le, we review the recent progress in this field.

Purpose:To study the molecular mechanism that d etermines the cell cycle differences between human giant-cell carcinoma cell st rains 95C and 95D. Methods:FACscan was used to analyze the cell cycle of 95C and 9 5D cells, and the proliferation ability of 95C and 95D cells was measured by MTT assay. We further detected the expression levels of cell cycle factors by Weste rn blotting. Results:Our data showed that the proliferation ability of 95D c ells is higher than that of 95C cells, and that the cell number in S phase of 95 D cells is much larger than that of 95C cells. We further found that the express ion level of p27 in 95D cell is lower than that of 95C cells. In addition, the e xpression levels of CDK2 and p-RB of 95D cells are higher than that of 95C cell s. Conclusions:Our results indicated that low expression level of p27 lead to the increased proliferation ability of 95D cells, which might reflec t the progression of human lung cancer cells in cell cycle facets.

Objective To summarize the outcomes and clinical experience of orthotopic heart transplantations in Shanghai Zhongshan Hospital.Methods From May 2000 through October 2005,141 patients,101 males and 40 females,diagnosed as having dilated cardiomyopathy in 118,hypertrophic cardiomyopathy in 2,restrictive cardiomyopathy in 2,end-stage ischemic heart disease in 9, primary malignant cardiac tumor in 4,valvular heart disease in 3 and others in 3,underwent orthotopic heart(transplantations) at our center.The operative procedures included 120 bicaval anastomotic cardiac transplantations,19 conventional Stanford orthotopic cardiac transplantations and 2 total heart transplantations.The immunosuppressive therapy strategies included Cyclosporine A or tacrolimus,corticosteroids and mycophenolate mofetil.For the latest 28 patients,induction therapy with Daclizumab was applied.Results There were 3 operative deaths with an operative survival of 97.9 %.During the follow-up from 1 month to 65 months,the actuarial survival rate was 90.8 % after 1 year,84.6 % after 3 year and 81.4 % after 5 year.Acute rejection,infections,graft failure and metastasis of primary cardiac tumor were the main causes of death in the 1st postoperative year,while acute rejection and graft coronary vasculopathy were the leading causes of death thereafter.Postoperative complications included acute rejection,infections,renal dysfunction and graft failure.Conclusions Orthotopic heart transplantation was proved to be a reliable choice for endstage heart disease with excellent outcomes.More attention should be paid to surveillance and management of acute rejection, infections and graft coronary vasculopathy in the long-term follow-up.