The rate of blinding caused by high myopic maculopathy is high, vitrectomy is the most common treatment. However, the effectiveness of vitrectomy for high myopic patients who have serious posterior scleral staphyloma is not ideal. Recent years, posterior scleral reinforcement is used as a supplementary method with vitrectomy in clinical, treating for high myopic maculopathy. lt achieves a positive curative effect especially in macular foveoschisis and macular hole cases. ln this article, we introduced a review of history, current situation, material and surgery operand of scleral reinforcement. lt also makes a further discussion of its prospects used in retina surgery.

Objective To investigate the effects of different penetration enhancers on percutaneous absorption of Xiaoyan Runma mucilage in vitro, and to improve the curative efficacy of this mucilages through selection of the effective penetration enhancers. Methods Xiaoyan Runma mucilage was prepared with different penetration enhancers. An intelligent permeability instrument was used for in vitro percutaneous absorption test of rats , with isolated mice abdomen skin serving as in vitro transdermal barrier and saline isotonic solution as receptor fluid. Then the contents of lidocaine hydrochloride in receptors were determined by HPLC.The accumulative transit dose (Q) and percutaneous permeability (J) within 12 h were calculated and compared with those of mucilage without any enhancer. Results With Q value serving as an index, different enhancers had different promote permeation effects on Xiaoyan Runma mucilage, and the effects in descending order were as follows:4% azone [(222.75±3.4) μg?(cm2)-1]>2% azone[(207.42±5.1) μg?(cm2)-1]>3% menthol [(183.38±4.9) μg?(cm2)-1]>5%menthol [(160.82±5.4) μg?(cm2)-1]>2% azone+3% menthol [(151.25±5.5) μg?(cm2)-1]>2% azone+5% isopropyl myristate [(127.26±7.1) μg?(cm2)-1]>2% oleic acid [(125.16±6.5) μg?(cm2)-1]>no enhancer [(109.82±8.2)μg?(cm2)-1].4% azone was the best penetration enhancer for the mucilage delivery in vitro, with Q and J value as [(222.75± 3.4)μg?( cm2 )-1 ] and 19. 896 μg?( cm2 )-1?h-1 , respectively, which was 2. 08 times those of mucilages without any enhancer. Conclusion Being as a transdermal absorption enhancer of Xiaoyan Runma mucilage, 4% azone has the best effect. This study can provide the optimal formulation for transdermal delivery system of Xiaoyan Runma mucilage.

Objective To explore the correlation between the serum levels of fibrinogen (FIB), C-reactive protein (CRP) and homocysteine (Hcy) with the carotid vulnerable plaque in patients with large artery atherosclerosis (LAA) stroke.Methods The patients with acute ischemic stroke (AIS) admitted to the Department of Neurology in The Second Hospital of Lanzhou University from Mar. 2014 to Feb. 2015 were collected continuously, and 273 patients with anterior circulation of LAA stroke were selected based on the TOAST classification. These patients were classified as non-plaque group (n=84), stable plaque group (n=42) and vulnerable plaque group (n=147) according to the carotid ultrasonography examination. Another 182 patients without carotid disease of non-stroke selected simultaneously from our department were regarded as controls. The 19 demographic parameters and hematological indices were compared among the four groups. The logistic regression was used to screen the independent risk factors for carotid vulnerable plaque in LAA stroke patients. The Spearman rank correlation was performed to analyze the correlation between the carotid plaque vulnerability in LAA stroke patients with all the indicators.Results The levels of FIB, CRP and Hcy in the four groups showed statistically signicantcant differences (P<0.05). The multivariate logistic regression analysis revealed that FIB (OR=1.408, 95% CI 1.028-1.927,P=0.033) was the independent risk factor for carotid vulnerable plaque in patients with LAA stroke. The Spearman correlation analysis presented a positive correlation between carotid plaque vulnerability in LAA stroke patients with FIB (r=0.292;P=0.000) and Hcy (r=0.172;P=0.000). Conclusions The serum FIB and Hcy levels may be the meaningful biomarkers to predict the vulnerable carotid plaque in patients with LAA stroke. The serum level of CRP has no obvious correlation with carotid plaque vulnerability in LAA stroke patients.

Objective To explore the possible mechanisms of Arsenic Trioxide in treating rheumatoid arthritis(RA)by observing the changes of HE staining and NF-KB expression as well as the apoptosis of syn- oviocytes in adjuvant-induced arthritis rats.Methods After the animal model was set up on Wistar rats sue- cessfully,they were randomly divided into AA model group and arsenic trioxide treatment group.The treat- ment group were injected with 4 mg'kg~(-1)9?d~(-1)arsenic trioxid fluid for 7 days.All of the rats were killed 3 days after the complete of injections.The joint specimens were exposed,fixed,decalcified,wrapped and cut into slices.All slices were examined by HE stain and immunohistological evaluation.Results HE staining showed that when compared with the normal control group,the layers of synoviocytes of the AA group were increased to 6-8,and the arrangement of synoviocytes was disordered and heavy inflammatory cell infiltration were found in the AA group.In the arsenic trioxide treatment group,the layers of synoviocytes increased to 3～4,and medi- um amount of inflammatory cell infiltration were found.The intensity of synovial NF-kB(p65)positive stain in AA model group was significantly higher than that in the normal control group.The synovial expression and ac- tivation of NF-kB in the treatment group were decreased markedly,and did not return to normal level.The average gray scale calculation showed that there were significant differences between the three groups(P

BACKGROUND:MicroRNAs (miRNA) through regulating specific target gene mRNA expression play important roles in different processes of diseases. OBJECTIVE:To study the interaction of miRNA-21 with its target gene TLR4 in Hela cels. METHODS:The candidate target gene of miRNA-21 was determined according to miRNA analysis databases. The constructed recombinant adenovirus vector carrying pri-miRNA-21 gene was used, which could package and amplify viruses to transfect Hela cels. Then, the expression of fluorescent proteins was detected. Forty-eight hours after transfection of miRNA-21 or control, extracted proteins were used for detection of TLR4 protein using western blot assay. RESULTS AND CONCLUSION:Recombinant adenoviruses pAd/pri-miRNA-21 and pAd/neg at 100 MOI could successfuly infect Hela cels. Bioinformatic analysis suggested several possible binding sites between miRNA-21 and TLR4. The experimental results showed that miRNA-21 down-regulated TLR4 at protein levels, indicating that miRNA-21 can interfere with the expression of TLR4 target gene.

Objective To explore the relationship between sleep quality and quality of life in patients with type 2 diabetes. Methods Multi-stage randomized cluster sampling was used in the survey and self-designed questionaire , Pittsburgh sleep quality index scale , diabetes specific quality of life scale and self-rating depression scale were adopted. Results The poor sleep quality rate was 33.6%. Compared with the group with 6~8 h sleep duration, the scores of physical function,psychological dimension,social relations and quality of life were higher in patients with < 6 h sleep duration (P < 0.01).The average quality of life score was significantly higher among the sleep disorder participants than the other groups(56.95 ± 14.57 vs 50.11 ± 11.08 vs 44.77 ± 9.61,P<0.01). After adjusting for age, gender, complications, course of disease and depression, etc. The correlation coefficient of sleep quality and quality of life was 3.92. Among them , the sleep quality and physical dimensions of the correlation coefficient is the largest(r=0.407,P<0.01). Conclusions It can be an effective method of improving their status of life quality by ameliorating their sleep quality , especially for the physical dimension.

Objective To investigate the neurotoxic effects of different concentrations of tetracaine and ropivacaine on the brachial plexus nerve in rats.Methods Forty-eight male Sprague-Dawley rats,weighing 410-430 g,were randomly divided into 8 groups (n =6 each):normal saline group (group NS),0.25％,0.50％ and 1.00％ tetracaine groups (groups T1-3 ),and 0.25％,0.50％,1.00％ and 2.00％ ropivacaine groups (groups R1-4 ).The rats received injection of normal saline 1.0 ml,0.25％,0.50％ and 1.00％ tetracaine 0.5 ml,0.25％,0.50％,and 1.00％ ropivacaine 1.0 ml and 2.00％ ropivacaine 0.5 ml in groups NS,T1-3 and R1-4 respectively through one side of the axillary sheath.The other side of the axillary sheath served as control side.Five days later,compound action potential and nerve conduction velocity (NCV) of the brachial plexus nerve were measured.Tne brachial plexus nerve was obtained as the specimen for microscopic examination with light and transmission electron microscope.Results Compared with the control side and group NS,the compound action potential and NCV of the brachial plexus nerve were significantly decreased in groups T2,3 and R3,4 ( P ＜ 0.05 ).The compound action potential and NCV of the brachial plexus nerve were gradually decreased with the increasing concentrations of tetracaine in groups T1 3 ( P ＜ 0.05 ).The compound action potential and NCV of the brachial plexus nerve were significantly decreased in group R4 as compared with groups R1-3 (P ＜ 0.05).The microscopic examination showed that the pathologic changes were more severe in groups T2,3 and R3,4 than those on the control side and than in group NS.Conclusion 0.50％ and 1.00％ tetracaine,and 1.00％ and 2.00％ ropivacaine can result in pathologic damage to the brachial plexus nerve in rats and the degree of damage is related to the concentration.

Objective The purpose of this study was to discuss the clinical significance of serum levels of Pro-gastrin-releasing peptide (ProGRP) in diagnosis,therapy monitoring and prognosis in patients with small cell lung cancer (SCLC).Methods Clinical diagnostic trial.Serum levels of ProGRP were measured by ELISA assays in 413 SCLC patients,418 NSCLC,120 with benign pulmonary diseases patients and 200 healthy subjects.Patients were recuited by the Shanxi Cancer Hospital from Dec.2005 to Oct.2008.Three hundreds and sixty-eight patients with SCLC were followed up from Dec.2005 to Oct.2011.The receiver operating characteristic curves (ROC) was used to set the cut-off value of ProGRP and the area under ROC (ROC-AUC).The sensitivity and specificity of ProGRP were analyzed for diagnosing SCLC.The survival analysis was performed by the Kaplan-Meier method and Cox's proportional hazards model for multivariate analysis of prognosis.Results Using healthy subjects group as control,the largest Youden index point of ROC was used to set the cut-off values of ProGRP and NSE (45.3 ng/L and 12.4 ng/L).The ROC-AUC of ProGRP was 0.798 (95％ CI:0.746-0.850)the sensitivity and specificity were 79.2％,98.1％ respectively.The AUC of NSE was 0.786(95％ CI:0.726-0.746),the sensitivity and specificity were 71.9％,96.7％ respectively; Combing detection of ProGRP and NSE,the sensitivity and specificity were 88.1％,95.8％ respectively.Serum levels of ProGRP in healthy subjects,benign pulmonary diseases,NSCLC and SCLC groups were 6.9 (5.3-8.6),36.8 (26.3-43.4),21.3 (18.6-35.2) and 1758.7 (368.4-2967.3) μg/L respectively.The serum levels of ProGRP in SCLC groups were significantly higher than those in the healthy group,benign pulmonary diseases group and NSCLC group (H =103.66,P =0.000).Serum levels of ProGRP in SCLC at stage Ⅰ-],stage m,stage Ⅳ were 543.3 (256.8-843.2),1440.6 (1042.4-2543.3) and 1897.6 (1586.5-3958.7) μg/L,respectively (H =25.974,P =0.000).Serum levels of ProGRP in 165 SCLC patients with complete remission(CR) were significantly declined after treatment (U =11.65,P ＜ 0.01).The levels of ProGRP in 146 SCLC patients with partial remission(PR) slowly decreased (U =9.17,P ＜ 0.01).Thirty-nine cases with progressive disease (PD)and 63 cases with stable disease(SD) presented elevated ProGRP levels (U =3.314,P ＜ 0.001 ; U =2.54,P ＜ 0.01,respectively).By the end of October 31st 2011,a total of 368 cases with SCLC were followedup.Ratio of follow-up was 89.1％.There were 56 deaths in 119 SCLC patients with ProGRP ＜ 1000 μg/L (median time =16.0 months,4-23 months) ; 159 deaths in 249 with ProGRP ＞ 1000 μg/L (median survival time =12.0 months,2-18 months).Median survival time of the two groups showed significant differences(x2 =11.04,P =0.001).Multivariate analysis by Cox's proportional hazards model revealed that ProGRP was independent prognostic factor related to the overall survival (OS) of SCLC patients.Conclusions The serum ProGRP is valuable tumor marker for diagnosis,treat monitoring and prognosis of SCLC.It's important to predict relapses and recurrence of diseases earlier,instruct therapy and prognosis assessment.

Objective To study the application value of 5S management for the instrument management in ENT department.Methods Totally 20 instrument nurses in ENT department implementing 5S management were enrolled into an observation group,and another 20 nurses using conventional management method were involved in a control group.The two groups were compared on instrument management quality and instrument nursing management satisfaction.Results The observation group had the qualification rate of sampled sterile items,qualification rate of instrument packaging,qualification rate of instrument cleaning,efficiency of instrument application,instrument preparedness,standardized instrument allocation,intact rate of prepared instrument as well as the familiarity with instrument management and operation significantly better than those in the control group (P＜0.05).The time consumed for adding instrument,finding instrument,environment arrangement and finding expired goods in the observation group was statistically shorter than that in the control group (P＜0.05).The times of instrument set repeated disinfection in the observation group was obviously less than those in the control group (P＜0.05),and the satisfaction over nursing management in the observation group was also significantly better than that in the control group (P＜0.05).Conclusion 5S management gains high application values for instrument management in ENT department,and thus is worthy promoting clinically.

ObjectiveTo explore the effect of blocking the JAK/STAT signal pathway on the activity of Caspase-3 in the synovial tissue of rheumatoid arthritis rats.MethodsFifty rat models of collageninduced arthritis,which had arthritis index more than 2 were divided into the model group,the low dosage of AG490 group,the medium dosage of AG490 group and high dosage of AG490 group.Inaddition,6 rats were treated as normal control group.Normal saline,AG490 1,5,10 mg·kg-1 ·d-1 were given by intraperitoneal injection.Then the volume claws and pathologic scores of the rat models were recorded and the activity of Caspase-3 in the synovial tissue were compared.The results were analyzed by one-way ANOVA and LSD-t or Tamhane's T2 test.ResultsThe arthritis of the CIA models progressed fast,the volume of the claws and the pathological score of them were significantly higher than those of the control group.At the same time,no Caspase-3 positive express could be detected in the control group,whilethe model group had slightly increased expression.After different dosages of AG490 were applied,the swollen of joints was significantly improved compared with the model group.The histopathological score of the medium AG490 dosage of group and high dosage group(2.7±0.8,1.8+0.9) were remarkably decreased than those of the model group(4.3+1.2),the differences were statistically significant (P＜0.01).In addition,the Caspase-3 expression in the low,medium and high AG490 dosage group ( 1.90±0.15,3.13±0.33,3.56+0.34) was significantly higher than that of the model group(1.48±0.18)(P＜0.05 or P＜0.01 ).ConclusionBlocking JAK/STAT signal pathway can increase the activity of Caspase-3,reduce the excessive proliferation of synovial tissue,and improve arthritis symptoms.