Pars plana vitrectomy (PPV) is a common vitreoretinal surgical procedure. With its rapid advances many vitreoretinal diseases that have the potential to blind can now be treated. Although surgical complications are decreasing due to the improvement of surgical tools and techniques, these are not uncommon in our daily clinical practice. The sclerotomy-related complications, for example, are of great concern because they can result in retinal detachment and loss of vision. This article will review the common sclerotomy-re-lated complications including the sclerotomy-related retinal breaks and detachment, fibrovaacular ingrowth into the sclerotomy site, and vitreous incarceration. The risk factors and the practical measures to prevent these complications are also discussed. (Ophthalmol CHN, 2009, 18: 225-228)

Objective To establish the analytical method for fingerprint of Aristolochia manshuriensis by HPLC-DAD-ESI/MS,which can be used as the basis for quality control of the drug and for the further studies on kidney toxicity metabolite.Methods Samples A.manshuriensis from different habitats were extracted by 75% methanol and analyzed by HPLC-DAD-ESI/MS,whose chromatographic fingerprints were established.Two ways to calculate the similarity were selected to compare the results by determining the common peaks.Results There were 30 main characteristic components in A.manshuriensis.The HPLC-DAD-ESI/MS fingerprint of the 30 common peaks was established preliminarily.The samples of A.manshuriensis from different habitats was found having a good similarity,and the range of similarities for 24 balches of A.manshuriensis were 0.871—0.998.Conclusion The method is reliable,accurate,and of good stability,and can be used for the quality control and variety identification of A.manshuriensis.

Objective To determine the risk factors of light perception and no light perception appearenee after vitrectomy for pro-liferative diabetic retinopathy (PDR). Design Retrospective, noncomparative case series. Participants 242 patients (288 eyes) who un-derwent vitrectomy for PDR. Methods 288 eyes of participants from 2002 to 2006 at Beijing Tongren Eye Center were reviewed. Cases that had postoperative visual acuity of light perception (LP) and no light perception (NLP) were recorded and PDR stages, traction reti-nal detachment involving macula, postoperative retinal detachment, postoperative vitreous hemorrhage, postoperative neovascular glauco-ma and re-operations were analyzed. Main Outcome Measures Postoperative complications, PDR stage, macular disorder. Results Subjects were divided into two groups. LP/NLP group included eyes that had postoperative visual acuity of light perception and no light perception (totally 14 eyes in this group). Another group (control group) included eyes that had postoperative visual acuity of hand mo-tion or better (totally 274 eyes in this group). When compared with control group, the LP/NLP group had significantly higher prevalence of PDR 6, traction retinal detachment involving macula, postoperative retinal detachment, postoperative vitreous hemorrhage, postopera-tive neovascular glaucoma and reoperation (P value was 0.042, 0.048, 0.048, 0.000, 0.000, 0.000, respectively). Conclusion Risk factors of light perception and no light perception after vitrectomy for PDR include PDR stage 6, traction retinal detachment involving macula, postoperative retinal detachment, postoperative, vitreous hemorrhage, postoperative neovascular glaucoma and re-operation. (Ophthalmol CHN, 2009, 18: 251-253)

Objective To determine the association of-429T/C and G1704T polymorphisms in the receptor for advanced glycation end products gene with proliferative diabetic retinopathy (PDR).Methods Case-control study.From the Beijing Desheng Diabetic Eye Study cohort of 1467 patients with type 2 diabetes mellitus (T2DM),a total of 97 patients with PDR and 105 diabetic patients without retinopathy (DWR,duration of diabetes 15 years) were included for this study.Questionnaires were collected and general ophthalmologic examinations were performed.Biochemical analysis was conducted.DNA was extracted from peripheral venous blood.The-429T/C and G1704T single nucleotide polymorphisms were detected by the means of PCR-restrication fragment length polymorphisms.Results The frequency distribution of-429T/C in DWR group was 81.0％ in TT,16.1％ in TC,2.9％ in CC.The frequency distribution of-429T/C in PDR group was 77.3％ in TT,20.6％ in TC,2.1％ in CC.There was no significant statistical difference between the two groups (x2 =0.40,P＞0.05).Frequency of the-429T/C minor allele C in the DWR and PDR group were 11.0％ and 12.4％,respectively,with no significant statistical difference between the two groups (x2 =0.20,P＞0.05).The frequency distribution of G1704T in DWR group was 66.7％ in GG,29.5％ in GT,3.8％ in TT.The frequency distribution of G1704T in PDR group was 78.4％ in GG,21.6％ in GT.There was no significant statistical difference between the two groups (x2 =3.44,P＞0.05).Frequency of the G1704T minor allele T in the DWR and PDR group were 18.6 ％ and 10.8 ％,respectively,in which significant difference was found within the two groups (x2 =4.79,OR=1.88,95％CI:1.06-3.33,P＜0.05).Conclusions G1704T polymorphism is associated with PDR presence and 1704G allele may increase the risk of PDR.

Objective To investigate the changes of brain function and cognitive function in patients with acute cerebellar stroke using amplitude of low-frequency fluctuation (ALFF) and functional connection (FC).Methods The cognitive function assessment and resting state functional magnetic resonance (rs-fMRI) scan were performed on patients with acute cerebellar stroke hospitalized in Taizhou People's Hospital or Nanjing Brain Hospital from May 2017 to June 2018.The differences of ALFF and FC values were compared.Pearson correlation analysis was used to understand the correlation between FC values and cognitive function scores.A total of 32 patients with acute cerebellar stroke and 34 healthy controls were included.Results Compared with the healthy controls,the scores of Montreal Cognitive Assessment (23.97 ± 6.04 vs 26.56 ± 2.93,t=-2.237,P=0.029),the Rey Auditory Verbal Learning Test (RAVLT;3(2) vs 6(2),Z=-4.136,P=0.000) were significantly lower,and the time consuming of Trail Making Test(TMT)-B ((251.56 ± 112.62) s vs (164.76± 52.37) s) was significantly higher (t=4.054,P=0.000) in the patients with acute cerebellar stroke.The rs-fMRI results showed significant group differences in ALFF values at the four brain regions,including the right frontal lobe,left hippocampus,right cingulate gyrus and cerebellum posterior lobe.The regions that showed significant group differences were set as regions of interest (ROIs),and then the functional connectivity between ROIs and the whole brain were analyzed.The results showed significant positive correlation between the RAVLT scores and the FC values from the left hippocampus to the left frontal lobe (r=0.272,P=0.031).The FC values from the right cingulate gyrus to right inferior parietal lobule were found to be correlated positively with the scores on the TMT-B (r=0.410,P=0.023).Conclusions The patients with cerebellar stroke had cognitive impairment,mainly in memory and executive function.The changes of ALFF and FC values in related brain area from cerebellar stroke enrich our understanding of cerebellar involvement in cognitive performance.

Objective:To evaluate the immunomodulating effect of oyster peptide on immunosup-pressed mice.Methods:ICR mice injected with cyclophosphamide (CTX)were adopted as the module group,with mice without treatment as the control group,and different dosages of oyster peptide (0.5 g/kg,1 .0 g/kg,and 2.0 g/kg)were given to the low,middle,and high groups for 1 5 days.The body weight,spleen,and thymus weight of the mice,structures under the microscope of the immune organs, numbers of white blood cells,ratios of T lymphocyte subsets,immune cytokines and numbers of nuclear cells,and DNA content in bone marrow were all assessed.Results:Compared with the control group, the structures of thymus and spleen of the mice in the CTX group appeared obscure and shrunk when ob-served under microscope,the number of their white blood cells declined (P =0.04),the proportion of their CD3 +T cells in peripheral blood declined (P =0.003),the proportion of their CD8 +T cells in pe-ripheral blood declined (P =0.002),the concentration of their IL-5 in peripheral blood significantly in-creased (P <0.01 ),the concentration of their nucleated cells and DNA density in bone marrow de-creased (P =0.04,P <0.01 ).Oyster could improve the structures of thymus and spleen of the immuno-suppressed mice.Compared with the CTX group,the number of white blood cells in 2.0 g/kg group in-creased (P =0.003),the proportion of CD3 +T cells in peripheral blood in 1 .0 g/kg group (P =0.04) and 2.0 g/kg group (P =0.02)increased,the proportion of CD8 +T cells in peripheral blood in 2.0 g/kg group increased (P =0.002),the concentration of IL-5 in peripheral blood in all the oyster treated groups increased (P <0.01 in 0.5 g/kg,1 .0 g/kg,and 2.0 g/kg groups),the concentration of IL-1 7 in peripheral blood in 2.0 g/kg group decreased (P =0.03),the concentration of nucleated cells in bone marrow of all the oyster treated groups increased (0.5 g/kg vs.CTX,P =0.04;1 .0 g/kg vs. CTX,P =0.02;2.0 g/kg vs.CTX P =0.01 ),the DNA content in bone marrow of all the oyster treated groups increased (P <0.01 in the 0.5 g/kg,1 .0 g/kg,and 2.0 g/kg groups).Conclusion:Oyster peptide could improve the structures of immune organs of the CTX-induced immunosuppressed mice,re-cover the imbalances of T lymphocyte subsets,improve the immune cytokines and increase numbers of nucleated cells and DNA content in bone marrow,thus improving the immunologic function.

Objective To establish a method for determination and optimize the extraction process of the content of plantamajoside in plantain.Methods Plantamajoside content was determined by HPLC.The effects of ethanol concentration, ethanol amount and extraction time on the extraction of plantamajoside from plantain were studied by orthogonal design.Results The calibration curve was linear (r=0.999 6) over the range of 12.52-125.10μg/ml.The average recovery was 98.57％ (RSD=1.45％).The optimum extraction process was as follows:60％ethanol, 10times volumes, extracted 2times, 1heach time.Conclusion The established method was simple, accurate and reproducible for determination of the content of plantamajoside in plantain.The optimal extraction process was stable and feasible.

Objective:To explore the application effect of modified early warning scoring system in treatment of patients with multiple injuries in emergency department.Methods:Using the convenient sampling method, a total of 126 patients with multiple injuries who were admitted to Emergency Department of Heping Hospital Affiliated to Changzhi Medical College from January 2018 to December 2019 were selected as the research objects. The patients were divided into the control group and the intervention group by chronological order , with 63 cases in each group. The control group was given the traditional multi-injury routine first aid and monitoring plan, while the intervention group applied a modified early warning scoring system on the basis of the control group. The success rate of first aid and the degree of deterioration of patients were compared between the two groups.Results:After the implementation of modified early warning scoring system, the success rate of first aid of patients in the intervention group was higher than that of the control group and the degree of disease deterioration was lower than that of the control group, and the differences were statistically significant ( P<0.05) . Conclusions:The modified early warning scoring system has a significant application effect in emergency patients with multiple injuries, which can improve the success rate of treatment of patients and reduce the degree of disease deterioration.

Objective:To investigate the pollution levels and influencing factors of polybrominated diphenyl ethers (PBDEs) in household dust in five cities in northern China.Methods:Based on the "Chinese Indoor Environment and Health Surveillance" project carried out by the National Institute of Environmental Health, Chinese Center for Disease Control and Prevention in 2018-2019, during the warm season (April 2018 to September 2018) and the cold season (November 2018 to March 2019), Lanzhou in Northwest China, Shijiazhuang in North China, Panjin in Northeast China, Luoyang in Central China, and Qingdao in East China were selected as the research sites. A total of 87 families were recruited to study residences in real-life scenarios. At the same time, dust samples were collected to detect the concentration of PBDEs. The level of household environmental indicators was measured, and the residential building characteristics and family behavior habits were collected through questionnaires. A total of 142 valid dust samples and 140 valid questionnaires were obtained. The differences in PBDE concentrations across seasons, wind zones, residential building characteristics, and family habits were analyzed. The exploratory factor analysis was performed to investigate the possible sources of PBDEs, and multivariate linear regression was used to explore the factors influencing PBDEs in household dust.Results:The M ( Q1,Q3) of total PBDE concentrations in 142 household dust samples in five cities was 144.51 (106.61, 222.65) ng/g in the warm season and 145.10 (98.57, 180.65) ng/g in the cold season, respectively. There were seasonal differences in the concentration of ∑ 12PBDEs in Luoyang and Shijiazhuang ( P<0.01). The concentration of BDE-71 was highest among PBDE homologues, followed by BDE-66 and BDE-47. Three factors were extracted by exploratory factor analysis in the warm season, and the cumulative variance contribution rate was 67.90%. The multivariate linear regression showed that the house completion less than ten years [ β (95% CI): 0.186 (0.013, 0.359)], infrequent home cooking [ β (95% CI):-0.342 (-0.570, -0.114)], and increased residential PM 10 concentration [ β (95% CI): 0.001 (0.000, 0.002)] during the warm season, as well as the house far from driveway [ β (95% CI): 0.093 (0.013, 0.172)], house area less than 90 m 2 [ β (95% CI):-0.138 (-0.264, -0.013)], and lower residential xylene concentration [ β (95% CI):-0.006 (-0.011, -0.001)] during the cold season might be related to the elevated concentrations of ∑ 12PBDEs in household dust. Conclusion:The pollution of PBDEs in household dust in five northern cities is at a medium to high level. Years of house completion, frequency of cooking at home, residential PM 10 concentration, distance from house to driveway, house area, and residential xylene concentration may influence household PBDE concentrations.

This work aims to evaluate a rapid detection method of carbapenem resistance genes in blood cultures based on Xpert Carba-R and preliminarily evaluate its clinical application.Methods:Sixteen strains of Enterobacterales carrying different carbapenem resistance genes were selected to prepare simulated positive blood culture samples and Xpert Carba-R was used to directly detect carbapenem resistance genes in the simulated positive blood culture. From January 2022 to June, a prospective study was conducted on a total of 117 Enterobacteriaceae-positive blood culture samples in the First Affiliated Hospital of Nanjing Medical University. Xpert Carba-R, detecting five kinds of carbapenem resistance genes in these samples, was evaluated in sensitivity and specificity compared to polymerase chain reaction sequencing. Meanwhile clinical data of positive patients was collected for prognostic analysis. Results:Of the 16 simulated specimens, 14 strains had carbapenem resistance genes detected by Xpert Carba-R, including 8 bla KPC, 5 bla NDM and 1 bla IMP, showing 100% agreement with the known results. As of the 117 clinical specimens, 28 cases were determined to be Enterobacterales harboring carbapenem resistance genes, including 24 bla KPC, 2 bla NDM and 2 bla KPC+ bla NDM. In comparison to the PCR sequencing, the sensitivity and specificity of Xpert Carba-R were both 100% for blood culture samples, and furthermore, the detection time was significantly reduced. Of the 25 positive patients, 9 cases were treated with monotherapy and 5 cases were effective, other 16 cases received combined treatment and 12 cases were effective. A total of 17 cases were effective, 8 cases were ineffective and 3 of them died, the mortality rate was 12% (3/25). Conclusion:Xpert Carba-R can rapidly and accurately detect carbapenem resistance genes in blood culture, which can provide evidence for rational drug therapy in early clinical stage.