Objective To investigate the effect of recombinant human erythropoietin (rhEPO) on the expression of glutamine synthetase (GS) of cultured rat retinal Müller cells in high glucose environment in vitro.Methods Mtüller cells were isolated from retinas of 10 Sprague-Dawley rats at postnatal day three to five by trypsin digestion,and were randomly divided into six groups,including normal control group,high glucose group,high glucose +5 U/ml rhEPO group,high glucose+ 10 U/ml rhEPO group,high glucose+ 20 U/ml rhEPO group,high glucose+40 U/ml rhEPO groups.After 48 hours,the apoptosis of retinal Müller cells were assayed by terminal transferase-mediated DNA end labelling assay,and the expression levels of GS protein were detected with semi-quantitative immunocytochemistry.Results Compared with the normal control group,the cell viability and GS protein were reduced while the cell death increased in Müller cells cultured in high glucose,the difference was statistically significant (t =27.4,P ＜ 0.01).Compared with the high glucose group,rhEPO treatment reduced the apoptotic Müller cells (t=857.2,2 374.6,2 473.2,2 537.7; P＜0.01),induced the expression of GS proteins (t=3.2,18.0,22.5,26.4; P＜0.05).Conclusions rhEPO can protect Müller cells from apoptosis under high glucose condition.The mechanism may be related to its function to up-regulate the GS protein expression,promote glutamic acid cycle,and reduce the excitotoxicity effects of high concentration of glutamate.

AIM:To evaluate the clinical effects of femto-LASIK using new Ziemer LDV Z6 femtosecond laser machine (Z6).
METHODS: Two - hundred cases ( 400 eyes ) was randomly separated into two groups: Group A included 200 eyes which corneal flaps were made by Z6, and Group B included rest of 200 eyes which corneal flaps were examined by a traditional Ziemer LDV CrystalLine femtosecond laser machine (CrystalLine). Visual acuity, slit lamp, refraction, Sim-K average, intraocular pressure (IOP), non-invasive tear break-up time (NIAvg-BUT), operation difficulty and complications were compared between two groups preoperatively and postoperatively.RESULTS:There was no significant differences between two groups in visual acuity, refraction, Sim-K average, IOP and NIAvg - BUT either preoperatively or 6mo postoperatively (P>0. 05). Although there were significant differences in operation difficulty and complications were found between two groups ( P< 0. 05 ), there was no serious complication in any group. Furthermore, a clear demarcation line could be observed in the cornea of Group A postoperatively.
CONCLUSION:More careful and strict requirements are needed when using the new Z6 femtosecond laser for corneal flaps.

The application of cerebrovascular intervention brings the diagnosis and treatment of cerebrovascular disease into a brand-new domain. Many neurological physicians have become physicians of cerebrovascular intervention by training. In the big teaching hospitals carrying out cerebrovascular intervention, advanced physicians are the hard strength in the lot of cerebrovascular intervention. The training aiming at cerebrovascular intervention and comprehensive abilities affects both the training results and the therapeutic results of cerebrovascular intervention. Therefore, it is an important issue to explore how to consummate and standard the training methods of advanced physicians studying cerebrovascular intervention.

[Objective]To investigate the feasibility of screening for velamentous umbilical cord insertion in early pregnancy by ultrasound.[Methods]A total of 2,796 cases of pregnant women,2 998 cases of fetuses that underwent prenatal ultrasound screening in the early and middle stage pregnancy and delivered in Dalian Women and Children Healthcare Center were included. The results of ultrasound screening of umbilical cord insertion during early pregnancy(11~13+6 w)were divided into three groups. GroupⅠ:it is clear that the placenta of the umbilical cord is located in the fetal membranes ,and then along with the fetal membranes for a long distance,and then enter the placenta. GroupⅡ:The placenta of the umbilical cord is located at the edge of the placenta,and then insert point is not distinguished between the placenta and fetal membranes. Group Ⅲ:It is clearly shows that the umbilical cord inserted into the placenta.[Results]1. The display rate of the umbilical cord in early and mid pregnancy ultrasound examinationearly pregnancyan examination showed that the rate of 99.23%(2 975/2 998). The single child display rate of 99.77%(2 590/2 596),twindisplay rate of 95.96%(380/396),three fetal the rate of 83.33%(5/6).In the second trimester of pregnancy(22~26 w)and examination showed that the rate of 86.99%(2 608/2 998). The single child display rate of 90.99%(2 362/2 596),twin display rate of 61.61%(244/396),three fetal the rate of 33.33%(2/6). 2. The results of early pregnancy,pregnancy,the examination of after birth Regard?ing to early pregnancy,28 cases were included in GroupⅠ,42 cases in GroupⅡand 2928 cases in GroupⅢ. Regarding to second pregnancy,37 cases were evaluated as velamentous umbilical cord insertion,30 cases were evaluated as battledore placenta and 2931 cases were evaluated as normal placenta. The results of postnatal examination were as follows:36 cases were identified as velamentous umbilical cord insertion,30 cases were evaluated as battledore placenta and 2932 cases were evaluated as normal placenta. 3. Comparison of 3 groups,early pregnancy examination results and pregnancy and after the birth. In early pregnancy,28 cases of GroupⅠwere diagnosed as velamentous umbilical cord insertion in the examination during the second trimester of pregnancy and after delivery. In the 42 cases of early pregnancy in Group Ⅱ,7 cases were diagnosed as velamentous umbilical cord insertion ,22 cases were diagnosed as battledore placenta and 13 cases were normal placenta. After birth ,6 cases were diagnosed as diagnosed as velamentous umbilical cord insertion ,23 cases were battledore placenta and 13 cases were normal placenta. In the 2928 cases of early pregnancy of Group Ⅲ,2 cases were diagnosed as diagnosed as velamentous umbilical cord insertion ,8 cases were battledore placenta and 2918 cases were normal placenta. After birth ,2 cases were diagnosed as diagnosed as velamentous umbilical cord insertion,7 cases were battledore placenta and 2919 cases were normal placenta.The diagnostic accuracy of early pregnancy was 98.29%.[Conclusion]Application of HD-Flow blood flow pattern in early pregnancy can make a diagnosis of some of the sail-shaped placenta.

The liquid-chromatography-mass technology was used in the metabolomic analysis of mouse's blood 1 hour after exhaustive exercise,in order to explore the potential mechanism of Rhodiola in fatigue elimination of exhaustive exercise mouse.The exhaustive mouse model was made by loaded-swimming.A total of 24 mice were randomly divided into theRhodiola + exercise group,exercise group andno-exercise group.The dose of Rhodiola was 0.4375 g·kg-1·d-1.The loaded-swimming was conducted after two successive weeks of medication.Blood was collected 1 h after swimming for the sample preparation.The enzyme assay and anthrone colorimetry were used to test blood lactate acid and glucose,respectively.UFLC-Q-TOF was used to detect metabolic profiles of each group.The principal component analysis (PCA),orthogonal partial least squares discriminant analysis (OPLS-DA) and heat map analysis were used to compare differences among groups with score chart and to obtain the characteristics biomarkers by load chart.The results showed that the blood lactate acid level of theRhodiola+ exercise group was significantly lower than that of theexercise group.And the glucose level of theRhodiola+ exercise group was significantly higher than that of theexercise group.The metabolomic analysis showed that there were no obvious changes on 1,25-(OH)2D3,diacylglycerol (DG) and inositol triphosphate (IP3).All three materials in theRhodiola + exercise group were significantly lower than those of theexercise group.They were much closer to theno-exercise group.And all three materials were related to the increasing of muscle tension.It was concluded that Rhodiola had the function of promoting fatigue eliminating.This effect may be related to cell membrane protection,regulation of 1,25-(OH)2-D3→IP3,DG pathway,and relieving of muscle tension after exercises.

Objective:To investigate the diagnostic value of mitochondrial associated protein fumarylacetoacetate domain containing protein 1 (FAHD1) and growth differentiation factor-15 (GDF-15) in sepsis.Methods:Based on the database of the whole process of sepsis early warning, diagnosis and treatment management, which was established on the study of sepsis early warning and standardized diagnosis and treatment system, adult patients with suspected infection admitted to the department of critical care medicine of Zhejiang Hospital, Second Affiliated Hospital of Zhejiang University, the First Affiliated Hospital of Sun Yat-Sen University, West China Hospital of Sichuan University, Ningbo First Hospital from May 2014 to October 2015 were enrolled. The basic vital signs, and the main blood routine results, liver and kidney function, blood gas, acute physiology and chronic health evaluation Ⅱ (APACHEⅡ) and sequential organ failure assessment (SOFA) score at the time of diagnosis of patients with or without sepsis were analyzed. The preserved serum samples were taken, the levels of procalcitonin (PCT), C-reactive protein (CRP) were detected by electrochemiluminescence method, immunoturbidimetry respectively, and FAHD1 and GDF-15 were detected by enzyme linked immunosorbent assay (ELISA). Univariate and multivariate Logistic regression were used to analyze the risk factors for sepsis diagnose. The indexes' diagnostic efficacy in sepsis were analyzed by receiver operating characteristics curve (ROC curve).Results:A total of 132 patients were enrolled, including 76 cases of sepsis and 56 cases of non-sepsis. Compared with the non-sepsis group, the heart rate in the sepsis group was increased (bpm: 116.4±17.8 vs. 97.4±19.1), while the mean arterial pressure (MAP), platelet count (PLT), arterial partial pressure of oxygen (PaO 2) were significantly decreased [MAP (mmHg, 1 mmHg = 0.133 kPa): 65.8±9.7 vs. 74.7±10.3, PLT (×10 9/L): 120 (69, 204) vs. 163 (117, 239), PaO 2 (mmHg): 83.0 (66.6, 108.0) vs. 108.0 (84.4, 130.0), all P < 0.05], direct bilirubin (DBil), serum creatinine (SCr), lactic acid (Lac), APACHEⅡ score and SOFA score were significantly increased [DBil (μmol/L): 13.00 (5.55, 55.31) vs. 6.20 (2.20, 21.90), SCr (μmol/L): 118.00 (70.00, 191.73) vs. 77.20 (59.65, 110.86), Lac (mmol/L): 2.90 (1.50, 4.10) vs. 1.90 (1.20, 2.80), APACHEⅡ score: 20.0 (16.0, 25.0) vs. 16.0 (10.0, 21.0), SOFA score: 12.0 (8.0, 16.0) vs. 8.0 (5.0, 13.0), all P < 0.05]. In addition, the serum levels of FAHD1, GDF-15, PCT and CRP in sepsis group were significantly higher than those in non-sepsis group [FAHD1 (μg/L): 3.96 (2.25, 5.92) vs. 2.47 (1.03, 3.54), GDF-15 (μg/L): 8.46 (4.37, 19.68) vs. 4.32 (1.74, 10.39), PCT (μg/L): 3.79 (1.37, 11.32) vs. 0.42 (0.12, 2.14), CRP (mg/L): 154.43 (61.33, 283.20) vs. 65.95 (28.15, 144.69), all P < 0.01]. Multivariate Logistic regression showed that serum FAHD1 [odds ratio ( OR) = 1.135, 95% confidence interval (95% CI) was 1.045-1.234], GDF-15 ( OR = 1.090, 95% CI was 1.029-1.155) and CRP ( OR = 1.007, 95% CI was 1.002-1.011) were risk factors for sepsis (all P < 0.05). ROC curve analysis of sepsis showed that the areas under ROC curve (AUC) of serum mitochondrial associated proteins FAHD1 and GDF-15 were 0.727 (95% CI was 0.641-0.802) and 0.677 (95% CI was 0.588-0.757), respectively; and the AUC of classical infection indexes PCT and CRP were 0.767 (95% CI was 0.683-0.837) and 0.680 (95% CI was 0.59-0.760), respectively. There was no significant difference between the AUC of mitochondrial associated proteins and classical infection indexes. The combination of FAHD1, GDF-15, PCT and CRP had the largest AUC, which was 0.809 (95% CI was 0.730-0.874), and the sensitivity was 75.00%, and the specificity was 80.00%. Conclusion:Mitochondrial associated protein FAHD1 and GDF-15 are associated with sepsis, and the diagnostic efficiency is improved when combined with PCT and CRP, which might provide experimental basis for screening diagnostic markers of sepsis.

Objective To discuss the protective effect of doxofylline on radical surgery for esophageal cancer.Methods Under elective general anesthesia, 60 cases, 35 males and 25 females, aged 45-70 years, BMI 20-30 kg/m2, ASA physical status Ⅰ or Ⅱ, FEV1%>50%, underwent radical surgery for esophageal cancer at middle and distal parts.Random number table was employed to divide these patients into two groups: doxofylline group (group D) and control group (group C) with 30 cases in each.After a routing intravenous induction in the two groups, mechanical ventilation was conducted after bronchial intubation with double channel catheter on the right side.The intravenous injection of doxofylline 4 mg/kg in group D was administrated 30 min after bronchial intubation with double channel catheter.Equal normal saline was instilled to the patients in group C.Blood samples were taken from radial artery to detect the levels of TNF-α, IL-6, IL-10, MDA and SOD at four time points: 10 min (T0) before the one-lung ventilation, 60 min after OLV (T1), after two-lung ventilation (T2) and the end of the operation (T3).Meanwhile, the blood and breath at these time points were tested.The occurrence of OLV, blood loss volumes, fluid input quantities, urine volumes, postoperative hyoxemia and pulmonary inflammation were observed.Results Compared with T0, the activity of SOD in serum and PaO2 in the two groups at T1-T3 decreased (P＜0.05).The concentrations of TNF-α, IL-6, IL-10 and MDA increased significantly (P＜0.05).Compared with group C, the activity of SOD activities and PaO2 in group D at T1-T3 increased while concentrations of TNF-α, IL-6, IL-10 and MDA decreased significantly (P＜0.05).The occurrence rates of postoperative hyoxemia and pulmonary inflammation in group D were obviously lower than those in group C (P＜0.05).Conclusion Doxofylline can suppress patients' inflammatory response and oxidative stress response after OLV and reduce the incidence rates of postoperative hyoxemia and pulmonary inflammation as well as alleviate lung injury triggered by radical surgery for esophageal cancer.

Objective To study the clinical characteristics and imaging features of perinatal autosomal recessive polycystic kidney disease ( ARPKD) and a systematic review of the literature was performed to improve awareness of the disease. Methods A newborn with infantile ARPKD admitted to the neonatal department of our hospital was studied and her clinical data and imaging features retrospectively reviewed. CNKI, CBMdisc, MEDLINE and Embase databases were searched using autosomal recessive, perinatal and polycystic kidney as keywords. 9 case reports were retrieved from 2005 to 2015 and a total of 9 patients were analyzed. Results The gestational age of patients with infantile ARPKD was from 33 to 37 weeks. 6 of them were diagnosed using prenatal ultrasound and one patient was diagnosed using genetic sequencing. One of 10 infants had a family history, 4 patientsˊ mothers had abnormal pregnancy history (spontaneous abortion or miscarriage) and 7 (70. 0%) patients with respiratory failure needed mechanical ventilation. The ultrasound of all the patients showed enlarged and hyperechogenic kidneys. 9 patients died, and only one patient was alive after renal transplant. Conclusions The characteristics of perinatal APRKD are enlarged and polycystic kidneys, hepatic cysts and liver fibrosis. Infants with this disease have poor outcomes and high mortality rate. Respiratory failure and renal failure are the main causes of death in the neonatal period and early diagnosis and treatment are necessary.

Objective To investigate the expression and significance of interkeulin 10 (IL-10)in children patients with mycoplasma pneumoniae pneumonia(MP). Methods Twenty-six children patients with MP( MP group)and20 health control( contrl group)were sequentially enrolled in this study. The production of IL-10 mRNA was measured by fluorescent quantitative polymerase chain reaction. Results Expression of IL-10 mRNA in MP group (33 893.22±5 207.60) copy/μg was significantly lower than that in control group(59 341.92 ±6 712.98) copy/μg(t = - 14. 49, P ＜ 0. 01 ). Expression of IL-10 mRNA in heavy degree MP group was significantly lower than that of mild degree MP group ( t= - 2. 20, P ＜ 0. 05 ). Conclusion The expression of IL-10 was low, and played an important role in the development of patients with MP.

OBJECTIVE:To compare pharmacoeconomic and effect of Xueshuantong for injection and Ginkgo leaf extract and dipyridamole injection in the treatment of ischemic stroke. METHODS:Retrospective study was conducted. Totally 404 inpatients with ischemic stroke were divided into Xueshuantong group(271 cases)and ginkgo leaf extract and dipyridamole group(133 cas-es) according to clinical treatment programs. Based on the conventional treatment,patients in 2 groups were given Xueshuantong for injection and ginkgo leaf extract and dipyridamole injection,respectively. The average treatment course was 10 d. Cost-minimi-zation analysis was performed with the determination index of total effective rate. RESULTS:The total effective rates in Xueshuan-tong group and ginkgo leaf extract and dipyridamole group were 90.77% and 88.72%,respectively,the difference was not statisti-cally significant(P>0.05). The costs in 2 groups were 12 860.21 yuan and 13 155.40 yuan,respectively,and xueshuantong group had lower than ginkgo leaf extract and dipyridamde group. CONCLUSIONS:Both Xueshuantong for injection and Ginkgo leaf ex-tract and dipyridamole injection are effective in the treatment of ischemic stroke. However,the economy of Xueshuantong for injec-tion is superior to the other one.