Objective To evaluate the changes of left ventricular regional function in normal subjects with aging and the influencing factors by Doppler tissue imaging. Methods One hundred and twelve normal subjects were divided into four groups according to age: I group with age≤18 years old ; II group with 18 60 years old. Using a quantitative tissue velocity analysis system and tissue tracking, the peak velocities of different ventricular segments at systole, early and late diastole (Vs, Ve,Va) , the Ve/Va ratios were obtained and the effects of age, gender, heart rate and STd were analyzed. Results (1) Peak velocities of different segments of each wall were decreased one by one from mitral annulus, the basal, middle segment to the apical portion. (2) Peak velocities of different ventricular walls were significantly different, with the antero- and posterio-inter-ventricular septum being the lowest CVe (6. 89?2. 60) ,(7. 94?2. 64)cm/s]and with the latero-,posterio-,antero, and inferior walls of the left ventricle being higherCVe (9. 85?3. 02) , (9. 80?3. 09), (8. 86?3. 16), (8. 23?2. 48) cm/s] . (3) Peak velocities of different segments were associated with age, STd, BMI, heart rate and not associated with gender. (4) The Ve/Va ratios were increased one by one from mitral annulus, basal, middle segment to apical portion, and were significantly lower in III group and IV group than in I group and II group. Conclusions Peak velocities of different segments at different walls change regularly and age is the most important influencing factor to the diastolic velocities.

Background Insulin can promote the occurrence of myopia.It has been proven that insulin receptor exists in human retinal pigment epithelial (RPE) cells and can promote RPE cells to secrete transforming growth factor-β2(TGF-β2),which is one of the most important myopic signal molecules.Objective This study was to investigate if PI3K/Akt mediates the promotive effects of insulin on proliferation of human RPE cells and secretion of TGF-β2.Methods Human RPE cell line,ARPE-19 cells,were regularly cultured using DMEM containing 10％ fetal bovine serum,and 10× 103 U/ml insulin,LY294002,10× 103 U/ml insulin+LY294002,Wortmanin,10× 103 U/ml insulin+Wortmanin were added into the medium respectively for 48 hours,and the regularly cultured cells served as blank controls.The proliferation value (absorbance,A) of the cells was evaluated by MTS,and the TGF-β2 level in the cell supernatant was detected by ELISA.The relative expression of TGF-β2 mRNA in the cells was assayed using reverse transcription PCR (RT-PCT) 1 hour and 2 hours after the addition of reagents.Results MTS showed that the proliferation value of the cells in the insulin+LY294002 group was 0.75±0.03,which was significantly lower than that in the insulin group (0.98± 0.04).No significant difference was seen in the proliferative value between the insulin+Wortmanin group and the insulin group (0.97±0.07 versus 0.98± 0.04,P＞0.05).ELISA revealed that the content of TGF-β2 in the the cell supernatant was (11.59±2.85) pg/ml and (49.16± 10.94) pg/ml in the insulin + LY294002 group and the insulin + Wortmanin group,respectively,showing a significant decline in comparison with (548.50±35.18) pg/ml in the insulin group (both at P＜0.05).A significant difference was found in the TGF-β2 content between the insulin+LY294002 group and the insulin+Wortmanin group (t =8.131,P =0.000).The RT-PCR showed that 1 hour and 2 hours after addition of the reagents,the expression levels of TGF-β2 mRNA in the cells were lower in both insulin+LY294002 group and insulin+Wortmanin group than those in the insulin group (P＜0.05).The decline range of TGF-β2 mRNA expression level was more significant in the insulin+LY294002 group than that in the insulin+Wortmanin group at 1 hour (t=4.176,P=0.014) rather than at 2 hours (t=0.756,P=0.492).Conclusions Insulin can promote the proliferation of human RPE cells and secretion of TGF-β2 through PI3K/Akt pathway.This may be one of the mechanisms of insulin causes myopia.

Objective To induce the experimental corneal neovascularization(CRNV) by alkali burn,and explore the methods for quantitative analysis of CRNV and observation of permeability of CRNV. Methods Thirty-six C57BL/6 mice were selected and divided into experiment group(n=30) and control group(n=6).For the experiment group,alkali burn was induced by application of filter paper with 1mol/L sodium hydroxide to the cornea for 5 s.For the control group,no intervention was conducted.Areas of CRNV were measured on day 4,7,10 and 14 after alkali burn.Histological examinations of cornea were performed with HE staining on day 3, 7,10,16 and 28 after alkali burn.On day 10,endothelial cell marker CD31 was used with immunohistochemical staining for CRNV counting,and fluorescence angiography(FA) was employed to reveal the permeability of CRNV.Corneal ulceration and hyphema were observed everyday.Results CRNV developed after alkali burn,and extincted afterwards.Axenic coneal ulceration and hyphema were frequently observed,with the incidences of 6.7% and 10.0%,respectively.Histologic changes of corneal tissues at different time points could be observed with HE staining.On day 10, CRNV could be labeled and counted with immunohistochemical staining for CD31 antibody,and the permeability of CRNV could be detected by FA. ConclusionCRNV counting with immunohistochemical staining for CD31 antibody and measurement of area of CRNV are appropriate methods for quantitative analysis of CRNV.FA is an effective method in the detection of permeability of CRNV.

BACKGROUND:Chinese medicine therapy is effective for patients with mild-to-moderate lumbar spinal stenosis and also has a better long-term effect than surgical patients, which can enhance perioperative efficacy and prevent spinal restenosis. OBJECTIVE:To evaluate the clinical efficacy of “Tongmai songjin yigu” massage therapy on lumbar spinal stenosis. METHODS:Eighty-four patients with degenerative lumbar spinal stenosis were randomly and equaly divided into treatment group and control group. Treatment group were treated with “Tongmai songjin yigu” massage therapy; patients in the control group were treated according to the guidelines for diagnosis and treatment of common disease in orthopedics and traumatology promulgated by China Association of Chinese Medicine, once a day, continuous for 2 weeks. RESULTS AND CONCLUSION:After treatment, the visual analog scale score in the treatment group was improved significantly (P < 0.05), and there was a significant difference in the Japanese Orthopaedic Association Scores on subjective symptom and daily life between the treatment and control groups (P < 0.05). The effective rate of the treatment group was higher than that of the control group (P< 0.05). These findings indicate that “Tongmai songjin yigu” massage therapy is better than traditional massage, but clinical large-sample studies are required.

0.05).⑥ The incidence of MSI at D3S1234,D3S4103,D3S1300 in recurring cases was 83.33 %,but the ratio of MSI inprimary cases was 30.77 %,the former was remarkablyhigher than the latter(P=0.004).CONCLUSION ①Microsatellite analysis showed that both LOH andMSI of FHIT gene existed in laryngeal carcinoma andhypopharyngeal carcinoma,the former was morecommon.② FHIT gene participates the developmenof laryngeal carcinoma and hypopharyngeal carcinoma and may be one of the candidate tumor suppressor genes.③ MSI of FHIT gene may be correlated with recurrence of laryngeal and hypopharyngeal carcinoma.

Objective To compare the transfection rate and safety between SonoVue + ultrasound and liposome mediated gene transfection to retinal pigment epithelium (RPE) in vitro, and to approach the feasibility of SonoVue and ultrasound enhancing liposome mediated gene transfection to RPE in vitro. Methods RPE were cultured in 24 well dishes with green fluorescent protein plasmid of 2 μg/well. All the cells were divided into 5 groups: control group, ultrasound irradiance group, SonoVue + ultrasound irradiance group(2 W/cm2 and 3 W/cm2),liposome group and liposome + SonoVue + ultrasound irradiance group. There were 10 wells in every group. Gene transfection results were observed under inversion fluorescent microscope. Seventy-two hours later, gene transfer was guantified under flow cytometry. The apoptosis rates of RPE were determined with Annexin Ⅴ-FITC and PI staining by flow cytometry. Results The transfection rate of ultrasound exposure group was (1.06 ± 0.13)%. The transfection rate of SonoVue + ultrasound group was (15.81 ± 1.70)% and (20.86 ± 2.63)%. The transfection rate of liposome group was (30.06 ± 3.49)% ,and the differences between above mentioned sets were significant(P<0.05). The transfection rate of liposome + SonoVue + ultrasound was (44.51 ± 1.28) %,and the differences between above mentioned two sets were significant (P<0.05). Conclusions The transfection rate of liposome is higher than that of SonoVue + ultrasound group. SonoVue and ultrasound can obviously enhance liposome mediated EGFP gene transfection to RPE in vitro.

Objective To determine the incidence and risk factors of iatrogenic retinal breaks in eyes undergoing pars plana vit- rectomy for idiopathic macular pucker.Design Retrospective case series.Participant 88 consecutive vitrectomies performed on eyes with idiopathic macular pucker.Method Consecutive vitrectomies performed on eyes with idiopathic macular pucker at Beijing Tongren Eye Center between 2002 and 2006 were retrospectively reviewed.Cases with iatrogenic retinal breaks were recorded and analyzed. Main Outcome Measure Number and location of retinal breaks,and anatomic outcome after surgical managements.Result A total of 88 consecutive vitrectomies were included in the study.Of the 88 eyes,8 eyes had 14 iatrogenic retinal breaks detected,with an aver- age incidence of 9.1%.Peripheral retinal breaks(8.0%)were more common than posterior retinal breaks(1.1%).All peripheral retinal breaks occurred around the selerotomy sites(100%)and the quadrant of predominant hand was involved most commonly(62%).Most of the breaks(88%)were detected during the surgery.All eyes with iatrogenic retinal breaks obtained anatomic retinal reattachment (100%).Conclusion Despite improvements in instrumentation and surgical techniques,iatrogenic retinal break continues to be an im- portant complication of pars plana vitrectomy in eyes with idiopathic macular pucker.This complication tends to occur more commonly at peripheral retina and is mainly selerotomy-related.

OBJECTIVETo investigate and clarify the key surgical techniques and evaluate clinical effectiveness of modular cementless femoral stems(LINK MP modular stem) in complex revision hip arthroplasty.

METHODSFrom January 2002 to December 2013, 470 patients in Chinese PLA General Hospital received revision hip arthroplasties using MP stems. Among them, 246 patients were followed for an average of 5.7 years (ranged, 0.5 to 11 years). There were 148 males and 98 females, with an average age of 62.5 years old (ranged from 26 to 83 years old). The most common reason for revision was aseptic loosening of femoral stems (107 cases, 43.5%), followed by prosthetic joint infection (104 cases, 42.3%). Other reasons included unexplained hip or thigh pain, periprosthetic femoral fracture, prosthesis wear and dislocation. According to Paprosky classification of femoral deficiency, there were 171 cases of type IIIA (69.5%), 14 cases of type I, 39 cases of type II, and 22 cases of type IIIB. The average preoperative Harris hip score (HHS) was 37.4 ± 7.5. In addition, radiographic presentation, degree of patients' subjective satisfaction, and clinical effectiveness were assessed as well.

RESULTSThe average Harris score was im- proved to 87.8 ± 4.2 after operation,with significant statistical difference when compared to preoperative score (t = 92.13,P = 0.00). Analysis of patients' subjective satisfaction for leg length discrepancy, stability and overall degree of satisfaction showed that the number of patients with great satisfaction were 27, 60, 61 respectively. The most common complication was the periprosthetic fracture (intraoperatively 21 cases and postoperatively 8 cases). Other complications included infection (7 cases), dislocation (5 cases), numbness possibly caused by incomplete sciatic nerve injury (6 cases) and thigh swelling (3 cases). The X-ray taken at the final follow-up revealed that prosthesis subsidence occurred in 4 cases, 2 of which needed a second revision.

CONCLUSIONThe application of modular cementless femoral stems (LINK MP modular stem) in complex revision hip arthroplasty (especially in cases with the serious defect of proximal femoral bone) shows good results at both the short-term and long-term follow-up, especially in the revision for prosthetic infection with the high success rate. In order to avoid complications and improve clinical outcomes,the surgeons should carefully select proper surgery candidates,perform the procedure with care, and master the key surgical techniques.

Adult ; Aged ; Aged, 80 and over ; Arthroplasty, Replacement, Hip ; adverse effects ; methods ; Female ; Hip Prosthesis ; Humans ; Male ; Middle Aged ; Patient Satisfaction ; Postoperative Complications ; therapy

AIM: To explore the fundus fluorescein angiographic characteristics and relevant clinical significance of age-related macular degeneration(AMD).METHODS: Fundus fluorescein angiography (FFA) was performed on 149 eyes of 112 patients using Nikon NF-505 fundus camera.RESULTS: Out of 149 eyes, 90 eyes were atrophic AMD (60.4%), 59 eyes were exudative AMD (39.6%) which were further divided, according to the composition and location of lesion, into subfoveal choroidal neovasculari-zation (CNV)(7 eyes of classic type, 26 eyes of occult type, 9 eyes with disciform cicatrices, juxtafoveal CNV(2 eyes of classic type, 12 eyes of occult type), and extrafoveal CNV(3 eyes of occult type).CONCLUSION: FFA can show CNV of AMD patients and its quality and location, which is helpful to guide the treatment and evaluate the prognosis.

Background and purpose: The incidence of breast cancer increases as patients age, elderly patients account for a large proportion. Due to the insufifcient systemic therapy, more complications and poorly physical condition, the prognosis of elderly patients is often worse than the younger. The aim of this study was to investigate the safety and tolerance with non-anthracyclin regimen as adjuvant chemotherapy in elderly breast cancer patients. Methods:From Nov. 2008 to Jan. 2012, 56 patients (≥65 years) after surgical excision were enrolled into this study. The patients were divided into two groups:TC and PC groups. Each patient received 4 or 6 cycles of chemotherapy of PC (175 and 600 mg/m2, respectively;n=21) or TC (75 and 600 mg/m2, respectively;n=35), administered intravenously every 3 weeks, as adjuvant chemotherapy. Radiation therapy (as indicated) and endocrine therapy, for patients with hormone receptor-positive disease, were administered after completion of chemotherapy. Results: In this study, 50 patients completed chemotherapy as plan, the proportion of two groups were above 90%. After a median follow-up of 33 months, the median disease-free survival(DFS) and overall survival(OS) were not reached. The relapse-free rate and survival rate were 89.5%and 100%in the PC regime group, which were 90.3%and 96.8%in the TC regime group. Major toxicities included:neutropenia, leucopenia, alopecia, nausea, vomiting and various degree of peripheral neuropathy. The incidence of gradeⅢ-Ⅳneutropenia was 76.2%in PC group vs 48.6%in TC group (P=0.044). The most common cause for withdrawing from treatment was to be unable to tolerate the adverse effects. Conclusion:Adjuvant chemotherapy with paclitaxel and cyclophosphamide is safe, tolerable and promising for elderly breast cancer patients.