AIM: To observe the efficacy of intravitreal injection with ranibizumab combined with laser photocoagulation for macular edema ( ME ) secondary to macular branch retinal vein occlusion( MBRVO) .
METHODS:A retrospective analysis included 33 patients (33 eyes) with ME secondary to MBRVO were taken. All patients received intravitreal injection of 0. 5mg ranibizumab ( 0. 05ml ) at first visit. The continue PRN treatment and laser photocoagulation were based on the visual acuity changes and optical coherence tomography findings. The changes of best corrected visual acuity ( BCVA) , central macular thickness( CMT) , and amplitude density and latency of P1 wave in mfERG were observed before treatment and 6mo after treatment.
RESULTS: Before the treatment, logMAR was 0. 68±0.35, 6mo after treatment was 0. 34±0. 23, BCVA was improved obviously ( P < 0. 01 ), BCVA in 21 patients ( 63.64%) were improved in two rows among all the patients. CMT before treatment was(487. 30±63. 58) μm, after treatment was(238. 84±52. 66) μm(P<0. 01). The amplitude densities of P1 wave in ring 1, ring 2 and ring 3 after treatment were significantly increased(all P<0. 01), and the latencies were decrease ( all P < 0. 05 ). The conjunctival hemorrhage was observed in 2 eyes after treatment.
CONCLUSION: Intravitreal injection with ranibizumab combined with laser photocoagulation for ME secondary to MBRVO can reduce the CMT and improve visual function.

AIM: To explore the effects of mindfulness- based stress reduction ( MBSR ) on anxiety, compliance and visual function in primary open angle glaucoma( POAG) patients. ·METHODS:Totally 64 patients, who were treated with topical medication and were diagnosed with POAG in the department of ophthalmology at Shaanxi Provincial People's Hospital, were randomly divided into the intervention group ( n=32 ) and the control group ( n=32 ) . Both groups received conventional mental health education while the intervention group was complemented with MBSR intervention. The patient's anxiety status, compliance rates and MD before and after the intervention were evaluated. ·RESULTS:After the MBSR intervention, the scores of HAMA of the intervention group were significantly lower than that of the control group (P<0. 01). The compliance of patients in intervention group was higher than that of the control group (P<0. 01). ·CONCLUSION:The MBSR intervention can effectively relieve the anxiety of patients and improve the compliance in primary open angle glaucoma patients. It can be promoted and put into clinical application.

BACKGROUND: Adipokines are secreted by adipose tissue, including a series of cytokines and chemokines. Additionally, adipokines have been found to play certain roles in pro- and anti-inflammatory regulation. OBJECTIVE: To analyze the regulatory effect of various adipokines in the inflammatory process of autoimmune response and immune diseases, thus providing the strategy for controlling and treating autoimmune diseases and searching effective indexes for assessing disease development, incidence of complications and prognosis. METHODS: CNKI and PubMed databases were retrieved for the articles addressing the role of adipokines in autoimmune diseases published from 1986 to 2016 using the keywords of adipokine, autoimmune in English and Chinese, respectively. RESULTS AND CONCLUSION: Adipose tissue plays a critical role in metabolism regulation, and its effect on the immune system has emerged through a series of studies concerning adipokines regulating immune response. Adipokines exert various functions, and regulate metabolism and inflammation. In the development and occurrence of autoimmune diseases, some factors for immune responses remain unclear, and in-depth studies on adipokines will be helpful for lifting the veil of autoimmune diseases.

Objective To assess the prevalence of the metabolic syndrome (MS) in Shanghai adults according to the criteria of the US National Cholesterol Education Programme Adult Treatment PanelⅢ ( NCEP ATP Ⅲ) definition. Methods Randomly selected adults were studied by means of stratified sampling. A cross-sectional study was conducted in Shanghai with a representative sample of 7 414 Chinese adults aged 35-74 years.Results Defined by the ATPⅢ criterion, the preliminary prevalence of MS was 19.81%. The prevalence of MS was 16.21% (95%CI 15.37%-17.05% ) after age was adjusted. The prevalence of MS was higher in female than in male (22.59% vs 16.64% ,P<0.01 ), and higher in urban than rural residents( 17.43% vs 17.16% ,P<0.01 ). The prevalence of MS increased with age in both male and female, especially in females aged above 55 years. There were 19.81% subjects with over 3 risk factors. The most common combination of four components in MS were central obesity, high triglyceridemia, low high-density lipoprotein-cholesterol and hypertension. Conclusions There is a high prevalence of MS in Shanghai adults. MS is increasingly becoming a noteworthy health problem. Early-diagnosis and integrated-methods of prevention and treatment of MS are mandatory.

Objective To analyze the correlation between the polymorphism of PTPN22 gene (R620W and R263Q sites)and pulmonary tuberculosis(TB)in Chinese Han population and to investigate the environmental factors associated with pulmonary TB. Methods A case-control study was conducted on 235 patients with pulmonary TB and 251 healthy subjects. The single nucleotide polymorphisms(SNP)of PTPN22 gene at R620W and R263Q sites were detected by the assay of polymerase chain reaction and re-striction fragment length polymorphism(PCR-RFLP). A questionnaire was designed to gather information about tuberculosis-associated environmental factors. Univariate and multivariate logistic analysis were con-ducted. Results Genotype frequencies of PTPN22 R620W(C1858T)SNP were 233(99. 15% ,CC),2 (0. 85% ,CT),0(0% ,TT)in patients with pulmonary TB and 240(95. 62% ,CC),11(4. 38% ,CT), 0(0% ,TT)in healthy subjects. There was a difference with the distribution of PTPN22 C1858T allele be-tween patients with pulmonary TB and healthy subjects[0. 43% vs 2. 19% ,P = 0. 01,odds ratio(OR)=0. 19,95% confidence interval(CI)= 0. 07-0. 35]. Genotype frequencies of PTPN22 R263Q(G788A) were 218(92. 77% ,GG),17(7. 31% ,GA),0(0% ,AA)in patients with pulmonary TB and 248 (98. 71% ,GG),3(1. 29% ,GA),0(0% ,AA)in healthy subjects. The frequencies of G788A allele in patients with pulmonary TB were higher than those in healthy subjects(3. 62% vs 0. 60% ,P﹤0. 01,OR=6. 03,95% CI=2. 12-18. 38). Conclusion The results of this study suggested that the R263Q GG geno-type of PTPN22 gene was associated with the susceptibility to TB in Chinese Han population.

Objective To explore the method for repair of total avulsion of 2~4 fingers and to find the best procedure. Methods The wrap-round flap with part toenail combind with the dorsal pedical flap to repair soft tissue defect of the dorsal of finger and part of the palmar of finger, the second simepulp flap to repair soft tissue defect of the palmar of finger,transfer of two tissues with one pedicle to repair total avulsion of 2~4 fingers. Results All of 9 composite transplants in 6 cases were survived,the received areas were primary healing in 8 finger,1 case repaired by the bilateral wrap-round flaps and second simepulp flaps for index and middle finger,the distal phalanx of middle finger necrosis because of dislocation of DIP,3 months later,injury healed after the necrosis of phalanx excised,but the nail and the nail bed were dead.Except 1 case which the grafted skin necrotized in the donor area of the big toe,the rest had primary healing.All cases were followed up 6~14 months,the activity of joints were: MP 0-70,PIP 0-40.The repaired pulps had excellent appearance,the nail was fine,1 finger's mail was atrophy and 1 finger's nail was defect.The donor area had good fountion without pain and edema,the grafted skin had normal color and the activity of joints were nomal. Conclusion The wrap-round flap with part toenail combined with the second simepulp flap is a good approach in treatment of the skin avulsion injury in the finger.

Objective To investigate the possibility to create versatile system recovery disc for PACS workstation using the software Ghost 11. Methods Firstly, PACS and Windows software was installed into a PACS workstation. Secondly, S&R&S V9.7 1112F intelligent system -packaging tool and DllCacheManager_V1.6 Dllcache backup -restore tool were used to package the system. Finally, Ghost 11 was adopted to produce mirror image of the system. Results The image could recover system easily. Conclusion The system-recovery disc created by Ghost11 can significantly minimized the workload when the PACS workstation runs into error and improves the maintenance efficiency.

Objective To discuss the role of miRNA-374a in invasion and metastasis of breast cancer.Methods Breast tissues from 48 patients(32 patients with breast cancer)were classified into high invasive and metastatic group(HIMG,group A),low invasive and metastatic group(LIMG,group B),and normal group (group C).Each group contained 16 specimens.6 samples were selected randomly from each group and were detected by microRNA array.Key microRNA (miRNA-374a)was selected and its target protein(BMP-2) was predicted by bioinformatics software.The rest 10 specimens of each group were detected by real-time qRT-PCR and Western blot to test the content of miRNA-374a,mRNA and protein of BMP-2.Correlation analysis was performed between miRNA and the target protein.SPSS 18.0 was used to make statistical analysis.Results The relative content of miRNA-374a was higher in group C than in group B,higher in group B than in group A(P ＜ 0.05).BMP-2 mRNA level was higher in group A and group B than in group C (P ＜ 0.05).The expression level of BMP-2 protein was lower in group C than in group B,lower in group B than in group A(P ＜0.05).Correlation analysis showed that miRNA-374a was negatively correlated with BMP-2 protein(P =-0.412 8).Conclusion miRNA-374a inhibits the invasion and metastasis by regulating BMP-2 in human breast cancer.

Background Retinal ischemia reperfusion injury (RIRI) is a common pathological process of many retinal vascular diseases with comprehensive pathogenesis mechanism.Researches showed that apoptosis of retinal cells and nerve fiber loss is the finally common pathway of RIRI,and Janus kinase signal transducer and activator of transcription (JAK-STAT) pathway is a newly discovered signal transcript channel in recent years,which is involved in varieties of pathological processes.However,whether JAK-STAT pathway is associated with RIRI is still unelucidated.Objective This study was to investigate the time course of activation of JAK-STAT signal pathway and its significance during RIRI.Methods Forty clear adult male Sprague-Dawley rats were randomized into RIRI 6-hour,12-hour,24-hour and 48-hour groups.RIRI models were induced in lateral eyes of the rats by perfusing normal saline solution into the anterior chamber to elevate intraocular pressure (IOP) to 110 mmHg for 60 minutes and then allowing reperfusion,and the fellow eyes of the rats served as normal control group.The rats were sacrificed and the eyeballs were enucleated at 6,12,24 and 48 hours after reperfusion.The expressions of JAK2 and STAT3 protein (absorbance) in the retinas were located and detected by immunohistochemistry,and the relative expression levels of JAK2 and STAT3 mRNA in the retinas were detected by real-time fluorescence quantitative PCR.The use and care of the rats followed the ARVO Statement.Results Immunohistochemistry showed that JAK2 and STAT3 were faintly expressed in inner nuclear layer and retinal ganglion cells (RGCs) in the normal control group and strongly expressed in various RIRI groups.Significant differences were found in the expression intensities of JAK2 and STAT3 protein among the five groups (F =88.735,96.625,both at P ＜ 0.01).Compared with the normal control group,the expression intensities of JAK2 and STAT3 were enhanced in RIRI groups,with the peak values in RIRI 12-hour group (JAK2:t=4.308,5.559,5.315,4.726;all at P＜0.01.STAT3:t=5.047,7.843,6.281,4.887;all at P＜0.01).The thickening of inner retinal layer,loosening of retinal tissue,vacuolus degeneration of cells and decrease of RGCs were seen in the RIRI eyes.The relative expressing levels of the JAK2 mRNA and STAT3 mRNA in the retinas were significantly different among the groups (F =111.239,129.539;both at P＜0.01),and the relative expressing levels of JAK2 mRNA and STAT3 mRNA in the retinas were significantly increased in RIRI 6-hour,12-hour,24-hour and 48-hour groups in comparison with the normal control group (JAK2 mRNA:t=3.504,5.102,4.679,4.213;all at P＜0.01.STAT3 mRNA:t =6.541,8.787,5.693,5.898;all at P＜0.01).Conclusions The retinal morphology appears to be abnormal and RGCs are evidently decreased in rat eyes with RIRI,and the expressions of JAK2 and STAT3 in the retinas are simultaneously up-regulated,indicating that JAK-STAT signal pathway is involved during the RIRI process.

OBJECTIVETo introduce the framework of evidence-based practice with a case of castration-resistant prostate cancer (CRPC) as an example.

METHODSA clinical question was formulated according the clinical scenario. A systematic search was conducted for the published literature in the databases of PubMed, EMBASE, Cochrane Library, Clinical Trial Registries, and Web of Knowledge up to Dec 2014. The identified literature was reviewed for quality appraisal before the evidence was applied to clinical practice.

RESULTSThe treatment was effective and the patient achieved disease remission.

CONCLUSIONEvidence-based practice should be integrated with clinical scenario, current evidence, and patients' willingness, and follow a systematic framework.