Objective To investigate the relationship between polymorphisms in the thymidylate synthase(TS) promoter enhancer region and invasion of bladder transitional cell carcinoma(BTCC).Methods The TS gene promoter and TS protein expression were detected by PCR and immunohistochemical Streptavidin-Peroxidase staining method respectively in 87 cases of BTCC and the immunoreactivity score(IRS) was estimated.Results The IRS of TS in BTCC was(3.38?2.15).The IRS of TS protein in stage of T_(2-4) was significantly higher than that in stage of T_(a-1),and the IRS was elevated with the increase of pathological grade of BTCC(all P

Objective:To observe the correlation analysis between the deep-superficial flow-density ratio (DSFR) and treatment response of macular edema secondary to branch retinal vein occlusion (BRVO).Methods:Forty-eight patients (48 eyes) with macular edema secondary to BRVO from December 2018 to December 2019 in the Department of Ophthalmology of Beijing Hospital were enrolled in this study. There were 29 males (29 eyes) and 19 females (19 eyes), with the mean age of 58.77±10.88 years. All eyes were treated with intravitreal injection of ranibizuma once a month for 3 months, and then treated as needed. According to the central retinal thickness (CRT) 12 months after treatment, the patients were divided into good response group (CRT≤250 μm) and refractory group (CRT> 250 μm). The flow density in the superficial capillary plexus (SCP) and deep capillary plexus (DCP) of all subjects was measured by optical coherence tomography angiography. The flow density of DCP and SCP measured at 3 follow-up times was selected and DSFR was calculated. The DSFR was recorded by the Study for the Treatment of Diabetic Retinopathy (ETDRS) -grid and Nine-grid. The flow density of DCP, SCP and DSFR were compared between the two groups by paired t test. At 3 months post-treatment, the efficacy of DSFR in ME treatment response was evaluated according to area under curve (AUC) of receiver operating characteristic. Univariate and multivariate binary logistic regression were used to analyze the factors affecting the response to ME treatment. Results:At 12 months after treatment, there were 27 eyes in good response group and 21 eyes in refractory group. There was no statistical significance in the flow density of DCP ( t=1.804, 1.064, 0.660) and SCP ( t=0.581, 0.641, 0.167) and DSFR ( t=0.393、-0.553、0.474) in all area of response group and refractory group using ETDRS-GRID recording method ( P>0.05). The SCP, DCP and DSFR of the most severe non-perfusion area were (27.10±5.70) %, (28.33±8.95) %, 1.35±0.54 and (27.54±6.70) %, (29.11±0.42) %, 1.01±0.40 in the response group and refractory group, respectively. There was no significant difference in the flow density of DCP and SCP between the two groups ( t=-0.237,-0.340; P>0.05). The difference of DSFR between two groups was statistically significant ( t=2.288, P=0.024). Univariate and multivariate binary logistic regression analysis showed that DSFR in the most severe non-perfusion area was associated with ME response (odds ratio=0.212, 0.085; P=0.027, 0.024). The AUC was used to evaluate the efficacy of DSFR in ME treatment response, the results showed that the AUC was 0.800, P=0.001, Youden index was 1.348, sensitivity was 67.7%, and specificity was 86.7%. Conclusions:DSFR reduction is more common in BRVO secondary to ME patients. DSFR correlates with ME treatment response.

Objective To observe the efficacy and adverse reactions of ECF regimen (epirubicin combined with cisplatinum and fluorouracil) and DOF regimen (docetaxel combined with oxaliplation and fluorouracil ) in the treatment of advanced gastric cancer .Methods 68 cases of advanced gastric cancer were randomly divided into the ECF group (30 cases) and the DOF group (38 cases) .The ECF group was treated with epirubicin 50 mg/m2 on 1 d ,cisplatin 20 mg/m2 on 1-3 d and fluorouracil 500 mg/m2 on 1-5 d .The DOF group was treated with docetaxel 75 mg/m2 on 1 d ,oxaliplatin 130 mg/m2 and fluorouracil 500 mg/m2 on 1-5 d . 21 d were as a cycle of treatment .All cases received two cycles of chemotherapy at least .The efficacy and toxicity were evaluated according to the WHO standard .Results All cases were evaluable for the objective response .The overall response rate was 46 .67% in the ECF group and 42 .11% in the DOF group .The major adverse reactions in the two groups were marrow depression , gastrointestinal reaction ,alopecia and neurotoxicity ,etc .The occurrence rate of neurotoxicity in the DOX group was 39 .47% (26/38) ,which was higher than 13 .33(4/30) in the ECF group ,the occurrence rate of nausea and vomiting in the ECF group was 93 .33% (28/30) ,which was higher than 68 .24(26/38) in the DOF group ,the difference between the two groups was statistically significant (P<0 .05) .Conclusion Both of the two regimens have the similar effect for treating advanced gastric cancer and the ad‐verse reactions are tolerable .

OBJECTIVE To study the prevention strategy of community-acquired pneumonia(CAP) for retired old cadres of PLA.METHODS We adopted the first and second prevention strategy of disease to deduce the frequency for CAP.RESULTS The old cadres were divided into common prevention group and important prevention group by evaluating their body condition.The common prevention group was taken the first prevention strategy:healthy education,inhabit surroundings improvement and proper exercises.The second prevention was carried out to personnel who have chronic disease of respiratory organs which included eliminating the risk factors and making efforts to find, diagnose and treat infection as early as possible.CONCLUSIONS The first and second prevention is an effective working mode which improves the level of CAP prevention.

[ABSTRACT]OBJECTIVETo investigate the efficacy and the related complications of combinedpostauricular methylprednisolone injection and systemic therapy for profound idiopathic sudden hearing loss (ISSNHL). METHODSTotal of 60 patients with ISSNHLwho had received therapy from June 2014 to May 2015 in Beijing Anzhen Hospital affiliated to Capital University of Medical Science,were randomly divided into 2 groups,the systemic application group (30 patients): dexamethasone (DEX) was applied intravenously in dose of 10 mg×5 d, and the postauricular injection group (30 patients): methylprednisolone sodium suecinate was injected subperiosteally near the upper one-thirds of postauricular sulcus every day, 40 mg×5 d.All 60 patients received the same medications for 2 weeks to improve the hearing. Hearing and tympanic membrane were monitered before the injections and two weeks after the termination of injections. SPSS 16.0 software was used to analyze the data.RESULTSThe postauricular injection group: 23 of 30 ears had improvement of hearing. No related complications were reported. The systemic application group: 23 of 31 ears had improvement of hearing (P>0.05) No related complications were reported.CONCLUSIONCombined postauricular methylprednisolone injection and systemic medications therapy can be considered as is an effective therapy for profound idiopathic sudden hearing loss. It can avoid the side-effects of high dose systemic corticostemid treatment. For ISSNHL patients, postauricular methylprednisolone injection may be an appropriate treatment.

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 clinical features of anuria caused by pediatric congenital bilateral ureteral stenotic obstruction,and to improve the diagnosis and treatment of the disease.Methods This series included 7 infants(2 males and 5 females;age range,35-57 d) with congenital bilateral ureteral stenotic obstruction.The clinical presentations were characterized by sudden anuria or oliguria.B-ultrasound,cystography and puncture pyelography were performed in all of them,and magnetic resonance urography(MRU) in 3.Based on the definite diagnosis,resection of stenotic segment of the ureter or ureteral implantation was performed on them.Results The diagnosis was confirmed by puncture pyelography in all of the 7 cases.Six cases underwent phase I surgery and recovered.No ureteral stenosis and cystoureteral reflux occurred during a follow-up of 2-4 years.The renal function was normalized in them.One case had stenosis recurrence due to scar formation,and was cured by the second operation.Conclusions Anuria caused by pediatric congenital bilateral ureteral stenosis should be diagnosed and treated as early as possible.Definite diagnosis can be established by puncture pyelography and MRU.Resection of the obstructive segment of the ureter,protection of renal function,and ureteral implantation are the main therapies.

Objective To evaluate the visual function before and after photodynamic therapy(PDT) in patients with subfoveal choroidal neovascularization (CNV) caused by age-related macular degeneration (AMD). Methods Twenty-five consecutive patients (34 eyes) treated with PDT (verteporfin) for subfoveal CNV in age-related macular degeneration diagnosed by fluorescein angiography (FFA), indocyanine green angiography (ICGA) and optical coherence tomography (OCT). Visual function including best corrected visual acuity, contrast sensitivity frequency, binocular function, confusion, stereo-vision, color vision, metamorphopsis and central scotoma were examed before photodynamic therapy and 1 week, 1 month, 3 month after photodynamic therapy. The follow-up time varied from 3 months to 2 years (mean 7.6 months). Results The changes of visual function at the 3rd month after photodynamic therapy revealed improving in 13 eyes (38.24%), without any change in 17 eyes (50.00%), and decreasing in 6 eyes (17.65%). Visual acuity with logMRA improved after photodynamic therapy, but without statistic difference. All spatial contrast sensitivity improved. Contrast sensitivity for spatial frequencies 5 cycles per degree (cpd) was better after photodynamic therapy with significant difference (P=0.045).Binocular function, fusion function, stereo function and color vision were slightly improved without statistic difference. Conclusion Damage of visual function in macular degeneration is many-sided. The treatment of PDT for exudative AMD can improve part visual function.

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.

Objective The purpose of this study is to investigate the surgical procedures and curative effect through a small incision on both sides of the scapula for surgical resection the ribs tumor which located un -der ventral surface of the scapula .Methods The group included 11 patients,6 males and 5 females,aged 18 to 49 years.Lesions were bilateral scapula deep square 2~4 single rib bone tumors .Among them there were five ca-ses of fibrous dysplasia ,case of bone cyst ,2 cases of plasma cell tumors and metastatic tumors in 3 cases.Surgery incision through cross-scapular ,to determine which lesions ribs ,cutting the lesions on both sides of the stripping and junction.Results The group obtained a satisfactory excision extension ,one case appeared hemopneumotho-rax postoperatively.Secondly,none of patients occured local recurrence .Thirdly,two patients with metastatic carci-noma died after one year because of multiple metastases .Conclusion Straddling scapular notch is the ideal way to cut off the rib tumor of ventral surface of the scapula .Possessing advantages of a little damage and effect on the function,and rapid recovery .