Objective To observe the changes of retinal morphology and function of macular-off rhegmatogenous retinal detachment (RRD) after scleral bulking.Methods In this prospective study,42 eyes of 41 patients who underwent scleral bulking were enrolled.There were 26 males (27 eyes) and 15 females (15 eyes),with an average age of (33.78± 11.21) years.Best corrected visual acuity (BCVA),intraocular pressure,indirect ophthalmoscope,visual fields,optical coherence tomography (OCT) and B scan of ocular ultrasound were measured for all patients.The average BCVA was 0.29±0.18.The retinal detachment time was (21.12±3.71) days.The mean visual field defect (MD) was (13.54±6.44) dB.The mean loss variance (LV) was (8.43±2.11) dB.All the patients were performed cryotherapy and sub-choroidal fluid drain out.The mean follow up was 12.4 months (from 6 to 24 months).At two weeks,1,3,6,12 months after surgery,the changes of BCVA,visual fields,retinal morphology and subretinal fluid were observed.Results Indirect ophthalmoscope combined with B scan showed the time of retinal reattachment was (7.32±2.53) days.Subretinal fluid was found completely absorbed by OCT with a mean of (7.82±3.52) months.At 12 months after surgery,subretinal fluid was completely absorbed in 37 eyes (88.10％).In these 37 eyes,15 eyes had normal retinal microstructure,5 eyes had neuroepithelial cystoid edema; 12 eyes had disrupted inner segment/outer segment (IS/OS) junction,and 5 eyes had disrupted IS/ OS and external limiting membrane (ELM).BCVA at 6 months after surgery was no significant difference with that at 12 months after surgery (t=-0.636,P=0.529).At 12 months after surgery,there were4 retinal patterns on OCT examination,including normal retinal microstructure,neuroepithelial cystoid edema,IS/OS line disruption,and IS/OS and ELM disruption.The BCVA difference among these 4 groups was significant (F =52.42,P ＜ 0.05).The BCVA difference between eyes with or without residual subretinal fluid was significant (t=-5.747,P=0.000).At 1,2 weeks and 1,3,6,12 months after surgery,the MDwere (11.38±2.53),(10.14±2.19),(9.17±2.13),(6.63±1.70),(5.71±1.89),(5.14± 1.69) dB respectively,with a significant difference between these time-points (F=63.528,P =0.00).However,the MD at 6 months after surgery was no significant difference with that at 12 months after surgery (t=1.442,P=0.157).At 12 months after surgery,there were 12 eyes with normal MD,30eyes with higher MD.There was no significant difference between surgery eyes with higher MD and fellow eyes in MD (t =-1.936,P =0.06).The MD value was positively correlated to the time of retinal detachment in patients with normal retinal microstructure (r=0.84,P =0.00).There were differences in LV during different periods after surgery (F=57.25,P =0.00).Conclusions The retinal microstructure,visual acuity,visual fields were gradually improved after scleral bulking.The patients had better vision with normal retinal microstructure.The time of retinal detachment positively correlated with visual fields damage.

0.05).The main side effects were myelosuppresion,gastrointestinal reation and peripheral nerve toxicity and phlebitis.Conclusion The therapeutic effectiveness of NP regimen was better than MVP regimen.There were no significant difference between the two regimens.They can be used as first line chemotheapy for NSCLC.

Objective To compare the therapeutic effects, adverse reaction and quality of life when advanced lung cancer patients were treated with chemotherapy alone (control group) or combined with Shenqifuzheng Injection (a traditional Chinese Medicine injection, treated group). Methods In the treated group, beside NP scheme chemotherapy, a 250 ml of Shenqifuzheng Injection was given intravenously per day for 6 successive weeks, while to the control group, only chemotherapy was given. Results The effective rate in the treated group and the control group was 46.7% and 36.7% respectively after 2 cycles chemotherapy, with no significance was found. But the rate of progression, adverse reaction in blood were all lower in the treated group than in the control group(P

Objective To observe the efficacy of intravitreal injection of ranibizumab (IVR) for different patterns of optical coherence tomography (OCT) of diabetic macular edema and the relationship between integrity of ellipsoidal zone and visual acuity outcomes.Methods Eighty-five IVR treated eyes were enrolled.The examination of BCVA was according to Early Treatment Diabetic Retinopathy Study,and the results were recorded as logarithm of the minimum angle of resolution (logMAR).Frequency-domain OCT was used to measure the central foveal thickness (CFT) and the integrity of ellipsoidal zone.All eyes were classified as diffuse macular edema (DRT group,31 eyes),cystoid macular edema (CME group,29 eyes),and serous retinal detachment (SRD group,25 eyes).All the patients were treated with intravitreal injection of 0.05 ml (0.5 mg) ranibizumab.The mean follow-up time was (9.21+3.56) months after IVR treatment.The changes of BCVA and CFT in 3 groups were compared and analyzed after 3,6 and 12 months.According to visual acuity at different ranges,the relationship between integrity of ellipsoidal zone and BCVA was analyzed.Results Compared with the average logMAR BCVA before treatment,except for 12 months after treatment in group SRD (t=2.104,P=0.053),the average logMAR BCVA after IVR at 3 months,6 months and 12 months improved in DRT group (t=7.847,6.771,6.426;P=0.000,0.000,0.000),CME group (t=8.560,6.680,5.082;P=0.000,0.000,0.000) and SRD group (t=5.161,3.968,2.104;P=0.000,0.001,0.053).The average logMAR BCVA of the DRT group was lesser than that in CME and SRD group after 12 months treatment (t=-2.043,-3.434;P=0.030,0.001).The average CFT after IVR at 3 months,6 months and 12 months reduced significantly in DRT group (t=12.746,10.687,9.425;P=0.000,0.000,0.000),CME group (t=13.400,11.460,10.169;P=0.000,0.000,0.000),and SRD group (t=1 1.755,10.100,9.173;P=0.000,0.000,0.000).After 12 months of treatment,the average CFT of the SRD group was thicker than that in DRT group and CME group (t=-3.251,-1.227;P=0.003,0.025);there was significant difference in the integrity of ellipsoidal zone among 3 groups (x2=1.267,P=0.531).The results showed that there were significant differences in the integrity of ellipsoidal zone with different ranges of BCVA before and after 12 months treatment (x2=20.145,41.035;P=0.000,0.000).Conclusions IVR could significantly improve the visual acuity of different patterns of DME,reduced the CFT,and had the best efficacy in the DRT group.There was relationship between the integrity of ellipsoidal zone and the visual acuity outcomes.

Objective o observe the expression of Notch1 and Delta-like ligand 4 (Dll4) on the fibrovascular membranes in proliferative diabetic retinopathy (PDR),and investigate its relationship with vascular endothelial growth factor receptor 2 (VEGFR2).Methods Fifty-seven PDR patients (60 eyes) who underwent vitrectomy were enrolled in this study.The PDR patients were divided into non-injection group (30 patients,32 eyes) and injection group (27 patients,28 eyes).The eyes in injection group received intravitreal injection with ranibizumab at 2 to 7 days before surgery.The preretinal fibrovascular membranes were obtained from the PDR patients during vitrectomy.Eighteen epiretinal membranes were obtained from the non-diabetic patients was served as controls.The real-time polymerase chain reaction (RT-PCR) and immunohistochemical methods were used to detecting the expression ofNotch1,Dll4 and VEGFR2.In the meantime,the numbers of the nucleus of vascular endothelial cells in the membranes stained with hematoxylin were counted.Results The immunohistochemical staining revealed that there were positive expression ofNotch1,Dll4 and VEGFR2 in all PDR membranes,regardless of the injection of the ranibizumab.The levels ofNotch1,Dll4 and VEGFR2 protein in non-injection group were higher than those of injection group (t=3.45,6.01,4.08;P=0.030,0.008,0.023).In injection group,the number of endothelial cells in the membranes reduced (17.17 ± 2.48) compared with that of the non-injection group (41.50± 5.57).There was significant difference in the number of endothelial cells in the membranes between the two groups (t=9.58,P＜0.05).RT-PCR showed that the differences of the mRNA expression ofNotch1,Dll4 and VEGFR2 were all statistically significant among the PDR group and control group (H=12.50,12.50,12.02;P＜0.05).The expression ofNotch1,Dll4 and VEGFR2 in the PDR membranes was higher than that of epiretinal membranes from non-diabetic patients.In the PDR group,the expression of Notch1,Dll4 and VEGFR2 of non-injection group was higher than that of injection group.Spearman correlation analysis showed that the expression of mRNA between VEGFR2 and Dll4 (r=0.83),VEGFR2 and Notch1 (r=0.81),Notch1 and Dll4 (r=0.87) were all significantly correlated (P＜0.05).Conclusions The expression of Notch1 and Dll4 in the PDR membranes are higher than that of the control group,and it is positively correlated with the expression of the VEGFR2.Notchl and Dll4 play a regulatory rule in the neovascularization in PDR,the acting way may be correlated with VEGFR2.

Objective To evaluate the effect and safety of pseudomonas aeruginosa injection (PA-MSHA) combined with ulinastatin (UTI) injection in the treatment of patients with malignant pleural effusion and/or ascites.Methods 52 patients were randomly divided into PA-MSHA group and PA-MSHA combined with UTI group,each group including 26 patients.All patients were given ultrasonic testing before treatment.The single drug group was given PA-MSHA 10 ml intrapleural and/or intraperitoneal injection.The two-drug combination group was given PA-MSHA 10ml and UTI 300 000 U,twice per week.Evaluation of the efficacy and adverse reaction was performed after 4 times.Results The effective rate of single PA-MSHA group was 34.6 ％ (CR 1 case,PR 8 cases),while the effective rate of PA-MSHA combined with UTI group was 61.5 ％ (CR 2 cases,PR 14 cases).The effective rate of PA-MSHA combined with UTI group was statistically higher than that of single PA-MSHA group (P ＜ 0.05).8 cases got fever in single PA-MSHA group,3 cases in PA-MSHA combined with UTI group got fever,side effect had no statistical significance (P ＞ 0.05).Conclusion PA-MSHA combined with UTI has better effect in the treatment of patients with malignant pleural effusion and/or ascites compared with single PA-MSHA,and both treatments have low side effects.

Objective To discuss the relationship between lung function before and after radiotherapy and radiation-induced pneumonitis in locally advanced non-small-cell lung cancer.Methods 76 patients were evaluated by pulmonary function tests before radiotherapy and in 1 month and 3 month after radiotherapy respectively.Results All patients were treated radiotherapy with irradiation dose of 60-70 Gy,the radiation pneumonitis occurred in 26 patients (group A),22 patients were grade 1,3 patients were grade 2,1 patient grade 3 and no patient was grade 4 and 5.50 patients without radiation pneumonitis were group B.There were significant difference between group A and group B for FEV1 before radiotherapy [(51.67±19.03) ％,(69.03± 14.54) ％,t =2.34,P ＜ 0.05].There were no significant difference between in 1 month and 3 months after radiotherapy for FVC (P ＞ 0.05).There was significant difference between in 1 month and 3 months after radiotherapy for DLCO (group A,P ＜ 0.01; group B,P ＜ 0.05).Conclusions For locally advanced non-small-cell lung cancer patients,the lower of FEV1 before radiotherapy inclineds to develop radiation pneumonitis,DLCO levels are lower significantly in patients prones to radiation pneumonitis.FEV1 and DLCO are sensitive indicators to predict radiation pneumonitis.

Objective To evaluate the effects of L-alanyl-L-glutamine (LALG) intensified parenteral nutrition support in advanced malignant carcinoma patients.Methods 68 patients were randomly divided into two groups,control group (n =34) received only parenteral nutrition,treatment group (n =34) received parenteral nutrition combined with a dose of 0.3 g ·(kg·d)-1 LALG.Nutrition status and immune functions were determined at pre-therapy and 15th days after therapy.Results After the therapy,the pALB and TRF of treatment group were significantly increased [(24.9±8.06) mg/dl vs (27.3±6.05) mg/dl; (1.62±0.43) g/L vs (2.06±0.32) g/L].Before therapy,no significant change in IgA,IgM and IgG was found in two groups (P ＞ 0.05).After the therapy,IgA and IgG of the treatment group after the therapy were significantly different from those before the therapy [(2.85±1.43) mg/L vs (3.63±5.36) mg/L; (0.95±0.43) mg/L vs (1.13±0.09) mg/L],IgA,IgM and IgG of the control group had no difference compared with those before the therapy (P ＞ 0.05),CD4+ of treatment group was significandy different compared with those of control group [(39.19±4.23) ％ vs (36.62±3.58) ％] (P ＜ 0.05).There is no significantly difference between CD:/ CD8+ CD8+ of treatment group and those of control therapy (P ＞ 0.05).After therapy,the score of quality of life in treatment group was higher than that in control group (P ＜ 0.05).Conclusion LALG intensified parenteral nutrition has better effects on improvement of the nutrition and immune functions.

Objective To observe the effect of different concentration netrin-1 on retinal vascular permeability in diabetes mellitus (DM) rats.Methods Eighty adult Sprague-Dawley rats were randomly divided into 8 groups,10 rats in each group,including normal control group (group A),normal+balanced salt solution (BSS) group (group B),normal+netrin-1 (500 μg/ml) group (group C) and DM group (50 rats in 5 subgroups).DM rats were induced by intraperitoneal injection of streptozocin.Three months after intraperitoneal injection,10 DM rats in the control group were injected with BSS (group D).Forty DM rats were injected with 5 μl of different concentrate netrin-1,and were divided into DM+netrin-1 10 μg/ml group (group E),DM+netrin-1 50 μg/ml group (group F),DM+netrin-1 100 μg/ml group (group G),DM+netrin-1 500 μg/ml group (group H)according to the different concentration.Non-DM rats in group C were injected with netrin-1 500 μg/ml.The expression of occludin was determined by immunohistochemistry for protein,and by real-time fluorescence quantitative reverse transcription polymerase chain reaction for mRNA level.Retinal vascular permeability was measured by Evans blue infusion.Results The expression of occludin protein and mRNA in group D were less than group A (t=27.71,8.59;P=0.00,0.00).However,the retinal vascular permeability increased in group D (t=-42.72,P=0.00).The expression of occluding protein,occludin mRNA and retinal vascular permeability showed significant differences between group D,E,F,G and H (F=146.31,16.54,67.77;P=0.00,0.00,0.00).Compared the group B with group C,there was no significant differences between the expression of occludin protein,occludin mRNA and the retinal vascular permeability (t=-1.13,0.93,1.04;P=0.27,0.36,0.31).The concentrate of netrin-1 showed a significant positive correlation to the expression level of occludin and occludin mRNA (r=0.73,0.81;P=0.00,0.00),but negative correlation to the vascular permeability (r=-0.61,P=0.00).Conclusion Netrin-1 can reduce the DM rats' retinal vascular permeability,which depended on the concentration of netrin-1.

Aim To study the regulatory of Jiaweisini-san on expression of hippocampal BDNF, NR1 and dental gyrus ( DG ) neurogenesis in rats with chronic stressed-depression and its possible mechamisms. Methods Chronic unpredictable mild stress was used to establish the rat model of stressed depression. The expression of BrdU, NeuN, brain -derived neurotro-phic factor ( BDNF ) and N-methyl-D-aspartate recep-tor1 ( NR1 ) in hippocampal dental gyrus were detected by fluorescently labeled immunohistochemical method. In addition, BDNFmRNA was detected by in situ hy-bridization. Results Chronic stress could inhibit the proliferation of neural precursors in hippocampal DG ( P<0. 01 );the expression of BDNF decreased signifi-cantly in DG in model rats ( P <0. 01 ) , while the ex-pression of NR1 increased significantly ( P <0. 01 ) . JWSNS and Fluoxetine hydrochloride significantly en-hanced the amount of new proliferating cells and the number of neurons in unit area of DG ( P<0. 01 ) , in-creased the expression of BDNF ( P <0. 01 ) and de-creased the expression of NR1 in DG(P<0. 01). Con-clusion JWSNS could promote the neuronal prolifera-tion in hippocampal DG of rat with chronic stressed-de-pression,and may exert an effect of promoting the pro-liferation of neurons in hippocampal DG by enhancing the expression of BDNF and decreasing the expression of NR1 .