Diabetic retinopathy ( DR ) is one of the most serious microvascular complications of diabetes. It also is a world's major causes of blind eye diseases. Although the injection of anti - vascular endothelial growth factor intraocular drug is becoming a hotspot of current research. Pan retinal photocoagulation (PRP) remains the effective and economical treatment for DR. As a destructive treatment, PRP will inevitably cause some changes on the normal morphology and function of the retinal and cornea. Currently, with the development of the optical coherence tomography, confocal microscopy and other auxiliary examination, we have more accurate and objective research to better understand the laser-neural tissue interaction. This may help us to protect the patient's visual function more efficiently.

Objective To observe the clinical efficacy of sertraline hydrochloride combined with compound alverine citrate in the treatment of irritable bowel syndrome(IBS).Methods 72 patients with IBS were randomly divided into control group and combined treatment group.The control group received a 10 -week course of twice daily 60mg compound alverine citrate singly.The combined treatment group received a 10 -week course of twice daily 60mg compound alverine citrate and thrice daily 50mg sertraline hydrochloride.The change of clinical efficacy and the score of abdominal pain,abdominal bulge,diarrhea,rectal and anal uncomfortableness were assessed before and after the treatment.Results The total clinical efficacy rate was 55.55% in the control group and 88.88% in the combined treatment group,the difference was statistically significant(χ2 =10.225,P <0.05).The scores of abdominal pain, abdominal bulge,diarrhea, rectal and anal uncomfortableness in the control group were (4.91 ±1.12) points, (3.55 ±0.45) points,(1.59 ±0.49) points,(1.86 ±0.26) points,which in the combined treatment group were (0.95 ±0.46)points,(1.08 ±0.51)points,(0.89 ±0.71) points,(1.12 ±0.35) points.The combined treatment group were significantly improved compared with the control group after 8 weeks treatment( t =10.314,10.264, 9.561,9.823,all P <0.05).Conclusion The clinical efficacy of sertraline hydrochloride combined with compound alverine citrate is more efficient on IBS,it is worth to extend and apply in clinic.

ObjectiveTo explore the influence of life events on the emotional state ot heart transplantation patients.Methods All the heart transplantation outpatients were interviewed by a certain psychiatrist in Zhongshan Hospital during Oct.2010 to Oct.2011.The demographic data,life events and the self-reported influenced degree were recorded by the same psychiatrist.A grounded theory-based approach with thematic content analysis of the field notes was used.ResultsEighty-eight patients were enrolled,including 69 males,and19 females.The average age of the patients was 46.5 ±14.3 years old.The average duration after operation was 39.3 ± 39.6 months.The life events were classified into 4 groups,which were medical financial problems,physical condition,family support and future life.The most frequently reported event was physical condition (50.2％ ) and the influenced degree was the highest (9.2 ±1.2),while most patients (96.6％) complained high medical and relevant cost and the influenced degree was (6.5 ± 2.1). Family support was reported by13.6％ patients and its influenced degree was (7.6 ±1.2).The age of the reporter of future life (6.8％) was under 33 years.ConclusionDifferent events have different influence to patients.Improving the social support of patients is helpful to improve quality of life.

Objective:To discuss the distinctive clinical manifestation of primary aspergillus laryngitis.Method:Six cases of primary aspergillus laryngitis in our department were reviewed,among which 3 cases were diabetes patients,and were laryngeal mucosal barrier impairment.2 cases were smoking, 2 cases were over use of voice and 1 case were gastro-pharyngeal reflux . Refractory hoarseness was the main clinical manifestation of all patients. The prophase treatment with antibiotics and glucocorticoid should breakdown the balance of flora and exacerbate the disease.Result:Stop using antibiotics and glucocorticoid and alter to oral administration of itraconazole in 2 to 4 weeks after final diagnosis can effectively cure the disease. No recurrence was found in 6 month to 4 years follow up.Conclusion:Diffuse hyperemia ,pachynsis and scattered lamellar leukasmus of vocal cord were the characteristic physical findings of primary aspergillus laryngitis.Pathology is the major means to get the final diagnosis. Oral administration of itraconazole could be effective.

Objective To summarize the outcomes and clinical experience of orthotopic heart transplantations in Shanghai Zhongshan Hospital.Methods From May 2000 through October 2005,141 patients,101 males and 40 females,diagnosed as having dilated cardiomyopathy in 118,hypertrophic cardiomyopathy in 2,restrictive cardiomyopathy in 2,end-stage ischemic heart disease in 9, primary malignant cardiac tumor in 4,valvular heart disease in 3 and others in 3,underwent orthotopic heart(transplantations) at our center.The operative procedures included 120 bicaval anastomotic cardiac transplantations,19 conventional Stanford orthotopic cardiac transplantations and 2 total heart transplantations.The immunosuppressive therapy strategies included Cyclosporine A or tacrolimus,corticosteroids and mycophenolate mofetil.For the latest 28 patients,induction therapy with Daclizumab was applied.Results There were 3 operative deaths with an operative survival of 97.9 %.During the follow-up from 1 month to 65 months,the actuarial survival rate was 90.8 % after 1 year,84.6 % after 3 year and 81.4 % after 5 year.Acute rejection,infections,graft failure and metastasis of primary cardiac tumor were the main causes of death in the 1st postoperative year,while acute rejection and graft coronary vasculopathy were the leading causes of death thereafter.Postoperative complications included acute rejection,infections,renal dysfunction and graft failure.Conclusions Orthotopic heart transplantation was proved to be a reliable choice for endstage heart disease with excellent outcomes.More attention should be paid to surveillance and management of acute rejection, infections and graft coronary vasculopathy in the long-term follow-up.

Objective:To acquire Chinese IL 18 mature peptide cDNA from adult PBMC,adult bone marrow cDNA libray,adult tonsil cDNA library,Embryonic cerebrum and cerebellum aged 3 months,Embryonic cerebrum and cerebellum aged 8 months.Methods:By RT PCR to aquire Chinese IL 18 mature peptide cDNA.Results:The six sequences of our seven species have basepair variation.Conclusion:The cDNA of Chinese IL 18 has polymorphism.

After the importance to construct academic native resource repository platform was elaborated,the native resource repository platform designed and constructed by Library of Second Military Medical University according to the demands of Second Military Medical University was described, which improved the management efficiency of scientific research and academic achievements.

Objective To investigate the functions of triple point-mutants of hypoxia-inducible factor 1α(HIF1α)in angiogenesis in bone defect region under normoxic conditions.Methods Triple point-mutations (the 402,564 and 803 amino acids)in HIF1α coding sequence (CDS)were induced.The triple mutant of HIF1α(402/564/803)was inserted into the adenovirus pAdEasy-1 system to complete viral packaging and titer measurements. The wild-type HIF1α gene and the empty adenovirus vector were packaged in the same way.For the in vitro experiment,the rabbit bone marrow mesenchymal stem cells (MSCs)were divided into four experimental groups:A,MSCs infected with viral solution containing mutant HIF1α;B,MSCs infected with viral solution containing wild-type HIF1α;C,MSCs infected with viral solution without any HIF1α;and D,MSCs without viral infection. The efficiency of infection was observed by the expression of human renilla reniformis green fluorescent protein (hrGFP).The expression levels of HIF1α mRNA and protein in infected cells in each experimental group were measured.For the in vivo experiment,the MSCs were divided into the same four groups and infected with the virus solutions from each group and cultured under normoxic conditions.At 72h after the infection,the MSCs were used as seed cells and transplanted into Apatite-wollastonite magnetic bioactive glass-ceramic (AW MGC)vector to construct artificial tissue-engineering scaffolds,and then the scaffolds were implanted into the in vivo rabbit radial bone defect model.The animals from each group were sacrificed 8 weeks after the surgery and the tissues from the implantation region were harvested for evaluation of angiogenesis.Results The 402,564 and 803 amino acids in CDS area were point mutated into alanine;three types of recombinant adenovirus were successfully constructed, packaged and characterized.The expression levels of HIF1αmRNA were significantly higher in Group A and Group B than in Group C and Group D (P <0.05 ).There was no significant difference between Group A and Group B group or between Group C and Group D (P >0.05 ).The HIF1α protein expression in Group A was significantly higher than that in the other three groups (P <0.05);however,there was no significant difference among groups B,C and D (P >0.05).There was prominent angiogenesis in bone defect region in Group A,but not in the other three groups.Conclusion ① Triple point-mutants of HIF1αefficiently expressed functional proteins under normoxic conditions.② Triple point-mutants of HIF1αeffectively promoted in vivo angiogenesis in bone defect region.

Objective To establish models of different susceptibility of heroin-induced conditioned place preference (CPP) in rats and investigate the relation between novel environmental response and heroin-dependent susceptibility. Methods After an open-field test, 70 male Sprague-Dawley rats were classified into 2 groups according to the numerical value of heroin-induced CPP, each accounting for 30%. The correlation between open-field test and CPP was analyzed. Results CPP value was much higher than pre-test scores in the rats after exposure to heroin (P<0.01). Compared with the low-CPP group, the high-CPP group had much higher scores in open-field test (P<0.01). The deviation of resident time at natural preference side tested and pre-tested had positive correlation with open-field test (P<0.05). Conclusion Heroin-induced CPP model of different susceptibilities could be successfully established by chronic heroin exposure. The novel environmental response is a reliable predictor for its vulnerability to develop heroin dependence.

Objective To evaluate the relation between cystatin C and the presence and severity of asymptomatic coronary artery disease in metabolic syndrome(MetS).Methods A total of 201 asymptomatic MetS patients with normal renal function were per-formed the coronary angiograph and the detection of serum Cystatin C level and other risk factors for atherosclerosis.Results Ser-um cystatin C level in the MetS patients with asymptomatic coronary artery disease were significantly higher than those in the pa-tients without coronary artery disease,moreover the more severe of the disease,the higher the cyctatin C,which was independently associated with other risk factors for atherosclerosis.Conclusion Serum cystatin C level can been used as the index for the presence and severity of asymptomatic coronary artery disease in Mets with normal kidney function.