AIM: To evaluate the diagnostic accuracy of macular ganglion cell - inner plexiform layer ( GCIPL ) measurements using high- definition optical coherence tomography ( Cirrus HD - OCT ) ganglion cell analysis algorithm for detecting early and moderate to severe glaucoma.
METHODS:Twenty normal control persons, 26 patients with early glaucoma and 29 patients with moderate to severe glaucoma were enrolled in this study. Macular GCIPL, optic nerve head ( ONH ) parameters and peripapillary retinal nerve fiber layer ( RNFL ) thickness were measured in each subject. Then all measured results of each parameter were calculated using SPSS17. 0. Areas under the receiver operating characteristic curves ( AUC) of each parameter were calculated to compare the diagnostic accuracy for detecting early and moderate to severe glaucoma.
RESULTS: For detecting early glaucoma, AUC of average RNFL and seven clock value of RNFL were the biggest ( 0. 871 and 0. 896 respectively ), the AUC of parameters in GCIPL were also significant, among them,
the average GCIPL showed bigger AUC(0. 847) than the minimum GCIPL (0. 812). For diagnosing moderate to severe glaucoma, the AUC of rim area was 0. 992, which was bigger than that of average RNFL ( 0. 991 ). The minimum GCIPL showed bigger AUC ( 0. 983 ) than the average GCIPL (0. 967). For early glaucoma diagnosis, the sensitivity of average RNFL was the highest (76. 9%), while the average GCIPL has the highest specificity (93. 5%).
CONCLUSION: AS a new diagnostic parameter for detecting glaucoma, GCIPL shows similar diagnostic potential compared with RNFL. For early glaucoma diagnosis, average RNFL is the most important parameter, while screening early glaucoma, average GCIPL should be paid more attention.

Objective To analyze the antibiotic susceptibility, ESBL genotype of clinical Klebsiella pneumoniae strains isolated from People′s hospital and facilitate the control of resistance spread. Methods Identification and antibiotic susceptibility tests of 1 205 strains from 2001 to 2007 were done by VITEK-2 system.The antibiotic susceptibility results were analyzed by whonet5.3.The ESBL gene was detected by PCR and the Chi-square test was used for statistical analysis.Results The rate of ESBL-producing strains in klebsiella pneumoniae has increased from 2001 to 2007[18.8% (40/213) in 2001, 20.9% (53/253) in 2002, 32.8% (42/128) in 2003, 33.6% (45/137) in 2004, 36.6% (60/164) in 2005, 45.3% (68/150) in 2006 and 45.6% (73/160) in 2007].The SHV gene was the most dominant in ESBL genotypes.There were 83.3% (50/60) ESBL strains in 2005 with SHV gene, 82.3%(56/68) in 2006 and 83.6%(61/73) in 2007.The rated of strains with CTX-M gene were increasing.There were 26.7%(16/60) ESBL strains with CTX-M gene in 2005, 36.7%(25/68) in 2006 and 54.8%(40/73) in 2007.The isolates with more than one type of ESBL gene were increasing.There were 45%(27/60) ESBL strains in 2005 with two types of ESBL gene, and no one had more than two types of ESBL gene in that year.There were 47.9%(35/73) ESBL strains in 2007 with two types of ESBL gene.In 2007 there were 9.6%(7/73) and 2.7%(2/73) ESBL strains with three types and four types of ESBL gene respectively.There was a statistical difference between the antibiotic resistance rates of cefotaxime, ceftriaxone and ceftazidime in SHV-gene-phore strains (χ2=13.22, P＜0.01).The strains with SHV gene were more resistant to cefotaxime than ceftriaxone and ceftazidime.There also was a statistical difference of the antibiotic resistance rate of cefotaxime, ceftriaxone and ceftazidime between strains with TEM gene (χ2=9.91, P＜0.01) and CTX-M gene (χ2=34.84, P＜0.01) respectively.None of the strains with CTX-M gene was sensitive to cefotaxime, and they were more resistant to ceftriaxone than ceftazidime.The strains with TEM gene were more resistant to cefotaxime than ceftriaxone and ceftazidime.There were statistical differences of the antibiotic resistance rate to cefotaxime (χ2=29.65, P＜0.01), ceftriaxone (χ2=20.26, P＜0.01) and ceftazidime (χ2=20.26, P＜0.01) between the strains with SHV gene only and strains with SHV and CTX-M gene concurrently.There were also statistical differences of the antibiotic resistance rates to cefotaxime (χ2=11.01, P＜0.01), ceftriaxone (χ2=9.93, P＜0.01) and ceftazidime (χ2=7.01, P＜0.01) between the strains with SHV gene only and strains with SHV and TEM gene concurrently.The antibiotic resistance rates to cefotaxime (χ2=11.54, P＜0.01), ceftriaxone (χ2=17.58, P＜0.01) and ceftazidime (χ2=14.11, P＜0.01) were statistically different between the strains with SHV gene only and strains with SHV and OXA gene concurrently.The antibiotic resistance rates to ceftazidime (χ2=23.61, P＜0.01) were statistically different between the strains with CTX-M gene only and strains with SHV and CTX-M gene concurrently. There was no statistical difference in antibiotic resistance rates to cefotaxime (χ2=3.55, P＜0.01) and ceftriaxone (χ2=3.35, P＜0.01) between the strains with CTX-M gene only and strains with SHV and CTX-M gene concurrently. The antibiotic resistance rates to ceftazidime (P=0.01) were statistically different between the strains with only TEM gene and strains with SHV and TEM gene concurrently, and there was no statistical difference of the antibiotic resistance rates to cefotaxime (P=0.29) and ceftriaxone (P=0.26) between the strains with TEM gene only and strains with SHV and TEM gene concurrently. ConclusionsThe producing rate of ESBL is increasing year after year and the SHV type of ESBL is the dominant one.Strains with more than one type of ESBL gene are increasing.The antibiotic resistance rates to cefotaxime, ceftriaxone and ceftazidime are statistically different between strains with same ESBL genotype.

Objective:To investigate the possibility of miR-125b in serum as a novel tumor marker for primary hepatocellular car-cinoma (HCC) and the diagnosis value of combined detection of miR-125b and alpha-fetoprotein (AFP) for HCC. Methods:We detected serum miR-125b expression of 65 cases of HCC patients and 30 cases of healthy controls by real-time quantitative PCR. Moreover, we analyzed the significance of miR-125b and explored the relationship between miR-125b and clinical pathological factors. Results:The level of miRNA-125b was down regulated in serum of HCC patients compared with healthy controls which showed significant differences (P<0.05). Furthermore, the expression of miRNA-125b has no distinct correlation with sex, age, HbsAg, AFP, ALT andα-GGT, which had no significant differences (P>0.05). The expression level of miRNA-125b correlated the difference with liver Cirrhosis, tumor size and tumor node metastasis (TNM) stages, which were considered significant differences (P<0.05). The receiver operating characteristic (ROC) curve analysis of serum miR-125b for the diagnosis of HCC yielded AUC of 0.917(95%CI:0.851~0.960, P<0.001)with 85.9%sensitivity and 93.5%specificity. The ROC curve analysis of combined miR-125b and AFP for HCC detection yielded AUC of 0.951(95%CI:0.894~0.982, P<0.001)with 92.9%sensitivity and 93.5%specificity. The ROC curve analysis of serum miR-125b as biomarkers for the group (AFP<20μg/L) of HCC yielded AUC of 0.889(95%CI:0.776~0.957, P<0.001)with 84.0%sensitivity and 87.1%specificity. Conclusion:Serum miRNA-125b combined with AFP has considerable clinical value for the early diagnosis of primary HCC.

Objective To compare the relativity between Tp-Te interval,Tp-Te /QT ratio with heart rate(HR)and explore their clinical significance retrospectively.Methods 200 normal individuals' ECG were randomly selected and the Tp-Te interval and Tp-Te/QT ratio were measured in precordial lead V6 retrospectively.The relativity between Tp-Te interval and Heart Rate,Tp-Te/QT ratio and Heart Rate were calculated retrospectively.Results The Tp-Te interval was about(83.17?12.64)ms in precordial lead V6 of normal individuals.The Tp-Te interval decreased linearly with the increase in HR with the range of Tp-Te interval being 56 to 114 milliseconds(Pearson's correlation coefficient r was-0.239,P=0.007 0.01).Conclusion There is an inverse correlation between Tp-Te interva and HR while no correlation between Tp-Te/QT ratio and HR.

Objective: To observe the difference in clinical efficacy between acupuncture with point selection based on syndrome differentiation along the meridians and acupuncture at non-meridian and non-acupoint points for functional dyspepsia (FD). Methods: A total of 74 FD patients were randomized into an observation group and a control group, with 37 cases in each group. Both groups received acupuncture treatment. Zusanli (ST 36) and Neiguan (PC 6) were selected in the observation group, with Taichong (LR 3) and Neiting (ST 44) added for excess syndrome, and Gongsun (SP 4) and Yinlingquan (SP 9) added for deficiency syndrome. Four non-meridian and non-acupoint points were selected in the control group. The treatments in both groups were performed once a day with a 2-day break after 5 consecutive treatments, which constituted one treatment course. A total of 4 courses were performed. The scores of Nepean dyspepsia index (NDI) and Leeds dyspepsia questionnaire (LDQ) were recorded before and after treatment, and during follow-up (8, 12, 16, 20 and 24 weeks after recruitment) to assess the clinical efficacy. Results: The NDI scores in the two groups after treatment and at each time point during follow-up were higher than those before treatment (all P<0.05), and the LDQ scores were lower than those before treatment (all P<0.05). The NDI scores after treatment and at each time point during follow-up in the observation group were higher than those in the control group (all P<0.01); the total LDQ score and scores of upper abdominal pain, postprandial satiety and upper abdominal burning sensation after treatment and at each time point during follow-up in the observation group were significantly lower than those in the control group (P<0.01 or P<0.05).. Conclusion: Acupuncture with point selection based on syndrome differentiation along the meridians has a better curative effect than acupuncture at non meridian and non-acupoint points in the treatment of FD.

Objective To identify the rale of NKX2-5 gene in cardiomyocyte differentiation and its mechanism.Methods P19 cells were divided into transfected and non-transfected groups.In the transfected group,P19 cells were with stable expression of NKX2-5 gene.The P19 cells were cultured in suspension for 4 days,and the formed aggregates were transferred to Petri dish for adherent culture.On days 4,8,12,and 16 of the adherent culture,the expressions of ct-saicomeric actin(α-SA)and cardiac troponin T(cTnT)were detected with double-labeling immunofluorescence and Western blot.The ultrastruetural changes were observed on day 16.Results In the transfected group,no expression of α-SA and cTnT was found on day 4,and the expression of these 2 proteins or co-expression existed on days 8,12,and 16.There were early cell junction and myofilament-like structure in the cytoplasm of some cells in the transfected group.In the non-transfected group,these 2 proteins were negative,and no differentiated cell was found.Conclusion Stable expression of NKX2-5 gene can induce cardiomyocyte differentiation from P19 cells,but the P19 cells with stable expression of JVKX2-5 gene is not suitable to be an in vitro model of cardiac development.

Objective To explore the perioperative nursing of esophageal hiatal hernia using the laparoscopic methods. Methods 26 cases of esophageal hiatal hernia undergoing the laparoscopic repair operation were given a whole comprehensive nursing before and after the operation. Results All 26 cases received the successful surgeries, restored successfully after the operation, and had no post-operative complications. The average time for leaving hospital was 4 days. Conclusions Strengthening the perioperative nursing of esophageal hiatal hernia is in favor of postoperative recovery and reducing postoperative complications.

BACKGROUND:The use of mesenchymal stem cels in the field of tissue engineering for osteoarticular injury repair is a very promising tool since these cels are readily expandable and able to differentiate into chondrocytes. Abundant evidence suggests that microRNAs play critical roles in chondrogenic differentiation of mesenchymal stem cels.
OBJECTIVE:To observe the chondrogenic effect of human bone marrow mesenchymal stem cels transfected with lentiviral vectors bearing miR-221-3p/222-3p inhibition, thereby provding new strategies for cartilage injury.
METHODS: miRNA microarray technology was applied to detect microRNAs expression profiles at three different stages of chondrogenic differentiation induction after transforming growth factor-β3 treatment and verified by real-time fluorescence quantitative PCR (RT-qPCR). Human bone marrow mesenchymal stem cels were infected with lentivirus bearing miR-221-3p/222-3p inhibition. After co-suppressing the expression of miR-221/222-3p, cel counting kit-8 was used to determine the cel proliferation, the differentiation of bone marrow mesenchymal stem cels towards chondrocytes was verified by type II colagen protein expression through immunohistochemistry and glycosaminoglycan accumulation was also elevated by sarranine O staining. RT-PCR was used to detect type II colagen and aggrecan mRNA expression at 21 days of chondrogenic induction.
RESULTS AND CONCLUSION: The expression of miR-221-3p/222-3p was inhibited after Lv-miR221-3p/222-3p inhibition co-transfected into bone marrow mesenchymal stem cels. microRNA microarray and RT-qPCR results showed that the expression of miR-221-3p/222-3p was declined significantly at the anaphase of chondrogenic differentiation. The expression levels of chondrogenic markers, Aggrecan and type II colagen were significantly increased in the miR-221-3p/222-3p inhibition group and cel proliferation was also inhibited significantly compared with non-transduced cels or transduced with the empty lentiviral vector group. miR-221-3p/222-3p knockdown in bone marrow mesenchymal stem cels could inhibit proliferation but promote chondrogenic differentiation of bone marrow mesenchymal stem cels.

OBJECTIVE To observe the clinical effects of the combination of Duhuo Bugu decoction and zoledronic acid in the treatment of malignant bone metastasis.METHODS Fifty patients with bone metastases of malignant tumor were selected from the Department of oncology,Chongqing Hospital of traditional Chinese medicine from September 2014 to February 2016, and were randomly divided into the observation group and the control group.Two groups were both treated by zoledronic acid, and the observation group was also treated by adding Duhuo Bugu Decoction.Changes of the analgesic effects,analgesic dosa-ges and life quality scores(KPS)of two groups were observed before and after treatment.Urinary type I collagen amino termi-nal peptide(uNTX)and bone alkaline phosphatase(BALP)were measured via ELISA method before and after treatment.RE-SULTS Compared with the control group,the analgesic medicinal amount of the observation group reduced significantly(P<0.05),and KPS improved significantly(P<0.05).After the treatment,numerical pain scores(NRS) of two groups had no significant changes(P>0.05).After the treatment,uNTX and sBALP level of the treatment group decreased compared with that before treatment(P<0.01).While compared with the control group,the difference was not significant(P>0.05).CON-CLUSION The combination of Chinese herbs and zoledronic acid is an effective therapy for bone metastasis malignant tumors. Chinese herbs can effectively improve the analgesic effect,reduce the analgesic medicinal amount,improve the patients'life quality,and have a tendency of synergy in improving the bone destruction caused by tumor.

Objective To observe the clinical efficacy of balance acupuncture predominantly by puncturing Jiaji points (EX-B2) from C4 to T1and from T12 to L1in treating hemiplegic balance disturbance after cerebral stroke. Method A total of 180 hemiplegia patients were randomized into 3 groups, 60 cases in balance acupuncture group, 60 cases in ordinary acupuncture group, and 60 cases in basic control group. After 1-month treatment and 3 months after the treatment, the motor function (Fugl-Meyer Assessment, FMA), balance function (Berg Balance Scale, BBS; Timed Up and Go Test, TUGT), and activities of daily living (ADL) (Barthel Index, BI) were observed.Result After 1-month treatment and 3 months after the treatment, limb function, balance ability and ADL were significantly different from those before the treatment in balance acupuncture group (P<0.01); after 1-month treatment, limb function in balance acupuncture group was significantly different from that in basic control group (P<0.05), and the differences were more statistically significant in comparing the rest indexes between the two groups (P<0.01); there were significant differences between ordinary acupuncture group and basic control group (P<0.05). Three months after the treatment, there was a significant difference in comparing balance function between balance acupuncture group and basic control group (P<0.05), and the differences were more statistically significant in comparing the rest indexes between the two groups (P<0.01), there was no significant difference in comparing balance function between ordinary acupuncture group and basic control group (P>0.05).Conclusion In combination with basic treatment, balance acupuncture works better than ordinary acupuncture and basic control in improving limb function, ADL and balance function of hemiplegia patients.