Laser photocoagulation,intravitreal injection of antibody against vascular endothelial growth factor (VEGF) or corticosteroids and pars plana vitrectomy are current popular therapeutic approaches for diabetic retinopathy (DR).However,some DR patients still progress to irreversible blindness even after the above treatments which do not aim at the pathological mechanisms and influence factors for DR.Thus,with the further elucidation on the molecular pathological mechanisms and overall understanding of the factors affecting DR development,more and more potential therapeutic interventions such as neuron protection,vascular reconstruction and protection,gene therapy,non-VEGF dependent antineovascularization agents have been explored.Individual precise therapy based on the potential therapeutic targets would provide the promising future for DR patients.

Objective To summarize the prognosis of elderly patients with colorectal cancer excision who were divided into different groups by the nutritional status before their surgery.Methods In our hospital,100 patients (age from 64 to 70)with colorectal cancer were performed the screening of nutritional risk by NRS2002 before surgery.Patients with score from 1 to 2 were as the group A,and patients with score over 3 were as group B.The related indexes and recovery between two groups were compared.Results The NRS2002 rating scale score showed that 76 patients were at nutritional risk,37 cases among them received nutrition support and had faster recovery of intestinal function the time of tube pulled out after operation[(1.8 ±0.4)d vs.(2.9 ±1.5)d],exhaust time[(2.4 ±0.6)d vs.(4.3 ±0.9)d],time of in-take food[(2.9 ±0.5)d vs.(4.5 ±1.1)d],length of stay[(10.8 ±0.9)d vs.(14.1 ±1.3)d],incidence of infection related complica-tions (0 vs.5.13%),the differences were statistically significant(P <0.05).Conclusion Problems exist in varying degrees of loss of nu-trition in elderly colorectal cancer patients before surgery,an objective assessment of the extent and targeted care and nutritional support can significantly improve the postoperative nutrition and to facilitate recovery of gastrointestinal function after surgery.

Objective To investigate the effect of using evidence - based nursing (EBN) in the course of nursing patients with severe craniocerebral injury combined pulmonary diseases. Method Divided 160 patients into research group and control group randomly, there were 80 patients in each group. Using EBN in the research group, and routine nursing measures was used in the control group, and then compare the rehabilitation of patients in 2 groups. Result The condition of rehabilitation in research group was significant better than that of in control group, P

Objective To investigate the effects of propofol on P2X7 receptor activition and IL-1β production induced by endotoxin in murine RAW264.7 macrophages. Methods RAW264.7 macruphages were treated with LPS (1 μg/ml) for 4 h to induce the production and release of IL-1β, and pretreated with BBG (specific P2X7 receptor antagonist) 1 μmol/L or propofol 1-100 μmol/L for 20 min before LPS stimulation, and IL-1β release was measured using ELISA kit. Whole-cell patch clamp technique was used to record the P2X7-gated currents induced by 1 mmol/L ATP, the cells were exposed to propofol with 1-1 000 -μmol/L for 4 min, and the IC_(50) level of propofol was achieved. Western blot technique was used to measure the production of pro-lL-1β protein and IL-1β protein intracellularly after LPS treatment for 4 h under different concentrations of propofol. Results IL-1β was released from RAW264.7 macrophages after LPS stimulation, which was decreased by propofol, and the IC_(50) level of propefol was (24±3) μmol/L. P2XT-gated currents were inhibited by propofol, and the IC_(50) level was (33±5) μmol/L. Pro-IL-1β protein intracellularly was up-regulated after LPS stimulation, and propofol with 3-100 μmol/L decreased the up-regulation of pro-IL-1β intracellularly induced by LPS. Conclusion Propefol could inhibit IL-1β release from RAW264.7 macrophages treated by LPS, which is mediated by inhibiting P2X7 receptor activition and decreasing the production of pro-IL-1β intracellularly.

Objective To evaluate the efficacy of transversus abdominis plane (TAP) block for postoperative analgesia in the pediatric patients undergoing operation on the inguinal region.Methods Sixty-four pediatric patients of both sexes, aged 1-3 yr, weighing 8.5-23.6 kg, of American Society of Anesthesiologists physical status Ⅰ , undergoing elective unilateral high ligation of the hernia sac or high ligation of the processus vaginalis, were equally randomized into either intravenous analgesia group (group VA) or TAP block group (group TAP).In group TAP, after induction of anesthesia, the pediatric patients received ultrasound-guided TAP block with 0.2％ ropivacaine 1 ml/kg injected locally.After the laryngeal mask airway was inserted, the pediatric patients were mechanically ventilated, and then inhaled 2％-3％ sevoflurane for maintenance of anesthesia.In group VA, postoperative analgesia was performed with fentanyl 0.35 μg · kg-1 · h-1 until 24 h after operation.The level of pain was rated using the FLACC pain scale.When FLACC score＞5, fentanyl 0.25 μg/kg was injected intravenously as rescue analgesic.The occurrence of TAP block-related adverse events, time for removal of laryngeal mask airway, and occurrence of fentanyl-related nausea and vomiting, respiratory depression, and emergence agitation were recorded.Results No TAP block-related adverse events were observed in group TAP, and no respiratory depression was found in the two groups.Compared with group VA, the time for removal of laryngeal mask airway was significantly shortened, and the requirement for rescue analgesics and incidence of vomiting and emergence agitation were decreased in group TAP (P＜ 0.05).Conclusion TAP block with 0.2％ ropivacaine 1 ml/kg provides good efficacy for postoperative analgesia with good safety in the pediatric patients undergoing operation on the inguinal region.

Objective To evaluate the accuracy of continuous noninvasive partial pressure of carbon dioxide monitoring in the old diabetic patients undergoing general anesthesia.Methods Sixty-six old diabetic patients of both sexes,aged 65-76 yr,weighing 49-95 kg,of American Society of Anesthesiologists physical status Ⅰ or Ⅱ,undergoing elective surgery under general anesthesia,were included in this study.Transcutaneous partial pressure of carbon dioxide (TcPCO2) was monitored by a noninvasive transcutaneous carbon dioxide monitor.Arterial blood samples were collected at 30 and 60 min after endotracheal intubation,partial pressure of arterial carbon dioxide (PaCO2) was monitored,and TcPCO2 and end-tidal pressure of carbon dioxide (PET CO2) were recorded.Bland-Altman analysis was used to measure the agreement.Results At 30 min after intubation,the results of Bland-Altman analysis showed that the mean difference between PaCO2 and TcPCO2 was 1.3,95％ confidence interval (CI) was 1.0-1.6,and the limit of agreement was-1.1-3.7;the mean difference between PaCO2 and PETCO2 was -3.2,95％CI:-3.6--2.8,and the limit of agreement was-6.6-0.2.At 60 min after intubation,the results of Bland-Altman analysis showed that the mean difference between PaCO2 and TcPCO2 was 1.4,95％ CI was 1.1-1.7,and the limit of agreement was-1.0-3.4;the mean difference between PaCO2 and PETCO2 was-3.1,95％CI was-3.5--2.7,and the limit of agreement was-6.7-0.5.The repeatability coefficients of PaCO2,TcPCO2 and PETCO2 were 2.1,2.3 and 2.3,respectively,at 30 and 60 min after intubation.Conclusion Continuous noninvasive partial pressure of carbon dioxide monitoring provides good accuracy and can be used as an alternative to PaCO2 monitoring,and the accuracy is higher than that of PETCO2 for the old diabetic patients undergoing general anesthesia.

Objective To investigate the relationship between angiotensin I-converting enzyme(ACE)inserting/defaulting(I/D) gene polymorphisms and the femoral artery intima-media thickness(FA-IMT) in patients with type 2 diabetes mellitus(T2DM).Methods The polymorphisms of ACE(I/D) was determined by polymerase chain reaction-restriction fragment length polymorphism(PCR-RFLP) method and the FA-IMT was assessed using non-invasive high resolution B-mode ultrasonography in 303 patients with T2DM in Hunan province.Results The frequency of I allele of ACE gene polymorphisms was higher in T2DM than that in healthy controls,but frequency of D allele was lower in T2DM than that in healthy controls(P

Aim To research the effect of diltiazem on cytokine expression and inflammatory cell activity in rat heart with ischemia/reperfusion.Methods The rats, underwent ischemia reperfusion, were divided into three groups:diltiazem group(D group),ischemia/reperfusion group (I/R group),and sham group (Sgroup).Echocardiogram was detected at 1,2,4 weeks after operation. RT-PCR was used to detect the inflammatory cytokines as IL-1β,TNF-α, IL-6 and anti-inflammatory cytokines as IL-10,TGF-β.Results Compared with I/R group,EF were increased and LVM, IL-β,TNF-α,IL-6 reduced significantly in D group.There was no significant/difference for IL-10 and TGF-β in three groups .Conclusion Diltiazem inhibits IL-1β,TNF-α, IL-6 expressions and inflammatory cell infiltration in rat heart with ischemia reperfusion.

Objective To discuss the effect and treatment methods of ureteral obstruction caused by primary or metastatic pelvic malignancy. Methods Clinical data of 51 cases with ureteral obstruction caused By pelvic malignancy were reviewed retrospectively. The treatment included traditional open operation in 17 cases in which 3 cases with uretero-uwtero, 9 cases with uretero-bladder anastomotic stoma and 5 cases with cutaneous ureterostomy, retrograde stenting in 19 cases (11 cases with unilateral ureter, 8 cases with bilateral ureter), pereutaneous nephrostomy in 15 cases. Results The median follow-up time was 21 months (range 6 to 72 months ). Three months after operation, uhrasonograph or intravenous urography(IVU)showed that 39 (76.5%) cases had nomal renal function, 12 (23.5%) cases had hydronephrosis relief and renal function improvement. No stricture in the uretero-uretero or uretero-bladder anastomotic stoma was recorded. Conclusions Appropriate treatment is dependent upon the accurate identification of the underlying pathological process and it can relieve ureteral obstruction and increase the quality of life for ureteral obstruction caused by pelvic malignancy.