Objective To observe the effect of amniotic homogenate on closing holes in experimental rhegmatogenous retinal detachment and investigate its mechanism.Methods Forty rabbits were randomly divided into group A,B,C and D with 10 rabbits in each group.Group A and C were the treatment groups,and group B and D were the control groups.All eyes of rabbits underwent pars plana vitrectomy,retinectomy,and fluid-air exchange.The surface of the breaks was treated with 0.1 ml amniotic homogenate in experimental groups and 0.1 ml PBS in control groups.At the end of operation,20% SF6 was tamponaded and the retina reattaced.The animals were executed 14 (group A and B) and 28 days (group C and D) after the surgery.The tissue sections were observed by light microscope,electron microscope and immunocytochemistry method.Results Fourteen days after the surgery,the retina reattached in 6 eyes in group A (60%) and 2 eyes in group B (20%) (P=0.021),Twenty-eight days after the surgery,the retina reattached in 8 eyes in group C (80%) and 3 eyes in group D (30%) (P=0.046).The difference of the rate of retinal reattachment among the 4 groups were statistical significant (P<0.05).Light postoperative inflammation of ocular anterior segment was observed,which was controlled 3-5 days after treated with topical steroids.The result of light microscopy showed that the eyes in treatment groups had multilayer of fibroblast like cells around the retinal breaks,adhering to the choroid and retinal pigment epithelial cells.The proliferative cells around the retinal breaks obvious less in control groups than that in the treatment groups,and the retina could not adhere to the choroid.The results of electron microscopy were the same as that of light microscopy.Immunohistochemistry staining of the fibroblast-like cells revealed positve glial fibrillary acidic protein,which suggested that the proliferative cells around the retinal breaks were retinal glial cells.Conclusions Amniotic homogenate helps to seal retinal breaks and promote retinal reattachment by stimulating the proliferation of retinal glial cells around the breaks.

Objective To study the microstructural and ultrastructural changes of the epididymis of experimental varicocele in adolescent rats and it's role in infertility resulting from varicocele. Methods A varicocele model was performed in adolescent Sprague Dawley rats by partially ligating the left renal vein,the different segments of the epididymides of the rats were prepared for light and electron microscopy,the microstructure and ultrastructure of the epididymis were studied. Results There were lesions of different degree and segment specific changes in the epididymis with varicocele.Light microscopically,the main changes were interstitial vascular hyperemia,lymphocytes infiltration,sperm granuloma developed in the interstitial;The structure of the columnar epithelia was anomalies,epithelial cells degeneration,even the vacuoles appeared in the epithelial cells.The number of halo and clear cells increased.Inside the cavity of the duct,there were shedding cells,macrophage,deformed sperms and residual bodies.Electron microscopically,numerous large lysosomes,the residual bodies,the defected main cellular organelles(e.g. the endoplasmic reticulum,the mitochondrion and the Golgi complex etc.)and even large clear vacuoles were presented in the cytoplasm of principal cells.Clear cells were filled with lysosomes that made them frequently bulging into the lumen.The microvilli of the columnar epithelia were sparse and showed local defects.The thickness of the basal membrane increased.Conclusion\ The experimental varicocele in adolescent rats lead to microstructure and ultrastructure lesions in the epididymis,which may be another important reason of infertility resulting from varicocele.\;[

Autoimmune liver disease is a group of liver diseases caused by the disorder of the autoimmune system, and some patients may have the symptoms of dry mouth and dry eyes. Patients with autoimmune liver disease and Sj gren’s syndrome are commonly seen in clinical practice. This article summarizes the research advances in the clinical manifestation, pathological features, key diagnosis/treatment points, and prognosis of autoimmune liver disease with Sj gren’s syndrome.

Objective To investigate the clinical value of glycosylated hemoglobin(HbA1c),glycosylated serum protein(GSP),sex hormone binding globulin(SHBG),three acylglycerol(TG),free fatty acid(FFA)in diagnosing gestational diabetes mellitus(GDM).Methods 103 cases of GDM patients and 98 cases of healthy pregnant women from February 2015 to August 2016 were selected as the GDM group and control group.The positive detection rates and levels of HbA1c,GSP,SHBG,TG and FFA were compared between the two groups.Moreover the diagnostic efficiency of various indicators was analyzed.Results The levels of HbA1c, GSP,TG and FFA in the GDM group were significantly higher than those in the control group,while the SH-BG level was significantly lower than that in the control group,the difference was statistically significant(P<0.05);the positive rates of HbA1c,GSP,SHBG,TG and FFA in the GDM group were significantly higher than those in the control group,the difference was statistically significant(P<0.05);the specificity,sensitivity and positive prediction value of HbA1c,GSP,SHBG,TG and FFA for jointly diagnosing GDM were signifi-cantly higher than those of single indicator,the difference was statistically significant(P<0.05).Conclusion Detecting HbA1c,NGSP,SHBG,TG and FFA is more accurate for jointly diagnosing GDM,has an important diagnostic value,and can serve as the assisted diagnostic indicators.

Objective To explore the clinical efficacy of laparoscopic tumor resection combined with aspiration for central renal angiomyolipoma(RAML).Methods Retrospective analysis of clinical data of 11 patients with central RAML between November 2015 and August 2018,including 8 females and 3 males,aged 35-58 years,mean (45.3 ± 4.8) years;4 cases on the left side,7 cases on the right side,including 4 endophytic tumors,7 exophytic tumors;body mass index (BMI) 22-27 kg/m2,mean (24.9 ±1.8) kg/m2.The maximum diameter of these tumors were 4.2-8.9 cm,with an average of (6.7 ± 2.4)cm.The preoperative serum creatinine was 53-85 μmol/L,with an average of (64.6 ± 16.4) μmol/L,and the glomerular filtration rate (GFR) of the affected side was 42-55 ml/min,with an average of (45.5 ±3.6) ml/min.Lateral kidney function is normal.8 patients underwent retroperitoneal laparoscopic surgery and 3 cases underwent laparoscopic surgery.Based on the preoperative imaging,tumor tissue was aspirated as much as possible by suction device if the tumor got maximal fat component and had not abundant blood supply.Clamp the renal artery in case of bleeding affected the surgery vision.On the contrary,if the tumor had abundant blood supply,the renal artery was clamped first,then removed the section of tumor with scissor and the remaining basal tumor was aspirated totally by suction device.The operation time,warm ischemia time,intraoperative blood loss,postoperative hospital stay,postoperative complications and surgical results were analyzed.Results All the 11 cases were successfully completed without conversion to open surgery,only one case got injury of renal collection system.The operation time was 95-126 min,mean (110.5 ± 12.8) min,and the blood loss was 120-200 ml,mean (155.6 ± 38.4) ml.The warm ischemia time was 22-31 min,mean (27.6 ± 3.3) min,and the postoperative hospital stay was 5-7 days.RAMLs were diagnosed by the postoperative pathological examination.The renal function was normal and no recurrence occurred in these patients at a mean follow-up of 13.9 months.All the 11 cases were successfully completed.Postoperative pathological diagnosis was RAML.There was no complication in the 11 cases.Preoperative serum creatinine and serum creatinine in the first month after surgery [(64.6 ± 16.4)μmol/L vs.(66.7 ± 15.5)tμmol/L,P =0.38] and preoperative renal GFR and GFR in the first month after surgery [(45.5 ± 3.6)ml/min vs.(43.2 ± 3.3) ml/min,P =0.067],the difference was not statistically significant.No recurrence was observed in the 11 cases with an average follow-up of 13.9 months.Conclusions Our initial experience suggests that laparoscopic tumor resection combined with aspiration is a safe,effective and minimally invasive method for the treatment of central RAML.

Objective:To learn about the progress of prevention and control of drinking-water-borne endemic arsenic poisoning in Henan Province, and provide scientific basis for achieving the goal of eliminating high arsenic hazards as scheduled.Methods:From July to August 2019, in accordance with the requirements of the National Monitoring Program for Drinking-water-borne Endemic Arsenic Poisoning, a general survey was carried out in 26 high-arsenic villages in 6 counties of Henan Province to investigate the water improvement situation and the operation of water improvement projects, and the arsenic content in drinking water of households was measured, meanwhile, the arsenic poisoning status of permanent residents in high-arsenic villages was investigated.Results:All 26 villages with high arsenic content in the province had undergone water improvement, with a water improvement rate of 100.00%. A total of 18 water improvement projects were investigated in 26 high-arsenic villages, all of which were operating normally. Twenty-six water samples were collected, and the arsenic content in the household water was < 0.01 mg/L, which met the sanitary standards for drinking water. No patient of endemic arsenic poisoning was found during the survey.Conclusion:In Henan Province, the drinking-water-borne endemic arsenic poisoning has been effectively controlled, and the prevention and control achievements should continue to be consolidated in the future.

ABSTRACT:In recent years ,there has been high prevalence of murine typhus in Yunnan Province ,People's Republic of China .A large outbreak of murine typhus occurred in Xishuangbanna Prefecture ,Yunnan Province in 2010 .However ,not all cases were confirmed by laboratory assays ;therefore ,field epidemiologic and laboratory investigations of murine typhus in Xishuangbanna Prefecture were conducted in 2011 .Blood samples were collected from clinical diagnostic cases at the acute and convalescence stages of murine typhus in Xishuangbanna Prefecture ,Yunnan Province ,from June to September of 2011 ,and blood and spleen samples were collected from mice sharing the same habitats as the patients .Immunofluorescence assays were used to test for the presence of IgM and IgG antibodies against Rickettsia typhi in sera from patients and mice .Real‐time PCR was used to detect the groEL gene of R .typhi in blood clots from patients at the acute stage and in spleen tissue from mice .A total of 1 157 clinically diagnosed murine typhus cases occurred in Xishuangbanna Prefecture ,Yunnan Province in 2011 ,with an incidence of 102 .10/100 000 .Of these cases ,80 were investigated by laboratory assays and 74 of 80 patients were confirmed to have murine typhus .The coincidence rate between the clinical diagnosis and laboratory detection was 92 .50% .The positivi‐ty rate for IgG antibodies against R .typhi was 14 .0% (14/100) for Rattus f lavipectus ,while the rate by PCR was 9 .0%(9/100) .That laboratory diagnoses confirmed that the severity of the murine typhus outbreak in Xishuangbanna cannot be ig‐nored .The distribution of host animals transmitting R .typhi underscores this conclusion .

Renal clear cell carcinoma metastasis to the gallbladder is rare. This paper reported a case of gallbladder metastasis of renal clear cell carcinoma detected after two years of left radical nephrectomy. The patient underwent laparoscopic cholecystectomy and followed by postoperative targeted therapy of sunitinib. No new metastasis was found after 5 months of follow-up.

Objective:To understand the prevention and control progress of drinking water-borne endemic fluorosis in Henan Province, to evaluate the effects of prevention and control measures, and provide a basis for adjusting prevention and control strategies.Methods:In 2019, a general survey was conducted in all registered drinking water-borne endemic fluorosis villages in Henan Province to monitor the basic conditions of water improvement, the fluoride content of drinking water and the prevalence of dental fluorosis in children aged 8-12 years. The control compliance (water fluoride content qualified and the detection rate of dental fluorosis of children ≤30%) status of the villages was analyzed, and calculate the compliance rate.Results:A total of 17 504 drinking water-borne endemic fluorosis villages were monitored, among them, 17 352 villages with water improvement and 152 villages without water improvement, with a water improvement rate of 99.1%. Among the 3 685 water improvement projects constructed, 3 448 were in normal operation, and the normal operation rate was 93.6%. There were 13 526 villages with qualified drinking water fluoride content, and the qualified rate of water fluorine was 77.3%; the actual beneficiary population was 11 011 000, and the population benefit rate was 90.1%. The qualified rate of water fluoride in the villages with and without water improvement was 77.9% (13 512/17 352) and 9.2% (14/152), respectively; the qualified rate of water fluoride in the villages with water improvement was significantly higher than that in the villages without water improvement (χ 2=400.58, P < 0.05). A total of 498 527 children of 8 to 12 years old were examined, 68 972 cases of dental fluorosis were detected, the detection rate of dental fluorosis was 13.84%, and the dental fluorosis index was 0.3. The number of villages meeting the control standard was 12 488, and the compliance rate was 71.3%. Conclusions:In Henan Province, the water improvement projects in the drinking water-borne endemic fluorosis areas have been basically implemented, and the disease has been effectively controlled. However, there is still a certain gap with the target of the "13th Five-Year Plan on National Prevention and Control of Endemic Diseases", and timely rectification is needed to ensure the effectiveness of the water improvement projects.