ObjectiveTo investigate the expression of ATA1 in the synovial tissue from patients with ankylosing spondylitis (AS) and to localize expression of ATA1 in AS synovial membranes.In addition,tag SNPs were genotyped to determine the possible association of this gene with AS risk.MethodsWestern blotting analysis was applied to determine the expression of ATA1 in the synovial tissues by comparing the expression profiles of AS(n=8),rheumatoid arthritis(RA,n=9) and osteoarthritis(OA,n=9) samples.Immuno-histochemistry was used to localize the expression of ATA1 in the synovial membrane.The levels of ATA1 in the synovial fluid of patients with AS were determined using ELISA with OA and RA as controls.Taqman method was used to genotype tag SNPs (rs2753934,rs2749531 and rs6575424) in 56 AS cases,260RA cases and 160 healthy controls.ANOVA,LSD test andx2 test were used for statistical analysis.Results Increased expression of ATA1 in synovial membranes of AS was found when compared with samples from RA and OA.ELISA results showed significantly elevated level of ATA1 in the synovial fluid of patients with AS (1.6+0.6),but not in samples of RA(1.4±0.5) and OA (1.2±0.5)(P＜0.05).Haplotype analysis did not reveal a haplotype association in AS or RA(P＞0.05).ConclusionThe current findings suggest that upregulation of ATA1 may play an important role in the pathogenesis of AS.

Objective To evaluate the significance of cystatin C (CysC) in the diagnosis for early kidney injury of diabetes and hypertension by testing serum CysC and serum creatinine concentration and urinary albumin excretion (UAE) in patients with type 2 diabetes and primary hypertension.Methods Sixty-six patients with type 2 diabetes were selected,among whom the total 38 patients whose UAE were 30-300 mg/24 h were classified into early diabetic nephropathy (DN) group,and 28 patients whose UAE were ＜ 30 mg/24 h were classified into non diabetic nephropathy (NDN) group.Fifty-two patients with primary hypertension were selected,among whom the total 25 patients whose UAE were ≥ 30 mg/24 h were classified into hypertension with kidney injury group,and 27 patients whose UAE were ＜ 30 mg/24 h were classified into hypertension without kidney injury group.Sixty health people were selected as control group.The UAE,CysC and creatinine levels were detected.Results The CysC in early DN group was significantly higher than that in control group and NDN group [(1.84 ± 0.83)mg/L vs.(0.41 ± 0.62) and (0.66 ± 0.59) mg/L],and there was statistical difference (P ＜ 0.05).There was no statistical difference in CysC between NDN group and control group (P ＞ 0.05).There were no statistical differences in creatinine and UAE among the DN group,NDN group and control group (P ＞ 0.05).The CysC in hypertension with kidney injury group was significantly higher than that in control group and hypertension without kidney injury group [(0.93 ± 1.04) mg/L vs.(0.41 ± 0.62) and (0.69 ± 0.57) mg/L],and there was statistical difference (P ＜ 0.05).There was no statistical difference in CysC between hypertension without kidney injury group and control group (P ＞ 0.05).There were statistical differences in creatinine and UAE among hypertension with kidney injury group,hypertension without kidney injury group and control group (P ＞ 0.05).Conclusion CysC can be regarded as the value to judge early kidney injury,and it is very important inunderstanding patient's condition,by which appropriate treatment can be carried out to prevent or decrease the occurrence of chronic renal failure.

Objective Through the evaluation of acute myocardial infarction patients care burden of caregivers,to understand caregiver stress con?dition,and to investigate the effective predictors of acute myocardial infarction patients care burden of caregivers,so as to provide the basis for im?provement of the care burden. Methods A cross?sectional study was conducted through convenience sampling using Zarit Caregiver Burden Inter?view as the measuring tool. Questionnaires were collected by face?to?face structured interviews towards caregivers. Care burden of caregivers was eval?uated on these primary caregivers of patients with acute myocardial infarction. Results Caregivers of patients with myocardial infarction endure high care burden level. There were statistically significance among patients with different ages or revenue,the relationship of caregivers with patients,nurs?ing hours per day,psychological alignment and patients′self?care ability. Conclusion Caregivers of patients with myocardial infarction endure high care burden level. The relationship between caregivers and patients,the patient′s gender,nursing total time,nursing time every day,and the pa?tient's life self?care ability are contributed to be predictive factors. Future interventions should be strengthen on the psychological ability of the align?ment as well as measures to improve the self?care ability of the patient's life.

Objective To investigate the value of ultrasound-diffuse optical tomography(US-DOT) in evaluation of the response to neoadjuvant chemotherapy (NCT) in patients with breast cancer.Methods Fifty women with breast cancer confirmed by biopsy-pathology scheduled to undergo NCT were enrolled.US-DOT was performed and the total hemoglobin concentration(HbT) prior to and at the end of NCT.According to the response to treatment in solid tumors,patients were divided into complete response(CR) group,partial response (PR) group,stable disease (SD) group and progressive disease (PD) group.The analysis of variance compared the differences of HbT before and after NCT in each group; Pearson correlation analyzed the relationship between the relative HbT variation and the tumor size changes;Mixedeffects model analyzed the relationship between HbT and tumor size.Results After NCT,CR group had 8 cases,PR group 30 cases,SD group 12 cases and no PD cases.Before and after NCT,the mean relative variations of HbT before and after NCT were-0.525 ± 0.222,-0.328 ± 0.180 and-0.173 ± 0.167 in CR,PR and SD groups,respectively.The differences of HbT before and after NCT were statistically significant in each group (P ＜0.05).There was significant difference among tumor diameter and HbT in CR group and PR group (P ＜0.001);while in the SD group,there was no difference among tumor diameter and HbT (P ＞ 0.05).The change of HbT after NCT showed positive correlation with the change in tumor size (r =0.6).Mixed-effects model also showed that HbT change was associated with tumor size.Conclusions USDOT marker HbT is closely related to tumor size of breast cancer before and after NCT and may be applied to evaluate the response of breast cancer to NCT.

AIM: To investigate the efficacy, safety and localization of multilayer amniotic membrane transplantation (AMT) for the management of corneal perforation associated with ulceration.METHODS: Six eyes (6 patients) were treated with multilayer AMT for corneal perforation associated with ulceration. The perforation size was 0.5-2mm in diameter. The amniotic membrane (AM) was applied to tamp the perforation, fill the ulcer and cover the surface of ulcer. The follow-up ranged from 5-19 months.RESULTS: The anterior chamber reformed at the first postoperative day in all patients, and kept in normal depth in the follow- up time. The epithelialization of the AM grafts was observed in about 3 weeks after surgery. During the first postoperative month, the corneal thickness at the perforation site gradually increased, and the stromal inflammatory cell invasions surrounding the corneal ulcer were gradually subsided.Two months postoperatively, the ulcer healed with scar with part neovascutarization; the corneal thickness of the ulcer area was stable and recovered almost normal. The vision was not improved in all patients after operation. During-follow up,no severe complications or recurrence of ulceration was noted.CONCLUSION: Multilayer AMT is an effective and safe method for the management of small corneal perforation associated with ulceration, but the ulcer healed with scar.

AIM: To evaluate the efficacy and safety of annular bubble conjunctival excision combining with amniotic membrane transplantation(AMT) for vernal keratoconjunctivitis(VKC) with gelatinous swellings(papillae) at the limbus.METHODS: Twenty eyes(10 patients) with VKC, were characterized by gelatinous swellings(papillae) at limbus and were underwent annular bubble conjunctival excision associated with AMT. The follow up ranged 5-21months.RESULTS: After operation, the symptoms were subsided remarkably: itching,discharge and foreign body sensation were almost disappear; photophobia and tearing were obvious in the first week after surgery, but were gradually alleviated, and almost disappear after one month of postoperative.Yellow-brown or filthy red gelatinous protuberances at limbus were cleaned away by operation and did not recur during the follow up. Corneal superficial punctuate keratitis(11 eyes) and corneal ulcers(3 eyes) were healed during the first week after surgery and did not recur. Conjunctival congestion was gradually lessened after surgery, which could not be noted 1months after surgery in 19 eyes, and the conjunctiva around the limbus, where AMT was performed, was whiter than the normal. But conjunctival congestion in 1 eye lasted for about 5mon accompanying with a little of itch, and this eye was treated with eyedrops with improvement but recurrence. No severe complications had been seen during the follow up.CONCLUSION: Annular bubble conjunctival excision combining with amniotic membrane transplantation is an effective and safe method for the treatment of vernal keratoconjunctivitis with gelatinous swellings (papillae) at limbus. But the candidates must be chosen with discretion.

AIM: To investigate the efficacy and safety of annular conjunctival excision combined with amniotic membrane transplantation for the management of earlier Mooren's ulcer.METHODS: Thirty eyes (24 patients) with earlier Mooren's ulcer were treated with this method, followed-up for 5-30mo. The characteristic of these patients was localized periphery corneal ulcer: the ulcer involved 30-120° corneal limbus with depth of 1/3-1/2 cornealthickness and width of 2-5mm.RESULTS: After surgery, symptoms subsided remarkably and immediately in all patients,and almost disappeared after stitches were removed. Corneal melts were controlled. At postoperative 2-3mo, the corneal thickness of the ulcer area became almost stable, which in some patients recovered normal and in others were still thinner than normal, and the average increase was about 1/3 of the corneal thickness. Corneal transparence and vision were improved. During follow-up, no severe complications or recurrence were noted.CONCLUSION: Conjunctival peritomy combined with amniotic membrane transplantation is an effective and safe method for the treatment of earlier Mooren's ulcer.

Objective To compare efficacy and side effects of intravenous versus oral indomethacin treatment for symptomatic patent ductus arteriosus (PDA) in preterm infants.Methods Fourty-nine preterm infants were reviewed retrospectively who were diagnosed as having symptomatic PDA confirmed by echocardiography.According to the using type and approach that were divided into 2 groups (intravenous group,n=21;oral group,n=28) and their doses and intervals were same.The rates of ductal closure and side effects were compared in 2 groups.Results There were no significantly different between 2 groups in single ductal closure and complicating other diseases. Soon closure of intravenous group was higher significantly than oral group [61.9 %(13/21) vs 28.6 %(8/28),P

Objective To investigate the efficacy,safety and localization of multilayer amniotic membrane transplantation(AMT) for corneal perforation associated with ulceration.Design A retrospective clinical case series.Participants Nine patients(9 eyes)with corneal perforation secondary to ulceration were enrolled into this study.These were little response to medicine,including bacterial keratitis(4 eyes ),fungal keratitis(2 eyes),fungal and bacterial mixed keratitis( 1 eye),virus keratitis( 1 eye),and Mooren's ulcer ( 1 eye).Size of perforation was 0.5～3.0 mm in diameter.Methods The AMT was applied to tamp the perforation,fill the ulcer and cover the surface of ulcer.After surgery,the medicine was continued to be used to treat the original corneal ulcer.The follow-up ranged from 6～20 months.In the suffering eyes,reformation of anterior chamber,healing of ulcer,complications and recurrence of ulceration were observed.Main Outcome Measures Of the postoperative eyes,reformation of anterior chamber,healing of ulcer,complications and recurrence of ulceration.Results The anterior chamber reformed at the first postoperative day in 9 eyes,and kept in normal depth in the follow-up time.At postoperative 2 months,the ulcer healed with sear and a smooth surface.Corneal thickness of the ulcer area recovered almost to normal.During follow up,no recurrence of ulceration or severe complications was noted.Conclusions Multilayer AMT is a safe and effective method for the management of small corneal perforation associated with ulceration,but the ulcer healed with scar.(Ophthalmol CHN,2008,17:101-103)

Objective To discuss the short-term currative effect of horizontal osteotomy across injured vertebral forⅤdegree old frac-ture-dislocations of thoracolumbar spine.Methods The data of 4 patients who received horizontal osteotomy across injured vertebral internal fixation in our hospital from April 2010 to October 2012 were retrospectively analyzed,of which 1 case with T8-9 fracture dislocation,2 cases with T10-11 fracture dislocation,1 case with T11-12 fracture dislocation.The Franke1 classification of all patients were grade A.Results All 4 cases were achieved completely fracture reduction and followed-up for 2-14 months(an average of 7.4 months),who could get sitting posi-tion with the support of brace 1 week after operation.The postoperative follow-up indicated that all 4 cases got fusion,but there was no improve-ment for Franke1 classification.Conclusion The method of horizontal osteotomy across injured vertebral forⅤdegree old fracture-dislocations of thoracolumbar spine has good short-term clinical effect,with the advantages of shorter operation time,less bleeding and good reduction effect.