With the widespread use of high-resolution spectral-domain OCT (SD-OCT) in clinical practice,one of the greatest progresses to the ophthalmologists is more dctailed image analyses of outer retina in the macular region.There are four clear hyper-reflective bands of outer retina in the SD-OCT images,instead of three bands in the time-domain OCT (TD-OCT),the bands from inner to external are external limiting membrane (ELM),inner segment/outer segment (IS/OS) junction,cone outer segment tips (COST),and retinal pigment epithelium (RPE),respectively.From a perspective of corresponding retinal histological structure,all of the three bands of ELM,(IS/OS) and COST are within the photoreceptor cells.Therefore,the integrity of the three bands correlates well with the status and function of photoreceptor cells.It is one of the hot topics to study the status and function,as well as injury and repair of the photoreceptor cells using SD-OCT.This article reviewed the relevant clinical studies about the three bands of ELM,IS/OS and COST,including macular hole (MH),idiopathic epiretinal membrane (IERM),rhegmatogenous retinal detachment (RRD) and age-related macular degeneration (AMD).

Objective To investigate the relationship between Clq/tumor necrosis factor (TNF)-related protein 9 (CTRP9)and coronary heart disease.Methods A total of 232 patients diagnosed with coronary heart disease(CHD)by coronary angiography at our hospital were selected as the CHD group,and 90 cases with normal coronary angiography served as the control group.The double antibody sandwich enzyme-linked immunosorbent assay(ELISA)was used to determine serum CTRP9 levels.Results Serum CTRP9 levels were lower in the CHD patients than in the controls [(116.9±19.5)ng/ml vs.(142.3±17.9)ng/ml,t＝-5.404,P＝0.000].SerumCTRP91evelswere negatively correlated with body mass index,fasting plasma insulin,fasting blood glucose,insulin resistanceindex(IRI),triglyceride and TNF-α(r＝-0.230,-0.225,-0.267,-0.235,-0.230and-0.222,P＝0.017,0.011,0.002,0.010,0.011 and 0.022).Multiple logistic regression analysis revealed that uric acid,IRI,CTRP9,and TNF-α were independent influencing factors for CHD,of which CTRP9 was a protective factor for CHD occurrence(OR ＝ 0.907,95％C1:0.854～0.963,P＝ 0.001).Conclusions Decreased serum levels of CTRP9 are associated with coronary heart disease,indicating that CTRP9 may play a protective role in coronary heart disease occurrence.

Regarding the prevention and treatment of hepatocellular carcinoma (HCC) recurrence after curative resection,surgeons do not have a clear consensus to evaluate the risk factors of recurrence and effectiveness of surgical resection.Therefore,postoperative HCC recurrence patterns were reviewed in this article,including differentiating intrahepatic metastasis (IM) and multicentric occurrence (MO),which play a key role in manifesting recurrence and patient prognosis.Additionally,the definitions of small HCC and curative resection,and the prophylactic and therapeutic values of anatomic resection and repeated hepatectomy in patients with recurrent HCC were reviewed.Fully understanding these issues might allow for a more objective,precise,and consistent clinical assessment of HCC.

Objective To compare the optical properties and visual quality between Tecnis ZMB00 and AcrySof ReSTOR SN6AD1 multifocal intraocular lens (MIOL) in patients undergoing cataract surgery.Methods A total of 120 patients (130 eyes) who umderwent elective cataract surgery in our hospital from March 2012 to July 2015 were selected prospectively.All patients were treated with diffractive MIOL,and divided into group A (Tecnis ZMB00 group) and group B (AcrySof ReSTOR SN6AD1 group).The uncorrected distance visual acuity (UCDVA),uncorrected near visual acuity (UCNVA),uncorrected medium distance visual acuity (UCIVA),best corrected distance visual acuity (BCDVA) and best corrected near visual acuity (BCNVA) were measured before and after surgery.The defocusing curve was drawn for analysis of the contrast sensitivity,and the postoperative visual function and survival quality questionnaire (VF-14) was used to evaluate the postoperative visual quality.Results At 1 week,1 month and 3 months after surgery,recovery of UCNVA,UCIVA and BCNVA in group A was better than that in group B (all P ＜ 0.05).At 1 week and 3 months after surgery,the recovery of UCDVA in group A was better than that in group B (all P ＜ 0.05).At 3 months after surgery,the spherical equivalent was lower in group A than group B (P ＜ 0.05).The contrast sensitivities under scotopia,photopic glare and scotopic glare of different frequencies in group A were higher than those in group B (all P＜0.05).The VF-14 score in group A at 3 months after surgery was lower than that in group B (P＜0.05).In group A,0.0 D and-2.5 D formed 2 peaks,and from-2.0 D to-2.5 D formed the platform stage,while in group B,only 0.0 D and-3.0 D formed 2 peaks.Conclusion The implantation of Tecnis ZMB00 MIOL after cataract surgery can improve the uncorrected visual acuity of treated eye,contrast sensitivities,postoperative visual function and quality of life of patients.

Objective: To summarize the experience of surgical treatment of subaortic stenosis. Methods: 70 patients with subaortic stenosis were treated surgically. The diagnosis was made by echocardiography, left ventricular catheterization and angiography. There were 46 males and 24 females. The mean age at operation was 11.8 years (range 3 to 46 years). 64 patients had discrete stenosis and 6 had tunnel stenosis. For the discrete stenosis cases, simply resection of stenosis membrane was done in 58 cases and plus myoctomy in 6 cases. For the tunnel stenosis cases, left ventricular muscle was resected to relieve obstruction. In 59 patients combined cardiovascular malformation were corrected at the same time. Results: There were two postoperative deaths. Mitral valve injury occurred in 1 patient. The mean systolic gradient of left ventricle to aorta was 7.5 mmHg with a range of 0-30 mmHg in 38 cases after operation. The 1-, 3-, 5-, 10-, 20-year follow-up rate was 83%, 77%, 68%, 45%, and 9%,respectively. All patients were asymptomatic postoperatively. No reoperation was required. Conclusion: Once subaortic stenosis was diagnosed, operation should be done. Preoperative echocardiography and routine exploration of the root of aorta should be done during operation are in diagnosing. The key point of the operation that left ventricular outflow tract should be thoroughly dredged, no injury should be made to the mitral valve, aortic valve and conduction bundle.

Objective To explore the effects of computerized working memory training on working memory and brain functional activition for stroke paitents. Methods 3 stroke patients voluntarily joined in the study, 10 healthy adults were recruited as control group. The patients received computerized working memory training for 4 weeks. Cognitive psychological tests (the n-back task, Stroop task and Raven`s Advanced Progressive Matrices task) and neuroimaging test (task- state functional magnetic resonance imaging) were administered before and after treatment. Results Working memory training significantly improved the working memory, fluid intelligence and attention for each trained patient (P<0.001), and could renovate the abnormal functional activity model and reorganize the functional brain network. Conclusion Computerized working memory could be used as an effective cognitive rehabilitation intervention for stroke patients.

Objective To investigate the clinical prediction value of chemokine CCL21 level for acute coronary syndrome.Methods Totally 212 patients receiving coronary arteriography were divided into acute myocardial infarction group(AMI,n=72),unstable angina pectoris group(UAP,n=76),and stable angina pectoris group(SAP,n=64).The serum level of chemokine CCL21 was detected by double-antibody sandwich enzyme-linked immunosorbent assay (ELISA)and the pathological changes of coronary artery were measured by Gensini scoring system.All patients were followed up for six months and the cardiovascular adverse events were recorded.Results The serum level of CCL21 was(169.72±14.64)ng/L in AMI group,(154.42±16.50)ng/L in UAP group,and(143.87±9.80) ng/L in SAP group,with statistically significant differences (F =99.818,P =0.000).Serum levels of CCL21 in ACS group and SAP group were positively correlated with Gensini score(r=0.474,P =0.000;r=0.350,P=0.049).Binary Logistic regression analysis revealed that chemokine CCL21 was an independent risk factor for predicting acute coronary syndrome (OR =1.049,P =0.022).The CCL21-judged area under the ROC curve in acute coronary syndrome group was 0.887 ± 0.028 (P =0.000),with diagnostic point of serum level of chemokine CCL21 at 159.15 ng/L,sensitivity of 0.635,specificity of 0.981.Serum level of CCL21 was higher in the patients with cardiovascular adverse events than in the patients without cardiovascular adverse events[(168.57±7.24)ng/L vs.(156.92± 6.53) ng/L],with statistically significant difference (t =16.100,P =0.000).Conclusions Serum level of chemokine CCL21 reflects the severity degree of coronary artery disease.The chemokine CCL21,as an independent and effective marker,can predict acute coronary syndrome.

Objective To discuss the incidence trends of hyperuricemia in people of different TCM constitutional types by analyzing the constitutional types of patients with hyperuricemia,and to lay a foundation for follow-up study in preventive and therapeutic measures for hyperuricemia.Methods 518 healthy people and 525 people of hyperuricemia were included in our research by identifying their TCM constitutional types by the self testing table of constitutional classification and determination of TCM promulgated by China Association of Chinese Medicine.Hyperuricemia's high-risk constitutional types were analyzed.Results People of dampness-heat constitution (24.57％),phlegm-dampness constitution (22.86％) and static-blood constitution (11.05％) were top 3 groups in occurrence rate of hyperuricemia,the risk ofhyperuricemia in these three groups above were significantly higher than the other constitutional types.On the contrary,the risk of hyperuricemia in the group of the mildly constitution (8.57％) and the group of qi-asthenia constitution (6.29％)were significantly lower than the other groups.Conclusion People of dampness-heat constitution,phlegm-dampness constitution and static-blood constitution were high risk groups of hyperuricemia,which deserved our attention in research of preventive and therapeutic measures for hyperuricemia.

In either type 1 or type 2 diabetes,there is significant loss of β cell mass.Understanding the changing of β cell mass in the course of diabetes would provide important information for diagnosis and treatment.Functional imaging like magnetic resonance imaging or positron emission tomography (PET) can provide safe and noninvasive detection of loss of β cell mass in the course of diabetes.Among them,radio-labelled imaging is the most sensitive imaging procedure of the β cell ; For dihydrotetrabenazine PET imaging aiming β cell mass,there has been some primary outcome.For the key factor causing type 2 diabetes,18 F-6-deoxy-6-fluoro-D-glucose (18F-6-FDG) PET imaging is an effective tracer to study the glucose transporting condition in vivo.Further development of functional imaging will be of great value in diagnosis and treatment of diabetes.

BACKGROUND:Many liver cancer stem cel markers have been found in liver cancer tissues and cel lines such as CD133, acetaldehyde dehydrogenase (ALDH), CD90, CD44, EpcAM, CD13, OV6, K19, c-kit and ABCG2. Of them, CD133, CD90 and CD44 have been shown to be strongly associated with the recurrence and metastasis of liver cancer. OBJECTIVE:To explore the dynamic changes of liver cancer stem cel markers and inflammatory factors during the induction of liver cancer in rats and their correlation. METHODS:Diethyl nitrosamine solution was given to Sprague-Dawley rats for 24 hours to induce rat models of liver cancer. Rats that were given common water were considered as the healthy control group. RESULTS AND CONCLUSION: Immunohistochemical staining revealed that Kupffer cels-related ED2 expression showed a gradual increase in the model group. Compared with the healthy control group, ED2 expression was significantly higher at 12, 16, 20 and 24 weeks after induction in the model group (P < 0.05). Quantitative PCR demonstrated that CD90 showed a gradualy increased trend during induction (P < 0.05). Compared with healthy tissue, CD90 increased significantly in the liver cancer tissue (P < 0.05). CD133 showed an increased trend, but one-way analysis of variance did not show significant differences (P > 0.05). During induction, no significant change was found in other liver cancer stem cel markers (P> 0.05). During the induction, tumor necrosis factor α, transforming growth factor β, MCP-1 and interleukin-6 expression levels were significantly increased (P < 0.05). Compared with healthy tissue, transforming growth factor β, MCP-1 and interleukin-6 expression levels were significantly higher in the liver cancer tissue (P < 0.05). Other inflammatory factors did not exhibit significant alterations during the induction (P > 0.05). Pearson correlation analysis demonstrated that MCP-1, transforming growth factor βand interleukin-6 expression levels were significantly positively correlated with CD90 expression (P < 0.05). These findings suggest that partial inflammatory factors released from Kupffer cels have a certain correlation with liver cancer stem cels. Kupffer cels can promote the occurrence of liver cancer.