Antenatal corticosteroids (ACS) have been used clinically for more than half a century. They effectively reduce the incidence of preterm-related complications, such as neonatal respiratory distress syndrome (NRDS). Based on the significant beneficial effect in singleton pregnancies, several international guidelines recommend that ACS for twin pregnancies refer to their singleton pregnancies protocol. However, the prevention effect of ACS on NRDS in twin pregnancy is inconsistent. This review summarizes the effects of ACS on the prevention of NRDS in twin pregnancy to provide a reference for clinical management and further study.

Objective To investigate the therapeutic effect of ozone in treating the recurrent herniated lumbar disc after surgery.Methods Thirty-seven lumbar discs in 37 patinets with recurrent lumbar disc herniation after surgery were injected with ozone under CT-guided.The operative approaches were via lateroposterior position of lumbar vertebrae in 30 and via posterior position in 7 cases.Results The process of injection was done successfully in all patients.Followed-up for three months to one year after the treatment,the cases of clinical therapeutic efficacy of excellent results were 9,the cases of good results were 22,no changes in 6 cases.Conclusion Ozone in treatment of recurrent herniated lumbar disc after surgery is a safe and effective method.

Objective To observe the characteristics of indocyanine green angiography and fundus fluorescein angiography (ICGA& FFA) in anterior ischemic optic neuropathy ( AION ) , and to investigate the etiology of AION and the value of ICGA and FFA in the diagnosis and study of AION. Methods Simultaneous ICGA and FFA were performed on 32 eyes of 31 AION patients and 38 eyes of 38 non AION patients. Results The eyes that all or a part of the optic disc lies in the watershed zones of the choroidal blood supply were significantly more in the AION group than those in the non AION group (P

Objective To investigate the preoperative design and application of the minimum foveolar translocation distance and angle of macular translocation. Methods The fundus fluorescein and indocyanine green angiographies were performed on 53 eyes of 53 patients with classic subfoveal choroidal neovascularization (SCNV), including 42 with exudative age-related macular degeneration and 11 with high myopic macular degeneration. The actual area of macular SCNV and the minimum foveolar translocation distance and angle were analyzed. Results The actual area of SCNV was 0.39~18.00 mm 2 with the mean of (3.08?3.22) mm 2. The designed minimum superior translocation distance was 67~2 240 ?m with the mean of (845.72?425.23) ?m;the minimum designed minimum inferior translocation distance was 53~ 2 430 ?m with the mean of (912.17?547.77) ?m. The minimum designed superior translocation angle was 1~32? with the mean of (13.23?6.68)?;the minimum designed inferior translocation angle was 1~35? with the mean of (14.06?8.46)?. The individual difference of the minimum designed superior and inferior translocation distance was more than 500 ?m in 16 eyes (30.19%), and the difference of translocation angle was more than 10? in 11(20.75%). Conclusion Preoperative design of minimum translocation distance and angle of macular translocation may be helpful to choose the operation program.

Objective To establish a matrine delivery system in vitreous is very important for the dynamic treatment of proliferative vitreoretinopathy(PVR) . Present study was to evaluate the efficacy of matrine polyactic acid microsphere(MAT-PLA-MS) in prevention of PVR. Methods The suspension of cultured fibroblasts was injected into vitreous cavity of 30 healthy adult New Zealand albino rabbits to induce PVR. Then the experimental rabbits were divided into 3 groups and 10 rabbits for each. The animals received intravitreal injection of 0.3 mL MAT-PLA-MS(4 mg) matrine in MAT-PLA-MS group. Free matrine normal sodium solution 0.3 mL(containing 2mg matrine) was injected in vitreous cavity in free matrine group. 0. 3 mL normal saline solution was injected into the vitreous of the left eyes and the equivalent volume of blank polyaetic acid microsphere(blank-PLA-MS) into the right eyes in control group. The changes of cornea, aqueous humor, lens, vitreous and fundus were examined and recorded by slit lamp biomicroscope, indirect ophthalmoscope, fundus color camera and B ultrasonogram on the 1st, 3rd, 7th, 14th, 21st, 28th and 35th day following injection of drug. The inhibition effect of matrine on PVR was evaluated according to Ryan' s grading criteria of PVR. Results On the 14th days after implantation of MAT-PLA-MS, the rate of retinal detachment was 60%, 10%, 5% and 60% in normal saline group, free matrine group, MAT-PLA-MS group and blank-PLA-MS group respectively. Statistically significant difference was found among normal saline group, blank-PLA-MS group, MAT-PLA-MS group and free matrine group(P ＜0. 05). On the 21st day after injection of fibroblasts, the morbidity of retinal detachment was 80%, 30%, 10% and 80% in normal saline group, free matrine group, MAT-PLA-MS group and blank-PLA-MS group respectively, showing a significant difference among different groups. On the 28th day, the incidence rate of retinal detachment was 90%, 50%, 15% and 90% respectively, presenting statistical difference among various groups (P ＜ 0. 05) as well as between free matrine group and MAT-PLA-MS group (P＜0. 05). On the 35th day, considerably difference also was seen in the morbidity of retinal detachment among various groups (90%, 60%, 15% and 90% respectively) (P＜0.05). Conclusion Implantation of MAT-PLA-M S into vitreous cavity can effectively inhibit the development of PVR induced by fibroblasts in rabbit model.

Lots of blinding diseases are caused by retinal ganglion cells apoptosis, but there is no the effective and ideal therapy in clinic currently. Recent study showed that stem cells can be an alternative renewable source of retinal ganglion cells, and they may be potential to repair the visual function. These results provide a new model of optic nerve regeneration for the treatment of these blinding diseases. But, some problems in clinical applications are waiting for further solving. Applications of stem cells in optic nerve regeneration is reviewed in this paper.

Immunology is a kind of important basic subject for medical education, involving theories and technologies covering many aspects of disease occurrence, diagnosis, prevention and treatment, and is also the source of new means of medical treatment in the future. Therefore, successful teaching of medical immunology is associated with high-level medical undergraduate education. An appropriate textbook is critical for curriculum construction of immunology. However, little analysis of immunology textbooks has been published. We selected several famous and popular English immunology textbooks and compared their teaching objectives, methods, and contents, concluding the features and targeting readers of each textbooks. Our research results could provide some advices for students to learn immunology theory and researchers to utilize immunology methods, and also give a glimpse of the development trend and direction of immunology.

Acetyl-CoA C-acetyltransferase (AACT) is the first enzyme in the terpene synthesis pathway, catalyzed two units of acetyl-CoA to acetoacetyl-CoA. In order to study the tanshinone biosynthesis in Salvia miltiorrhiza, a novel AACT gene, SmAACT, was cloned using cDNA microarray and RACE strategy. The full length cDNA of SmAACT is 1 623 bp (accession No. EF635969), which contained a 1 200 bp open reading frame (ORF) encoding a 399 amino acid protein. Nine introns were found in the genomic sequence. SmAACT was upregulated by YE and Ag+ elicitors both with cDNA microarray and quantitative RT-PCR analyses along with the accumulation of tanshinones. Sequence homology comparison and phylogenetic analysis all suggested that SmAACT belonged to the class of acetyl-CoA C-acetyltransferase. The transcription level of SmAACT was relatively higher in root than that in stem and leaf tissues. SNP analysis revealed that SmAACT was highly variable in the region of 6 to 9 introns with 33 SNPs in the 600 bp region, there are 5 SNPs in the cDNA region while they are all synonymous cSNPs. Some special genotypes were found in Salvia miltiorrhiza from different areas. SmAACT will be an useful gene for further analyze the mechanism of gene regulation among the tanshinones biosynthesis.

Objective To demonstrate the validity of volumetric QCT and dual energy X-ray absorptiometry( DXA )in bone mineral density (BMD) measurement and compare the difference in discriminating osteoporotic postmenopansal women with and without vertebral fracture. Methods One hundred and eighteen postmenopausal women [ mean age (62. 1 ± 7.0) years ] who received thoracolumbar radiographic examination were enrolled and divided into four groups (normal, osteopenia, osteoporotic and osteoporotic fractured group) also based on their BMD value of lumbar vertebra(AP-SPINE) measured by DXA: >x- 1s,x- 1s-x-2s, 0. 05 ]. In osteoporotic groups, AP-SPINE was not correlated significantly with other variables except 3D-CORT ( R2 = 0. 189, P < 0. 01 ) ; parameters of App60,80,100,120 BV/TV% were correlated significantly with 3 D-TRAB (R2 = 0. 955, 0. 951,0. 941,0. 912, P < 0. 01, respectively) and 2 D-TRAB(R2 = 0.912, 0.910, 0.878, 0.821, P < 0.01, respectively). The precision of 3D-BMD measurement was between 0. 70%--2. 25%. Conclusions Parameters derived from 3D-vQCT technique can discriminate osteoporotic postmenopausal women with fractured vertebrae from those without fractured vertebrae, and have better the capability than DXA. Among them, 3D-INTGL was the best parameter for diagnosing serious osteoporosis. App BV/TV% could be used to reflect the lost of trabecular bone precisely and to clinically predict fracture risk.

Objective To investigate the effect of different doses of protamine neutralizing heparin on perioperation of on-pump coronary artery bypass graftting (CABG).Methods A total of 180 on-pump CABG patients hospitalized from January 2015 to November 2016 were randomly divided into three groups,the protamine group l,protamine group 2 and protamine group 3,60 patients in each group.Heparin (3 mg/kg) was used before extracorporeal circulation.After intracardiac operation was over,protamine was used to neutralize the heparin to adjust the activated clotting time (ACT) in protamine group 1,which was 10％ higher than that of intubation.Meanwhile,protamine group 2 was neutralized to equal to the ACT before intubation,and protamine group 3 was 10％ lower than that before the intubation.The differences of intraoperative and postoperative parameters were compared between the three groups.Results No death was found in the three groups during hospitalization.Comparing with protamine group 1 and protamine group 2,the time of operation,the ACT before the leaving operation room,the ACT of the first hour after returning to ICU,the amount of bleeding during operation,the time of closing and the amount of red blood for transfusion were decreased in protamine group 3 (P ＞ 0.05).The total amount of protamine for neutralizing and the ratio of protamine and heparin were significantly increased in protamine group 3 (P ＜ 0.05).The heart dysfunction after operation,perioperative myocardial infarction,pulmonary edema,pulmonary infection,renal dysfunction,poor wound healing,neurological complications,and time of in hospital stay showed no significant differences between three groups (P＞0.05).Conclusion ACT below 10％ of preoperation is safe,after neutralization of heparin by protamine,which can obviously reduce the bleeding,the time of sternal closure and the amount of red blood cell transfusion,showing a positive clinical significance.