Background Diabetic macular edema is the primary complication of diabetes.Becacizumab and triamcinolone acetonide(TA) have been intravitreally used to treat diabetic macular edema,but it is necessary to compare and evaluate their efficacy and safety.Objective The aim of this trial was to discuss and compare the safety and efficacy of intravitreal injection of becacizumab and TA for diabetic macular edema.Methods A case-controlled study was designed.In this pilot clinical trial,total 98 eyes of 98 patients determined as diabetic macular edema by optical coherence tomography(OCT) and fluorescine funds angiography(FFA) were assigned to becacizumab group and TA group according to the visiting time.Becacizumab of 0.05ml(1.25mg) was injected into vitreous via 4mm posterior to limbus in becacizumab group and TA of 0.1ml(4mg) was used at the same way.The visual acuity,central macular thickness(CMT) and intraocular pressure(IOP) were examined before and 4,8,12 weeks after injection.The complication after injection was compared between these two groups.This study was approved by Ethic Committee of Xi'an Central Hospital.Written informed consent was obtained from each patient prior to this protocol.Results All of the patients finished the medical procedure and follow-up.No significant differences were found in the demographic characteristics between two groups(P＞0.05).The vision was obviously improved in both becacizumab group and TA group in 4,8,12 weeks after injection in comparison with before injection(P＜0.01),but no evident differences were seen in vision at various time points between two groups (P＞0.05).The CMT values were reduced after injection compared with before injection in both two groups(P＜0.01),however,there was no any difference was found in CMT value between becacizumab group and TA group whatever before and after injection(P＞0.05).In 4,8,12 weeks after intravitreous injection,the IOPs were elevated in TA group compared with becacizumab group(P＜0.05,P＜0.01),and the IOP was higher after injection than that before injection in TA group(P＜0.01).The incidence of increased IOP after intravitreal injection of TA was 14.3%.No complication was observed in becacizumab group during the follow-up duration.Conclusion Both becacizumab and TA can treat diabetic macular edema by intravitreal administration.Intravitreal injection of TA may be the more favorable therapy for diabetic macular edema in comparison with becacizumab.However,this outcome indicate that IOP should be monitored during the follow-up period.

Objective To analyze the clinical manifestations of primary Sj(o)gren's syndrome (pSS)with peripheral neuropathies.Methods Eighty-six patients who fulfilled the 2002 American-European Consensus Group criteria for pSS were enrolled in the study.For each patient,medical data,including clinical,laboratory,immunologic and electromyography data were collected and analyzed.The clinical manifestations of primary Sj(o)gren's syndrome were compared between patients with and without peripheral neuropathy.Statistical methods used were t-test,chi-square test and Logistic regression.Results Eighty-six patients were analyzed,and neurological involvement was noted in 26％ (22/86) patients.The clinical spectrum of peripheral neuropathies encountered in Sj(o)gren's syndrome patients was wide,with sensory neuropathies being the most common.Median nerve,peroneal nerve and sural nerve were the most likely involved,and lower limb involvement accounted for 73％ (16/22).Peripheral neuropathy was diagnosed during the Sj(o)gren's syndrome course in all patients,and about 45％ patients' neurological involvement were diagnosed early in the course of the disease.The frequency of Raynaud's phenomenon was significantly higher (32％ vs 5％,P=0.002) as well as acroanesthesia (68％ vs 5％,P＜0.01) in pSS with peripheral neurological involvement than in pSS without peripheral neuropathy.The median values of EULAR Sj(o)gren's syndrome disease activity index (ESSDAI) were 5.3 (range 2.8-7.8) and 3.4 (range 1.5-5.3) in the PNS and non-PNS groups respectively (P＜0.01).We found a significant rise of peripheral neuropathy risk associated with Raynaud's phenomenon (relative risk 9.489,95％CI 2.191-41.093,P=0.003) and ESSDAI (relative risk 1.528,95％CI 1.179-1.979,P=0.001).Elevated titers of rheumatoid factor (P=0.023) and ANA (P=0.003) were common in patients with peripheral neuropathy.Conclusion Peripheral neuropathy is not a rare manifestation of pSS.Neurological involvement can be diagnosed early in the course of the disease.Raynaud's phenomenon and high disease activity may be the risk factors for peripheral neuropathy.

Objective To evaluate the expression of RAR-? gene in cervical carcinoma cell lines SiHa,HeLa,C33A and Caski and to analyze the relation between their gene expression and the promoter methylation of RAR-? DNA.Methods The expression of mRNA and protein of RAR-? gene in the four cell lines were analyzed by RT-PCR,western blot and immunofluoreseence,respectively.Methylation specific PCR(MSP)was used to check whether there was methylation in the promoter of RAR-? gene.The demethylating agent 5-aza-2'-deoxycytidine(5-Aza-cdR)was used to treat methylated cell lines and the change of RAR-? gene methylation and RAR-? gene expression defects were observed.The cell proliferation was assayed with 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide method.Results The mRNA and protein expression levels of RAR-? in cell lines SiHa,HeLa,Caski and C33A were 0.25 ?0.08,0,0.60?0.19,3.12?0.92 and 0.23?0.07,0,0.14?0.05,0.68?0.21,respectively.The mRNA and protein expression of RAR-? in SiHa,HeLa and Caski cell lines were decreased or silenced, whereas its expression increased in C33A cell line.MSP method showed that there were RAR-? gene methylation in SiHa,HeLa and Caski cell lines,while there was no RAR-? gene methylation in C33A cell line.After treated with 5-Aza-cdR,the mRNA and protein expression levels of RAR-? in SiHa,HeLa, Caski and C33A cell lines were 1.82?0.59,2.13?0.62,1.67?0.43,2.95?0.89 and 0.69?0.21, 0.83?0.29,0.56?0.16,0.64?0.20 respectively.The mRNA and protein levels of RAR-? had a significant difference between before and after interference with 5-Aza-cdR in SiHa,Helm,and Caski cell lines(P0.05).The 5-Aza-cdR treatment could suppress cell proliferation.Conclusions The RAR-? gene expression defects play an important role in the carcinogenesis of cervical cancer.Aberrant methylation in promotor region of RAR-? gene may be an important mechanism for the loss of expression of RAR-? gene.

ObjectiveTo analyze the clinical characteristics and treatment of severe acute respiratory syndrome (SARS).MethodsDuring epidemic period of SARS,all suspected patients were isolated and treated at very early stage. Clinical symptoms, signs and changes of the chest film were observed carefully to make early diagnosis and begin early intervention. 14 SARS cases with definite diagnosis were treated by Western Medicine combined with Chinese Traditional Medicine.3 cases of them with severe type were treated by timely technical ventilation,which was nasotracheal intubition guided with fibronchoscope,with the principle of low tide volume and high PEEP to improve oxygen combination.ResultsAll patients were cured to discharge. Only two cases of mild pulmonary fibrosis were found after 2 months' follow-up. None of the medical workers taking part in rescuing and treating SARS patients and none of the family members of the patients were infected.ConclusionDuring SARS epidemic period,early isolation,early diagnosis,early combined treatment of Western Medicine and Chinese Traditional Medicine,and prompt technical ventilation intervention on severe cases are important factors to successfully rescue and treat SARS patients.

Objective To investigate the effects of diet intervention on the community hypertensive patients body mass index, blood pressure control, lipid. Methods A total of 68 patients with hypertension in communities were randomly divided into two groups ( n = 34 ) and the control group ( n = 34 ), the observation group were implemented the system of nutrition dietary intervention, the control group did not impose any education. The body mass index, blood pressure control and blood lipid changes were observe at 6 months postintervention. Results After 6 months, the body mass index, blood pressure, blood lipids and other indicators were significantly better in diet intervention group than those in the control group. In which body mass index, blood pressure, triglyceride reduction was particularly significant ( P < 0.01 ). Conclusions Nutrition dietary intervention is more effective to control hypertension in patients with body mass index, blood pressure, reduce blood fat, prevent the occurrence of complications and improve patient quality of life.

Background Patients often suffer from a few complications of neurological and psychiatric problems after traumatic brain injury including damage of cognition, mental disorders and behavior problems. Damage of cognition is a common sequela in traumatic brain injury. Numerous researchers were focus on the cognition changes of patients with mild brain injury. But their conclusions are debatable. Executive function is one of the important components of cognition. In this study,we tried to find out the executive functional alterations of the patients with mild brain injury.Methods 159 patients with brain injury caused by transportation events and 68 normal controls were assessed executive function. The executive function tests included the block design in WAIS, the Stroop test, the verbal fluency and the modified version of Wisconsin card sorting test (M-WCST). These tests were applied to compare the scores of traumatic brain injury patients with various severities including mild, moderate, and severe and with different CT/MRI results.Results Patients with mild head injury got significantly lower scores on all tests than normal controls ( P＜0.01 ). But there was no significant difference between mild and moderate brain injury group. Except Stroop test and WCST categories, patients with mild brain injury got significantly lower scores on all other tests than those with severe brain injury ( P ＜0.05). In the brain injury cases with damage signs on CT/MRI, there was no significant difference on scores of all tests except block design tests among brain injury patients with various severities. Among the brain injury cases without any damage signs on CT/MRI, there was no significant difference on scores of all tests among brain injury patients with various severities. The correlation analysis showed that scores of block design and verbal fluency test were negatively related to the severity of brain injury( P＜0.05). The age and the education level of the patients had negative and positive correlation, respectively, to executive function.Conclusions The executive function of patients with mild brain injury was impaired when the medication was terminated. We should pay more attention to patients with mild brain injury by performing various tests for assessment of disability.

Objective To examine the prevalence of chikungunya virus in brain tissue samples from rat?like animals in Xiamen, Shenzhen and Guangzhou, and to explore whether the rat?like animals are potential sources of human chikungunya fever infections and the host of the virus. Methods Rat?like animals were trapped in residential areas, city parks, hospitals, markets and schools in Xiamen, Shenzhen and Guangzhou (Yuexiu and Baiyun districts) between January 2013 and June 2016. Brain tissue samples of the trapped animals were collected under sterile. Chikungunya virus was detected by using reverse transcription polymerase chain reaction (RT?PCR). Results Totally 1092 rat?like animals were trapped, which belonged to 7 species, 3 genera, 2 families, 2 orders. Rattus norvegicus was the dominant species in the indoor environment, Rattus losea was dominant in wild environment, and 1092 brain tissue samples were collected. No detectable chikungunya virus was found in the brain tissue samples by RT?PCR. Conclusion There is a low possibility that rat?like animals act infectious sources of human chikungunya fever infections and the host of the virus.

Objective To compare the prevention and control effects of binocular myopia after wearing orthokeratology lenses or glasses for correction in adolescents with low-to-moderate unilateral myopia.Methods The clinical data of 46 adolescents with unilateral myopia treated in First Affiliated Hospital of Army Medical University were retrospectively analyzed,the patients were divided into the orthokeratology lenses group and spectacles group according to the correction methods,with 23 cases in each group.The axial length(AL),changes in spherical diopter(SD)and anisometropia between the myopic eye and the control eye with orthokeratology lenses spectacles for unilateral myopia correction,and orthokeratology lenses for unilateral and binocular myopia were compared.Results There was no significant difference in baseline AL,SD or anisometropia between the two groups(P>0.05).One year after unilateral myopia correction,the increase of SD for the myopic eye in the orthokeratology lenses group was less than that in the spectacles group(P<0.05),and there was no significant difference in the AL elongation of myopic eyes between the two groups(P>0.05);the elongation of AL for the control eyes in the orthokeratology lenses group was more than that in the spectacles group;the increase of SD for the myopic eyes in the orthokeratology lens group was lower than that in the spectacles group(P<0.05),and there was no significant difference in the increase of SD for the control eyes between the two groups(P>0.05);the anisometropia of patients in the orthokeratology lenses group was less than that in the spectacles group(P<0.05).The biological parameters of the eyes before and after wearing orthokeratology lenses in the patients with monocular and binocular myopia in the orthokeratology lens group were compared,the elongation of AL for the myopic eyes with lens in one eye was less than that with lenses in both eyes(P<0.05),and the elongation of AL for the control eye was more than that with lenses in both eyes(P<0.05),the increases of SD in both myopic eyes and control eyes were more than those with lenses in both eyes(P<0.05),and the anisotropia was more than that with lenses in both eyes(P<0.05).Conclusion Orthokeratology lenses is better than spectacles in controlling the increase of myopia in low-to-moderate unilateral myopia,which can reduce anisometropia between eyes.However,the AL of the emmetropic eye increases rapidly during unilateral myopia correction by orthokeratology lenses,and the progression of binocular myopia can be significantly delayed after wearing orthokeratology lenses.

Objective To explore the effect of folic acid and DNA methyltransferase 1 (DNMT1) on cervical cancer and cervix precancerous lesion. Methods 100 patients with cervix squamouscell carcinoma (SCC), 101 patients with cervical intraepithelial neoplasm (CIN) and 109 patients with cervix inflammation (CI) diagnosed by histology were included in this study. Radioimmunoassay (RIA), polymerase chain reaction (PCR) and Western blot were used to detect the levels of serum folate, HPV16 infection and the expression of DNMT1 protein,respectively. Results The average levels of serum folate were (2.60 ± 1.61) ng/ml, (3.14 + 2.08) ng/ml and (3.32+1.74) ng/ml,and the expression of DNMT1 protein were 2.40 + 0.99,1.88 + 0.33 and 0.89 ± 0.29 in the group of SCC, CIN and CI, respectively.The relationship of folate levels and DNMT1 protein expression showed inverse correlation (r=-0.186, P=0.00l). The results in our study indicated that there was an additive interaction between low-level of serum folate and high-expressionof DNMT1 protein related to the risk of CIN and SCC, with OR value as 2.50(95%C/: 1.21-9.22) and 6.03 (95%C/: 2.79-21.72) respectively. The relative excessrisk of interaction (RERI) , attributableproportion of interaction (API) and synergy index (S) were 0.92, 0.36 and 2.59 in the CIN group while 2.47, 0.41 and 1.96 in the SCC group. Conclusion The low level of serum folate and high expression of DNMT1 protein seemed to be associated with high risk of cervical cancer and its precancerous lesion. It suggested that there might be a synergistic action between serum folate and DNMT1 in the progression of cervix carcinogenesis.

Objective To explore the effect of health education in improving the social function of schizophrenia patients.Methods 100 schizophrenia inpatients who met the demand were randomly divided into the experiment group and the control group.The two groups accepted the routine therapy of antipsyehotic drags and the nursing.In addition,the experiment group accepted the health education and the exercise of social function for 8 months.The scores of social disability screening schedule(SDSS) and brief psychiatric rating scale(BPRS)were compared among the schizophrenia inpatients.Results After 8 months of therapy and nursing.the total score and the scores of social function shrink,self care,interest to outside environment,sense of responsibility and planning in the experiment group were lower than those in the control group.The differences had statistical meanings(P<0.05 or P<0.01).Conclusions Giving continuous and normative health education and exercise of social function to schizophrenia patients can improve the social function.retard the mental deterioration and reduce the rate of recurrence.