Objective To observe the diameters of macular hole and destroyed boundary line between inner and outer segment (IS/OS) of the photoreceptors and the correlation with the visual acuity in patients with idiopathic macular hole(IMH). Methods The clinical data of 39 eyes (37 patients) with IMH were retrospective analyzed. All the patients had undergone the examinations of visual acuity (Snellen chart), intra-acular pressure, ocular fundus (indirect ophthalmoscope), and Fourier-domain optical coherence tomography (FD-OCT) whose speed was 27 000 A scan/s, area was 6.0 mm×6.0 mm, and the mode was 512×128. The diametres of macular hole and destroyed IS/OS, and the correlations with visual acuity were detected. Results The mean IogMAR was 0.99±0. 44 (ranged from 0. 15 to 2.00), the mean diameter of macular holes was (942.0± 348. 4)μm(ranged from 171 to 1491 μm), and the mean diameter of IS/OS disruption was (1870. 35±673.2) μm(range from 463 to 3176 μm). There was a significant correlation among the diameter of the macular hole, the diameter of the IS/OS disruption, and IogMAR in IMH (P= 0. 038, 0. 002, 0. 000). In eyes with closed macular hole after surgery, the IogMAR and the diameter of the IS/OS disruption had a significant decrease. Conclusion Using FD-OCT the photoreceptor changes can be visualized in vivo. The abnormality in the IS-OS boundary line appears to be involved for a much larger area beyond the macular hole itself, and persists there with small size even after the maeular hole closure surgery.

Acupuncture Therapy ; Administration, Inhalation ; Aged ; Aged, 80 and over ; Cerebral Infarction ; drug therapy ; therapy ; Combined Modality Therapy ; Drugs, Chinese Herbal ; administration & dosage ; Female ; Humans ; Male ; Middle Aged ; Oxygen Inhalation Therapy

Objective To compare everolimus (EVR) with calcineurin inhibitor (CNI) minimization or withdrawal on renal function of liver transplant patients with standard CNI therapy.Methods A search was conducted on databases which included the PubMed,Embase and Cochrane library for randomized controlled trials (RCTs) comparing EVR with CNI with minimization or withdrawal (the EVR group) with standard CNI therapy (the standard CNIs group) on renal function of liver transplant patients.A metaanalysis was performed using RevMan 5.3 software.Results Five RCTs which included 1 264 patients were selected into this study.There were 790 patients in the EVR group and 474 patients in the standard CNIs group.On meta-analysis,the EVR group had significantly better renal function (SMD =0.36,95％ CI 0.09 ～ 0.64,P ＜ 0.05),but higher rates of infection (RR =1.37,95％ CI 1.08 ～ 1.74,P ＜ 0.05),dyslipidemia (RR =2.46,95％ CI 1.79 ～ 3.38) and leukopenia (RR =2.37,95％ CI 1.32 ～ 4.26).No significant differences were found on the mortality and the acute rejection rates between the two groups (all P ＜ 0.05).Conclusions EVR with CNI minimization or withdrawal after liver transplantation provided effective immunosuppression and improved patients' renal function.The treatment increased the rates of infection,dyslipidemia and leukopenia.

Objective To assess the feasibility and accuracy of transesophageal echocardiography (TEE) in screening patients,intraoperative guidance of occluder releasing and efficacy assessment in the patients of percutaneous left atrial appendage (LAA) occlusion with Watchman.Methods Ultrasonic instrument Philips iE33(proble model X7-3t) were used to measure the maximum diameter and the depth of LAA ostium in enrolled patients by TEE,and intraoperative guided puncture of interatial septum,positioning Watchman transmission system and instruction closure release under TEE,immediate evaluate the postoperative therapeutic effect and record the complications by TEE.At 45 days after implantation,patients should repeat TEE to assess the efficacy.Results Eighteen patients underwent device implantation.Seventeen patients implant successfully,except one patient can't implant device beacuse of the LAA morphologe was not suitable.There was one patient showing thrombus formation on the surface of device,one patient of LAA and the device axial angulation was 90 °.At 45 days after implantaion,16 patients were fullowed up,there were no major stroke at all.Conclusions TEE has important application value in screening of preoperative patients,intraoperative guidance of occluder releasing and efficacy assessment in the patients of percutaneous left atrial appendage occlusion with Watchman.

Objective To detect the expression of humar telomerase reverse transcriptase (hTERT) and telomerase activity in HeLa,MCF-7,SMMC7721 PC-3m and U2OS cell lines. Methods The techniques of immunochemistry and TRAP-ELISA were employed to detect the expression of hTERT and telomerase activity in different tumor cell lines.Results The positive rate of hTERT in HeLa cells(93.75%?3.10%)was significantly higher than that in U2OS cells(2.75%?0.96%),besides the other three cell lines showed an positive rates of hTERT in MCF-7(92.50%?2.65%),SMMC7721 (53.75%?2.22%)and PC-3m(23.50%?2.89%); Meanwhile,the telomerase activity of HeLa cells (94.58%?3.49%) was also much higher than that of U2OS(3.02%?0.43%),likewise the telomerase activities of the other three cell lines (MCF-7,SMMC7721,PC-3m) were 73.90%?4.50%,66.67%?3.35% and 50.62%?1.96%, respectively. Conclusion The expression of hTERT and telomerase activity show obvious differences among five tumor cell lines,suggesting that telomerase inhibitors cannot effect on all the tumor cell lines.

Objective To conduct a systematic review on the safety and efficacy of enhanced recov -ery after surgery ( ERAS) in perioperative management of hepatectomy .Methods A literature search was conducted on databases which included the PubMed , Embase, Cochrane Library, Sinomed, Wangfang, VIP and CNKI for randomized controlled trials ( RCTs) on application of ERAS in patients after hepatectomy . The data collection ended in August 2015.A meta-analysis was performed using RevMan 5.3 software.Re-sults Eleven RCTs which included 1074 patients were selected into this study .There were 530 patients in the ERAS group and 544 patients in the control group .On Meta-analysis, when compared with the control group, the ERAS group had significantly shorter length of hospital day (WMD=-2.36, 95%CI: -3.19~-1.54 , P<0.05 ) , shorter time for functional recovery ( WMD=-2.30 , 95%CI: -3.77 ~-0.83 , P<0.05), lower total complication rate (RR=0.65, 95%CI:0.52~0.80, P<0.05), and significantly decreased rates of postoperative pulmonary infection (RR=0.36, 95%CI:0.14~0.91, P<0.05) and nausea and vomiting (RR=0.48, 95%CI:0.26~0.89, P<0.05).There were no significant differences between the two groups on the rates of postoperative bleeding , biliary fistula, abdominal infection, delayed incisional healing, wound infection and urinary tract infection (P>0.05).The ERAS group had significant-ly lower hospitalization cost (SMD=-1.61, 95%CI:-2.42~-0.80, P<0.05), but the differences between the two groups on mortality and re-admission rates were not significant (P>0.05).When compared with the control group , the drainage tube removal time ( WMD=-2.83 , 95% CI:-3.92~-1.76 , P<0.05), time to first mobilization (SMD=-2.34, 95%CI:-2.98~-1.70, P<0.05), time to first feeding ( SMD=-5.08 , 95%CI: -9.33~-0.83 , P<0.05) , time to passage of first flatus ( SMD=-3.60, 95%CI:-4.85~-2.34, P<0.05) in the ERAS group were significantly shorter , but there was no significant difference on the time to the first bowel motion ( P>0.05 ) .Conclusions ERAS in the peri-operative management of hepatectomy was safe and beneficial .

Child ; Erythroblastosis, Fetal ; therapy ; Humans ; Infant, Newborn ; Male ; Rh Isoimmunization ; immunology

Objective To explore the effect of speech therapy on articulation disorder of indifferent kinds of children with cerebral palsy(CP).Methods 49 CP children with articulation disorder were divided into the common group(n=21)and family rehabilitation group(n=28).All children in the two groups were treated with systemic speech therapy,but those in the family rehabilitation group were added with family rehabilitation.The changes of articulation disorder of children in two groups before and after treatment were observed.Results After treatment,all children got improvement,but the effect of children with spastic type was superior to those with other CP types.The efficiency rate of the family rehabilitation group was 39.3%,that of the common group was 14.3%,there was a significant difference between two groups(P<0.05).Conclusion The children with different CP type have different therapeutic effects for articulation disorder,the family rehabilitation can improve the therapeutic effect.

Objective To investigate the effects of fragile X mental retardation protein（FMRP）on the development and migration of cerebellar neurons in mouse model.Methods Plasmids containing FMRPmutant-EGFP or EGFP were established and transfected into the lateral ventricle of the embryo mouse.Fragile X syndrome（FXS）genotype of the mouse model was identified.Nissl staining and immunofluorescence staining were conducted to assess the changes in neuron development and migration.Results In the experimental group,Nissl staining showed that the deep cerebellar neuclei contracted and divided by white matter,and the non-polarized Purkinje cells retained in internal granular layer;while immunofluorescence staining showed that Tbr2-positive unipolar brush cells changed the migration pathway and accumulated in the ventricular zone.Conclusion Cerebellar neurons showed abnormal formation and migration with the absence of FMRP.

Objective To investigate the short-term efficacy and the influencing factorof zoledroniacid combined with ra-diotherapy and single radiotherapy in the treatmenof bone metastasiin non-small cell lung cance(NSCL) .MethodTotally 117 NSCLpatientwith bone metastase(153 lesions) receiving the bone lesion radiotherapy in the TumoCenteof ouhospital from 2009 to 2013 were selected and treated by zoledroniacid combined with radiotherapy (combined therapy group ,n=54) and the single radiotherapy (single radiotherapy group ,n=63) .The bone pain relief and influence factorwere analyzed .ResultThe effective ratein the single radiotherapy group and the combined radiotherapy group were 69 .74% and 92 .21% respectively (χ2 =13 .75 ,P＜0 .01);the multivariate Logistiregression analysishowed thathe bone pain relief wacorrelated with the treatmenmode ,moreovethe bone pain relief rate in the combined therapy group wasignificantly highethan thain the single therapy group (OR=4 .60 ,95% CI:1 .23-17 .20 ,P=0 .02) .In the subgroup analysiof treatmenmode,the patientwith osteolytile-sions(OR=26 .59 ,95% CI:3 .29-215 .12 ,P=0 .00) had betteeffec.The combined therapy group had more superiority in the as-pecof non-skeletal related eventoccurrence (OR=4 .40 ,95% CI:1 .49 -12 .99 ,P=0 .01) .Conclusion Radiotherapy combined with zoledroniacid habettecurative effeccompared with single radiotherapy in the NSCLC patientwith bone metastasi.