BACKGROUND: The clinical features and classification of various anomalous synkinetic movements related to ocular muscles caused by abnormal innervations have not been fully understood.OBJECTIVE: To report and analyze the clinical features of anomalous synkinetic movements related to ocular muscles caused by abnormal innervations, as well as to classify them according to the same neuromuscular nerves.DESIGN: A retrospective case analysis.SETTING: Department of Ophthalmology, the Affiliated Hospital of the Medical College of Qingdao University.PARTICIPANTS: The study was mainly conducted in the Department of Ophthalmology, the Affiliated Hospital of the Medical College of Qingdao University. A total of 836 cases of abnormal ocular movements were found from January 1997 to January 2002. Among them 67 cases of anomalous synkinetic movements were diagnosed.METHODS: All patients were inquired of case history and their ocular movements were examined. The anomalous synkinetic movements were found and classified into congenital and acquired. All cases were analyzed according to the same neuromuscular nerves, such as between branches of oculomotor nerve, oculomotor and abducens nerve, supranucleus and other anomalous synkinetic movements.lous synkinetic movements were determined by inquiring the history of observed.RESULTS: Sixty-seven anomalous synkinetic movements (8%) of 836 abnormal ocular movements were diagnosed; congenital anomalous synkinetic movements were the most common ones (88.06%) and were often seen in patients with Duane's syndrome. Anomalous synkinetic muscles occurred the most common between lateral and medial rectus, lateral rectus and levator palpebrae muscle (36.89% respectively) in congenital cases, and those occurred between inferior rectus and levator palpebrae muscle more commonly (30%) in acquired cases.CONCLUSION: Anomalous synkinetic movements related to ocular muscles are not infrequently seen. When we find paradoxical movements between ocular muscles, or between ocular muscles and other unrelated muscles, anomalous synkinetic movements should be considered.

Objective To discuss effect of fasting and taking food on hemostasis effect of patients with gastric ulcer and bleeding. Methods 160 patients with gastric ulcer and bleeding were divided in-to the experimental group and the control group, the experimental group was allowed to take lower ho-moiothermy water gruel (liquid), the control group was required absolute fasting (not medication), until bleeding stop. The two groups adopted identical treatment and nursing. The lienable stomach tube was placed respectively, everyday pH value monitor and occult blood test were carried out by taking out gas-tric juice when fasting and 2 hours after meals. Continuous monitoring tests continued till occult blood test of gastric liquid became negative for 3 times. Stool was kept for occult blood test, at the same time the gastrointestinal tract symptom and bleeding condition were observed, routine blood test was carried out one every other day. The data underwent statistical analysis with SPSS13.0 statistics software package, compari-son between two groups used t test. Results The inner stomach pH value of the experimental group in-creased obviously, the average pH value and percentage of pH above 4 was evidently higher than those of the control group. The time of occult blood test of gastric liquid and stool turning to negative in the experi-mental group was shorter than those of the control group. Conclusions Taking food can elevate pH of gastric liquid, reduce damage caused by gastric acid to gastric mucosa, thus hasten hemostasis process and promote healing.

AIM: To study effects of prolonged intensive endurance exercise and Panaxadiol saponins (PDS) on red blood cells (RBC) membrane fluidity in rats, as well as the mechanism. METHODS: By the membrane fluorence polarization, Pyrollol-NBT, TBA methods and Scanning Electron Microscope, RBC membrane fluidity,RBC-SOD and serum MDA were measured after 7 weeks prolonged intensive swimming. RESULTS: Fluorence polarization(P value) were significant higher and fluidity were lower( P

AIM and METHODS: To detect the changes of amyloid protein (?-AP) and polypeptide growth factor levels and study their role in the possible pathogenesis of Alzheimers disease (AD) and vascular dementia (VD). We detected serum ?-AP, transforming growth factor- ?(TGF-?) and insulin-like growth factor (IGF-Ⅱ) levels by radio immunoassay in 8 patients with AD,15 patients with VD and 63 patients with ischemic cerebrovascular disease(ICVD) and 38 cases healthy volunteers. RESULTS: In AD and VD groups, serum ?-AP, TGF-? and IGF-Ⅱ were significantly higher than that in ICVD and control group; Serum ?- AP,TGF-? and IGF-Ⅱ contents in ICVD group were obviously higher than that in normal control, the highest increase occurred in sequel of cerebral infarction(SCI) and vertebrobasislar ischemia(VBI) groups. There are positive correlation among ?- AP, TGF-? and IGF-Ⅱ in AD and VD groups.CONCLUSION: ①?- AP is a risk factor in the pathogenesis of AD and VD. ② TGF- ? and IGF-Ⅱ play roles in the neurotoxin effect that lead to dementia. ③ ?-AP plays a important role in formation of senile plaque.

Objective To compare the efficacy of add-on adefovir dipivoxil (ADV) therapy and switch-to entecavir (ETV) monotherapy in chronic hepatitis B (CHB) patients with suboptimal response to lamivudine (LAM).Methods A prospective study was performed in 120 CHB patients from Zhuji People' s Hospital and the First Affiliated Hospital of Zhejiang University School of Medicine during June 2010 and June 2011.All patients previously received more than 24 weeks LAM treatment,but HBV DNA was still positive.Patients were randomized assigned to two groups:60 patients received add-on ADV therapy and another 60 switched to ETV monotherapy.Both groups were treated for 48 weeks.Liver and kidney function,alpha-fetal protein (AFP),HBV serum markers,HBV DNA and prothrombin time (PT) were examined,and ultrasonography or CT scan of liver was performed every 1-3 months.x2 test was used to compare the HBV DNA negative rates,HBeAg seroconversion rates,resistance rates and adverse reaction at week 48 between two groups.Results Thirty-three out of 38 patients (86.8％) with baseline HBV DNA 103-105 copies/mL became HBV DNA negative after add-on ADV treatment for 48 weeks,twenty-seven out of 39 patients (69.2％) with baseline HBV DNA 103-105 copies/ml became HBV DNA negative after switch-to ETV treatment.There was a statistical difference between two groups (x2 =4.578,P ＜ 0.05).Sixteen out of 22 patients (72.7％) with baseline HBV DNA ＞ 105 copies/mL became HBV DNA negative after add-on ADV treatment for 48 weeks,while only 52.4％ (11/21) patients achieved HBV DNA negative in the switch-to ETV group.There was also a statistical difference between two groups (x2 =4.865,P ＜0.05).None of patients in add-on group developed virological breakthrough and resistance,while 5 patients in switch-to ETV group developed virogical breakthrough and 3 patients developed genetic mutation.Among them,rtM204V + rtL180M + rtS202G mutation was detected in 2 patients,and rtM204V + rtL180M +rtT184A mutation was detected in 1 patient; all mutations happened in the baseline HBV DNA ＞ 105 copies/mL group.Conclusion The add-on ADV therapy is better in viral inhibition than switch-to ETV therapy for CHB patients with suboptimal response to LAM,and it can reduce the occurrence of drug resistance.

Objective To evaluate the adenoma detection rate( ADR)of fecal occult blood test (FOBT)-positive population in colorectal cancer screening programme and to analyse potential influence of“resection and discard”strategy on ADR. Methods Data of patients who paticipated in the Shanghai color-ectal cancer screening programme with FOBT-positive and received colonoscopy in the Digestive Endoscopic Center of Changhai Hospital from July 2013 to July 2014 were retrospectively analysed. ADR was calculated and compared by different genders. Multivariate logistic regression model was used to analyse the risk factors of polyp resection without retrieval. Results A total of 222 FOBT-positive patients were involved with 36. 5% male proportion. The total ADR was 19. 8%,higher in male(28. 4%)than in female(14. 9%)(P=0. 015). The independent risk factors of polyp resection without retrieval were diminutive polyp( OR =15. 256,95% CI:4. 159-55. 957),located in rectum( OR = 3. 663,95% CI:1. 427-9. 398) and polyp number >2(OR= 3. 988,95%CI:1. 562-10. 187).Conclusion ADR of FOBT-positive population is approx-imately 20%in our center. Low male proportion and“resection and discard”strategy may lead to lower ADR. ADR should be calculated by different genders and advanced endoscopic technology should be employed rou-tinely to predict the pathological diagonosis of the lesions.

Multiple markers that related to gastric cancer has been widely used in clinical, to predict its occurrence, development and prognosis. Serum level of fibrinogen (FIB) and neutrophil to lymphocytes ratio (NLR) respectively as representative indicators of coagulation system and inflammation, can predict the prognosis of patients with gastric cancer and survival time. The rise of fibrinogen is associated with enhanced capacity of the gastric tumor cells proliferation, invasion and migration. High NLR is associated with significantly induced survival of patients with gastric cancer. The combination of fibrinogen and NLR (F-NLR) combines the advantages of each individual indicator in predicting the occurrence, development and prognosis of cancer. It has shown a great prognostic potential in gastric cancer, and can be widely applied in prospect.

OBJECTIVE To investigate the improve-ment functions of flavonoid compounds on temozolomide(TMZ)-,aging-or AD model-induced dysregulation of hip-pocampal NSC lineage progression,retardancy of den-dritic spine maturation in new-born neurons,as well as impairment of hippocampal-related learning and memory.METHODS We applied 30-week-old neural stem cell(NSC)specific promoter Nestin-GFP and NestinCreERT2:Rosa26-LSL-tdTomato transgenic mice and 16-week-old AD model 5XFAD transgenic mice,together with hippo-campal microinjection(ih),endogenous fluorescence trac-ing and immunofluorescent staining.RESULTS Both fla-vonoid compound A and its functional derivative flavo-noid compound B dose-dependently improved TMZ-,aging-or AD-induced defects of hippocampal NSC lin-eage progression and the maturation of dendritic spines of newborn neurons,thereby improving hippocampus related learning and memory.CONCLUSION This paper provides a new idea and treatment strategy for the devel-opment of new flavonoids that can promote neurogene-sis for neurodegenerative diseases and aging.

Obesity is one of the most challenging global public health issues, and more than half of adults in Chia are overweight or obese. Obesity has been shown to be a risk factor for type 2 diabetes, cardiovascular disease, colon cancer and other specific cancers, and has become a serious threat and even a danger to the health and quality of life of the nation. With the mature development of bariatric surgery in the last 20 years, it is now widely recognized for its effectiveness and safety in the treatment of obesity and related metabolic diseases, as well as improving patients′ life expectancy and quality of life. However, previous data from the literatures suggest that some patients require revisional surgery after bariatric surgery, with the incidence of revisional bariatric surgery as 5% to 50%. The main reasons for revisional bariatric surgery are poor post-operative outcomes, including the lack of significant weight loss, weight regain and no significant improvement or even recurrence of associated metabolic disease, and other reasons include the development of anaemia, malnutrition and long-term chronic pain. Currently, there is only the East Asian expert consensus on revised bariatric surgery proposed by Chinese Society for Metabolic & Bariatric Surgery in 2018. However, there are still no uniform standards regarding the indications, contraindications and surgical modalities of revisional bariatric surgery in clinical practice. The authors summarize the latest researches of revisional bariatric surgery, in order to provide the guidance value for clinical practice.

Objective·To measure the parameters of the uterine artery,umbilical artery and middle cerebral artery in a rat model of preeclampsia(PE)by Doppler ultrasound,and compare the pathological changes in placental blood vessels and pregnancy outcomes,in order to provide an effective method and reference for evaluating placental function in PE animal models.Methods·PE(n=8)and normal pregnancy(NP,n=8)groups in Sprague-Dawley(SD)rat models were established by intraperitoneal injections of N'-nitro-L-arginine methylesterhydrochloride(L-NAME)and 0.9%sodium chloride solution.Blood pressure and proteinuria indexes were detected to evaluate whether the model was successfully established.On gestational day 19(GD19),Doppler ultrasound was utilized to measure the parameters of the uterine artery,umbilical artery and the fetal middle cerebral artery in both the PE and NP groups.After termination of the pregnancies,placental function was evaluated through the pathology of placental blood vessels and the quality of the fetuses and placentas.Results·In the PE group,both blood pressure(GD15:P=0.001;GD19:P=0.001)and proteinuria(GD15:P=0.001;GD19:P=0.001)were significantly higher than those in the NP group.The pulsatility index(PI)of the umbilical artery and uterine artery was notably elevated in the PE group compared to the NP group(both P=0.000).Furthermore,the resistance index(RI)of the fetal middle cerebral artery was significantly lower than that in the PE group(P=0.000).While the number of fetal rats did not differ significantly,the quality of placental and fetal rats was notably lower in the PE group(P=0.006 and P=0.000,respectively).Immunohistochemical staining of placental tissue revealed that the number of placental micro vessel densities in the PE group was less than that in the NP group(P=0.001).Correlation analysis revealed that placental micro vessel density,fetal quality and placental quality were inversely related with the RI of the umbilical artery and the PI and RI of the uterine artery,and positively correlated with the S/D,PI and RI of the fetal middle cerebral artery(all P<0.05).Conculsion·Doppler ultrasound assessment of the uterine artery,umbilical artery and middle cerebral artery indices in L-NAME-induced PE rat models effectively reflects pregnancy outcomes and placental vascular pathology.This method is valuable for evaluating placental vascular perfusion in PE rat models,offering practicality and convenience for research involving animal models.