The mammalian TOR ( mTOR ) pathway is a key regulator of cell growth and proliferation which is also a fundamentally important player in a large variety of human diseases. The pathway regulates many key cellular processes and is implicated in a large number of pathological conditions, including cancer, obesity, diabetes, and cardiovascular disease, age - related diseases and other proliferative disease. It integrates signals from nutrients, energy status and growth factors to regulate many processes, including autophagy, ribosome biogenesis and metabolism. Our article reviews the advancement of laboratory results on mTOR pathway in proliferative diseases in ophthalmology.

Objective To analyze the distribution and influential factors of exam results in medical students' general surgery theory course.Methods 171 medical students were selected as subjects by cluster sampling,and the distribution and influential factors of exam results were analyzed.SPSS 17.0 software was used for statistical analysis,measurement data with (-x) ± s,and normality test with Kolmogorov-Smirnov test.Those quantitative data which do not meet the normal distribution were compared with Mann-Whitney U and Kruskal-Wallis H test.Rank transformation univariate multi-factor variance of LSD (Levene test equal error variance between groups) or Tamhane method (Levene test range error variance between groups) were compared between two groups(3-4) and the influence factors of whether the grade was good was analyzed by single factor and multi factor non conditional Logistic regression model,with the test level of alpha=0.05.Results The distribution of total exam results was normal.77 score was outlier,and the scores of female students were higher than those of male students.Scores of total exam results,multiple-choice questions and essay questions in different classes were significantly different.Data from multivariate logistic regression analysis showed that male students(OR=0.212,95％CI:0.077-0.584) were unfavorable factor for good exam results,while higher scores in noun explanation (OR=12.160,95％CI:1.985-74.495),multiple-choice questions (OR=9.887,95％CI:2.997-32.617),essay questions(OR=18.323,95％CI:6.593-50.928) were favorable factors.Conclusion The cause analysis of score's outlier and sex difference should be strengthened,and the influence of examination items on score should be emphasized.

To observe Antiarrhythmic effects of L-dicentrine．Methods using experimented model of arrhythmials．Results: L-dicentrine iv l0 mg/kg could convert BacRinduccd arrhythmia into sinus rhythm in rats,and could significantly increase the tolerant dose of aconine to produce Ventricular fibrillation (VF) and Cardiac ［rrest (ca) in rats． The drug could also decrease the incidence of VF and CP by cardiac rats and by chloroform in mice． L-dicelltrine had protective effects on ouabain ind uced　Arrhythmias in guined pigs and on adrenalice induced arrhythmias in rabbit s ． The drug might also inhibit the arrhymias induced by stimulation ofhypothaplu s． Conclusion: L-dicenirine have significant antiarrhythmic properties．

Objective To assess the clinical significance of three-dimensional speckle tracking imaging (3D-STI) in the evaluation of left ventricular myocardial function in breast cancer survivors with postoperative anthracycline-based chemotherapy.Methods A total of 51 breast cancer survivors with postoperative anthracycline-based chemotherapy were recruited and 31 female healthy volunteers as the controls.Conventional echocardiography and 3D-STI derived parameters [including global longitudinal strain (GLS) and global area strain (GAS)] were measured before and at 3 and 6 anthracycline-based chemotherapeutic cycles.The receiver operating characteristics (ROC) curve was constructed to determine optimal sensitivity and specificity of 3ID-STI derived parameters for the prediction of future cardiotoxicity.Results In comparison with the controls and baseline cases,GLS and GAS deteriorated significantly (P ＜ 0.05 for both).No statistical difference in GCS and conventional parameters showed before and after the initiation of chemotherapy (P ＜0.05,respectively).The ROC curves showed that GAS as the best 3D-STI predictor of patients who develop cardiotoxicity during the follow-up.The area under ROC(AUC) of GAS was 0.894,and its optimal cut-off value was-28.4％,with a specificity of 88.0％ and a sensitivity of 82.9％.AUC of GLS was 0.802,and its optimal cut-off value was-14.3％,with a specificity of 62.0％ and a sensitivity of 85.4％.Conclusions Early decreases in GAS and GLS based on 3D-STI may allow the prediction of subsequent cardiotoxic development accurately in breast cancer survivors with postoperative anthracycline-based chemotherapy.

To study the chemical constituents of Dipsacus asper, chromatographic methods such as D101 macroporous resin, silica gel, octadecylsilyl (ODS) column chromatographic techniques and preparative HPLC were used, and five compounds were isolated from 70% (v/v) ethanol extract of the plant. By using spectroscopic techniques including 1H NMR, 13C NMR, 1H-1H COSY, HSQC, HMBC and TOF-MS, the compounds were identified as 3beta-hydroxy-24-nor-urs-4 (23), 12-dien-28-oic acid (1), ursolic acid (2), oleanolic acid (3), 3-O-alpha-L-rhamnosyl(1 --> 3)-beta-D-glucopyranosyl (1 --> 3)-alpha-L-rhamnosyl (1 --> 2)-alpha-L-arabinopyranosyl hederagenin 28-O-beta-D-glucopyranosyl (1 --> 6)-beta-D-glucopyranosyl ester (4), 3-O-[beta-D-xylopyranosyl (1 --> 4)-beta-D-glucopyranosyl (1 --> 4)] [alpha-L-rhamnosyl(1 --> 3)]-beta-D-glucopyranosyl (1 --> 3)-alpha-L-rhamnosyl(1 --> 2)-alpha-L-arabinopyranosyl hederagenin (5), separately. Among them, 1 is a new compound, and 2 is isolated from this plant for the first time.

Objective:To understand the related factors of tic disorders(TD) and early intervention among schoolchildren.Methods:Using stratified-cluster random sampling techniques,4,020 children were selected from 61,836 schoolchildren in Daxing district of Beijing.Totally 4,020 children and their parents were asked to fill in a self-designed questionnaire covering both motor and vocal tics and general information.A three-stage procedure was used:screening,interview and clinical investigation.A total of 3,813 children were investigated successfully.The children who were reported with tic symptoms as well as those who were reported by their teachers or classmates were surveyed according to the TD criteria in Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition(DSM-Ⅳ).Eighty-six TD children were investigated respectively about the related factors of TD,and 86 healthy children matched in age,sex and grade were selected as controls.Telephone interview was carried out to find the doubtful TD cases in family members.Those people identified as having tics underwent a semistructured interview to determine whether they had TD according to DSM-Ⅳ criteria.Related risk factors of TD were investigated according to self-designed formulary medical history sheet. Results:Positive TD inheritance family history(7.0%),abdominal delivery style(36.0%),carbonate drink(10.5%),obesity(14.0%) and psychological stress were risk factors of TD(P<0.05).The multivariate analysis of variance indicated that inheritance family history,delivery style,dwelling environment,carbonate drink,parent-child relation,hobby,underachieve,self-care ability were closely related to the high incidence of TD (P<0.05).Conclusion:The occurrence of tic disorders may be related to multiple interacted factors.Early intervention is most important.

Objective To summarize the appearances of MS lesions on DWI, and to quantitatively study the ADC and AI values in different clinical MS subgroups Methods One hundred and eighty seven lesions were studied in 18 cases of MS at different clinical stages Routine MR and DWI were performed in all cases ADC and AI were calculated in the lesions,NAWM, and normal control group Results Hyperintensity (edema like on T 2WI) was demonstrated on DWI at acute primary progressive MS lesions Hyperintense ring sign was found at acute relapse MS lesions ADC increased in all subgroups of MS Significant difference of ADC was demonstrated among MS lesions, NAWM, and normal control groups Significant decrease of AI was demonstrated at later stages Hyperintensity was found in all MS lesions on T 2WI The hyperintensity lesions on DWI had enhanced or non enhanced appearances on CE T 1WI The ADC value of enhanced MS lesions was less than that of the non enhanced lesions ( t =4 19, P 0 05) Conclusion DWI could give quantitative information for different pathological changes in MS lesions of different clinical subgroups Quantitative measurement of diffusion has great potential value in the diagnosis, differential diagnosis, and the prediction of prognosis in MS

·AlM:To evaluate the visual and anatomic outcomes of intravitreal ranibizu mab injections for myopic choroidal neovascular ization ( mCNV) in Chinese patient s.
·METHOD S: This study is ar etrospective case.Thri ty-five p atients treated for mC NV were included in this study.Their eyes were treated with a single intravitreal injection of 0.5 mg ranibizumab following a pro re nata ( PRN) regimen indicated by persistent or recurrent CNV. Best correc te d visual acuity ( BCVA ) , CNV findings on fundus fluorescen t angio graphy ( FFA ) , central retinal thickness ( CRT ) on optical coherence tomography ( OCT ) , total number of treatments, and complications were evaluated.
· RESULTS:The mean follow-up duration was 20mo (range 16-24mo).Twenty-eight patients (80%) were followed up for more 22mo.The mean baseline BCVA was 0.74 logarithm of the minimum angle of resolution (logMAR) [standard deviation (SD) 0.23] and improved significantly to 0.49 logMAR ( SD 0.31 ) ( P<0.001, Wilcoxon signed-rank test) after treatment.At the final months of follow-up, 21 of the 35 eyes (60%) showed an improvement of 2 lines or more in BCVA, 13 eyes ( 37%) remained unchanged, and 1 ey e (3%) had a deterioration of 2 lines or more.Mean CRT decreased from 297 μm ( SD , 72 ) at baseil ne to 228 μm ( SD, 61 ) at the final follow-up (P<0.001, paired t-t est). During follow-up, the mean number of repeat injections was 3.2 ( SD, 0.94;range, 1-7 injections).No drug-related complications were observed after treatment.
· CONCLUSlON:The long-term outcomes observed in this study suggest that intravitreal ranibizumab is safe and effective for treating mCNV.

Objective To study the effects of Poly(I:C) on lung adenocarcinoma A549 cells viability and illuminate the mechanism of Poly (I:C)-induced apoptosis in A549 cells.Methods A549 cells were transfected with the complex of Poly(I:C) and lipofectamine 3000.The viability of A549 cells was tested by methyl thiazolyl tetrazolium (MTF) method.The apoptotic cells were tested by flow cytometry.The caspase proteins were tested by Western blotting and the expressions of interferon-β (IFN-β) and CXCL-10 were assayed by real-time PCR.After employing the pan-caspase inhibitor Z-VAD-FMK and caspase-8 inhibitor Z-IETD-FMK,the variation of Poly (I:C) proapoptosis in A549 cells was observed.RNA interfering experiments were employed to knock down melanoma differentiation related antigen 5 (MDA5) or retinoic acidinduced gene Ⅰ (RIG-Ⅰ),and the above indexes were tested.Results The viability of A549 cells was significantly reduced to 74.92％ ±--6.24％ after 200 ng/ml Poly (I:C) transfection compared with that before transfection (95.32％ ± 3.05％,t =2.883,P =0.041).The apoptotic rates induced by 100,200,400 ng/ml Poly(I:C) were 9.97％-± 0.88％,23.63％-± 1.41％,32.57％-± 2.39％,respectively.All of them were higher than that in the control group (0.74％-± 0.15％),with significant differences (t =4.489,P =0.002;t =11.616,P =0.000;t =16.932,P =0.000).Besides,the death receptor pathway proteins such as TNF-related apoptosis inducing ligand (TRAIL),cleaved-caspase-8 and cleaved-caspase-3 increased obviously.MDA5/RIG-Ⅰ pathway was also activated dramatically and the expressions of IFN-β,CXCL-10 were significantly up-regulated.The apoptotic rates reduced to 3.17％ ± 0.66％,5.35％ ± 0.64％ with pancaspase inhibitor Z-VAD-FMK and caspase-8 inhibitor Z-IETD-FMK pretreatment,compared with the control group (15.87％ ±0.93％),and the differences were statistically significant (t =8.643,P =0.001;t =6.824,P =0.002).Moreover,the expressions of TRAIL,IFN-β and CXCL-10 induced by Poly (I:C) were inhibited with MDA5 or RIG-Ⅰ depletion.Conclusion Poly(I:C) can reduce the survival rate of A549 cells and promote the apoptosis mainly by activating the death-receptor pathway mediated by MDA5/RIG-Ⅰ probably,which may involve in IFN-β,CXCL-10.

Objective Seven triterpenes were isolated from the methanol extract of the roots of Rosa laevifgata. Methods The compounds were isolated and purified by a combination of various chromatographic approaches, including silica gel, Sephadex LH-20, semipreparative HPLC and so on. Their structures were identified on the basis of pfysicochemiscal and spedtroscopic analysis. The in vitro anti-inflammatory activity test was investjgated. Results On the basis of spectroscopic data analysis, their structures were identified as 18,19-seco-2α,3β,23α-trihydoxyl-19-oxo-urs-11,13(18)-dien-28-oic acid (1), (2R,19R)-methyl 2-acetyloxy-19-hydroxyl-3-oxo-urs-12-en-28- oic acid (2), pomonic acid (3), cecropiacic acid 3-methyl ester (4), 2-acetyl tormentic acid (5), pomolic acid (6), and 2α,3α-dihydroxyurs-12,18-dien-28-oic acid (7). Conclusion Among them, compound 1 named as rosasecotriterpene A is a new triterpene. The anti-inflammatory activities of compounds 1—7 are tested in vitro. The results show that all the isolated compounds have obvious inhibitory effects on the release of NO from RAW264.7 cells induced by LPS. The inhibitory effects of compounds 1 and 7 are more significant, showing good anti-inflammatory activity in vitro.