Objective To analyze the reasons and mechanisms of stereoscopic function abnormality in elder patients after the cataract extraction with intraocular lens implantation. Methods 150 cases with artificial lens implantation were randomly selected.Routine eye examinations were carried out and the associated refractive error and presbyopia were corrected.Bilateral simultaneous visual perception and fusion function were examined.The stereoscopic function was tested using "the stereoscopic function examination diagram"created by Yan Shao-ming.Ninety-seven patients who were found to have unrecover-ed or abnormal stereoscopic function were enrolled for analysis. Results In these 97 cases,53(54.6%)were found to have preexisting eye disorders that could affect visual acuity and binocular single vision before the operation.Macular problem was the most prevalent problem in this group.Twenty-seven(27.8%)patients had complicated with corneal astigmatism,after cataract,paralysing strabismus and diplopia as well as macular edema after the operation.In addition,the contralateral unoperated cataract in 17(17.5%)patients and post-operative anisometropia in 9(9.3%)patients were also the causes of stereoscopic function abnormality.There was no reason could be identified in 8 cases. Conclusions The pre-existing eye disorders before lenses implantation,complications of the operation,contralateral unoperated cataract and anisometropia are all the major factors that affect visual acuity recovery and bilateral stereoscopic function rehabilitation.

Objective To screen a cell line which stably suppresses DAPK expression and to observe the growth characters.Methods Four pairs of shRNA were designed,synthesized and inserted into the pDsRed1-N1-U6 vector.The recombinant plasmids were purified and transfected into PC12 cell.Meanwhile,a pDsRed1-N1-U6 vector was transfected as control.The cell clones were screened by G418,and the stable PC12 cell line was established.DAPK expression was detected by Western blot.MTT method and Flow Cytometry(FCM) assay were used to assess the growth characters of the cell line.Results The shRNAs were transfected into PC12 cell and the cell clones were successfully screened out.Of the four recombinant plasmids,the F2 was the best interfering shRNA.Beyond our expectation,the F1 recombinant plasmid had an enhanced effect on DAPK expression.Conclusion A stable PC12 cell line with stable inhibition of DAPK expression by was established using siRNA expression vectors.

Objective To test serum differentially expressed proteins between early-stage (stage IB-ⅢA) and late-stage (stage Ⅳ) lung cancer patients by proteinchip technology and investigate its clinical value. Methods SELDI-TOF-MS and WCX-2 protein chip were used to detect the serum protein of 30 cases of early stage lung cancer patients and 30 cases of late stage lung cancer patients. The data were analyzed by using Biomarker Wizard software. Results There are ten different proteins in the serum between the two groups of lung cancer patients. Four protein markers 7978, 8139, 15 951 and 16 133 are over expressed and seven protein markers 2867, 6885, 8701, 8840, 13 781 and 13 955 are low expressed in the late group. Conclusion SELDI-TOF-MS proteinchip technology is a convenient, sensitive and high-throughput analysis method which can screen several relatively specific protein markers for late stage lung cancer from the serum samples. This selected protein markers can predict metastasis of lung cancer patients.

BACKGROUND: Color Doppler flow imaging can exam the early myocardial disorder in type 2 diabetic patients. What does exercise tolerance test work for the examination of such disorder in combination with color Doppler flow imaging (CDFI) ?OBJECTIVE: To analyze in comparison the early evaluation on reduced diastolic function in left ventricle in patients with type 2 diabetes between the examinations of exercise tolerance test combined with color Doppler flow image and simple color Doppler flow imaging.DESIGN: Cases-controlled comparison and self-comparison.SETTING: Department of electrodiagnosis and department of Endocrinology in a municipal hospital.PARTICIPANTS: Thirty-six cases of inpatients with type 2 diabetes were selected from Department of Endocrinology of Shenyang Red Cross Hospital from March to December in 2004, of which, 25 cases were males and 11cases females. The diabetic patients included had no cardiac vascular complications and participated in the study in volunteer. Thirty-two patients who received annual routine health check at the same period were selected as the control, of which, 20 cases were males and 12 cases females.METHODS: Metronics treadmill exercise test equipment was used for exercise tolerance in two groups. Before exercise(at quiescent state) and after exercise tolerance, Vivid 4 CDFI was used to determine flow velocity at E and A peak values respectively, ratio between flow velocities at E peak value and A peak value as well as isovolumtric relaxation time (IRT).MAIN OUTCOME MEASURES: Comparison of cardiac functional indexes before and after exercise tolerance in two groups.RESULTS: Thirty-four diabetic patients accomplished exercise tolerance test, of which, 1 case presented frequent ventricular extrasystole, another one presented precordial pain and stopped the test. In the control, all of 32 cases ratio between flow rates of E peak value and A peak value was remarkably lower than that in the control (0. 90 ± 0. 25, 1.40 ± 0.30, P ＜ 0.05 ); IRT was remarkably longer than that in the control [ (112. 07 ± 20. 16),imental group, the ratio between flow rates of E peak value and A peak value was remarkably lower than that in the control (0.62 ±0. 12, 1.28 ±0.87, P＜ 0.01 ); IRT was remarkably longer than that in the control[ (138. 10± 19.21), (97.37±9.61) ms, P ＜0.01].CONCLUSION: CDFI can supervise and evaluate at early stage the cardiac functional changes in type 2 diabetic patients. Due to the induction of exercise tolerance, the combination of exercise tolerance test and CDFI provides more accurate, objective and valuable conclusions at early stage.

Objective To investigate the relation ship between the changes of platelet parameters and intracranial hemorrhage in premature children with low birth weight. Methods 73 premature children with low birth weight were selected as research subjects and divided into PIVH group (35 cases) and non PIVH group (38 cases) according to intracranial hemorrhage or not,and 20 normal newborns were selected as controls. The neonatal platelet parameters of three groups were detected and compared. Results There were 35 cases of 73 premature children with low birth weight occurred intracranial hemorrhage, the incidence rate was 47. 9%. The gestational age and birth weight of PTVH group were (29.3 ± 1.2) weeks and (1 653.0 ± 182. 1) g and which were significantly lower than the non PIVH group( all P ＜0.05) ; the asphyxia rate of PIVH group was 60.0% and which was significantly higher than the non PIVH group(P＜0.05). The PLT and PCT of PIVH group were (187.52 ±52.03) × 109/L and (0.127 ± 0.05) % and which were significantly lower than the control group (all P ＜ 0. 05) ; The PLT and PCT of non PIVH group were(223.48 ±42.15) × 109/L and (0. 189 ±0. 06)% and which were significantly lower than the control group(all P＜0. 05) ; The PLT and PCT of PIVH group were significantly lower than the non PIVH group(all P ＜ 0.05) ; while the MPV and PDW among the three groups had no significant difference ( all P ＞ 0. 05 ). Conclusion The abnormal decrease of PLT and PCT should be involved in the pathogenesis of intracranial hemorrhage in premature children with low birth weight, clinical attention should be paid to the monitoring of platelet parameters in premature children so as to alert and minimize its incidence.

BACKGROUND:Mycobacterium tuberculosis heat shock protein 10 (r-Mt cpn10) is one of the main factors that cause bone tuberculosis dissolution and absorption as wel as inhibits the proliferation of osteoblasts. Receptor activator of nuclear factor kappa B ligand and osteoprotegerin are the important factors influencing bone metabolism.
OBJECTIVE:To observe the effect of r-Mt cpn10 on human osteoblast proliferation, alkaline phosphatase secretion, expression of receptor activator of nuclear factor-kappa B ligand mRNA and osteoprotegerin mRNA. METHODS:Human bone marrow stromal cel s were induced to differentiate into osteoblasts, and osteoblasts at passage 3 were cultured with various concentrations of r-Mt cpn10 (0.1, 1, 10 mg/L). Osteoblasts cultured without r-Mt CPN10 were assigned as controls.
RESULTS AND CONCLUSION:MTT assay results showed that, compared with control group, r-Mt cpn10 at different concentrations inhibited osteoblast proliferation and alkaline phosphatase secretion (P<0.05). RT-PCR analysis showed that, r-Mt cpn10 at different concentrations increased receptor activator of nuclear factor-kappa B ligand mRNA expression (P<0.01), and inhibited osteoprotegerin mRNA expression in a concentration-dependent manner (P<0.01). 10 mg/L r-Mt cpn10 exhibited the strongest effect (P<0.01). The r-Mt cpn10 can inhibit osteoblast proliferation and alkaline phosphatase activity, and it may influence bone metabolism by regulating the expression of receptor activator of nuclear factor-kappa B ligand mRNA and osteoprotegerin mRNA.

BACKGROUND:The mycobacterium tuberculosis heat shock protein 10 exerts effects on the osteoclasts by in vitro mouse cranium experiment,
OBJECTIVE:To investigate the effect and mechanism of recombinant mycobacterium tuberculosis heat shock protein 10 (CPN10) on the differentiation of osteoclasts in the in vitro culture system that induces osteoclast differentiation.
METHODHuman macrophage colony-stimulating factor-dependent adhesive blood mononuclear cells were divided into four groupreceptor activator for nuclear factor-κB ligand (RANKL)+CPN10 (1 mg/L), RANKL, CPN10 (1 mg/L), and negative control (complete culture medium). Monocytes were resuspended in a-MEM medium containing macrophage colony-stimulating factor, and were cultured in each group for 7, 14, 21 days. The morphology, quantity and bone resorption area of osteoclasts were examined by tartrate-resistant acid phosphatase (TRAP) staining. The expressions of NFATc1 and c-Fos gene and protein were also detected.
RESULTS AND CONCLUSION:In negative control group, no TRAP-positive multinucleated osteoclasts generated, while in the other groups, TRAP-positive multinucleated osteoclasts differentiated and formed the lacunae in the smal bone grinding. The number of osteoclasts formation and resorption in CPN10 group were significantly lower than that in RANKL+CPN10 group. The expression of NFATc1 and c-Fos in the negative control group C was significantly lower than that of RANKL+CPN10 group and CPN10 group. However, CPN10 expressed NFATc1 and c-Fos protein, which was significantly lower than RANKL+CPN10 group. CPN10 is involved in the formation of osteoclasts, and the mechanism is related with the upregulation of NFATc1, c-Fos expression.

Objective To investigate the clinical and imaging features in patients with vertebrobasilar dolichoectasia (VBD) through a comparative study in patients with ischemic stroke with or without VBD.Methods The patients with acute cerebral infarction were divided into either a VBD group or a non-VBD group according to magnetic resonance angiography.The VBD group was further divided into an anterior circulation infarction subgroup and a posterior circulation infarction subgroup.The cardiovascular risk factors,the diameter of basiar artery (BA),bifurcation height,and horizontal displacement were compared in all groups.Results A total of 269 patients with acute cerebral infarction were included,28 had VBD,accounting for 10.41％ of the patients with acute cerebral infarction during the same period.The proportion of male patients (78.6％ vs.66.8％ ;x2 =4.392,P =0.036),age (70.38 ± 10.58 years vs.62.86 ± 12.20 years; t =2.870,P =0.009),and the proportion of hypertension (89.3％ vs.47.7％ ; x2 =17.367,P =0.000) in the VBD group were significantly higher than those in the non-VBD group.The multivariate logistic regression analysis showed that the advanced age (odds ratio [OR] 1.248,95％ confidence interval [CI] 1.137-1.371; P=0.000),hyperglycemia (OR 1.599,95％ CI 1.181-2.164; P =0.002),hypertension (OR 1.251,95％ CI 1.020-1.534; P =0.032) and increased triglyceride level (OR 1.876,95％ CT 1.021-3.445; P =0.043) were the independent risk factors for VBD,while female gender (OR 0.133,95％ CI 0.024-0.735; P =0.021) was the independent protective factor for VBD.Of the 28 cerebral infarction patients with VBD,9 had anterior circulation infarction and 19 had posterior circulation infarction.There were significant differences in BA diameter ([5.40 ± 0.49] cm vs.[6.00 ± 0.77] cm; t =2.046,P =0.041),and the proportions of high score in bifurcation height (x2 =6.768,P =0.037) and horizontal displacement (x2 =5.241,P =0.042) between the 2 groups (all P ＜0.05).The multivafiate logistic regression analysis showed that the BA bifurcation height was an independent risk factor for posterior circulation infarction (OR 1.347,95％ CI 1.069-2.457; P =0.038) in patients with VBD.Conclusions VBD accounted for 10.41％ of the patients with acute cerebral infarction during the same period.Advanced age,hyperglycemia,hypertension and increased triglyceride level were the independent risk factors for VBD.Female gender was the independent protective factors for VBD,and the BA bifurcation height was an independent risk factor for VBD occurring posterior circulation infarction.

The traditional discipline-centered curriculum design can neither keep up with developments of modern medical science nor reach requirements of the education reform in the new century.Since 2011,College of Stomatology in School of Medicine in Shanghai Jiao Tong University had developed ‘ disease oriented integrated curriculum system reform’ for students of long-term stomatology education.In view of the problems existing in the original curriculum system,the integrated curriculum system was set up by coalescing clinical medicine curriculum according to the related systems and oral medicine curriculum according to the developmental rules of diseases.Lectures were combined with discussion classes in the reform and performance appraisal system was changed from simplex judgments into comprehensive evaluations.At last,further considerations of promoting the reform based on the practice were proposed.

Objective To study the method and effect of deep inferior epigastric perforator flap(DIEP)in repairing the large defects of lower limbs.Methods Eight cases,from July 2009 to November 2011,including 3 cases of plantar skin defects with bone exposure after foot injuries,three cases of plate exposure after tibia fracture surgery and 2 cases of heel repeated ulceration after skin graft,were repaired by deep inferior epigastric perforator flap.Results All deep inferior epigastric perforator flaps survived with good functions,except 1 case whose distal with poor blood supply and the flap survived after treatmenting,three cases of flap bloated with good appearances after second operation.Conclusion DIEP is a proper option for repair of large defects of lower limbs.It has the advantages of abundant blood supply,large flap area,abdomen can suturing without abdominal complications.