AIM:To investigate efficacy of ranibizumab combined with laser treatment for patients with branch retinal vein occlusion (BRVO) and macular edema.METHODS: We selected 67 patients (67 eyes) with BRVO and macular edema in our hospital from March 2013 to June 2016, they were randomly divided into observation group (n=31) and control group (n=36).The observation group was treated with ranibizumab combined with laser treatment.The control group was treated with macular grid photocoagulation.We observed best corrected visual acuity (BCVA), centre macular thickness (CMT) and macular leakage of two groups.RESULTS: The BCVA of observation group at 1, 2 and 3mo after treatment were 0.41±0.07, 0.42±0.05 and 0.48±0.05, significantly higher than those of the control group (P<0.05).The CMT of observation group at 1, 2 and 3mo after treatment were 203.11±59.13μm, 201.41±56.22μm and 204.22±60.13μm, significantly lower than those of the control group (P<0.05).The blood vessel leakage of observation group at 3mo after treatment was significantly better than that of the control group (P<0.05).No leakage ratio in the observation group was 71%.There were no postoperative infection, aseptic endophthalmitis and other complications in the two groups.CONCLUSION: Ranibizumab combined with laser treatment in patients with BRVO and macular edema has better curative effect, can improve the visual acuity of patients, eliminate macular edema, and is safe and reliable.

Objective To analyze the basics and influencing factors for the medical expenditure of poor patients of tumor and end-stage renal diseases in Hubei province,and put forward policy recommendations for the critical illness insurance and health poverty alleviation.Methods 535 patients with tumor and end-stage renal diseases in Wuhan,Xiangyan and Shiyan in Hubei province were selected for a questionnaire survey,with 415 of the questionnaires subject to data analysis.Single factor variance analysis and multiple linear regression were used to analyze the influencing factors for their medical expenditure.Results 83.9% of the patients held their medical costs as too high;84.6% of them complaining significant drop of their annual family income due to their diseases; disposable household income of urban patients higher than their rural counterparts both before and after their disease; types of medical insurance and diseases are significant influencing factors for medical expenditure.Conclusions Poverty rate is high among patients of such patients.To reduce their financial burden,the government is recommended to cover more major diseases,enhance support for those of critical illness and improve the medical assistance system.

Objective To observe the effect of movement exercise combined with electroaeupuneture on the expression of Nestin in the hippocampus dentate gyrus (DG) after cerebral ischemia-repeffusion.Methods Fifty- four Wistar rats were used and randomly divided into a control group (Group A),an exercise training group (Group B),and an exercise training combined with electroacupuncture group (Group C).The middle cerebral arteries (MCA) of all the rats were occluded for 1 h,followed by reperfusion for 7,14 and 21 davs.Immunohistochemistry method was used to detect the expression of Nestin in the hippoeampus dentate gyrus.Results The number of Nes- tin-positive cells peaked in DG in all groups on the 7th day after cerebral isehemia-reperfusion.The number of Nes- tin-positive cells in DG ipsilateral to the ischemia-reperfusion lesion were significantly more than those in the opposite side at various time points (P

Objective:To examine the expression of nitric oxide synthase(NOS),the content of nitric oxide and blood flow in nasal mucosa of allergic rhinitis guinea pigs,so as to further investigate the mechanism of allergic rhinitis.Methods:One hundred and twenty guinea pigs were randomly divided into control group(injected with normal saline)and allergic group(nasal challenge with egg albumin).The guinea pigs were executed before and immediately,24,48,72 h after the last nasal challenge;the expression of endothelial nitric oxide synthase(eNOS)and inducible nitric oxide synthase(iNOS)and the content of nitric oxide were examined in mucosa tissues.The blood flow in the nasal mucosa was determined in animals before execution.Linear regression correlation was used to analyze the relationship between the nitric oxide content and blood flow in nasal mucosa.Results:The immunostaining for iNOS in surface epithelium of allergic rhinitis guinea pigs was markedly stronger than that of normal guinea pigs at all time points(P

Objective To discuss the safety and efficacy of transcatheter arterial chemoembolization (TACE) in treating patients with inoperable hepatocellular carcinoma (HCC) who has a history of hepatic failure. Methods A total of 7 HCC patients who had a history of hepatic failure (study group) were enrolled in this study. TACE was carried out in all these 7 patients. Other 51 patients who had no liver failure history were used as the control group. All the patients were followed up for at least six months. The postoperative adverse events, changes of liver function and the prognosis were recorded, and the results were compared between the two groups. Results In the study group, neither treatment-related death nor severe adverse events occurred. No significant difference in the occurrence of mild adverse events existed between the two groups. After TACE the liver functions, including alanine aminotransferase, total bilirubin, prolonged prothrombin time, albumin, etc. in the study group were significantly worse than those in the control group,groups. Conclusion For patients with inoperable hepatocellular carcinoma who has a history of hepatic failure, TACE is a safe and effective treatment.

Objective To explore the feasibility of amide proton transfer (APT) MR imaging for the detection of basal ganglia abnormalities in patients with Parkinson' s disease (PD).Methods Twentyseven patients with PD and twenty-three age-matched normal control subjects underwent cerebral APT and structural MR imaging.The magnetic resonance ratio asymmetry (MTRasym) values at 3.5 ppm of bilateral globus pallidus,putamen and caudate were measured on APT images.MTRasym (3.5 ppm) values of cerebral structures between PD patients and control subjects were compared with independent-samples t test.Paired-samples t test was used to compare the difference of MTRasym (3.5 ppm) between the side of onset and contralateral side in patients with PD.The difference of MTRasym (3.5 ppm) among normal controls,early-stage PD,and advanced-stage PD patients was assessed with one-way analysis of variance.Results Compared to normal controls,MTRasym(3.5 ppm) values of globus pallidus,putamen and caudate were significantly increased in PD patients ((0.89 ±0.12)％ vs (0.57 ±0.16)％,(1.05 ± 0.11)％ vs (0.82 ± 0.15)％,(1.15 ±0.13)％ vs (0.78 ±0.19)％; t =3.311,2.562,3.277 respectively,all P values ＜ 0.05).Significant differences in MTRasym (3.5 ppm) values of these cerebral structures were observed among normal controls,early-stage PD and advanced-stage PD patients.And MTRasym (3.5 ppm) values in globus pallidus,putamen and caudate were significantly higher in early-stage PD patients than normal controls.In PD patients,even not statistically significant,MTRasym (3.5 ppm)values of sides of onset were slightly lower than contralateral sides.Conclusions APT MR imaging can sensitively identify the difference of MTRasym (3.5 ppm) in the basal ganglia between PD patients and normal controls.APT might be a useful tool to evaluate abnormal metabolite in basal ganglia of PD patients.

Objective To explore the feasibility of amide proton transfer (APT) MR imaging to detect cerebral abnormality of the substantia nigra and red nucleus in patients with Parkinson disease (PD). Methods Twenty-seven patients with PD and twenty-three age-matched healthy control subjects were recruited in this study. According to Hoehn&Yahr stages, PD group was divided into two subgroups:early-stage(n=14) and advanced-stage(n=13). PD with right limb onset were seen in 14 patients, and PD with left limb onset in 13 patients. All the PD patients and healthy controls underwent brain APT MR imaging. The magnetic resonance ratio asymmetry (MTRasym) values at 3.5 ppm of bilateral substantia nigra and red nucleus were measured on APT images. MTRasym(3.5 ppm)values of substantia nigra and red nucleus between PD patients and control subjects were compared with independent-samples t test. The difference of MTRasym(3.5 ppm)among normal controls, early-stage PD, and advanced-stage PD patients was assessed with one-way analysis of variance. Paired-samples t test was used to compare the difference of MTRasym (3.5 ppm) in substantia nigra and red nucleus between the side of onset and contralateral side in PD patients. Results Compared to normal controls, MTRasym(3.5 ppm) values of substantia nigra significantly decreased in PD patients[(0.96±0.35)%vs. (1.20±0.39)%respectively, t=-2.093 P=0.039]. No significant differences in MTRasym (3.5 ppm) values of red nucleus were observed between normal controls and PD patients[(0.97 ± 0.36)% vs. (1.09 ± 0.38)% respectively, t=-1.148, P=0.254]. Significant differences in MTRasym(3.5ppm) values of these cerebral structures were observed among normal controls, early-stage PD and advanced-stage PD [substantia nigra(1.20±0.30)%,(1.09±0.32)%and(0.81±0.37)%respectively, F=3.954, P=0.022;red nucleus(1.09±0.28)%,(1.21±0.35)%and(0.71±0.33)%respectively, F=7.563, P=0.001]. MTRasym(3.5 ppm) in substantia nigra showed a consistently decreasing tendency from normal controls to early-stage PD, to advanced-stage PD. MTRasym(3.5 ppm) values of sides of onset and contralateral sides of substantia nigra and red nucleus in PD patients had no significant statistically difference (substantia nigra(0.93 ± 0.33)% vs.(0.99 ± 0.30)%, t=-0.660, P=0.515; red nucleus(1.01 ± 0.36)% vs.(0.93 ± 0.29)%, t=0.545, P=0.590). Conclusions APT MR imaging can show sensitively the difference of MTRasym (3.5 ppm) in substantia nigra and red nucleus between early PD patients and normal controls, Thus, APT is a useful tool to diagnose PD and monitor the disease progression.

Objective To evaluate the outcomes of mature B-cell acute lymphoblastic leukemia(mature B-ALL) and to assess the safety and efficacy of the treatment protocol.Methods From February of 2003 to December of 2012,15 children were diagnosed as mature B-cell acute lymphoblastic leukemia/lymphoma possible (mature B-ALL/NHLp) in Shanghai Children's Medical Center(SCMC) were enrolled,and they were treated with SCMC-mature B-ALL/NHLp-2003 protocol.All of the clinical characteristics,therapeutic effects and long-term outcomes were analyzed.The statistical data were processed by SPSS 21.0.Results The median age on diagnosis was 8.7 years (1 year and 5 months to 14 years and 4 months).Among them,4 cases presented with local mass including maxillofacial tumors,neck and abdominal mass.The others had systemic manifestations such as fever and pale face.These neoplastic cells retained the expressions of surface membrane immunoglobulin M,terminal deoxynucleotidyl transferase,Cμ,CD10,CD19,cCD79 a differently.Follow-up was updated to November 30,2013.The median follow-up period was 80 months (39-128 months).Theestimated 5-year event free survival rate was (80.0 ± 10.3) ％.According to univariate analysis,increased lactate dehydrogenase level (＞ 4-times the normal value),increased serum ferritin level (＞ 2-times the normal value),no small residual disease markers were indepen-dent poor prognostic factors(x2 =5.49,4.89,5.49,all P ＜ 0.05).Conclusions SCMC-mature B-NHL/ALLp-2003 protocol is feasible and safe for children with mature B-ALL/NHLp,but more sample cases need to be investigated.