Background Clinical effectiveness of intavitreal injection of glucocorticosteroid for macular edema has been verified,especially triamcinolone acetonide(TA).However,the efficacy and safety of combination of TA with macular laser grid photocoagulation for macular edema is concerned. Objective This clinical trial was to evaluate the efficacy and safety of intravitreal injection of TA combined with macular laser grid photocoagulation in the treatment of macular edema. Methods A case-cohort study was designed.One hundred and twenty eyes of 120 patients with macular edema from diabetes or retinal vein occlusion were included in this study.The patients were randomized into trial group and control group,with the matched age,course,visual acuity,intraocular pressure (IOP).The patients of the trial group received intravitreal injection of TA combined with macular laser grid photocoagulation,and those of the control group were managed with macular laser grid photocoagulation only.Best corrected visual acuity ( BCVA),optical coherence tomography(OCT),fundus fluorescein angiography(FFA) and IOP were examined before TA injection and 1 week,1 month,3 months,6 months after treatment and compared among different time points between two groups.Written informed consent was obtained from each patient prior to entering this trial. Results Compared with TA injection before,the BCVA was significantly elevated in the trial group 1 week,1 month,3 months and 6 months after TA injection( all P=0.000),however,no obvious improvement of visual acuity was found in the control group before and after treatment at any time point (P＞0.05 ).At various time points,the visual acuity was significantly improved in the trial group than the control group (P =0.037,0.000,0.002,0.046 ).Macular thickness was significantly decreased at various time points after TA injection in comparison with before TA injection in the trial group(all P=0.000),but no significant change in macular thickness in the control group between before and after treatment at any time point( P＞0.05 ).Macular thickness was lower in the trial group compared with the control group at various time points after treatment ( P＜0.05 ).Recurrence of macular edema was seen in 7 eyes ( 1 1.67％ ) 4-6 months,and the IOP raise( ＞21 mmHg)was found in 11 eyes( 14.1％ )after TA injection in the trial group.Conclusions Intravitreal injection of TA combined with macular laser grid photocoagulation can be an effective method in the treatment of macular edema.However,recurrence of macular edema or increase of IOP may occur in a few patients within 6 months after TA injection.A long-term follow-up should be performed for the evaluation of efficacy and safety after intravitreous injection of TA.

Objective To discuss human papilloma virus(HPV)prevalence and HPV genotypes distribution and the infection factors,to provide scientific guidance for the prevention and treatment of cervical cancer.Methods From March to November in 2009,605 women received cervical HPV testing in the Tumor Hospital of Harbin Medical University,to obtain specimens of cervical cytology,rapid flow-through hybridization technique (namely Hybribio flow-through hybridization)was used to detect HPV genotypes simultaneously.Single-factor and multivariate factors non-conditional Logistic regression analytic method was used to discuss the relationship between HPV infection of females and age,marital condition,level of education,level of income,occupation,initial age for sex,contraception,number of pregnancies,delivery approach and smoking.Results HPV infection rate was 21.49%(130/605),the positive rate of HPV infection in high-risk subtypes was 15.70%(95/605),the most common type was 5.29%(32/605)in the samples.Single factor non-conditional logistic regression model analysis showed that initial age for sex was the risk factor(X2=4.4618,P<0.05),HPV prevalence increased with a lower initial age for.sex reduced.But there was no significant difference in age,marital condition,education,income,occupation,contraception,number of pregnancy,delivery approach and smoking teams(X2=0.0525,1.8510,1.0348,0.2592,1.1176,1.5664,2.8835,1.4597,2.6161,all P>0.05).The analysis of multivariate factors nonconditional Logistic regression showed that the age of initially having sex,marital status and number of pregnancies were the risk factors(X2=21.6637,8.0574,15.7573,all P<0.05).Conclusions The risk factors for HPV infection are mainly about having sex too young,marital status and number of pregnancies,attention should be paid to screening for HPV.

·AIM: To evaluate the safety and postoperative complications of femtosecond laser - assisted small incision lenticule extraction (SMILE). ·METHODS: Retrospective case series. A total of 1127 patients (2 236 eyes) who were treated with SMILE for myopia or myopia astigmatism between June 2016 and May 2017 were enrolled in this study. Eyes that developed postoperative complications were noted and identified. The incidence, risk factors, management and prognosis were analyzed. The follow-up was 6mo. ·RESULTS: The rate of postoperative complications was 8. 05%, included diffuse lamellar keratitis (3. 31%), delayed visual acuity (2. 59%), minor interface residue (0. 63%), and ghost images ( 1. 52%). These complications had an impact on best corrected visual acuity (BCVA) at 3mo in only 1 eye with decentered ablation and was re-treated with topography-guided laser- assisted subepithelial keratomileusis (LASEK). Good visual outcomes were achieved in all eyes finally. · CONCLUSION: Although few eyes suffered postoperative complications, SMILE is an acceptable safe surgery. Careful surgical skill, appropriate surgical parameter, and rational postoperative medication can decrease the risk of complication.

OBJECTIVETo study the biological function of killer cell immunoglobulin-like receptor (KIR) and the role of donor inhibitory KIR and recipient genetic background in HLA matched unrelated hematopoietic stem cell transplantation (HSCT).

METHODSHLA genotype of 51 patients (ALL 18 cases, CML 15 cases, AML 10 cases and others 8 cases) and their respective matched unrelated donors from Database of China Marrow Registration was determined by polymerase chain reaction sequence oligonucleotide probes (PCR-SSOP) and sequence specific primers (PCR-SSP). The KIR genotype was determined by PCR-SSP.

RESULTSAll the patients and the donors expressed KIR2DL1, KIR2DL2/L3, KIR2DL4, KIR3DL2 and KIR3DL3. 96.7% individuals expressed KIR3DL1. Among them, 21.57% of KIR was completely identical, while 78.43% was not. Of the non-identical KIRs, 25.49% were the recipient's KIR genotype containing the donor's ones, and 27.45% was the donor's containing the recipient's. 74.62% of donor's KIR2DL1 lacked recipient's C2 ligand, 5.91% of donor's KIR2DL2/L3 lacked recipient's C1 ligand, 19.74% of donor's KIR3DL1 lacked recipient's Bw4 ligand and 54.91% of donor's KIR3DL2 lacked recipient's A3, A11 ligand.

CONCLUSIONKIR genotype and HLA class I antigen are inherited independently. KIR2DLI and KIR3DL2 of donors may cause alloreactivity of NK cell. The mismatch of KIR/HLA in donor-recipient plays a very important role in matched unrelated allo-HSCT. The outcome of HSCT can be better predicted by the model of the presence of KIRs on the donor' sNK cells and the absence of corresponding KIR ligand in the recipient's HLA.

Adolescent ; Adult ; Child ; Child, Preschool ; Female ; Gene Frequency ; Genotype ; HLA Antigens ; genetics ; Hematopoietic Stem Cell Transplantation ; Humans ; Infant ; Killer Cells, Natural ; immunology ; Male ; Receptors, KIR ; genetics ; Transplantation, Homologous

OBJECTIVETo analyze the allele frequencies and polymorphism of human leukocyte antigens (HLA) -A, B, Cw, DRB1 and DQB1 between donors-recipients on high-resolution typing; and to analyze the matching and mismatching proportion between donors and recipients.

METHODSHLA high-resolution types were determined by sequence based typing (SBT), sequence specific oligonucleotide probe (SSOP) and sequence specific primer (SSP) on 2540 unrelated Chinese Han individuals including 1168 recipients and 1372 donors, then statistical analyses were carried out.

RESULTSForty-four HLA-A alleles were detected, and among them the frequencies of A*1101, A*2402, A*0201, A*0207, A*3303, A*0206 and A*3001 exceeded 0.05, and accounted for 80.4%. Eighty-one HLA-B alleles were detected, and the frequencies of B*4001, B*4601, B*5801, B*1302 and B*5101 exceeded 0.05, and accounted for 43.0% of total. There were 44 HLA-Cw alleles, among them the frequencies of Cw*0702, Cw*0102, Cw*0304, Cw*0801, Cw*0602, Cw*0303, Cw*0302 and Cw*0401 exceeded 0.05, and were 80.3% of total. There were 61 HLA-DRB1 alleles, the frequencies of DRB1*0901, DRB1*1501, DRB1*1202, DRB1*0803, DRB1*0701, DRB1*0405, DRB1*0301 and DRB1*1101 exceeded 0.05, and were 70.1% of total. Finally, 22 HLA-DQB1 alleles were detected, the frequencies of DQB1*0301, DQB1*0303, DQB1*0601, DQB1*0602, DQB1*0202, DQB1*0302, DQB1*0401, DQB1*0502 and DQB1*0201 exceeded 0.05, and they were 87.4% of total. All the five loci were of heterozygote deficiency. The HLA-A, B and DRB1 loci conformed to Hardy-Weinberg equilibrium (HWE) (P > 0.05); but HLA-Cw and HLA-DQB1 loci did not (P < 0.05). Except several particular genotypes, all the five loci conformed to HWE. After comparing data between donors and recipients, only 22.4% of recipients found HLA matched donors (10/10); 24.6% of recipients found single HLA allele mismatched donors (9/10); 26.3% of recipients had two HLA alleles mismatched donors (8/10).

CONCLUSIONThe characteristics of allele frequencies and polymorphism of HLA-A, B, Cw, DRB1 and DQB1 on high-resolution typing in Chinese Han population is valuable for donor searching in unrelated hematopoietic stem cell transplantation, and it provides genetic basis for donor registry and usage of donor resource for Chinese Marrow Donor Program.

China ; ethnology ; Gene Frequency ; Genetics, Population ; HLA-A Antigens ; genetics ; HLA-B Antigens ; genetics ; HLA-C Antigens ; genetics ; HLA-D Antigens ; genetics ; HLA-DQ Antigens ; genetics ; HLA-DQ beta-Chains ; HLA-DR Antigens ; genetics ; HLA-DRB1 Chains ; Hematopoietic Stem Cell Transplantation ; Histocompatibility Antigens Class I ; genetics ; Histocompatibility Testing ; Humans ; Tissue Donors

Objective To further explore the genetic characteristics of oidiomycetes mutant strains like bacterial morphology on the basis of the study on morphology and structure of mutated candida.Methods The standard strains of candida albicans were induced by low temperature and under the condition of low temperature and nutrient deficiency.Variation of standard strains of Candida albicans were induced by clinical antifungal drugs such as fluconazole with different concentration gradient.Fungal gene template was prepared by boiling method,sequences of 16SRNA and 18SRNA were amplified using bacteria conservative gene sequence of 16SRNA and fungal conserved gene sequence of 18SRNA,and observed and recorded the results agarose gel electrophoresis.At the same time,the amplified fragment of bacterial conservative gene 16SRNA was sequenced,and the sequence was analyzed by BLAST comparison.Results the 16SRNA sequences of candida variant were amplified positive,while the standard strain of candida albicans did not show the corresponding amplification band.Except 2 strains which showed a faint band,the other variants of the 18SRNA sequences did not amplified the target band,while the standard strains of candida albicans showed a corresponding amplification bands.Suggested that proportion of 18SRNA sequences in the genome of oidiomycetes mutant strains like bacterial morphology was not much even lack.The 16SRNA fragments amplified of oidiomycetes mutant strains like bacterial morphology did determination of DNA sequence after purification.BLAST comparison analysis,it was found that sequence of oidiomycetes mutant strains like bacterial morphology had higher similarity with bacterial sequences in the database.Conclusion Oidiomycetes mutant strains like bacterial morphology contained bacterial and a small amount of fungus conservative gene.Oidiomycetes mutant strains like bacterial morphology with original nuclear biological character are ones from eukaryotes.This study is great significance in biological evolution,especially in the evolution of prokaryotic cells and eukaryotic cells.

Objective:To explore the characteristics and the influential factors of unmet needs and services development of rehabilitation for people with extremely severe hearing disability (PSHDs). Methods:A total of 90 052 PSHDs were included. Multiple response was used to analyze the characteristics of unmet needs and services of rehabilitation. The structural equation model of the received service and unmet needs of PSHDs was developed. Results:The reporting rate of unmet needs of rehabilitation for PSHDs, from high to low, were assistive devices (61.5%), nursing care (24.1%), medicine (23.4%), functional training (17.6%) and surgery (2.5%). The reporting rate of received service for PSHDs, from high to low, were assistive devices (58.3%), nursing care (24.4%), medicine (22.4%), functional training (22.0%) and surgery (2.2%). Structural Equation Model showed that the more services received, the more needs for cochlear implantation surgery and speech therapy (P < 0.001); the better family income situation, the more needs for cochlear implantation surgery (P < 0.001); and age factor had significant effects on the unmet needs of cochlear implantation surgery and speech therapy (P < 0.001). Conclusion:PSHDs reported unmet needs and received services mainly included assistive devices, nursing care, medicine and functional rehabilitation training. Those PSHDs who had received services would report more demand of unmet needs, supposed that improving the accessibility and coverage of services should be emphasized in the development of rehabilitation services. According to ICF model, on the basis of the characteristics of the unmet needs of PSHDs, it proposed to take measures to implement precise rehabilitation services to improve the quality of services.

Objective:To explore the characteristics and related factors of unmet needs of nursing care and service for adults with extremely severe and severe intellectual disabilities. Methods:A total of 127 547 adults with extremely severe and severe intellectual disabilities were sampled. Descriptive statistics and multiple response analysis were conducted, and a structural equation model of unmet needs of nursing care and received the services was developed. Results:A total of 26 038 adults with extremely severe and severe intellectual disabilities reported unmet needs of rehabilitation, including nursing care (52.50%), medicine (36.90%), assistive device (20.90%), functional training (19.70%) and surgery (0.80%) respectively. A total of 11 640 adults with extremely severe and severe intellectual disabilities reported received rehabilitation services, including nursing care (49.90%), medicine (36.80%), functional training (19.10%), assistive device (14.10%) and surgery (1.00%) respectively. The structural equation model showed that received nursing care service (main effect = 0.646) and received rehabilitation services (included nursing care) (main effect = 0.014), age (main effect = 0.031), household registration (main effect = 0.015) and educational level (main effect = -0.158) had effects on unmet needs of nursing care (P < 0.001). Conclusion:Adults with extremely severe and severe intellectual disabilities reported unmet needs mainly involved in field of nursing care, and their rehabilitation services mapped to their main needs. It proposed to develop rehabilitation services tailored to their rehabilitation experience, age, socioeconomic status, functional conditions and characteristic of unmet needs, to develop accessible services items and individualized nursing care programs, and to expand the nursing care service supply and coverage of nursing care.