Objective To observe the effect of high glucose on the expression of activating transcription factor 4 (ATF4) in cultured retinal Müller glia cells.Methods The retinal tissue of Sprague Dawley (SD) rats was collected,and Müller cells were isolated and cultured.The glial fibrillary acidic protein (GFAP) and glutamine synthetase (GS) of Müller cells were identified by streptavidin-biotinperoxidase complex.Cultured rat Müller cells were divided into control group (5.5 mmol/L glucose),group A (20 mmol/L glucose),group B (30 mmol/L glucose) and group C (40 mmol/L glucose).ATF4 protein expressions in Müller cells of four groups were measured by Western blot four days after cultured.Results GFAP and GS expressed in more than 95％ of Müller cells.Over 95％ of Müller cells of group A,B and C were positive for GFAP and GS.Western blots indicated that ATF4 protein in group A,B and C increased obviously compared with the control group (q=0.293,0.754,0.484; P＜0.05).Conclusion High glucose can increase the expression of ATF4 protein and cause endoplasmic reticulum stress in retinal Müller glia cells in vitro.

Objective To assess the effects and side effects of ropivacaine combined with sulfentanyl in epidural anesthesia for caesarean section. Methods Two hundred ASA Ⅰ- Ⅱ patients scheduled for elective caesarean section were randomly divided into 2 groups (100 cases each):group S received 0.75% ropivacaine and 0.75 μg/ml sulfentanyl; and group R received 0.75 % ropivacaine. Epidural space L2-3 was punctured and the catheter was put upward 3 cm in all patients. Local anesthetic agents were administered until a complete sensory block was established extending upper T4-T6. In the operation, Bp, HR,SpO2, ECG were observed and the onset time, the upper spread and duration of sensory block were recorded.Assessed anesthetic efficacy and side-effects on newborn. Results The onset time [(4.5±1.2) min], the time needed to reach the highest sensory level [ ( 13±5) min ] were significantly shorter and the duration of sensory block [ (402±150 ) min ] was significantly longer in group S than those in group R (P < 0.05 ). There was no significant difference in the side effects such as tachycardia, nausea, vomiting, and shivering. Apgar score in newborn was not affected. Conclusion The anesthetic efficacy of epidural 0.75% ropivacaine is significantly enhanced which also has smaller local anesthetic requirements and low incidence of side-effects,in epidural anesthesia for caesarean section when sulfentanyl is added.

Objective To observe the effect of cyanin on the expression of L-glutamate/ L-aspartate transporter (GLAST) in high glucose cultured retina Müller cells. Methods The retinal tissue of SpragueDawley (SD) rats was collected at postnatal 10 day, and Müller cells were isolated and cultured according to literature. The Müller ceils (2nd-4th generations) were treated with five different medium as normal group (group A), high glucose control group (group B), high glucose+30 μmol/L cyanin group (group C), high glucose+60 μmol/L cyanin group (group D) and high glucose+100 μmol/L cyanin group (group E). Cell relative survival rates (A value) were measured by MTT assay at 570 nm. The GLAST protein expression in M011er cells was observed by Western blot. Results MTT assay showed that the A value of the five group were 0. 450 8±0. 020 4, 0. 270 1±0. 031 4, 0. 332 0±0. 023 2, 0. 428 3±0. 017 2, 0. 361 9±0. 027 0,the cell relative survival rate were 100. 0%, 59. 9%, 73.6%, 95%, 80.3% respectively. The A value of group C, D, E were significantly higher than that of group B (F=32.25, P<0.05), the A value of group D were significantly higher than that of group C and E (F=21.07, P<0. 05). Western blot showed that the GLAST protein expression of group B was lower than that of group A (t=5.25, P<0. 05) ; there was no obvious changes of GLAST protein expression in group A, C, D and E (F= 2. 979, P>0.05).Conclusion Cyanin can rescue high glucose-induced GLAST reduction.

Objective To observe the distribution of TCM syndromes in patients with functional constipation (FC). Methods One hundred and five cases of patients with FC were analyzed with relevant factors and summarized to syndromes of FC by cluster analysis. Results There was a correlation between distribution of syndromes of FC and patient's age, job occupation, course of disease, incentives and patient's eating habits. The distribution of syndromes analyzed by cluster analysis was consistent with diagnostic criteria. Conclusion The syndromes of FC are divided into heat constipation, qi constipation, deficiency constipation and cold constipation. Among these syndromes, the number of excess constipation patients especially heat constipation is more than the number of others.

Epidemiological and animal studies have demonstrated that dietary lower intake of n-3 polyunsaturated fatty acids (n-3 PUFAs) and(or) higher intake of n-6 polyunsaturated fatty acids(n-6 PUFAs) leading to imbalance of their ratios are closely related to obesity.The mechanisms underlied are involved in PUFA′s effects on fatty acid synthesis and oxidation,adipocyte proliferation and differentiation and leptin expression.At transcription level,PUFAs can regulate the activities of peroxisome proliferator-activated receptors and CCAAT enhancer bin-ding proteins.

Objective To establish a pregnant mouse model infected with Porphyromonas gingivalis (P.g), and investigate the relationship of P.g infection to prematurity and associated birth abnormalities. Methods Fifty two female mice were randomly divided into P.g infection group (n=26) and control group (n=26). Mice in P.g infection group were anesthetized, the pulp cavity of the first molar was opened and directly injected with W83 strain P.g, and the tooth was then filled. Six weeks after infection, the mice were mated with males and the formation of vagina plug was recorded as 0d. The P.g extracted from the granulation tissue in tooth root was cultivated. The pregnant days and the connatal body weight of infant mouse were recorded, the serum and placental tissue were collected to assess the systemic and local conditions during pregnancy. Results After periodontal P.g infection, the TNF-α, IL-17, IL-6 and IL-1 levels in peripheral blood sera increased significantly. The average gestation was shorter in P.g infection group (18.25d) than in control group (20.45d, P<0.01), and the connatal body weight of infant mouse was also less in the former than in the latter (P<0.01). Immunohistochemistry and PCR revealed the existence of P.g in placenta tissue. P.g infection caused premature rupture of membranes, placental abruption, degeneration and necrosis of trophoblastic and endothelial cells; significantly increased the number of neutrophils and macrophages in placenta tissues, and increased the expression of local TNF-α and COX-2 inflammatory factors at the same time. In P.g infection group, the expressions of CD-31 in endothelial cells of placenta tissues and the apoptotic factor caspase-3 decreased, and the DNA oxidative damage index 8-OHdG increased. Conclusions P.g infection in female mice may cause premature birth and lower connatal body weight of infant mouse, and increase the expression of serous and local inflammatory factors in the placenta. It is suggested that timely removal of periodontitis or gingivitis can prevent some of reproductive abnormalities.

This study compared the efficacy of non-penetrating trabecular surgery and trabeculectomy for the treatment of open angle glaucoma. We searched the Cochrane Library, PUBMED (1966 to 2009), Embase (1980 to 2009) and CMB-disk (1979 to 2009) for the randomized clinical trials (RCT) concerning the two treatment strategies. The reports, including the papers listed in bibliographies, were evaluated against a set of quality criteria and the RCTs that satisfied the criteria were selected and subjected to Meta analysis by employing the Cochrane Collaboration's RevMan 4.5 software package. A total of nine RCTs were included in the study. The analyses of the reports showed that, 12 months after surgery, there was significant difference in the reduction of interocular pressure (IOP) between non-penetrating trabecular surgery and trabeculectomy (Z=6.05 P<0.00001). There also existed statistically significant difference in the reduction of IOP at the censored time between the two procedures (Z=4.92, P<0.00001). Difference in the success rate was also found between the two surgeries (Z=3.82, P=0.0001). It is concluded that, compared with the non-penetrating trabeculectomy, the traditional trabeculectomy could reduce IOP more and had higher success rate while the non-penetrating trabecular surgery is associated with lower postoperative complications.

Background Retinal Müller cells can offer nutrient and maintain the normal structure of retina.Researches showed that the abnormality of Müiller cells leads to retinal vascular disease.To explore the effect of high glaucoma on retinal Müller cells is of a very important significance for the study on diabetic retinopathy (DR).Objective This study was to investigate the effects of different concentrations of glucose on retinal Müller cells in vitro.Methods Retinal tissue was isolated from 1 10-day-oM clean SD rat.Mtiller cells were cultured by explant culture method and passaged in DMEM containing 20％ fetal bovine serum.The third generation of cells were obtained and identified using glial fibrillary acidic protein (GFAP) staning.Then,5.5,30.0 and 40.0 mmol/L glucose were added into the culture medium for 4 days respectively.The proliferation (A570) of Müller cells was detected by MTT,and apoptosis rate of Müller cells was calculated by flow cytometer to evaluate the effects of 5.5,30.0 and 40.0 mmol/L glucose to cell vitality.Results Cultured and passaged cells grew well with the spindle shape.The positive reactive cells were ＞95％ for GFAP.The A570 value of Müller cells was 0.24±0.01,0.21±0.03 and 0.20±0.02 in 5.5,30.0 and 40.0 mmol/L glucose group respectively,showing a significant difference among the three groups(F=6.755,P＜0.05).Compared with 5.5 mmol/L glucose group,As70 values were significantly lower in 30.0and 40.0 mmol/L glucose group (q =0.645,0.486,P ＜ 0.05).Apoptosis rates of Miiller cells were (26.40 ±0.25)％,(30.19±0.16)％ and (36.23±0.19)％ in 5.5,30.0 and 40.0mmol/L glucose groups,with a significant difference among them (F =294.530,P＜0.05),and those in 30.0 and 40.0 mmol/L glucose groups were significantly reduced in comparison with 40.0 mmol/L glucose group (q =0.754,0.484,P ＜ 0.05).Conclusions High concentration of glucose inhibits the viability and promote the apoptosis of retinal Müller cells at a concentrationdependent manner.

Background Epipolis laser in situ keratomihusis(Epi-LASIK) is an potential surgery for myopia because it synthesize advantages of LASEK and LASIK. But its clinical effectiveness and safeness is remarkable.Objective This study was to evaluate the clinical curative effects and safeness of Epi-LASIK for myopia in different diopter of population. Methods Retrospective study was designed for 208 eyes of 104 patients who underwent EpiLASIK for the correction of myopia. The patients were divided into two groups according to preoperative diopter:lower myopia group( ≤ -6.00 D, 111 eyes) and high myopia group ( ＞-6.00 D,97 eyes). The time of epithelial healing, postoperative syndrome, postoperative visual acuity, refraction, intraocular pressure (IOP) , the safe index, the efficacy index and haze were evaluated at 1,3,6,12 months postoperatively. The written informed consent was obtained from each individual before surgery. Results After operation, 20 eyes ( 18.02% ) of lower myopia group and 29 eyes (29.90%) of high myopia group had obvious pain, presenting statistically significant difference between two groups (X2 = 4. 060, P＜0.05 ). The mean time of epithelial healing was (5.49±0. 83 )days in lower myopia group and (5.85± 0.68 )days in high myopia group with a delayed epithelial healing time in high myopia group( u= 3. 377 ,P＜0.05 ).One year after the treatment,the uncorrected visual acuity( UCVA ) ≥ 1. 0 was 90. 99% ( 101 eyes) in lower myopia group and 75.26% ( 73 eyes) in high myopia group, and 9.91% ( 11 eyes) and 15.46% ( 16 eyes) of the eyes improved byl line or more in best spectacle corrected visual acuity(BCVA) ;whereas 3.60% (4 eyes)and 6. 18% (6 eyes)lost a line or more. 91.89% ( 102 eyes) and 85.57% (83 eyes) in both groups gained within 1.00 D of the attempted correction. The safety index and efficacy index were 1.04 and 0. 98 in lower myopia group,and 1. 01 and 0. 96 in high myopia group without statistically significant difference( P＞0. 05 ). haze occurred in 6 eyes in lower myopia group and 9 eyes in high myopia group and the difference in haze grading was not statistically significant between two groups ( P＞0. 05 ). The high intraocular pressure appeared in 10 eyes and 9 eyes in low myopia group and high myopia group respectively during the fellow up duration and back to normal after topical use of timolol. Conclusion Epi-LASIK is an effective and safe method for correction of different diopters of myopia because of its mild symptom and lower incidence of haze.

AIM: To compare the efficacy and safety of bevacizumab with mitomycin ( MMC ) in augmenting trabeculectomy for glaucoma.
METHODS: Databases including PubMed, CBM, CNKI, VIP and WanFang Data were electronically searched for all randomized controlled trials ( RCTs) about comparing the efficacy and safety between bevacizumab and MMC in augmenting trabeculectomy for glaucoma before the date of Jun. 2016. Two reviewers independently screened literatures according to the inclusion and exclusion criteria, and evaluated the included studies. Then, Meta-analysis was performed.
RESULTS: A total 4 RCT involving 286 eyes ( 143 for bevacizumab group, 143 for MMC group) were included. The results of Meta-analysis showed that there was no significant difference between bevacizumab and MMC in the last follow-up after surgery in IOP (WMD=2. 21, 95%CI: -0.17 to 4.58, P=0.07), complete success rate (OR=0. 69, 95%CI:0. 26 to 1. 81, P=0. 45) and the numbers of anti-glaucoma medicine ( OR= 0. 12, 95%CI: -0. 15 to 0.39,P=0. 39). And there was no significant difference between bevacizumab and MMC in postoperative complications:hypotony (OR=0.7, 95%CI:0.12 to 4.05, P=0.69), bleb leak (OR=1, 95%CI: 0. 21 to 4. 74,P=1), encapsulated bleb (OR=1. 15, 95%CI: 0. 38 to 3. 44, P=0.81), choroidal detachment (OR=1. 22, 95%CI: 0. 29 to 5.22, P=0. 78) and cataract (OR=1. 15, 95%CI: 0. 38 to 3.44, P=0. 81).
CONCLUSION: Bevacizumab and MMC in augmenting trabeculectomy for glaucoma have similar efficacy and safety. Bevacizumab can't result in better outcome in term of IOP reduction. Clinicians should choose suitable solution according to disease characteristics.