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.

ObjectiveTo explore the influence of life events on the emotional state ot heart transplantation patients.Methods All the heart transplantation outpatients were interviewed by a certain psychiatrist in Zhongshan Hospital during Oct.2010 to Oct.2011.The demographic data,life events and the self-reported influenced degree were recorded by the same psychiatrist.A grounded theory-based approach with thematic content analysis of the field notes was used.ResultsEighty-eight patients were enrolled,including 69 males,and19 females.The average age of the patients was 46.5 ±14.3 years old.The average duration after operation was 39.3 ± 39.6 months.The life events were classified into 4 groups,which were medical financial problems,physical condition,family support and future life.The most frequently reported event was physical condition (50.2％ ) and the influenced degree was the highest (9.2 ±1.2),while most patients (96.6％) complained high medical and relevant cost and the influenced degree was (6.5 ± 2.1). Family support was reported by13.6％ patients and its influenced degree was (7.6 ±1.2).The age of the reporter of future life (6.8％) was under 33 years.ConclusionDifferent events have different influence to patients.Improving the social support of patients is helpful to improve quality of life.

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.

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 explore influence of low high density lipoprotein cholesterol (HDL‐C) level on kidney func‐tion in patients with coronary heart disease (CHD) after percutaneous coronary intervention (PCI) .Methods :A to‐tal of 300 CHD patients ,who were treated and received PCI in our hospital from Feb 2012 to Jun 2014 ,were select‐ed .According to HDL‐C level ,they were divided into normal HDL‐C level group (n=179 ,HDL‐C≥1. 04 mmol/L) and low HDL‐C level group (n= 121 ,HDL‐C< 1.04 mmol/L) .Baseline data were compared between two groups ,and multi‐factor Logistic regression analysis was used to analyze risk factors for kidney injury after PCI .Re‐sults:Compared with normal HDL‐C level group ,there were significant rise in percentages of overweight (30.73%vs .39.67% ) ,smoking history (29.05% vs .41.32% ) ,myocardial infarction history (35.20% vs .46.28% ) ,left ventricular ejection fraction (LVEF) <50% (18.99% vs .24.79% ) ,anemia (16.20% vs .27.27% ) and kidney in‐jury (12. 85% vs .22. 31% ) in low HDL‐C level group , P<0. 05 or <0. 01. Multi‐factor Logistic regression analysis indicated that age ,myocardial infarction history ,anemia ,LVEF<50% ,diabetes mellitus ,dosage of contrast agent and low HDL‐C level were risk factors for kidney injury in CHD patients after PCI (β=0.499~1.171 ,P<0.05 or<0.01) .Conclusion:Low HDL‐C level is a risk factor for renal function injury in CHD patients after PCI .

Objective To evaluate the relation between cystatin C and the presence and severity of asymptomatic coronary artery disease in metabolic syndrome(MetS).Methods A total of 201 asymptomatic MetS patients with normal renal function were per-formed the coronary angiograph and the detection of serum Cystatin C level and other risk factors for atherosclerosis.Results Ser-um cystatin C level in the MetS patients with asymptomatic coronary artery disease were significantly higher than those in the pa-tients without coronary artery disease,moreover the more severe of the disease,the higher the cyctatin C,which was independently associated with other risk factors for atherosclerosis.Conclusion Serum cystatin C level can been used as the index for the presence and severity of asymptomatic coronary artery disease in Mets with normal kidney function.

Objective:To acquire Chinese IL 18 mature peptide cDNA from adult PBMC,adult bone marrow cDNA libray,adult tonsil cDNA library,Embryonic cerebrum and cerebellum aged 3 months,Embryonic cerebrum and cerebellum aged 8 months.Methods:By RT PCR to aquire Chinese IL 18 mature peptide cDNA.Results:The six sequences of our seven species have basepair variation.Conclusion:The cDNA of Chinese IL 18 has polymorphism.