Abstract?AlM: To evaluate the efficacy of intravitreal injection with Ranibizumab combined with sub-Tenon injection with Triamcinolone acetonide ( TA ) for macular edema ( ME) due to central retinal venous occlusions ( CRVO) .?METHODS:Forty-six patients (46 eyes) were diagnosed ischemic CRVO with significant macular edema by fundus fluorescence-angiography ( FFA ) and optical coherence tomography ( OCT ) . All the patients had panretinal photocoagulation ( PRP ) , a week after the four times therapies. Twenty-three patients ( 23 eyes ) in group A were randomly chosen to receive intravitreal injection with ranibizumab ( lVR ) , another 23 patients ( 23 eyes ) in group B to treat with both lVR and sub-Tenon injection with TA ( PSTT ) . There was no significant difference on macular edema and best corrected visual activity ( BCVA) between the two groups. The changes in BCVA and central macular thickness ( CMT) before and 1wk; 1, 3, 6mo after treatments were analyzed.?RESULTS: One week after the treatment: the BCVA increased while the CMT decreased compared with that of pretreatment in groups A and B (P<0. 05). BCVA and CMT changes between two groups were statistically significant differences (P<0. 05). One month and three months after the treatment:the BCVA increased while the CMT decreased compared with that of pretreatment in group A and B (P<0. 05), the difference was significant between two groups ( P< 0. 05 ). Six month after the treatment:the BCVA increased while the CMT decreased compared with that of pretreatment in groups A and B. Compare BCVA difference between the groups was statistically significant change (P<0. 05), CMT difference was not statistically significant (P>0. 05).?CONCLUSlON:Not only lVR can decrease ME caused by CRVO and increase the BCVA, but also lVR combined with PSTT can. But combined therapies can be more rapidly and have more positive effect on decreasing the ME and protecting the visual function.

OBJECTIVETo observe the effect of Modified Yiqi Chutan Recipe (MYCR) on blood flow perfusion in treating mid-late stage non-small cell lung cancer (NSCLC) patients by using multislice CT perfusion (CTP) , and to assess the relationship between each CTP parameter and the prognosis as well.

METHODSTotally 87 mid-late stage NSCLC patients were randomly assigned to the treatment group (44 cases, Shenyi Capsule + MYCR +chemotherapy) and the control group (43 cases, chemotherapy alone) in the ratio of 1:1. And 21 days consisted of 1 therapeutic course, 4 courses in total. All of them underwent CTP of primary tumor and routine thoracic CT examination (plain CT and enhancement CT) 3 times (before therapy, after 2 and 4 cycles). CT findings were analyzed for tumor size and perfusion parameters [blood flow (BF), blood volume (BV), permeability surface (PS), mean transit time (MTT), and time to peak (TP) before and after treatment, and relationship between perfusion parameters and prognosis was also assessed.

RESULTSIn 87 cases, 7 dropped out and 80 cases were available, 40 in the treatment group and 40 in the control group. (1) The relief rate was 47.5% (19/40) and the total stable rate was 77.5% (31/40) in the treatment group, and they were 40.0% (16/40) and 65.0% (26/40) in the control group, with no statistical difference between the two groups (χ² = 0.672, 1.227; P > 0.05). (2) Compared with before treatment group in the same group, BF and PS decreased, and MTT increased in the two groups after 2 and 4 courses (P < 0.05); BE and PS decreased, and MTT increased in the control group after 2 courses (P < 0.05). Compared with the control group after 4 courses, BE decreased more significantly in the treatment group (P < 0.05). (3) After 4 courses, all patients were assigned to the remission group (35 cases) and the non-remission group (45 cases) according to the RECIST standard. Compared with before treatment in the same group, BF, BF, and PS all decreased, and MTT increased in the remission group after treatment (all P < 0.05); BF increased in the non-remission group after treatment (P < 0.05). (4) All patients were assigned to the BE increase group (34 cases) and the BE decrease group (46 cases) according to changed BE values after treatment. Results showed the mean survival rate was 246 days in the BF increase group (the 1-year accumulative survival rate being 13.0%) and 387 days in the BE decrease group (the 1-year accumulative survival rate being 53.1%). The life span was prolonged and the 1-year accumulative survival rate was elevated in the BE increase group, with statistical difference as compared with the BE decrease group (χ² = 19.057, P < 0.01).

CONCLUSIONSShenyi Capsule plus MYCR could reduce BE in mid-late stage NSCLC patients , improve vascular permeability, showing better synergistic effect with chemotherapy. CTP could not only reflect the change of tumor size, but also reflect vascular function of the tumor. Meanwhile, changes of CTP parameters were closely associated with prognosis. Patients with post-treatment decreased BE value had better prognosis and longer life span.

Capillary Permeability ; drug effects ; Carcinoma, Non-Small-Cell Lung ; diagnosis ; drug therapy ; Drugs, Chinese Herbal ; therapeutic use ; Humans ; Phytotherapy ; Tomography, X-Ray Computed

The aim of this study was to detect the localization and level of tyrosine phosphorylated proteins during in vitro capacitation of guinea pig sperm. Sperm from mature guinea pigs were incubated in modified TALP under 5% CO_2 in air at 37 ℃. The capacitation effect was assessed by chlortetracycline (CTC) staining. Western blotting and indirect immunofluorescence were used to analyze the level and localization of tyrosine phosphorylation. The results showed that guinea pig sperm underwent a time-dependent increase in protein tyrosine phosphorylation during the in vitro capacitation and the percentage of protein tyrosine phosphorylated sperm increased from 36% to 92% from the beginning of incubation to 7h incubation. Also, there was a shift in the site of phosphotyrosine-specific fluorescence from the head of sperm to both the head and the flagellum of sperm. Moreover, there were three proteins phosphorylated in this experiment. After 0 to 0.5h incubation, the protein of 40kDa was detected by anti-phosphotyrosine monoclonal antibody, and the intensity of this protein increased in the following incubation. Then, after 1h incubation, another protein of 80kDa was found and the level of this protein reached the highest point at 3h. Also, in 3h incubation, a protein of 45kDa was detected and the intensity of this protein increased in the following incubation.

Objective:Since malignant fibrous histiocytoma (MFH) may be taken as an undifferentia-ted pleomorphic sarcoma (UPS), this study was conducted to reassess 33 previously diagnosed MFH cases in the past 10 years based on the latest WHO concept. And then to search for the clinicopathological features, probably tumorigenesis, and the line of differentiation of the remaining MFH/UPS cases.Methods: Thirty-three cases in tissue microarray were studied by immunohistochemistry with panels of neurogenic, myogenic, and lipogenic antibodies. Three expertise pathologists reevaluated the slides separately. Results: Among the 33 cases, 17 cases (51.5%) of MFH had their diagnoses changed, including 5 leiomyosarcomas, 3 malignant peripheral nerve sheath tumors, 1 fibrosarcoma, 1 inflammatory myofibrosarcoma, 1 giant cell tumor and 1 angiomatoid fibrous histiocytoma. The remaining 16 cases (48.5%) were finally diagnosed as MFH/UPS, among which patients were mainly old adults (median age: 63 years; range: 38 to 76 years). The median tumor size was 6.0 cm (range: 3.0 to 14.0 cm), 8 cases (50%) located in lower limb and 5 cases (31.3%) located in thigh. These tumors had marked cytological and nuclear pleomorphism. Immunohistochemistry showed that Vimentin was strongly positive in all 16 MFH/UPS (100%), Muscle-specific actin was variously positive in 8 cases (50%) and 1 case focally expressed Desmin. Eleven cases (68.8%) variously expressed CD68 (KP1) and 7 cases (43.8%) expressed CD68 (PG-M1), which were much higher than leiomyosarcoma, malignant peripheral nerve sheath tumor and liposarcoma with significant difference. Moreover, Ki67 expression rates were from 10% to 100%, including 14 cases more than 50% and 11 cases more than 70%. However, only 2 cases (12.5%) showed P53 positive. Conclusion: MFH/UPS often show marked histological pleomorphism, and the diagnosis must be made by exclusion of other definitive sarcomas, especially myogenic and neurogenic sarcoma. Only Vimentin was always expressed in MFH/UPS, while some of the tumors were positive for myogenic antigen and CD68. It was suggested that MFH/UPS might arise from primary mesenchymal cells, and some cases exhibited fibroblastic and/or myofibroblastic features. In addition, histiocytic phenotypic marker did have more expression in MFH/UPS than in other sarcomas. MFH/UPS still had certain clinicopathological characteristics.

Objective:To explore the clinicopathologic features and diagnostic criteria of hepatosplenic T-cell lymphoma (HSTCL). Methods: Three cases of HSTCL were seached for morphology, immunophenotypings, Epstein-Barr virus (EBV) in situ hybridization and T-cell receptor? (TCR?) gene rearrangement. Results: In the bone marrow, the infiltrative pattern of tumour cells was interstitial and sinusoidal infiltration in one case,while the other two cases showed diffuse infiltration. In the liver of one case and the spleen of another case, tumour cells respectively showed sinusoidal infiltration. The immunophenotyping: three cases showed strongly positive for CD3 and TIA-1, but negative for Granzyme B, CD56 and TCR?. EBV in situ hybridization was not detected in all the cases. TCR? monoclonal rearrangements were detected in two cases. Conclusion: HSTCL is a rare entity which is classified into peripheral T cell lymphomas. And it is regarded as a subset of unactived cytotoxic T-cell lymphomas. The negative results of EBV in situ hybridization and the presentation of TCR? gene monoclonal rearrangements may be helpful in diagnosis and differential diagnosis of HSTCL. These three cases showed similar characters to those of international cases reported.

Objective:To evaluate angioimmunoblastic T-cell lymphoma(AITL) completely, we gave in-depth investigation of histopathological features, specific immunochemical markers, antigen receptor gene rearrangements and in situ hybridization for Epstein-Barr virus (EBV). Methods: 15 cases of typical AITL displayed effacement of the normal lymph node architecture partially or completely, abundance of arborizing high endothelial vessels, infiltration of polymorphic cells and hyperplastic atypical T lymphocytes with or without clear cytoplasm. Clinical characteristics, histological manifestations, and immunohistochemical staining for CD3, CD20, CD4,CD21, CXCL13, CD10, and BCL6 were analyzed. Polymerase chain reaction for immunoglobulin heavy chain (IgH) and T cell receptor ? (TCR?) rearrangements and in situ hybridization for Epstein-Barr virus encoded RNA (EBER-1) were performed.Results: Histologically, we found eight cases with regressed lymphoid follicles, six with absence of follicles and one with hyperplastic follicles with interfollicular lesions. We also found eight cases displaying aggregation of clear cells, four infiltration of large lymphoid cells, five abundant epithelioid histiocytes. CD20 staining showed hyperplasia of large B cells in four cases. CD21 expression exihibited extrafollicular expansion of follicular dendritic cell meshworks in 11 cases (73.3%), partially with a tendency of perivascular distribution. Positive rate for CXCL13 and CD10 are 73.3% and 6.7% respectively. Monoclonal rearrangements of TCR? were detected in 6/15 (40%) of cases, IgH rearrangements in 7/15 (46.7%), of which five were monoclonal, while two oligoclonal. 8 out of 15 cases (53.3%) contained EBV-positive cells. Among the four cases with large B cell proliferation, three were EBV-positive. Conclusion: AITL display great complexity and diversity clinicopathologically. Only when we recognize such diversity, can we reasonably apply and properly evaluate immunochemical markers and molecular techniques, and thus give a correct diagnosis.

Objective:To isolate endophytic fungi from Panax ginseng and study their antifungal and antitumor activities.Methods:Endophytic fungi were isolated from 5-year-old garden ginseng and 15-year-old transplanted ginseng.The antifungal active endophytes were screened with Pyricularia oryzae P-2b model using mircodilution method,and the activities of endophytes against pathogenic fungi were tested in vitro.The antitumor activities of the endophytes were examined by MTT method in vitro.Results:Sixteen(33.3%)of the 48 endophytic fungi fully suppressed the activity of P.oryzae P-2b;11(22.9%)colonies showed satisfactory antifungal activities against Candida albicans,Cryptococcus neoformans,Trichophyton rubrum,and Aspergillus fumigatus;and 5(10.4%)colonies showed satisfactory antitumor activities against tumor cell lines MKN45,LOVO,HepG2,and HL-60.Among the bioactive colonies,Yuan-25 showed best antifungal activity,with its MIC80 aganinst Trichophyton rubrum being 4 mg/L,which was similar to that of fluconazole.Yuan-27 showed the best antitumor activity,with its IC50 similar to that of doxorubicin.Conclusion:Isolated endophytic fungi of Panax ginseng has antifungal and antitumor activities and is worth further exploring.

Objective To clinically observe obstructive sleep apnea syndrome(OSAS) before and after cerebrovascular disease attacking and find prevention ways.Methods Seventy cases of berebrovascular patients were observed the OSAS status and the clinic data were collected in the mean time.Results We found 70% patients with snore and suffocation,89% with day drowse before attacking.After attacking,82% in-patient cases appeared different degree lower ventilation or apnea during 1～7d sleeping,which the average paroxysm frequency were 79 times per night and the average time were 72s per paroxysm.The therapeutic effects were good through different measures.Conclusion The active measures should be taken on OSAS after cerebrovascular disease attacking,which has a high frequency of OSAS.

From 95% alcohol extract of Ascidian Styela clava, collected from the shallow bay near Qingdao City, Shandong Province, six compounds, named, isovaleramide (1), thymine (2), thymidine (3), uracil (4), 2'-deoxyuridine (5) and ?-palmityl glycerin ether (6) were isolated,. Their structures were elucidated by various spectral analysis (IR, MS, ~1HNMR, ~(13)CNMR) and comparison of chemical and physical data with authentic samples reported in literatures. All of these compounds are first reported to be isolated from Ascidian Styela clava.

Objective To explore the treatment of thromboangitis obliterans (TAO) of lower extremities.Methods From March 1994 to February 2009,24 cases (26 limbs) affected by chronic ischemia were diagnosed as TAO by Doppler ultrasound and DSA,CTA or MRA.According to the different levels of the extensive and diffuse arterial occlusion,the revascularization was performed in the ways:19 cases (21 limbs) underwent venous arterialization,3 cases (3 limbs) underwent endovascular therapy,and 2 cases (2 limbs) underwent thrombectomy.ResultsAfter the venous arterialization,19 cases (21 limbs) were followed up for 1 to 14.5 years.Apart from the 5 limbs amputation (23.8%),the postoperative results of the most limbs were satisfactory (61.9%).The ABI before therapy (0.38?0.11) was significantly lower than that 6 months after therapy (0.79?0.08),P