Objective To observe the efficacy of retinal inner limiting membrane peeling and intravitreal injection of triamcinolone acetonide for secondary epiretinal membrane.Methods Forty-two patients (42 eyes) with secondary epiretinal membrane underwent vitretinal surgery in our hospital from June 2011 to June 2015 were retrospectively studied.All patients underwent pars plana vitrectomy + epiretinal membrane peeling + retinal inner limiting membrane peeling and intravitreal injection of triamcinolone acetonide.The follow-up time was from 3.0 months to 18.0 months,averaged (8.3 ± 2.4) months.Postoperative best corrected visual acuity (BCVA),macular morphology and complications were observed.Resules At the final follow-up,BCVA improved in 30 eyes,unchanged in 8 eyes and decreased in 4 eyes,and there was significant difference compared with that before operation (t =3.145,P =0.000).The preoperative and postoperative thickness of meuroepithelium in the centual macular area were(315.62 ±132.12) μm and (233.42 ± 146.32) μm,and there was significant difference(t =4.322,P =0.000).Small amount of retinal hemorrhage happened in 6 eyes after operation,vitreous hemorrhage was in 1 eye,transient high intraocular pressure was in 6 eyes;Prepheral retinal hole occurred in 3 eyes,which were cured by laser treatment and C3F8 tamponade.Conclusion Intravitreal injection of triamcinolone acetonide can reduce the macular edema,decrease the reoccurrence of epiretinal membrane and imporve the visual acuity.The retinal inner limiting membrane peeling in secondary macular epiretinal membrane surgery can release the macular pucker,lifting and traction on the fovea,improve the metabolism of macular local,is conducive to the recovery of macular function.

Objective To investigate the implementation and application of rotational DSA dual volume technology in displaying the intracranial artery stent.Methods Firstly,the “stent opacity”single volume technology was used to display 5 types of stent which were released in 7 cases of pure intracranial artery stenting and 12 cases of stent-assisted aneurysm embolization.Then we applied “vessel translucent”and “vessel opacity”single volume technology to display corresponding vessel segments.Finally,by coalescing the single volume imaging of stent and vessel,the “vessel opacity + stent opacity”dual volume image and “vessel translucent+ stent opacity”dual volume image were performed.We compared the effects of two kinds of dual volume imaging and assessed the imaging characteristics and influencing factors of each method.Results (1)On the “stent opacity”single volume display mode,in 7 cases of pure intracranial artery stenting,the display effect of two Pipeline stents and three Apollo stents belongs to level 1,the display effect of two Enterprise stents belongs to level 2;In 12 cases of stent-assisted aneurysm embolization,in the stent segments which weren’t influenced by artifacts,the display effect of two LEVIS stents belongs to level 1,the display effects of 5 Enterprise stents and 2 Solitaire AB stents belongs to level 2;While in the stent segments which were influenced by the artifact of spring coil and bone,the display effect significantly reduced, three pieces of Enterprise stents were even unable to identify.(2)On the “vessel opacity”single volume display mode,1 9 cases of vessel segment at the stent completed opacity display.The surface structure of vessel was very clear,but the structure under the surface was completely being covered.On the “vessel translucent”single volume display mode,the surface structure of 19 cases of vessel segment at the stent displayed clear at the tangential position.The vessel lumen also presented transparent state.(3)On the “stent opacity+vessels opacity”double volume display mode,the start-stop location and the adherence of stents in blood vessels in 1 6 cases were displayed clearly. When using the “stent opacity+ vascular opacity”double volume imaging,except 3 cases which used ball expansion Apollo stents could display comprehensive relationship between the blood vessels,in the other 13 cases,the relationship between stent and vascular could not be fully displayed.Conclusion On the condition that the single volume display technology shows stent well,the “stent opaque+vessels translucent”double volume display technology can well present the stent condition in the vessels.

OBJECTIVE: To study the photostability of the levofloxacin hydrochloride injection. METHODS: The content of levofloxacin hydrochloride was determined and its UV spectra changes were observed after being lighted by three different light sources-the UV light, the sunlight and the natural light for different periods of time. Whether there is any decomposed product or not was determined by TLC. RESULTS: There were decompositions of levofloxacin hydrochloride injection subjected to illumination from three light resources, with that under the sunlight decomposed faster; Rf value under TLC of the decomposed product was found to be 0.72. CONCLUSION: Levofloxacin hydrochloride injection should be kept away from UV light, the sunlight and the natural light.

Objective To explore the anti-hepatic-fibrosis mechanism of Baogan Ning(BN).Methods Fifty Wistar rats were randomized into 5 groups: normal group,model group,high-and low-dosage BN groups(35.4 and 17.7 g/kg respectively),and colchicine group(0.11mg/kg).Rat models of hepatic fibrosis were induced by multiplex factors.Hepatic protein was extracted,and the expression of hepatic leptic receptors of OB-Rb,JAK2 and STAT3 was detected with Western Blot method.Results The protein expression was not obvious in the normal group,and the color of protein band in the medication groups was light but dark in the model group.Compared with the normal group,the expression of OB-Rb,JAK2 and STAT3 increased in the model group.However,the expression of OB-Rb,JAK2 and STAT3 decreased in the medication groups as compared with the model group.And the expression of OB-Rb,JAK2 and STAT3 decreased in the BN groups as compared with the colchicines group.Conclusion The anti-hepatic-fibrosis mechanism of Baogan Ning is probably related with the inhibition of OB-Rb expression,thus inhibit the JAK2/STAT3 message pathway.

Objective:To discuss the mechanism of Baoganning anti-liver fibrosis.Methods:liver fibrosis rat models were established by complex factors.Automatic biochemical analyzer was used to detect TC、TG and RIA isotope analysis was used to detect serum leptin.To observe the influence of Baoganning on TC、TG and leptin level of liver fibrosis model rats. Results:Compared with the normal group,levels of serum TC,TG decreased apparently in model and every drug groups(P0.05).Conclusion:Baoganning can effectively prevent and treat liver fibrosis in rats,which may be closely related to the improvement of liver function,adjustment of lipid and reduction of serum leptin.

Objective To analyze the impac factors of serum N?terminal pro?brain natriuretic peptide (NT?proBNP) in patients with renal failure in non?dialysis phase, and to determine the cut?off point of as a diagnostic values in these patients with heart failure (HF). Methods Cross?sectional study was applied. Clinical data of 145 patients (37 cases of CKD4, 89 cases of CKD5, and 19 cases of acute renal injury (AKI) with renal failure in non?dialysis phase were collected. Comparison between groups and lineal regression analysis were utilized to investigate the impact factors of NT?proBNP, and the receiver operating characteristic curve (ROC curve) to select a better cut?off point of diagnosis in these patients with HF. Results (1) Compared with patients without HF, patients with HF had significantly higher edema, cardiac troponin I, serum phosphorus concentration, and left atrial diameter (LA), while ALB and left ventricular ejection fraction (LVEF) were decreased (P<0.05). (2) The NT?proBNP was divided into 4 groups with four points: First groups of 36 cases, NT?proBNP 1 ?862 ng/L, second groups 37 cases, 866?2670 ng/L, third groups 37 cases, 2790?20 000 ng/L, fourth groups 35 cases, 20 900?35 000 ng/L. With the increase of NT?proBNP levels, the occurrence of AKI and CKD4 decreased gradually while the occurrence of CKD and edema were significantly increased (P<0.01). Systolic blood pressure, troponin I, uric acid, serum phosphorus, parathyroid hormone, 24 hours urine protein, LA, interventricular septum thickness (IVS), left ventricular posterior wall thickness (LVPW) level gradually increased. Hb, ALB, calcium, CO2, eGFR, LVEF significantly decreased (P<0.01). The serum NT?proBNP of patients with HF was significantly higher than that of patients without HF (19 150 ng/L vs 1530 ng/L, P<0.01). The serum NT?proBNP of patients with edema was significantly higher than that in patients without edema (5460 ng/L vs 1630 ng/L, P<0.01). (3) Single factor linear regression analysis indicated that higher NT?proBNP was positive correlated with HF, edema, cardiac troponin I, uric acid, serum phosphorus, LA, IVS and LVPW (P<0.05), while negative correlated with Hb, eGFR, ALB, serum calcium, CO2, LVEF (P<0.05), and not correlated with eGFR, uric acid, serum calcium (P>0.05). (4) The best cut?off point of NT?proBNP predicting HF in patients with renal failure in non?dialysis phase was 3805 ng/L, AUC=0.848, 95%CI 0.786?0.910. Sensitivity was 82.4%, specificity 74.5%, positive predictive value 62.1%, negative predictive value 87.3%, positive likelihood ratio 3.2, negative likelihood ratio 0.24. Conclusions The level of NT?proBNP>20 000 ng/L is mainly found in end?stage renal disease patients with HF. HF is a main factor for the increase of NT?proBNP in patients with renal failure in non?dialysis phase. High phosphorus viremia, anemia, and hypoalbuminemia are closely related to NT?proBNP. Therefore NT?proBNP predicting HF should take into account the effects of these confounding factors in these patients.

Objective To detect the M-type phospholipase A2 receptor (PLA2R),and thrombospondin type-1 domain-containing 7A (THSD7A) expression in renal tissue and the levels of their antibodies in adult idiopathic membranous nephropathy (IMN).Also to determine the value of the two markers in the diagnosis of IMN.Methods One hundred and sixteen patients with biopsyproven MN at the Second Hospital of Hebei Medical University from December 2014 to August 2015 were enrolled,including 86 patients with IMN,10 patients with HBV-MN and 10 patients with stage Ⅴ lupus nephritis (LN-Ⅴ).Twenty patients with minimal change disease (MCD) were regarded as control group.We conducted immunohistochemical analysis of the presence of THSD7A and PLA2R the Paraffin section and enzyme linked immunosorbent assay (ELISA) detecting serum PLA2R-AB and THSD7A-AB concentration to investigate whether there was a correlation between them and clinical indicators.Results Compared with the SMN and MCD groups,the positive rates of PLA2R and PLA2R-AB were significantly higher in IMN groups.Expression PLA2R was detected in 88.4％,47.4％,10％ and 0％ and PLA2R-AB in 82.6％,15％,10％,0％,respectively,of the patients with IMN,HBV-MN,LN-Ⅴ and MCD.Expression THSD7A was detected in 2.3％ of the patients with IMN while not detected in SMN and MCD.THSD7A-AB antibody was negative in all patients.Compared with serum PLA2R-Ab negative individuals,patients with serum PLA2R-Ab positive had lower serum albumin (P ＜ 0.001),higher urine protein excretion (P=0.01).The sensitivity of PLA2R-AB,PLA2R,THSD7A and PLA2R+THSD7A in the diagnosis of IMN were 82.6％,88.4％,2.3％,88.6％,and the specificity was 92％,66.7％,100％,66.7％,respectively.Conclusions PLA2R in renal tissue and serum PLA2R-AB are specific markers for the diagnosis of IMN,which are closely related with the severity of IMN.Expression of THSD7A is only positive in some of IMN patients with negative PLA2R,which can be used as a supplementary examination of IMN patients with negative PLA2R.

The present residents training for ultrasound departments depends mostly on poorlyscheduled rotation and clinical clerkship,with repeated and obsolete subjects in their training.The authors identified these setbacks and such characteristics as complication of ultrasound medicine,complex and variable ultrasonic scan technique,and the high threshold for beginners.In view of this,the authors adopted the tutorial system training mode for cultivating the residents in their medical care,teaching,research and foreign language competencies.A questionnaire survey of 44 residents so trained evaluated outcomes of the mode,with constructive suggestions raised on expansion of the training base,improvement of teachers’competency and reduction of trainees' workload.

Objective To study the regulation of microRNA 199a (miR-199a) on adhesion,migration and invasion ability of human eutopic endometrial stromal cells (ESC) from patients with endometriosis.Methods ESC were transfected with miR-199a mimics or negative control (NC) RNA by lipofectamine 2000.The adhesion,migration and invasion ability of ESC were detected by cell adhesion assay,scratch assay,cell migration assay and matrigel invasion assay,respectively.Luciferase reporter assay was used to evaluate whether IKKβ was the target gene of miR-199a.The expression of ikappa B kinase beta (IKKβ),inhibitory kappa B alpha (IκB-α),phospho-IκB-α (p-IκB-α) and nuclear factor-kappa B (NF κB) protein were measured by western blot.Results ( 1 ) Adhesion potential:the adhesion inhibitory rates were ( 14 ± 4 )％ in miR-199a group and 0 in control group,which showed significant difference (P＜0.01 ).(2) Migration and invasion:in the scratch assay,ESC transfected with miR-199a exhibited a lower scratch closure rate than that of controls.In migration and invasion assays,the migration and invasion ability of miR-199a group were significantly decreased compared with those of NC group [ 130 ± 31 vs.247±36 (P＜0.01); 63 ± 15 vs.133 ± 17 (P＜0.01),respectively].(3) The luciferase activity of miR-199a group was significantly lowered than that of control group [ 0.160 ± 0.006 vs.0.383 ± 0.083 ( P ＜0.01 ) ].The protein levels of IKKβ,p-IκB-α,IκB-α and NF-κB of 0.350 ±0.195,0.443 ±0.076,1.970 ±0.486 and 0.454 ± 0.147 in miR-199a group were significantly different compared with the NC group in which the protein levels were set at 1.000 ( P ＜ 0.01 ).Conclusions miR-199a can inhibit the adhesion,migration and invasion of the ESC.IKKβ is the target gene of miR-199a in ESC.One of the mechanisms of the inhibition effect is probably that miR-199a inhibits the activation of NF-κB signaling pathway by targeting IKKβ gene.

To investigate the effects of Losartan,an angiotensinⅡ(AngⅡ)receptor(AT_1) antagonist,on pancreatic stellate cells(PSCs)and its possible mechanisms.Methods (1)PSCs were isolated from pancreatic cancerous samples to test the expressions of AT_1 and collagenⅠafter incubated with AngⅡor/and Losartan.(2)Ninety S-D rats were divided into normal group,control group and treatment group,with 30 rats in each.The rats in control and treatment groups were induced pancreatic fibrosis by injection of 2% trinitrobenenze sulfonic acid(TNBS)into biliopancreatic duct.Rats in treat- ment group were then treated with Losartan by garage daily and rats in control group were only given distilled water.The rats were sacrificed on day 3,7,14,21 and 28,respectively,and pancreas were removed.The histological abnormalities were observed by electron microscope.The mRNAs of trans- forming growth factor?_1(TGF?_1)and procollagenⅠwere detected by reverse transcription-polymerase chain reaction(RT-PCR).The expression of TGF?_1 and?-smooth muscle actin(?-SMA)proteins was assessed by immunohistochemistry and the level of?-SMA protein was quantified by Western blot. Results In vitro,there existed AT_1 expression in PSCs,and Losartan reduced expression of collagenⅠ.Losartan treatment reversed the histological abnormalities observed by electron microscope,com- pared to treatment with distill water.The expression of?-SMA,TGF?_1 and procollagenⅠwere signifi- cantly higher in the control group than those in normal group and were reduced by Losartan to different extent in treatment group.Conclusion AT_1 antagonist can inhibit the activation and the profibrogenic action of PSCs by blocking AT_1 receptor-mediated pathways.