Objective To observe the preliminary clinical results and safety of 27-gauge microincision vitrectomy surgery for partial vitreoretinal diseases.Methods A total of 13 patients (13 eyes) who underwent 27-gauge microincision vitrectomy surgery were enrolled.The follow-up period was 6 to 12 months.Preoperative and postoperative visual acuity and intraocular,total operative time,cutting time for removing vitreous,wound healing status,intraoperative and postoperative complications were observed.Results Mean best corrected visual acuity improved from preoperative (1.26±0.66) logMAR (0.10±0.09) to postoperative (0.63±0.52) logMAR (0.35±0.24),and the difference was statistically significant (t=2.743,P=0.018).The difference of mean preoperative intraocular pressure (IOP),IOP of postoperative day 1,day 5,one month and final postoperative visit were not statistically significant (F=0.593,P＞0.05).The mean total operative and cutting times were (36.38±14.97) min and (10.12±3.54) min respectively.Postoperative scleral incision showed linear closure,no cases of postoperative sclerotomyrelated complications such as wound dehiscence,vitreous incarceration and subcoujunctival fluid were observed.No intraoperative and postoperative complications of iatrogenic retinal breaks,endophthalmitis,choroidal detachment,retinal detachment and vitrous hemorrhage were observed.Conclusions The 27-gauge microincision vitrectomy surgery can improve postoperative visual acuity for treatment of vitreoretinal diseases and induce fewer sclerotomyrelated complications,which maybe a safer surgical approach.

Objective To study the effect of dual stress on the behaviors and the expression of hippocampal let-7a and serotonin receptor 4(HTR4) in rats.Methods Newborn SD rats were randomly divided into dual stress group (DS,n=6) and control group (C,n=6).The DS rats were deprived of the mother care 6 hours per day from postnatal day 1 to 14 and then were exposed to chronic mild stress for 21 days from 10 weeks old,while the rats from C group received no experimental handle but husbandry care.Open field test,forced swimmiug test and sucrose consumption test were conducted to evaluate rats' depression-like behaviors at the age of thirteen weeks.The let-7a level in hippocampus was detected by real-time Polymerase Chain Reaction and the HTR4 protein level was measured by Western Blotting.Results In the open filed test,the rearing times of DS rats was shorter than that of C group((7.50±2.35) vs (19.00±5.73),P＜0.05).In the forced swimming test,the floating time of DS rats was longer than that of C group ((110.17 ± 1.72)s vs (70.33± 1.16)s,P＜ 0.05).In the sucrose c onsumption test,DS rats consumed less sucrose than rats from C group did((0.80±0.73) vs (0.52±0.26),P＜ 0.05).The protein level of hippocampal HTR-4 in DS group was lower than that of C group((1.44±0.38) vs (0.46±0.29),P＜0.01).The let-7a level in DS group was higher than that of C group((0.04±0.01) vs (1.58±0.27),P＜0.01).The Pearson correlation analysis revealed that the sucrose preference rate of rats were negatively and positively correlated with hippocampal let-7a and HTR4 level respectively(r=-0.653,P＜0.05; r=0.774,P＜0.01),and hippocampal let-7a level showed negative association with HTR4 protein level (r=-0.803,P＜0.01).Conclusion Dual stress can induce the depressive behaviors of rats and affect the expression of let-7a and HTR4 in hippocampus.Hippocampal HTR4 and let-7a might be involved in determining individual ability to experience pleasure in rats;and hippocampal let-7a may be involved in the regulation of HTR4 gene expression in rats.

Objective To investigate the clinical characteristics and etiology in infants undergoing colonoscopy in order to improve the understandings of lower gastrointestinal tract diseases and their endoscopic manifestations.Methods The clinical and endoscopic data of the infants aged ≤ 3 years old who underwent conoloscopy at the Department of Gastroenterology,Children's Hospital of Chongqing Medical University,from July 2010 to December 2014,were retrospectively analyzed.A total of 223 children were included,148 male and 75 female.The age range was from 26 d to 3 years old(＜6 months:41 cases;6-12 months:68 cases;1-3 years old:114 cases).Results A total of 235 colonoscopies were performed under deep sedation by single or double manipulators.Cecal intubation was successful in 192 colonoscopies and terminal ileal intubation was completed in 29 colonoscopies,with a high success rate of 94.0％ (221/235 colonoscopies).The main symptoms included hematochezia (124 cases,55.6％),persistent/chronic diarrhea (55 cases,24.7％),hematochezia with chronic diarrhea(22 cases,9.5％),and others(22 cases,9.5％).Of the 223 patients,clear diagnosis were established for 215 children (96.4％),with food protein-induced proctocolitis (FPIPC) (78/223 cases,35.0％),colonic polyps (50/223 cases,22.4％),colitis (29/223 cases,13.0％),antibiotic associated diarrhea (AAD) (19/223 cases,8.5％),FPIPC with AAD (10/223 cases,4.5％).Conclusions Colonoscopy serves as a very important tool for the accurate diagnosis of lower gastrointestinal diseases with hematochezia and/or chronic diarrhea.FPIPC and colonic polyps are the most common causes for hematochezia and/or chronic diarrhea.AAD may be another important cause of chronic diarrhea and bloody stool in infants.Moreover,ghe application of colonoscopy in combination with histopathology can also play an important role in the diagnosis of some rare diseases,such as intestinal tuberculosis,primary intestinal lymphangiectasia,Behcet's disease and primary immunodeficiency disease.

Objective To investigate the clinical efficacy of heat-sensitive point Dazhui(GV14) moxibustion in treating cervical spondylotic radiculopathy. Method Ninety-six patients with cervical spondylotic radiculopathy were randomly allocated to a heat-sensitive point Dazhui moxibustion (observation) group of 30 cases, a non-heat-sensitive point Dazhui suspended moxibustion (control) group of 33 cases and a medication group of 33 cases. The observation group received heat-sensitive point Dazhui moxibustion; the control group, non-heat-sensitive point Dazhui suspended moxibustion; the medication group, oral administration of Jingtong granules. The clinical symptoms were assessed and serum hypersensitive C-reactive protein (HsCRP) and interleukin-8 (IL-8) were measured in the three groups before and after 15 days of treatment. Result All the three treatments had a certain effect on cervical spondylotic radiculopathy. The therapeutic effect was best in the observation group (P<0.05). After treatment, serum HsCRP and IL-8 contents decreased in all the three groups compared with before (P<0.05). They were even lower in the observation group than in the control and medication groups (P<0.05) but had no statistically significant differences between the control and medication groups (P>0.05). Conclusion The therapeutic effect of heat-sensitive point Dazhui moxibustion is better than those of non-heat-sensitive point Dazhui suspended moxibustion and oral Jingtong granules. It is a more ideal way to treat cervical spondylotic radiculopathy. The mechanism of its action may be related to post-treatment decrease in inflammatory factors in the lesion.

Objective:To observe the clinical efficacy of brain-benefiting and collateral-unblocking needling technique for chronic alcoholic gastritis complicated with depression. Methods:A total of 92 cases with chronic alcoholic gastritis complicated with depression were included in this trial. They were randomly allocated into an observation group (n=46) and a control group (n=46) by random number (envelope) method. Patients in the observation group received the brain-benefiting and collateral-unblocking needling technique. Scalp points included Shenting (GV 24), Xinhui (GV 22), Qianding (GV 23), Baihui (GV 20), Chengguang (BL 6), Tongtian (BL 7) and Luoque (BL 8). Body points included Neiguan (PC 6), Zusanli (ST 36), Zhongwan (CV 12), Gongsun (SP 4), Shenmen (HT 7), Daling (PC 7), Qimen (LR 14), Xinshu (BL 15) and Taichong (LR 3). The control group only received the same body acupuncture as the observation group. The treatment was conducted once a day, 30 min for each treatment, and 10 times made up a course of treatment. The efficacy was observed after 3 courses of treatment, and there was a 2-d interval between two courses. Results:After 3 courses of treatment, the clinical symptoms and gastroscopic features were significantly improved in the observation group than that in the control group. The clinical efficacy, self-rating anxiety scale (SAS) and self-rating depression scale (SDS) were significantly better than those in the control group (allP<0.05). Conclusion:The brain-benefiting and collateral-unblocking needling technique can significantly improve clinical symptoms in patients with chronic alcoholic gastritis complicated with depression and substantially alleviate their gastroscopic features, anxiety and depression.

Objective To evaluate the effect of hydrogen peroxide (H2O2) on autophagy in melanocytes,and to explore its possible regulatory mechanisms.Methods Normal human melanocytes at exponential growth phase were divided into several groups:blank control group receiving no treatment,positive control group treated with 100 nmol/L sirolimus solution,and experiment groups treated with H2O2 solution at different volume fractions of 10-7-10-3 respectively.After 4-hour treatment,cell counting kit-8 (CCK-8) assay and flow cytometry were performed to evaluate the cellular proliferative activity and detect apoptosis of melanocytes respectively.Acridine orange staining was performed to detect autophagosome formation,transmission electron microscopy to observe ultrastructural changes of autophagosomes,and Western blot analysis to measure the expression of autophagy-specific protein Beclin 1 and microtubuleassociated protein 1 light chain 3B (LC3B).A total of 84 autophagy-related genes were analyzed by RT2 Profiler PCR Array,so as to screen differentially expressed autophagy-related genes.Results After the treatment with H2O2 at different volume fractions of 10-3,5 × 10-4,10-4,5 × 10-5,10-5,5 × 10-6 and 10-6,experiment groups showed significantly decreased cellular proliferative activity,but significantly increased apoptosis rate compared with the blank control group (F =286.95,301.23,respectively,both P ＜ 0.05).With the increase in volume fractions of H2O2,the cellular proliferative activity was significantly gradually decreased (P ＜ 0.05),while the apoptosis rate showed an opposite trend (P ＜ 0.05),except that the 5 ×10-6 H2O2 group showed no significant differences in the apoptosis rate compared with the 10-5 H2O2 group and 10-6 H2O2 group.Acridine orange staining and electron microscopy showed autophagosome formation in the 10-5 H2O2 group,10-6 H2O2 group and positive control group.Western blot analysis revealed that Beclin1 expression and LC3B-Ⅱ/LC3B-Ⅰ ratio were significantly higher in the 10-5 H2O2 group,10-6 H2O2 group and positive control group than in the blank control group (all P ＜ 0.05).RT2 Profiler PCR Array showed significant up-regulation of ATG12,ATG3,ULK1,PIK3CG,PTEN and PIK3C3 genes and significant downregulation of EIF2AK3 gene in the 10-5 H2O2 group,10-6 H2O2 group and positive control group compared with the blank control group.In the 10-5 H2O2 group and positive control group,the mTOR gene was significantly up-regulated,and the ULK2 gene was significantly down-regulated.The 10-6 H2O2 group showed no obvious changes in the expression of mTOR gene,but significant up-regulation of AMPK and JNK1 genes.Conclusion H2O2 at volume fractions of 10-5 and 10-6 can induce autophagy in melanocytes,likely by influencing the expression of some related signaling molecules.

Objective To investigate the impact of transvaginal natural orifice transluminal endo-scopic surgery(NOTES)-assisted laparoscopic nephrectomy on female sexual function and quality of life . Methods This was a prospective study on the change of female sexual function and quality of life of female patients who underwent transvaginal NOTES-assisted laparoscopic nephrectomy from May .2011 to Nov. 2012.A total of 42 cases were included in this study (28 of them with severe hydronephrosis , non-functio-ning kidney , 11 with pyelonephrosis , 1 with renal tuberculosis , 1 with duplex kidney complicated with hy-dronephrosis, and 1 with renal angiomyolipoma ).The mean age was 36.9±5.3 (26-45) years, and the mean body mass index was 21.7±2.6 (14.7 to 27.1) kg/m2.Twenty-four cases were operated on the left side, 18 cases on the right .The female sexual function and quality of life were assessed before and 4 months, 7 months and 1 year after surgery using the Female Sexual Function Index (FSFI) questionnaire and the MOS 36-item Short-Form Health Survey (SF-36), respectively. Results The mean FSFI of 42 cases preoperatively and 4 months, 7 months and 1 yr postoperatively were 27.74 ±4.34, 27.19 ±4.49, 28.54±4.23, and 28.68 ±4.19, respectively.There was no statistically significant difference among them (F=1.111, P=0.346).Compared with that of preoperation , the physical function, vitality, metal health, body pain, and general health of the patients were improved , but the role-physical, role-emotion and social function were not improved at postoperative month 4 and month 7 (P<0.05).Each item of SF-36 was im-proved after postoperative 1 year ( P<0.05) . Conclusions Transvaginal NOTES-assisted laparoscopic ne-phrectomy does not cause negative effect on the female sexual function .The quality of life can be improved after operation .The physical function is improved at early stage , and the psychological function as well .

Preeclampsia is a kind of idiopathic disease during pregnancy. Its pathogenesis may involve many factors, such as mother, placenta and fetus. The study found that the abnormal metabolism of blood glucose and blood lipid during pregnancy may be closely related to the onset of preeclampsia. This paper reviews the research progress of abnormal glycolipid metabolism in preeclampsia at home and abroad in order to better guide the management of related aspects during pregnancy.

Objective To explore the implementation effects of cli nical nursing path for severe preeclampsia pregnant women after cesarean section.Methods A total of 50 cases with severe preeclampsia after cesarean section who did not undergo clinical nursing pathway were chosen as control group,while another 50 cases with the same disease who received clinical nursing pathway were treated as study group,and we compared the length of hospital stay,medical cost,index of blood pressure (SBP,DBP,MAP),and complications of two groups.Results ICU stay time (64.51 ±24.1 3)h,length of hospital stay (6.56 ±3.02)d of the study group were significantly shorter than (85.96 ±28.55)h,(9.69 ±4.58)d in the control group, and medical costs were significantly lower than that of control group (P <0.05);SBP,DBP,MAP improvement were better than those of control group (P <0.05).In addition,the overall complication incidence in the study group was lower than that of the control group (1 0.64% vs 30.30%,P <0.05 ).Conclusions It is remarkable to implement clinical nursing pathway on severe preeclampsia for women after cesarean section which is valuable to be applied in clinical work.

Objective To evaluate the quality of evidence-based guidelines on senile functional constipation management and provide references for decision-making and the development of evidence-based guidelines suitable for China. Methods A search of Guideline International Network (GIN), National Guideline Clearinghouse (NGC), National Institute for Health and Clinical Excellence (NICE), Scottish Intercollegiate Guidelines Network (SIGN), Canadian Medical Association (CMA), New Zealand Guidelines Group (NZGG), Registered Nurses Association of Ontario (RNAO), National Health and Medical Research Council (NHMRC), American College of Gastroenterology (ACG), China Guideline Clearinghouse (CGC), Medlive website, and related websites and databases were conducted to screen the guidelines on senile functional constipation management with inclusion and exclusion criteria. Appraisal of Guidelines for Research & Evaluation Ⅱ (AGREE Ⅱ) was applied on the methodological value evaluation for searched guidelines. The overall agreement among 3 appraisers was measured by the intraclass correlation coefficient (ICC). The analysis of advices from guidelines was performed. Results A total of 5 evidence-based guidelines were included, which were all from abroad. The average scores of guidelines in six domains of AGREE Ⅱ were 97.78% (scope and purpose), 78.52% (stakeholder involvement), 79.86% (rigor of development), 89.63% (clarity of presentations), 63.89% (applicability), and 86.87% (independence) respectively. The ICC were 0.887- 0.971. Considering the overall quality evaluation, 3 of them were grade A and 2 of them were grade B. The recommendations of included guidelines were almost consistent. Conclusions The overall quality of included guidelines is high. There is no local evidence-based guideline of senile functional constipation management in China. High-quality guidelines can offer the evidence support for the development of clinical practical guideline for senile functional constipation management. Foreign guidelines should be localized before their application in the clinic in China.