The idiopathic macular hole ( lMH ) is research priority associated with the regenerate quickly of vitrectomy. The unaided visual acuity and the best corrected visual acuity is partial for the visual acuity of the patient with lMH. The mechanism and clinical significance of modern visual function measurements associated with lMH, including contrast sensitivity, visual field, multifocal electroretinogram, and stereoscopic vision, have been introduced. These measurements could be of great value in early diagnosis of lMH, assessment of surgical indication and evaluation of visual performance after vitrectomy. They would also be helpful to the analysis of postoperative impaired visual function and its management. Having an adequate understanding of the contents and significance of visual function is helpful to the improvement of lMH surgery techniques and postoperative visual acuity.

BACKGROUND:Proto-oncogene c-Src plays an important role in regulating cardiovascular diseases such as hypertension. At present, there were no studies concerning exercise intervention effects on c-Src expression in aortic endothelial cels so as to regulate hypertension. OBJECTIVE: To observe the effects of aerobic exercise on c-Src mRNA expression and c-Src activity in the aorta blood vessel endothelial cels of spontaneous hypertensive rats. METHODS: A total of 8 male Wistar rats were considered as normal control group. Sixteen spontaneous hypertensive rats were randomly assigned to 8 rats as spontaneous hypertension group and 8 rats as spontaneous hypertension exercise group. Rats in the spontaneous hypertension exercise group carried on 90 minutes unloaded aerobic swimming every day, 6 days a week, for 8 weeks. The rats in the normal control group and spontaneous hypertension group did not swim. Blood pressure of rats was measured once a week. 8 weeks later, the c-Src mRNA expression and c-Src activity were determined in aortic vascular endothelial cels of rats in each group. RESULTS AND CONCLUSION: Compared with spontaneous hypertension group, blood pressure was lower, but c-Src mRNA expression and c-Src activity were significantly higher in the spontaneous hypertension exercise group. The c-Src activity and c-Src mRNA expression were higher in the spontaneous hypertension exercise group than normal control group and spontaneous hypertension group (P < 0.01). Results indicated that aerobic exercise can promote the increase in c-Src activity and c-Src mRNA expression in aortic endothelial cels of spontaneous hypertensive rats.

Objective To investigate the effect of cluster nursing on quality of life and mental state of cervical cancer patients receiving chemotherapy. Methods 72 cervical cancer patients receiving chemotherapy were randomly divided into control group and observation group.The control group was given routine care and the observation group was given cluster nursing on the basis of routine care.The quality of life core questionnaire (EORTC QOL-C30) and Symptom Checklist SCL-90 score were tested at the end of treatment. Results Compared with the control group, after using cluster nursing, the EORTC QOL-C30 functional areas of physical function role function, cognitive function , social function, emotional function of patients in the observation group were significantly improved( <0.05), the main symptoms of nausea areas vomiting and pain were decreased significantly ( <0.05),and sleep,diet,diarrhea and constipation were improved significantly (<0.05) . SCL-90 scale showed that the somatization,obsessive-compulsive symptoms,depression and anxiety in observation group were decreased significantly compared with the control group ( <0.05),the somatization, obsessive-compulsive symptoms and anxiety were increased significantly in control group compared with China norm (<0.05) .Conclusion Cluster nursing on patients with cervical cancer receiving chemotherapy can effectively improve quality of life and reduce the incidence of negative emotions.

Objective To study the prognostic value of left ventricular endocardial pacing in percutaneous transluminal septal myocardial ablation(PTSMA)in patients with hypertrophic obstructive cardiomyopathy(HOCM).Methods Fifteen HOCM patients with resting left ventricular outflow gradient(LVOTG)≥30 mmHg and/or stress LVOTG≥50 mmHg were included in this study.Left ventricular endocardial pacing was attempted in the patients 20 minutes before PTSMA.Heamodynamic parameters and LVOTG were monitored during operation and follow up echocardiography was performed 1 month after the operation.Results The mean chickness of the ventricular septals decreased from 22.07?7.85 mm before PTSMA to 17.39?5.79 mm 1 month afterwards(P

Objective To compare the value of contrast-enhanced ultrasound (CEUS) and conventional ultrasound (CUS) in the localization and definition of different types of uterine myomas.Methods With real-time CEUS technique, 56 patients with uterine myomas proved by pathology were observed. The accuracy between CEUS and CUS in the localization and definition of different types of uterine myomas was retrospectively analyzed. Results The accordance rates of CEUS and CUS in the diagnosis of total uterine myomas, intramural myomas, submueous and subserous myomas were 94.6% (53/56) vs 73.2%(41/56),99.3%(31/32) vs 78.1%(25/32) and 91.6%(22/24) vs 66.7%(16/24),respectively,and in the definition of number and margin of myomas were 92.8 % (104/112) vs 80.30% (90/112) and 91.9 (103/112) vs 78.6 % (88/112). The accordance rates of CEUS and CUS in the diagnosis of typical uterine myomas were 95.8% (23/24) and 87.5% (21/24),and in the diagnosis of atypical uterine myomas were 93.8%(30/32) and 62.5% (20/32),which were different in statistics (P<0.05). Conclusions CEUS is better than CUS in revealing the number and margin of different types of uterine myomas. The accordance rates of CEUS were higher than those of CUS in the diagnosis of different types of uterine myomas and atypical uterine myomas. CEUS may be a new technique in the localization and definition of uterine myomas.

Objective To analyze the clinical and imaging features of 2 siblings with leukoencephalopathy due to NADH dehydrogenase (ubiquinone)flavoprotein 2 (NDUFV2) gene mutation,in order to better understand and diagnose it earlier.Methods Clinical and follow-up data of the proband and his brother were collected.Clinical features including symptoms,signs and cranial magnetic resonance imaging (MRI) were analyzed,and 2 patients were followed up for a long time.Sanger sequencing,targeted next generation sequencing,and whole exome sequencing were performed to identify potential genetic variations in the 2 patients and their parents.Results (1) Clinical characteristics and follow-up:ages of onset were 4 months and 1 year respectively.Both of the patients presented rapid motor regression hyperinyotonia,positive pathological character.During the follow-up the condition became stable,motor function and cognition improved gradually after cocktail therapy.(2) Brain MRI of the 2 patients showed prominent abnormalities in deep cerebral white matter,presenting T1 hypointense,T2 and fluid attenuated inversion recovery (FLAIR) hyperintense in the periventricular area.FLAIR images revealed that the abnormal white matter was partially rarefied and cavitated.Diffusion weighted images (DWI) showed high signals along the periphery of the involved areas.The follow-up MRI showed the cavitation still existed and even expanded,and DWI showed regional linear or spotty high signals around the original lesions.(3) Novel mutations in NDUFV2 gene,c.467T>A and c.404G>C,were identified in proband and his brother.The former inherited from his father,while the latter inherited from his mother,which was the new mutation not reported in the international.Conclusions The clinical features of the brothers presented subacute leukoencephalopathy with relatively stable or improved outcome.This was distinctive from the phenotypic features reported in 12 cases with hypertrophic cardiomyopathy or Leigh syndrome.The finding expanded the phenotypic spectrum of NDUFV2 mutations.Pathogenic gene of these patients which is the basis of genetic counseling for this family was determined.

Objectives To explore intraocular drug concentration changes and the pharmacokinetics after topically applied of bevacizumab with armexin A5-associated liposome on rabbit eyes.Methods A total of 105 healthy New Zealand white rabbits were selected and divided randomly into 3 groups (group A,B and C),and each group had 35 rats.Bevacizumab with annexin A5-associated liposome,bevacizumab liposome and bevacizumab were topically applied 50 μl respectively on right eyes of rabbits in group A,B and C,respectively.Aqueous,vitreous body and retina/choroid were obtained at 5,15,30 minutes and 1,2,4,8 hours and the free bevacizumab concentrations in these ocular tissues were measured by ELISA (enzyme linked immunosorbent assay).DAS 2.1.1 software was used to fit the pharmacokinetic parameters.Results The peak drug concentrations in aqueous humor of the eyes in group A,B,C were at 15 minutes after topical administration and the difference was statistically significant (F=301.061,P＜ 0.01).The peak drug concentrations in vitreous of the eyes in the group A,B,C were at 2 hours after topical administration and the difference was statistically significant (F=885.997,P＜ 0.01).The peak drug concentrations in retina/choroid of the eyes in the group A,B,C were at 1 hour after topical administration and the difference was statistically significant (F=644.908,P＜0.01).Least significant difference pair-wise test found that the drug concentrations in aqueous humor,vitreous and retina/choroid of group A was higher than that of the group B and C respectively (P＜ 0.05),while that of the group B and C had no significant different (P＞ 0.05).Pharmacokinetic fitting analysis found that the half-life (t1/2) of bevacizumab in aqueous humor were 1.14,1.29,1.29 hours,the distribution t1/2 were 1.40,1.50,1.42 hours and the eliminated t1/2 were 2.62,2.84,2.73 hours in vitreous,the distribution t1/2 were 2.61,2.99,2.70hours and the eliminated t％ were 2.61,2.99,2.70 hours in retina/choroid respectively for the 3 groups.Changes of bevacizumab concentration in aqueous humor of rabbit eyes for 3 groups was complied with one compartment model,and that in vitreous body and retina/choroid complied with two compartment model.Conclusions Topically applied annexin A5-associated liposome has higher ocular concentrations of bevacizumab than those of controls.Changes of bevacizumab concentration in aqueous humor of rabbit eyes was complied with one compartment model,and that in vitreous body and retina/choroid complied with two compartment model.

Retinopathy of prematurity (ROP) is a proliferative vascular retinal disease. Cryotherapy, laser photocoagulation, intravitreal injection of anti-vascular endothelial growth factor, scleral buckling surgery and vitrectomy are the main treatments. Treated with cryotherapy or laser photocoagulation or intravitreal injection of anti-vascular endothelial growth factor, patients with a history of ROP have thicker foveas, and the morphology of the fovea and the development of the retinal vessels in the macular area are affected, resulting in abnormal vision development. However, the specific mechanisms by which different treatments of ROP affecting the development of the macula are not yet clear. It still need further study with large samples to verify and explore, whether changes in the levels of intraocular vascular endothelial growth factor changing the process of normal macular development and how the abnormal development of the macula affects visual function.

Objective To explore the safety and clinical effects of laparosepie splenectomy.Methods Clinical data of 24 cages of laparoscopic splenectomy in our hospital from 2002 to 2008 were retrospectively analvzed.Among these 24 cases,there were 6 cases with liver cirrhosis,10 cases with ITP,2 cases with hemolytic anemia(Evens syndmm),2 cases with spelenic rupture,and 4 cases optimum spleen ambuty.Results All the 24 cases were successfully underwent laparoscopic splenectomy.The mean operation time wag 146 minute.the mean volume of blood loss was 220 ml.the postoperative gastrointestinal peristalsis time Was from 24 to 48 hours.The mean hospitalization time was 9 days after operation.Conclusions Provided mastering operation indication and technique,Laparoscopie spleneetomy is a safe and minimally invasive surgery.