·Uveitis is an inflammation of any or all parts of the uveal tract including the iris, ciliary body and the choroid. Despite current advances in diagnosis and management, visual loss occurs in 35%-45% of patients with uveitis. The etiopathogenesis of uveitis remains unknown; it may be associated with environmental and immunogenetic factors. Many studies have demonstrated polymorphisms in major histocompatibility complex (MHC) genes may determine involvement in uveitis. Recently polymor-phisms in non-MHC genes, including cytokine and che-mokine genes, have been reported to play important roles in the pathogenesis of uveitis. This article reviewed the advances in the studies on cytokine and chemokine gene polymorphisms associated with uveitis.

Cyclodextrin(CD) is gradually applied in the nonviral gene vector system,due to its biocompatibility and flexibility of tailing via structural modification,polymerization or supramolecular combination.The ideas and research progress of the CD,its low molecular derivatives,CD polymers and CD supramolecular combination in the field of norviral gene vectros were reviewed,and their "structure-safety-transfection efficiency" relationships were discussed.

Background The dosage of verteporfin photodynamic therapy (PDT) for central exudative chorioretinopathy(CEC) depends on the calculation formula of Treatment of Age-related Macular Degeneration with Photodynamic Therapy Study Group(TAP)and Verteporfin in Photodynamic Therapy Study Group(VIP).Some local adverse responses or normal tissue damage have been noted under the standard dose of verteporfin during the treatment of CEC.So it is necessary to explore an appropriate therapeutic dosage of verteporfin.Objective This clinical study aimed to observe and compare the clinical efficacy and safety of different doses of verteporfin PDT for CEC.Methods Ninety eyes of 90 patients with CEC were enrolled in this study with the approval of the Ethic Commission of Affiliated Second Hospital of Nanchang University.Written informed consent was obtained before PDT.The patients were randomly divided into standard dose group,half dose group and 1/3 dose group.All of the patients received PDT.Standard dose(6 mg/m2),3 mg/m2 or 2 mg/m2 of verteporfin was applied in the three groups respectively,with the laser intensity 50 J/cm2.The patients were followed-up for 3 months.Repeat treating regimen was performed in the same way in the patient with fundus fluorescein leakage after initial PDT.Results The BCVA(logMAR) value was 0.44±0.36 after PDT in the standard dose group.Visual acuity improved in 20 patients (66.67％),stabilized in 8 patients(26.67％)and decreased in 2 patients (6.67％).The BCVA showed a significant difference between the preoperative and postoperative BCVA (t =6.719,P =0.000).CNV disappeared in 19 patients (63.33％),obviously improved in 7 patients (23.33％),partially disappeared in 3 patients (10.00％) and unchanged in 1 patient (3.33％).The central fovea thickness (CFT)value was significantly declined in postoperation compared with preoperation (t =5.758,P =0.000).Eight patients received secondary PDT with the recurrence rate 26.67％.In the half dose group,visual acuity improved in 18 patients(60.00％),stabilized in 11 patients(36.67％)and decreased in 1 patient (3.33％).CNV disappeared in 16 patients (53.33％),obviously improved in 8 patients (26.67％),partially disappeared in 5 patients (16.67％) and unchanged in 1 patient (3.33 ％).Significant difference was seen between the preoperative BCVA and postoperative BCVA(t=8.294,P =0.000).The decrease of C FT was significant in postoperation(t =8.493,P =0.000).Ten patients received secondary treatment with the recurrence rate 33.33％.In 1/3 dose group,visual acuity improved in 8 patients (26.67 ％),stabilized in 12 patients (40.00％),decreased in 10 patient (33.3％).CNV disappeared in 8 patients (26.67％),obviously improved in 8 patients (26.67％),partially disappeared in 6 patients (20.00％) and unchanged in 8 patient (26.67％).There was no significant difference between the preoperative BCVA and postoperative BCVA (t =0.536,P =0.596).The difference between preoperative CFT and postoperative CFT was insignificant(t =0.942,P=0.354).Fourteen patients received secondary PDT and 8 patients received three times with the recurrence rate 73.33％.Conclusions 3 mg/m2 verteporfin PDT for CEC shows a similar clinical efficiency and safety to 6 mg/m2 verteporfin.3 mg/m2 verteporfin PDT can decrease cost,but the effect of 2 mg/m2verteporfin PDT is not satisfacted.

Adult ; Bronchoalveolar Lavage ; methods ; Humans ; Male ; Middle Aged ; Pneumoconiosis ; therapy ; Treatment Outcome

Objective To study the epidemiological characteristics of diabetes mellitus and to provide effective prevention and intervention methods in rural area in Kunming.Methods A cross-sectional study was conducted among 3 440 permanent residents aged 20～74 years in kunming rural districts.Results The general prevalence rate of diabetes was 4.01% and the standardized rate was 2.90%.The standardized prevalent rate for male(3.55%) was higher than that for female(2.61%),and the prevalence rates varied among different groups of rural inhabitants.Conclusion It is necessary to take effective methods to prevent and control diabetes in rural area.

Objective To study the effect of bromocriptine(BRC) on the activation of T lymphocyte stimulated by phytohemagglutinin(PHA).Methods After CD4+ T cell line Jurkat E6-1 cells were stimulated by PHA,prolactin(PRL) and BRC,respectively,the expression of linker for activation of T cells(LAT) and zeta-chain T cell receptor associated protein kinase 70 000(ZAP-70) mRNA of T lymphocytes were checked by RT-PCR.The expression of PRL mRNA of T lymphocytes was detected by Real time PCR.The expression of CD25(cluster of differentiation) as a marker of early activation on the surface of T lymphocytes was detected by flow cytometry,and the activation of nuclear factor-?B(NF-?B) was detected by luciferase reporter system.Results 1.BRC inhibited the expression of ZAP-70 as the common signal molecules both in the T lymphocyte activation pathway and PRL-prolactin-prolactin receptor(PRLR) signal transduction pathway,and decreased the expression of PRL mRNA produced by activation T lymphocytes.2.BRC enhanced the expression of LAT mRNA as another important signal molecular on the T lymphocytes and CD25 on the surface of the T lymphocytes.3.The activation of NF-?B of T lymphocytes was decreased.Conclusions BRC might inhibit the activation of T lymphocytes by inhibiting the expression of ZAP-70,the common signal molecules between T lymphocytes activation and PRL-PRL pathway,and PRL mRNA,the like-T lymphocyte growth factor.

Objective To compare adductor canal block(ACB)with topical anesthesia for postoperative analgesia in the patients undergoing arthroscopic knee surgery.Methods Sixty patients of both sexes,aged 18-64 yr,with body mass index of 18-30 kg/m2,of American Society of Anesthesiologists physical status ⅠorⅡ,scheduled for elective arthroscopic meniscectomy,were divided into 2 groups (n=30 each) using a random number table:ACB group and topical anesthesia group(TA group).In group ACB,0.2% ropivacaine 20 ml was injected into the adductor canal under the guidance of ultrasound at 30 min before operation to perform ACB.In group TA,0.25% ropivacaine 20 ml was injected into the articular cavity at 5 min before the end of operation.The development of effective analgesia (VAS scores ≤4)and weakened quadriceps femoris muscle strength(muscle strength 0-2 grade,post-operative muscle strength was assessed by using manual muscle testing),related complications(local anesthetic intoxication,bleeding at the puncture site and hematoma) and occurrence of postoperative nausea,vomiting and delayed emergence were recorded.Results Compared with group TA,the rate of effective analgesia within 12 h after surgery was significantly increased (P<0.01),and no significant change was found in the incidence of weakened quadriceps femoris muscle strength,nausea and vomiting in group ACB(P>0.05).Local anesthetic intoxication,bleeding at the puncture site,hematoma or delayed emergence was not observed in the two groups.Conclusion ACB produces better efficacy for postoperative analgesia than topical anesthesia in the patients undergoing arthroscopic knee surgery.

ObjectiveTo campare the quality of life of schizophrenics treated with aripiprazole or clozapine.Methods90 cases with schizophrenia were randomly divided into aripiprazole group and clozapine group.After 6 mouths of treatment,all subjects were assessed with Positive and Negative Syndrome Scale(PANSS),WHO QOL-100 and Treatment Emergent Symptoms Scale(TESS).ResultsAripiprazole could significantly improve all aspects of quality of life except domination,and had a better result in physical,psychological,level of independence,solial relations,environment domain than clozapine did.Clozapine could only improve psyclological domain.There was no significant difference between the score of PANSS in two groups.However,aripiprazole had a better result in negative symptoms.ConclusionSchizophrenic outpatients treated with aripiprazole have a better quality of life than those with clozapine.

Objective To explore the application value of the lower leg perforator flaps in repairing soft tissue defect on ankle.Methods From January 2007 to December 2012,62 cases of soft tissue defect on ankles have been repaired.The defects were combined with tendon and/or bone exposure for all the cases,among them 7 cases were exposure or sinus tract after achilles tendon rupture surgery,8 cases with ankle or intertarsal joint defect and exposure,24 cases with distal tibia fracture,or medial malleolus fracture,or lateral malleolus fracture,or calcaneus fracture,11 cases with different level of infection.Fifteen cases were primarily repair,and 47 cases were secondly repair or extended phase.The cases were repaired by applying different types retrograde transferred perforator pedicle flaps of lower legs,with 10 cases of posterior tibial artery perforator flaps on the medial malleolus,12 cases of front top flaps of com peroneal artery on external ankle,40 cases of back top flaps of peroneal artery on external ankle.The sizes of the flap ranged from 4.0 cm ×5.5 cm to 9.0 cm × 15.0 cm.Ten cases were applied direct suturing in donor site,and other cases were applied skin grafts to repair the defect.Results Flaps in 56 cases completely survived.Partial necrosis appeared in 3 cases of front top flaps of peroneal artery on external ankle,one perforator flap of posterior tibial artery on the medial malleolus and 2 cases of back top flaps of peroneal artery on external ankle.All these cases recovered after careful dressing changes.Sixty two cases were followed up for 3-12 months.Texture of flaps was soft with good elasticity.All of the donor skin grafts in patients survived.Conclusion Perforator flaps have the advantage of easy operation,little damage to the main blood vessels,high reliability in flap survival,less destroy to donor site.It is important that individualized flap is selected given different position of defect.

OBJECTIVETo describe the pathologic features and diagnostic algorithm of pulmonary alveolar proteinosis (PAP).

METHODSThirty-nine biopsy and postmortem cases of PAP were studied by light microscopy and histochemical staining using periodic acid-Schiff (with digestion) (PAS-D), mucicarmine (with digestion) (mucicarmine-D) and alcian blue.

RESULTSHistologically, the affected lung tissue displayed the following characteristic features: (1) alveoli and some of the small bronchioles were filled with eosinophilic and fine granular proteinaceous material with needle-like clefts; (2) proteinaceous material was seen admixed with various numbers of degenerated and sometimes exfoliated pneumocytes; (3) pneumocytes were hyperplastic; (4) alveolar capillaries and alveolar septa had become hyperemic, but pulmonary interstitial inflammation was not obvious; (5) no significant inflammation was identified in the bronchial wall; (6) compensating emphysema was noted in the surrounding lung parenchyma. Fragments of eosinophilic, finely granular proteinaceous material with needle-like clefts were also found in the bronchoalveolar lavage fluid under light microscopy. The proteinaceous material was stained red by PAS-D. The staining for mucicarmine-D was negative, while alcian blue staining was either weakly positive (faint blue staining) or negative. Pathologic examination of lung biopsies and bronchoalveolar lavage fluid thus remaines the gold standard for diagnosis of PAP.

CONCLUSIONSIdentification of homogeneous, eosinophilic, finely granular and PAS-D-positive proteinaceous material with needle-like clefts in alveolar spaces or bronchoalveolar lavage fluid is of diagnostic importance in PAP. Bronchoalveolar lavage, being a relatively safe and non-invasive procedure, can be a useful adjunct in arriving at the final conclusion.

Adult ; Bronchoalveolar Lavage ; Bronchoalveolar Lavage Fluid ; cytology ; Female ; Humans ; Lung ; pathology ; Male ; Middle Aged ; Periodic Acid-Schiff Reaction ; Pulmonary Alveolar Proteinosis ; pathology ; therapy ; Pulmonary Alveoli ; pathology