Retinopathy of prematurity( ROP),a leading cause of childhood visual impairment,is a vascular proliferative retinopathy in premature infants. Although the hallmark of ROP is abnormal retinal vasculature, a growing body of research in animals and observations in patients support a critical role for the neural retina in the ROP disease process. ROP can affect the foundation of the retina and optical nerve during the development duration in childhood, presenting with abnormalities in electroretinogram and multifocal electroretinogram. In addition,it was found that ROP has different degrees of influence on the development of the dioptric system ,which will result in refractive error as the child progress to adulthood. The relationship of the electrophysiology features or refractive abnormality and ROP was summarized in this article.

The progress of modality therapy has improved both survival rate and quality of life of retinoblastoma(RB) patients.However,some problems are still left and unsolved.Parts of the RB relapse after they are treated for the first time.Even more remarkable,the related individuals to the RB patients run a risk of RB.Gene diagnosis and treatment are emerging and appear to solve these problems.Some researches in developed countries and Hong Kong have successfully made progress in gene diagnosis of RB.However,the detection rate of Rb1 gene mutation is very low.Researches documented for many years that gene diagnosis for RB is extremely complex,so we should go further to achieve a goal of gene diagnosis.Gene diagnosis of RB is still an initiation in China.We should strengthen relevant study and spread this technique.

Objective To detect the quantity of Th17 cells and expressions of related cytokines including interleukin (IL)-17 and IL-22, in peripheral blood and skin lesions of patients with psoriasis vulgaris, and to analyze their correlation with disease severity and clinical course. Methods Peripheral blood was obtained from 44 patients with progressive psoriasis vulgaris and 28 normal human controls. Three-color flow cytometry was carried out to detect the quantity of Th17 cells, and ELISA to examine the levels of serum IL-17 and -22.Skin samples were obtained from 20 patients with psoriasis vulgaris and 8 normal human controls, and a quantum dot-based double labled immumofluorescence method was used to determine the quantity of Th17 cells.Results The percentage of peripheral blood Th17 cells was higher in patients with psoriasis vulgaris than in normal human controls (4.71% ± 2.55% vs. 0.55% ± 0.39%, P ＜ 0.01 ). Elevated expressions of IL-17 and IL-22 were noted in the patients compared with the normal human controls (24.02 ± 12.31 ng/L vs. 7.16 ±4.04 ng/L, P ＜ 0.05; 18.32 ± 8.14 ng/L vs. 6.52 ± 4.15 ng/L, P ＜ 0.01 ). The percentage of peripheral blood Th17 cells and serum levels of IL-17 and IL-22 were positively correlated with psoriasis area and severity index (r= 0.53, 0.47, 0.53, respectively, all P ＜ 0.01 ), but unrelated to the clinical course of psoriasis (r = 0.09,0.03, 0.19, respectively, all P ＞ 0.05). There was an infiltrate of Th17 cells in psoriatic lesions, which was mainly distributed around the blood vessels in superficial dermis, whereas there were only a small number of CD4+ T cells in the normal control skin with the absence of Th17 cells. Conclusions Th17 cells are involved in the development of psoriasis, and Th17 cell-secreted cytokines, such as IL-17 and IL-22, may serve as a new therapeutic target for psoriasis.

Objective To investigate the clinical value of anatomic M-mode echocardiography (AMM)for pristine diagnosis of myocardial ischemia in patients with coronary heart diseases (CAD).Methods 44 inner patients who were suspected as CAD were detected.Ordinary ultrasound was performed first.The ventricular segmental wall thickness and amplitude were measured by AMM.Then,we got the ventricular wall thickening fractions.All subjects should take the coronary angiography after the ultrasound examination in 1 -3 days.Patients with the vascular stenosis rate≥50% were defined as the CAD group,patients with the completely normal angiographic results were included in the normal control group according to the results of angiography.The parametric differences between the patients and the normal control subjects were compared.Results In the normal control subjects,the ventricular segmental wall amplitude >5mm accounted for 78.67%,the ventricular wall thickening fractions >30% accounted for 99.13%.But in CAD group,the ventricular segmental wall amplitude <4mm accounted for 61.14%,<5mm accounted for 93.47%,the abnormal ventricular wall thickening fractions <30% accounted for 88.43%.The sensitivity, specificity,accuracy of AMM were 77.47%,90.00%,77.39% respectively.Conclusion The ventricular wall thickening fractions of AMMhas quite significant correlation with morbid blood vessel in patients with CAD,they are effective reference indicators to evaluate the left ventricular wall motion quantitatively.

Objective To figure out the preliminary clinical value of real-time three-dimensional echocardiography(RT-3DE) in evaluating the systolic dyssynchrony in patients with coronary artery heart disease(CAD).Methods Eighty patients who were suspected as CAD were included in this study.RT-3DE was performed first.After the analysis,we got the data:ejection fraction (EF),16 segments systolic dyssynchronic index (SDI 16).All subjects should take the coronary angiography.According to coronary angiography results,the patients with the vascular stenosis rate ≥50% were defined as the CAD group,and the patients with the vascular stenosis rate <50% were defined as the coronary atherosclerosis group,the patients with the completely normal angiographic results were included in the control group according to the results of angiography.The parametric differences among the groups were compared.Results There was no significant difference in LVEF among the three groups.SDI 16 had no significant difference between the control group and the coronary atherosclerosis group (t=-1.03,P>0.05).However,SDI 16 had significant difference between the control group[(3.72±2.68)%]and the CAD group[(7.14±3.10)%],the same between coronary atherosclerosis group[(5.12±3.46)%]and the CAD group[(7.14±3.10)%](t=-3.71,-2.34,all P<0.05).ROC curve analysis revealed that a cut-off value for SDI of 5.49%,yielded a sensitivity of 81.8%,with a specificity of 73.1% to predict coronary atherosclerosis to CAD(AUC=0.743).Conclusion SDI 16 >5.49% has a higher value in evaluating systolic dyssynchrony in patients with CAD with RT-3D of Siemens Acuson SC2000 ultrasonic diagnostic instrument.

BACKGROUND:Three-dimensional (3D) printing technology exhibits a broad future in the orthopedics,especially exhibiting good guidance and auxiliary in the treatment of tibial plateau fractures.However,the related researches are few,and there is a lack of evidence-based medicine to confirm its application values.OBJECTIVE:To compare the efficacy of 3D printing-assisted surgery and traditional surgery in the treatment of tibial plateau fractures through a meta-analysis.ME=THODS:MEDLINE,Cochrane library,Embase,CBM,CNKI and WanFang databases were searched by computer and the relevant literatures were retrieved manually,to collect the controlled trials concerning the efficacy of 3D printing-assisted surgery versus traditional surgery for tibial plateau fractures.Methodology quality of the trials was assessed critically and relative data were extracted,followed by analysis on Stata 11.0 (Stata Corporation,College Station,TX) software.RESULTS AND CONCLUSION:(1) Seven controlled trials involving 362 patients were included.(2) Meta-analysis results showed that the 3D printing-assisted surgery had shorter operation time (SMD=-2.411,95％C/=-2.718-2.104,P=-0.00) and less intraoperative blood loss (SMD=-1.579,95％C/=-1.842--1.316,P=-0.00) than those in the traditional surgery.The excellent and good rate in Rasmussen and Hospital for Special Surgery knee scores showed no significant differences between two growps (P ＞ 0.05).(3) To conclude,compared with the traditional surgery,the 3D printing-assisted surgery can significantly shorten the operation time and reduce the intraoperative blood loss in the treatment of tibial plateau fractures.

Background Fibrin glue has been utilized to adhere the graft during the pterygium excision with conjunctival autografts.Several relevant clinical randomized controlled trial(RCT) and retrospective studies have been published abroad,but the samples for its effectiveness and safety issue of fibrin glue and suture are still underinvestigation.Objective Current study was to quantificationally assess the efficacy and safety of fibrin glue versus sutures in the application of pterygium excision with conjunctival autografts.Methods Based on established search strategy,a computerized literature search was conducted to identify all citations concerning the RCT for effectiveness and safety evaluation of fibrin glue and suture for the graft fixation during the pterygium excision with conjunctival autografts from MEDLINE ( from 2000 to October,2010 ),EMbase ( from 2000 to October,2010 ),Cochrane Central Register of Controlled Trials ( Issue 4,2010 ),CBMdisc ( 2000 to October 2010 ),CNKI ( 2000 to October 2010 ),and the relevant conference proceedings and references searched by hand was performed as supplement.The included literature was scored with Jadad table.The Cochrane Collaboration' s RevMan 5.0 software was used for the test of heterogeneity or test for overall effect.The effective indexes,such as operative duration,recurrence rate and complication,were evaluated by Meta analysis.Results Six RCTs involving 401 eyes of 377 participants were identified.These literatures were published with English in 2004-2010 from China,New Zealand,Sweden,Israel,Turkey and Malasia and the Jadad scores were 4-5.The quantitatively analysis revealed that fibrin glue appeared to short the operative time compared with suturing method (MD =14.23 ;95％ CI:- 16.18- 12.29;P=0.00) and drop the rate of recurrence ( RR =0.49,95％ CI:0.26 -0.95 ; P =0.03 ).No significant differences were found in the rate of postoperative graft dehiscence or absence (RR =3.41,95 ％ CI:0.85-13.68;P =0.08 ).Conclusions Fibrin glue shows the good effectiveness and easy application during the pterygium excision with conjunctival autografts.Long-term follow-up of multi-central RCTs with a larger number of cases are still needed to support this conclusion.

Objective To investigate the effect of atorvastatin and rosuvastatin on endothelial function in diabetics with coronary heart disease. Methods A total of 73 consecutive diabetics with coronary heart disease who were not receiving statins were randomized to receive atorvastatin 20 mg/d or rosuvastatin 10 mg/d. The levels of lipids, high-sensitivity C-reactive protein(hs-CRP), monoxide nitrogen(NO), endothelin-1 (ET-1) and endothclium-dependent relaxing function(EDF) were assessed before and after 3 months of the treatment. Results The treatment with statins significantly improved endothelial function in diabetics with coronary heart disease. For both rosuvastatin group and atorvastatin group in pro-treatment versus post-treatment, EDF was higher[(5.2±2.4)% vs. (7.9±3.1)%, P=0.008; (5.0±2.8)% vs. (7.6±3.6)%, P=0.024, respectively], NO was also higher((46.6±14.5) μmmol/L vs. (73.3±18.5) μmmol/L; (51.7±14.0) μmmol/L vs. (79.8±16.0) μmmol/L,both P<0.001], ET-1 was lower[(108.2±29.6) pg/L vs. (77.5±26.4) pg/L, P =0.005;(117.1±34.5) pg/L vs. (80.7±28.2) pg/L, P= 0.003, respectively],and hs-CRP was lower[3.17(1.33～6.32) mg/Lvs. 1.39(0.81～2.58) mg/L, P=0.006; 3.43(1.51～7.02) mg/L vs. 1.63(0.69～3.11) mg/L, P = 0.001, respectively]. There were no differences in these between rosuvastatin group and atorvastatin group. Significant negative correlation existed between EDF and hs-CRP. Conclusions A 3 months treatment with either atorvastatin 20 mg/d or rosuvastatin 10 mg/d is effective in improving endothelial function in diabetics with coronary heart disease.

Objective To analyze and evaluate neoadjuvant chemotherapy's value and significance in combining with surgical treatment for limited small cell lung cancer(LD-SCLC).Methods A total of 94 LD-SCLC patients underwent complete resections combined with chemotherapy between January 2000 and January 2011 in Shanghai Pulmonary Hospital.Among these cases,initial two cycles of neoadjuvant chemotherapies were performed for all pathologically confirmed patients (Group A),and initial operations followed by adjuvant chemotherapy were administered to patients without pathology (Group B).The survival rate was analyzed by log-rank test and Kaplan-Meier method.Multivariate analysis of the prognostic factors was performed using Cox's regression model.Results Group A included 43 cases and Group B included 51 cases.The mean age was (56.37 ± 10.18) years.According to the 6th edition of Tumor,Node,Metastasis(TNM) classification of lung cancer,54 cases were at stage Ⅰ or Ⅱ,40 cases were at stage Ⅲ.Overall 5-year survival(5-YS) was 27％.The 5-YS for patients with stage Ⅰ-Ⅱ was notably better than that of stage Ⅲ (34％ vs 20％,P =0.033).For patients with stage Ⅲ,the 5-YS of Group A was significantly better than that of Group B(34％ vs 12％,P =0.020),besides median overall survival for Group A and Group B were 46 and 15 months(P =0.009).Furthermore,the results of multivariate analysis showed that neoadjuvant chemotherapy,surgery and histopathology of SCLC were independent factors that strongly affected survival and prognosis.Conclusion In combined surgical treatment for LD-SCLC,neoadjuvant chemotherapy obviously improved the prognosis of patients with stage Ⅲ.Therefore,it was very important and necessary that pre-surgical neoadjuvant chemotherapy was administered to resectable stage Ⅲ LD-SCLC patients.

Objective To study the role of photoallergens and contact allergens in the pathogenesis of chronic actinic dermatitis (CAD).Methods Ba sed on the standard procedures of photopatch test recommended by the British Pho todermatology Group (BPG) and the routine procedures of patch test,photopatch a nd patch tests were performed on 56 patients with CAD,42 patients with polymorp hous light eruption (PLE) and 25 patients with chronic eczema on scalp and face by standard photopatch test series recommended by the International Contact Derm atitis Research Group (ICDRG) and home-made standard series of contact allerge ns.A set of ten Philips TL20W/09N tubes was used as the source of irradiation.Results In the 56 CAD patients,the positive rates were 46.43 %,57.14 % and 32.14% for photopatch test,patch test and both tests,respectively,which appea red to be significantly higher than those in the patients with PLE.Positive pa tch reactions were found in 65% of the patients with chronic eczema,which was s imilar to that of CAD.And the frequency of the positive allergens in chronic ec zema was the same as that in CAD,in which fragrance mixture (FM) ranked the fir st,followed by balsam of Peru (BOP),cobalt chloride,nickel sulphate.In CAD,FM and BOP were the most common allergens and photoallergens,which accounted fo r 44% and 32% of the positive reactions in patch tests,15.38% and 17.95% in pho topatch tests,respectively.Conclusions Both photoallergens and contact aller gens may play important roles in the pathogenesis of CAD.Allergens positive in patch tests and photopatch tests and related compounds which can cause cross-r eactivity with the above allergens should be avoided by the patients with CAD.