Induced pluripotent stem cells (iPSCs) are a type of pluripotent stem cells that can be generated from adult somatic cells.They have similar characteristics and function to embryonic stem cells (ESCs).Over the past decade,iPSCs were widely concerned in regenerative medicine and stem cell field.Especially the patient specific iPSCs have several advantages over ESCs,such as convenient source,do not exist immune rejection and ethical issues,even keep certain individual genotype.At present,tremendous progress have been made about the application of iPSCs in a variety of retinal diseases.Here,this article reviews pluripotent stem cell sources of RPE,photoreceptors and retinal ganglion cells and current transplantation strategies,the safety problems and prospects.

Objective To explore the value of left parasternal anterior mediastinaotomy (Chamberlain procedure) in the diagnosis of mediastinal lymph node enlargement with unknown causes and anterior mediastinal space-taking lesions. Methods By using the Chamberlain procedure, biopsy was performed in 32 cases of enlarged mediastinal lymph nodes with unknown causes or mediastinal space-taking lesions, which were found by CT scans. Results All of the 32 cases were pathologically diagnosed, with a diagnostic accuracy of 100%. Three patients with pericardial effusion received concurrent pericardial fenestration and then their symptoms relieved. Four patients underwent concurrent lung biopsy. The operating time was (48?15) min, the blood lose was ( 40.6?23.5) ml, and the postoperative hospital stay (3.6?1.4) days. No deaths or postoperative complications occurred. Conclusions Chamberlain procedure is a safe and valuable method in the diagnosis of mediastinal space-taking lesions with unknown causes or enlargement of the fifth and sixth groups of mediastinal lymph nodes, which routine mediastinoscope cannot reach. Some other simple therapies, such as lung biopsy or pericardial fenestration, can also be employed at the same time.

ObJeetive To report a simple and efficient method to label two different types of retinal ganglion cells (RGCs) in mouse retina.Methods Eyeballs were harvested from normal adult C57 BL/6 J mouse,the retinas were isolated,four radial cuts were done,the retinas were pasted on the nitrocellulose membrane with the ganglion cell layer upturned.The immunofluorescence double staining and laser confocal nmicroscope was used to reveal conventional retinal ganglion cells and intrinsically photosensitive retinal ganglion cells (ipRGCs) using Brn3a and Melanopsin.Results The double staining results of whole mount retina showed that conventional RGCs and melanopsin immunopositive ipRGCs had a complementary distribution in mouse retina,these two subtypes of RGCs were predominantly present in the ganglion cell layer.The numbers of ipRGCs was just about 1％-2％ of conventional RGCs,and the axons of ipRGCs toward the direction of the optic disc,several dendrites toward the inner plaximem layer.Conclusion The immunofluorescence double staining of whole mount retina is a simple,stable and efficient method to label two different types of mouse RGCs.

Obesity is becoming a chronic epidemic worldwide. Persistent obesity, in addition to triggering changes in skeletal muscle function and structure, may also lead to the occurrence of skeletal muscle atrophy, that maybe associate with autophagy and ubiquitin protea-some, interleukin-6, leptin, adiponectin, interleukin-10, tumor necrosis factor-alpha, growth hormone, angiotensin II, glucocorticoid, ad-vanced glycation end-product and myostatin, etc.

Objective To assess the value of 18 F-FDG PET imaging in the localization of epileptic foci.Methods 18 F-FDG PET were performed in 22 patients with medically intractable epilepsy (15 males,7 females,mean years:19.0 years,mean duration:8.2 years). The open skull operations were undergone in 21 patients according to the results of 18 F-FDG PET, combining with scalp EEG and CT or/and MRI. 1 patient was refered for stereotactic operation. During operation,EcoG was detected for identifying the site of epileptogenic focus and lobectomy was performed . All specimens were examninated with the pathological tests. All patients were followed up for the curative effects. Results PET showed abnormalities in 21 patients(95.5%). Among them,single or multiple focal hypometabolisms were found in 20 patients and focal hypermetabolism in 1 patient. The scalp EEGs showed abnormalities in 17 patients(77.3%),but 8 of them did not showed clear latreralizing manifestations.The abnormalities were found on MR or/and CT in only 5 cases (22.7%).The epileptogenic foci detected by PET were consistent well with EcoG in 18cases(85.7%), consistent approximately in 2 cases and not consistent in 1 cases .Among 19 patients with abnormal PET findings , the pathological abnormalities were found in 18 cases (94.7%).No pathological abnormality was found in the patients with nomal PET imaing. After the open skull operations, 9 patients (42.9%) becomed seizure free . 9 patients (42.9%) had more than 50% seizure reduction and 3 patients (14.3%)showed no improvement. The patient treated with stereotactic operation also showed no significant improvement.Conclusion 18 F-FDG PET imaging is a sensitive and accurate modality to localizate the epileptic foci and has important clinical value in surgical therapy.

Objective To treat the patients suffering from intractable epilepsy after brain injury with low-dosage linac accelerator stereotactic radiosurgery through positron emission tomography (PET) localization. Methods PET examination based on 18 F-2-fluorine-2-deglucose (FDG) was carried out in 32 patients in order to localize epileptogenic foci followed by radiosurgery with peripheral radiation dose of 9-13 Gy. The follow-up was conducted over one year. The seizure frequency of epilepsy was recorded to evaluate the therapeutic effect. Results The PET imaging showed that the cortical area around the cerebromalacia caused by primary injury presented low metabolic change. The metabolic changes in different injury areas mainly concentrated in the epileptic foci. In some cases,the low metabolic areas not only was localized at the part of impact lesion but also at the part of contrecoup lesion. The seizure frequency gradually decreased after radiosurgical treatment in most patients,with obvious statistical significance compared with pretreatment. According to Wieser's classification of operative effect,the cases at the grades Ⅰ-Ⅱ accounted for 44% (14/32),grades Ⅲ-Ⅳ for 41% (13/32) and grades Ⅴ-Ⅵ for 16%(5/32). No fresh complications were found in all the cases. Conclusions Low-dosage stereotactic radiosurgery with the PET localization is a safe,effective and minimally invasive surgical approach to intractable posttraumatic epilepsy.

Objective To study imageology anatomy concerned of sellar turica and explore its potential role on growth of pituitary adenomas. Methods According to classification of sinus sphenoidalis,103 normal imageology data of sellar turica region were analyzed, including 83 cases with entire saddle type sinus sphenoidalis and 20 cases anti-saddle type sinus sphenoidalis. Furthermore, the clinical data of 45 cases of pituitary adenomas with extension into sinus sphenoidalis were retrospectively studied. Results The relationship between sellar floor's shapes and sinus sphenoidals'types was that the larger the sinus sphenoidalis was, the deeper the floor was(98.8%). The relationship between sellar floor's shapes and the superior surface of hypophysis was that most of depressed sellar floors were companied with depressed superior surfaces of hypophysises(93.8%). The anteroposterior shapes of sellar turica in midsagittal can be divided into 4 types such as bag-type, kettle-type, tube-type, and sifter-type. 45 patients suffering from pituitary adenoms with extension into sinus sphenoidalis all had entire saddle type sinus sphenoidalis. Conclusions The imageology anatomy concerned of sellar turica could explain the phenomena of pituitary adenomas with extension toward sellar floor and sinus sphenoidalis. Referring to the literatures concerned, it indicated that the imageology anatomy was the key factor of affecting the growth of pituitary adenomas.

Objective To evaluate the follow-up diagnostic value of 3 T magnetic resonance angiography (MRA) after intracranial aneurysm coil embolization.Methods The databases such as PubMed,EMbase,Cochrane Library,CBM,CNKI and VIP were retrieved.According to the inclusion criteria of diagnostic tests,the diagnostic tests of the follow-up diagnostic value about MRA were screened after intracranial aneurysm coil embolization.The methodological quality included in the studies was evaluated using QUADAS items and the meta-analysis was conducted using Meta-Disc 1.4 software.The receiver operating characteristic curve was drawn and the area under the curve was calculated.The residual sensitivity and specificity diagnosed by MRA after intracranial aneurysm embolization were evaluated.Results A total of 6 studies were included,including 253 patients.The pooled sensitivity and specificity in 3 T MRA diagnosing residual intracranial aneurysms were 0.915 (95％ confidence interval [ CI]0.850 - 0.959) and 0.847 (95％ CI 0.787 - 0.896) respectively.The area under the receiver operating characteristic curve was 0.951,Q =0.892.Conclusions 3 T TOF MRA can be used as an effective and feasible imaging follow-up method after embolization of intracranial aneurysms,however,because of the methodological limitations,the high-quality research is needed to further validate the application value of the MRA during follow-up after intracranial aneurysm embolization.

Objective To observe the clinical effects of phosphocreatine treatment on left ventricular function and on amino-terminal pro-brain natriuretic peptide (NT-proBNP) level in elderly patients with chronic heart failure. Methods In our department, the 172 elderly patients with chronic heart failure were randomly divided into treatment group and control group (n= 86, each).The control group received routine anti-heart failure treatment. The treatment group received conventional therapy plus creatine phosphate sodium for 4 weeks. The cardiac function was evaluated and the NT-proBNP level was measured in all subjects. Results Four weeks after treatment, the improvements of left ventricular ejection fraction (LVEF), left ventricular end-systolic diameter (LVESD) and left ventricular end-diastolic dimension (LVEDD) were better in treatment group than in control group (all P＜0.05). The plasma NT-proBNP level decreased significantly in treatment group as compared with control group [before treatment: (956.4 ± 644.2) pmol/L and (973.6 ±639.8) pmol/L; after treatment: (414. 5 ± 163.8 ) pmol/L and ( 719.3 ± 477. 5 ) pmol/L, all P＜0. 05]. Conclusions Phosphocreatine could improve left ventricular function and decrease plasma NT-proBNP level in elderly patients with chronic heart failure.

Objective To assess the efficacy and safety of ACD-A solution as anticoagulant during continuous renal replacement therapy (CRRT) in high risk of bleeding patients.Methods Forty high risk bleeding patients on continuous veno-venous hemofiltration (CVVH) were randomly divided into two groups:ACD-A group (22 patients,61 cases) and heparin-free group (18 patients,47 cases).Serum creatinine,function of the coagulation system,electrolyte and acid-base were monitored pre-and post-CVVH.The vital signs of the patients during treatment,dialyser clotting and the incidence of bleeding episodes were recorded.Results (1) The serum level of creatinine decreased significantly after treatment in both groups,but the rate of decrease was obviously higher in ACD-A group than that in heparin-free group[(55.4± 10.2)％ vs (42.0±5.2)％,P=0.031].(2) The average duration of CVVH treatment was (17.3±3.8) h in ACD-A group and (9.7±4.5) h in heparin-free group.There was significant difference between them (P =0.019).The frequency of dialyzer clotting was much higher in heparin-free group than that in ACD-A group (88％ vs 4.9％,P ＜ 0.001).(3) There was no significant difference in the function of the coagulation system between pre-and post-CVVH in either group (P ＞ 0.05).(4) Electrolyte,acid-base and glucose tended to be stable during the treatment in ACD -A group.(5) The vital signs were kept stable and no bleeding episodes were found in all patients of two groups.Conclusions Anticoagulation with ACD-A is safe,effective and convenient for CRRT in critically ill patients at high risk of bleeding.The occurrence of complications can be reduced by configurating appropriate replacement fluid and close laboratory monitoring.