Diabetic retinopathy ( DR ) is one of the main blinding eye diseases for people over the age of 50, and diabetic macular edema ( DME) is the leading cause of vision loss is DR patients. The early diagnosis and early treatment is important. As OCT and FFA, mfERG, especially the retinal thickness, volume, retinal edema index quantitative indicators such as objective evaluation of macular edema, embodies the new progress of retinal imaging technology in recent years. OCT is a non -contact clinical application in recent years, noninvasive, high resolution of ophthalmic imaging examination, can do it on retinal ultrastructure observation and quantitative analysis, and the technology is relatively mature, become a routine inspection diagnosis of macular edema. Laser photocoagulation, intravitreous injection with Ranibizumab and vitrectomy is nowadays the important means for the treatment of intractable macular edema.

The Tongmai Yangxin pill (TMYX) has potential clinical effects on no-reflow (NR); however, the effective substances and mechanisms by which this occurs remain unclear. This study evaluates the cardioprotective effects and molecular mechanisms of TMYX against NR. We used a myocardial NR rat model (2 h after myocardial ischemia and 2 h after reperfusion) to confirm the effect and mechanism of action of TMYX in alleviating NR. In vitro studies in isolated coronary microvasculature of NR rats and in silico network pharmacology analyses were performed to reveal the underlying mechanisms of TMYX and determine the main components, targets, and pathways of TMYX, respectively. The experiment was approved by the Ethics Committee of Hunan University of Chinese Medicine (LLBH-202212160001). TMYX showed therapeutic effects on NR by improving cardiac structure and function, reducing NR, ischemic areas, and cardiomyocyte injury, and decreasing the content of cardiac troponin I (cTnI). Moreover, the mechanism of TMYX predicted by network pharmacology is related to the hypoxia inducible factor-1 (HIF-1), nuclear factor kappa-B (NF-κB), and tumor necrosis factor (TNF) signaling pathways. TMYX increased the expression of G protein-coupled estrogen receptor (GPER), phospho-extracellular signal-regulated kinase (p-ERK), and HIF-1α. In vitro, TMYX enhanced the diastolic function of coronary microvascular cells; however, this effect was inhibited by GPER inhibitor (G-15), eNOS inhibitor (L-NAME), and sGC inhibitor (ODQ). This study integrates pharmacology and experimental evaluation to reveal that TMYX activates HIF-1α/eNOS signaling pathway by upregulating GPER to relax coronary microvessels, thereby significantly alleviating NR.

Objective To explore the occurrence of enteral feeding intolerance and its influencing factors in patients with severe acute pancreatitis. Methods A retrospective analysis of severe acute pancreatitis patients undergoing enteral nutrition therapy admitted to a tertiary hospital from October 2012 to October 2015 was performed. The occurrence of enteral feeding intolerance was analyzed,and its influencing factors were evaluated by single factor analysis and multivariate logistic regression analysis. Results There were 54 patients suffered from enteral feeding intolerance among 92 patients. The results of single factor analysis and multivariate regression analysis showed that higher APACHE II score,intra-abdominal pressure and central venous pressure were independent risk factors of feeding intolerance,while adding dietary fiber was a protective factor. Conclusion Severe acute pancreatitis patients with higher APACHE II score,intra-abdominal pressure and central venous pressure can aggravate the risk of feeding intolerance,while adding dietary fiber is beneficial for reducing the incidence.

Objective To observe the changes of the quality of life in type 2 diabetes accompanying subclinical atherosclerosis and explore the effect of diabetic macrovascular complications in the quality of life.Methods One hundred and thiry-six type 2 diabetes were measured carotid intima media thickness (IMT) and then divided into AS group(n =51) and CON group(n =85).Two groups were examined with Special of Quality of Life for Diabetes Mellitus (DSQL).Plasma glucose,plasma insulin,glycosylated hemoglobin(HbA1c),high sensitivity C-Reactive Protein (hs-CRP) as well as insulin resistance index (HOMA-IR) and body mass index (BMI) were observed.Results The scores of DSQL and all domains had obvious difference between AS group and control group(P ＜0.05 orP ＜0.01) ;Relative to the control group the AS group was significantly increased BMI,HbA1c levels,hsCRP levels.The DSQL was associated with IMT,BMI,HbA1c,hsCRP,HOMA-IR.Conclusion The diabetic macrovascular compliations might result in impaired quality of life,which is associated with hyperglycemia,insulin resistance,inflammation,and central obesity.Psychotherapy and health education are very important for the improvement the DSQL in type 2 diabetic accompanying subclinical atherosclerosis.

the effect of maintaining integrity of epithelial cells by increasing occludin protein expression,and the effect is related with the up-regulation of occludin mRNA.

Objective To observe any effect of transcutaneous electrical nerve stimulation (TENS) on pul monary function,airflow obstruction,dyspnea,exercise capacity and levels of tumor necrosis factor-α (TNF-α) in the sputum of patients with chronic obstructive pulmonary disease (COPD).Methods Thirty patients with stage Ⅰ or Ⅱ COPD were randomly divided into a treatment group and a control group with 15 cases in each.TENS applied at the Feishu acupuncture point (BL13) was used in the treatment group,while sham stimulation of the same point without current output was used in the control group.The treatment was administered 40 minutes once daily,5 days a week for a total of 4 weeks.The outcome measures were measured before and after 4 weeks of treatment.Results FVC,FEV1,FEV1％,and peak expiratory flow rate (PEFR) all improved significantly in the treatment group after 4 weeks of treatment.After treatment,the average TNF-α level in induced sputum and exercise capacity as indicated by the average BODE index had both improved significantly in the treatment group.Compared with the control group,pulmonary function,TNF-α and the BODE index in the treatment group were all significantly better.There was no significant difference in pulmonary function,BODE index or TNF-α before and after treatment in the control group.Conclusion TENS at the Feishu acupoint can reduce airway inflammation,improve pulmonary function and exercise capacity,and decrease TNF-α levels in patients with stage Ⅰ or Ⅱ COPD.This treatment should be very useful for enhancing their ability in the activities of daily living.

Objective To evaluate the differential diagnostic value and superior of biliary atresia(BA)in the infants with cholestatic hepatopathy by high-frequency ultrasonography (HUS).Methods After 4 hours fasting,124 infants with cholestatic hepatopathy were scanned with high-frequency US.The data of hepatic size and parenchyma,gallbladder,triangular cord (TC) sign,bile duct,right hepatic artery (RHA)and portal vein (PV) were observed and measured.Meanwhile,the other data were collected,which included the clinical diagnosis,blood biochemical tests,the MRCP and dynamic duodenal liquid color check finding,the pathological results after liver puncture biopsy and so on.Results In 124 infants with cholestatic hepatopathy,BA was found in 61 infants and ruled out in 63.TC thickness,RHA diameter,and gallbladder length and width exhibited significant differences between the group with BA and the group non-BA(all P ＜0.001).The correctness for the diagnosis of BA was 90.3％ by the combination of TC sign and abnormal gallbladder morphology,and 83.1 ％ by stool color,81.5 ％ by γ-GT,47.5 ％ by MRCP,83.3 ％ by dynamic duodenal liquid color check,95.2％ by the pathology after liver puncture biopsy,respectively.Conclusions HUS is superior to other diagnostic methods in BA with higher accuracy rate,noninvasion,simplicity and economy.

Objective To investigate network user's attention rate of the keyword“cardiovascular and cerebrovascular diseases”(CCD). Methods The keyword was analyzed by using Baidu index. Results The overall trend of keyword search rose slightly. The mobile search grew significantly. During the Spring Festival overall search decreased significantly. According to clustering analysis the word“symptom”was most often used with“CCD”;30 to 39 years old age group accounted for about 50%of total number of online search. Men accounted for 70% of all keyword search, women accounted for 30%. The rankings of CCD search number were more on top in the economically developed area. Conclusion It is necessary to strengthen publicity and education to prevent the happening of CCD during Spring Festival. Men need to raise awareness about CCD. The construction of rural informatization should be speeded up. Network education could be used as a part of method for the primary and secondary prevention of CCD. Keyword analysis method could effectively analyze the network user search behavior and find information they need.

Objective To analyze the detection rate of neonatal congenital malformation,and to explore the risk factors for neonatal malformation.Methods A total of 29 831 infants born in Shenzhen People's Hospital from January 2011 to December 2015 were analyzed retrospectively,the detection rate of congenital malformations was calculated,381 infants with congenital malformation were selected as malformation group,and 381 healthy infants were selected as healthy control group,and the risk factors of congenital malformation were analyzed.Results A total of 381 infants with congenital malformation were screened out,the incidence rate of congenital malformation being was 12.77‰(381/ 29 831 cases).The incidence rates of multi-finger or multi-toe,cleft lip,congenital heart disease were the high,which were 18.64％ (71/381 cases),17.32％ (66/381 cases) and 16.80％ (64/381 cases),respectively.The multiple Logistic analysis showed that birth children with low weight newborns (＜ 2 500 g),multiple births,preterm birth (＜ 37 weeks),pregnancies ＞ 1,low literacy levels of mothers,living in towns,late childbirth (≥ 35 years of age),pregnancy syndrome,viral infection during early pregnancy,medication history during pregnancy,rubella unvaccinated,exposure to harmful substance,smoking and alcohol during pregnancy and paternal smoking,chronic diseases,total 16 items were related risk factors for neonatal congenital malformations (all P ＜ 0.05).Among them,the impact of viral infection during early pregnancy,alcohol,smoking,pregnancy syndrome,exposure to harmful substance,medication history during pregnancy on the incidence of malformations in neonates was relatively serious.Conclusions The incidence rate of congenital malformations among neonates conforms to the present situations in China,which was closely correlated with genetic and environmental factors.Health education targeting pregnant women and the women of childbearing age should be carried cut to reduce the birth of neonatal congenital malformations.

Objective To investigate the effect of mixed application of lecture-based learning and flipped classroom and problem-based learning in microbiology teaching. Methods The five-year program students of Grade 2013 and Grade 2014 were randomly divided into two groups, and the experimental group (48 students in the teaching reform class) carried out the blended teaching, while the contrast group (48 students of parallel class) carried on the traditional teaching. After the lecture, the teaching effect of the hybrid teaching method and traditional teaching method was analyzed after the theoretical and the experi-mental operation test were adopted, and the four part questionnaire surveys including the integrated use of knowledge, active classroom atmosphere, innovation ability and teaching satisfaction were proceeded in each group. The data of each group was analyzed by t test analysis with SPSS 19.0 respectively. Results The theory test scores of experimental group was (90.16±3.14), which was higher than the control group (82.33± 4.21). The difference between them was very significant (P=0.000). Survey results showed that the integrated use of knowledge, active classroom atmosphere, innovation ability and teaching satisfaction were higher than traditional group. The difference was statistically considered significant (P<0.01). Conclusion Hybrid teaching method is very good for training and development of students' comprehensive quality and ability. It has important significance in improving the students' score.