Objective To investigate the efficacy and safety of intravitreal ranibizumab and (or) triamcinolone combined with laser photocoagulation for macular edema secondary to branch retinal vein occlusion (BRVO) during one year period.Methods The data of 31 eyes from 31 consecutive patients with macular edema secondary to BRVO during one year follow-up visit were retrospectively analyzed.Mean best corrected visual acuity (BCVA) logMAR was (0.74±0.36) and mean central retinal thickness (CRT) was (484.48± 164.81) μm at baseline.All patients received standardized clinical comprehensive examinations including vision,intraocular pressure and optical coherence tomography for diagnosis before treatment.All patients received intravitreal injections of 0.5 mg ranibizumab (0.05 ml) at first visit.The continue PRN treatment were based on the visual acuity changes and the optical coherence tomography findings.Eyes received combined triamcinolone acetonide 0.05 ml (40 mg/ml) and ranibizumab for macular edema recurrence after two injections of ranibizumab and received laser photocoagulation during 10-14 days after third injections of ranibizumab.Mean injection of ranibizumab was 3.52± 2.01,15 eyes with triamcinolone acetonide (0.84 ± 1.21),21 eyes with laser photocoagulation (0.97± 0.95) and 12 eyes with three treatment.Compared the visual acuities and CRTs of the first and the last visits by statistical analysis.Results Mean visual acuity improved significantly to 0.42±0.33 logMAR (t=6.611,P=0.000).Mean improvement of visual acuity was 2.90± 3.07 lines.A gain of three or more logarithmic lines was evaluated in 20/31 eyes (64.52％) at the last visit.Mean CRT was (326.19± 117.80) μm (t=4.514,P=0.000).Mean reduction of CRT was (333.58±134.17) μm.A decrease of 100 μm of CRT was evaluated in 17/31 eyes (54.84％).No severe ocular and systematic side effect was found.Conclusion The efficacy and safety of intravitreal ranibizumab and (or) triamcinolone combined with laser photocoagulation for macular edema secondary to BRVO were assured.

Corticosteroids,anti-vascular endothelial growth factor,antibiotics and antiviral were the main 4 classes of drugs for intravitreal injection.Depending on the class and volume of medication,age and gender of patients,ocular axial lengths or vitreous humour reflux,intraocular pressure (IOP) can be elevated transiently or persistently after intravitreal injection.Transient IOP elevation occurred in 2 weeks after intravitreal injection,and can be reduced to normal level for most patients.Only a small portion of such patients have very high IOP and need intervention measures such as anterior chamber puncture or lowering intraocular pressure by drugs.Long term IOP elevation is refers to persistent IOP increase after 2 weeks after intravitreal injection,and cause optic nerve irreversible damage and decline in the visual function of patients.Thus drug or surgical intervention need to be considered for those patients with high and long period of elevated IOP.Large-scale multicenter clinical trials need to be performed to evaluate the roles of the drug and patients factors for IOP of post-intravitreal injection,and to determine if it is necessary and how to use methods reducing IOP before intravitreal injection.

BACKGROUND: The key point in the treatment of acute cerebral infarction lies in inproving the blood supply of brain effectively as soon as possible as well as rescue ischemic and half diazonal nerve cells, so as to contract the local of infarction as great as possible.OBJECTIVE: To observe the effect of traditional treatment of cerebral piamatral microcirculation in gerbil with cerebral ischemic reperfusion injury by supplementing qi and activating blood circulation.DESIGN: Contrast animal experiment at random.SETTING: Zhabei Branch of Shanghai Changzheng Hospital.MATERIALS: The experiment was performed in the Institute of Naval Medicine (key laboratory of the whole army). Twenty-two healthy Monglian gerbils of clean grade (six months old) were selected and randomly divided into medicine group and control group with 11 gerbils in each group.METHODS: Animals were routinely anaesthetized and fixed in prone position to open the cranium window in median line and expose the pia mater. The cranium window was protected by being covered with a cotton ball containing artificial cerebrospinal fluid (ACSF) after operation. Gerbils were fixed in dorsal position with an median incision made in the lateral cervical nucleus to isolate and expose bilateral common carotid artery (CCA). The bilateral CCA were occluded by atraumatic micro-bulldog clamp, and the occluded blood flow in the distal end was observed under the microscope. Thirty minutes after occlusion of bilateral CCA, the vascular clamp was unclamped to recover the cerebral blood reperfusion. Gerbils in the medicine group were abdominally injected with 0.4 mL of Huangqi injection (containing 0.8 g of crude drug), 0.3 mL of compound Danggui injection (containing Danggui, Chuanqiong and Honghua, 0.09 g for each)and 0.3 mL of Danshen injection (containing 0.45 g of Shengyao). Animals in the control group were abdominally injected with same-volume of normal saline. The changes of pial microcirculation were quantitatively observed in two groups through cranium window respectively before blockage, at the reperfusion after blockage as well as in 120 minutes after injection by laser microcirculation microscope and the TV video system.MAIN OUTCOME MEASURES: The changes of piamatral microcirculation as well as comparison in venous blood flow velocity in gerbils of each group before and after ischemic reperfusion.RESULTS: All gerbils were involved in the analysis of results with no animal died in the experiment.①When the CCA of animals in the two groups were blocked, obvious contraction of piamatral microcirculation was seen and partial blood vessels were blocked up. Platelet and red blood cells etc.adhered to the arteriolae of grade Ⅰ and veinules below grade Ⅲ with microthrombus formed and large ischemic area appeared. The blood flow rate was obviously slowed down. Moderate and severe aggregations were found in red blood cells, and the white blood cells were significantly increased.There was obvious exudation in the periphery of microvessels. After CCA reperfusion, the arteriolae and veinule were in different thickness, and the thrombus in veinule of grade Ⅰ and Ⅱ formed in the cerebral ischemia were difficult to be removed by blood flow. Red blood cell moderately aggregated, and the number of white blood cells greatly increased. White small thrombus could be seen sometimes, while the exsudation in the periphery of microvessel was not significantly ameliorated. Great changes were found in gerbils of the medicine group after abnormal injection of supplementing qi and activating blood circulation medicine: almost all arteriolae and venulae were opened, and the rate of blood flow was accelerated with the blood flow rate remarkably increased. Deposit in the venulae began to decreased, and the thrombus was gradually dissolved. Red blood cells were moderately aggregated or normal. Blood flow in ischemic spot was improved significantly than that after reperfusion. The exudation in the periphery of microvessels was gradually lessened even dissolved. However,no obvious change was found in gerbils of the control group. ②The blood flow rate of arteriole in the medicine group was 1.04-1.50 mm, which was obviously higher than that in the control group with significant differences (P ＜ 0.5-0.01).③The blood flow rate of veinule in the medicine group was 0.96-1.12 mm/s, which was remarkably higher than that in the control group with marked differences (P ＜ 0.05-0.01).CONCLUSION: The effect on piamatral microcirculation of gerbil with cerebral ischemic reperfusion by supplementing qi and activating blood is exact, which is directly related with accelerated blood flow rate, expanded veinule and arteriolae as well as ameliorated blood-supply of brain.

The evaluation of quality of life after stroke primarily includes body,psychology, society,and the ability of activities of daily living,and they can be mainly obtained from self rating quality of life by the patients,The commonly used evaluation methods include six generic measurement scales and four updated Stroke Specific Quality of Life Scales.The latter includes the Stroke Adapted Sickness Impact Profile,the Stroke Impact Scale,Stroke Specific Quality of Life Scales,and Stroke and Aphasia Quality of Life Scale.This article reviews the generic meas- urement scales,Stroke Specific Quality of Life Scales and the various factors that influencing quality of life after stroke.

Objective To investigate the factors associated with vision and hole closure for idiopathic macular hole (IMH) after vitrectomy surgery.Methods Eighty-nine eyes of 89 patients with IMH were enrolled in this retrospective study.There were 15 males and 74 females.The patients aged from 42 to 82 years,with the mean age of (64.13 ± 7.20) years.All subjects underwent best corrected visual acuity (BCVA) and optical coherence tomography (OCT) examinations.The BCVA ranged from 0.01 to 0.4,with the mean BCVA of 0.12 ± 0.09.The MH stages was ranged from 2 to 4,with the mean stages of 3.56 ± 0.77.The basal diameter ranged from 182 μm to 1569 μm,with the mean basal diameter of (782.52± 339.17) μm.The treatment was conventional 25G pars plana vitrectomy combined with phacoemulsification and intraocular implantation.Fortyone eyes received internal limiting membrane peeling and 48 eyes received internal limiting membrane grafting.The follow-up ranged from 28 to 720 days,with the mean follow-up of (153.73 ± 160.95) days.The visual acuity and hole closure were evaluated on the last visit and the possible related factors were analyzed.Results On the last visit,the BCVA ranged from 0.02 to 0.8,with the mean BCVA of 0.26±0.18.Among 89 eyes,vision improved in 45 eyes (50.56％) and stabled in 44 eyes (49.44％).Eighty-six eyes (96.63％) gained MH closure but 3 eyes (3.37％) failed.By analysis,patients of early stages of MH and smaller basal diameter of MH will gain better vision outcome (t=2.092,2.569;P＜ 0.05) and patients of early stage MH will gain high hole closure rate after surgery for IMH (t=-5.413,P＜0.05).However,gender,age,duration,preoperative BCVA,surgery technique,gas types and follow-up time had no relationship with the effect after surgery for IMH (P＞0.05).Conclusions Stages of MH and basal diameter of MH may be the factors associated with the visual outcome for idiopathic macular hole after surgery.However,age,gender,duration,surgery patterns,gas types and followup time showed no effects on operational outcomes.

Abstract: Objective　A survey on the plague foci in Qiaojia County of Jinsha River Basin was conducted to understand the composition of plague host vectors and the prevalence of plague among animals, to explore the occurrence and epidemic risk of plague, and to provide scientific basis for plague monitoring and control in this area. Methods　Seven villages and towns in Qiaojia County were selected as the research areas, and the cage night method and the clamp line method were used to investigate the small mammals and their surface parasitic fleas. The host animal organs, serum and surface parasitic flea's samples were collected. The plague indicator animal serum was collected simultaneously on the spot, and the collected host animal organs and flea's samples were cultured and detected for Yersinia pestis. The indirect hemagglutination test (IHA) was used to detect the fraction 1 capsular antigen (F1) antibody of the host animal and the indicator animal serum samples. Results　A total of 525 small mammals belonging to 3 orders, 6 families, 12 genera and 23 species were captured. The dominant species in farming areas were Apodemus chevrieri (31.05%), Niviventer confucianus (13.90%) and Anourosorex squamipes Milne-Edwards (11.43%). The dominant species in residential areas were Rattus norvegicus (66.67%) and Rattus tanezumi (20.00%). The rat densities in agricultural and residential areas were 20.98% and 1.00%, respectively. A total of 277 external parasitic fleas belonging to 15 species, 13 genera, 5 families were collected. The dominant species were Palaeopsylla remota (22.02%), Neopsylla specialis specialis (20.58%), Frontopsylla diqingensis (18.77%) and Ctenophthalmus (Sinoctenophthalmus) quadratus (11.55%), and the rat fleas index was 0.53. No Yersinia pestis was isolated from all rodent organs and flea samples. A total of 167 serum samples from dogs and 15 serum samples from rats were collected, and plague F1 antibody was detected by IHA. IHA detection of plague F1 antibody were negative. Conclusions　Qiaojia County has the distribution of the main host and main vector of plague, and the rat density is high, but the rat body flea index is low. There is no positive detection of plague host animals, vector fleas and indicator animals. It can be considered that the risk of plague occurrence and epidemic in the region is not high in the near future. It is necessary to further strengthen the monitoring and control of plague and other rodent-borne diseases in the region.

OBJECTIVETo investigate the clinical outcomes of the posterior C1,2 screw-rod combined with C2 unilateral translaminar screw and contralateral pedicle screw fixation and autogenous bicortical iliac crest graft fusion in treating upper cervical instability with vertebral artery variations.

METHODSFrom June 2008 to December 2012, the clinical data of 12 patients with upper cervical instability underwent C1 lateral mass screws-C2 unilateral laminar and contralateral pedicle screws fixation combined with autogenous bicortical iliac crest graft fusion were analyzed retrospectively. There were 8 males and 4 females with a mean age of 47.5 years (ranged, 16 to 77 years). Patients suffered from occipitocervical activity limitation of motion with pain or not, VAS was 0-7 points with an average of (3.50 +/- 2.71) points. Unilateral vertebral artery hypoplasia was demonstrated by vertebral arteriography (VAG) or CTA in all patients. Cervical X-ray and CT scans were done within 7 days after surgery in order to confirm internal fixation position. Internal fixation loosening and breakage, reduction losing, bone fusion ratio were observed during follow-up.

RESULTSNo nerves and vertebral artery injuries occurred during operation. Cervical pain obviously decreased and VAS was (0.92 +/- 0.90) points. Cervical alignment of 12 patients had well-recovered by X-ray while Atlantoaxial ventral lamina cortex of 1 case was encroached by CT scan without neurological symptom. All patients were followed up for 6 months to 3 years, no internal fixation loosening and breakage, reduction losing were found. All patients obtained bone fusion in 6-12 months after operation.

CONCLUSIONPosterior C1 lateral mass screws-C2 unilateral laminar and contralateral pedicle screws fixation combined with autogenous bicortical iliac crest graft fusion can achieve biomechanical stability and raise the successful rate of bone fusion, while avoiding the risk of vertebral artery injury and overcoming the insufficient of bone fusion during bilateral laminar screws placement as well. Posterior C1 lateral mass screws fixation is a safe and effective additional method in treating upper cervical instability with vertebral artery variations.

Adolescent ; Adult ; Aged ; Bone Screws ; Cervical Vertebrae ; surgery ; Female ; Humans ; Internal Fixators ; Joint Instability ; surgery ; Male ; Middle Aged ; Tomography, X-Ray Computed ; Vertebral Artery ; pathology

Objective:To explore the relationship of NSCL/P with MTHFR gene polymorphism in Xinjiang Uyghur and Han popula-tion and the ethnic difference.Methods:rs1801131 and rs1801133 polymorphism was detected by SNaPshot genotype method in 170 children with NSCL/P and 100 healthy controls of Uyghur and Han population.Results:Rs1801133 TT and T allele was statistically difference between 2 nationalities(P <0.05),Rs1801133 CT and CT +TT genotypes in total case group and control group were sta-tistically different(P <0.05);Rs1801131 and rs1801133 conjoint analysis showed that between the 2 nationalities and between case and control groups of total population were statistically different(P <0.05);rs1801131 genotype between 2 nationalities or total cases and controls were not statistically different(P >0.05).Conclusion:Rs1801133 TT and T allele in Han nationality are more likely to suffer from NSCL/P than in Uyghur,rs1801133 CT and CT +TT genotypes are protective factors.Rs1801131AC and rs1801133CC conjoint is relevant to NSCL/P,and the risk in Uyghur is higher than in Han.MTHFR rs1801131 gene polymorphism may not be relat-ed with NSCL/P in Uyghur or Han.

Objective To investigate the mechanism and role of ?-ray of 103Pd in the treatment of biliary duct cancer.Methods A series of biliary duct cancer cells were treated with different ?-ray dose,and MTT [3-(4,5-dimethy thiazol-2-yl)-2,5-diphenyl terazolium-bromide] technique was used to determine the inhibition rate of ?-ray of 103Pd on the biliary duct cancer cells;and electron micro-technique,DNA agarose gel electrophoresis and flow cytometry to evaluate the morphological characteristics and apoptosis rate of the biliary duct cancer cells were also used.Results The ?-ray radiation of 103Pd resulted in significant inhibition of the biliary duct cancer cells.The features of biliary duct cancer cells apoptosis(e,g:apoptic bodies,DNA ladders band hypodiploid DNA peak) could be seen in the group with lower dosage(5.333mci),and cell necrosis was seen in higher dosage(more than 6.645 mci).Conclusions The ?-ray radiation could induce apoptosis of the biliary duct cancer cells,but with dose dependence,and apoptosis can be an important mechanism for radiation treatment of biliary duct cancer.

Lipid metabolism disorder is an important risk factor to obesity, hyperlipidemia and type 2 diabetes as well as other chronic metabolic disease. It is also a key target in preventing metabolic syndrome, chronic disease prevention. Plant polyphenol plays an important role in maintaining or improving lipid profile in a variety of ways. including regulating cholesterol absorption, inhibiting synthesis and secretion of triglyceride, and lowering plasma low density lipoprotein oxidation, etc. The purpose of this article is to review the lipid regulation effects of plant polyphenols and its related mechanisms.
Animals ; Humans ; Lipid Metabolism ; drug effects ; Metabolic Diseases ; drug therapy ; metabolism ; Polyphenols ; pharmacology