Central serous chorioretinopathy (CSC)is a common eye disease characterized by macular serous retinal detachment.However,sometimes there are some atypical features,such as diffuse retinal pigment epitheliopathy,choroidal neovascularization (CNV),acute bullous retinal detachment,subretinal fibrosis,etc.Atypical CSC often is misdiagnosed because of its similar manifestations to polypoidal choroidal vasculopathy (PCV),inflammatory diseases such as Vogt-Koyanagi-Harada syndrome (VKH),et al.Furthermore,there are some other ophthalmic and systematic diseases which can cause serous retinal detachment and other atypical features.Nevertheless,the therapeutic regimens of these diseases are in great variation.In view of this,oculist should pay more attention to the differential diagnosis of CSC by fully understanding its clinical findings and concerning the general history including gluococorticoid administration.In this way,a precise diagnosis and correct management can be done.

AIM　Here the development of a simple, rapid and simultaneous method for the separation of five ephedrine alkaloids obtained with non-aqueous capillary electrophoresis (NACE) were reported. The effects of the electrolyte, non-aqueous solvent on the separation were also discussed. METHODS　A running buffer of 50 mmol/L ammonium acetate in methanol was found to be the most suitable for this separation. RESULT　The best separation was achieved within 8 minutes. CONCLUSION　The separation is not only dependent on differences in the pK value of the alkaloids but also on the intramolecular interaction and solvation. So much improved selectivity could be achieved in nonaqueous medium.

Objective: To investigate the CE fingerprint of Salvia miltiorrhiza . Methods : Separation was performed on a 50?m?50cm uncoated capillary with 20mmol?L -1 borate solution as CE buffer. The run voltage was 15kV and the UV detection was set at 210nm. Results : Fingerprint consisted of 11 common peaks. The validation of methods meet the requirements for SDA's technical regulations. Conclusion : The method was accurate and simple for quality control of Salvia miltiorrhiza.

Object To develop a rapid method for the determination of ephedrine alkaloids in Ephedra sinica Stapf by nonaqueous capillary electrophoresis (NACE) and evaluate the extracting method by determining the amount of alkaloids Methods The buffer contained 50 mmol/L ammonium acetate in methanol without any additives was used And the detection wavelength was 210 nm Results The best separation result was achieved within 8 min Linearity was obtained in range of 9 8-147 0 ?g/mL pseudoephedrine, 6 8-102 0 ?g/mL for norephedrin, 9 4-141 0 ?g/mL for ephedrine, 4 8-72 0 ?g/mL for norpseudoephdrine, 6 8-102 0 ?g/mL for methylephedrine respectively The recovery range of these five alkaloids was 95 0%-100 4% Conclusion This method is rapid and accurate for the quantitative analysis of ephedrin alkaloids in E sinica

Objective To evaluate the effects and safety of uterine artery embolization for uterine leiomyoma. Methods Total of 185 patients with uterine leiomyoma were treated by UAE. They were followed for one to 6 years to observe the changes of leiomyoma size and improvement in clinical symptoms. Ovarian function was evaluated in 44 cases. Results Bilateral embolization of uterine arteries was performed in 185 patients. Follow-up of 1 ～6 years for 292 leiomyoma indicated that one to 9 months after embolization, shrinkage of leiomyoma size was the most significant factor. One year after embolization, leiomyoma sizes decreased a little. Shrinkage of submucous leiomyoma was more significant than that of intratumoral one, and the latter was more significant than subserous one. Shrinkage of leiomyoma with large size ( volume ≥ 150cm~3) was less than that of small one. Menorrhagia, anemia and pressure symptoms were all resolved. There was no significant difference between pre- and post embolization ovarian hormone level. Conclusions The significant reduction in leiomyoma volume and resolution of clinical symptoms confirmed that the treatment validity of symptomatic leiomyomas by UAE. UAE is an effective therapeutic procedure which has no adverse effect on the ovarian function.

Objective To observe the clinical features of acute macular neuroretinopathy (AMN).Methods Six patients (11 eyes) with AMN were included in this study,with every 2-week follow-ups till six months.Among them,five had preceding dengue fever (83.3％),one had history of head trauma (16.7％).All patients received routine examination,fundus photography,infrared reflectance (IR) imaging,spectral-domain optical coherence tomography (SD-OCT) scanning and fluorescein fundus angiography (FFA) initially,and fundus photography,IR,SD-OCT during follow-up.Results Sudden onset of central/paracentral scotoma in one eye or both eyes was the main visual symptom.There were 1 eye with normal fundus,2 eyes with wedge-shape lesions,8 eyes with yellow-white or brown sheet lesion.IR imaging demonstrated localized areas of hypo-reflection in the macula.SD-OCT scanning through these areas revealed hyper-reflection in the photoreceptor layer and disruption of its normal reflective structures.Subsequent SD-OCT demonstrated that the hyper-reflection of the photoreceptor layer regressed gradually,followed by thinning of the outer nuclear layer.The external limiting membrane and ellipsoid zone became continuous;however,the interdigitation zone was not restored.There was no remarkable findings of the AMN lesions on FFA.The scotomas persisted in all 6 patients (11 eyes) by the last visit.Conclusions IR imaging demonstrated localized areas of hypo-reflection in the macula.SD-OCT revealed hyper-reflection in the photoreceptor layer in acute stage and the interdigitation zone was not restored in late stage.AMN has a relative poor prognosis with persistent scotomas through at least 6 months.

A sensitive and selective method based on gas chromatography hyphenated to mass spectrometry (GC-MS) was developed and validated for the determination of atractylon in rat plasma. Plasma samples were processed by liquid-liquid extraction with ethyl acetate-n-hexane (1:1, v/v) using acetophenone as an internal standard (IS). Analytes were determined in selective ion monitoring (SIM) mode using target ions at m/z 108.1 for atractylon and m/z 105.1 for acetophenone. The calibration curve was linear over the concentration range of 10-1000 ng/mL with lower limit of quantification of 10 ng/mL. The intra- and inter-day precision variations were not more than 10.4% and 9.6%, respectively, whilst accuracy values ranged from -6.5% to 4.9%. Extraction recovery of the assay was satisfactory. This method was suc-cessfully applied to quantification and pharmacokinetic study of atractylon in rat plasma after in-tragastric administration of Atractylodis extract.

[Objective]To analyse and summarize Professor CHEN Mingxian's clinical experience in the treatment of gastric cancer by"tonifying the spleen and stomach,removing stasis poison,clearing cancer poison".[Methods]Through clinical learning and medical case analysis,this paper elucidates Professor CHEN's understanding of the etiology and pathogenesis of gastric cancer,gives examples of the treatment of gastric cancer,and attaches two cases.[Results]Professor CHEN thinks weakness of the spleen and stomach is a prerequisite for the occurrence of gastric cancer,which runs through the occurrence and development of gastric cancer.Stasis coagulation is the key link for the transformation of precancerous lesions into gastric cancer,and the residual cancer poison is the main pathogenesis of the recurrence and metastasis of gastric cancer.In the treatment,the three methods of"tonifying the spleen and stomach,removing stasis poison and clearing cancer poison"are established,and the flexible fusion application with the syndrome reflects the concept of"always strengthening the body resistance,not forgetting to attack evil and combining prevention and treatment".Two cases of gastric cancer with emaciation after surgery were treated by tonifying the spleen to produce muscle and eliminate distention,removing blood stasis and detoxifying cancer,but each had its own emphasis on strengthening the body resistance and eliminating evil.After treatment,all the cases were stable,and no recurrence and metastasis were observed during follow-up period.[Conclusion]Professor CHEN treats gastric cancer by"tonifying the spleen and stomach,removing stasis poison and clearing cancer poison",which has good curative effect and certain clinical practical value.

Objective To explore the clinical characteristics of late-onset ornithine carbamoyltransferase deficiency (OTCD) in order to improve the clinicians' understanding of this disease.Methods The clinical,therapeutic and follow-up data of two patients with late-onset OTCD diagnosed in the Department of Neurology,Qilu Hospital of Shandong University from November 2017 to February 2018 were collected and analyzed.Results Case 1 is a 17-year-old male who was admitted into Qilu Hospital with recurrent dizziness and vomiting for 4 months,sudden mental abnormality and convulsion for 3 days.The liver dysfunction,respiratory alkalosis and hyperammonemia (434 μmol/L) had been found before his admission.His blood ammonia fluctuated obviously from 180 μ mol/L to 2998 μmol/L,though he was given hemodialysis and arginine infusion,and died on the fourth day after admission.Case 2 is a 15-year-old male,complained with recurrent dizziness,vomiting,bluntness and somnolence for 20 days.He was found with hyperammonemia (600 μmol/L) and liver dsyfunction in a local hospital.He was getting better after intravenous administration of arginine and liver protective drugs.After admission,the blood ammonia,liver function and amino acids,acylcarnitine profiling in dried blood spots,and organic acid analysis in urine were normal,and he has not recurred since restriction of protein diet.Brain magnetic resonane imaging of both patients showed cytotoxic edema of bilateral frontal lobe and insular cortex,and their genetic detection both showed c.119G＞A(p.R40H) hemizygous pathogenic mutation of OTC gene inherited from their respective mothers.Conclusion Unexplained hyperammonemia and acute encephalopathy with insular and frontal cortical involvement should be on the alert to the urea cycle disorders,especially OTCD.Early diagnosis and reasonable treatment are the key to changing the prognosis.

Macular pigment (MP) is composed of lutein, zeaxanthin, and meso-zeaxanthin, which accumulate mainly at the macula. MP has antioxidant function and can filtering blue wave. Measurement of MP is about its optical density, that is, macular pigment optical density (MPOD). This review summarizes the function and clinical use of MP and MPOD. Researches has show that MPOD is related to some ocular disease such as age-related macular degeneration, macular telangiectasia type 2, diabetic retinopathy, Stargardt disease et al. MPOD can be used in the judgment of clinical diagnosis, treatment effect. The specific mechanism of MP metabolism in the retina and in the pathogenesis of the disease, genotype specific nutritional therapy of xanthophyll, the establishment of a database combined with artificial intelligence and the rapid and convenient MP determination are all issues of great contention that need to be resolved.