AIM: To evaluate the repeatability and reproducibility of thickness profile measurement of intra-retinal layers determined by an automated algorithm applied to OCT images from Cirrus optical coherence tomography (OCT) instrument.METHODS: In this prospective cross-sectional study,retinal thickness images at 6mm×6mm around fovea were obtained from 86 eyes of 43 normal subjects with Cirrus HD-OCT instrument.The retinal images from patients were analysis by Cirrus automated algorithm GCA software,including ganglion cell layer and inner plexiform layer(GCIPL).During this study,operator A would make 2 times measurements to all patients,after that operator B would make another 2 times measurements by Repeat scan model.All the data,including GCL average thickness,min thickness,12 clock average thickness,2 clock average thickness,4 clock average thickness,6 clock average thickness,8 clock average thickness and 10 clock average thickness were measured by SPSS 15.0 software.Standard deviation (SD),coefficient of variation (CV) and interclass correlation coefficient (ICC) were calculated from the results of three-times tests by different examiner to evaluate the repeatability and from the results of two different examiners to assess the reproducibility.Written informed consent was obtained from each subject prior to any medical procedure.RESULTS: The average GCIPL thickness of OD was 85.12±3.95μm;the minimum average GCIPL thickness was 83.21±4.41μm;the standard deviation of OD in clock map was from 3.79μm to 4.84μm;CV(95%CI) was between 0.26 and 0.93;ICC was from 0.939 to 0.989.The average GCL+IPL thickness of OS was 84.65±8.73μm;the minimum average GCPL thickness was 81±13.08μm;the standard deviation of OS in clock map was from 8.24μm to 10.56μm;CV(95%CI) was between 0.92 and 4.94;ICC was from 0.264 to 0.968.CONCLUSION: Cirrus HD-OCT GCA software with automated algorithm can offer accurate and repeatable thickness profile of OCT retinal image.GCA is a useful and reliable approach to the measurement of intra-retinal layer thickness,which may improve the diagnosis and monitoring of retinal diseases.

The dynamic expression of cytokines and phenotypes during the differentiation process of dendritic cell precursors (pre-DCs) to mature dendritic cells (DCs) was investigated,and the effects of inflammatory stimulation with lipopolysaccharide (LPS) on DCs differentiation were understood.The differentiation of bone marrow cells isolated from Balb/c mice was induced to DCs in an 8-day cell culture system with RPMI-1640 complete culture medium containing 10％ FBS,20 ng/mL recombinant mouse granulocyte-macrophage colony-stimulating factor (rmGM-CSF) and 10 ng/mL recombinant mouse interleukin-4 (rmIL-4).On the day 3,6 and 7 after culture,DCs were divided into non-LPS group and LPS group,given 500 ng/mL LPS for 24 h stimulation and no stimulation respectively.The expression levels of CD 1 l c+,MHC-Ⅱ +,CD40+,CD80+ and CD86+ were detected by flow cytometry,and those of IL-2,IL-4,IL-10,IL-12 p70 and IFN-γ in the supernatant by ELISA.On the day 3 and 6 after culture,the expression of IL-2,IL-4,IL-10 and IFN-γ in DCs showed no significant differences between non-LPS group and LPS group,whereas the differences were significant at day 7.The expression levels of cytokines (for IL-2,IL-4,IL-10,IFN-γ and IL-12 p70:152.86±6.91,778.33±8.35,44.55±2.54,5.8.26±1.09 and 2423.00±57.21 pg/mL respectively) in LPS group were higher than those in non-LPS group,especially IL-12 p70 increased obviously at day 7.It was concluded that during the differentiation process of pre-DCs to mature DCs,LPS stimulates DCs producing large amounts of IL-12 p70 and Thl-type cytokines as compared with Th2-type cytokines,and day 7 may be a key time-point for DCs polarization.

OBJECTIVETo evaluate therapeutic effects of Rigidfix cross pins combined with Intrafix pins for the reconstruction of anterior or posterior cruciate ligament under arthroscopy.

METHODSFrom January 2009 to June 2010,34 patients with anterior or posterior cruciate ligament injuries were divided into two groups : group A and group B. There were 24 patients in group A, including 19 males and 5 females,with an average age of (31.83±9.57) years old. The patients in group A were treated with anterior cruciate ligament reconstruction under arthroscopy; Rigidfix cross pins and Intrafix pins were used to fix femoral and tibial side respectively. Among the 10 patients in group B, 8 patients were male and 2 patients were female, with an average age of (27.20+7.59) years old. The patients in group B were treated with posterior cruciate ligament reconstruction under arthroscope; Intrafix pins and Rigidifix cross pins were used to fix femoral and tibial side sepectively. The drawer test and Lachaman test were used to evaluate postoperative knee stability. All the patients were followed up at least 18 months. Lysholm and Tegner knee scores were used to evaluate the clinical therapeutic effects.

RESULTSAll the 34 patients were followed up, and the duration ranged from 18 to 26 months,with an average of (20.79±2.39) months. All the patients obtained good pain relief and knee stability. In group A,Lysholm scores significantly increased from 43.04±7.57 preoperatively to 85.41±4.68, 92.50±3.05, and 93.45±2.57 at 6,12, and 18 months postoperatively; Tegner scores significantly increased from 2.62±0.92 preoperatively to 7.45±1.14, 8.58±0.77, and 8.95±0.55 at 6, 12, and 18 months postoperatively. In group B,Lysholm scores significantly increased from 46.20±8.27 preoperatively to 86.40±5.14,90.40±2.67,and 92.00±3.85 at 6,12,and 18 months postoperatively ;Tegner scores significantly increased from 2.00±0.66 preoperatively to 7.10±0.99, 8.60±0.84, and 8.80±0.42 at 6,12, and 18 months postoperatively. There were no differences in Lysholm and Tegner scores between group A and B at different times during follow-up. Lysholm scores of all patients significantly increased from 43.97±7.79 preoperatively to 85.70±4.76,91.88±3.06,and 93.02±3.01 at 6,12,and 18 months postoperatively. Tegner scores of all patients significantly increased from 2.44±0.89 preoperatively to 7.35±1.09, 8.58±0.78, and 8.91±0.51 at 6,12,and 18 months postoperatively. During the follow-up period,there were no serious immunological rejection and complications.

CONCLUSIONReconstruction of anterior or posterior cruciate ligament under arthroscopy with Rigidfix cross pins and Intrafix pins fixation is feasible therapy for anterior or posterior cruciate ligament injuries, and the fixation is rigid. The therapy restores knee stability and provides a satisfactory short-term results.

Adolescent ; Adult ; Anterior Cruciate Ligament ; surgery ; Arthroscopy ; methods ; Bone Nails ; Case-Control Studies ; Female ; Humans ; Male ; Middle Aged ; Posterior Cruciate Ligament ; surgery ; Reconstructive Surgical Procedures ; instrumentation ; methods

Aim To study the effect of Baoxinbao film on endothelin(ET) and nitric oxide(NO) secretion in patients with stable angina pectoris(SAP).Methods 76 patients with SAP were randomly divided into two groups, with 40 cases in the baoxinbao group plastered with baoxinbao film and 36 cases in the isosorbide dinitrate group receiving isosorbide dinitrate. The levels of plasma ET and NO before and after treatment were observed. Results The concentrations of plasma ET were increased and plasma NO reduced significantly in the SAP patients respectively, as compared with those in the control group(all P

OBJECTIVETo study the therapeutic mechanism of Zhizhu Pill (ZP) for treating functional dyspepsia (FD) rats.

METHODSTotally 30 ten-day-old male rats were randomly divided into the normal control group (n =10) and the model group (n = 20). The FD rat model was induced using gastric administration of 0.1% iodoacetamide (IA) combined tail clamping. The model was evaluated when rats were 8-week old. Successfully modeled rats were randomly divided into the model group (n = 10) and the ZP group (n = 10). Rats in the normal group and the model group were administered with normal saline by gastrogavage, while those in the ZP group were administered with ZP Decoction (2 mL/100 g) by gastrogavage. All medication lasted for 7 successive days. The contractile activity in in vitro longitudinal gastric muscle was recorded using Power Lab biological signal collecting system. The expression of growth hormone secretagogue receptor (GHSR) in stomach of FD rats was detected using Western blot and immunohistochemistry (IHC).

RESULTSCompared with the normal group, average frequencies of gastric contraction and changing rates of amplitude obviously decreased in the model group (P < 0.05). Results of Western blot and IHC showed that the expression of GHSR decreased in the model group (P < 0.01). Compared with the model group, average frequencies of gastric contraction and changing rates of amplitude obviously increased in the ZP group (P < 0.05). Results of Western blot and IHC showed that the expression of GHSR increased in the ZP group (P < 0.01).

CONCLUSIONZP could promote the gastric motility in FD rats induced by gastric administration of IA combined tail clamping, and its mechanism might be related to up-regulating GHSR protein level.

Animals ; Drugs, Chinese Herbal ; pharmacology ; Dyspepsia ; drug therapy ; Gastrointestinal Motility ; Male ; Muscle Contraction ; drug effects ; Muscle, Smooth ; drug effects ; metabolism ; Random Allocation ; Rats ; Receptors, Ghrelin ; metabolism

Objective To investigate the expression of survivin in T lymphocytes that were stimulated by Con A and alloantigens in renal grafts in vitro and in vivo. Methods According to the different treatments, the experiment was divided into three parts. (1) The C57BL/6 mice splenocytes stimulated by Con A (10 mg/L) were cultured in the RPMI-1640 medium. Following the proliferation blockade or not, the expression of Survivin in the splenocytes was detected. (2) The GVHR model was established by transfusing the C57BL/6 mice splenocytes into Balb/c× C57BL/6 F1 mice, and the expression of Survivin in the donor splenocytes was detected at the different time points. (3) Seventythree cases of clinical renal allograft biopsy specimens were collected, pathologically diagnosed and classified according to the Banff 97 classification, and then the expression of Survivin was detected.Results Survivin was expressed in the CD3+ splenocytes that received Con A stimulation. The positive cell count reached the peak on the day 3, and subsequently declined. In the GVHR model, the lymphocytes infiltration and Survivin expression were detected around the portal vein and portal area on the post-splenocytes-transfused day (PSTD) 4 to 12. But on the PSTD 14, the Survivin expression could not be detected in the infiltrated lymphocytes. In the renal allograft biopsy specimens,lymphocytes did not express Survivin in 13 specimens of the group without acute cellular rejection.was difference between the two groups (P＜0. 01 ). Conclusion The activated T cells possess the capacity to express Survivin, and the expression is time-dependent. For the characteristics of Survivin expression of T cells, it may be applied as an approach to diagnose the acute cellular rejection and judge its degree and stage in the clinical allograft biopsy specimens.

Objective To develop the hypothesis ‘saturated or non-saturated cytotoxicity model' and explain the various phenomena of antibody mediated immunoresponses in recipients,including rejection and accommodation.Methods The imitating complement dependent cytotoxicity.The threshold set to identify as saturated or non-saturated cytotoxicity depends on antigen-antibody complex(R)whether or not above lethal number(D)in effective time.Feasibility of the hypothesis was examined through explaining various phenomena mediated by anti-donor antibodies,especially some contradictory phenomena.Results Hyperacute rejection,accelerated rejection and acute rejection could be well explained by saturated cytotoxicity.Accommodation of ABO imcompatible transplantion,de novo antibody induced injury,change of protein profile,and C4d deposition in graft could be well elucidated by the hypothesis.Conclusion The hypothesis saturated or nonsaturated cytotoxicity model' help to interpret and interconnect various phenomena of antibodies mediated immune response,such as rejection and accommodation.

Objective To investigate the risk factors associated with the death of pediatric septic shock,for improving prognosis and decreasing mortality.Methods Sixty-four patients in intensive care unit diagnosed as septic shock were enrolled from Apr.2002 to Apr.2008.The factors such as age,sex,C-reacted protein,WBC,platelet count,blood glucose,procalcitonin(PCT),serum lactic acid,pediatric critical illness score(PCIS),ventilator using and complication of multiple organ dysfuction syndrome(MODS) were researched,these research factors were analyzed by univariate analysis,then to be analyzed by Logistic regression.Results The mortality was 59.38%(38/64 cases).Twenty patients with severe septic shock were all died.Thirty-four patients had breath failure and 26 cases had MODS,the mortality were 62.50%,76.92%,100.00% in patients complicated with 2,3,4 organs dysfunction.In the univariate analysis,variables significantly associated with death in septic shock were PCT,lactic acid,PCIS,MODS.In the Logistic regression,variables significantly associa-ted with death were PCT,lactic acid,PCIS and MODS.Conclusions The mortality of septic shock was high,and decreased PCIS,elevated serum lactic acid level and PCT,and multiple organ dysfuction are the risk factors associated with the death of septic shock.

Objective To evaluate the effect of health education on endemic fluorosis in Jiangsu province,and to provide reference data for further prevention and control of the disease.Methods In 2011,according to history prevalence of endemic fluorosis in Jiangsu province,a total of 10 countries were selected,and 3 townships were chosen in each county.Health educational activities were carried out in the classes of grade 4 - 6 in thecentral primary school.In the meantime,3 villages were chosen in each selected township where the health educational activities in the community were carried out.Before and after the health education activities,questionnaire surveys on knowledge of endemic fluorosis were conducted in each county.Thirty students in one classof the fifth grade in the central primary school were randomly selected,and 15 housewives near the central primaryschool were also randomly selected.Results After the health educational activities,the rates of knowledgeawareness in the students and the housewives were 95.90％ (2946/3072) and 92.85％ ( 1752/1887 ),respectively,and increased significantly compared with those before the intervention[71.53％(2015/2817),77.40％( 1384/1788 ) ],and the difference was statistically significant(x2 =657.337,174.894,all P ＜ 0.01 ).Before the health educational activities,the rates of knowledge awareness in the students were lower than those in the housewives,and the difference was statistically significant (x2 =6.120,P ＜ 0.05 ).After the health educational activities,the rates of knowledge awareness in the students were higher than those in the housewives,and the difference was statistically significant(x2 =21.847,P ＜ 0.01 ).ConclusionsThe rates of knowledge awareness in the students and the housewives are increased significantly after the health educational activities.The consciousness and activity of the target people to take part in preventing and controlling of the endemic fluorosis have been enhanced greatly.The good behaviors in the target people are gradually formed,the desired effect is achieved.

Objective：To study the toxicity mechanism(s) of ifosfamide(Ifo) in suspending cultured rat hepatocytes.Methods：Hepatocytes of adult rat were isolated using two-step perfusion method and cultured suspendingly. Cell viability,intracellular enzyme leakage, contents of sulfhydryl groups and MDA contents of hepatocytes were examined 3 hours after ifosfamide was administered at 5,10,20 mmol/L. Surface and ultrastructure of hepatocytes were also observed. Results：Cell viability and TSH,NPSH,PSH contents of hepatocytes significantly declined, and LDH,AST activities in media increased due to the leakage of intracellular enzymes. The decrease in PSH content was ascribed to depletion of TSH. The higher the dose was, the more serious these changes became. However, MDA contents of the hepatocytes were not found increased at any ifo dose groups. In pathological examination, “bulla" formation was found on the surface of the hepatocytes, deformation，swelling even vacuolation of mitochondria and dilation of rough，smooth endoplasmic reticulum were also observed. Conclusions：Ifo has toxic effect on suspending cultured rat hepatocytes. The decrease in sulfhydryl groups contributes to the hepatotoxicity induced by Ifo.