Objective To evaluate the clinical features, diagnosis, and outcome of the treatment of cytomegalovirus (CMV) retinitis, and the relationship between CMV retinitis and acquired immunodeficiency syndrome (AIDS). Methods A total of 95 eyes of 56 patients with cytomegalovirus retinitis and AIDS were studied. The fundus feature, visual acuity and CD4 + T lymphocyte counts were analyzed and the follow up periods ranged from 2 weeks to 18 months. Results Before the definitive diagnosis of CMV retinitis, the courses of AIDS were 4 to 26 months in all patients. In the initial examination, the granular form of CMV retinal lesion was noted in 55 eyes (57%) in which retinal lesion of 46 eyes was peripheral. The fulminant form of CMV retinitis of 25 eyes (26%) was found in the posterior pole and consisted of densely opaque retinal lesions with blotchy hemorrhage and vasculitis. The overlap between these two presentations was noted in 15 eyes. Papillitis was observed in 7 eyes of CMV retinitis in this series of patients. The visual acuity ranged from finger counting to 0.5. The patients with extensive CMV retinitis or CMV retinitis in the posterior pole got poorer vision. The CD4 + T lymphocyte counts of 30 patients was 0 30 (mean, 15?9/?l), and the survival time ranged from 2 weeks to 18 months (mean, 6.4?3.3 months). The vision was improved and CD4 + T lymphocyte counts was significantly higher in the group treated with ganciclovir, and progression of CMV retinitis occured and the vision decreased in the non treated group. Conclusion CMV retinitis is the most common intraocular complication in patients with AIDS. Diagnosis of CMV retinitis is based on the characteristic of necrotizing retinitis which was typically associated with retinal hemorrhage and vasculitis. Ganciclovir is effective for the treatment of CMV retinitis.

Objective To explore the therapeutic effects of radical mastectomy(RM) and extended radical mastectomy(ERM) for stage II, III breast cancer. Methods The 5 year and 10 year survival rates in 691 patients with stage II, III breast cancer treated either by extended radical mastectomy or radical mastectomy were retrospectively analyzed . Out of the 691 patients, 206 stage II cases and 193 stage III cases underwent RM, and 142 stage II and 150 stage III cases received ERM. Results In patients with stage II, III breast cancer located in the central portion or medial portion of mammary, the 5 year survival rates and in stage III patients 10 year survival rate after ERM were significantly higher than those after RM (P

Objective To investigate the clinical characteristics of patients suffering from autoimmune hemolytic anemia(AIHA) associated with acute kidney injury (AKI).Methods The clinical data of 2 case patients with AIHA and AKI in the People's Hospital of Huadu District of Guangzhou was analyzed and associated literatures were reviewed.Results Two patients presented with severe anemia,raised reticulocyte count,positive Coomb's test,and acute renal failure.They were no effect therapy when treatment with agent of erythropoietin (EPO),iron or folic acid.The level of serum indirect bilirubin was at normal range.Liver function and serum LDH were normal too.However,treatment with corticosteroids was effective.Conclusion When patients suffering AKI occur worsening anemia,AIHA probably should be concerned.Treatment with corticosteroids early is effective.

Objective To investigate the changes in corneal astigmatism after trabeculectomy using removable suture and the duration of postoperative diopter stabilization.Methods From June 2014 to July 2016,70 primary glaucoma patients (70 eyes) were enrolled and divided into two groups,including experimental group 40 patients (40 eyes) with trabeculectomy using removable suture and control group 30 patients (30 eyes) with trabeculectomy alone.Then,several variables of corneal topography,corneal curvature,diopter and intraocular pressure were recorded and analyzed before operation and 1 week (before removal of the suture),1 month and 3 months after surgery.Results In the two groups,postoperative diopter and intraocular pressure at each time point approached significant difference (all P ＜ 0.01).There was significant difference in comparison of corneal astigmatism 1 week after surgery (3.80 ± 1.31) D and preoperative corneal astigmatism (1.48 ± 0.79) D in experimental group,and this was true of the control group for corneal astigmatism 1 week after surgery [(1.42 ± 0.32)] and preoperative data (1.12 ± 0.36) D (all P ＜ 0.05).Moreover,corneal astigmatism 1 month and 3 months after surgery in the experimental group was (1.50 ± 0.71) D and (1.36 ± 0.61) D,and this data in the control group was (1.24 ± 0.31) D and (1.09 ±0.34)D respectively,and their differences was not statistically significant compared with the control group (all P ＞ 0.05).There was significant difference in the corneal astigmatism 1 week after operation (P ＜ 0.01),while there was no significant difference in this variable 1 month and 3 months after operation between the two groups (all P ＞ 0.05).Although the corneal astigmatism 1 month after operation was enhanced compared with 3 months after operation,but the difference was not statistically significant (all P ＞ 0.05).In addition,the number of with-the-rule astigmatism in the experimental group and the control group were 33 eyes and 22 eyes respectively (P =0.36).Conclusion The corneal astigmatism caused by trabeculectomy using removable suture was significantly enhanced in the early period,but it decrease easily in 1 month after removing the suture,with keeping stable in 3 months and getting with-the-rule astigmatism 3 months after surgery.

Objective To investigate the effects of dihydroartemisinin (DHA) on the proliferation of gastric cancer cell line SGC7901 and its mechanism.Methods SGC7901 cells were divided into the DHA group and the control group.SGC7901 cells in the DHA group were treated with DHA of different concentrations (6.25,12.50,25.00,50.00,100.00 μmol/L),SGC7901 cells in the control group were cultured in the 0.1％ DMSO medium.The proliferation of SGC7901 cells was detected by the MTF method at different time points (24,48,72 hours).Cell cycles of SGC7901 in the DHA group were observed by flow cytometry at 24 hours after treatment.The expressions of Cyclin A,Cyclin D1,Cyclin E,Cyclin-dependent kinase 4 (CDK4) and P16 were detected by Western blot after treating SGC7901 with DHA at concentration of 100μmol/L for 24 hours.The interaction between CDK4 with Cyclin D1 or P16 was examined using the co-immunoprecipitation assay.All data were analyzed using the one-way analysis of variance or the t test.Results The proliferation of SGC7901 cells was significantly inhibited after the treatment with DHA at different concentrations (6.25,12.50,25.00,50.00,100.00 μmol/L) for 24,48 and 72 hours (F =78.66,235.37,93.75,P ＜ 0.05).Compared with control group,the number of SCG7901 cells in the G0/G1 phase in the DHA group was significantly increased (F =18.42,P ＜0.05).After treating SGC7901 cells with DHA for 24 hours,the protein expressions of Cyclin D1 and CDK4 were 0.67 ± 0.15 and 0.64 ± 0.18 in the control group,which were significantly higher than 0.17 ± 0.05and 0.24 ± 0.06 in the DHA group (t =7.746,5.164,P ＜ 0.05).The protein expressions of Cyclin E were 0.42 ± 0.06 in the control group and 0.35 ± 0.06 in the DHA group,with no significant difference (t =2.021,P ＞ 0.05).The protein expressions of Cyclin A were 0.35 ± 0.09 in the control group and 0.38 ± 0.08 in the DHA group,with no significant difference between the 2 groups (t =1.266,P ＞ 0.05).The protein expressions of P16 were 0.29 ± 0.07 in the control group and 0.54 ± 0.12 in the DHA group,with significant difference between the 2 groups (t =4.408,P ＜ 0.05).The results of co-immunoprecipitation assay showed that DHA decreased the interaction between CDK4 and Cyclin D1,and increased the interaction between CDK4 and P16.Conclusion DHA induces SGC7901 cells arrested in G0/G1 phase,and the effect may be related with its downregulation of Cyclin D1 and CDK4,up-regulation of P16,decreasing the interaction between CDK4 and Cyclin D1,and increasing the interaction between CDK4 and P16.

Objective: To investigate the influence and significance of DHA on expression of angiogenesis-related genes in SGC7901 cells. Methods:SGC7901 were treated with DHA (5, 10, 20, 40, and 80μmol/l) for different times (24, 48, and 72 h), and the growth inhibition was detected by MTT. The expression of vascular endothelial growth factor (VEGF-C), cyclooxygenase-2 (COX-2) vascular cell adhesion molecule-1 (VCAM-1), and PTEN mRNA were detected by fluorescence-based quantitative poly-merase chain reaction (qRT-PCR). Their corresponding protein levels were tested by Western blot. Results:DHA significantly inhibited the growth of SGC7901 cells in a dose-and time-dependent manner (P<0.05). The expression of the angiogenesis-related genes signifi-cantly changed, as shown by RT-PCR and Western blot analyses. Compared with the control group, the expressions of VEGF-C, COX-2, and VCAM-1 were down-regulated, whereas the expressions of PTEN were up-regulated, after DHA treatment (P<0.05). Con-clusion:DHA inhibits cell growth in gastric cancer SGC7901 cells. The effect may be due to its reduction of VEGF-C, COX-2, and VCAM-1 gene expression, as well as its promotion of PTEN expression in gastric cancer cells.

Objective To analyze the causes of complications and death of the femoral intertrochanteric fracture during perioperative period, and to assess the orthopedics surgery risk of aged. Methods 499 of 547 cases were retrospectively re?viewed (132 male, 367 female), who underwent operation from May 2007 to Jun 2014 in our hospital. Their age varied from 59 to 103 years old, with an average of 78.3 ± 7.3 years old. According to Evans classification, there were 84 cases of type I, 67 type II, 187 type III, and 161 type IV. The causes of death were analyzed and discussed. The factors including health assess?ment before operation, age, operating time and blood loss were studied statistically to find out their correlation with mortality of operation. Results There were altogether 354 complications, including pulmonary infection, urinary system infection, DVT, and cardiac events. There were 30 cases of death and the mortality was 6.0%. The major causes of death included infectious shock, pulmonary infection, cardiac events, kidney failure and hemorrhagic shock caused by hepatic rupture. Statistical results from the score of APACHEⅡshowed the factor which definitely influenced the mortality was the amount of blood loss during op?eration.APACHEⅡscoring area under the ROC curve was 0.938, and the best cutoff value was 17.5 (about an index of 0.767), with the sensitivity of 86.7%and specificity of 90%. The area of risk of death under the ROC curve by APACHE Ⅱscore was 0.817, the best cutoff value of 16.765%(about an index of 0.483), and the sensitivity and specificity of 93.3%and 55.0%. Conclu?sion There were a lot of complications and accompanied diseases when femoral intertrochanteric fractures happened in aged pa?tients. The main cause of death was septic shock. There were relationships between hemoglobin and the operating time and the de?gree of trauma. What’s more, it was confirmed that the APACHEⅡscoring system was very useful to value the condition of the patients with femoral intertrochanteric fractures, which can be recommended.

Objective:To compare the clinical outcomes between replacement with a composite press-fit radial head prosthesis versus open reduction and plate-screw internal fixation in the treatment of adult Mason Ⅲ radial head fractures.Methods:The clinical data of 64 adult patients with Mason Ⅲ radial head fracture were retrospectively analyzed who had been admitted to Department of Orthopedics, Beijing Friendship Hospital from January 2012 to December 2019. They were 18 males and 46 females, aged from 32 to 58 years (average, 45.7 years). They were divided into 2 groups: 32 cases received mini-plate-screw internal fixation (internal fixation group) and 32 cases replacement with a composite press-fit radial head prosthesis (replacement group). At the last follow-up, elbow valgus angle, range of elbow motion, Mayo score of elbow function and visual analogue scale (VAS) pain score were recorded and compared to evaluate the postoperative clinical outcomes.Results:There was no statistically significant difference in the preoperative general data between the 2 groups, showing they were comparable ( P>0.05). All patients were followed up for 8 to 48 months (average, 18.7 months). The operation time was, respectively, (81.4±8.2) min and (68.9±7.3) min for the internal fixation group and the replacement group, showing a statistically significant difference ( P< 0.05). For the internal fixation group and the replacement group at the last follow-up, the flexion and extension angles were 95° to 125° and 100° to 140°, the rotation angles 135.3°±11.2° and 143.5°±12.8°, and the Mayo scores 79.2±3.8 and 83.4±3.9, all significantly favoring the replacement group ( P<0.05). The VAS pain scores before operation and at the last follow-up were 7.6±0.7 and 0.9±0.7 for the internal fixation group, and 7.9±0.8 and 0.7±0.6 for the replacement group, showing significant differences between preoperation and the last follow-up in both groups ( P<0.05). All the incisions healed by the first intention, with no postoperative infection. Internal fixation loosening with ulnar neuritis was reported in one case in the internal fixation group; peri-prosthesis absorption with no prosthesis loosening was observed in one case in the replacements group. Conclusion:In the treatment of adult Mason Ⅲ radial head fractures, although both replacements with a composite press-fit radial head prosthesis and open reduction and plate-screw internal fixation can lead to satisfactory results, the former may be more effective.

Objective To investigate the in vitro effects of bladder cancer cell proliferation after silencing Notch1 gene. Methods The siRNA eukaryotic expression vector of Notch1 (psiRNA1)was constructed and transfected into bladder cancer cell lines T24 and BIU-87. Methabensthiazuron (MTT) and flow cytometry (FCM) assays were used to detect bladder cancer cells line growth, cell cycle and apoptosis after the transfection. RT-PCR and Western blotting were used to determine the expression changes of Notch1 in these cell lines. Results After transfection for 72 h, the rate of G0/G1 phase cells inceased from (23.89±1.32) % to (80.13±2.69)% in T24 cell line, and increased from (24.63±1.68)% to (69.44±2.41)% in BIU-87 cell line (both P<0.05). In addition, apop-totic cell index in T24 and BIU-87 cell lines increased from (1.28±0.14)% to (13.75±1.23)%, from (1.01±0.27)% to (8.72±1.01)%, respectively(both P<0.05). The growth of T24 and BIU-87 cell lines was obviously inhibited 24 h after the transfection, and the inhibitory effects lasted until 96 h after the transfection. Notch1 mRNA and protein significantly downregulated after transfection compared to the control(P<0.05). Conclusions Silencing Notch1 expression can inhibit the prolif-eration of bladder cancer cell lines. Notch1 gene might act as a tumor gene in bladder cancer.

Objective To determine the association of mutations in aldosterone synthase (CYPllB2)and 11 beta-hydroxylase(CYP11B1)genes with primary aldosteronism(PA).Methods Five mutations of CYP11B2 and CYP11B1 genes were analyzed in patients with PA and normal population.Among them,intron 2 was detected by 2 independent PCR reactions,and the others were analyzed using Taqman probes.The Haploview 4.0,SNPassoc 1.5-3 and Haplo.stats 1.3.8 were used to analyse the association between polymorphisms and PA.Results All the selected mutations were successfully genetyped.Only rs64lO allelic frequencies in patients with aldosterone-producing adenoma (APA)and idiopathic hyperaldosteronism(IHA)were significantly different with those in controls (P＜0.05).There was a relative excess of AA homozygotes and AG heterozygotes of rs6410 allele in APA group compared with control group(P＜0.01).There were significantly different genotypes AA and AG of rs6410 allele between patients with IHA and controls only after adjusted for age,gender,eeptible haplotype AAAWT was identified to be significantly associated with APA(OR=1.44,95%CI 1.19-1.76).Three susceptible haplotypes AAAWT,AGGWT and AGAWC were identified to be significantly associated with IHA(OR=1.55,95%CI 1.23-1.96;OR=1.49,95%CI 1.17-1.89;OR=1.40,95%CI 1.04-1.88).In contrast,1 protective haplotype GGAWT showed significant difference between patients with APA and controls(OR=0.73,95%CI 0.55-0.97).Conclusion There is a significant association between genetic variations in CYP11B2 and CYP11B1 genes and genetie predisposition to PA.