Age-related macular in human retinal results in strict loss and enduring decrease in visual acuity. A lot of medical evidence has shown that macular degeneration, associated with Choroidal neovascularization (CNV), leads to irreversible injure in composition and function of retinal tissue. A new analytical and restorative treatment, scotoma-based photocoagulation (SPB), curdles the affected areas so effectively and timely that it can delay or prevent age-related macular degeneration (AMD). A scanning laser ophthalmoscope (SLO) image is involved and the function and character of scotometry are analyzed. Combining anatomical and pathological features, this paper introduces process of acquiring the image and algorithms of analyzing it. Furthermore, integrate image of retinal is extracted from SLO through feature extraction, special registration and superimposition. The treatment can be applied to clinical diagnosis without great revisions and provide direction for pertinent fields.

Objective To investigate the effects of preconditioning with repeated electroacupuncture (EA)at Shenshu acupoint on renal ischemia-reperfusion (I/R) injury in rats.Methods Fifty adult male Sprague-Dawley rats,weighing 260-320 g,were randomly divided into 4 groups:sham operation group (n =5),I/R group,pentobarbital sodium + I/R group (PB + I/R group) and repeated EA at Shenshu acupoint + I/R group (EA + I/R group).The model of renal I/R injury was established by occlusion of bilateral renal pedicles for 45 min followed by reperfusion.Pentobarbital sodium 30 mg/kg was injected intraperitoneally everyday for 5 consecutive days and I/R was induced 24 h after the last injection in PB + I/R group.The animals received EA at Shenshu acupiont 30min per day for 5 consecutive days under pentobarbital sodium anesthesia and I/R was induced 24 h after the last preconditioning in EA + I/R group.Blood samples were taken at 1,3 and 7 days after I/R to determine the levels of serum blood urea nitrogen (BUN) and creatinine (Cr).The animals were then sacrificed and the kidney was isolated.The histological changes of the kidney was scored.The apoptosis in renal tubular epithelial cells was measured using TUNEL at 3 days after I/R.Apoptosis index (AI) was calculated.The expression of proliferating cell nuclear antigen (PCNA),Bcl-2,Bax,Fas and FasL in renal tubular epithelial cells was measured by immuno-histochemistry at 3 days after I/R.Results Compared with group S,the levels of serum BUN and Cr,and histological score were significantly increased at 1,3 and 7 days after I/R in I/R and PB + I/R groups,and at 1 and 3 days after I/R in EA + I/R group,the expression of PCNA,Bcl-2,Bax,Fas and FasL was up-regulated in I/R,PB + I/R and EA + I/R groups,and Bax/Bcl-2 ratio was significantly increased in I/R and PB + I/R groups (P ＜0.05).Compared with I/R and PB + I/R groups,the levels of serum BUN and Cr,and histological score were significantly decreased at 3 and 7 days after I/R,AI and the expression of Bax,Fas and FasL were significantly decreased,and the expression of PCNA and Bcl-2 was up-regulated in EA + I/R group (P ＜ 0.05).Conclusion Preconditioning with repeated EA at Shenshu acupoint can attenuate the renal I/R injury in rats by promoting the proliferation of renal tubular epithelial cells and reducing the apoptosis in cells.

Objective To provide a framework for understanding the need for a structured assessment of altered mental status (AMS) to better understand underlying causes of the mental status changes in adults and therefore potentially improve diagnostic skills and eventually management.Methods This is a prospective cohort observational study.We recruited consecutive adult patients with undifferentiated AMS at a single center tertiary care academic emergency department over 24 months.Demographical,clinical presentations,assessment approaches,cause factors,emergency treatments and outcomes were collected prospectively.Results One thousand nine hundred and thirty-four patients with AMS were recruited,this number of patients represented 5％ of the total ED census.Out of 1934 patients,1026 (53.1％) were male,908 (46.9％) were female.Mean age was (51.95 ± 15.71) years.Etiologic factors included neurological (n =641,35.0％),pharmacologic & toxicologic (n =421,23.0％),systemic and organic (n =266,14.5％),infectious (n =167; 9.1％),endocrine/metabolic (n =145,7.9％),psychiatric (n =71,3.9％),traumatic (n =38,2.1％),gynecologic and obstetric (n =35,1.9％).Total mortality rate was 8.1％ (n =156).The death rate was higher in elderly patients (≥ 60) than that in younger patients (10.8％ vs.6.9％,P =0.003).Conclusions The patient with AMS poses a challenge to physicians in ED.The most frequently encountered diagnostic category causing AMS were primary CNS disorders,intoxication,organ system dysfunction and endocrine/metabolic diseases.Fatality rate is very high.Prompt evaluation and treatment are essential to decrease the morbidity and mortality associated with this condition.

BACKGROUND:Abnormal immunological function is possibly observed after cardiac valve replacement. However, effect of continuous venovenous hemofiltration on immunological function after cardiac valve replacement is rarely reported.
OBJECTIVE:To observe the effect of continuous venovenous hemofiltration on the cellular immune function in patients with multiple organ dysfunction syndrome after cardiac valve replacement.
METHODS:Thirty-one patients with multiple organ dysfunction syndrome after cardiac valve replacement in Xijing Hospital, the Fourth Military Medical University of Chinese PLA, from August 2008 to July 2009, were included in this study. They were treated with continuous venovenous hemofiltration using AV600 hemofilter and were divided into two groups:survival group (17 survivors) and death group (14 deaths). In addition, 16 healthy blood donors served as the control group.
RESULTS AND CONCLUSION:The duration of acute renal failure before continuous venovenous hemofiltration of survival group was significantly lower than that of death group (P<0.05). Before continuous venovenous hemofiltration, the CD4+/CD8+ratio and Th1/Th2 ratio of survival group and death group were lower than that of control group (P<0.05), and lymphocyte apoptosis rate and Fas/FasL antigen expression were higher than that of control group (P<0.05). This evidence suggested the presence of immunosuppression state and Th1/Th2 disbalance. During continuous venovenous hemofiltration, the CD4+/CD8+ratio and Th1/Th2 ratio of survival group were gradual y increased (P<0.05), while lymphocyte apoptosis rate and Fas/FasL antigen expression were gradual y decreased (P<0.05) at 24 hours. The above changes were observed in both survival group and death group, but emerged latter in death group. Continuous venovenous hemofiltration can improve cellular immune function, maintain the balance of T lymphocyte subsets and Th1/Th2, down-regulate Fas/FasL expression on the surface of lymphocyte membrane, and decrease lymphocyte apoptosis rate in patients with multiple organ dysfunction syndrome after cardiac valve replacement. Early continuous venovenous hemofiltration can improve patients’ prognosis.

Background:Gankyrin is an ankyrin repeat oncoprotein overexpressed and involved in the tumorigenesis and progression of various cancers. Aims:To investigate the effect and underlying mechanism of down-regulation of gankyrin expression on proliferation of gastric cancer cells. Methods:Lentivirus vector carrying gankyrin-targeted siRNA was transfected into human gastric cancer cell line MKN28. Cell proliferation,cell cycle distribution and β-catenin/ cyclin D1 signaling pathway was analyzed by MTT assay,flow cytometry and Western blotting,respectively,in gankyrin-silenced MKN28 cells and control cells. Results:The transfection efficiency of lentivirus vector was more than 90% ,and the protein expression of gankyrin in gankyrin siRNA transfected MKN28 cells was significantly repressed( P ﹤ 0. 01). Compared with cells transfected with control lentivirus and cells without transfection,MKN28 cells transfected with gankyrin siRNA showed markedly repressed cell growth after 3-day-culture;the proportion of cells in cell cycle G1 phase was significantly increased,and that in S phase was significantly decreased;down-regulated expression of β-catenin and cyclin D1 was observed(P all ﹤ 0. 01). Conclusions:Down-regulation of gankyrin expression in gastric cancer cells may induce cell cycle G1 phase arrest and inhibit cell proliferation by suppressing β-catenin/ cyclin D1 signaling pathway. Gankyrin might be a promising novel target for targeted therapy of gastric cancer.

Hunan University of Chinese Medicine has improved the implementation of animal ethics education from the aspects of carrying out elective courses, emphasizing the implementation of pre-class learning, integrating ethics education into experimental teaching, cultivating students' good medical literacy in a subtle way, and further deepening their learning by offering elective courses of animal ethics. The results show that the opening of elective courses and the enforcement of experimental animal ethics education in experimental classes have greatly strengthened the students' experimental animal ethics, which is conducive to the formation of students' medical literacy.

Objective To knockout the MATP gene of mouse melanoma cell line B16F10 using CRISPR/Cas9 system,and to lay foundation for the functional study of MATP gene.Methods Specific primers of MATP were designed according to the report in http://crispr.mit.edu/ website.The primers were linked to pCAS9/gRNA1 vector.Then the positive vector was transfected into mouse melanoma B16F10 cells,and monoclonal cell lines were obtained by the infinite dilution method.After the genomes of different monoclonal cell lines were extracted and sequenced,the cell lines with MATP gene cleavage were screened,and the expression of MATP in these cell lines was verified by Western-blot analysis.Results Three MATP gene knockout cell lines were successfully obtained.The western-blot results showed that the cell lines did not express MATP protein.Conclusions The knockout of MATP gene in B16F10 cell line can be successfully achieved using the pCAS9/gRNA1 vector.

Objective To explore the influencing factors of serum uric acid (UA) level and its relationship with SLC2A9 gene polymorphism. Methods A total of 2000people in the health examination center of Yangpu District Central Hospital were selected to examine their blood pressure, blood sugar, blood lipid and other biochemical indicators. The single nucleotide polymorphism (SNP) locus rs2241480 of SLC2A9 gene was detected and analyzed. According to UA level, UA was divided into high UA group (n=217), middle UA group (n=1705) and low UA group (n=78). The biochemical indexes and SLC2A9 genotype of each group were compared, and the relationship between UA and SLC2A9 gene polymorphism was analyzed. Results The prevalence of hyperuricemia (HUA) was 10.85% in physical examination population, 12.92% in males, which was significantly higher than 8.48% in females (P﹤0.05). With the increase of UA level, body mass index (BMI), systolic blood pressure (SBP), diastolic blood pressure (DBP), fasting blood glucose (FBG), total cholesterol (TC), triglyceride (TG), low density lipoprotein cholesterol (LDL-C), blood urea nitrogen (BUN), creatinine (Cr) increased significantly, and high density lipoprotein (HDL-C-c) increased significantly.) there was a significant decrease, with statistical significance (P﹤0.05). The genotyping of rs2241480 locus in different UA levels showed significant difference (P﹤0.05). Male (OR=1.99), BMI (OR=3.01), SBP (OR=3.77) were independent risk factors for HUA, while HDL-C (OR=0.27) and rs2241480 locus genotype (CC, OR=0.41) were protective factors (P﹤0.05). Conclusion Traditional cardiovascular risk factors such as blood pressure and lipid are independent risk factors for UA level. SLC2A9 gene polymorphism may be associated with the occurrence of HUA.

TCM experimental teaching has a very important position in university training process, in which the laboratory standardized management and the strengthening of the teaching quality monitoring play important roles. According to the the experimental teaching reforms and requirements enacted in recent years by the Ministry of Education of the People’s Republic of China, Hunan TCM University has conducted a series of standardized management of exploration and practice in the laboratory.

Objective To investigate the risk factors of surgical site infection (SSI) related complications after radical gastrectomy for gastric cancer in elderly patients.Methods The clinical data of 410 elderly patients with gastric cancer who underwent radical gastrectomy was retrospectively collected from 2009 to 2016.Univariate and multivariate analysis were performed to investigate the risk factors of SSI related complications,and the impact of SSI on short-term prognosis.Results SSI developed in 50 out of 410 elderly patients who underwent radical gastrectomy for gastric cancer,including 19 incisional infections and 31 organ lacuna infections.The corresponding incidence was 12.2％,4.6％ and 7.6％,respectively.By univariate analysis,age ＞ 75 (x2 =5.315,P =0.021),preoperative anemia (x2 =3.983,P =0.046),NRS 2002 ≥ 3 (x2 =4.785,P =0.029),diabetes (x2 =5.895,P =0.015),preoperative obstruction (x2 =5.250,P =0.022),undifferentiated carcinoma (x2 =4.448,P =0.035),cardiac carcinoma (x2 =5.265,P =0.022) and combined organs resection (x2 =4.165,P =0.041) were associated with SSI.Multivariate analysis showed that advanced age (OR =2.422,P =0.016),diabetes (OR =2.524,P =0.026),preoperative obstruction (OR =2.098,P =0.047) and high NRS 2002 score (OR =1.969,P =0.043) were independent risk factors for SSI.Conclusion The independent risk factors of SSI for elderly gastric cancer patients are advanced age,diabetes,preoperative obstruction and high NRS 2002 score.