Background It is very important for us to understand retinal function change in the patient with diabetic mellitus in clinic. At present,the study about diabetic mellitus associated with macular edema includes fundus fluorescense angiography ( FFA) and multifocal electroretinogram ( mfERG) etc.. However, seldom research is performed in the mfERG findings for different types of diabetic macular edema. Objective This study aimed to investigate the mfERG change in different types of diabetic macular edema compared with normal population. Methods Fifty-seven eyes with diabetic macular edema from 40 patients and 35 eyes from age-and gender-matched normal subjects were enrolled in this study. The eyes with diabetic macular edema were assigned to local macular edema group (n=16) ,diffuse macular edema group (n = 22) and cystoid macular edema ( n = 17 ) based on the manifestation of FFA. MfERG was recorded in all the individuals. The informed consent was obtained from each subject prior to any the medical examination. Results In focal diabetic macular edema group,the response density of P1 wave was significantly attenuated in ring 1 , showing a statistical difference in comparison with controls (t =2. 170,P = 0.038) ,and the latencies of P1 and N1 waves showed obvious prolong in ring 4 and 5 (t = 2.519,P = 0. 017 ;t = 2. 451 ,P = 0. 020). In diffuse diabetic macular edema group,the response densities of P1 and N1 waves were declined in ring 1,3,5 and ring 1,3,4,5 respectively,and the latencies of P, in ring 3,4 were significantly delayed respectively in comparison with controls (all P < 0. 05 ). In cystoid diabetic macular edema group, the response densities of P1 and N1 waves were lowed from ring 1 through 5 respectively, and the latencies of P1 and N1 waves were significantly longer from ring 3 through 5 and ring 4 respectively with the statistically significant difference from controls (all P<0. 05). The visual function of fovea was badly damaged. Conclusion These studies indicate that the most serious damage of visual function is in foveal area in cystoid diabetic macular edema group, and is then parafoveal area of diffuse diabetic macular edema group and perifoveal area in focal diabetic macular edema group. The outcome of mfERG presents a good consistency with FFA findings in the patients with diabetic macular edema.

AIM: To study the clinical curative effect of 2mm micro incision phacoemulsification combined with 23G minimally invasive vitrectomy for cataract and vitreoretinal diseases.METHODS: Retrospective analysis of 92 patients (99 eyes),including 49 male (53 eyes),43 female (46 eyes) with mean age was 57.1±1.9 years,in our hospital for cataract and vitreoretinal treatment of the disease from February 2013 to February 2016.All patients underwent 2mm micro incision phacoemulsification combined with 23G minimally invasive vitrectomy.Curative effect and complications were observed.RESULTS: Combined surgical procedures were carried out smoothly.posterior capsule rupture did not occurred.seven eyes were filled with BSS fluid,46 eyes with C3F8,49 eyes with intraocular lens at phase Ⅰ,21 eyes placed intraocular lens when silicone oil was removed.The visual acuity improved in 84 eyes (85%),unchaged in 15 eyes (15%).Postoperative complications included transient high intraocular pressure in 18 eyes (18%),anterior chamber reaction in 7 eyes (7%) and corneal edema in 8 eyes (8%).CONCLUSION: The 2mm micro incision phacoemulsification combined with 23G minimally invasive vitrectomy is a safe and effective surgical method with less injury,fewer complications.

Recombinant PCR applies to fulfill gene recombination by PCR thermal reaction.Over the twenty years,it has branched into three characteristic strategies:splicing by overlapping extension(SOE),jumping polymerase chain reaction(JPCR)and DNA shuffling.Recently,the technique aimed with exploiting natural source of different allele genes is developing up on simplification of experimental procedure,on trap for mutation and variation,and on highthroughput screening with technology of surface display and fluorescent probe.The recombinant PCR is increasesing value in broad range from biological basic research to bioengineering study.

Objective To evaluate the impact of the off -pump coronary artery bypass (OPCAB) on left ventricular(LV) function with transesophageal echocardiography(TEE). Methods Blood flow velocities of pulmonary vein (PV) and mitral valve (MV) were performed in 21 patients with coronary heart disease and myocardial infarction two weeks pre-OPCAB, and the left ventricular SV, CO and LVEF were measured by biplane Simpson′s method, the data were compared with the results observed one month post-OPCAB. Results The peak flow velocities of PV had significant difference between pre- and post-OPCAB(P

Child ; Digestive System ; metabolism ; Glutamine ; metabolism ; Humans ; Immune System ; metabolism ; Nutritional Physiological Phenomena ; physiology

Pleiotrophin, discovered in 1989, was thought as a muhi-funetional growth factor; It plays an important role in tumor occurrence and central neural system. The latest research showed pleiotrophin signal pathway probably takes part in neural repair after peripheral nerve injury, especially in the followed crisis point, such as the protection of spinal cord neuron, the promotion of the speed of neuron axon regeneration, the guidance of neuron axon regeneration, skeleton muscle reirmervation. It potentially makes a key role in the guidance of neural axon regeneration in peripheral neural system and muscle reianervation. Along with the related researches go deep, pleiotrophin gene might become a controllable target for promoting the result of peripheral neural repair and reconstructing the neuromuscular junction.

This paper illustrates the immunology teaching reform of higher medical education to meet demands of the 21st century. The teaching reform includes cultivating students’humanities quality,scientific consciousness,ability to research and the following-up of immunology progress. According to the teaching practice and the results from the questionnaire,the new teaching model is better than traditional teaching model and is approved by the students.

Objective To explore the expression and significance of Dickkopf-1 (Dkk-1) and cell lymphoma/leukemia-2 (Bcl-2) protein in sinonasal squamoucell carcinoma(SNSCC) .MethodThe immunohistochemical SP method and Western blomethod were adopted to determine the expression of Dkk-1 and Bcl-2 in 30 specimenof SNSC(SNSCgroup) ,38 specimenof sinonasal inverted papillomas(SNIP group) and 20 specimenof middle turbinate mucosa(control group) .ResultThe expression of DKK-1 protein in the SNSCgroup wasignificantly down-regulated compared with the SNIP group and the control group ,while the expression of Bcl-2 protein in the SNSCgroup wasignificantly up-regulated compared with the SNIP group and the control group;in the SNSCgroup ,the positive rateof DKK-1 protein and Bcl-2 protein in the high and middle differentiation group and the low differentiation group were 100 .00% ,68 .75% ,33 .33% and 50 .00% ,62 .50% ,100 .00% respectively ,the differencewere statistically significan(P＜0 .05) .Conclusion Dkk-1 protein may play an importanpromoting role in the developmenand pro-gression procesof SNSC,the expression of Dkk-1 protein hanegative correlation with the expression of Bcl-2 protein in SNSC,which may become new targespoof SNSCgene therapy .

The comprehensive and precise functional evaluation is imperative in finding the disabilities of patients with quadriplegia,and it is the basement of providing appropriate rehabilitation training.The predominant instruments which have been used to evaluate the functional capacity of the quadriplegics include Barthel Index,Functional Independence Measure,Quadriplegia Index of Function,a short-form of Quadriplegia Index of Function Scale and Spinal Cord Independence Measure.The purpose of this article is to introduce the characters of each instrument above in functional evaluation for quadriplegics and the comparison among them.

Objective To introduce the clinical application of a extensive revense peroneal artery flap in repairing big soft tissue defect in foot, especially in repairing a big defect in distal foot and the exposure of one or more metatarsophalangeal joint. Methods The skin flaps were used in 11 cases to repair the big soft tissue defect in foot, including the distal part of foot. The flap upper boundary may surpass the capitulum fibulae; The lower boundary may reach the back line between external malleolus and internal malleolus; Lat-eral boundary could overrun anterior margin of fibula about 2 cm; Inboard boundary could get to medial mar-gin of gastrocnemius muscle. In attention: the two branch vessels from peroneal vessel in the site of 11-13 cm and of 5-7 cm above the outer anker would be included in the flap. Results Ten of 11 skin flaps survived satisfactory. A small, marginal portion of one flap in one case presented necrosis. Conclusion The reverse peroneal artery flap is easy to elevate and safety, which is an ideal flap for a huge soft tissue defect in foot, especial in the distal part of foot.