Objective To study the effect of mitomycin C(MMC)‐chitosan (CS)sustained release microspheres on the scar‐ring prevention of the filtering passage during glaucoma filtering surgery .Methods Filtering surgery model was established on 96 eyes of 48 healthy adult New Zealand white rabbits which were divided into 4 groups ,24 eyes in each group .The right eyes implan‐ted MMC‐CS microspheres in 24 rabbits(group A) ,whereas that of the fellow eyes implanted empty CS microspheres(group B) , and in other 24 rabbits which right eyes only used 0 .20 mg/mL MMC cotton(group C) ,on the opposite sides with no adjunctive treatment(group D) .Intraocular pressure ,filtering bleb ,anterior chamber flare ,complications and the numbers of corneal endotheli‐al cells were observed after surgery .Rabbits were killed on the 7th ,14th and 21th day postoperatively in batch and histopathological examination was carried out .Results (1)the intraocular pressure:group A can maintain the low level of intraocular pressure for a long time ,followed by group C ,group B and group D ,and difference between groups was statistically significant (P< 0 .01) .(2) The filtering blebs :the filtering bleb survival time of group A was longer than other group(P<0 .01) .(3)Complication:there was not any complication in the 4 groups .(4)The number of corneal endothelial cells :the number of corneal endothelial cells of group A preoperative and postoperative had no statistical significance differences(P>0 .05) .(5)Histopathologic findings :group A had bet‐ter conjunctival epithelial integrity ,subconjunctival fibroblast less than other groups ,filtration had no obvious inflammation infiltra‐tion around the mouth area ,but also had fewer new collagen fibers .Conclusion MMC‐CS sustained release microspheres is a safe and effective treatment to inhibit inflammatory cells activity and fibroblast activity in surgery sites ,and can significantly improve outcome of filtration surgery .

OBJECTIVE:To study the targeting of folic acid(FA)-modified docetaxel(DOC)nano-liposome(L-DOC-FA)to hepatocellular carcinoma Bel-7402 cells in vivo and in vitro. METHODS:The cell viability and survival rate of Bel-7402 cells was tested by CCK-8 kit after treated with 0,1,2,5,10 and 20 μg/ml DOC,L-DOC and L-DOC-FA for 24 h. And then,the fluores-cein isothiocyanate was used to label L-DOC and L-DOC-FA nano-liposome,and the rate of L-DOC and L-DOC-FA absorbed by hepatocellular carcinoma Bel-7402 cells were detected. 125I was used to label L-DOC and L-DOC-FA nano-liposome,and then the contents of them in the subcutaneous tumor tissues were detected. 28 Balb/c naked mice were selected and given liver cell suspen-sion via back ih to induce tumor model. After modeling,naked mice were divided into blank control group(normal saline),DOC group(3 mg/kg),L-DOC(3 mg/kg,by DOC)and L-DOC-FA(3 mg/kg,by DOC). They were given relevant medicine intrave-nously once a day for consecutive 30 d. The relative tumor volume in naked mice was detected. RESULTS:DOC,L-DOC and L-DOC-FA all inhibited the cell viability of Bel-7402 cells,the survival rate of cells decreased in concentration-dependant manner;compared with DOC and L-DOC,the cell viability decreased after treated with L-DOC-FA,the survival rate of cells decreased (P<0.01). The rate of L-DOC and L-DOC-FA absorbed by Bel-7402 cells in descending order as L-DOC-FA(69.5%)>L-DOC (31.2%),with statistical significance (P<0.01). The content of L-DOC-FA in tumor was significantly more than that of L-DOC (P<0.01). In addition,3 mg/kg L-DOC-FA showed better inhibitory effect than 3 mg/kg L-DOC and DOC on tumor,and the rela-tive tumor volume was smaller(P<0.01). CONCLUSIONS:L-DOC-FA has obvious targeting to Bel-7402 cells in vivo and in vi-tro,and shows good inhibitory effect on tumor in vivo and in vitro.

Objective To analyse the clinical features in general paresis of insane(GPI)as to offering an early diagnosis. Methods A retrospective analysis of 2 cases of GPI was focused on their clinical manifestations. Results The clinical features of GPI showed: (1) Chronic onset, progressive development in 2 cases; (2) Dementia was key symptom.Hasegawa dementia scales were 4 and 17 in 2 cases.2 cases accompanied with abnormal mentality,such as delusion of grandeur ,euphoria and so on;(3)GPI have features of pupil change,dysarthria,muscular tension,abnormal reflection; (4) Serum and cerebrospinal fluid (CSF) syphilis antibody reaction manifested positive, CSF protein content was increased significantly, and cells increased ( with lymph cell mainly ); (5) Head MRI manifested: cerebral atrophy in 2 cases, multiple abnormal signals in cerebral parenchyma in 1 case. Conclusions GPI misdiagnosis rate is high. Important basis of diagnosis remains on clinical manifestations, laboratory and imaging examinations.

Objective To study the effect of α-lipoic acid on the retinal expression level of VEGF and diabetic retinopathy in rats with diabetes mellitus and mechanism.Methods Totally 72 Wistar rats were divided into 4 groups:12 (control group)in group A,24 in modeling group(group B),24 in group treated withα-LA(group C)and 12 in high-glucose(group D).Group B to group D were given 60 mg/kg STZ through intraperitoneal injection,rats in group C were given 100 mg/kg α-LA and rats in group D were given 5.0% glucose-solution.The body mass,FPG,FINS,HOMA-IR,expression level of VEGF,activity of SOD,GSH and IL-6 of 4 groups were compared by statistics.Results After 72 h,the FPG of group A was(4.57 ±0.1 5 )mmol/L,that of group B was (21.72±4.28)mmol/L,that of group C was(21.54±4.96)mmol/L and that of group D was(21.83±4.77)mmol/L,the difference had statistical significance (P <0.05).The body mass of group A was(210.5±5.2)g,that of group B was(21 1.2 ±5.7)g,that of group C was(209.8±5.8)g and that of group D was(208.7±3.4)g,the difference had no statistical significance (P >0.05).The body mass,FPG,FINS,HOMA-IR,expression level of VEGF,activity of SOD,GSH and IL-6 among 4 groups at 4 w,8 w and 12 w had statistical difference (P <0.05).After 12 w,the difference of GR stage among group B to group D had statistical significance (P <0.05).Conclusion α-LA can inhibit the expression of VEGF in rats with diabetes mellitus,which is related to its ability to re-duce the oxidative stress and inflammation reaction,as well as to alleviate the insulin resistance.

Objective To explore significance of alpha‐fetoprotein isoform L2(AFP‐L2) in the screening of Down syndrome in pregnant women ,so as to provide references for clinical application .Methods A total of 250 healthy pregnant women and 22 preg‐nant women with Down syndrome were enrolled in this study .Serum specimens were collected and AFP‐12 was separated and cap‐tured by using the magnetic bal ,time‐resolved fluorescence immunoassay was used to detect levels of AFP and AFP‐L2 ,and the percentage of AFP‐L2 (AFP‐L2% ) was calculated .Results The serum level of AFP of pregnant women with Down syndrome [(20.2±4.2)ng/mL]was lower than that of healthy pregnant women[(46.7±19.9)ng/mL],and had statistically significant difference(P<0 .05) .Serum AFP‐L2% of pregnant women with Down syndrome was higher than that of healthy pregnant women , and had statistically significant difference(P<0 .05) .Conclusion Detection of AFP level and AFP‐L2% could be an indicator for Dow n syndrome screening .

Objective To investigate the associations of aquaporin-4 (AQP4) promoter polymorphisms with anti-AQP4 antibody and genetic susceptibility to multiple sclerosis (MS) and neuromyelitis optica (NMO) in Southern Chinese population.Methods The polymorphisms of AQP4promoter 0 and 1 were analyzed by PCR and DNA sequencing in 18 NMO,38 MS,13 recurrent myelitis (RM),6 recurrent optic neuritis (RON)patients and 39 healthy controls. Results Fourteen polymorphism loci were observed in AQP4-promoter 0,while 6 ones were observed in AQP4-promoter 1.Among them,the incidence rate of polymorphism at position - 1003 bp (A-G) of AQP4-promoter 0 in anti-AQP4 antibody-positive patients was significantly higher than that in anti-AQP4 antibody-negative patients and controls (former:13/18 vs 20/45,P =0.046; latter:13/18 vs 10/39,P =0.001 ).The incidence rates of polymorphism at position between -401 bp and -400 bp ( C inserted) of AQP4-promoter 1 in anti-AQP4 antibody-positive and -negative patients were significantly higher than that in controls( former:5/16 vs 0/28,P =0.008; latter:8/38 vs 0/28,P =0.027 ). The incidence rates of polymorphism at position - 1003 bp (A-G) of AQP4-promoter 0 and position between -401 bp and -400 bp ( C inserted)of AQP4-promoter 1 in patients with NMO and MS were significantly higher than that in controls( NMO:11/18 vs 10/39,P =0.010;4/15 vs 0/28,P =0.020; MS:19/38 vs 10/39,P =0.027;8/34 vs 0/28,P =0.018).Conclusions Polymorphisms loci were observed in AQP4-promoter 0 and AQP4-promoter 1,which may have an influence on the susceptibility to MS and NMO.Polymorphism at position - 1003 bp ( A-G) of AQP4-promoter 0 may be related to the emergence of anti-AQP4 antibody in patients with NMO and MS.

Objective To improve differential diagnosis between acute disseminated encephalomyelitis ( ADEM) and classical multiple sclerosis ( CMS).Methods All 20 cases of ADEM and 24 cases of CMS were examined.Their epidemiological and clinical findings,laboratory features and magnetic resonance imaging ( MRI) data were analyzed using x2 test for categorical variables,Wilcoxon Rank-Sum tests for continuous variables.Results ADEM and CMS showed no sex predominance.Patients with ADEM ((27 ±15) years) were younger than CMS ((37 ±13) years,Z= -2.218,P =0.027).The following findings were more commonly seen in ADEM compared with CMS:predemyelinating infectious disease (75% vs 4%,x2 =23.652,P = 0.000),fever (65% vs 4%,x2 =18.609,P = 0.000),meningeal irritation sign (40% vs 0,x2 = 9.189,P =0.002),seizure (25% vs 0,x2 =4.514,P = 0.034),and encephalopathy.ADEM patients were more likely to present with blood leucocytosis ( (11.9 ± 5.8) ×109/L vs (8.0±3.2) ×109/L,Z= -2.030,P=0.042),high C-reactive protein (2.74 mg/L vs 0.49 mg/L,Z = - 3.028,P = 0.002),increased erythrocyte sedimentation rate (11.00 mm/h vs 7.00 mm/h,Z= -2.406,P =0.016),and cerebrospinal fluid leucocytosis (9 × 106/L vs 2×106/L,Z =- 2.781,P = 0.005).There were no differences in cerebrospinal fluid protein and oligoclonal band between the two groups.The following MRI lesions were more commonly seen in ADEM patients:cortical gray matter lesions (14/20,x2=15.213,P=0.000),basal ganglia gray matter lesions (14/20,x2 =8.910,P = 0.003),and brainstem lesions ( 14/20,x2 = 5.867,P = 0.015).In contrast,lesions in subcortical white matter (21/24,x2 = 17.628,P =0.000),periventricular area (21/24,x2 =15.213,P=0.000) and corpus callosum ( 14/24,x2 = 8.640,P = 0.003 ) were more common in the MRI image of CMS patients.The lesions in spinal cord were usually centrally distributed in ADEM (83% ),while peripherally in CMS (85%,x2 = 11.542,P = 0.001).The lesions had poorly defined margins in ADEM (95%),but well defined margins in CMS (75%,x2 =21.787,P = 0.000).Conclusion There are differences in epidemiological and clinical findings,laboratory features and MRI appearances between ADEM and CMS.

OBJECTIVE:To prepare Diacerein (DCR)-loaded (poly lactic-co-glycolic acid) PLGA microspheres for intra-articular injection and investigate its related properties. METHODS:PLGA was used as microspheres material,and the microsphere was prepared by emulsification solvent evaporation method. The contents of DCR-PLGA microspheres were determined by HPLC,and drug-loading amount and entrapment efficiency were also calculated. Using entrapment efficiency as evaluation index,the preparation technology was optimized by orthogonal test. The morphology and particle size of microspheres were observed by optical microscope and SEM. Accumulative release rate was investigated by using in vitro release test. RESULTS:The linear range of DCR was 2.1-105.0 μg/mL(r＝0.999 9). RSDs of precision,stability,reproducibility and recovery tests were all lower than 2.0%. The optimal technology was PLGA concentration of 200 mg/mL,volume ratio of oil-water 1∶50,polyvinyl alcohol concentration of 1%. The prepared DCR-PLGA microspheres were spherical,average particle size was(11.2±4.7)μm, drug-loading amount was(4.25 ± 0.26)% and encapsulation rate was(92.30 ± 1.93)%,respectively. The drug release rate of DCR-PLGA microspheres within 360 h was about(73.08 ± 5.33)%. CONCLUSIONS:DCR-PLGA microspheres are prepared successfully with good morphology,suitable particle size and obvious sustained release effect,which are suitable for intra-articular injection.

OBJECTIVETo investigate the alkaloids in the roots of Dactylicapnos scanden (D. Don) Hutch.

METHODThe compounds were isolated by various column chromatographic methods. The structures were elucidated by spectroscopic analysis.

RESULTEight compounds were isolated and identified as d-isocorydine (1), protopine (2), d-magnoflorine (3), d-isocorydine-beta-N-oxide (4), d-corydine-alpha-N-oxide (5), d-corydine-beta-N-oxide (6), 6S, 6aS-N-methyllaurotetanine-alpha-N-oxide (7), and 6R, 6aS-N-methyllaurotetanine-beta-N-oxide (8).

CONCLUSIONCompounds 4-8 were isolated from this species and the genus Dactylicapnos for the first time.

Objective:To explore the surgical technique and therapeutic effect of flap wrapping repair of soft tissue defect after digit degloving injury with free arm medial perforator flap.Methods:From October 2009 to December 2020, 15 patients with soft tissue defect after digit degloving injury were repaired with free arm medial perforator flaps. The patients were 9 males and 6 females aged 22 to 50 years old, with an average of 32 years old. Injury mechanism: 13 cases of machine strangulation and 2 cases of machine crushing. Plane of sleeve avulsion injury: at the distal metacarpophalangeal joint of thumb in 2 cases, at the middle and distal segment of single finger of 2nd to 5th fingers in 4 cases, and at distal metacarpophalangeal joint of 2nd to 5th fingers in 9 cases. Seven cases were in left hand and 8 in right hand. Emergency surgery was performed in 2 cases and scheduled surgery in 13 cases. The flap was designed in a shape of a long strip, and the size of the flap was 5.0 cm×2.5 cm-14.0 cm×3.5 cm. During the operation, the artery of the flap pedicle was anastomosed with the palmar digital proper artery or common digital artery of the recipient digit, the subcutaneous vein or the companion vein of the artery was anastomosed with the dorsal or palmar digital subcutaneous vein, and the medial brachial cutaneous nerve carried in the flap was anastomosed with the stump of palmar digital proper nerve. All the donor sites were directly sutured. After the surgery, follow-up visits were conducted regularly at outpatient clinic, or via telephone and WeChat review or by home visit. The flap appearance, sensation and function recovery of digital joints were observed together with the patient satisfaction. Results:All flaps survived successfully after surgery. Six patients with degloving defect of the whole digit had encountered poor wound healing caused by distal phalangeal necrosis. The second stage stump trimming was performed to keep the digit to the distal end of the middle segment. Two cases of thumb and 2 cases of middle finger suffered further burning and worn tears at 7-9 months after surgery and self-healed. The follow-up period was 6-28 (average 16) months. The flap was soft without bloating. The sensation recovered to S 2-S 3. The shape of fingers was good, and no secondary flap surgery was necessary. The overall movement of interphalangeal joints was poor. According to the evaluation standard of Michigan hand function questionnaire, 15 patients achieved very satisfactory with the overall appearance and function of hands. The linear scars at donor site were hidden without complications such as tenderness and contraction. Conclusion:The free medial perforator flap of the arm is easy to design and thin, hence does not affect the shape of a digit. So, it is ideal for the repair of soft tissue defect after digit degloving injury.