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.

Objective To analyze the risk factors associated with postoperative respiratory failure (PRF) in elderly patients undergoing noncardiac surgery. Methods In a prospective randomized joint study, 582 patients conforming to the criteria established by the four medical centers were enrolled for analysis. Univariate analysis and multivariate logistic regression analysis were used to examine the relations between perioperative risk factors and PRF. PRF was defined as mechanical ventilation after operation lasting for more than 48h or reintubation and mechanical ventilation within 6h after extubation.Results Fifty-one patients developed PRF (8.8%) . Multivariate logistic regression analysis identified that the type of surgery, ASA physical status classification, history of COPD and plasma albumin upper abdominal surgery and peripheral vascular surgery. The reason that neurosurgery topped the list was that most neurosurgical patients suffered from severe head injury and postoperative mechanical ventilation was prolonged because of coma. Our study showed that physical status was also a significant predictor of PRF. According to ASA classification, one class higher increased the risk by 6.325 time s. Conclusion Based on these predictors of PRF, in high risk elderly patients necessary measures can be taken to decrease the development of PRF.

Objective To investigate the relationship between PSMA expression and histologic grading of prostatic carcinoma. Methods Different prostatic tissues and non-prostatic tumors (PCa 70,prostate intraepithelial tumor 21,BPH 20,nonprostatic malignancies 30) were analysed for the expression of PSMA by using PSMA mono-clonal antibody and ABC immunohistochemical staining. Results All prostatic tissues but 2 cases of prostatic carcinoma and 4 cases of benign prostate hyperplasia were stained positively,while all of the non-prostatic tumors were stained negatively.There was a negative correlation between PSMA expression and histologic grading of prostatic adenocarcinoma. Conclusions PSMA was prostatic organic specific and could be a prognostic marker of prostate adenocarcinoma.

Neurofibromatosis type 1 is a term of Von Recklinghausenan.It is an autosomal dominant inherited disease which derived by neural crest cell.Prevalence of this disease is 1/3000 1/3500 and is a disease with the highest mutation rate.The pathogenesis of neurofibromatosis type 1 is associated with the deficiency of NF1 gene.Recently,the genetics and genomics research of neurofibromatosis make a great progress.With the development of gene linkage and position cloning technology,the gene sequence of neurofibromatosis type 1 has been found.Recent research of genetics and genomics of NF1 and the structure and function,abnormal expression,the relation of genotype and phenotype,the mutation sensitivity domain of NF1 gene were reviewed.

Objective To explore the effects of upper limb robot-assisted therapy on motor function and activities of daily living in con-valescent stroke patients. Methods From June to September, 2016, 12 chronic stroke patients at their first-ever stroke were enrolled and ran-domized into experimental group (n=6) and control group (n=6). Both groups received routine rehabilitation. Additional robot-assisted thera-py was provided to the experimental group, and additional repetitive movement training was provided to the control group, 20 minutes a day, five days a week for four weeks. Fugl-Meyer Assessment-Upper Extremities (FMA-UE), modified Ashworth Scale (MAS) and Func-tional Independent Measure (FIM) were used to assess the motor function of the upper limbs and hands, the muscular tension of shoulder and elbow, and activities of daily living (ADL) before and after treatment. Results After treatment, the scores of FMA-UE and FIM were bet-ter in both groups (Z>2.032, P<0.05), and no significant difference was found between two groups (t<0.723, P>0.05), however, the scores were a little bit higher in the experimental group than in the control group. After treatment, for the experimental group, the MAS scores of shoulder abduction/adduction and elbow flexion/extension improved (Z>2.121, P<0.05);for the control group, the MAS scores of shoulder abduction/adduction improved (Z>2.000, P<0.05), but the MAS scores of elbow flexion/extension were not significantly different (Z<1.890,P>0.05). There was no significant difference in the MAS scores of shoulder abduction/adduction and elbow flexion/extension between two group (Z<1.734, P>0.05). The moving trail recorded by the computer, gradually became a regular pattern from the mass, saying the motor control ability became better. Conclusion Upper limb robot-assisted therapy can promote the recovery of the motor function of upper limbs and ADL in convalescent stroke patient, similar to the repetitive movement training.

Objective Due to redundant valuations and inaccurate quantities and specifications in processing temporary medical orders, expensive medicines, water and cream medications, program patches of electronic prescriptions included in the nurse work station were designed and developed. Methods Based on the software and hardware platforms of No.1 Military Medical Project, it was developed under Powerbuilder 9.0 without more tables and database expenses. Result Paperless prescription was realized. Conclusion The clinician's workload is reduced. Inaccurate patient expenses and drugs data are stopped.

Objective To establish the early warning model based on the control chart method for hand,foot and mouth disease (HFMD) in Wuchang District and to determine the optimum alarming threshold to provide the data support for HFMD monitoring work.Methods The data of HFMD in Wuchang District during 2009-2014 were collected from the National Infectious Diseases Notification System for constructing the data base.The mobile percentile method was adopted to establish the early alarming model,which was evaluated by the screening test.The sensitivity,specificity,positive predictive value and negative predictive value were calculated.Then the receiver operating characteristic (ROC) curve was drawn and the optimum alarming threshold was found out.Results The early alarming threshold of HFMD in Wuchang District was P90,its sensitivity,specificity,positive predictive value and negative predictive value were 75.00％,93.88％,50.00％ and 97.87％,respectively.Conclusion Determining the early warning threshold should be optimized according to onset characteristics combining with the local epidemic situation,which pays attention to regional specificity and increases the monitoring ability of infectious diseases.

AIM:To investigate the changes of Wnt signaling pathway in catalpol-induced proliferation of rat bone marrow mesenchymal stem cells (BMSCs).METHODS:The BMSCs were isolated from SD rats , purified by differ-ential time adherent method and divided into control group and catalpol (1.0 mg/L) group.Flow cytometry was used to de-tect the proliferation index of BMSCs .The mRNA levels of Wnt3a, Wnt5a, Wnt11 and β-catenin was evaluated by real-time PCR.In addition, the protein expression level of β-catenin was determined by Western blotting .RESULTS:Prolife-ration index was increased from 8.90%±0.46% to 17.93%±1.68% after treatment with catalpol (P<0.01).Com-pared with control group , the mRNA expression of Wnt5a, Wnt11 andβ-catenin was all increased with catalpol treatment . No difference of Wnt3a mRNA expression between control group and catalpol group was observed .Meanwhile, the protein expression of β-catenin was increased in catalpol group compared with control group .CONCLUSION:Catalpol promotes BMSCs going into the cell cycle .Classical and non-classical Wnt signaling pathways are activated in this process .

Objective To evaluate the change of left atrial(LA) volume and function in patients with paroxysmal atrial fibrillation (PAF) after catheter ablation using real-time tri-plane echocardiography (RT-3PE) as well as quantitative tissue velocity imaging (QTVI).Methods Eighty-two PAF patients underwent first-time RFCA were included.Routine and tri-plane ultrasound images of 1 week before and 1 month,3 months,6 months after RFCA were stored for offline analysis.A range of LA structural and functional parameters were measured off-line using the EchoPAC workstation,including LA anteroposterior diameter (LADap),LA mediolateral diameter (LADml) and LA superior-infra diameter (LADsi),early and late diastolic transmitral flow velocity and ratio (E,A and E/A),the peak velocity of pulmonary vein and ratio (S,D,Ar,S/D),the maximum volume of the left atrium (LAVmax),the volume before LA active contraction obtained at time of the P wave on the surface electrocardiogram(LAVp),the minimum volume of the left atrium (LAVmin),LA passive emptying fraction (LAPEF),LA active emptying fraction (LAAEF),LA total emptying fraction (LATEF),LA expansion index (LAexpI),average peak velocity of six wall of the left atrium (Vs,Ve,Va).Results After 3,6 months,LADap decreased significantly(P ＜ 0.05) ;3 months of follow up,peak A increased,E/A ratio decreased (P ＜0.05);6 months of follow up,peak A increased,E/A ratio reduced,peak S increased,peak D reduced,S/D increased(P ＜0.05) ;3 months of follow up,LAVmin reduced,LAAEF and LATEF increased (P ＜0.05);6 months of follow up,LA volume decreased,LAAEF and LATEF increased (P ＜0.05);3,6 months of follow up,the average Va increased(P ＜0.05).Conclusions LA reconstitution and function were recovering slowly 1 month after RFCA,and noticeable improvement can be observed 3 and 6 months after RFCA.