Background Choroidal neovascularization(CNV)has been descrihed as a main reason of visual loss in a lot of ocular diseases.Researches showed that local hypoxia and retinal pigment epithelial(RPE) cells play an important role in the formation of CNV.A closely relationship of angiopoietin-2 (Ang-2) and angiogenesis has been proved.However,whether the expression of Aog-2 in hypoxic cultured human RPE cells is associated with the pathogenesis of CNV is still below understood.Objective This study was to investigate the effects of hypoxia on expression of Ang-2 in cultured human RPE cells in vitro,and discuss the possible effects of Ang-2 in the formation of CNV.Methods Human RPE cells were cultured and passaged,and 4-7 generation of cells were used in the experiment.The cells were incubated in cultural plate at the density of 5×107 cells/L.The culture medium containing 200 μmol/L CoCl2 was used to establish the hypoxia model of human RPE cells culturecd in vitro for 0.5,1,2,4,6,12and 24 hours,and the RPE cells cultured under normoxia were as controls.Reverse transcription polymerase chain reaction(RT-PCR) was used to detect the expression of Ang-2 mRNA in cultured human RPE cells,and enzymelinked immunosorbnent assay(ELISA) was used to assay the content of Ang-2 protein in supernatant of cultured human RPE cells.Results The survival rate of human RPE cells was 90％ after resoscitation.The fourth generation of cells showed the fusiform with the less pigment in them.The Ang-2 mRNA/β-actin mRNA value in human RPE cells was significantly different among various groups(F=1086.30,P=0.00),The Ang-2 mRN A/β-actin mRNA value in hypoxia cultured for 0.5 hours group began to increase and peaked in hypoxia culture for 4-6 hours group,with the significant differences in comparison with normoxia control group(P＜0.05).The Ang-2 mRNA/β-actin mRNA value decreased to the baseline level at hypoxia for 24 hours.The ELISA analysis showed that the concentration of Ang-2 protein in supernatant of RPE cells showed significant difference among groups(F=1034.00,P=0.00).The concentration of Ang-2 protein increased at hypoxia culture for 0.5 hours and peaked at 6 hours,showing significant differences in comparison with the control group (P＜0.05).Conclusions Hypoxia could significantly up-regulate the expression of Ang-2 in human RPE cells cultured in vitro.Ang-2 expresses highly in the early stage of hypoxia,implying that Ang-2 participates in the formation of CNV.

OBJECTIVETo observe the clinical effects of clavicular hook plate combined with suture anchor in treating type Tossy III chronic acromioclavicular dislocation.

METHODSFrom January 2008 to December 2012,18 patients with type Tossy III chronic acromioclavicular dislocation were treated with clavicular hook plate and suture anchor. There were 12 males and 6 females, aged from 20 to 56 years old with an average of 31.5 years. Ten cases were left dislocation and 8 cases were right dislocation. Operation time was 3 weeks to 4 months after injury with a mean of 1.8 months. Functional exercise was adopted 2 weeks after operation. And Karlsson standard was used to evaluate curative effect.

RESULTSAll patients were followed up for 6 to 24 months with an average of 16 months. According to Karlsson standard, 17 cases were excellent and 1 was poor.

CONCLUSIONClavicular hook plate combined with suture anchor can repair conoid ligament and trapezoid ligament in treating type Tossy III chronic acromioclavicular dislocation, and had advantages of simple operation, less trauma, stable fixation, it can obtain satisfactory effects.

Acromioclavicular Joint ; diagnostic imaging ; injuries ; surgery ; Adult ; Bone Plates ; Female ; Follow-Up Studies ; Humans ; Joint Dislocations ; diagnostic imaging ; surgery ; Male ; Middle Aged ; Radiography ; Suture Anchors ; Treatment Outcome ; Young Adult

Infant neurodevelopmental assessment is a basic method of estimated high risk infant early development outcome.The early individualized neurodevelopmental assessment consist of monthly observations and evaluations of the infants' behavior modulation,motor repertoire which includes non functional and functional motor,autonomic system stability and muscle tensility,etc.The aims of early neurodevelopmental assessment are to discover the brain developmental abnormal and brain injure induced by various risk factors.Basis of the characteristics of which early brain development have better plasticity,administed early intervention and training,which can intervent neurodevelopmental problems such as cerebral palsy and developmental delay.By developmental assessment also make infant' parents to understand their children' ability and mental specialty,being help for infants' nursing,caring and early education.The applied of neurodevelopmental assessment can provide a new way and idea for infant' early development and intervention.

The time that industrial microbiology alone took the course is short,so it requires a discussion about reform on teaching content and method.The thesis first discusses the reforms on teaching content from basic theory knowledge combining to scientific research,experiment and producing practice.Then reforms the teaching method,such as adopting the computer-assisted instruction(CAI) pattern,combining the problem-based learning(PBL) and case-based studying(CBS) each other,and leading into partly bilingual education method.By all above investigation and discussion practice in two aspects,the students produces deep interest to industrial microbiology,and reached the purpose of teaching reform.

Objective To study the etiology,clinical presentation,MR images,treatment and prog-nosis of spontaneous spinal epidural and subdural hematoma.Methods From1995to2002,6cases diag-nosed as spontaneous spinal epidural and subdural hematoma were reviewed retrospectively.All of the pa-tients were males aging from30to68years with an average of 47years.The onset was acute while the pa-tients were in resting or light activity without prior history of any infection,administration of drugs or trau-ma.One patient had the history of hypertension,and another one was found to have diabetes after admission.The clinical characteristics were sudden pain involving neck,shoulder,chest and back,then dysfunction of motion and sensation of extremities and sphincter within few minutes.4cases of spontaneous spinal epidural hematoma were located at T 5~6 ,T 2~4 ,C 4~5 and C 6 ~T 1 respectively,and2cases of spontaneous spinal subdu ral hematoma at C 7 ~T 1 and C 7 ~T 2 respectively.Results All cases were proved with surgery and pathology.MR imaging showed occupying mass in the posterior or posteriolateral region inside the spinal canal.T 1 -weighted imaging was most useful owing to its typical signal changes with the hematoma.T 2 -weighted gra-dient echo sequence was capable to identify epidural and subdural spinal hematoma.Total laminectomy and hematoma debridement were performed.The outcome was closely related to the interval between the onset and surgery.The patients were followed up from6to18months with an average of 10months.All cases showed no significant improvement of spinal cord function except 5cases with incomplete recovery of sphincter function.Conclusion Spontaneous spinal epidural and subdural hematoma are rare entities.MRI is a most helpful diagnostic tool for this disorder.It should be stressed that early diagnosis and prompt surgical intervention are of great importance for prognosis of spontaneous spinal epidural hematoma.

Objective To investigate complications in patients after noncardiac thoracotomy in hypothyroidism with ST changes. Methods Sixty one patients with hypothyroidism undergoing noncardiac thoracotomy were divided into ST segment change group(28 patients having ST segment depression≥0.05 mV) and controls(33 patients) according to the results of Holter. All patients were added with thyroid hormone, until the function of thyroid gland was normal before thoracotomy. The myocardial ischemia was measured by Holter within 48 hours after thoracotomy. Serum thyroid hormones was examined by radioimmunoassay during, before and after thoracotomy. And cardiovascular events were foliowed-up to hospital. Results Before and after thoracotomy serum TT3 in ST segment change group was (1.30±0.41), (2.09±0.45)nmol/L, TT4 was (80.56±30.28), (84.55±33.57) nmol/L, respectively; compared with the control group[TT3: (1.43±0.52), (2.38±0.51)nmol/L, TT4:(82.70± 29.43), (93.47±35.02)nmol/L], no significant differences were found(all P>0.05). After thoracotomy, 24 patients occurred myocardial ischemia, 10 patients occurred cardiovascular events in ST segment change group; 8 patients occurred myocardial ischemia, a patient occurred cardiovascular events in control group, there were significant differences between two groups(χ2=22.95,10.95, all P<0.05). The positive predictive value of ST segment change in Holter detection was 36% (10/28) recording in cardiovascular events of patients with cardiovascular disease undergoing noncardiac thoracotomy and hypothyroidism, negative predictive value was 97%(32/33). Conclusions Myocardial ischemia and other cardiovascular events tend to occur in hypothyroidism patients with ST segment change after noncardiac thoracotomy. ST segment change of preoperative Hoher detection recording cardiovascular events of hypothyroidism patients undergoing noncardiac thoracotomy has certain predictive value.

Objective To explore the feasibility of language sample analysis in assessment of language development in children in order to provide evidences for its clinical application. Methods The study population consisted of a cross-sectional sample of 50 preschool Putonghua-speaking children aged 4 to 6 years. The data on measurement of utterance length (MLU) and lexical diversity (D) were computed from 20 minutes' conversational language samples, and correlation analysis was conducted among MLU, D, age, Wechsler Preschool and Primary Scale of Intelligence (WPPSI) and Peabody Picture Vocabulary Test (PPVT). Splited sample analysis by comparing MLU of first one hundred utterances and MLU of last one hundred utterance, D of odd lexicals and D of even lexicals were conducted to test the validity of language sample indictors. Results MLU and D development of the preschool Putonghua-speaking children were positively related to age. MLU, D, age, verbal intelligence quotient (VIQ) and PPVT were associated with each other (P<0.05 or P≤0.01) except age and VIQ(P>0.05). There were significant correlations between MLU of first one hundred utterances and MLU of last one hundred utterances and between D of odd lexicals and D of even lexicals(P=0.000). Conelusion Language sample analysis proves to be feasible in assessment of language development in preschool children aged 4 to 6 years.

Allelic Imbalance ; Genetic Techniques ; Humans

Administration, Inhalation ; Animals ; Disease Models, Animal ; Female ; Fluorine ; blood ; Fluorocarbons ; adverse effects ; pharmacokinetics ; Male ; Rabbits ; Rats

Objective To investigate the clinical factors dominant in the efficacy of lung recruitment maneuver (RM) with high-level positive end-expiratory pressure (PEEP) under pressure control ventilation in patients with 2009 influenza A (H1N1)-associated acute respiratory distress syndrome (ARDS) by analyzing the clinical data of 24 patients treated with mechanical ventilation.Methods A retrospective study was carried out in a 16-bed capacity emergency intensive care unit (EICU) of the First Affiliated Hospital of China Medical University from October 2009 to January 2010.Twenty-four patients with influenza-associated ARDS were included.During pressure control ventilation,when SpO2 persisted lower than 88％ for more than 30 min,RM with high-level PEEP was initiated to normalize lung volume at 30 cmH2O for 60 s.The RM was responded as SpO2 increased more than 3％ within 15 min; otherwise,the increase below 3％ in SpO2 would be considered non-responded.Variations in respiratory mechanics,oxygen metabolism and hemodynamic parameters were measured before and after RM.Results Of 24 patients with influenza-associated ARDS,16 survived and 8 deceased.The median duration of mechanical ventilation (DMV) in EICU was 5.5 days (range from 3.5 to 12.0 days).During the entire study period,a total of 158 RMs with high-level PEEP were done,including 76 (48.1％) responded RMs (the responded group) and 82 (51.9％) non-responded RMs (the non-responded group).In survivor group,the ratio of effective RM was higher than in nonsurvivors group (66.2％ vs.33.3％,P ＜ 0.01).Compared with the data before RM,HR was increased (92.6 ± 11.8) vs.(73.0 ± 12.6),P =0.038 and MAP was decreased (66.1 ±9.3) mmHg vs.(73.9 ± 11.4) mmHg,P=0.049 during RM,and these difference were not statistically significant at 3 min after RM.The decrease in SpO2 after 134 procedures of RMs in 85.9％ patients,and the minimum value of SpO2 occurred at (2.1 ±0.6) min after RM.In the responded group,the maximum SpO2 were higher than that before RM by (6.9 ± 1.6) ％ occurred at (12.7 ±2.6) min after RM.Compared with the data before RM,SpO2 were increased (90.4 ± 4.4) ％ vs.(86.7 ± 7.6) ％,P =0.047) in responded group at 30 min after RM.The initial PEEP level in the responded group was lower than that of the non-responded group (8.6 ± 3.4) cmH2O vs.(11.3 ±4.2) cmH2O,P=0.028.The initial mean DMV in the responded group was also shorter than that in the non-responded group (4.1 ± 3.1) d vs.(5.8 ± 2.5) d,P =0.011.Furthermore,the initial dynamic lung-thorax compliance (Cdyn) was obviously higher in the responded group than that in the non-responded group (30.8 ±6.2) mL/cmH2O vs.(26.1 ±5.1) mL/cmH2O,P=0.038.Conclusion The lung RM with high-level PEEP may cause temporary hemodynamic changes and the initial PEEP level,DMV,and Cdyn may be potential factors influencing the efficacy of lung RM.