Objective To observe the degree of choriocapillary ectasia (CCE) and sub-foveal choroidal thickness (SFCT) in central serous chorioretinopathy (CSC) with different activity and discuss their relations.Methods Forty eyes of 40 CSC patients were recruited.The activity of CSC was determinate by fundus fluorescein angiography (FFA).There were 23 eyes with active CSC (active-CSC group),and 17 eyes with inactive CSC (inactive-CSC group).All eyes in both groups were examined with optical coherence tomography angiography(OCTA),and the CCE area of the choriocapillary layer was measured within a 3 mm× 3 mm zone centered on the central fovea of macula.Ectasia was classified based on CCE area,more than 66％ of examination area was high ectasia,and 33％-66％ as medium ectasia,below 33％ as low ectasia.SFCT was measured with frequency domain optical coherence tomography.The relationship between CCE degree,SFCT and CSC group was analyzed.Results Among the 23 eyes of active-CSC group,there were 5 eyes of low ectasia,12 eyes of medium ectasia,6 eyes of high ectasia.Among 17 eyes of inactive-CSC group,there were 11,4,2 eyes of low,medium and high ectasia respectively.Active-CSC group had more advanced degree of ectasia than that in inactive-CSC group(Z=-2.472,P=0.013).SFCT of active-CSC group and inactive-CSC group were (418.13±-126.15),(429.76±105.80) μm respectively,the difference was not significant (t=-0.308,P=0.760).SFCT in eyes with low ectasia,medium ectasia,high ectasia were (419.13±105.60),(381.00±125.12),(515.13±67.68) μm respectively.The difference among the three group was statistical significant (F=4.106,P=0.025).SFCT in eyes of high ectasia was obviously thicker than low ectasia and medium ectasia,the difference was statistical significant (P=0.007,0.048);the SFCT difference between low ectasia and medium ectasia did not appear statistical significance (P=0.326).There was no linear relation between SFCT and CCE degree (r=0.247,P =0.124).Conclusions Active-CSC eyes has more advanced CCE degree than inactive-CSC eyes,but SFCT is the same between the two groups.High ectasia eyes have thicker SFCT.

Standardized patients for interview has been widely used in medical education and examinations.Nevertheless the standard training of SP is still not widely used in China up to the present.Referring to the character of SP working as "the people providing case history","the assessor" and"the teacher",we have described how to write scenarioes,establish the score criteria,institute the training steps,form the measures of examination and supervision in detail in this article,and resummarized the experiences we got during the training period.

This paper discussed the methods of developing clinical thinking ability and the key emphasis on the related main medical and teaching activity.

Objective To observe the therapeutic effects and side effects of FLAG regimen(fludarabine, Ara-C, and granulocyte-colony stimulating factor( C-CSF) for refractory or relapsed acute myeloid leukemia( AML). Methods Twenty-six AML were treated with fludarabine plus intermediate-dose Ara-C and G-CSF,of whom 15 cases belonged to refractory and 11 cases belonged to relapsed. Results After two courses of treatment, 14 cases were completely relieved (53. 8% ) and 5 cases were partially relieved (19.2% ). The overall effective rates was 73.1%. The main side effects were severe myelosuppression and non-hematological toxicity was mild. Conclusion FLAG regimen was very effective for refractory or relapsed acute myeloid leukemia and was well tolerated. The treatment-related mortality rate was low,so it provided a treatment choice for these patients.

Two DNA fragments, designated as P190CRI (AA1-55) and P190CRV (AA1597-1667) respectively, which encoded amino acid residues of conserved region I and V on the P190 antigen, were amplified by polymerase chain reaction from genomic DNA in FCC1/HN strain of Plasmodium falcipamm isolated from Hainan Province, China. It was found that there were five bases substitution in the P190CRV, in comparison with the nucleotide sequences of MAD20 strain. These two sequenced fragments were inserted into pGEX-2T plasmid. E.coli JM109 (DE3) were transformed with the recombinant plasmids and the parental plasmid. The results show that the two fragments were expressed at high level as C-terminal fusions with glutathione s-transferase (GST). The fusion proteins were easily purified from bacterial lysates by affinity chromatography using glutathione sepharose 4B.

190-kilodalton glycoprotein (P190) of Plasmodium falciparum. precursor of the major surface protein of merozoites, is considered a promising candidate for blood stage malarial vaccine. We designed six primers according to the sequence of MAD20 strain, with a GC clamp and BamHI site at the 5'- end of each one, and a GC clamp and Xbal site at the 3'- end of each one. The primers were synthesized by phosphoramidite approach (User's Manual of ABI Company) and purified using HPLC. Three fragments in the second, third and fourth conserved regions of P190 gene of Plasmodium falciparum FCC1/HN strain isolated from the blood of patients in Hainan Province of China were amplified by the polymerase chain reaction (PCR) technique. The amplified fragments were subcloned into pUC18 vectors and sequenced using the dideoxy chain termination method. All three regions of P190 gene of FCCl/HN strain also were highly conservative as compared with P190 gene of MAD20 (Papua New Guinea isolate), K1 (Thailand isolate), Wellcome (West Africa isolate) and CAMP (Malaysia) strains of Plasmodium falciparum. The C at position 81 in the second conserved block of P190 gene of FCC1/HN isolate was substituted by T, which did not change the amino acid determined by the coden corresponding to the substitution.

Aim To investigate the effect of dipfluzine on hERG potassium currents expressed heterologously in xenopus oocytes.Methods Using Xenopus oocytes expression system,the current amplitude and kinetic characteristics of hERG were measured with the two electrode voltage-clamp technique before and after dipfluzine application.Results Dipfluzine(8 nmol?L-1~5 ?mol?L-1)concentration-dependently inhibited hERG currents;the concentration for half maximal inhibition(IC50)was 98.0 nmol?L-1.Dipfluzine-induced inhibition of hERG currents was voltage dependent at membrane potentials between-10 and 40 mV.Dipfluzine at 1 ?mol?L-1 didn't statistically shifted V1/2 of hERG currents activation.Dipfluzine at 1 ?mol?L-1 significantly decreased the activating time constants and the deactivating time constants,and enhanced hERG currents activation and deactivation.Conclusion Dipfluzine concentration-dependently inhibits hERG currents and modifies kinetic characteristics of hERG activation and deactivation,which may be correlated with its antiarrhythmic effect.

To study the effects of the active components of Xiaoxuming Decoction (XXM), a compound traditional Chinese herbal medicine, on chronic cerebral ischemia in rats.

Objective To investigate the value of ISS in predicting mortality after multiple trauma.Methods A total of 550 patients with multiple trauma treated from March 2007 to May 2011 were divided into survivor group (n =473) and death group (n =77) according to the outcome.ISS and acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ]) were used to predict patients' risk of death.Receiver operation characteristic curve (ROC) was developped to compare the area under the curve (AUC),optimal cut-off point,and prediction index for the two scoring systems.Results ISS and APACHE Ⅱ score were higher in death group than in survivor group (P ＜ 0.05).ISS showed the diagnostic cut-off point of ≥20,with a sensitivity of 76.7％,specificity of 83.7％,concordance rate of 82.7％,and AUC of 0.835.With regard to APACHE Ⅱ,the diagnostic cut-off point was ≥20,with a sensitivity of 80.5％,specificity of 89.2％,concordance rate of 88.0％,and AUC of 0.922.ISS and APACHE Ⅱ were equivalent in predicting mortality (P ＞ 0.05).Conclusion ISS presents a moderate value for predicting the mortality of multiple trauma patients and it is more rational to set ISS≥20 points as the criteria for severe multiple trauma.

Objective To study the utility and feasibility of CRAMS score to assess prognosis of patients with acute trauma.Methods A retrospective review of 1 802 patients with acute trauma was conducted to calculate CRAMS and ISS score.Receiver operation characteristic curve (ROC) was used to measure the prognostic role of CRAMS in comparison with ISS.Results Area under the curve (RUC) was 0.885 for CRAMS (95 ％ CI 0.870-0.900) and was 0.792 for ISS (95％ CI 0.773-0.811),with statistical difference of the two scoring systems (Z=4.280,P ＜0.01).To identify patients with potential critical illness,optimal cut-off point was≤7 for CRAMS and≥24 for ISS.CRAMS presented better sensitivity (x2 =16.910,P ＜ 0.01),but lower specificity (x2 =5.260,P ＜ 0.05) and accuracy (x2 =0.693,P ＞ 0.05) for predicting mortality when compared with ISS.Conclusions CRAMS is better than ISS in predicting prognosis for patients with acute trauma and exhibits a high discrimination.RAMS has advantages of simple operation,easy grasping and accurate and timely reflection of illness severity,which facilitates the early detection and treatment of critical illness in inhospital trauma patients.