Background Optic neuritis is one of the common clinical neuro-ophthalmic diseases.Spectraldomain OCT (SD-OCT) is a valuable tool in assessing the thickness changes of retina,while enhanced depth imaging (EDI) OCT can further quantitatively and morphologically evaluate the changes of retina and choroid.The pathological mechanism of optic neuritis is unclear now.Objective This study was to quantitatively measure the retinal and choroidal thickness in early optic neuritis eyes by SD-OCT and EDI OCT.Methods A prospective cohort study was carried out in Tianjin Eye Hospital from July 2015 to May 2016.Twenty eyes of 20 patients with acute optic neuritis were enrolled as optic neuritis group and 22 eyes of 20 healthy subjects with matched age and gender were included in the normal control group.The mean thickness of retinal nerve fiber layer (RNFL) and choriod in superior,inferior,nasal and temporal quadrants at 3.4 mm around optic disc was measured,and the mean thickness of RNFL,ganglion cell layer (GCL),inner plexiform layer (IPL),inner nuclear layer (INL),outer plexiform layer (OPL),outer nuclear layer (ONL) and photoreceptor layer also was measured by EDI OCT.Pattern visual evoked potential (P-VEP) and visual field were examined in all the individuals,the correlations of mean defect (MD) with the thickness of RNFL,choroid and the thickness of RNFL,GCL,IPL,INL,OPL,ONL,photoreceptor layer at macular area were evaluated.Results The RNFL thickness values were (424.00±160.30),(428.40±169.83) and (108.15 ±50.66) μm in superior,inferior,nasal quadrants at 3.4 mm arear around optic disc in the optic neuritis group,which were significantly higher than (265.68±26.25),(283.27±52.81) and (72.68± 12.01) μm in the normal control group (t=4.571,3.814,3.190,all at P＜0.01),and there was no significant difference between the two groups (t =0.849,P =0.401),and no significant differences were found in choroidal thickness of 4 quadrants between the two groups (all at P＞0.05).The thickness of RNFL,GCL and IPL at 1 mm area around macula and the thickness of GCL,IPL,INL at 3 mm area around macula were evidently thining in the optic neuritis group compared with the normal control group (all at P＜0.05).The latency of P100 wave was (133.15±11.11) seconds in the optic neuritis group and that in the control group was (94.59 ±4.38) seconds,showing a significnat difference between them (t =15.058,P＜0.05).Positive correlations were found between MD and the RNFL thickess in superior,inferior,nasal quadrants at 3.4 mm arear around optic disc (r =0.649,0.649,0.635,all at P＜0.05),however,no evidentlylinear correlations were found between MD and choroidal thickness in 4 quadrands (r =-0.120,-0.102,-0.415,0.120,all at P＞0.05),and the thickness of RNFL,GCL,IPL,INL,OPL,ONL,photoreceptor layer at macular area was significantly linear correlated with MD.Conclusions EDI OCT can reflect the RNFL edema around optic disc and thining of various layers of retina at macular area in acuter optic neuritis eyes,however,the choroidal thickess is unchanged.EDI OCT is a useful tool in quantitative evaluation of retinal and choroidal thickness of early optic neuritis.

Objective To investigate the relationship between interleukin (IL)-18 and podocyte injury of lupus nephritis (LN). Methods Sixty cases of biopsy proven LN patients were enrolled into the study. Thirty cases were selected as controls. The clinical and pathological data, blood and urine samples and renal tissues were collected. The Nephrin expression was detected by immunohistochemical method and IL-18 was measured by enzyme linked immunosorbent assay. The relationship between IL-18 and the Nephrin expression, clinical and pathological indicators of LN were analyzed. Results Thirty-eight cases were in active disease and 22 cases were in inactive disease in LN group according to SLE disease activity index (SLEDAI) 2000. One-way ANOVA showed that the level of plasma and urine IL-18 in the LN groups were higher than those in the control group [(200±38) ng/ml, (18±5) ng/ml] (F=110.84, 203.09, P<0.01). Plasma and urine IL-18 level in active LN group [(565 ±128) ng/ml, (200 ±47) ng/ml] was higher than that in the inactive group [(376 ±106) ng/ml, (67 ±22) ng/ml] (P<0.01), the level of IL-18 of type Ⅳ LN was significantly higher than that of typeⅢand type Ⅴ LN (P<0.01). The expression level of Nephrin in LN groups were lower than those in healthy control group (0.28±0.02)(F=136.39, P<0.01). The expression level of Nephrin in active LN group (0.13±0.03) was lower than that in the inactive group (0.18±0.02) (P<0.01), the level of typeⅣLN Nephrin was significantly 01). The Pearson correlation analysis showed that, compared with plasma IL-18, urine IL-18 level in the LN group was not only negatively correlated with the level of Nephrin and serum C3 (r=-0.780, -0.565, P<0.05), but positively correlated with 24 h UP, erythrocyte sedimentation rate (ESR), SLEDAI and GAI (r=0.546, 0.467, 0.599, 0.634, P<0.05). Serum IL-8 level was independent of albumin (ALB), C4, C reactive protein (CRP) and CI (P>0.05), and was negatively correlated with estimated glomerular filtration rate (eGFR) (r=-0.562, P<0.05). It was positively correlated with serum creatinin, blood urea nitrogen, AI, TLAI and inflammatory cell infiltration (r=0.529, 0.482, 0.665, 0.690, 0.671, P<0.05). Conclusion IL-18 has a very close relationship with podocyte injury in patients with LN, and the uIL-18 can be a potential non-invasive detection method to monitor podocyte injury in LN patients.

ObjectiveTo investigate the application of the ratio of early diastolic peak velocity of mitral valve(E) and early diastolic peak velocity of mitral annular(Ea) on evaluating left ventricuiar diastolic function in patients with chronic heart failure.MethodsLeft atrial diameter(LAD),left ventricular end-diastolic diameter (LVEDd),interventricular septal thickness (IVST),left ventricular ejection fraction (LVEF),E and late diastolic peak speed of mitral valve (A) of 30 patients with diastolic heart failure(DHF,DHF group),30 patients with systolic heart failure(SHF,SHF group) and 30 healthy persons (control group) were detected by conventional echocardiography.E/A ratio and E-wave deceleration time (DT) were calculated.Early diastolic peak velocity of longitudinal septal and left ventricular lateral part of mitral annulus (Esep,Elat) were measured by tissue Doppler imaging (TDI).Ea and E/Ea ratio were calculated as well as the relevant analysis was made.Results ( 1 ) LAD and IVST in DHF group were significantly higher than those in control group [(44.90±8.31) mm vs.(30.87±3.48) mm,(9.43±2.18) nn vs.(8.17 ± 1.12)mm,P＜0.05].LVEDd in SHF group was obviously higher than that in control group and DHF group [(66.30 ± 10.21) mm vs.(44.77 ± 4.17) mm,(48.60 ± 8.85) mm,P＜0.05],and LVEF and DT were significantly lower than those in control group and DHF group(P ＜ 0.05 ).(2) Esep,Elat and Ea in DHF and SHF group were significantly lower than those in control group( P ＜ 0.01 ),and E/Esep,E/Elat and E/Ea ratios were obviously higher than those in control group (P ＜ 0.01 ).( 3 ) The level of B type natriuretic peptide (BNP) in DHF and SHF group was significantly higher than that in control group [(477.73 ± 722.76),(978.60 ± 825.04) ng/L vs.(29.23 ± 17.84) ng/L,P ＜ 0.05 ].The level of BNP in SHF group was significantly higher than that in DHF group (P＜0.05 ).(4) Multivariate linear regression analysis showed that NYHA classification and BNP were correlated with E/Ea ratio (P ＜ 0.05).(5) The area under curve (AUC) of E/Ea in diagnosing chronic heart failure was 0.984 (95％ CI:0.000-1.000).AUC of E/Ea in identifying DHF and SHF was 0.857(95％ CI:0.773-0.940).The sensitivity and specificity of E/Ea were much higher than those of E/A.Conclusions Chronic left ventricular systolic insufficiency is commonly combined with different-degree diastolic dysfunction.The evaluation of left ventricular diastolic function can be more simple and accurate combined with pulse wave Doppler and TDI.

Objective To understand the intensity and characteristics of acute toxicity of esculentoside A on mice and measure relevant parameters and observe its diuresis effect on rat. Methods After intraperitoneal injection of different concentrations of esculentoside A to mice, toxic reactions were observed. Rats with water load were intraperitoneally injected with different doses of esculentoside A. Total urine volume in six consecutive hours after the injection was determined. Results The LD50 of esculentoside A calculated by Bliss method was 26. 19 mg · kg-1 , and the 95% confidence interval was 23. 11-29. 85 mg·kg-1 . The mortality and acute toxicity of esculentoside A appeared to be dose-dependent while the blank control group had no abnormal reaction. The urine volume was significantly different between high dose group and the negative control group. No significant difference in urine volume was found between middle and the negative control group, and between low dose group and the negative control group. Conclusion Esculentoside A is poisonous to mice when single dose was intraperitoneally injected, and high dose of esculentoside A has diuresis effect on rat.

Objectives To study the status of medical compliance and the reason of non-medical compliance behavior of the Hui diabetics. Methods 121 Hui diabetics were recruited by convenient sampling, investigated by medical compliance questionnaire and interviewed by open questions about the reason of non-medical compliance behavior (e.g. drug therapy, diet therapy, sports therapy, self monitoring and periodic review). Results The mean score of the medical compliance behaviors was (32.69±8.64), and the overall rate of non-medical compliance was 95.9%(116/121) in Hui diabetics. Arranged by the rate of non-medical compliance in descending order, the five dimensions of medical compliance behaviors were sports therapy, self monitoring, periodic review, diet therapy and drug therapy in turn. The reason of non-medical compliance behavior mainly included the cognition of treatment, the economic conditions, job, minority customs and religion. Conclusions Non-medical compliance behaviors existed in five major diabetes therapies in the Hui diabetics. The patients and their families should be educated and conducted individually according to their specific situation to improve the medical compliance behavior.

Objective To investigate the clinical value of prenatal MRI in the diagnosis of fetal bowel obstruction.Methods Pregnant women suspected to have fetal abdominal abnormalities by ultrasonography were suggested to undergo MRI examinations within two days.Scanning sequence included FIESTA,SSFSE and T1WI SPGR sequence,with field of view focused on the fetal abdomen.After the final diagnoses of the cases were obtained by induced labor pathological examination or postpartum imaging or operation,the imaging data and the clinical data were reviewed and analyzed retrospectively.Results A total of 23 cases with bowel obstruction were included in the study.Four fetuses with duodenal atresia showed low T1 signal,high T2 signal characterized by double-bubble sign on MRI.There were 10 fetuses with jejunoileal atresia,showing bowel dilatation and hyperintense micro-colon on T1WI.Five cases of them depicted expansion of the terminal ileum with high T1 meconium signal.One each fetus had colonic atresia,intestinal malrotation with double-bubble and whirl sign.Annular pancreas with double-bubble sign and pressure trace of the bracket shape was detected in 3 fetuses.Meconium peritonitis was present in 4 fetuses,with 2 of them showing dilatation of intestine,ascites and pseudocysts.Conclusions According to the signal characteristics of amniotic fluid and meconium in the gastrointestinal tract on MRI,the obstructive level and development status of the distal bowel can be determined with MRI.It can provide additional information to ultrasonography,which brings clinical significance to prenatal diagnosis and intrapartum surgical operation.

Objective To evaluate the role of phosphoinositide 3 kinase/protein kinase B (PI3K/Akt) signaling pathway in hydrogen-induced inhibition of cell apoptosis during myocardial ischemia/reperfusion (I/R) in rats.Methods Forty healthy male Sprague-Dawley rats,weighing 300-350 g,were randomly allocated into 4 groups (n =10 each) using a random number table:sham operation group (S group),I/R group,hydrogen group (group H),and hydrogen + LY294002 group (group HL).Myocardial I/R was induced by occlusion of the anterior descending branch of left coronary artery for 30 min followed by 120 min reperfusion.In H and HL groups,99.6 ％ hydrogen 5 ml/kg was injected intraperitoneally immediately after beginning of reperfusion,and in addition LY294002 (0.3 mg/kg) was injected through the caudal vein before hydrogen injection in group HL.Arterial blood samples were collected at the end of 120 min reperfusion for determination of serum creatine kinase isoenzyme-MB (CK-MB) and lactate dehydrogenase (LDH) activities.The rats were then sacrificed.Myocardial apoptosis was detected by TUNEL and apoptosis index (AI) was calculated.The expression of Bcl-2,Bax and caspase-3 was detected by immuno-histochemistry.Bcl-2/Bax ratio was calculated.Results The serum CK-MB and LDH activities and AI were significantly increased,the expression of myocardial Bcl-2,Bax and caspase-3 was upregulated,and the ratio of Bcl-2/Bax was decreased in group I/R as compared with group S.Compared with group I/R,the serum CK-MB and LDH activities and AI were significantly decreased,the expression of myocardial Bcl2 was up-regulated,while the expression of myocardial Bax and caspase-3 was down-regulated,and the ratio of Bcl-2/Bax was increased in group H,and no significant changes were found in the parameters mentioned above in group HL.The serum CK-MB and LDH activities and AI were significantly increased,the expression of myocardial Bcl-2 was down-regulated,while the expression of myocardial Bax and caspase-3 was up-regulated,and Bcl-2/Bax ratio was decreased in group HL as compared with group H.Conclusion Hydrogen can activate the PI3K/Akt signaling pathway,and further up-regulates Bcl-2 expression and down-regulates Bax and Caspase-3 expression,thus inhibiting cell apoptosis during myocardial I/R in rats.

This study was aimed to analyze changes of content and quantity of essential oil of processing drugs of Rhizome Atractylodes and to achieve the impact of pyrolysis characteristics for using excipients, in order to offer evi-dences for further research and its processing technology. Steam distillation was used to extract essential oil in the Rhizome Atractylodes. Infrared spectroscopy and gas chromatography were used in the qualitative and quantitative analysis on constituents of essential oil of processing products of Rhizome Atractylodes. Thermogravimetric analysis was used in the comparison of pyrolysis characteristics between Rhizome Atractylodes and its excipients. The results showed that the content of essential oil was declined after processing. However, after being processed, the content of atractylodin was increased at different degrees compared to crude product. The change of atractylodin showed differ-ent tendency in different processing drugs. The atractylodin content from high to low was in the order of products stir-baked to yellowish, products roasted by bran, products prepared with rice water, crude drug. At the temperature of more than 220oC, excipients had major impact for the pyrolysis characteristics of Rhizome Atractylodes. It was concluded that the essential oil declined, but atractylodin increased after Rhizome Atractylodes being processed. It also provided experimental basis for further research on processing technology, ormulation of quality standard and improvement of processing mechanism.

Objective:To use polylactic-co-glycolic acid(PLGA) as vector material to prepare the compound total flavonoids of Rhizoma Drynariae(TFRD) and total flavonoids of Chrysanthemum(TFC) sustained release microcapsule TF-PLGA microcapsules,and to investigate the the best preparation technique of TF-PLGA microcapsules and their sustained release characteristics in vitro.Methods:The TF-PLGA microcapsules were prepared with TFRD,TFC,and PLGA by emulsifying-solvent evaporation technique under certain conditions.With the encapsulation efficiency(EE) as the evaluation indicator,the optimal formulation was verified by single factor experiment and orthogonal design;the general morphology,the particle size and distribution of the microcapsules were observed by light microscope(LM) and scanning electron microscope(SEM);the cumulative drug release rate of TF-PLGA microcapsules was detected by constant temperature commotion method in vitro and the release curves of the TF-PLGA were drawn.Results:The optimal prescription was as follows:the concentration of PLGA was 140 g·L-1,oil phase volume was 1.4 mL,emulsifying speed was 900 r·min-1,emulsifying time was 5 min,the average EE was(83.89±2.30)%,and the average drug loading rate(DL) was(5.90±0.07)%.The LM and SEM resluts showed that the TF-PLGA microcapsules presented as round ball,the average particle size was(44.34±14.68)μm,and the distribution was relatively narrow.The drug release in vitro results showed that the initial drug release rate(24 h)was about 40%,and the cumulative drug release rate was over 90% after 50 d.Conclusion:The TF-PLGA sustained release microcapslue has better drug-loaded and sustained-release effects with simple preparation technique and better repeatability.

Objective:To observe the repair effect of nano hydroxyapatite/magnesium(nHA-Mg)porous composite material modified by poly lactic acid/glycolic acid copolymer(PLGA) on the jaw bone defect of rabbits,and to elucidate the mechanisms preliminary.Methods:The mandibular defect models of 10 mm×5 mm×1 mm in the 18 rabbits were established.Nine rabbits were selected and implanted with nHA-Mg composite materials modified by PLGA in the left as experimental group and the right as blank control group;the other nine were implanted with nHA-Mg in the left as positive control group and the right as blank control group.The rabbits were sacrificed at 4, 8, 12 weeks (respectively 3 of experimental group and positive control group every time)and the mandibular defect areas were intercepted and observed by imaging and histological examination;the sizes of the newborn trabecula area and residual materials in experimental group and positive control group were compared.Results:Compared with positive control group and blank control group, the percentage of newborn trabecula area of the rabbits in experimental group was increased (P<0.05),and there was no statistic difference between positive control group and blank control group (P>0.05).The imaging results showed that the new bone formation can be observed in experimental group and better than positive control group and blank control group.The paraffin section results indicated that there were visible vascular tissue and newborn trabecula,the osteoblasts gathered around the bone trabecula;a lot of pits were located in the bone trabecula, and the pits contained osteocytes in experimental group.As the prolongation of time,thickened newborn trabecula, dense arrangement and trend of converting to lamellar bone were observed in experimental group.The hard tissue section results showed that the remaining amount of materials in experimental group was more than that in positive control group.Conclusion:nHA-Mg porous composite materials modified by PLGA can effectively reduce the rate of degradation in the body, promote osteogenesis and guide the bone regeneration.