The materal-neonatal safety and materal stress response were evaluated during intratheeal anesthesia. Method: Forty-two parturients(ASA grade 1 )were randomly divided into two groups: spinal group (n=21), epidural group (n=21). 3 ml of 0.5% hyperbaric bupivacaine was given in spinal group; 12-15ml of 0.75 % bupivacaine was administrated in epidural group. Materal arterial samples were drawn before anesthesia,after anesthesia induction, after delivery and at the end of surgery; umbilieal venous samples were taken for measurements of blood catecholamine, sugar and lactate concentrations. Result; Compared with those before intrathecal blockade, plasma levels of catecholamine of two groups were significantly decreased in different periods during anesthesia (P0.05); there were not any significant differences between the two groups in neonate Apgar scores. Conclusion:Both of two techniques can inhibit stress response of parturients to cesarean sections and have no adverse effects to neonates when applied in proper management.

OBJECTIVE:To cut down the mistakes in PIVAS of our hospital in order to guarantee safe drug use of patients.METHODS:Various errors occurred in PIVAS of our hospital in 2008 were collected and analyzed.Relevant countermeasures were carried out then errors occurred in 2009 were compared statistically.RESULTS & CONCLUSIONS:Errors occurred in PIVAS of our hospital mainly were printing errors of label,shelf errors of drugs,dispensing errors and describing errors.The error rate was decreased from 0.016 1% in 2008 to 0.006 4% in 2009 and the safety of drug use was improved.

Background Researches have demonstrated that age-related macular degeneration (AMD) is associated with the oxidative stress injury of retina.Coenzyme Q10 (CoQ10) is an important antioxidant agent.CoQ10 level in blood plasma is a primary index of reflecting the oxidative stress ability of human.However,the study on CoQ10 content in retina has not been seen yet.ObjectiveThe aim of this study is to establish a method of detecting CoQ10 content in retina by the high-performance liquid chromatography (HPLC). Methods The retinas were isolated from 10 healthy eyes of donors aged 20-28 years.The donor eyes were obtained from National Development and Research Institute,Inc.USA.Isolated retina tissue was prepared into homogenate then lyophilized and deproteinized with methanol.Samples were extracted with heptane prior to the HPLC analysis with the chromatographic conditions as follows:RP-18 column,a mobile phase consisted of methanol-hexane-acetic acid-isopropanol (V/V=55:9:1:1) and 0.42% sodium acetate,ultraviolet rays (UV) detector at 275 nm.Results CoQ10 was effectively isolated from human retina.The limit of detection of CoQ10 was 0.14mg/L.The peak area and concentration of CoQ10 showed a good linear correlation within the concentration range of 0.2-395.00mg/L (R~2＝0.9943).Repeatability study showed that the relative standard deviations for CoQ10 at the concentration of 0.86mg/L,2.59mg/L and 3.45mg/L were 2.7%,0.1% and 3.3%,respectively.The within- and inter-day standard deviations for the analysis of CoQ10 were 1.6% and 3.7%,respectively.The recovery was 101%-113% for the human retina samples.The concentration of CoQ10 in 10 retinas from human donors was 0.51±0.20μg/eye in average.Conclusion A HPLC method for the quantified analysis of CoQ10 in human retina is developed.

Objective:To investigate the relationship of expression of vascular endothelial growth factor (VEGF) and clinical features in patients with intracranial aneurysm and arteriovenous malformation (AVM).Methods:A total of 64 patients with AVM and intracranial aneurysm,who were treated in First Hospital of Shijiazhuang from February 2011 to November 2015,were chosen as research subjects,AVM were 32 cases and intracranial aneurysm were 32 cases.The samples were sectioned for VEGF immunohistochemical staining;the location and intensity of staining were recorded;the positive indexes were computed.The VEGF expression of different age and Hunt&Hess classification in patients with intracranial aneurysms were analysed;the VEGF expression of different diameters,ages,Spetzler classification in patients with AVM were analysed.Results:There were no statistical differences in the VEGF expression of different ages in patients with intracranial aneurysms (P＞0.05);the VEGF expression of different Hunt&Hess classification in patients with intracranial aneurysms was statistical difference (P＜0.05).The positive rate of VEGF in the artery of AVM was lower than that in the vein,the difference was statistically significant (P＜0.05).There were no statistical differences in the VEGF expression of the different Spetzler classification,different diameters and different ages in patients with AVM (P＞0.05).Conclusion:The expression of VEGF in the vein and the artery of patients with AVM is different,the expression of VEGF is not correlated with the age of intracranial aneurysm and the size and age of AVM.VEGF cannot be used as a predictor in the patients with intracranial aneurysms and AVM.

BACKGROUND:The choice of schwannoma resection is strongly associated with whether the tumor was completely resected, whether stretch during resection injures spinal nerves, and final y with the prognosis of treatment.
OBJECTIVE:To evaluate the spinal stabilization after laminectomy combining unilateral or bilateral nail-rod system for schwannoma in the spinal canal or intervertebral foramen.
METHODS:A total of 48 cases of schwannoma in the spinal canal or intervertebral foramen of neck, chest and waist underwent laminectomy combining unilateral or bilateral nail-rod system. 34 cases in spinal canal received bilateral nail-rod system, and 14 cases in the intervertebral foramen received unilateral nail-rod system.
RESULTS AND CONCLUSION:At 3 days and 3, 6, 12 months after internal fixation, radiograph results demonstrated that location of implants was good. Bone graft fusion was found. No spinal instability and vertebral slippage occurred. Neural functional score Bodford (1997) and quality of life score were significantly increased after treatment (P<0.01). Muscle strength assessed by Lovett grade was significantly elevated after treatment (P<0.01). Pain evaluated by Virtual Rescan grade was significantly lessened after treatment (P<0.01). Schwannoma was completely resected in 48 patients. After treatment, six patients affected leakage of cerebrospinal fluid. One case experienced infection of cerebrospinal fluid. One case had to undergo secondary operation due to the infection. Three cases received nerve root resection due to tumor erosion. These experimental results confirmed that laminectomy combining unilateral or bilateral nail-rod system for schwannoma in the spinal canal or intervertebral foramen has the advantage of the tumor ful y exposed to the operator, which can help completely resect schwannoma and effectively avoid spinal nerve injury. Even more important thing is that the spinal stability is reconstructed by unilateral or bilateral nail-rod system, which prevents the occurrence of vertebral slippage and vertebral destabilization. Long-term effect stil needs further research.

Objective To compare the difference of antihypertensive efficacy,the result of heart and lung function test(CPET)and 6 minutes walking distance(6MWD)in hypertension patients with different angiotensin converting enzyme(ACE)gene polymorphisms.Methods 120 patients with hypertension were randomly divided into four groups:the control group treated with nifedipine zyban,perimental group of group A(II),group B(ID),group C(DD)treated with lisinopril tablets.The blood pressure control situation,the changes of the CPET and 6MWD results were compared in the four groups 3 and 6 months after treatment.Results After 3 months,there were no significant changes in blood pressure drop of the four groups,and the differences were no statistically significant among the four groups in the range of blood pressure drop(all P>0.05),the body mass,maximum oxygen uptake(VO2/kg)and 6MWD of the four groups were not significantly changed..After 6 months,the blood pressure of the four groups decreased,and there were no statistically significant differences between the four groups in the drop of blood pressure(all P>0.05),VO2/kg(mL):the control group(17.94±1.51)mL,group A(18.04±1.85)mL,group B(19.70±1.25)mL,group C(21.25±2.20)mL and 6MWD:the control group(448.66±50.26)m,group A(445.07±41.21)m,group B(488.56±55.66)m,group C(500.54±53.25)m.The improvement range of VO2/kg and 6MWD was group C>B>A(group B compared with group A:ct=12.01,P=0.03;group C compared with group B:dt=17.26,P=0.02),there were no statistically significant differences between the control group and group A(all P>0.05).Conclusion This study found no ACE genotype associated with the antihypertensive effects of lisinopril,but found improvement of CPET and 6MWD result in different groups,DD type is superior to the ID,the ID type is better than type II.

Objective To compare the predicted efficiency ofmacular hole closure index (MHCI) calculated by 2 different methods for postoperative anatomical outcomes after idiopathic macular hole (MH) surgery.Methods This is a prospective exploratory clinical study.A total of 63 patients (63 eyes) with idiopathic MH,who received vitrectomy,inner limiting membrane peeling and gas tamponade,were enrolled in this study.All the patients received optical coherence tomography (OCT) examination at each visit to measure the MHCI using the formula MHCI=(M+N) /BASE,M and N is the distance from outer limiting membrane break points to the beginning points of detached photoreceptor from retinal pigment epithelium of both side of the hole,respectively.BASE is the length of MH base.MHCI1 was measured by built-in caliper of OCT software,MHCI2 was measured by ImageJ software.The minimum macular diameter (MHD) was measured by built-in caliper of OCT software.Based on the OCT images,the anatomical outcomes were classified grade A (bridge-like shape closure),grade B (complete closure) and grade C (poor closure).Grade A and B are considered as good closure,grade C as poor closure.Patients were followed up at 3,6 and 12 months after surgery.The closure grades at last visit were the final outcome.The relationship between MHCI 1,MHCI2 and closure grades was analyzed.And the predicted efficiency of MHD,MHCI1 and MHCI2 for anatomical outcomes after the surgery was studied.Results The mean MHCI1 was 0.68±0.21 (0.30-1.35),MHCI2 was 0.95±0.26 (0.41-1.55),and MHD was (476.24±210.18) μm (127-956 μm).MHCI1 and MHCI2 were both negative correlated with the closure grades (r=-0.665,-0.691;P＜0.001).The receiver operating characteristic (ROC) curve analysis ofMHCI1,MHCI2 and MHD for the prediction of good or poor closure showed that area under the curve (AUC) was 0.928,0.957 and 0.916 respectively,and 0.505,0.67 and 559 μm were set as the lower cut-offvalue.The sensitivity was 96.2％,92.3％ and 90.9％ respectively,and specificity was 81.8％,72.7％ and 76.9％ respectively.Accordingly,the ROC curve analysis for the prediction of grade A or B closure showed that AUC was 0.840,0.847 and 0.653 respectively,and 0.705,0.965 and 364 μm were set as the upper cut-off value.The sensitivity was 80.0％,82.9％,63.4％ respectively and specificity was 75.0％,85.7％,65.9％.Conclusion MHCI1 and MHCI2,measured by built-in caliper of OCT software or ImageJ software,both have good predictive efficiency for the anatomical outcomes of MH surgery.

BACKGROUND: Previous studies demonstrated that proliferation of cancer cells can be inhibited via RNA interference on the expression of vascular endothelial growth factor (VEGF). However, few studies report RNA interference on the expression of VEGF in gallbladder carcinoma, OBJECTIVE: To design and screen shRNA targeting VEGF, and to observe the effect of small interfering RNA targeting on proliferation of gallbladder cancer cells. METHODS: The VEGF-shRNA fragment was synthetized and connected with pCYU6/GFP/Neo-shRNA plasmid vector, shRNA was transfected into gallbladder cancer cells. The gallbladder carcinoma models of nude mice were prepared and randomly divided into blank control, negative control and experimental groups, With 6 animals in each group. ShRNA was injected into tumor. Cell growth was detected by fluorescence microscope MTT. The RNA interference efficiency was examined by fluorescent quantitative RT-PCR. Changes of tumor volume were also observed. RESULTS AND CONCLUSION: Gallbladder cancer cells ware shrunk with round shapes and a part of cells were dead after RNA interference on VEGF. shRNA-VEGF1 and shRNA-VEGF2 could signiticently inhibit mRNA gene expression of VEGF, the inhibition ratio was 86% and 82%, respectively. The tumor volume of the experimental group was smaller than the other groups, with slowly growth (P < 0.05). No obvious changes were found in the blank control and negative control groups. The constructed hVEGF-shRNA vector markedly decreases VEGF gene expression and inhibits cellular proliferation, eventually, to treat gallbladder cancer.

Objective To investigate the relationship between the expressions of osteopontin (OPN), matrix metalloproteinase 2 (MMP-2) and vascular endothelial growth factor (VEGF) in gastric cancer and the poor prognosis of gastric cancer patients. Methods A total of 35 patients with gastric cancer after radical gastrectomy from January 2014 to March 2015 in Dalian Third People ' s Hospital were retrospectively analyzed. The expressions of OPN, MMP-2 and VEGF in gastric cancer tissues and adjacent normal tissues were detected by immunohistochemical SP staining. The relationship between the expressions of OPN, MMP-2 and VEGF and the poor prognosis of gastric cancer patients was analyzed. Results The positive expression rates of OPN, MMP-2 and VEGF in postoperative pathological tissues of gastric cancer were 80.0％ (28/35), 77.1％(27/31) and 88.6％(31/35), respectively. OPN expression was associated with vascular invasion, lymph node metastasis, degree of differentiation, degree of invasion, and Lauren classification (all P< 0.05). MMP-2 expression was associated with vascular invasion, lymph node metastasis, and degree of invasion (all P<0.05). VEGF expression was associated with vascular invasion, lymph node metastasis, degree of invasion, and Lauren classification (all P< 0.05). OPN, VEGF and MMP-2 had synergistic effects in the invasion and metastasis of gastric cancer, and the expressions of them were positively correlated (all P< 0.05). The sensitivity of combined detection of OPN, VEGF and MMP-2 (87.5％) was higher than the sensitivity of individual detection (68.8％, 62.5％ and 56.3％) (P< 0.05). Conclusions OPN, MMP-2 and VEGF expressions are closely related to the poor prognosis of gastric cancer patients, and have synergistic effects in the invasion and metastasis of gastric cancer. The combined detection of OPN, MMP-2 and VEGF may have a more accurate prediction of the prognosis of gastric cancer.

Objective: To observe the changes of retinal microstructure in lamellar macular hole (LMH) after vitrectomy. Methods: A retrospective clinical observational study. Forty patients (41 eyes) with LMH and received vitrectomy in Ophthalmology Department of Peking University People’s Hospital from January 2014 to September 2018 were included in this study. Among them, 14 patients (15 eyes) were males and 26 patients (26 eyes) were females, with an average age of 67.8±8.6 years. There were 37 eyes with a lens and 4 eyes with an IOL. There were 29 eyes with LMH of tractional type, 7 eyes of degenerative type, and 5 eyes of mixed type. All patients underwent BCVA and OCT examinations. The BCVA examination was performed using the international standard visual acuity chart, which was converted into logMAR visual acuity. The average logMAR BCVA was 0.57±0.27; the mean macular retinal thickness (CRT) was 192.3±108.9 μm, the mean macular thickness (MRT) was 427.5±110.2 μm. Among the 29 eyes of tractional type, there were 17 eyes with retinal cavity, 8 eyes with macular retinoschisis, and 3 eyes with incomplete ellipsoid zone. Among the 7 eyes of degenerative type, there were 5 eyes with lamellar hole-associated epiretinal proliferation (LHEP), 5 eyes with retinal cavity, and 5 eyes with incomplete ellipsoid zone. Among the 5 eyes of mixed type, 2 eyes with LHEP, 1 eye with macular epiretinal membrane, and 4 eyes with incomplete ellipsoid zone. The average follow-up time after surgery was 12.8±5.2 months. Among them, 10 eyes were followed up for equal or greater than 24 months. After the surgery, the same equipment and method before the surgery were used for relevant examination. The changes of BCVA, CRT, and MRT before and after surgery were observed. Continuous variables were compared by t test. Results: At the last follow-up, the mean logMAR BCVA was 0.37±0.26. Compared with before surgery, the difference was statistically significant (t=5.98, P<0.01). The mean CRT and MRT were (245.2±90.8) and (347.0±46.7) μm, respectively. Compared with before surgery, the differences were statistically significant (t=-2.49, -5.24; P<0.05, <0.01). CRT and MRT changed greatly within 6 months after surgery, and then tended to be gentle. Among the 3 eyes with incomplete ellipsoid zone of tractional type before surgery, ellipsoid zone recovered in 2 eyes and partially recovered in 1 eye. Among the 17 eyes with retinal cavity and 8 eyes with macular retinoschisis before surgery, there were still 4 eyes with retinal cavity, but all the retinoschisis were disappeared. Among the 5 eyes with retinal cavity of degenerative type before surgery, there were still 2 eyes with retinal cavity and all the eyes with incomplete ellipsoid zone. Among 10 eyes with a follow-up time of equal or greater than 24 months, the macular ganglion cell complex partially atrophied in 6 eyes, and the nerve fiber layer separated in 2 eyes. There was no full-thickness macular hole after surgery. Conclusion For most LMH patients, vitrectomy can effectively improve the visual acuity and promote the recovery of retinal microstructure.