0.05). But the mean light sensitivity at central 10? eccentricity were significantly decreased 3 months after photocoagulation (P

Objective To observe the clinical characteristics of patients with macular branch retinal vein occlusion (MBRVO) and the changes of the area of foveal avascular zone (FAZ). Methods The data of 69 eyes of 69 patients with MBRVO , who had been diagnosed by ophthalmoscopy, slit-lamp examination and fluorescein angiography, were retrospectively studied. The relationship of locations between artery and vein on the obstructive site, and the characteristics of fundus pictures, retinal vasculature changes and the complications were analyzed. In 69 patients with MBRVO, 36 had the course of disease for more than 3-6 months, of whom the area of FAZ was compared with that of 30 healthy people. Results In 69 patients, superior MBRVO occurred in 45 eyes (65.22%), and inferior MBRVO occurred in 24 eyes (34.78%). Most of the arteries were anterior to the veins at the obstructive site. Four clinical types of MBRVO were found, and the main complication was macular edema. There was a significant difference in area of FAZ between patients with MBRVO and healthy people (P

ObjectiveTo observe the effect of enema with Chinese medicine Changduqing combined with plasma exchange for treatment of endotoxemia in patients with acute-on-chronic liver failure.Methods A prospective randomized controlled trial was conducted, and 68 patients with acute-on-chronic hepatic failure who were hospitalized from January 2009 to June 2012 in the First Affiliated Hospital of Henan University of Traditional Chinese Medicine were randomly divided into treatment and control groups, 34 cases in each group. The patients in control group were treated with plasma exchange combined with western medicine comprehensive treatment such as protecting liver, reducing enzyme, removing jaundice, and in cases with hepatitis B, antiviral therapy was added. The treatment in patients of treatment group was the same as that in the control group, but additionally Changduqing enema of TCM decoction was given(ingredients: radix et rhizoma ginseng 10 g, flos magnolia officinalis 6 g, radix et rhizoma rhei 6 g, fructus aurantii immaturus 6 g, radix paeoniae rubra 10 g),twice a day combined with 3-4 times of plasma exchange treatment, once every 72 hours. The course of treatment of both groups was 4 weeks. The changes of total bilirubin (TBil), alanine aminotransferase(ALT), albumin(ALB), prothrombin activity(PTA), endotoxin, the improvement of clinical symptoms and signs such as lacking in strength, poor appetite, abdominal distension, oliguria, bleeding tendency, hepatic encephalopathy, infection and ascites were observed before and after treatment, and the survival rate in 24 weeks of follow-up was also investigated.Results Before treatment, the comparisons of TBil,ALT, ALB and PTA between the two groups were of no statistically significant differences(allP>0.05); compared with those before treatment, the levels of TBil and ALT were obviously decreased, and PTA was markedly increased after treatment in both groups, the degree of change being more prominent in treatment group〔TBil(μmol/L): 89.6±52.3 vs. 124.6±64.4, ALT(U/L):52.4±32.1 vs. 98.3±42.5, PTA:(53.8±11.5)% vs.(41.2±10.2)%, allP<0.05〕. The ALB levelsbefore and after treatment of both groups showed no significant difference(bothP>0.05). After treatment, the endotoxin(kU/L) in both groups were decreased in inchoate, developing and fully-developed stages and the descent being more significant in treatment group(inchoate stage: 0.094±0.015 vs. 0.109±0.032, developingstage: 0.102±0.019 vs. 0.146±0.062, fully-developed stage: 0.124±0.022 vs. 0.196±0.074, allP<0.05). The 24-week survival rates of developing and fully-developed stages in patients of both groups were lower than the rate in patients of inchoate stage, and the rates of treatment group in inchoate and developing stages were remarkably higher than the rate in control group〔inchoate stage: 94.1%(16/17) vs. 83.3%(15/18), developed stage: 85.7%(12/14) vs. 42.9%(6/14),bothP<0.01〕.ConclusionEnema with TCM Changduqing combined with plasma exchange for treatment of patients with acute-on-chronic liver failure can remove bilirubin, ameliorate endotoxemia, elevate PTA level and increase the survival rate of patients in 24 weeks of follow-up.

Objective To prepare a radiofrequency (RF) ablation probe guided by endoscopic ultrasonography (EUS) and to evaluate its efficacy and safety. Methods A modified 19-gauge needle ( Olympus) was used, which was electrically insulated with shrink tubing, with the tip of lcm naked. The insulation was tested, and the current signal was stable. Three rabbits were anesthetized with 8% chloral hydrate ( 3 ml/kg) intraperitoneally, fixed on the dissecting table. A standard neutral pad was applied to the thigh of the rabbit to complete the electrical circuit, both the pad and the needle electrode connected with RF generator. After anesthesia was ready, the needle was advanced through the gastric wall into the liver. Ablations were performed three times in the same zone. Extent and tissue lesion were measured after ablation. Results Ablation could be successfully performed by the needle electrode, with brown lesions surrounded by normal hepatic tissue. The mean diameter of the ablated zone in the liver was 1.0 cm× 1.2 cm. After ablation,specimens along the passage were subjected to NADH staining, and no lesions were found. HE and NADH staining showed no viable cells in the central ablation area. Conclusion With the advance of the technology and selection of materials, an EUS-guided needle electrode can be made. This preliminary animal trial demonstrates that radiofrequency ablation can be performed effectively and safely by using this EUS-guided needle electrode.

Objective To observe the time characteristics of acute aortic dissection (AAD) in Urumqi and its peripheral areas in Xinjiang Uygur autonomous region, and to explore the effect of meteorological conditions on the onset of AAD.Methods Retrospective analysis of the related data of the adult AAD patients diagnosed by imaging examination, and admitted to the First Affiliated Hospital of Xinjiang Medical University from March 2010 to July 2016 was performed. The onset time, the contemporaneous meteorological data, including daily minimum, average, and the highest temperature, daily average air pressure, daily average relative humidity, daily precipitation, daily average wind speed, daily maximum wind speed, and sunshine duration per day were collected. Analysis of concentrated distribution trend of the AAD onset was done by circular distribution statistics. Meteorological conditions were compared between the AAD day and no AAD day. The changes of air temperature 5 days before onset were observed.Results A total of 379 patients were enrolled, with 307 male and 72 female. The ratio of male to female was 4.19:1, the average age was 52.27±12.18; and the underlying diseases was hypertension (about 58.05%); the incidence sites were Urumqi and Changji city. ① The incidence of AAD in Urumqi and its peripheral areas had clear concentrated trend, and the peak period of AAD corresponded to January 1st to 2nd (homogeneity testr = 0.104,r0.05 = 0.009,P < 0.05). ② The minimum, mean and maximal atmospheric temperatures on the AAD day were lower than no AAD day [℃: 4.10 (-9.55, 14.60) vs. 7.75 (-6.70, 16.20), 14.10 (-1.50, 25.00) vs. 17.50 (0.60, 26.78), 8.50 (-6.22, 19.45) vs. 12.10 (-3.60, 20.90), allP < 0.05], sunshine duration was significantly shorter than no AAD day [hours: 8.50 (4.60, 10.70) vs. 8.90 (5.50, 11.50), P< 0.01], and atmospheric pressure were higher than no AAD day [kPa: 91.24 (90.66, 91.75) vs. 91.12 (90.62, 91.61), 19.11 (18.99, 19.22) vs. 19.09 (18.98, 19.19), bothP < 0.05]; there were no significant differences in the incidence of daytime temperature difference, average relative humidity, precipitation, average wind speed, and maximum wind speed between the two groups. ③ the peak period of AAD occurrence was December (38 cases), which was followed by January (36 cases); and there were 26 cases of each month in May, June, July, and September, which were lower than the rest of months. It was shown by the temperature distribution that the minimum average temperature was in January (-12.46 ℃), followed by December (-9.03 ℃); the maximum average temperature was in July [(24.59±3.21)℃], followed by August [(23.14±3.64)℃]. ④ The patients was sorted according to the quartile of daily mean temperature, into < -5.2 ℃, -5.2-10.7 ℃, 10.7-20.4 ℃, and > 20.4 ℃ groups, and each group had 104, 99, 98, 78 cases of AAD, respectively. The number of AAD in lowest temperature group was 1.33 times of the highest temperature group. In the 45-59 and 60-74 years, the number of AAD in lowest temperature group was higher than that in the highest temperature group (50 vs. 36, 26 vs. 13). In patients with hypertension, the number of AAD in lowest temperature group was higher than that in the highest temperature group (60 vs. 44). ⑤ The maximum air temperature, mean air temperature of the day from 5 days before to the onset day of AAD, and the lowest temperature from 3 days before to the onset day of AAD display slowly decrease trends, but there was no significant difference in daily temperature.Conclusions The incidence of AAD in Urumqi and its peripheral areas was concentrated from January 1st to 2nd of each year. When the temperature was lower than -5.2 ℃, AAD were more likely to attack. The 5 days changes of temperature and daily temperature before the attack were relevant with onset of AAD. It was speculated that the weather conditions such as air temperature may affect patient who has a past history of cardiovascular disease to attack AAD.

The optimum fermentation conditions of Asp.niger FS25 producing ?-glucanase was as follows,medium compositi on(g/100mL):barley flour 6,corn liquid 2,bran 0 8(NH 4) 2SO 4 0 4,FeSO 4 ?7H 2O 0 01,Na 2HPO 4?3H 2O 0 1,CaCO 3 0 5,MgSO 4?7H 2O 0 03;i nitial pH 5 0,cultivate temperature 32℃,50mL medium volume in 250mL triangle flask.The ?-glucanase activity of fermentation fluid reached 80 1u/mL,increa sing 84 1% contrasted to the initial.

Objective To analyze the results of the Objective Structured Clinical Examination(OSCE) of medical interns in Department of Gynecology and Obstetrics,and to assess the role of OSCE in clinical teaching and practice. MethodsAtolal of 104 medical interns of five-year education program in 2002 and seven-year education program in 2003 in School of Medicine had taken part in OSCE of gynecology and obstetrics.The OSCE consisted of six stations: gynecologic examination,obstetric examination,oral test,interrogation of standardized-patients(SP),drawing partogram,and non-stress test(NST) explanation.After gathering the data of each station,the software of SPSS 11.0 was used to make statistical analysis. Results The median scores were as follows: 92.0 for gynecologic examination,91.0 for obstetric examination,83.5 for oral test,80.0 for interrogation of SP,80.0 for drawing partogram,and 70.0 for NST explanation.There was no significant impact of familiarity to OSCE on the results of the test.The results showed that medical interns did good job in basic performance,but lack of clinical practice skills in some complicated practice of gynecology and obstetrics.Conclusion The grading system and stations setup of OSCE in Department of Gynecology and Obstetrics in Shanghai Sixth People's Hospital show objectivity and equity.The OSCE can be widely applied in the after-department examination and even graduation examination.

Objective To find out the mechanism of strephenopodia and strephexopodia of children with spastic cerebral palsy by analyzing their gait character.MethodsForty children with spastic cerebral palsy and forty healthy children with normal walking ability were involved in this research.Footscan 7 gait analysis system was used to measure foot initial touchdown part,the ratio of different part touchdown phase to single supporting phase,the degree of strephenopodia and strephexopodia in different part.Two groups' characteristic parameters were analyzed by statistics method.ResultsSignificant differences were found in foot first touchdown part between two groups(P<0.05).The phenomenon that toes or metatarsus or whole foot first touch the earth was found in children with spastic cerebral palsy.The ratio of anterior foot and middle foot touchdown phase to single supporting phase were higher than normal children(P<0.05).In spastic cerebral palsy group the phenomenon of strephexopodia was more serious than strephenopodia during anterior foot touchdown phase.ConclusionLots of children with spastic cerebral palsy are suffering long-time compression pain and strephexopodia with anterior foot,active rectification must be performed during rehabilitation care.

Objective To observe the consistency of T-cell receptor (TCR) genes mutation in lymphocytes in rats after irradiation in vivo and in vitro.Methods A total of 48 female rats were randomly divided into 6 equal groups.Peripheral blood samples from them were collected to separate the lymphocytes and then irradiated to X-ray irradiation with the dose rate of 200 cGy/min at the doses of 0,0.5,0.75,1.0,2.0,and 3.0 Gy,respectively.Then all the lymphocyte samples were cultured for 7 days.Flow cytometry with direct immunofluorescence was used to detect the TCR gene mutation.The levels of TCR gene mutant frequency (TCRMF) of different groups were calculated.Results The TCRMF levels of different groups after irradiation in vivo and in vitro all displayed a dose-dependent manner and there were no significant differences in the TCRMF between different dose irradiation groups(t = -1.1-0.3 ,P ＞0.05).Conclusions A consistency of TCRMF after irradiation in vivo and in vitro is proven.The results of TCRMF of peripheral blood lymphocytes irradiated in vitro by flow cytometry can precisely reflect the TCR genes mutation after whole-body irradiation.

Objective To seek a new method to identify viability of myocardium by adenosine stress echocardiography combined with quantitative tissue velocity imaging(QTVI)and tissue tracking(TT).Methods Fifteen healthy canines were selected to establish the models of acute myocardial infarction and reperfusion by ligating anterior descending branch of coronary artery for 90 minutes and then releasing the artery to get reperfusion.After reperfusion.peak velocity in systole(Vs),peak velocity in isovolumic contraction(VIVC)and the displacement in systole(Ds)were measured on anterior wall and anterior septum at baseline.The 2,3,5-triphenyl tetrazolium chloride(TTC)staining was set as a"gold standard"for defining the viable and non-viable groups.The sensitivity and specificity of assessing myocardial viability were determined with QTVI and TT.Comparison of variables between viable and non-viable group was made by using t test.One way analysis of variance and LSD-t test were used to estimate the significance of differences in different states.Results Compared with baseline,Vs,VIVC and Ds decreased significantly(P＜0.01)after reperfusion in both viable and non-viable group.After administration of adenosine,Vs and Ds increased(P＜0.05),but VIVC didn't change significantly compared with that before administration of adenosine in viable group(P＞0.05).Variables in non-viable group didn't change significantly after administration of adenosine(P＞0.05).By receiver operating characteristic(ROC)analysis for predicting myocardial viability,when a cutoff value of △Vs(%)rate was 17.9,the sensitivity and the specificity was 78.6%and 81.1%,respectively,and when the cutoff value of △Ds(%)rate was 18.4,the sensitivity and the specificity was 75.0%,83.6%,respectively.Combined △Vs(%)with △Ds(%),the sensitivity and specificity to prediction of myocardium viability could reach 94.6%and 68.0%,respectively.Conclusions When the viability of myocardium after myocardial infarction is assessed by using the method of adenosine stress echocardiography with QTVI and TT,the sensitivity and the specificity are greatly enhanced.