Long-term use of systemic or topical glucocorticoid can cause posterior subcapsular opacities ( PSO ) , named glucocorticoid-induced cataract ( GIC ) . There are many hypotheses on the pathogenesis of GIC. However, no one has well explained the formation of PSO, which leads to no effective approaches in the prevention and/or treatment. A new opinion is that hormones might affect lens epithelial cells through GR - mediated vimentin changes, which eventually result in the formation of GIC. Therefore, the association between vimentin and lens epithelial cell proliferation and differentiation, maybe a new direction for further studies in the pathogenesis of GIC.

Objective: To investigate the risk factors of various types of lung cancer by case-control study in Taiyuan, China. Methods: In this case-control study, the incident lung cancer patients with pathological evidence came from hospitals and the randomly selected residents all over the city were chosen as the cases and the controls, respectively. After completion the survey by questionnaire, the trend test and multivariate unconditioned logistic regression analysis were used after adjusting the confounding variables. The relationship between various risk factors and different pathological types of lung cancer was analyzed. Results: Active smoking was the main risk of lung cancer and this risk factor was significant [OR (odds ratio): 3.75, 95% CI (confidence interval): 2.39-5.89], especially for squamous-cell lung cancer (OR: 5.01, 95% CI: 2.42-10.37) and small-cell lung cancer (OR: 5.06, 95% CI: 2.10-12.18). There were significant linear trends of ORs for quantity of cigarettes consumed, duration of smoking and cumulative quantity of smoking. Various types of indoor air pollution such as passive smoking occurred in working and living places and long period of coal or wood use for cooking and heating were closely associated with the risk of lung cancer. The study on relationship between PM2.5 (particulate matter 2.5 μm) and lung cancer is in startup stage, and no significant relationship was revealed. Conclusion: Smoking is still an important risk factor for lung cancer in Taiyuan, China. In addition, passive smoking and environmental air pollution also played an important role in development of lung cancer. Copyright © 2013 by TUMOR.

Background The early diagnosis and treatment is vital for the age-related macular degeneration (AMD).Previous examining methods were fundus fluorescein angiography(FFA)and optical coherence tomography (OCT).However,a new diagnostic technique,fundus autofluorescence(FAF),is applying in ophthalmology.objective This study was to observe the FAF characteristics of atrophic AMD. Methods Thirty-nine eyes of 28 patients with atrophic AMD were diagnosed and collected in our hospital and classified based on the criteria of Chen Song.FAF was performed by a confocal scanning laser ophthalmoscope(Heidelberg Retina Angiograph 2,HRA2).Characteristics of FAF images were compared with FFA images or color fundus photographs.Written informed consent was obtained from each patient prior to the examination. Results Areas with abnormal increased or decreased FAF signals were consisted or unconsisted with funduscopically visible alterations.Seven manifestations of FAF were found in the eyes with preatrophic stage of atrophic AMD,including slight change,focal increase pattern,patchy pattern,linear pattern,lacelike pattern,reticular pattern,and speckled pattern.In atrophic stage of atrophic AMD,geographic atrophy showed a well-defined hypoautofluorescence area;while non-geographic atrophy showed a ill-defined hypoautofluorescence area.There were three abnormal FAF patterns(focal,band and diffuse)in the junctional zone of geographic atrophy and diffuse pattern in the junctional zone of non-geographic atrophy. Conclusion FAF imaging is helpful for the diagnosis of atrophic AMD as a new non-invasive technique.

Objective To observe the clinical effect of combination of clopidogrel and simvastatin on coro-nary heart disease and transient ischemic attack(TIA). Methods 76 patients with coronary heart disease and TIA were randomly divided into test group (n=40) and control group (n=36). The control group was treated with en-teric-coated aspirin 50 mg×2 every night after supper, and the test group was treated with clopidogrel 25 mg×2 and simvastatin 10 mg×2 every night before sleep. Liver and kidney function, blood coagulation function and blood lipids were measured before treatment and after. 1 year followed-up. Results The effective rate was 95.0% (38/40) in test group and 55.5% (20/36) in control group(χ2=6.45,P<0.01). LDL-C was (3.18±1.24) mmol/L and (2.60±1.03)mmol/L(t=2.67,P<0.01),TC was(5.18±1.24) mmol/L and (4.02±2.18) mmol/L(t= 4.91, P<0.01),TG was (1.50±1.02) mmol/L and (1.30±1.03) mmol/L(t=1.02, P>0.05), respectively in test group before and after treatment. However, there was no statistical difference in LDL-C, TC and TG (t=0.17, 0.00,0.52,0.57,P>0.05 for each) in control group. The two groups showed no difference after treatment (t= 1.51,2.55,0.57, P>0.05 for each). Conclusions Glopidogrel combined with simvastatin capsules is safe in pre-vention of TIA attack.

Objective To observe the anatomical and biomechanieal properties of the forearm in terosseous membrane (IOM), providing the scientific theoretical basis for the diagnosis and treatment of the IOM injury. Methods Ten radius-IOM-ulna structures (left for 5 and right for 5) were harvested from 5 fresh-frozen adult cadavers to measure the length, width and thickness of the tendinous part. Then the tendi-nous part with its radial and ulnar insertions were isolated, embedding the proximal part of the radius and the distal part of the ttina in commercially available dental base acrylic resin powder. The embedded speci-mens were mounted on MTS 858 testing machine using a 10 000 N load cell for all tensile tests. The speci-mens were tested at a displacement rate of 50 mn/min until failure. The load-displacement curve was de-scribed by the computer while the maximum load and stiffness were recorded. Results The IOM consisted of three components: the tendinous part, the membranous part, and the dorsal oblique accessory cord. The IOM was fiat in the neutral position, while it flexed during the pronation and supination. Six specimens ob-tained the tear of tendinous portion at a maximum load of (1021.50±250.13) N. The stiffness was (138.24±24.29) N/mm with displacement to failure of (9.77±1.77) mm. Other 4 specimens failed by fracture through the ulnar fixed site before there was failure of the IOM at a maximum load of (744.40±109.85) N. The stiff-ness was (151.17±30.68) N/mm with displacement to failure of (6.51±0.51) ram. Conclusion The IOM has stiffness comparable to the ligament between the radius and the ulna and play an important role for the maintenance of longitudinal stability of the forearm. These results can provide objective criteria for the eval-uation of reconstructive methods.

Objective To evaluate the therapeutic efficiency and side effect of concurrent radiotherapy and weekly chemotherapy with low-dose eisplatin(DDP) and 5-fluorouracil(5-FU) for advanced cervical canc-er. Methods 73 patients with advanced cervical cancer were randomized into two groups: 37 cases in the chemo-radiotherapy group received radiotherapy combined with DDP 40 mg and 5-FU 500 mg weekly for 6-7 weeks. 36 cases in the only radiotherapy group received radiotherapy alone. Radiotherapy was given with conven-tional fraction,the total tumor dose was 50 Gy. Results The rate of overall response and three-year survival and local recurrenc and distant metastasis for the chemo-radiotherapy group and the only radiotherapy group were 97.30%, 89. 19%, 8. 11% and 10. 81%, and those for the only radiotherapy group were 77.78%,66. 67% ,30.56% and 33.33%. The difference of the four groups was statistically significant ( P <0. 05). The rate of bone marrow inhibition and reaction of digestive tract in chemo-radiotherapy group were higher than those in simple radiotherapy group, but most reactions were grade 1 and grade 2, without statistically significant dife-renee between two groups. Conclusion Concurrent radiotherapy and weekly chemotherapy with low-dose cis-platin and 5-fluorouracil for advanced cervical cancer can significantly improve local control rate and survival rate, and have slight side effects.

[Summary] Thedawn phenomenon is a term used to describe hyperglycemia or an increase in the amount of insulin needed to maintain normoglycemia, occurring in the absence of antecedent hypoglycemia, during the early morning hours, and mostly affecting children with type 1 diabetes. Currently, hyperglycemia before breakfast time is defined as dawn phenomenon, and postbreakfast abnormal hyperglycemia is referred as the extended dawn phenomenon. Dawn phenomenon is regarded as the result of the β cell dysfunction, which increased endogenous glucose production and the persistent insulin resistance. By using continuous glucose monitoring technology, dawn phenomenon can be effectively identified:The difference between the lowest glucose level during nocturnal time and the glucose value before breakfast over 1. 11 mmol/L. And the long-acting insulin analogs and insulin pump are effective treatments for dawn phenomenon.

Objective To investigate the regulation of blood-testis barrier by Rab13-PKA pathway in rats.Meth-od First, shRNA vector targeting at Rab13 was constructed and then the Rab13 shRNA was transfected into the rat testis by injection.Western blot was used to detect the knock-down effect of Rab13 and the expression of blood-testis barrier ( BTB) constituent proteins.PKA activity was detected by autoradiography and scintillation counting.Further, immunoflu-orescence analysis and phalloidin staining were applied to observe the distribution of occludin and F-actin, respectively. Results The expression level of Rab13 in the testis was reduced by approximately 70%after transfection of Rab13 shRNA as compared with the non-targeted control group ( P<0.01 ) , while the expression of BTB constituent proteins remained unchanged.PKA activity was significantly increased after Rab13 RNAi transfection (P<0.01).The distribution of occlu-din at BTB was remarkably increased after Rab13 RNAi silencing around stage VIII but not at other stages of the seminifer-ous epithelial cycle.The assembly of F-actin at BTB was also intensified in Rab13-silenced testis.Both the changes of dis-tribution of occludin and F-actin induced by Rab13 shRNA were found to be antagonized by the PKA specific inhibitor H89.Conclusions Rab13 can modulate the distribution of occludin and F-actin at the blood-testis barrier in rats by regu-lating PKA activity, which may participate in the regulation of BTB function.

Objective To investigate the value of peripheral blood for the prognosis of patients withbloodstream infection. Methods A retrospective analysis of patients with bloodstream infection was conducted inthe intensive care unit (ICU) of Mianyang Central Hospital of Sichuan from January 2012 to October 2016. Accordingto the 28-day survival, the patients were divided into survival group and death group. The white blood cell (WBC),neutrophils count (NEU), lymphocyte count (LYM), neutrophil/lymphocyte ratio (NLR), monocyte count (MO), eosinophilcount (EO), basophil count (BA), hemoglobin (Hb), platelet count (PLT) and procalcitonin (PCT) in peripheral bloodwere recorded when patients were diagnosed with blood infection. Receiver operating characteristic curve (ROC),Kaplan-Meier survival analysis and Cox regression were used to evaluate the value of these risk factors for predictingthe outcome. Results 305 patients were enrolled. 182 patients survived while 123 patients died during the 28-dayperiod. ① There was no significant difference in gender, age and comorbidities between the two groups. There was nosignificant difference in infection rate between the two groups except for fungal infection rate. The fungal infection ratein the death group was significantly higher than that in the survival group (9.8% vs. 3.3%, P = 0.019). ② The LYM,MO, EO and PLT in the death group were significantly lower than those in the survival group [LYM (×109/L):0.58 (0.29, 0.93) vs. 0.76 (0.44, 1.23), MO (×109/L): 0.47 (0.19, 0.80) vs. 0.58 (0.30, 0.94), EO (×109/L):0.00 (0.00, 0.01) vs. 0.03 (0.01, 0.09), PLT (×1012/L): 89 (47, 148) vs. 126 (82, 186), all P < 0.05]. The NLR in the death group was significantly higher than that in the survival group [17.09 (7.60, 33.51) vs. 12.86 (6.51, 24.85), P < 0.05]. There was no significant difference in the WBC, NEU, BA, Hb and PCT between the two groups. ③ It was shown by ROC curve analysis that the maximum area under the ROC curve (AUC) of EO was 0.755. When the best cut-off value was 0.015×109/L as a predictor of death in 28 days, the sensitivity was 80.3%, and specificity was 64.7%. ④ It was shown by survival analysis that the 28-day survival rate in the patients with EO < 0.015×109/L was significantly lower than that of patients with EO > 0.015×109/L [38.3% (62/162) vs. 83.9% (120/143), χ 2 = 56.999, P = 0.000]. ⑤ It was shown by Cox regression that EO was the independent factor for 28-day survival (β = 1.466, χ 2 = 39.535, P = 0.000). Risk of death was 4.331 times greater in patients with EO < 0.015×109/L than in those with EO > 0.015×109/L [hazard ratio (HR) = 4.331, 95% confidence interval (95%CI) = 2.743-6.840]. Conclusions Compared to other parameters in peripheral blood, EO has the best correlation with the prognosis of bloodstream infection. EO is the independent prognostic predictor for 28-day survival.

Objective To compare the specificity and sensitivity of antibodies against cell membrane associated DNA (cmDNA)、 nucleosome (AnuA)、 double stranded DNA (dsDNA)、 deoxyribonucleoprotein (DNP) and antinuclear antibodies (ANA) in systemic lupus erythematosus (SLE). To analyze the relationship between these auto-antibodies in SLE. Methods One hundred and twenty five SLE patients and 118 other rheumatic diseases patients were studied. The latter included primary Sj?觟gren syndrome, ploymyositis, dermatomyositis, rheumatoid arthritis, osteoarthritis and systemic sclerosis. Indirect immunofluorescence was used to measure the anti-cmDNA antibodies and ANA. The enzyme-linked immunosorbent assay (ELISA) was used to measure the AnuA. Anti-DNP antibodies were detected by latex agglutination text and anti-dsDNA antibodies were detected by colloidal gold-technique. Results The seropositive rates of AnuA、 anti-cmDNA、 DNP、 dsDNA antibodies and ANA were 68%、 38.4%、 51.2%、 49.6% and 95.2% respectively in SLE patients. They were much higher than those of control groups (P