OBJECTIVE:To investigate the utilization of microbioecologics in outpatient department of pediatrics of our hospital.METHODS:Prescriptions were randomly collected from outpatient department of pediatrics of our hospital in Dec.2009 to analyze the utilization of microbioecologics.RESULTS:Of total 8 858 prescriptions,microbioecologics were used in 486 cases,accounting for 5.48%;bifidobacterium combined with lactobacillus,enterococcus and bacillus cereus tablets(live) accounted for 59.26%.Microbioecologics combined with antibiotics accounted for 8.49% but the combination of tow kinds of microbioecologics hadn't been found.CONCLUSIONS:The utilization of microbioecologics is rational in outpatient department of pediatrics of our hospital on the whole.

Objective:To investigate the rat retinal DNA damage induced by acute hypobaric hypoxia and the protective effect of Radix Astragali seu Hedysari compound on it. Methods:Seventy-two healthy clean grade male Sprague Dawley (SD) rats were randomly divided into normal oxygen control group, hypoxic model group and Radix Astragali seu Hedysari compound gavage group by computer random number distribution, with 24 rats in each group.The rats in the normal oxygen control group were fed in normal condition, while the rats in the hypoxic model group and Radix Astragali seu Hedysari compound gavage group were fed in a hypobaric oxygen chamber, which simulated an altitude of 5 kilometers, and the rats were administered intragastrically with Radix Astragali seu Hedysari compound (0.1 g/kg) or the same volume of normal saline once a day according to grouping.Retinal tissue was obtained on the 7th day of continuous administration of drugs after the rats were sacrificed by euthanasia.Histopathological staining was performed to observe the pathological morphology of retina in each group.Immunohistochemistry was used to identify the expressions of p53 and histone family 2A variant ( γH2AX). Real time-PCR was used to determine the relative expression levels of 8-oxoguanine nucleoside triphosphatase (MTH1) and 8-hydroxyguanine glycolsylase (OGG1) mRNA.The use and care of the animals followed Regulations of the Administration of Affair Concerning Experimental Animals by State Science and Technology Commission. Results:The retina of hypoxic model group was thicker than that of the normal oxygen control group and Radix Astragali seu Hedysari compound gavage group, especially the nerve fiber layer and the ganglion cell layer.The positive staining intensities of p53 and γH2AX were stronger in the retinas of the hypoxic model group than those in the the normal oxygen control group and Radix Astragali seu Hedysari compound gavage group.The relative expression levels of MTH1 and OGG1 mRNA in the hypoxic model group were 0.573±0.081 and 0.772±0.136, which were significantly lower than 0.846±0.160 and 1.013±0.168 in the normal oxygen control group, respectively (both at P<0.05). The relative expression level of MTH1 mRNA was 0.748±0.114 in the Radix Astragali seu Hedysari compound gavage group, significantly higher than that in the hypoxic model group ( P<0.05). No significant difference was detected in OGG1 mRNA expression level between the Radix Astragali seu Hedysari compound gavage group and the hypoxic model group ( P=0.743). Conclusions:The intervention of Radix Astragali seu Hedysari compound plays a protective role in hypobaric hypoxia-induced retinal DNA damage through modulating the expression of p53, γH2AX, OGG1 and MTH1.

This study was aimed to evaluate the efficacy and safety of acupuncture treatment for diabetic peripheral neuropathy.MEDLINE, EMBASE, China National Knowledge Infrastructure (CNKI), and Wanfang database were searched. The study endpoints included clinical total efficacy, peripheral nerve conduction velocity and adverse reactions. The Review Manager software 5.2 was used in the bias and risk assessment as well as efficacy. GRADE profiler software was used to evaluate quality of evidences. The results showed that there were 18 randomized controlled trials (RCTs) with 1158 patients included. The clinical total efficacy rate of acupuncture treatment was obviously better than the drug control group [RR: 1.38, 95%CI (1.25, 1.53),P < 0.000 01]. The sensory nerve conduction velocity was that for nervus medianus, the acupuncture treatment group was superior to the drug control group [MD = 2.55, 95%CI (1.23, 3.87),P = 0.000 1]; for nervus peroneus communis, the acupuncture treatment group was superior to the drug control group [MD = 3.42, 95%CI (2.56, 4.28),P < 0.000 01]. The motor nerve conduction velocity was that for nervus medianus, the acupuncture treatment group was superior to the drug control group [MD= 4.10, 95%CI (1.01, 7.19),P = 0.009); for the nervus peroneus, the acupuncture treatment group was superior tothe drug control group [MD = 3.09, 95%CI (1.99, 4.19),P < 0.000 01]. The adverse reactions and safety indicators were that no adverse reaction was reported in both studies with no abnormal safety indicator. The quality of evidence showed that the sensory nerve conduction velocity for nervus peroneus communis was moderate; the motor nerve conduction velocities for nervus medianus and nervus peroneus communis were low. While, the clinical efficacy rate and the quality of evidence for sensory nerve conduction velocity of nervus medianus were relatively low. It was concluded that the current clinical evidences were uncertain for the efficacy and safety of acupuncture in diabetic peripheral neuropathy treatment.

Purpose To detect the expression of FOXO3 in lung cancer specimens and lung cancer stem cell, for diagnosis and treat-ment of lung cancer. Methods Immunohistochemistry, semi-quantitative PCR and Western blot were used to detect FOXO3 protein expression in clinical specimens of lung cancer. PCR and Western blot verified FOXO3 mRNA and protein expression of lung cancer cells. Results Immunohistochemistry showed that the FOXO3 was significantly lower expressed in lung cancer tissues and the corre-sponding lung cancer stem cells;Detection of FOXO3 mRNA and protein by RT-PCR and Western blot showed both had significantly lower expression;as progression of the disease, there was a clear decreasing trend, in which negative expression rate of FOXO3 protein accounted for 66. 7% in all patients;at the same times, the rate of the expression gradually decreased with loss of differentiation and metastasis of the tumor. Conclusions FOXO3 shows low expression in lung tissue and lung cancer stem cells, while it is closely relat-ed to the degree of malignancy and lung cancer metastasis, which may be a new target for the treatment.

Objective To evaluate the long-term results of vitreoretinal surgery without use of intraocular silicone oil or gas in patients with diabetic tractional retinal detachment (DTRD).Methods The clinical interventional case series study included 104 patients (112 eyes) with DTRD,who were consecutively treated by pars plana vitrectomy without use of intraocular silicone oil or gas.Among the eyes,there were 6 eyes with iris neovascularization (INV),1 eye with neovascular glaucoma (NVG) and 50 eyes with macular retinal detachment.There were no pre-existing retinal holes or breaks prior to surgery nor any iatrogenie retinal breaks developed during vitrectomy.Cataract removal combined with intraoeular lens implant surgeries were performed on 15 eyes.Follow-up duration varied from 12 to 65 months (mean: 29 months).Results Subretinal fluid was completely absorbed within 2 months after surgery.In 107 eyes (95.54%),the retina reattached after surgery and remained attached till the end of follow-up period.Best corrected visual acuity (BCVA) improved in 79 eyes (70.53%),remained unchanged in 14 eyes (12.500%) and got worse in 19 eyes (16.79%).The BCVA improving rate was lower in the macular detached group (33 eyes/50 eyes,66.00% Vs 46 eyes/62 eyes,74.19%,χ2=0.89,P=0.344).No obviously aggravated opacity of lens was observed after vitreoretinal surgeries in the eyes without cataract surgeries.Seven (6.25%) eyes showed INV (5 new onset eyes),and none of them developed into NVG.In multivariate logistic regression,factors associated with postoperative rubeosis iridis were pre-existing rubeosis iridis I-adjusted odds ratio (OR)= 10.2],low preoperative BCVA (OR= 11.1) and low postoperative BCVA (OR = 16.7).Conclusions Vitreoretinal surgery for DTRD may not necessarily be combined with silicone oil or gas tamponade if there are no preoperative or intraoperative retinal breaks,and only using irrigation fluid could access a good long-term prognosis result.

ObjectiveTo evaluate and compare the prognosis of idiopathic macular holes (IMH) and traumatic macular holes (TMH) treated by pars plana vitrectomy (PPV). Methods The clinical data of 72 IMH eyes and 55 TMH eyes, which were treated by PPV between November 2001 and December 2007,were retrospectively reviewed. The visual outcomes and macular anatomic closure were evaluated, and their relationships with prognostic factors including the size of macular hole (MH), preoperative visual acuity (VA) and duration of disease were analyzed. Results The closure rate of IMH (100. 0%) was significant higher than that of TMH (85.5%) (P=0. 001). The postoperative VA of IMH and TMH were (0. 25±0.02) and (0. 21±0. 21) respectively, both significantly increased compare to their preoperative VA (t=-6. 841, -4. 093; P=0.000). VA-increased IMH and TMH eyes had same VA (χ2=3. 651, P=0.07).Pre-PPV VA≥0. 1 IMH eyes had better outcomes than Pre-PPV VA＜0. 1 IMH eyes (χ2 = 12.04, P=0. 001), while Pre-PPV VA had no effects on TMH outcomes (χ2=0. 371, P=0. 486). IMH eyes with small holes had better outcomes (t=2. 476, P=0. 016), and TMH eyes with small holes had better closure (t= -4. 042, P＜0. 001). The duration of disease had no significant influence on TMH visual (χ2=0. 704,P = 0. 401 ) and anatomic (χ2 = 0. 166, P= 0. 684) outcomes. Conclusions PPV is an effective treatment for MH. The closure rate of IMH is higher than that of TMH. The diameter of MH and preoperative VA are major factors for IMH outcomes, and the duration of disease and preoperative VA have no effects on postoperative VA in TMH.

Objective To observe the change of diffusion upper limit of macromolecules through pathological retina and the difference between the layers of retina. Methods Retinal edema was emulated by establishing branch retinal vein occlusion(RVO)model in miniature pig eyes under photodynamic method.Two days later,the retinas of both eyeballs were peeled off.The diffusion test apparatus was designed by ourselves.FITC-dextrans of various molecular weights(4.4,9.3,19.6,38.9,71.2 and 150 kDa)and Carboxyfluorescein(376 Da)were dissolved in RPMI-1640 solutions and diffused through inner or outer surface of retina.The rate of transretinal diffusion was determined with a spectrophotometer.Theoretical maximum size of molecule(MSM)was calculated by extrapolating the trend-linear relationship with the diffusion rate.In separate experiments to determine the sites of barrier tO diffusion,FITC-dextrans were applied to either the inner or outer retinal surface,processed as frozen sections.and viewed with a fluorescence microscope. Results FITC-dextrans applying tO inner retinal surface,4.4 kDa dextrans were largely blocked by inner nuclear layer(INL);19.6-71.2 kDa dextrans were blocked by the nerve fiber layer(NFL)and inner plexiform layer;150 kDa dextrans were blocked by NFL.FITC-dextrans applying to outer retinal surface,most dextrans with various molecular weights were blocked before outer nuclear layer(ONL).No matter applying to the inner or outer surface,Carboxyfluorescein can diffuse through the whole retina and aggregate at INL and ONL.After RVO,the inner part of retina became edema and cystoid,loosing the barrier function.Compared with the normal retina,the MSM in RVO tissues increased(6.5±0.39nm Vs 6.18±0.54nm,t=4.143,P=0.0001). Conclusions After RVO,the barrier function of inner part of retinal is destroyed and the upper limit of diffusion macromolecule size increased.which is nevertheless limited.ONL acts as bottle-neck barriers to diffusion,if the outer part of retina is damaged,the change of the diffusion upper limit will be prominent.

Objective To observe and classify the characteristics of optical coherence tomography (OCT) for several common diseases which could lead to submacular choroidal neovascularization (CNV), and to provide the warrant to make the differential diagnosis and treatment of CNV. Methods The data of OCT of 165 patients (187 eyes) with CNV due to AMD, CEC, high myopia and ICNV diagnosed by fundus photography and fundus fluorescein angiography (FFA) were retrospectively analyzed, and the images of OCT were classified considering the results of FFA, and the characteristics of different types of the images were sumerized. Results Well-defined fusiform thickening of retinal pigment epithelial (RPE) and choriocapillary layer in CNV with well-defined border (60 eyes), dispersed backscattering increase in poorly-defined CNV (101 eyes), optic darkspace beneath RPE layer in serous detachment of RPE layer (19 eyes), quickly decreased high backscattering region under RPE layer in hemorrhagic detachment of RPE layer (11 eyes), slight to moderate backscattering region between RPE layer in fibrovascular detachment of RPE layer (10 eyes), and detachment of neurepithelial layer from RPE layer with the optic darkspace between the layers in detachment of neurepithelial layer (45 eyes) were observed. Conclusions The images of OCT for the common diseases which could lead to submacular choroidal neovascularization may be divided into 6 types. Analyzing the characteristics of images of OCT is helpful in differential diagnosis and treatment of CNV.

Objective To investigate the effect of triamcinolone acetonide (TA) with different dosage and excipient on retina. Methods Thirty-two purebred New Zealand white rabbits randomly divided into 4 groups underwent intravitreous injection with TA. Group 1:4 mg TA without excipient; group 2:25 mg TA without excipient; group 3:4 mg TA with excipient; group 4:25 mg TA with excipient. Electroretinography (ERG) was performed on each rabbit before intravitreal injection, 1 week, 1 and 2 months after the injection. All the animals were killed and the eyeballs were extirpated 2 months after the injection, and pathological examinations including light and electron microscopy were performed. Results No significant difference was found in the latent period of ERG at the points of time before and after the injection in all the groups, but the amplitudes of ERG waves was lower in groups containing excipient than that before the treatment (P

Objective To evaluate the therapeutic effects of treatments of eye-retaining and enucleation for choroidal melanomas. Methods The clinical data of 44 patients (44 eyes) with choroidal melanomas after eye-retaining treatments and enucleation surgery were retrospectively analyzed. The metastasis, retention rate of eyeball after eye-retaining treatment, and visual acuity prognosis were observed and analyzed. In 44 eyes treated by eye-retaining therapy, transpupillary thermotherapy (TTT) was performed primaryly on 7 (15.9%),~ 106 Ru brachytherapy on 25 (56.8%), and local resection of tumor combined with ~ 106 Ru brachytherapy on 12 (27.3%).The average follow-up period was 13.3 months. Results Forty-four patients had no melanoma metastasis during the follow-up period. In 39 patients (88.6%) who had their eyes retained successfully, the retention rate of eyeball was 100%, 92.9%, and 83.3% in 6, 14, and 24 eyes with small, middle, and large tumor, respectively. In the patients treated by eye-retaining therapy, the visual acuity was ≥0.3 in 11 (28.2%), ≥0.05-