Background Neuromyelitis optica,term of Devic's disease,is characterized by the symptoms of both optic neuritis and myelitis.In clinic,misdiagnosis rate of neuromyelitis is too high to ignore because of the unsynchronous exsist of both optic neuritis and myelitis.Objective This study aims to analyze the clinical characteristics of Devic's disease in order to reduce the misdiagnosis rate.Methods Thirty six patients diagnosed as Devic's disease in General Hospital of PLA from January 2000 through October 2008 were included in this study.The clinical data including sex,age,initial events,clinical signs of optic neuritis and myelitis,misdiagnosis status were analyzed.Results The 21 patients showed the initial events of eye and were diagnosed as neurititis.In all of the 36 patient,the ratio of the patients was from 30 to 50 years.The prevalence of atrophy of optical nerve within 1-3 months was 72.7% and that of above 3 months was 91.4% in these patients.The incidence rate was obviously increased in 1-3 months course group (χ~2=7.59,P=0.009) and ＞3 months course group(χ~2= 20.29,P＜0.001) in comparison with ＜1 month course group.Two patients without clinical signs were determined the diagnosis by visual evoked potential.In 22 patients received magnetic resonance imaging of spinal cord,the lesions of 14 patients located in cervical cord and that of 9 patients was in thoracic cord and only 1 patient in lumbar cord.Conclusion Devic's disease is more common in female patients with the age between 30-50 years.Most patients visit ophtalmologist firstly due to initial events of eye.Occurrence of optic atrophy is associated with disease course.MRI suggest that the lesions of spinal cord are often in cervical cord and thoracic cord.

Objective To evaluate the feasibility of video-assisted thoracoscopic resection of thymoma for myasthenia gravis.Methods Between July 2005 and February 2006,10 patients with thymoma were enrolled in this study.After double lumen intubation,video-assisted thoracoscopic resection of the thymus and thymoma was performed on the patients under total intravenous anesthesia.The largest tumor in this series was 6 cm ? 4 cm ? 3 cm.For a three-trocar technique,three incisions with a length of 1,3,or 1.5 cm were made respectively at the fifth intercostal space on the midaxillary line,fourth intercostal space on the middle between the anterior axillary line and midclavicular line,and sixth intercostal space on the anterior axillary line.During the operation,to expose the ipsilateral thymus and part of the contralateral thymus,the mediastinal pleura was cut along the internal thoracic artery,and superior vena cava or phrenic nerve.The thymus was then separated,and the thymic vein was dissected along the brachiocephalic vein and ligated.All the patients received radiotherapy after the operation with a dose of 4000 cGy.Results The operation time ranged from 70 to 130 minutes(mean,110 minutes)and the blood loss was less than 100 ml in all the cases.After the operation,7 patients presented Masaoka stage Ⅰ and 3 were at stage Ⅱ.No patient died or had cardiopulmonary complications or myasthenia crisis.The symptoms of myasthenia gravis were relieved in 1 week.The patients were followed up for 8 to 15 months(mean 13.0 months).During the period,none of them developed recurrence,metastasis,or aggravation of the myasthenia gravis.Conclusions It is feasible to resect stage Ⅰ to Ⅱ thymoma by video-assisted thoracoscopy.The procedure is minimal invasive with a few postoperative complications and good cosmetic outcomes.

Objective To construct Nedd4 knockout bone marrow-derived macrophages(BMDM) cell line by CRISPR/Cas9 technology and to provide an effective tool for studying the function and mechanism of Nedd4 in macrophage.Methods First,three high-grade sgRNAs targeting Nedd4 gene exons were screened using the online tool before synthesized sgRNAs were inserted into the PX330 plasmid respectively.Secondly,the recombinant plasmids were transferred into BMDM cells and monoclonal cells were obtained by limiting dilution method.The protein levels of NEDD4 in monoclonal cells were detected by Western blotting.Finally,the DNA sequence of the monoclonal cells was confirmed by sequence analysis.Results One Nedd4 knockout BMDM cell line was obtained.The sequencing result showed that the Nedd4 gene had 16bp deletion mutation in this cell line.Conclusion The Nedd4 knockout BMDM macrophage cell line constructed by CRISPR/Cas9 technology will be a useful tool for studying the function and mechanism of Nedd4 in BMDM cells.

Optical coherence tomography (OCT) can depict mild papilledema and slight changes in the internal segment and external segment; measure thickness of the retinal nerve fiber layer,retinal thickness and macular volume; detect missing axons and damage to the macular ganglion cell complex.Thus,OCT has important application values and widespread prospects in diagnosis and differential diagnosis of glaucoma and non-glaucoma optic neuropathy,optic nerve diseases and macular diseases,outer and inner retinopathy as well as evaluation of curative effects,follow-up observation,prognosis and mechanisms in neuroophthalmological diseases.Neuro-ophthalmologists should pay more attention to the exploration and application of OCT in the field of neuro-ophthalmology.

cases of vitreous haemorrhage secondary to Eales′ disease were selected for vitrectomy. According to the duration of vitreous haemorrhage, the patients were divided into two groups : Group 1 (20 eyes)-early vitrectomy group with a duration between 3 to 6 months; Group 2(20 eyes)-deferred vitrectomy group with a duration of more than 6 months . All the patients were followed up for a minimum period of 3 months following vitrectomy. The eyes in Group 1 showed a preoperative ultrasonic picture of complete posterior detachment, a final visual acuity of 0.6 or better in 13(65%) was achieved in mild vitreous organization on kinetic echography. Poor visual outcome in the deferred group was secondary to cystoid macular oedema, macular scar, macular pucker formation and macular degeneration. Improved visual outcome in the early vitrectomy group is probably due to haemorrhage and its products which have no time to damage the macula and to advance into macular traction and cystoid macular oedema.

Objective To study the rule of distribution and evol vement of TCM syn dromes in HIV/AIDS patients. Methods Totally 177 HIV/AI DS patients were investigated with questionnaire in the epide miological study to collect the data of diagnosis, and the rou tine test of CD4+T lymphocyte count was carried out. Results The young and mid dle-aged females were the most involved group with an increasing incidence in G u angdong Province and with a strong relation of sex and infection route. The main symptoms of the 177 HIV/AIDS patients were fatigue, cough and loss of appetite, the secondary ones were night sweating, skin itching, headache, and hair loss, and the most common sign was skin rash. The leading TCM syndromes were qi and yi n deficiency and lung and kidney deficiency. The distribution of symptoms and si gns, syndromes and various indices was significantly different in gender, age an d infection route (P

Background The research field of optic neuritis has developed rapidly and become more complex in recent years.It is very important for the reseachers and clinicians to known its status and the future trend.Objective This survey was to learn the distribution pattern,subject domain knowledge and worldwide research tendency of optic neuritis based on literatures in PubMed database.Methods Literatures on optic neuritis published in January 2000 to July 2012 were identified in PubMed database.The analytic dimention of an article included journal,published year,author,country and language.After core Mesh terms had been characterised by bibliographic item co-occurrence mining system (BICOMS),the co-occurrence matrix was built.Cluster analysis and multiple diamensional analysis were finished by SPSS 17.0.Then visualized network was drawn using ucinet 6.0.Results Totally 2 191 literatures were included,the number of articles increased from 105 in 2000 to 282 in 2011.The United States,England,Germany,Netherlands and Japan together accounted for 73.71％ of articles.There were 52 high-frequency subjects and hot topics were clustered into 9 categories.The visualized domain knowledge map was successfully built.The immunologic research was fully developed.The topic on etiology and diagnostic research,pathologic research,physiologic research and neuromyelitis optica (NMO) research had become core domain,while the studies of medication therapy,non-central nervous system idiopathetic demyelinating optic neuritis,epidemiology and genetics were not developed well.Conclusions Global optic neuritis publications display a continuous growth in the new millennium.The Big 5 in scientific literature on optic neuritis are the United States,England,Germany,Netherlands and Japan.The international main research focus includes 9 fields,which may provide reference or scholars both in scientific research and clinical research.

Diabetic retinopathy is the leading cause of blindness in those of working age.It is well known that the retinal vasculature is altered during diabetes.More recently,it has emerged that neuronal,glial dysfunction and electroretinogram changes occur in those with diabetes.Current research is directed at understanding these neuronal and glial changes because they may be an early manifestation of disease processes that ultimately lead to vascular abnormality.This review will highlight the recent advances in our understanding of the neuronal,glial dysfunction,electroretiongram changes that occur during diabetes.

ObjectiveTo explore the relationship between the expression of smooth muscle 22 alpha ( SM22α),α-smooth muscle actin (α-SMA) and the development of varicose veins of the lower extremities. MethodsWe collected tissues of varicose saphenous vein in the experimental group,and what left over of normal saphenous vein tissues harvested for a coronary bypass operation ( control group).RT-PCR were applied to investigate the expression level of SM22αmRNA and immunohistochemical techniques were applied to investigate the expression level of SM22α and α-SMA protein in normal and varicose veins.ResultsThe expression level of SM22α mRNA in normal and abnormal veins was 0.2614 ±0.1168 and 0.5114 ± 0.1554 respectively ( t =5.020,P ＜ 0.01 ).The immunohistochemical staining showed that signals of SM22α and α-SMA protein existed in the cytoplasm of smooth muscle cells.The integrate optical density (IOD) of SM22α in normal and abnormal veins was 10 055 ± 3584 and 16 226 ± 3378 respectively ( t =4.991,P ＜ 0.01 ).The IOD of α-SMA in normal and abnormal veins was 9746 ± 3903 and 15 371 ± 4318 respectively (t =3.861,P ＜ 0.05 ). ConclusionsSM22α and α-SMA was down-regulated in varicose veins,indicating that the VSMC had transformed the typical contractile phenotype into the typical synthetic phenotype.Phenotype changes of VSMC further promote venous wall remodeling leading to the occurrence of varicose veins.

ObjectiveTo guide fluid management and evaluate the clinical index through monitoring extravascular lung water index(EVLWI) of patients with pulmonary contusion.MethodsThirtyone severe chest trauma patients with pulmonary contusion were selected,performed with central venous catheterization or femoral artery catheterization,and connected to pulse index continuous cardiac output (PICCO).EVLWI after pulmonary contusion were measured by using thermal dilution.The intake and output of patients were recorded in detail,fluid intake was controlled,furosemide was prescribed,and the changes and correlations of oxygenation index,EVLWI and liquid balance difference at different time points were evaluated.ResultsEVLWI after pulmonary contusion at 1st to 7th d after hospitalization was respectively (9.25 ±0.71),(8.98 ±0.61),(8.61 ±0.59),(7.75±0.53),(6.64 ±0.49),(6.22±0.36),(5.59 ±0.39) ml/kg.Comparing with 1st d after hospitalization,EVLWI declined from 3rd d (P ＜ 0.05).Oxygenation index at Ist to 7th d after hospitallzation was respectively( 145.76±23.61 ),( 144.19±20.24),( 146.67±19.25 ),(159.33±15.42),(177.38±14.25),(199.33±19.04),(213.71±18.51) mm Hg(1 mm Hg =0.133 kPa).Comparing with 1st d,oxygenation index from 4th to 7th d had significant difference (P ＜ 0.05 ).The fluid volume at 1st d to 7th d were all negative balance,that of 3rd d to 6th d had significant difference comparing with 1st d [(-431.43±121.17),(-601.43±127.09),(-629.52±140.69),(-320.01 ±93.71) ml vs.(-213.81±63.91 ) ml](P ＜ 0.05 ).Oxygenation index and EVLWI had negative correlation(r =-0.824,P＜0.01).Liquid balance difference and the changes of oxygenation index and EVLWI had no correlation.ConclusionEVLWI effectively monitoring after pulmonary contusion can not only evaluate the changes of pulmonary vascular permeability of patients with pulmonary contusion,but also have important significance to guide fluid management.