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 the therapeutic effects of transcutaneous electric acupoint stimulation on early-stage adhesive shoulder periarthritis. Methods:by using the research approach of evidence-based medicine such as multi-center,large sample and randomization,the 163 cases of early-stage adhesive shoulder periarthritis were treated with transcutaneous electric point stimulation and electric acupuncture respectively to observe the therapeutic effect of transcutaneous electric acupoint stimulation and compare its effect with electric acupuncture.Results and Conclusion:The total effective rate of transcutaneous electric point stimulation on early-stage adhesive shoulder periarthritis reached 96.5%,showing no significant difference with the electric acupuncture group;the transcutaneous electric acupoint stimulation could not only relieve pain,but also improve the shoulder joint movement. As a result,the transcutaneous electric acupoint stimulation is an easy and more effective therapy for shoulder periarthritis.

This paper focuses mainly on the study of optimal fermentation conditions of S-adenosyl-L-methionine.Effects of carbon sources,nitrogen sources,inorganic constituents,growth factors and adding time of L-methionine on the yield,the content and biomass of S-adenosyl-L-methionine are studied.And ingredients of the culture medium are also optimized by the method of uniform design.The final optimum culture medium contains: glucose 30 g,Yeast powder 11 g,(NH_4)_2SO_4 12 g,K_2HPO_4?3H_2O 5 g,KH_2PO_4 10 g,MnSO_4?H_2O 0.09 g,ZnSO_4?7H_2O 0.14 g,MgCl_20.5 g,CaCl_2 0.3 g,CuSO_4 0.005 g per liter. Using that optimum culture medium,the yield of S-adenosyl-L-methionine can reach 0.9 g/L in Erlenmeyer flask which is 30 % higher than before.Experiment on 5 L fermenter reveals that the accumulation of S-adenosyl-L-methionine can reach 2.66 g/L.Biomass is 23.4 g/L.

Objective To study surface heparinization of small intestinal submucosa(SIS)and an- tithrombegenicity of beparinized SIS films with plasma initiation technique for the engineering vascular scaffolds. Methods The SIS films were grafted with heparin by hypothermia plasma initiation technique.The blood com- patibility of the modified SIS films was assessed by observing blood coagulation time in vitro and the long term pa- tency of hepafinized SIS vascular scaffolds directly under the circulation of blood.Results The hypothermia plasma initiation method could attach heparin onto the SIS surface,The water contact angle of SIS films modified with heparin was decreased while the surface free energy and hydrophilicity increased.The prothrombin time(PT),ac- tivated partial thromboplastin time(APTT)and thrombin clotting Time(TT)of the SIS films modified with heparin were prolonged obviously.Small caliber engineering vascular scaffold made of heparinized SIS films kept the patency for six weeks.Conclusion Heparin can be attached to SIS films by hypothermia plasma initiation technique.The modified surfaces provide good and persistent antithrombogenicity,and possess potent blood compatibility,

·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 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.