Hyperhomocysteinemia is an independent risk factor for arterial and venous obstructive vascular di-seases. Raised plasma homocysteine concentrations are caused by genetic and non-genetic factors. The pathogenic mechanism is not clear. It may be associated with endothelium dysfunction, abnormal lipid metabolism, hypertrophy of intima media, increased platelet aggregation and several clotting factors interfered, etc. The metabolism and pathogenic mechanism of homocysteine are reviewed in this article, which provides theoretical foundation for the treatement of hyperhomocysteinemia.

Objective　To investigate the operation treatment of gallbladder carcinoma(GBC). Methods The clinical data of 132 patients with GBC from 1980 to 1999 were analysed. Results　The mean age was 55 years and the occurrence sex ratio in female/male was 1.5∶1. Gallstone was found in 80% of the patients, and 87.1% of the GBC were adenocarcinoma. Before December 1990(forward group), simple cholecystectomy were performed on 11 cases, radical cholecystectomy on 9 cases, extended radical cholecystectomy on 5 cases, palliative extra- or intra- drainge on 15 cases, surgical biopsy on 30% cases. Hospital death occurred in 4 cases, the postoperative complications occurred in 20 cases including biliary fistula in 4 cases, pancreatic fistula in 2 cases. Since January 1991(latter group), radical simple cholecystectomy were performed on 2 cases, radical cholecystectomy on 16 cases, extended radical cholecystectomy on 24 cases; palliative extra- or intra- drainge in 9 cases, surgical biopsy on 8 cases. Hospital death occurred in 1 cases; postoperative complications in 12 cases, including biliary fistula in 1 cases, pancreatic fistula in 1 cases. Radical resection rate was 35.7% in forword group, 72.6% in latter group. Conclusions　Surgical tech-nique progress and application with Peng's Multifunctional Operative Dissector can improve the resection rate of GBC. Extended redical resection is an effective and active method to treat middle or late stage GBC.

Objective To explore the lymphcyte subsets distribution in cerebrospinal fluid in patients with HIV infection ,and to investigate the clinical significance of the lymphocyte subsets in cerebrospinal fluid in HIV central nervous system complication . Methods 34 patients with HIV infection ,including 20 patients without nervous system symptoms (simple HIV group) and 14 pa‐tients with nervous system symptoms (neurological HIV group) ,and 15 cases of healthy people (control group) were selected . Flow cytometry was used to detect lymphocyte subsets ,and immunoturbidimetry was used to detect the level of IgG in cerebrospinal fluid .Results The percentage of CD8+ T cells was higher and percentage of CD4+ T cells was lower in the simple HIV group and neurological HIV group than those in the healthy control ,with statistically significant differences (P<0 .01) .The level of IgG in pa‐tients with HIV infection was higher than that in the healthy control group (P<0 .01) .While no significant difference were found in the percentage of B cells and NK cells among the there group (P>0 .05) .There were also no significant differece between the sim‐ple HIV group and neurological HIV group in the ratio of each lymphcyte subset in cerebrospinal fluid (P>0 .05) .Conclusion The immune disorder in cerebrospinal fluid in patients with HIV infection may appear in the early time before the nervous system com‐plication .The changing trends of lymphocyte subsets are consistent with the peripheral blood ,which demonstrate that the T lym‐phocyte subsets may be correlated with the nervous system symptoms of HIV .

Although it has been frequently used to treat thoraxic tumors,radiation induced lung injury (RILI) is the major factor of dose limitation in thoracic radiotherapy.Amount of endogenous and exogenous reactive oxygen / nitrogen species (ROS/RNOS) could be generated in the radiated organisms and further cause molecular damage of DNA,protein and membrane lipids,which results in celluar structure damage,dysfunction and RILI.In addition,a series of cytokines could also induce chronic oxidative stresses that contribute to increases in cell membrane permeability,tissue edema and extracellular matrix proteins accumulation and even further result in pulmonary fibrosis.Oxidative stress theory offers new clues and strategies for further understanding the mechanism of RILI,and some anti-oxidative stress drugs may have potential clincial application in RILI treatment.

Objective To analyze retrospectively the MR features of MELAS patients,in order to improve the early diagnosis of MELAS.Methods MR data of 1 6 MELAS patients confirmed by clinical diagnose and muscle biopsy were retrospectively analyzed. MR features of plain scan(n=1 6),ASL(n=3),MRA(n=1 5),DWI(n=14)and MRS(n=3)were analyzed.Results MRI data demonstrated brain lesions mainly distributed in posterior cerebral hemisphere extending to subcortical area,which was not consistent with the vascular supply territories.The lesions were observed as low signal on Spin-echo sequence of T1 WI,while high signal on T2 WI, FLAIR and DWI.The focal lesions showed increasing Lac peak on MRS.Fifteen of 16 patients underwent MRA and one showed increased arterial branches in lesion zones.Three patients had ASL scanning demonstrating high irrigation in lesion zones which would wander once relapsed.Meanwhile,old lesions showed encephalatrophy and cerebromalacia.All patients’muscle biopsy pathology showed ragged red muscle fibers.Under electron-microscopic,bioblasts were bigger and more than average level and muscle fibers atrophied.Mitochondrial DNA sequence of 3 patients showed mtDNA A3243G transgenation.Conclusion The DWI,MRS and ASL sequences show good ability in MELAS diagnosis and differential diagnosis.

Gene chip is a research tool on molecular biology which can detect generous gene expression rapidly.The studies on gene chip of leiomyoma have revealed the changes of gene expression related to cell growth,proliferation,apoptosis,metabolism,angiogenesis,formation of extracellular matrix,cell differentiation and immunity.The article reviews the advance on gene chip of leiomyoma and approaches the pathogenesis of leiomyoma on molecular level.

Objective To observe the therapeutic effects of fenestration in the treatment of dentigerous cyst in mixed dentition stage. Methods From 2004 to 2007, 8 cases of dentigerous cyst in mixed dentition stage were treated, among whom 3 were boys and 5 were girls with ages between 7 and 12 years old. The dentigerous cysts of 2 cases were in superior maxillary bone and the other 6 cases were in inferior maxillary bone. Each of 5 cases had one tooth in dentigerous cyst cavity, and each of the other 3 had 3 teeth in dentigerous cyst cavity. All patients received fenestration under local anesthesia. The patients were followed up for 18 months after fenestration, and the soft tissue healing, facial malformation, permanent teeth eruption and bone tissue healing were observed. Results It was found during follow up that cyst cavity disappeared in all the patients and all had normal facial morphology with no maxillary bone malformation. In five cases, permanent teeth erupted totally and dental occlusion kept normal. In one case, 2/3 of permanent teeth erupted and dental occlusion kept almost normal. While in the other two cases, permanent teeth were to erupt. It was revealed by X ray examinations that the shadow of maxillary bone density decrease disappeared in all the patients. Conclusion Fenestration can keep the teeth and bone in the treatment of dentigerous cyst in the mixed dentition stage.

Background Intermittent exotropia is a type of strabismus that between latent extropia and manifest extropia.The assessment of fusional convergence/divergence is important for understanding control ability of exodeviation in children with intermittent exotropia.Objective This study was to analyze the correlations between fusional convergence/divergence and control ability of exodeviation in children with intermittent exotropia.Methods Sixty-three children with intermittent exotropia were recruited in Beijing Tongren Eye Centre from July 2013 to February 2014 under the informed consent of children and their parents.Angle of deviation was measured by wearing prism and covering method alternately.The control ability of exodeviation was evaluated and scored by the Revised Newcastle Control Score (RNCS),and fusional convergence and divergence were measured with 1 Δ-40Δ horizonal prisms and regulating targets.The correlations between the measured parameters of fusional convergence/divergence and control scores of exotropia were analyzed by Spearman rank correlation analysis.Results The mean diopter of the right and left eyes was (-1.95 ± 1.63)D and (-2.01 ± 1.73)D,respectively,and the mean deviation angle for distantly and near was (36.67 ± 15.69) Δ and (38.25 ± 14.83) Δ,respectively,without significant differences between them (diopter:t =-0.13,P＞0.05;deviation angle:t =-0.57,P＞0.05).Considerably negative correlations were found between the breakpoints of fusional convergence for distant or near and control scores of exodeviation (rs =-0.41,P=0.03;rs =-0.56,P＜0.01).No significant correlations were found between the breakpoints of fusional divergence for distantly or near and control scores of exodeviation (rs =0.05,P =0.78;rs =0.04,P ＜0.75).In addtion,there was no significant correlation between fusional recovery level and control scores (both at P ＞ 0.05).Conclusions Breakpoints of fusional convergence may be useful in grading the severity of intermittent exotropia in children,and it is probably one of the surgical indications of intermittent exotropia.

AIM:To explore and compare effect of coaxial micro-incision phacoemulsification and standard coaxial phacoemulsification in the treatment of cataract.
METHODS:A total of 88 patients(88 eyes) with senile cataract who underwent selective cataract ultrasonic emulsification resorption combined with intraocular lens implantation in the hospital from Aug. 2013 and Aug. 2015 were selected, they were divided randomly into the control group ( 44 cases, 38 cases completed, 6 cases dropped out ) and the observation group ( 44 cases, 40 cases completed, 4 cases dropped out ) . The control group received standard coaxial 3. 0mm small incision phacoemulsification, the observation group received coaxial 1. 8mm micro-incision phacoemulsification. All patients were combined with intraocular lens implantation. Intraoperative effective ultrasonic time, cumulative release energy, best corrected visual acuity before and after surgery in the two groups were recorded, corneal endothelium cell population, incision corneal thickness, percentage of cornea hexagon cell, corneal astigmatism changes before the operation, 1d, 7d, 30d after the operation were compared.
RESULTS: There was no significant difference in intraoperative effective ultrasonic time, cumulative release energy in the two groups(P>0. 05). There was no significant difference in postoperative best corrected visual acuity between the two groups(P>0. 05). Corneal endothelium cell population, percentage of cornea hexagon cell 1d, 7d, 30d after the operation in the two groups were significantly decreased compared with those before the treatment ( P < 0. 05 ), but there was no significant difference in the two groups ( P > 0. 05 ). Incision corneal thickness 30d after the operation in the observation group was significantly lower than the control group(P<0. 05). Degree of corneal astigmatism in the observation group 1d, 7d, and 30d after the operation were significantly lower than the control group (P<0. 05).
CONCLUSION: Coaxial micro - incision phacoemulsification and standard coaxial phacoemulsification can improve visual acuity of cataract patients, but the former can reduce degree of corneal astigmatism.

Background Plasticity of visual system is one of the mechanisms of deprivation amblyopia.Our previous study showed that synapsin plays a role during visual developmental plasticity,and conventional protein kinase C-γ (cPKC-γ) probably is one of upstream kinases of synapsin.However,whether or how the cPKC-γ plays its effects on visual developmental plasticity is below understood.Objective This study was to investigate the dynamic expression of cPKC-γ in visual cortex of normal mice and explore the effects of abnormal visual experience on cPKC-γ expression.Methods The bilateral visual cortex tissues were obtained from 36 clean C57BL/6 mice at postnatal (P) 7,14,21,28,35,42 days respectively and 6 mice for each for the researching of cPKC-γ dynamical expression in visual cortex over aging.Other 24 C57BL/6 mice were randomized into developmental phase group and adult phase group,12 for each group.The monocular deprived (MD) models were established by suturing the upper and inferior eyelides in P14 mice for 14 days in 6 mice in the developmental phase group and 6 healthy mice served as controls,and MD models were established in the same way in 6 P60 mice in the adult phase group,and the same aged mice (6 mice) were used as controls.The mice were sacrificed and bilateral visual cortexes were obtained.The expression of cPKC-γ protein in the visual cortex was quantitatively detected using Western blot assay.The study protocol was approved by Ethic Committee of Tongren Eye Hospital.The use and care of the experimental mice followed the ARVO Statement.Results The cPKC-γ protein was faintly expressed in visual cortex in normal P7 mice,with the related expressing level of (39.74± 11.22)％ and (40.78± 10.37)％ in the left and right cortex,respectively.The expressing level of cPKC-γ protein was gradually increased over aging,with the peak value of (138.68±15.73)％ and (138.47±23.48)％ in P21 mice.A significant difference was found in the expression of cPKC-γ protein in various ages of mice (Fage =57.174,P =0.000),and the expression of cPKC-γ protein was not significantly different between the left and right visual cortexses (Flateral =0.059,P =0.809).No significant differences were found in the expression of cPKC-γ protein on bilateral visual cortexes among the mice of the developmental phase group and adult phase group (Fage =1.798,P =0.159) or among the MD group and normal control group (Fgroup =0.104,P=0.749).Conclusions The dynamic expression of cPKC-γ in the visual cortex of normal mice presents a consistant tend with the aging and development of visual critical period.MD does not affect the expression of cPKC-γ protein in bilateral visual cortexes.Further researches should be performed in the activity of cPKC-γ protein in MD mice.