AIM: To systemically evaluate the clinical efficacy and safety of intraocular implants for vitreous retinal surgery.METHODS: We performed a comprehensive search for studies reporting vitreous surgery with intraocular implants randomized controlled and a retrospective controlled clinical trials from China Hownet ( CNKI ), Wanfang database, and VIP literature database. Studies obtained from those database were filtered according to the criteria, and data were retrieved from eligible studies for further analysis. Then we performed a meta-analysis to evaluate the efficacy and safety of intraocular implants using comprehensive Meta - analysis software version 2 (Biostat, Englewood, NJ).
RESULTS: In total 36 studies were recruited for our Meta - analysis, including 5 092 cases. Meta analysis showed: 1) regarding the efficacy of repairing the retinal detachment, silicone oil was a better intraocular implants than C3 F8(OR= 1. 76; 95% CI: 1. 19-2. 60, P = 0. 0047) and SF6( OR = 4. 68; 95% CI: 1. 48 - 14. 81, P = 0. 0087); 2) regarding the risk of postoperative cataract, silicone oil showed significant higher risk than BBS (OR = 3. 24; 95%CI: 2. 10-4. 99, P= 1. 09 e-7), and C3 F8(OR= 3. 03; 95% CI:1. 50 - 6. 10, P = 0. 0019 ); 3 ) regarding the risk of postoperative intraocular pressure, silicone oil showed significant higher risk than BBS (OR= 6. 74; 95% CI: 3. 38-13. 41, P= 5. 67 e-08), and C3 F8 also showed a higher risk than BBS (OR= 4. 79; 95% CI: 2. 37-9. 68, P = 1. 29 e-05). In addition, silicone oil showed significant lower risk as compared with heavy silicone oil (OR= 0. 16; 95% CI: 0. 08-0. 53, P= 0. 0026).
CONCLUSION: The intraocular implants for the treatment of retinal detachment in vitreous retinal surgery are mainly divided into two major categories, liquid and gas implants. The silicone oil, a major liquid implant, shows higher efficacy in terms of treating retinal detachment than the gas implants. However, the silicone oil is associated with a higher risk of postoperative cataract and intraocular pressure as compared with gas implants.

Objective To learn about electrolytes imbalance and water intoxication in children treated with high-dose cyclophosphamide(HD-CTX)as well as the renal function and the relative clinical symptoms,and study the mechanisms of hyponatremia.Methods Patients' clinical manifestations during and after HD-CTX therapy were summarized.Serum electrolytes and creatinine(Cr)were detected before and 6 or 8 hours after therapy with HD-CTX,antidiuretic hormone(ADH) in some patients were measured.Results Of 108 therapeutic cases 24 accompanied with vomits and 22 with a decreased urine output,in which 4 developed eyelid or ankle edema.Seven cases had neural-sarcous symptoms and 5 cases had abdominal pain or diarrhea.Serum sodium decreased significantly after HD-CTX[(139.12?3.30) mmol/L vs(134.06?8.23) mmol/L] in whom rechecked after 6 h,(141.77?3.59) mmol/L vs(133.26?6.41) mmol/L in those rechecked after 8 h(Pa0.05].Serum Cr increased 8 h after therapy[(29.95?13.61) ?mol/L vs(43.33 ? 17.25) ?mol/L P

ObjectiveTo analyze the characteristics of top of the basilar syndrome (TOBS) in clinic and imaging.MethodsData of 31 TOBS cases were analyzed retrospectively.ResultsThe clinical features of TOBS patients were sudden unconsciousness or vertigo and dyskinesia of the limbs, the dismovement of the eyeballs, abnormality of the pupils, partial blindness or cortical blindness, hypesthesia, disturbance of memory and counting. CT and MRI showed multi-infarction included thalami, occipital lobe, cerebellum, midbrain, temporal lobe.ConclusionTOBS can be diagnosed accurately according to clinical features and imaging signs.

Tolvaptan is a novel oral selective arginine vasopressin V2 receptor antagonist.Tolvaptan improves heart failure signs and symptoms without serious adverse events.Tolvaptan has no effect on all-cause mortality and cardiovascular death or admission rate for heart failure.But in heart failure patients with hyponatremia,tolvaptan can decrease cardiovascular death and admission rate for heart failure.

Aim To investigate the effect of GW0742 on the endothelial dysfunction induced by high glucose
(glucose at 55 mmol · L -1 )in isolated rat thoracic aorta and its related mechanisms.Methods The end
othelium-dependent relaxation of acetylcholine was per-formed in the absence or presence of GW0742 at differ-ent concentrations under high glucose condition.The structure of aorta was observed by HE staining.Moreo-ver,the content of NO was also measured by nitrate re-duction method.The mRNA and protein expression were detected by quantitative real-time PCR and West-ern blot,respectively.Results Compared with the control group,acetylcholine-induced vasodilatation was impaired by high glucose.Meanwhile,the structures of endothelial cells and smooth muscle cells were also in-terrupted.Furthermore, the expressions of PPARβmRNA and protein reduced while the NF-κB p65 ex-pression increased significantly which occurred in par-
allel with decreasing eNOS expression and NO concen-tration (P <0.01 ).GW0742 (0.01 ,0.1 ,1 μmol· L -1 )restored the relaxation of acetylcholine in a dose-dependent manner,and reversed the mRNA and pro-tein expression of PPARβ,NF-κB p65 and eNOS,as well as NO content (P <0.01 ).Conclusion GW0742 attenuates the injury of endothelial dysfunc-tion induced by high glucose,which may be,at least partly,mediated by the up-regulation of PPARβ,then the down-regulation of NF-κB,and the activation of eNOS-NO signal pathway.

Objective:To evaluate three-stage induced membrane technique combined with anterior and posterior double-plate fixation in the treatment of a total talus defect after infection.Methods:Included in this study were 11 patients with talus infection who had been treated at Department of Orthopaedics, Foshan Hospital of Traditional Chinese Medicine from January 2014 to December 2018. They were 8 males and 3 females, aged from 23 to 63 years (mean, 37.0 years). The infection followed re-implantation after open dislocation of total talus in 4 cases, internal fixation for open talus fracture of Gustilo type Ⅲa in 3 cases and surgery of open ankle fracture of Gustilo type Ⅲc in 2 cases, and was complicated with ankle intraarticular tuberculosis in 2 cases. The three-stage operations consisted of debridement, total talus resection, implantation of antibiotic bone cement and vacuum sealing drainage at the first stage, change of bone cement, re-debridement, wound closure or flap covering at the second stage 7 to 10 days later, and reconstruction after infection control using anterior and posterior double-plate fixation and induced membrane technique at the third stage 6 to 12 weeks later. Assessment of lower limb shortening was performed by comparing the full length of the leg between the normal and affected sides; the functions were assessed by comparing the ankle-hindfoot scores of American Orthopedic Foot and Ankle Society (AOFAS) and visual analogue scale (VAS) between preoperation and the final follow-up.Results:The 11 patients were followed up for an average of 24.3 months (from 12.2 to 37.5 months). Superficial skin necrosis was observed in 2 patients and injury to superficial peroneal nerve in one. Absolute calcification of the autograft area was observed in all patients, leading to ankle fusion. The final follow-ups observed no significant difference in the full length of the leg between the normal and affected sides [(380.4±35.5) mm versus (376.3±32.8) mm] ( P>0.05) , a significant increase in the ankle-hindfoot AOFAS scores from preoperative 28.0±3.4 to 72.8±5.4, and a significant decrease in VAS scores from preoperative 5(5,6) to 0(0,1) (all P<0.05). Slight varus developed in 2 patients and slight ankle stiffness in 3; recurrence of infection or breakage of implants was found in none of the patients. Conclusion:Three-stage induced membrane technique combined with anterior and posterior double-plate fixation can effectively control infection of the talus, maintain the length and reconstruct the function of the lower limb after a total talus defect.

Objective To discuss the comparability of blood urea nitrogen (BUN),creatinine (Cr),uric acid (UA) results and provide basis for result concordance in different biochemical systems.Methods The within-run precision and the between-day precision for the median and high values of quality control materials were tested in Beckman LX-20 and Hitachi 7600 chemistry analyzer respectively,and the evaluation criteria were according to the precision requirement of manufacturer and our laboratory.According to American Clinical and Laboratory Standards Institute (CLSI) document EP9-A2,serum BUN,Cr,UA from 40 patients were detected by Hitachi 7600 chemistry analyzer as experimental method and by Beckman LX-20 chemistry analyzer as comparative method.The relative bias ( SE％) between experimental method and comparative method was calculated and the concordance of biochemical analysis system was determined according to EQA requirements and acceptable performance criteria Results The between-run and between-day precision coefficients of variation for BUN,Cr and UA in two biochemical analysis systems were lower than the precision requirement of manufacturer and our laboratory.In Hitachi 7600 chemistry analyzer,the SE％ for BUN at three levels of medical decision were 9.4％,2.0％ and 0.8％,the SE％ for Cr were 7.3％,3.8％ and 2.8％,the SE％ for UA were 7.9％,1.7％ and 1.2％.Two biochemical analysis systems were not comparable in BUN analysis because SE％ of serum BUN levels detected by Hitachi 7600 at low medical decision level exceeded the specified range.The remaining items between two biochemical analysis systems were concordant.Conclusion While the same test is detected by more than two systems in one laboratory,it is necessary to do method comparison and bias evaluation for concordance in order to ensure the comparability among test results.

A 48-year-old man presented with a 4-day history of fever and 10-year history of papulovesicles on the face, neck, trunk and limbs which had been aggravated 10 days prior to the presentation.Skin biopsy showed a dermal infiltration of numerous small- to medium-sized atypical lymphocytes, which was mainly located around blood vessels or appendages, with the involvement of subcutaneous fat tissue and destruction of blood vessels. The infiltrating atypical cells stained positive for CD45RO, CD8, CD56, T-cell intracellular antigen-1, granzyme B, Epstein-Barr virus-encoded small nuclear RNAs (EBER), but negative for CD20, CD79a, CD3, CD4 or CD30. Cytoplasmic CD3ε was also observed in these cells. Laboratory examinations on admission revealed a progressive decrease in peripheral erythrocytes, white cells and platelets, persistent increase in serum aminotransferase and bilirubin, and decline in serum fibrinogen and hypertriglyceridemia. The B-mode ultrasound of the abdomen showed hepatosplenomegaly. Based on the above findings,the diagnosis was made as extranodal nasal type NK/T-cell lymphoma of skin complicated by hemophagocytic syndrome.

Objective To investigate the correlation between bone mineral density(BMD)and the PXh haplotype combining estrogen receptor (ER) gene Xba Ⅰ , Pvu Ⅱ polymorphisms and osteocalcin gene Hind Ⅲ polymorphism in postmenopausal women.Methods In 307 subjects,the BMD of lumbar vertebrae and proximal femur were measured by dual energy X-ray absorptiometry and the Xba Ⅰ and Pvu Ⅱ polymorphisms of ER gene and the Hind Ⅲ potymorphism of osteocalcin gene were detected by polymerase chain reaction and restriction fragment length polymorphism (PCR-RFLP).Results (1)The BMD of greater trochanter was significantly lower in XX genotype group than in xx genotype group ( P<0.05).The BMD of femoral neck, greater trochanter and Ward's triangle were lower in Xx genotype group[(0.695±0.087)g/cm2 , (0.592±0.106)g/cm2, (0.500±0.115) g/cm2] and X allele group[(0.697±0.088)g/cm2 , (0.594±0.105)g/cm2, (0.505±0.123)g/cm2] than in xx genotype group[(0.737±0.108) g/cm2,(0.653±0.119)g/cm2 ,(0.554±0.130)g/cM2] and non-X allele group[(0.737 ± 0.108) g/CM2, (0.653 ± 0.119) g/cm2 , (0.554 ± 0.130) g/cm2] ,respectively (all P<0.05 ).(2)The BMD of Ward's triangle was lower in PP genotype group and P allele group than in pp genotype group and non-P allele group (P<0.05).(3)The BMD of femoral neck, greater trochanter and Ward's triangle were lower in hh genotype group and h allele group than in I-IH genotype group, and were lower in non-h allele group than in HH genotype group(all P<0.05).(4)Women carrying PX, PXh haplotypes combining ER gene and osteocalcin gene had lower BMD at femoral neck than those not carrying PX,not carrying PXh haplotypes, respectively (all P<0.05).ConclusionsER gene(Xba Ⅰ) polymorphism and osteocalein gene(Hind Ⅲ) polymorphism are associated with BMD in postmenopausal women.The presence of X allele or h allele　shows negative influence on the BMD of postmenopausal women.The PXh haplotype is a suitable　genetic marker of postmenopausal women osteoporosis in Fuzhou area.

OBJECTIVE: To study the association of the vitamin D receptor gene BSM Ⅰ, TAQ Ⅰ and APA Ⅰ genetic polymorphisms with bone mineral density and biochemical markers of bone turnover in postmenopausal women.METHODS: ①total of 576 postmenopausal Han ethnic women of 48-84 (62.17±6.37) years old in Fuzhou city were investigated, on the basis of their informed consent, through random sampling method from January 2007 to December 2008. ②The subjects were recorded regarding to their age, menopause duration, body mineral index and postmenopausal fracture incidence. ③Dual energy X-ray absorptiometry was used for measuring the bone mineral density of vertebrae L<,2-4>, left femoral neck, trochanter and Ward's triangle. ④The genetic polymorphisms of vitamin D receptor gene BSM Ⅰ, TAQ Ⅰ and APA Ⅰ were detected using polymerase chain reaction-rastriction and fragment length polymorphism (PCR-RFLP) technique. ⑤The biochemical markers of bone turnover (serum bone gla protein, serum bone alkaline phosphatase, urinary pyddinoline and urinary deoxypyridinoline) were detected with enzyme linked immunosorbent assay.RESULTS: A total of 561 subjects up to standard were involved in the result analysis. ①There was no significant difference in bone mineral density among genotypes of vitamin D receptor gene BSM Ⅰ, TAQ Ⅰ and APA Ⅰ polymorphisms (P > 0.05). ②There was no significant difference in the biochemical markers of bone tumover among genotypes of BSM Ⅰ, TAQ Ⅰ and APA Ⅰ polymorphisms (P > 0.05). ③There was no significant difference in the incidence of osteoporosis among genotypes of BSM Ⅰ, TAQ Ⅰ and APA Ⅰ polymorphisms (P > 0.05). ④There was no significant difference in the incidence of postmenopausal fracture among genotypes of BSM Ⅰ, TAQ Ⅰ and APA Ⅰ polymorphisms (P > 0,05).CONCLUSION: BSM Ⅰ, TAQ Ⅰ and APA Ⅰ polymorphisms of the vitamin D receptor gene are not obviously associated with osteoporesis in postmenopausal women, and accordingly can not be taken as genetic markers of osteoporosis in postmenopausal women in Fuzhou.