Background Vitrectomy is a primary approach to the treatment of proliferative diabetic retinopathy (PDR).However,postoperative rehaemorrhagia often occur.Ranibizumab is an effective drug of antivascular endothelial growth factor,but whether the combination of intravitreal injection of ranibizumab with vitrectomy can reduce the incidence of postoperative rehaemorrhagia in PDR patients is still unclear.Objective This study was to investigate the preventive effect of the combination of intravitreal injection of ranibizumab with 25-gauge vitrectomy on postoperative rehaemorrhagia.Methods A retrospective cohort study was perfomed.The clinical data of Ⅴ-Ⅵ stage of PDR patients who received 25-gauge vitrectomy in Peking University Interuational Hospital from January 2014 to July 2015 were collected and analyzed.The PDR patients were divided into only surgery group and drug with surgery group.The patients in the only surgery group (34 eyes of 49 patients) received 25-gauge vitrectomy,and the patients in the drug with surgery group (32 eyes of 25 patients) received the intravitreal injection of ranibizumab 0.05 ml (0.5 mg) 7 days before 25-gauge vitrectomy.The distribution of eye number in different grades of visual acuities was observed and compared between the two groups in 1 day,1 week,1 month and 3 months after surgery,and the incidence of rehaemorrhagia was intergrouply compared in 1 day,3-7 days and 1 month after surgery.Results The eye number and percentage of the different visual acuities in the drug with surgery group was not significantly different from the only surgery group in 1 day,1 week,1 month and 3 months after surgery (1 day:Z=0.673,P=0.412;1 week:Z=0.113,P=0.737;1 month:Z=1.755,P=0.185;3 months:Z=2.474.P=0.116).Rehaemorrhagia occurred in postoperative day 1 and day 3-7 was 1 eye and 1 eye respectively in the drug with surgery group,and that in the only surgery group was 9 eyes and 9 eyes respectively,showing significant difference between the two groups (all at P＜0.05).The eye number of rehaemorrhagia in postoperative 1 month was 4 in the only surgery group,and no rehaemorrhagia appeared in the drug with surgery group.Conclusions The combination of intravitreal injection of ranibizumab with 25-gauge vitrectomy can efficiently reduce the incidence of postoperative rehaemorrhagia.

Objective To investigate the expression and significance of miR?135a?5p in endometrial carcinoma and to correlate expression levels with clinicopathological features. Methods Fifty five endometrial carcinoma samples and thirty normal endometrial tissue samples were surgically obtained,and the expression of miR?135a?5p was quantitated by real?time polymerase chain reaction. The relationship between the expression level of miR?135a?5p and clinicopathological data of individual patients was analyzed. Results The expression of miR?135a?5p was lower in the endo?metrial carcinoma group than in the normal endometrial group(P=0.021),and correlated significantly with the histologic grade of the endometrial neoplasm(P=0.008). Conclusion The expression of miR?135a?5p is lower in endometrial carcinoma than in normal endometrial tissue. In en?dometrial carcinoma,the miR?135a?5p expression status has a statistically significant relationship with the histological characteristics of the tumor.

Objective To find the changes and effects of nitric oxide synthase activity in atherosclerotic rabbit models. Methods Thirty rabbits were divided into 3 groups at random: control group, atherogenic diet group, balloon-injury+ atherogenic diet group. Three months later underwent pharmacological triggering with Chinese Russell’s viper venom and histamine to make the plaque rupture. Lipid concentrations and the levels of nitric oxide (NO), NOS and hydroxy radical (OH) in the serum were obtained at different period, and pathologic changes were observed. Results In atherogenic diet group and balloon-injury+ atherogenic diet group, serum lipid concentrations markedly increased, but the levels of NO did not show any difference. The activity of NOS and OH levels were obviously increased after the atherogenic diet. But it reduced after pharmacological triggering and plaque rupture. Conclusion In early period of atherosclerosis, NOS activity up regulated and endothelium functions were compensated. But, When the atherosclerotic plaques were unstable, the activity of NOS descended obviously and endothelium function goes into incompensation.

Objective To investigate the mutations of the gene in Chinese patients with X linked juvenile retinoschisis (XLRS), and to provide the genetic diagnosis and consultation of heredity for the patients and their families. Methods Genomic DNA was isolated from leukocytes of 29 male patients with XLRS, 38 female carriers and 100 normal controls (the patients and the carriers were from 12 families). All 6 exons of XLRS1 gene were amplified by polymerase chain reaction (PCR) and analyzed by single strand conformation polymorphism (SSCP) assay. The positions and types of XLRS1 gene mutations were determined by direct sequencing. Results Eleven different XLRS1 mutations were identified in these 12 families, including one frameshift mutation due to base loss of the first exon: c.22delT(L9CfsX20), one nonsense mutation due to base loss of the first exon (Trp163X), one splice donor site mutation(c.52+2 T→C; IVS1+2T to C), and eight missense mutation due to base replacement(Ser73Pro, Arg102Gln, Asp145His, Arg156Gly, Arg200Cys, Arg209His, Arg213Gln, and Cys223Arg). No gene mutation was detected in the control group. Four new mutations included frmaeshift mutation(L9CfsX20) and mutations of Asp145His, Arg156Gly, and Trp163X at the fifth exon. A newly discovered non-disease-related polymorphism (NSP) was the c.576C to T (Pro192Pro) change at the sixth exon. Conclusion Eleven different XLRS1 mutations were detected, which is the cause of XLRS in Chinese people. The detection of gene mutations may provide the guidance of genetic diagnosis and the consultation of family heredity for the patients and their families.

Objective To identify the prognosis factors of the patients with high-degree carotid artery stenosis and evaluate the effect of different therapy prospectively.Methods A hundred and three patients with spoke or tansient ischemic attack(TIA)suffering from severe carotid artery stenosis were included into this study consectively.They were given intra-artery intervention or antiplatelet therapy based on clinical factors and the intension of the patients or their Legally Autllorized Representative (LAR)and thus divided into 2 groups.Forty patients were transplanted with stent,63 were given only with antiplatelet drugs.The major outcome of end-point was the 2-year functional prognosis evaluated by modified Rankin score(mRS),while the minor one was the cardiovascular events in 1 year.2 year or longer after the index stroke or TIA,which was defined as stroke,TIA,acute myocardic infarction(AMI)and sudden death in this study.Results There were no statistical significances of sex,years,medical histories,blood pressure, total cholesterol,triglyceide in two groups at baseline.For the major outcome,intra-artery intervention was an independent protective factor for impaired function(mRS 3-6)with the method of binary Logistic(RR= 0.13,P=0.001,95%CI 0.036-0.460).For the minor outcome,the incidence of the cardiovascular events in 1 year and 2 year after the index stroke or TIA was lower in the intra-artery intervention group than in the antiplatelet therapy(For 1 year follow up,intervention group:antiplatelet therapy group= 12.5%:42.9%,OR=0.19,95%CI 0.07-0.55,P=0.001;For 2 year follow up,17.5%:47.6%,OR =0.23,95%CI 0.09-0.60,P=0.002).The median time of cardiovascular events in the two groups was further investigated in 55 months and 54 months separately. Kaplan-Meier analysis showed no significant difference.Survival analysis with Cox-regression showed that neither therapy of intra-artery intervention nor antiplatelet therapy was an independent factor for the cardiovascular events(RR=1.063,95%CI 0.40- 2.83,P=0.900).Conclusions For the stroke or TIA patients suffering from high-degree carotid artery stenosis,intra-artery intervention is superior pure drug therapy in achieving better theapeutical effect and reducing the incidence of the cardiovascular events after the index stroke or TIA.However,its long term effect needs further study.

Objective: To investigate the roles of Bcl-xl and Bcl-xs in the development and progression of endometrial carcinoma, and to explore their correlation.Methods: The expression of Bcl-xl and Bcl-xs in 32 cases of endometrial carci-noma, 12 cases of endometrial atypical hyperplasia, 6 cases of endometrial simple hyperplasia and 10 cases of normal en-dometrial tissues were examined by RT-PCR and Western-blot.Results: The expression of Bcl-xl mRNA and protein was significantly higher in endometrial cancer tissues than in normal endometrial tissues (P<0.05), and was statistically associat-ed with the pathological stage of endometrial carcinoma.(F=5.33, P=0.02).The expression of Bcl-xs mRNA and protein in atypical endometrial hyperplasia and endometrial carcinoma tissues were significantlly lower than that in normal endometri-al tissues (P<0.05), which was also associated with clinical stage and lymph node metastasis of endometrial carcinoma (P<0.05).The expression of Bcl-xl was negatively correlated with the expression of Bcl-xs in different endometrial tissues (r=-0.76).Conclusion: The abnormal expression of Bcl-xs and Bcl-xl was a factor for the pathogenesis and development of endometrial carcinoma.The negative correlation between Bcl-xl and Bcl-xs in different endometrial tissues as well as their relative expression ratio may have certain impact on the genesis of endornetrial cancer.

BACKGROUND:The self-expanding Smart nitinol stent system is a popular treatment for carotid artery stenosis, because it is easy to manipulate and deploy, and endothelialization is rapid. OBJECTIVE:To assess the efficacy of Smart nitinol stent system for the treatment of severe atherosclerotic carotid stenosis. METHODS:We conducted a retrospective, single-center, non-randomized, paral el control ed trial. A cohort of 103 patients with severe atherosclerotic carotid stenosis was included in the analysis after obtaining written informed consent from participants or their guardians. Treatment was undertaken according to each patient’s wishes after weighing the options:a Smart nitinol stent system (Cordis Corporation, Miami, FL, USA) was used in 40 patients, while 63 were managed conservatively with antiplatelet drugs. The primary outcome is the degree of disability of dependence 2 years after treatment, assessed by the modified Rankin Scale. The secondary outcomes are mRS scores 90 days and 1 year after treatment, recurrence of cerebrovascular events, and severity of neurologic deficit measured using the National Institutes of Health Stroke Scale 1 and 2 years after treatment. The study protocol was approved by the Ethics Committee of Beijing Jishuitan Hospital, China (approval number:201605-01) and conducted in accordance with the guidelines of the Declaration of Helsinki, formulated by the World Medical Association. This trial was registered at ClinicalTrial.gov (NCT02800174). DISCUSSION:Previous studies of the Smart nitinol stent system for the treatment of carotid stenosis are mostly self-control ed case series or smal cohort studies with short fol ow-up periods. Consequently, the long-term influence of Smart nitinol stent deployment on the risk of cerebrovascular events and long-term outcomes are not known. This trial il uminates the therapeutic benefits of the Smart nitinol stent system in a 2-year fol ow-up study involving a large cohort of patients with severe atherosclerotic carotid stenosis.

Objective To investigate the expression of advanced glycation end products(AGEs)in a rat model of polycystic ovarian syndrome (PCOS)induced by dehydroepiandrosterone. Methods The PCOS rat model was established using dehydroepiandrosterone . After confirming that the model rats were set up successfully,serum AGEs concentrations were measured using competitive ELISA and the expression of AGEs in the ovarian tissues of these rats was detected using immunohistochemistry. Results The serum AGEs level in the experimental group were signifi?cantly higher than that in the control group(P<0.05). Furthermore,AGEs expression were significantly higher in the experimental group than in the control group(P<0.01). Conclusion AGEs are highly expressed in the rat PCOS model,signifying their importance in the diagnosis and pathogenesis of PCOS.

Objective To study the effect of homeobox genes CDX1 and CDX2 on the phenotype of esophageal adenocarcinoma cells.Methods Esophageal adenocarcinoma cell line SEG-1 was transfected with CDX1 or CDX2 cDNA.The morphology,growth rate,division index and tumorigenicity were analyzed.Results The expression of CDX1 or CDX2 leaded to occurring adeniform-like manifestation.The growth rate,division index and tumorigenicity were reduced,especially by CDX2.Conclusion CDX1 and CDX2 all could increase differentiation of esophageal adenocarcinoma cells and reduction of its malignancy.

Objective: To study the immunotherapeutic effect on the esopgageal adenocarcinoma mediated by gp96-peptide complexes isolated from the same kind of tumor. Methods: gp96- peptide complexes were purified from nude mice tumors burdened by subcutaneous injection of human esophageal adenocarcinoma cell line SEG-1 . gp96-peptide complexes were carried by the dendritic cells(DC) induced from human peripheral blood mononuclear cells to prepare gp96-DC vaccine. The proliferation of lymphocytes was tested with trypan-blue stain. The quantity of interferon-?(IFN-?) released from cytotoxic T lymphocytes (CTL) was detected with ELISA method. The killing effect of CTL on target cell SEG-1 was measured with MTT. Results: We obtained 120 ?g gp96 from 55 g tumor tissue. DC, gp96, and gp96-DC all could elicit the proliferation of lymphocytes and make them becoming into CTL which released IFN-? and showed different degrees of killing effect on target cell SEG-1. gp96-DC has the strongest eliciting effect among them. At the ratio of E(effect) to T(target) as 40∶1,the killing rate was 68%.No significant difference between the effects of CTL induced by DC alone and of lymphocytes without specific antigen on SEG-1 and K562 cells. Conclusion: The gp96-peptide complexes from tumors can improve the effect of eliciting lymphocyte proliferation of DC and make the lymphocyte becoming into CTL more effectively.These CTLs show prominent killing effect on the target tumor cells.