Corticosteroids,anti-vascular endothelial growth factor,antibiotics and antiviral were the main 4 classes of drugs for intravitreal injection.Depending on the class and volume of medication,age and gender of patients,ocular axial lengths or vitreous humour reflux,intraocular pressure (IOP) can be elevated transiently or persistently after intravitreal injection.Transient IOP elevation occurred in 2 weeks after intravitreal injection,and can be reduced to normal level for most patients.Only a small portion of such patients have very high IOP and need intervention measures such as anterior chamber puncture or lowering intraocular pressure by drugs.Long term IOP elevation is refers to persistent IOP increase after 2 weeks after intravitreal injection,and cause optic nerve irreversible damage and decline in the visual function of patients.Thus drug or surgical intervention need to be considered for those patients with high and long period of elevated IOP.Large-scale multicenter clinical trials need to be performed to evaluate the roles of the drug and patients factors for IOP of post-intravitreal injection,and to determine if it is necessary and how to use methods reducing IOP before intravitreal injection.

Objective To investigate the efficacy and safety of intravitreal ranibizumab and (or) triamcinolone combined with laser photocoagulation for macular edema secondary to branch retinal vein occlusion (BRVO) during one year period.Methods The data of 31 eyes from 31 consecutive patients with macular edema secondary to BRVO during one year follow-up visit were retrospectively analyzed.Mean best corrected visual acuity (BCVA) logMAR was (0.74±0.36) and mean central retinal thickness (CRT) was (484.48± 164.81) μm at baseline.All patients received standardized clinical comprehensive examinations including vision,intraocular pressure and optical coherence tomography for diagnosis before treatment.All patients received intravitreal injections of 0.5 mg ranibizumab (0.05 ml) at first visit.The continue PRN treatment were based on the visual acuity changes and the optical coherence tomography findings.Eyes received combined triamcinolone acetonide 0.05 ml (40 mg/ml) and ranibizumab for macular edema recurrence after two injections of ranibizumab and received laser photocoagulation during 10-14 days after third injections of ranibizumab.Mean injection of ranibizumab was 3.52± 2.01,15 eyes with triamcinolone acetonide (0.84 ± 1.21),21 eyes with laser photocoagulation (0.97± 0.95) and 12 eyes with three treatment.Compared the visual acuities and CRTs of the first and the last visits by statistical analysis.Results Mean visual acuity improved significantly to 0.42±0.33 logMAR (t=6.611,P=0.000).Mean improvement of visual acuity was 2.90± 3.07 lines.A gain of three or more logarithmic lines was evaluated in 20/31 eyes (64.52％) at the last visit.Mean CRT was (326.19± 117.80) μm (t=4.514,P=0.000).Mean reduction of CRT was (333.58±134.17) μm.A decrease of 100 μm of CRT was evaluated in 17/31 eyes (54.84％).No severe ocular and systematic side effect was found.Conclusion The efficacy and safety of intravitreal ranibizumab and (or) triamcinolone combined with laser photocoagulation for macular edema secondary to BRVO were assured.

BACKGROUND: Clinical researches found that portal vein occlusion was beneficial to inhibit growth of hepatocarcinoma, promote compensatory hyperplasia of un-blocking hepatic tissue and decrease metastasis of portal vein occlusion; however, it should be fu~her proved by animal experiments.OBJECTIVE: To investigate models of portal vein occlusion of hepatic VX2 tumor in rabbits and evaluate value of multi-slice CT.DESIGN: Randomized grouping design and animal study.SETTING: Department of Radiology, Xinqiao Hospital of the Third Military Medical University of Chinese PLA.MATERIALS: The experiment was carried out in the Imaging Department of Xinqiao Hospital of the Third Military Medical University of Chinese PLA from July 2002 to January 2005. Forty New Zealand rabbits were divided according to digital table into 4 groups: immediate group (transplantation of tumor after immediate portal vein occlusion), 3-week group (transplantation of tumor at 3 weeks after portal vein occlusion), negative control group and positive control group, 10 in each group.METHODS: Hepatic VX2 tumor was transplanted with abdominal-embedding innoculation at immediate portal vein occlusion and 3 weeks after portal vein occlusion. Meanwhile, they were divided into negative control group (Left external branch of portal vein was done sham-operative block,and left exite was embedded and inoculated pseudoly) and positive control group (Transplanted tumor did not suffer from portal vein occlusion). All rabbits were scanned with multi-slice CT.MAIN OUTCOME MEASURES: General changes of liver, changes of tumor, metastasis of tumor, vascular-imaging displaying rate of multi-slice CT of hepatic artery and portal vein, blood flow of liver, blood volume,mean transit time, permeability of vascular surface and fraction of hepatic arterial infusion (HAI).RESULTS: All 40 animals were involved in the final analysis. ① Tumor did not grow in both immediate group and 3-week group. In 3-week group,left endite was atrophied and growth of tumor was inhibited. The maximal diameter of tumor was smaller than that in positive control group [(2.55 ±0.46), (3.59±0.37) cm, t=5.57, P ＜ 0.001]. Incidences of metastasis in liver and lung were lower in 3-week group than those in positive control group (10%, 40%; 100%, 90%); however, there was no significant difference. ② Scanning with multi-slice CT, displaying rate of branches hepatic artery was lower in grade Ⅲ than that in grade Ⅰ and Ⅱ (40%, 70%,100%, P ＜ 0.05); but there was no significant difference of displaying rate of portal vein at various grades (P ＞ 0.05). ③ Values of blood flow of liver,blood volume, mean transit time and permeability of vascular surface were lower in immediate group and 3-week group than those in control groups,but values of HAI were increased.CONCLUSION: Ligating left external branch of portal vein is an ideal way to establish models of portal vein occlusion of hepatic VX2 tumor in rabbits; furthermore, multi-slice CT plays a key role in evaluating effect of portal vein occlusion.

Objective To determine the anatomical basis of an algorithm to safely elevate the deep circumflex iliac artery osteocutaneous perforator(DCIAP) flap. Methods 1.Six unfixed corpses underwent whole body gelatine/lead oxide injection.Specimens were dissected by layers.Angiography and photography were used to document the precise course,size,location,and type of individual perforators in the lateral lumbar region.The surface areas of cutaneous territories and perforator zones were measured and calculated with Photoshop and Scion Image.2.One specimen also underwent whole body carboxymethylcellulose/lead oxide injection,CT scan and 3D-Reconstrution. Results An average of 1.6 DCIA perforators with a diameter of 0.7mm was present in 92% of specimens.Perforators were located 5～10 cm posterior to the anterior superior iliac spine,12～35mm above the crest,with a perforator zone of 31 cm~2.The DCIA reliably perfused the medial aspect of the iliac crest.Conclusion The DCIA reliably perfused the medial aspect of the iliac crest and lateral lumbar region.It offers a large quantity of bone on a pedicle of large diameter.The mobility of the skin component allows better tissue positioning during complex reconstructions.

Objective To evaluate the clinical value of selective arterial infusion chemotherapy and embolization for rectal carcinoma.Methods Seldinger technique was used to insertsuperselectively catheter for 30 patients primary rectal carcinoma.Gelation embolization was done after infusionchemotherapy;All patients underwent operation in 7 day after chemoterapy and embolization.Results The clinical symptoms were obviously improved in all patients,25 in 30 patients were completely excised and the hemorrhage was obviously reduced.Conclusion The superselective arterial infusion chemotherapy and embolization may improve the clinical symptom and increase the resection rate in rectal carcinoma.

Objective To study the applied value of the improved pyelographic technique under PACS system.Methods The pyelography in 200 cases(including the traditional pyelography in 92,the traditional big dose pyelography in 8 and the improved pyelography in 100) were retrospectively analysed in groups.Results The improved pyelography in comparison with the traditional pyelography,compressing time reduced 9~11 minute during radiography and the contrast medium amount was the same in both.Conclusion The improved pyelography is superior to the traditional or the traditional big dose pyelography.

OBJECTIVE:To investigate the mechanism of litchi saponin in impr oving action of insulin resistance(IR)in rats with hyperlipemia-hepar adiposum.METHODS:The hyperlipemia-hepar adiposum was used to establish IR model of rats,the effects of litchi saponin,roglitazone and gliclazide on the index of fasting serum glucose(FSG),total cholesterol(TC),triacylglycerol(TG),high density lipoprotein-cholesterol(HDL-C),tumor necrosis factor(TNF)-?,content of insulin,in?sulin sensitivity(ISI)and so on were observed in the model rats2hours after medication.RESULTS:Litchi saponin could sig?nificantly lower the level of FSG,TC,TG,contents of insulin and the concentration of TNF-?(P

Objective To comparatively study the features of two reprogramming systems of induced pluripotent stem cells (iPSCs)from human dental origin.Methods Two kinds of reprogramming system,i.e.STEMCCA lentivirus /feed layer and Sen-dai virus /matrigel were used to induce human stem cells from apical papilla(SCAP)into iPSCs,respectively.The induction efficien-cies,workload of generating iPSCs,aneuploidy karyotype ratio,complexities of eliminating exogenous transcription factors and spe-cific markers expression were compared between these two systems.Results The STEMCCA reprogramming system required to prepare the feeder cell MEF.The reprogramming efficiency was 0.1%.Transcription gene-free iPSCs cells were obtained by the Cre-loxp enzyme digestion technique at the later stage.Sendai virus reprogramming system was feeder-free and the preparation of matrigel was quite simple with unified standard.The reprogramming efficiency was 0.7%,which was much higher than that of STEMCCA system(P <0.05).The exogenous virus and transgenes could be gradually eliminated after several passages of natural subclone.Conclusion The Sendai virus/matrigle reprogramming system is much more applicable for the induction of iPSCs from dental origin than the STEMCCA system.

Objective To compare the growth characteristics,proliferation and osteo/odontogenic differentiation capability of stem cells from human dental pulp (dental pulp stem cells,DPSCs) and apical papilla (stem cells from apical papilla,SCAP) in vitro.Methods Human dental pulp and apical papilla tissues were separated from impacted third molars of young healthy donors at the age of root development and digested by collagenase type Ⅰ and dispase type Ⅱ to derive primitive DPSCs and SCAP.Cells were then induced for osteo/odontongenic differentiation by medium containing β-glycerophosphate,dexamethasone and KH2PO4.Flow cytometry was utilized to test the expression of specific markers of stem cells,including CD24,CD34,CD45,CD90,CD105,CD146,STRO-1 and OCT-4.AR-S was used to display the mineralization structure and RT-PCR was applied to analyze the expression of bone sialoprotein (BSP),osteocalcin (OCN) and dentine sialophosphoprotein (DSPP).Results Both DPSCs and SCAP were positive for CD90,CD105,CD146,STRO-1 and OCT-4,in percentages varying according to cell type,without expression of CD34 or CD45.Only SCAP expressed CD24 positively.Both cells formed organized mineralization structure after 2 weeks of induction in time-dependent manner,with more mineralization by SCAP and expressed differentiation markers,including BSP,OCN and DSPP.Conclusion Human DPSCs and SCAP possess the characteristics of MSCs and could be differentiated into odontonblast-like cells in vitro.Both cells are approachable stem cell sources for dental tissue engineering.

Objective To investigate the factors associated with vision and hole closure for idiopathic macular hole (IMH) after vitrectomy surgery.Methods Eighty-nine eyes of 89 patients with IMH were enrolled in this retrospective study.There were 15 males and 74 females.The patients aged from 42 to 82 years,with the mean age of (64.13 ± 7.20) years.All subjects underwent best corrected visual acuity (BCVA) and optical coherence tomography (OCT) examinations.The BCVA ranged from 0.01 to 0.4,with the mean BCVA of 0.12 ± 0.09.The MH stages was ranged from 2 to 4,with the mean stages of 3.56 ± 0.77.The basal diameter ranged from 182 μm to 1569 μm,with the mean basal diameter of (782.52± 339.17) μm.The treatment was conventional 25G pars plana vitrectomy combined with phacoemulsification and intraocular implantation.Fortyone eyes received internal limiting membrane peeling and 48 eyes received internal limiting membrane grafting.The follow-up ranged from 28 to 720 days,with the mean follow-up of (153.73 ± 160.95) days.The visual acuity and hole closure were evaluated on the last visit and the possible related factors were analyzed.Results On the last visit,the BCVA ranged from 0.02 to 0.8,with the mean BCVA of 0.26±0.18.Among 89 eyes,vision improved in 45 eyes (50.56％) and stabled in 44 eyes (49.44％).Eighty-six eyes (96.63％) gained MH closure but 3 eyes (3.37％) failed.By analysis,patients of early stages of MH and smaller basal diameter of MH will gain better vision outcome (t=2.092,2.569;P＜ 0.05) and patients of early stage MH will gain high hole closure rate after surgery for IMH (t=-5.413,P＜0.05).However,gender,age,duration,preoperative BCVA,surgery technique,gas types and follow-up time had no relationship with the effect after surgery for IMH (P＞0.05).Conclusions Stages of MH and basal diameter of MH may be the factors associated with the visual outcome for idiopathic macular hole after surgery.However,age,gender,duration,surgery patterns,gas types and followup time showed no effects on operational outcomes.