Background Idiopathic macular epiretinal membrane (IMEM) combined with age-related cataract (ARC)is a common eye disease and the primary managing approach is the combination of phacoemulsification,intraocular lens (IOL) implantation and vitrectomy.However,whether the ocular length measured by IOL Master is accurate for the calculation of IOL refraction in the eye with IMEM remains unclear.Objective The aim of this study was to evaluate the refractive outcomes of combination surgery of phacoemulsification,IOL implantation and vitrectomy in IMEM eyes.Methods A prospective cohort study was designed.Forty-two eyes of 42 patients with IMEM combined with ARC (IMEM+ARC group) were enrolled in Peking University People's Hospital and the combination of phacoemulsification,IOL implantation and vitrectomy was performed from September 2010 to August 2011,and 47 eyes of 47 patients with ARC were included for the phacoemulsification combined with IOL implantation in the corresponding period (ARC group) under the approval of Ethic Committee of Peking University People's Hospital and informed consent of the patients.Ocular length and corneal curvature were measured using IOL Master,and the expected IOL diopter was calculated with SRK-T formula.Regular eye examination and medical optometry were performed 1 month and 3 months after operation to obtain the actual diopter and the refractive error.The outcomes were compared between the two groups.The correlations of refractive error with change of fovea thickness were evaluated after operation in the IMEM+ARC group.Results There were no statistically significant differences in the age,ocular length and corneal curvature between the two groups before operation (P =0.863,0.704,0.770).The visual acuity was improved 3 months after operation in comparison with before operation in both groups (P=0.001,0.000).The negative diopters were obviously higher 1 month and 3 months after operation than those before operation in both groups (all at P＜0.001),but no significant difference was seen between the IMEM+ ARC group and ARC group (Fgroup =0.417,P =0.520).The diopter deviations 1 month and 3 months after operation were (-0.727±0.666)D and (-0.628±0.627)D in the IMEM+ARC group,and those in the ARC group were (-0.664±0.644) D and (-0.642±0.550) D,showing insignificant differences between the two groups (Fgroup =0.036,P =0.849 ; Ftime =1.523,P =0.221).In IMEM + ARC group,the macular fovea thickness was (474.89 ± 135.76)μm in preoperation,and the shift values of macular fovea thickness were (-83.84 ±91.12)μm and (-158.53±113.03) μm in postoperative 1 month and 3 months.No positive correlations were presented between the diopter deviations and change of fovea thickness 1 month and 3 months after operation in the IMEM+ARC group (r=0.200,P =0.229 ; r =0.065,P =0.698).Conclusions Myopia shift after operation is similar in the IMEM combined with ARC patients to the only ARC patients,suggesting that the ocular length and corneal curvature measured by IOL Master is not affected by epiretinal membrane.

Diabetic cardiomyopathy(DCM) is a disease independently related with coronary artery atherosclerotic heart disease, hypertensive heart disease, valvular heart disease, congenital heart disease and other heart diseases that are uniquely associated with diabetes mellitus, and the pathological manifestations of DCM are mainly myocardial hypertrophy, interstitial fibrosis, necrosis and apoptosis.Endoplasmic reticulum is the central location of many important cellular functions, and endoplasmic reticulum swelling and functional disorder in diabetic cardiomyocytes, high blood sugar can cause endoplasmic reticulum stress, suggesting that endoplasmic reticulum stress(ERS) may be involved in the pathogenesis of diabetic cardiomyopathy and development.Based on this, this paper summarizes the progress of ERS in diabetic cardiomyopathy from the pathogenesis of diabetic cardiomyopathy, unfolding protein reaction and the related role of ERS in DCM.

Objective To investigate spiral CT,PET/CT and clinical manifestations in non-HIV infectious penicilliposis marneffei lung disease, to improve diagnostic level of this disease.Methods Imaging manifestations of 6 cases of non-HIV infectious penicilliposis marneffei confirmed by bronchofiberscope lung biopsy and/or pus culture were analyzed retrospectively All cases underwent chest CT,two had brain MRI,and two had PET/CT scan before treatment.Imaging appearances were observed and combined with clinical dates and literatures.Results Unilateral lung lesion was detected in 1 case,bilateral lungs lesions in 5 cases.Multiple patchy consolidation,stripe shadow in bilateral lungs or right lung were found in 3 cases, multiple nodes in 2 cases, mass with nodes in 1 case.Among 6 cases, 2 had septa interlobulare thickness,1 had tracheal fistula,2 had pericardium and pleura involvement,4 had bone destruction,1 had the brainand liver involvement.6 cases showed multiple lymphadenectasis,amalgamation and necrosis in bilateral hilar,mediastinaand the neck.2 had abdominal cavity and or retroperitoneal lymphadenectasis.On PET/CT,2 cases showed high uptake,and the range of SUV value were 1.4-13.9.Initial misdiagnosis by imaging was found in 5 cases.6 patients recovered after anti fungus treatment.Conclusion Imaging appearances of non-HIV infectious penicilliposis marneffei mainly reveals as multiple patchy consolidation,nodes and mass in bilateral lungs, all accompany with lymphadenectasis, many with bone destruction,lack of specificity, which needs lesion biopsy and pus culture to make confirmed diagnosis.

Cerebral Veins ; Female ; Humans ; Middle Aged ; Prosthesis Implantation ; Stents ; Tinnitus ; etiology ; surgery

In order to understand the existing problems in the management of medical ethical review,this paper summed up related domestic literature published in 2001 to 2015 with the method of literature analysis.There existed several problems in the construction and management,the ability of ethical review,external supervision,and other aspects of the current medical ethics committee.It suggests that strengthening external continuous supervision,strengthening the ethics committee itself construction and management and participating in standardized certification can help medical ethics committee to solve the above problems and have important significance for the standardized development.

ObjectiveTo investigate the relationship between microalbuminuria (MAU) and short-term outcome in patients with acute ischemic stroke.MethodsThe consecutive patients with acute ischemic stroke admitted to hospital were enrolled prospectively.The first urine specimen was taken on the following morning after admission for detecting urine albumin/creatinine ratio (UACR).UACR 30-300 mg/g was defined as MAU positive.Stroke severity was evaluated with the National Institutes of Health Stroke Scale (NIHSS) at admission and the modified Rankin Scale (mRS) was used to evaluate functional outcome at discharge, and good outcome was defined as mRS score of 0 to 2.ResultsA total of 244 patients with acute ischemic stroke were enrolled, including MAU positive in 53 patients (27.12%), and poor outcome in 67 patients (27.50%).Univariate analysis showed that age, baseline NIHSS score, systolic blood pressure, fasting blood glucose, globulin, D-dimer, white blood cell count, neutrophils, and the proportions of ischemic heart disease in patients of the MAU positive group were significantly higher than those of the MAU negative group (all P<0.05).Multivariate logistic regression analysis showed that MAU (odds ratio [OR] 1.520, 95% confidence interval [CI] 1.151-1.794;P=0.031), baseline NIHSS score (OR 1.570,95% CI 1.357-1.808;P<0.001) were the independent risk factors for short-term poor outcome in patients with acute ischemic stroke.ConclusionsThe incidence of MAU is high in patients with acute ischemic stroke.MAU positive can be used as one of the independent predictors of short-term poor outcome in patients with acute ischemic stroke.

Humans ; Infant, Newborn ; Male ; Protein C ; metabolism ; Protein C Deficiency

Objective To explore effects of ginsenosides Rg1 on the expression of poly(ADP-ribose) polymerase-1 (PARP-1) and tumor necrosis factor receptor (TNFR) 1 in cortex cells after focal cerebral ischemia in rats. Methods Ninety healthy rats were randomly divided into sham-operative group, focal cerebral ischemia group, ginsenoside Rg 1groups (low, medium and high concentrations) and drug control group. Rats were intraperitoneally injected saline 45 mg/kg, saline 45 mg/kg+ginsenosides Rg1 10, 20 and 40 mg/kg, nimodipine 1 mg/kg 5 d before surgery, respectively. Focal cerebral isch?emia model was made by middle cerebral artery occluding in rats. The neurological deficit score and TTC staining were used to verify the success of the rat model. The expressions of PARP-1 and TNFR1 were evaluated by immunohistochemical meth?od and Western blot technique. Results There were obvious symptoms of neurological deficit and large pale infarct area in focal cerebral ischemia group compared with those of sham-operative group. There were higher percentages of neurological deficit score and infarct area in ginsenosides Rg1 groups and positive control group than those of sham-operative group, but which were lower than those of ischemia group (P<0.05). There were no significant differences between ginsenosides Rg1 groups and positive control group. The positive cells of PARP-1 and TNFR1 were higher in ginsenosides Rg1 low-dose group than those of sham-operative group and positive control group, while ones of medium and high-dose Rg1 group were higher than those of sham-operative group, and were lower than those of ischemia group (P<0.05). Compared with sham-op?erative group, PARP-1 and TNFR1 expression strips were significantly enhanced in ischemia group. Expression strips were higher in ginsenosides Rg1 low-dose group than those of sham-operative group. Expression strips were higher in ginsen?osides Rg1 medium-dose group than those of sham-operative group, but which were lower than those of ischemia group, and ones of high-dose group were lower than ischemia group (P<0.05). Conclusion Ginsenoside Rg1 shows protective effects on focal ischemia injury, which may be related with down-regulation of the expression of PARP-1 and TNFR1.

Objective To observe the dynamic changes of leptin and transforming growth factor (TGF)-β1 in formation of liver fibrosis in rats,and the role of leptin in liver fibrosis.Methods Six rats were served as normal control(0 week)and killed at the beginning of the study.Thirty-two rats were subcutaneously injected with 60%CCl4 to establish fibrotie models.The rats were than sacrificed at 3,6,9 and 12 weeks with eight each.Expressions of leptin mRNA,Ob-Rb mRNA,TGF-β1 mRNA and TGF-βRⅡmRNA in liver were detected by reverse-transcription polymerase chain reaction(RT-PCR).Expression of Smad3 and Smad7 proteins were determined by Western blot.The expression and loealization of leptin,Ob-Rb and TGF-β1 in liver tissue were detected by immunohistochemistry.Results The expression of leptin mRNA,Ob-Rb mRNA,TGF-β1 mRNA and TGF-βR Ⅱ mRNA in 0 week were 0.43±0.45,0.57±0.21,0.19±0.12 and 0.30±0.22,respectively,and increased to 1.27±0.19,1.70±0.29,1.70±1.00 and 2.14±1.02 at 12 weeks(P＜0.05).At the same times the level of Smad3 increased from 0.44±0.24 at 0 week to 1.75±1.05 at 12 weeks.While the expression of Smad7 was decreased from 1.35±0.12 at 0 week to 0.74±1.21 at 12 weeks(P＜0.05).The expressions of leptin,Ob-Rb and TGF-β1 were increased with the formation of the fibrosis(P＜0.01).Conclusions With the development of liver fibrosis,the expressions of leptin,Ob-Rb mRNA and protein are increased and improved the formation of the fibrosis.Its mechanisms may be correlated with up-regulation of TGF-β1,TGF-βR Ⅱ and Smda3 expressions and down-regulaton of Smad7 expression by leptin.

AIM: To investigate the role of epigenetic modification in Pdx-1 gene transcription and expression, and to compare the differences between epigenetic modifications of Pdx-1 gene promoter in various cell types of mice. METHODS: The promoter DNA methylation and histone modification status of Pdx-1 and MLH1 genes in NIT-1 cells, NIH3T3 cells and mouse embryonic stem cells were measured by chromatin immunoprecipitation-real time PCR method. The expression levels of these genes in the three cell lines were measured by real time RT-PCR. The relation between epigenetic modifications and gene expression was analyzed. RESULTS: (1) Compared to mES cells, there was lower DNA methylation and higher H3K4m3 modification levels in the promoter of Pdx-1 gene in NIT-1 cells (P<0.05). DNA methylation, H3 acetylation, H3K4m3 and H3K9m3 modification levels in the promoter of Pdx-1 gene in NIH3T3 cells were distinctly increased (P<0.05). (2) Pdx-1 gene transcription expressed only in NIT-1 cells. The Spearman's rho between Pdx-1 gene expression and DNA methylation (r=-0.802,P<0.01) was observed. The Pearson correlation between Pdx-1 gene expression and H3K4m3 modification (r=0.997,P<0.01) was also found. The Spearman's rho between Pdx-1 gene expression and H3K9m3 modification (r=-0.879,P<0.01) was observed. (3) No correlation between housekeeper MLH1 gene expression and epigenetic modification was found. CONCLUSION: DNA methylation, H3K4m3 and H3K9m3 modification coordinated participate to regulate and control the expression of Pdx-1 gene. It is of great significance to the differentiation of β cells from ES cells.