Retinoblastoma (RB) is the most common infant eye malignant tumor.Conventional management mainly include enueleation of eyeball,evisceration of orbital tissue,radiotherapy and chemotherapy,but the prognosis is not significantly improved,and its long-term effects ale often devastating.Recent years,the development of gene therapy brings a chance for achieving the goal of treatment BB and improving patients'prognosis.The progress in gene therapy for RB,the vector of gene transfer,the methods of gene delivery and the commonly used technologies (RNA interference) to the therapeutic targets were reviewed.

Objective To explore the correlationship between Cystatin C and the cognitive dysfunction, encephalatrophy and the cerebral perfusion in Alzheimer's disease ( AD ) patients, and to analyze the probable mechanisms of the Cystatin C level alterations. Methods For the 61 male and 55 female AD patients,the levels of Cystatin C,Urea,Cr andβ2?microglobulin were detected by biochemistry analysis.The hypocampus volume and Ev?ans index were measured by MRI imaging. The cerebral perfusion was evaluated by magnetic resonance perfusion imaging of arterial spin labeling technique and image processing. The cognitive level of AD patients was done by MMSE scale and MoCA scale. Results The Cystatin C levels in serum of male AD patients were dramatically dif?ferent from female AD patients(male:(0.95±0.20)mg/L,female:(1.32±0.41)mg/L)(P=0.04). For male AD patients,age and Cystatin C had a correlationship among the hypocampus volume((6157.14±355.58)mm3),Evans index(0.33±0.02),MMSE score(21.66±7.97),and MoCA score(21.96±6.19)(age:P=0.040,0.049,0.035, 0.039;Cystatin C:P=0.035,0.038,0.037,0.035),but for female only age((79.52±8.82)years) had a correla?tionship with the hypocampus volume((6319.53±377.74)mm3),Evans index(0.31±0.02),MMSE score(22.93± 6.22),and MoCA score(23.41±8.20)(P=0.044,0.045,0.047,0.046). For male AD patients,the marked correla?tionship was showed between Cystatin C and the index of cerebral perfusion(P=0.034),but for female patients, there's no correlationship(P=0.086) . Conclusion The Cystatin C level is distinctly different in male and female AD patients. The Cystatin C level in male AD patients maybe be an index to predict the degree of the cognitive dys?function and the level of cerebral perfusion.

Objective To explore the application of integrating 64-slice CT image with three-dimensional electroanatomic mapping(Carto-Merge) in guiding catheter ablation of atrial fibrillation(AF).Methods Fifteen patients with drug-refractory AF received catheter ablation of AF.64-slice CT scan was performee 1-3 days prior to the ablation procedures.Using a novel software package,the left atrium(LA)with PVs was segmented and extracted for image registration with a combination of landmark registration and surface registration.Results The integration of the CT image into the electroanatomic mapping system was performed successfully in all patients with an error of 2.11?0.82 mm.Thirty pairs of PVs were electrically isolated after circumferential rediogrequency pulmorary rein ablation.The mean procedure time was 170.51?38.47 minutes.Cardiac tamponade occurred in one patient.All the fifteen patients were free of AF recurrence after 3 months of follow up including the 2 cases of persistent AF who required antiarrhythmic drugs.No thromboembolic events or stenosis were observed.Conclusion Integration of 64-slice CT image into the CARTO system successfully performed in patients undergoing catheter ablation of AF and enhance the ablation success rate.

Background The pathogenesis of allergic conjunctivitis has not been clearly established.Current researchers indicate that interleukin-4 (IL-4), IL-5 and IL-13 may play an important role in allergic conjunctivitis.But whether the roles of these inflammatory factors are same in different types of allergic conjunctivitis remains unclear.Objective This study was to investigate the expressions of IL-4, IL-5 and IL-13 in ocular surface with different types of allergic conjunctivitis.Methods A prospective cohort study was designed.Eighty individuals were recruited in Shanxi Eye Hospital from April 2013 to September 2014, including 20 patients with vernal keratoconjunctivitis (VKC), 20 patients with seasonal allergic conjunctivitis (SAC), 20 patients with perennial allergic conjunctivitis (PAC) and 20 normal healthy subjects.Surficial tissues were binocularly scraped using disinfected scraper from upper eyelid conjunctiva, and 4 μl of tear fluid was obtained with capillary tube.The expressions of IL-4, IL-5 and IL-13 protein and mRNA in the conjunctival epithelial cells were detected by immunohistochemistry and real-time fluorescence quantitative PCR.The IL-4, IL-5 and IL-13 concentrations in tear fluid were assayed by Luminex method.This study complied with Declaration of Helsinki and the research protocol was approved by the Shanxi Eye Hospital Ethics Committee.Written informed consent was obtained from each subject prior to entering the cohort.Results IL-4, IL-5 and IL-13 were positively expressed in cytoplasm of conjunctival epithelial cells in the VKC group,SAC group and PAC group,but the expressions of IL-4,IL-5 and IL-13 were absent in the normal control group.The relative expression levels of IL-4 mRNA were 4.11±1.24,2.71±0.71 and 2.00±0.80;the relative expression levels of IL-5 mRNA were 4.02±0.43,2.07±0.45 and 1.47±0.50;and the relative expression levels of IL-13 mRNA expression levels were 6.44±0.66,4.35±1.26 and 2.39±0.86 in the VKC group,SAC group and PAC group, showing significant differences among the 4 groups (F =51.32,220.18,162.49, all at P＜0.01).The relative expression levels of IL-4,IL-5 and IL-13 mRNA were significantly higher in the VKC group than those in the SAC group and PAC group;and those in the SAC group were significantly elevated in comparison with the PAC group (all at P＜0.05).No IL-4, IL-5 and IL-13 were detected in the tear fluid in the normal control group;while the concentrations of IL-4,IL-5 and IL-13 in the tear fluid were (14.06±3.50), (10.88±1.82) and (34.28±8.42) pg/ml in the VKC group,and (7.71 ±0.65), (5.10± 1.33), (23.77±6.29) pg/ml in the SAC group as well as (3.30± 1.50) pg/ml, (2.43± 1.28) pg/ml and (17.67 ± 4.28) pg/ml in the PAC group, showing significant differences among the 3 groups (F =200.29,260.49,128.23, all at P＜0.01).IL-4, IL-5 and IL-13 concentrations in the tear fluid were significantly higher in the VKC group than those in the SAC group and PAC group,and those in the SAC group were significantly raised in comparison with the PAC group (all at P＜0.01).Conclusions IL-4,IL-5 and IL-13 participate in the pathogenesis of multiple allergic conjunctivitis,but their expressions in the ocular surficial tissue are discriminatory in different types of allergic conjunctivitis.

Objective To study the CT features of peritoneal Metastasis in post-operative patients of ovarian carcinomas.Methods CT appearance of peritoneal metastasis of ovarian carcinomas proved by surgery and pathology in 33 post-operative patients were reviewed.The CT features of the foci were recorded and analyzed,especially on the location,quantity,density and size.Results In the peritoneal cavity,186 implant foci and 10 recurrent foci were found.metastasis often occurred in the right upper abdomen,especially the right subphrenic spaces.The most frequent locations were the right suprahepatic and subhepatic spaces,the small bowel mesentery,the gastrocolic ligament and the omentum.The density of the foci was most of solid.The size was ranged from 0.5~13 cm.Conclusion Peritoneal metastasis is the most frequent route of metastases for ovarian carcinomas.It is frequently found in upper abdomen,especially in the subphrenic spaces.Localized ascites in the peritoneal cavity is another important sign suggesting peritoneal implants.CT scan from the diaphragm to the pelvic floor will be helpful to diagnose peritoneal implants in cases of post-operative ovarian carcinomas.

Purpose:To evaluate the short-term effects and toxic side-effects of GEM plus CBP combination chemotherapy in treating advanced non-small-cell lung cancer(NSCLC). Methods:27 patients with grades Ⅲ and Ⅳ NSCLC(10 naive cases,17 retreated chemotherapy cases received Gemcitabine 1 250 mg/m 2 ,iv drip d 1.8,and carboplatin 300 mg/m 2 in the first day. Results:There were 6 CR+PR cases in naive patients,the overall response rate(OR)was 60.0%,iv drip 7 of retreated chemotherapy cases were CR+PR,the OR was 41.2%. The OR of both group patients was 44.4%.The main toxic side-effects of the patients were marrow-suppression. Conclusions:The combination chemotherapy of gemcitabine plus carboplatin was effective for advanced NSCLC and the toxicities were well tolerated.

Objective To assess the effectiveness of continuous aspiration of subglottic secretions (CASS)in preventing ventilator-associated pneumonia.Methods The relevant randomized controlled trials were searched in the Cochrane Library,Pubmed,CNKI,VIP and Wanfang databases.The experimental group received CASS and the control group did not(NASS group).Two reviewers selected studies according to the inclusion and exclusion criteria,the quality of studies was critically appraised and data were extracted by two reviewers independently.Meta-analysis was conducted by using RevMan 5.2.Results Sixteen randomized controlled trials met the inclusion criteria and enrolled 2 576 patients.According to the meta analysis,compared with NASS,CASS reduced the incidence of ventilator-associated pneumonia,shortened the length of stay in the intensive care unit and the duration of mechanical ventilation.There was no effect on hospital mortality.Conclusions Continuous aspiration of subglottic secretions appears effective in preventing ventilator-associated pneumonia,decreasing the duration of intensive care unit length of stay and mechanical ventilation among critically ill patients with mechanical ventilation.

OBJECTIVE To investigate the effect of norepinephrine (NE) on expression of interleu?kin-6 (IL-6) in human macrophages and explore its pro-inflammatory and pro-atherosclerotic mecha?nisms. METHODS Murine U937 macrophages were cultured and stimulated with 0.01-10μmol·L-1 of NE for 6, 9, 12, 24 and 48 h. The IL-6 mRNA level of 24 h was analyzed by RT-PCR, and IL-6 protein expression in the supernatant at 0, 6, 9, 12, 24 and 48 h was detected by ELISA. After 24 h, intracellular reactive oxygen species (ROS) generation was observed by DCF fluorescence. The cells were pretreated with antioxidant N-acetylcysteine (NAC), complexⅡinhibitor thenoyltrifluoroacetone (TIFA) and NADPH oxidase inhibitor diphenyleneiodonium (DPI) for 1 h, and stimulated with different concentrations of NE for 24 h, before the level of IL-6 protein was detected by ELISA. RESULTS The expression of IL-6 mRNA and protein increased with the concentration NE 0.01-10 μmol · L-1 and incubation time. IL-6 mRNA and protein levels in macrophages were 2.62 and 4.47-fold those in cell control group when treated with NE 1.0μmol·L-1 for 24 h. Meanwhile, as the concentration of NE increased, the generation of ROS was 1.87, 2.56, 2.91 and 5.36-fold that of cell control group (P<0.01). NAC 10 mmol · L-1 and DPI 10 μmol · L-1 significantly antagonized the effect of NE on IL-6 expression, but TIFA had no effect. CONCLUSION NE upregulates IL-6 expression, which may contribute to the formation and develop?ment of atherosclerosis via ROS mediated by NADPH oxidase in macrophages.

Objective To study the clinical efficacy,safety and compliance of specific sublingual immunotherapy in allergic rhinitis children. Methods 80 cases of children with allergic rhinitis were randomly divided into the experimental group and the control group with 30 patients in each.The experimental group received dermatophagoides farinae drops by sublingual medication and the control group received standardization allergen vaccine of dermatophagoides pteronyssinus by subcutaneous injection. The observing time lasted 12 months. Clinic symptoms score before and after treatment,safety and compliance between two groups were compared. Results The clinic symptoms score after treatment in both groups were significantly decreased. There was obvious difference between two groups in the incidence of adverse reactions and treatment compliance. Conclusions Sublingual immunotherapy by dermatophagoides farinae drops is effective and comparable to subcutaneous injection therapy by allergen vaccine. It may be a new choice for children with allergy disease.

Objective To evaluate the effect of intravenous lidocaine on postoperative pain and acute rehabilitation after laparoscopic hysterectomy.Methods Ninety-six patients scheduled for lapa-roscopic hysterectomy under general anesthesia were randomized into 2 groups (n = 48 ).In test group,lidocaine 1.5 mg/kg was administered at induction,then with a continously infusing rate of 2 mg·kg-1 ·h-1 until the end of surgery.In control group,saline was instead.Record the resting and coughing pain scores at 6,12,24 and 48 h after surgery,morphine consumption during the first 48 h, time to first flatus,6 min walk test (6MWT)result,and side effects such as dizzy,nausea and vomi-ting.Results Resting VAS scores at 6,12 and 24 h postoperatively were lower in test group than in control group (P <0.05).Coughing VAS scores in test group were lower than in control group at all time points (P <0.05).The morphine consumption was lower in test group than in control group (P<0.05).Time to first flatus was earlier in test group than in control group (P <0.05 ).6MWT at day 4 and 5 were significantly enhanced in test group (P <0.05 ).Conclusion Intravenous lidocaine can reduce postoperative pain scores and morphine consumption,as well as improve early rehabilita-tion after laparoscopic hysterectomy.