Objective To investigate the characteristics of process of the formation of idiopathic macular hole, measurement was made for the patients using optical coherence tomography (OCT). Methods OCT was performed in 55 eyes of 40 cases (40 initially diseased eyes and 15 contralateral eyes). Results OCT images showed that among the 40 initially diseased eyes the number of macular hole of 1, 2, 3 and 4 stages was respectively 1, 11, 23 and 5 eyes. The depth of fovea of eye of stage 1 was 331 ?m. The average diameters of the macular holes in stage s 2, 3 and 4 were respectively 298.1 ?m, 681.2 ?m and 557.5 ?m. Ten out of the 15 contralateral eyes were observed with macular hole (stage 1 and 2 were 6, 3 eyes respectively and lamellar hole was 1 eye). Separation of posterior vitreous was observed in 16 out of 55 macular holes eyes (account for 29%). OCT images showed that there were split and cystic space with separated vitreous centrally attached to the fovea in the case of stage 1. It was observed that the contracted operculum attached to post erior vitreous with an opening apart from the center in the case of stage 2. Stage 3 displayed a full-thickness hole with surrounding edema and stage 4 showed a full-thickness hole and a complete separation of the posterior vitreous from retina. Conclusions OCT can display clearly the size, shape and process of the formation of macular hole. It was observed that the initial changes in the vitreous detachment and fovea by investigation of the contralateral eyes. OCT is also a useful method for the diagnosis, study on the mechanisms of the formation of macular hole.

Objective To explore the gene diagnosis of Gitelman syndrome.Methods The clinical data of a child with Gitelman syndrome were retrospectively analyzed along with gene detection results of his elder sister and parents.Results A 6-year-old boy was hospitalized for fever and hypokalemia.Gene detection of SLC12A found a new locus mutation of EXON21 c.2522A＞G p.(Asp841Gly) and a heterozygosis of EXON16 c.1946C＞T p.(Thr649Met).The diagnosis of Gitelman syndrome was confirmed.His mother carried a heterozygosis mutation of EXON21 c.2522A＞G p.(Asp841Gly),while his father and elder sister carried a heterozygosis mutation of EXON16 c.1946C＞T p.(Thr649Met).Conclusion Gene detection of SLC12A is helpful in the diagnosis of Gitelman syndrome.The newly discovered mutation of SLC12A3 gene has enriched the mutation spectrum of Gitelman syndrome.

Carvedilol is a novel β-receptor blocker with vasodilative and potent antioxidative effects. It may inhibit the activation of transduction factors induced by oxygen radicals, block the gene expression in cardiac remodeling, and decrease cardiomyocyte apoptosis. It is reported that carvedilol may reduce the in vivo oxidation of low density lipoprotein (LDL) and auto-antibody titre of antioxidant and increase the antioxidative capacity of LDL. Carvedilol and its metabolite BM-910228 may inhibit the inotropic response induced by oxygen radicals. Carvedilol may provide cardiac protection in acute myocardial ischemia and improve cardiac function, reduce the mortality rate of heart failure.

Objective To investigate the characteristic of OCT images of congenital macular coloboma and its utility in the diagnosis of the diseases. Methods Seven patients (9 eyes) with congenital macular coloboma who had been examined by visual acuity determination, slit lamp examination, ophthalmoscope and fluorescein angiography received OCT scan and fundus color photography. The results were retrospectively analyzed. Results The manifestation of congenital macular coloboma by OCT was the retinal and choroidal tissues focally pitted outwards along with sclera. The 3 dimensions of pit: horizontal diameter 668- 4 339 ?m ( 3 119 in average), vertical length 668- 4 531 ?m ( 2 591 in average), pits depth 230-2 146?m(1 084 in average).The retinal neurosensory layer became thin and defect. And the retinal neurosensory layer was thinner in the centre than that near the edge. Reflection of retinal pigment epithelium was uneven and discontinued. The dark area of choroid was enlarged. Conclusions It can be clearly shown by OCT that abnormal structure of retina and out layer of choroid in congenital macular coloboma. It is implied that the characteristic of OCT is helpful in the diagnosis of congenital macular coloboma.

After a description of the connotation and features of ubiquitous information society and the connotation and components of information literacy of medical staff in ubiquitous information society, the approaches were put forward for training and improving the information literacy of medical staff in ubiquitous information society.

Autologous stem cell transplant (ASCT) is a potentially curative therapy for patients with relapsed and refractory or aggressive non Hodgkin ' s lymphoma, relapse is still common and is caused by high levels of tumour cell burden in the host and contamination of the stem cells with tumour cell. To improve effect of ASCT, ① in vivo puring with riluximab in pre transplant, depletion of B cells from the peripheral blood and clear the contamination of the malignant cells; ②the combination chemotherapy replace with rilumixab and non cross resistance drug in post transplant, killing tumour cells in the host; (3)involved field radiation therapy(IFRT) as a adjunct to pre or post transplant, reducing the relapse rate.

Recenly,the incidence of posttransplatation lymphoproliferative disorder(PTLD) is rising,Immunodeficiency and EBV-infection are risk factors of pathogenesis related. The majority of PTLD originates from malignant proliferation of B-cell.Typical pathologic findings of PTLD are large number of plasmacytoid B cells in lymphotic tissue and often with necrosis in regional areas. Molecular biology findings are ras or p53 gene mutation and c-myc?bcl-6 gene rearrangement. Highly immunosuppressed patients may present with diffuse infiltration and functional failure of multiple organs,the prognosis is poor. Except for the decrease or discontinuation of the immunosuppressive therapy,antiviral agents and interferon- ?,anti B-cell monoclonal antibodies,autologous EBV-specific cytotoxic T cell and combination chemotherapy may achieve better responses.

B-cell lymphomas(BCL) are the most frequent types of lymphoma and encompasses different entites with variable clinical behavior and diverse molecular features. In general terms, it can be subdivided into 2 main groups, low- and high-growth fraction lymphomas. In low-growth fraction lymphomas, cell accumulation can be achieved through the inhibition of apoptosis without a very severe deregulation of cell proliferation. In contrast, high-growth fraction BCL are characterized by an enhanced proliferative activity, as a result of the deregulation of oncogenes with cell cycle regulatory functions, such as Bcl 6 and c-myc. A fraction of both low- and high-growth lymphomas acquire additional alterations in cell cycle control, usually involving cyclin-dependent kinase inhibitors and evolve to highly aggressive tumors.

In the 46th annual meeting of the American Society of Hematology, the advance in the treatment of maligmant hematological disease concentrats on targeted therapies, including oblimersen,combination therapy rituximab with the chemotherapeutic agent, proteasome inhibitor bortezomid, flavorpiridol and radioimmunotherapy. Hematopoietic cell transplantation (HCT) is an effective therapy of maligmant hematological disease. The foremost advantage of the nonmyeloablative or reduced-intensity HCT is the reduction of treatment-related mortality .

Objective To improve standards of diagnosis and therapy for acute focal bacterial nephritis bY comparing the characters of acute focal bacterial nephritis and acute pylonephritis.Methods Thirty-five patients of upper urinary tract infection whoever accepted ultrasonographic and computed tomographic (CT) examinations in Beijing Hospital from January 2007 to January 2013 were studied retrospectively.Eighteen patients were diagnosed as acute focal bacterial nephritis (AFBN) according to CT imaging features,the other 17 patients were diagnosed as acute pyelonephritis (non-AFBN).The clinical feature,laboratory and imaging examination were compared between the two groups.Results Leukocyte count,percentage of neutrophil,fasting blood-glucose,ESR,NAG/Cre of urine,the combination of more than one kind of antibiotics and duration of antibiotic treatment were higher or much more in AFBN group patients than non AFBN patients,the differences between two groups were statistical significance(P ＜ 0.05).Urine microorganism culture was mainly Escherichia coli no matter in AFBN group or non-AFBN group,microorganism species of AFBN patients were more complex than non-AFBN patients.The most common contrast-enhanced CT feature of AFBN included local distribution of inflammatory area,wedge-shaped or unregular-shaped hypodense lesions on bilateral or single kidney,and mass-like hypodense lesions in more severe cases.NAG/CRE of urine was higher in AFBN group patients with bilateral kidney lesions than with single kidney lesions and non AFBN patients.The remission time of AFBN and non-AFBN was (3.4 ± 2.9) d,(3.0 ± 1.8)d respectively.The relapsing rate of AFBN and non-AFBN within half a year was 2/18,2/17,respectively.Conclusions The symptoms of acute focal bacterial nephritis are not specific.Abdominal contrast-Enhanced CT,ESR,leukocyte count,urine NAG/CRE are probably a predictor of AFBN.Antibiotic treatment with appropriate usage and sufficient duration could bring satisfactory outcomes and prognosis in acute focal bacterial nephritis and pyelonephritis patients.