Diabetic macular edema (DME) is a leading cause of vision loss in diabetic patients.It is very important to correctly select a treating approach for DME.At present,the treating methods of DME include retinal laser photocoagulation,application of the glucocorticoid,intravitreous injection of anti-vascular endothelial growth factor (VEGF) drugs,administration of inhibitor of protein kinase C,vitrectomy and combined treatment etc.However,each method has its advantage and disadvantage.Retinal photocoagulation,vitrectomy,intravitreous injection and drug delivery system implantation are invasive treatment methods,and they can not rescue damaged retinal photoreceptors.Therefore,it is recommended that DME should be early diagnosed and effective treatment.The research status at home and abroad and future development trends of DME treatment were summarized.

Congenital adrenal hyperplasia (CAH) owing to steroid 21-hydroxylase deficiency (21-OHD) was a relatively frequent of autosomal recessive disorders characterized by the inactivation of the steroid-synthesizing enzyme in the adrenocortex.Corticosteroids (glucocorticoids and mineralocorticoid) replacement therapy was the primary treatment of 21-OHD.The main objective of 21-OHD treatment in children was to maintain normal growth.Inadequate or excessive treatment was commonly observed.A number of studies reported that 21-OHD adult were at increasing risk of developing metabolic syndrome and cardiovascular events.However,there was few researches on 21-OHD children with metabolic disorders,and no domestic reports.The article summarized recent clinical research progresses in research on the alterations of lipid and carbohydrate metabolism in children with classic 21-OHD.

Objective To analyze the effect of erythropoietin therapy with oral iron supplementation on red blood cell distribution width (RDW)in chronic heart failure patients with anemia.Methods 148 patients of chronic heart failure with anemia from September 2014 to March 2015 in our hospital were included and randomly divided into two groups with the random number table,with 74 cases in each group.The control group were treated with convention-al anti heart failure therapy,the treatment group were treated with erythropoietin and oral iron supplementation on the basis of routine treatment for four weeks.RDW was tested by automatic five classification blood analyzer.The correla-tion between RDW and other detection indexes was analyzed.Results The levels of RDW in the treatment group were significantly lower than those of the control group[(13.08 ±0.792)vs (14.32 ±0.864),t =-8.974,P <0.01].Before treatment,bivariate analysis in the treatment group showed that RDW had positive correlation with NT-proBNP and high -sensitivity C -relative protein (hs -CRP)(r =0.783,P <0.01;r =0.870,P <0.01),but negative correlation with serum creatinine (Cr)and hemoglobin (r =-0.338,P <0.01;r =-0.743,P <0.01).Af-ter treatment,bivariate correlations analysis in the treatment group showed that the difference of RDW was positive correlation with the difference of NT -proBNP,high -sensitivity C -relative protein (hs -CRP)(r =0.783,P <0.01;r =0.680,P <0.01),but negative correlation with the difference of hemoglobin(r =-0.459,P <0.01),and no correlation with the others (Cr,UA,LDL,TC,TG and LVEF).Conclusion On the basis of conventional anti heart failure treatment,erythropoietin therapy with oral iron supplementation against anemia could improve heart func-tion of CHF and decrease the levels of RDW.RDW may be served as one of observing indexes of the worsening and effect judgment in chronic heart failure patients with anemia.

Along with the rapid development of global medical technology, great progress has been made in clinical diagnosis and treatment of childhood cancer,hence childhood cancer survival rate is increasing markedly. The clinicians have become concerned about life quality of childhood cancer survivors. A number of studies reported that long-term childhood cancer survivors are at increased risk of developing metabolic syn-drome,especially after cranial irradiation,abdomal irradiation,or total body irradiation. Metabolic syndrome is a variety of metabolic abnormalities commonly clustered together in a condition of the same individual,which sig-nificantly increases risk of cardiovascular diseases. Though the etiology of the metabolic syndrome in cohorts of childhood cancer survivors has not been elucidated,the predisposing factors have been identified as the lack of hormones after cancer treatment,damage from medicine or radiation therapy,endothelial dysfunction and so on. Accordingly,early diagnosis of metabolic syndrome is of great importance with medical interventions,such as encouraging cancer survivors to improve dietary habit and enhance exercise to achieve ideal weight,and to subse-quently decrease the risk of metabolic syndrome and cardiovascular events.

Aim To investigate the protective effects and mechanisms of a 5-lipoxygenase (5-LO) inhibitor zileuton on the acute lung injury (ALI) induced by focal cerebral ischemia-reperfusion injury (CIRI) in rats.Methods The right middle cerebral artery in rats were occluded by inserting a thread through internal carotid artery for 2 h,and then reperfused for 24 h.Zileuton(10,50 mg?kg-1) was orally administered 2h before ischemia and 0,5,10 h after reperfusion.Morphological changes of the lung tissue were observed by hematoxylin-eosin (HE)staining technique. Lung wet/dry weight ratios were detected to observe the water content of the lung. The mRNA of cysteinyl leukotrienes recepor1 (CysLTR1) was detected by RT-PCR. The content of Leukotriene B4 (LTB4) in serum was measured by enzyme linked immunosorbent assay (ELISA) technique. The expression of TNF-? protein was measured by immunohistochemical technique. The activities of MPO, T-AOC, and Na+,K+-ATPase from the lung tissue were measured by biochemical method.Results With the use of zileuton 10, 50 mg?kg-1,the pathological changes of the lung were alleviated. and the wet/dry weight in the lung tissue was reduced(P

Objectives: To study the reliability and sensitivity of serum transferrin receptor(sTfR) and sTfR/SF in assessing iron status,and explore the efficacy for monitoring early iron deficiency. Methods:941 women at reproductive age from Hebei Province and Shunyi county were included in the study. We determined the serum ferritin (SF)、zinc protoporphyrin (ZPP) and hemoglobin (Hb), and divided them into four groups: iron normal, IDS (iron deficiency store),IDE (iron deficiency erythropoiesis),IDA (iron deficiency anemia), according to the current criteria for assessing iron status. We randomly selected 189 aliquotes of serum from four groups to determine their sTfR and calculated the ratio of sTfR/SF, ie, sTfR/LogSF、Log (sTfR/SF). Results: sTfR increased significantly according to ID status of different stages,but sTfR/SF greatly increased in all stages. sTfR correlated with the conventional iron status parameters significantly, and could reflect the different aspects of iron status. The efficacy of Log (sTfR/SF) in identifying iron store deficiency reached 99%,higher than sTfR/LogSF and sTfR. sTfR can effectively identify functional iron deficiency,with the efficacy of 83%. Conclusion: sTfR and sTfR/SF all are promising for assessing iron status and screening iron deficiency in women at reproductive age.

Objective To explore the clinical features,maternal and fetal outcome in preeclampsia complications.(Methods)Clinical data of 86 cases of preeclampsia complications in heart,liver,kidney and brain were analyzed retrospectively.All the patients were divided into two groups: early onset preeclampsia(EOPE) group,36 cases,onset gestational weeks

Vertebral artery stenosis (VAS) is often caused by atherosclerosis.The clinical diagnosis is more difficult because the symptoms are not typical,and the non-invasive examination is not easy to be detected.The annual stroke incidence is higher in patients with VAS,particularly the symptomatic severe vertebral artery stenosis.About 20％ of posterior circulation strokes are caused by VAS.This article reviews the epidemiology,natural history,diagnosis and clinical treatment of VAS.

Background Congenital cataract is the major cause of blindness in children with plentiful clinical manifestations and closely linked with genetics. Objective Present study was to investigate the classification of congenital cataract in Yunnan province.Methods The manifestation characteristics of 184 eyes of 116 patients with congenital cataract in Yunnan province were analyzed.The relationship of performance of various types of congenital cataract between phenotype and hereditary feature were explored. Results All of the 116 congenital cataract eyes from 116 patients were divided into ten types based on the clinical appearance,including the complete cataract,nuclear cataract,posterior polar cataract,anterior polar cataract,coralliform cataract,coronary cataract,pulverulent cataracts,lamellar cataract and blue cataract.Bilateral nuclear cataract and unilateral entire cataract is most prevalent in these patients.Blue cataract and coralliform cataract belong to the less types.Forty-four in 116 cases were found to have the hereditary history and determined as autosomal dominant inheritance.Sporadic cases were determined in 72 cases.Conclusions The analysis of phenotype of the hereditary congenital cataract offers some clues to the classification of congenital cataract.