Diabetic retinopathy (DR) is the most serious and common blinding ocular complication in all microangiopathy of diabetes mellitus.The occurrence of DR associated with a variety of factom,the pathogenesis has not yet been completely clear,and there are several theories.In recent years,the relationship between the occurrence of DR and sex hormone levels become a hot ophthalmic research,research shows that the prevalence of DR significantly increased in postmenopausal women,in which estrogen change plays the main role.Learning connection between estrogen and DR will contribute to the clinical diagnosis and treatment of DR.This article reviews recent research advances in the relationship between estrogen and DR.

The discovery and application of cancer stem cell markers have very important significance on tumor treatment and prevention.DCLK1 is discovered only in the cancer stem cell marker but not nomal stem cells for the first time.Some studies have shown that DCLK1 expression was detectded in gastrointestinal cancer,esoph-ageal cancer,bile duct carcinoma and glioma.The expression of DCLK1 in tumor is closely related to tumor devel-opment,progression,and recurrenceand migration.Although DCLK1 remain to be known as cancer stem cell mark-er,it provides a new developing prospectives for tumor targeting specific treatment.

Objective To evaluate the significance to detect the Ryanodine receptor (RyR) antibody in the sera of myasthenia gravis (MG) patients.Methods Sarcoplasmic reticulum abound with RyR was extracted by centrifugation,and levels of antibodies in 66 MG patients with thymoma (MGT),98 non-thymoma MG (NTMG) patients,50 non-myasthenia gravis (NMG) patients and 123 normal persons were examined by ELISA-RyR method.Results RyR antibody positive rate of MGT was the highest among MGT,NTMG and NMG groups ( P 0.05).Ages,clinical scores and levels of acetycholine receptor antibodies of patients with RyR antibody positive sera were higher than those with RyR antibody negative sera ( P

Objective The aim of this study was to explore the association of tumor necrosis factor-α (TNF-α)promoter-308A/G polymorphism with rheumatoid arthritis(RA)susceptibility in East Asian population based on the meta-analysis. Methods We searched all the publications about the association between TNF-α promoter -308A/G polymorphism and RA in East Asian population from PubMed, Ebsco, Chinese Biomedical Literature Database(CBM), Chinese National Knowledge Infrastructure(CNKI), and Wanfang (Chinese). Meta-analysis was performed for genotypes AA versus GG, GA versus GG, AA versus GG+GA,GA+AA versus GG, and A allele versus G allele in a fixed/random effect model. Results A total of 4 studies (957 cases and 1196 controls)were included in the current meta-analysis(three Chinese and one Japanese studies). When all groups were pooled, significant association of A allele and decreased RA risk was found (OR=0.36, 95%CI=0.16～0.80, P=0.01). When analyses were limited to race homogeneous population,significant association of A allele and decreased RA risk was found in Chinese population(OR=0.40, 95%CI=0.16～1.01, P=0.05). Conclusion This meta-analysis demonstrates significant negative association between TNF-α promoter-308A/G polymorphism and RA in East Asian and Chinese population.

Objective: To find out the relationship between the use of different dosages of mannitol and the changes of cerebral blood flow in patients with stroke at the peak of edema formation. Methods: Twenty-eight patients with hemispheric stroke were treated with 20% mannitol solution for reduction of increased intracranial pressure, at the dosages of 125 ml or 250 ml. Transcranial Doppler was used to monitor the blood flow of the bilateral middle cerebral arteries before and after the treatment. The monitoring parameters included peak systolic velocity (Vs), end diastolic velocity (Vd), mean velocity (Vm), and pulsatility index (PI), and percentage rate (PR) of change in each parameter. At the same time, the blood pressure of brachial artery was monitored. Results: Vs, Vd, and Vm on the affected and unaffected sides were improved significantly in patients using 125 ml mannitol. The PI on the affected sides decreased markedly (P = 0.002, P = 0.028) from 45 min to 60 min; the PI on the unaffected sides did not decrease significantly (P > 0.05); there were no significant differences in the PR of Vs, Vd, Vm and PI on both sides (P > 0.05). Vs, Vd, and Vm on the affected and unaffected sides were improved fluctuatly in patients using 250 ml mannitol. The PI on the affected sides did not decrease markedly (P > 0.05 ); the PI on the unaffected sides decreased significantly (P = 0.005) 60 min after mannitol infusion; the PR of PI at 60 min had significant difference between two sides (P = 0.006). The peaks of the velocity of blood flow increasing and PI decreasing on the affected sides occured later than that on the unaffected sides in patients both using 125 ml and 250 ml mannitol. Conclusion: The improvement of cerebral hemodynamics on the affected sides is more significant than that on the unaffected sides with 125 ml mannitol, and the improvement of cerebral hemodynamics on the unaffected sides is more significant than that on the affected sides with 250 ml mannitol.

Medical and health equipment are rapidly developing in the direction of intelligence and portability. As a representative of them, wearable devices are playing an more and more important role in medical service. To this end, this review discussed the development process of wearable devices, and defined the concept of wearable devices. The existing wearable devices were divided into four categories according to their shapes: hand wear, head wear, lower limb wear and trunk wear. The application of them in medical service were particularly introduced. The 4 future development trends of wearable device, included adding fashionable element, focusing on a particular area, new interactive model and invisible portability, were analyzed and reviewed. Based on above analysis, we could got a comprehensive understanding for the application of current wearable device in medical treatment, and could hold the development direction of wearable device in medical treatment of hospital. While, for above products, there were some differences in technique level between domestic manufacturer and developed country, and there is a larger potential in the relevant products and arithmetic aspects.

Objective To evaluate the advantages and disadvantages of different puncture positions in percutaneous nephrolithotomy. Methods Three hundred fifty-six patients who underwent PCNL were analyzed from March 2012 to October 2015. The passage caliber was 16F-20F. There were 217 cases in prone position and 139 cases in supine position. Results The successful operation in PCNL was 354 cases , while the remaining 2 cases were performed by open surgery. The primary stone clearance rate was 75.5%. The additional PCNLs were performed in 23 cases, and 63 cases of residual calculi were treated by ESWL. 11 patients were treated due to infection or bleeding by the additional PCNLs. There were 3 cases with massive hemorrhage which were treated by Interventional embolization therapy , 12 cases in postoperative fever , no renal resection , no intestinal injury, no deaths. There was no significant difference in stone clearance rate and complication rate between the two groups. Conclusion The puncture position of PCNL can be optional based on the stone size , stone location, degree of hydronephrosis ,and patient′s cardiopulmonary condition individually.

ObjectiveTo investigate effects of pamidronate on the proliferation and differentiation of osteoblasts of rats in vitro.MethodsOsteoblasts isolated from newborn rat calvaria were treated with various concentrations of pamidronate, the proliferation of osteoblasts was evaluated with the method of methyl thiazole tetrazolium (MTT) and activity of alkaline phosphatase (ALP) in medium was measured with kit of ALP detecting.ResultsThe proliferation of osteoblasts increased under the stimulation of Pamidronate range 10-6-M-10-12 M(P<0.05), but was inhibited at the concentration of high level (10-4 M). The activity of ALP decreased in the experiment.ConclusionPamidronate can act on the osteoblasts directly and increase the proliferation of bone cells, but inhibit the differentiation of the same cells.

OBJECTIVE To determine the distribution of bacterial flora in hospital infection and to provide laboratory(evidence) for controlling hospital infection and selecting rationally antibiotics in clinic practice.METHODS All(isolates) were identified by routine procedure.MRSA and ESBLs-producing rate of Escherichia coli and Klebsiella pneumoniae were(examined.) RESULTS Among all these clinical infectious specimens,there were 202 strains of Gram negative bacilli,(accounting) for 40.9%(202/495);166 strains of fungi,accounting for 33.5%;621 strains of Gram positive cocci,for 20.6%(102/495).Candida albicans,E.coli,Pseudomonas aerugionosa,C.tropicalis and C.glabrata took the first five bacteria in infection.Analysis of drug resistant bacteria suggested that the isolated rate of ESBLs-producing strains in Staphylococcus aureus be 47.6%,be CNS in MRCNS 78.1% and MRSA in SA be 42.3%.CONCLUSIONS Multidrug resistance and fungus infection are the main risk factors in our hospital.We must improve means of treatment on clinical work and use antibiotic rationally to reduce the infection rate.

Objective To investigate the causes of complications induced by peripherally inserted central catheters(PICC)in cancer patients and summarize pertinent nursing measures.Method The clinical data of 26 tumor patients with PICC were analyzed retrospectively .Result The complications occurred in 8 patients with a rate of 30.8%, among which unsuccessful catheteration occurred in 1 case,oozing of blood at the mouth of catheter in 1 case,phlebitis in 1 case,dislocation in 1 case,skin allergy-like reactions in 2 cases and catheter emersion in 1 case,catheter breaking in 1 case and dislocation in 2 cases.Conclusion The skilled operation,preventive maintenance of catheters and health education to the patients are the important measures for prevention and reduction of the complications.