AIM: To evaluate the effect of intravitreal bevacizumab (IVB) injection 1 week before pars plana vitrectomy (PPV) in proliferative diabetic retinopathy (PDR) patients. METHODS: A retrospective research was done on 46 PDR patients who were divided into PPV group (n=28) and IVB group (n=18, PPV with preoperative IVB). Bevacizumab was injected 1 week before PPV. Main outcome measures were visual acuity, incidence of iatrogenic retinal breaks, intraoperative and postoperative bleeding. RESULTS: At 1 month after surgery, visual acuity in PPV (82.1%) and IVB group (88.9%) improved significantly (P<0.01) and the difference between the two groups was not significant. Iatrogenic retinal breaks were reported in 18 cases (64.3%) in PPV group and 4 cases (22.2%) in IVB group (P<0.05). Intraoperative bleeding was encountered in all cases in PPV group and 7 cases (39%) in IVB group (P<0.01). Postoperative bleeding was reported in 9 cases (32.1%) in PPV group and none in IVB group (P<0.01). CONCLUSION: IVB injection before PPV is helpful in reducing iatrogenic retinal breaks, intraoperative and postoperative bleeding in PDR patients.

Objective To select valuable biomarkers for diagnosis and predicting outcome of sepsis-related acute respiratory distress syndrome(ARDS) from D-dimmer (DD),yon Willebrand factor (vWF),platelet (PLT),N terminal-pro brain natriuretic peptide (NT-ProBNP),interleukin-6 (IL-6),interleukin-8 (IL-8) and surfactant protein D (SP-D).Methods A total of 48 sepsis accompanied with ARDS patients and 40 sepsis patients were prospectively studied with comparison.The clinical characteristics of all the patients were recorded in detail.The blood samples were obtained within 24 hours of ICU admission.The concentration or activity of the seven biomarkers was quantitatively assayed and the results were recorded.To select the most valuable biomarkers as clinical indices,diagnosis model and death predictive model were constructed by Logistic regression.Results Among the seven candidate biomarkers,SP-D,vWF and IL-8 showed the most value.Their area under the receiver operator characteristic curve (ROC) were 0.758 (P ＜ 0.01),0.783 (P ＜ 0.01) and 0.747 (P ＜ 0.01) respectively,and raised to 0.847 (P ＜ 0.001) when the three biomarkers were combined.IL-8,age greater than or equal to 60 years and APACHE Ⅱ score greater than or equal to 20 were related to ARDS death with 12.138(lnIL-8)(P=0.022),6.157(P=0.040) and7.415(P=0.014) of OR values respectively.Conclusion SP-D,vWF,IL-8 should be valuable for early prediction of sepsis-induced ARDS and the diagnostic accuracy raised through combined utilization.IL-8 may be predictable for prognosis of sepsis related ARDS and the comprehensive evaluation combining clinical indices with IL-8 should be suggested in clinical practice.

Objective To discuss the effect of daidzein on hepatocellular carcinoma SMMC7721 cell proliferation CD133 expression on tumor stem cell.Methods Hepatocellular carcinoma SMMC7721 cells were cultured,digested and passaged,and divided into six groups with different drug:control group with no daidzein,100 μg/mL daidzein group,200μg/mL daidzein group,300μg/mL daidzein group,400μg/mL daidzein group ,500μg/mL daidzein.The inhibition ratio,hexokinase,alkaline phosphatase and CD133 levels in SMMC7721 cell were detected and compared at 24 h,48 h,72 h among those groups. Results The inhibition ratio was increased by Daidzein dose increasing,and decreased apparently by times extending,especially in 400μg/mL and 500μg/mL daidzeingroups.Compared with control group,the hexokinase and alkaline phosphatase activity and CD133 expression were decreased apparently in groups treated with daidzein(P<0.01).The more the dose,the higher the drop(P<0.01).Conclusion Daidzein can inhibit hepatocellular carcinoma SMMC7721 cell proliferation,and inhibit CD133 expression on tumor stem cell.

To study and compare the protective effects of Cordyceps sinensis from different habitats on acute injury of hepatic tissue induced by carbon tetrachloride ( CCl4 ) . Methods:The rat model of acute injury of hepatic tissue induced by CCl4 was established. The biochemical indicators of alanine aminotranferease ( ALT) and aspartate aminotransferease ( AST) in the serum and superoxide dismutase ( SOD) and L-glutathione( GSH) in the liver tissue were detected, and the liver tissue HE staining was used for the histopathology determination. Results:Compared with those in the model group, the levels of AST and ALT in the serum were sig-nificantly reduced, the levels of SOD and GSH in the liver tissue were notably increased, and the necrosis of liver cells was improved in Cordyceps sinensis groups at low, medium and high dose from different habitats (P<0. 05), however, the differences between the two different habitats were not significant (P>0. 05). Conclusion: Cordyceps sinensis from Qinghai and Tibet shows some positive differences in the protective effect on the acute chemical liver injury induced by CCl4 in rats,however, the differences are not remarka-ble.

Abstract: Occupational epidemiology aims to explore the effect of occupational hazards on the health of workers and understand ， their mechanisms. It plays an important role in occupational health and occupational medicine.Currently occupational ， ， exposures in the workplace are complex and diverse and multiple factors affect workers´ health at the same time. Therefore it is important to elucidate the pathogenesis of occupational disease caused by occupational hazards and implement early - - intervention. System epidemiology collects data on multi level exposure and multi omics information to conduct network analysis - on the relationship amongrisk factors. and to study the mechanisms of exposures and health outcomes based on multi level data. ， ， ， ， Using the study design of system epidemiology occupational environmental lifestyle and social factors are combined as a ， system to evaluate the health of workers which can better evaluate the adverse health effects caused by occupational hazards. - ， ， The studies base on multi omics design will explore the pathogenesis of occupational diseases at the molecular cellular and tissue levels to evaluate the impact of occupational hazards on workers´ health and to explore interventions from multiple - perspectives to reduce the occurrence of occupational or work related diseases.

Mice was stimulated by peptidoglycan from Lactobacillus sp and detect cytokines production。It was found that PG induced the production of inflammatory cytokines (IL-1,TNF-? in peritoneal macrophages,IFN-? in spleen cell)and did not induce the IL-2 production in spleen cell. Affymetrix MOE430A genechip was used to analyze changed gene expression of immune cells. It was found that expression of cytokines and related genes were changed under peptidoglycan administration. This might induced by activation of TLR-NF-?B signal pathway.

CD127 is the interleukin7 receptor ?(IL7R?),it regulates the specific respond of T lymphocytes to IL7.CD127 plays an indispensable role in the development of thymocytes into T lymphocytes,the survival and homeostatic proliferation of memory T cells.There are only two phases of the life period of T cells that do not express CD127:immature CD4+8+double positive(DP)thymocytes and activated T cells.Recently,it was found that CD127 play an important role as the specific marker of memory T cells and regulator T cells.The role and mechanism of CD127 in the life period of T cells were discussed herein.

Objective:To investigate the expression of Bcl-2 and Bax in renal tissues of patients with hepatitis B virus- associated glomerulonephritis(HBV-GN).Methods:Twenty HBV-GN specimens with complete nephrology data and 10 normal renal specimens were randomly chosen for the present study.Cell apoptosis was detected by means of terminal deoxynucleotidyl transferase mediated d-UTP nick end labeling(TUNEL)and the apoptotic index was calculated;immunohistochemistry was used to detect the protein expression of Bax and Bcl-2.ResuLts:The apoptotic index in HBV-GN group was obviously higher than that of the control group;the apoptotic cells were mainly distributed in the proximal and distal renal tubules and the collecting duct epithelial cells,seldom seen in the glomerular cells.The expression of Bcl-2 in HBV-GN patients was predominately present in the renal tubular epithelia cells(positive in the plasma,membrane and nuclear);the expression of Bax was found in both glomerular cells and renal tubular cells,mainly in tubular epithelial cells,seldom seen in Bowman's capsule or glomerular mesangial region.Conclusion:Apoptosis in the kidney of HBV-GN patients mainly occurs in the renal tubular epithelial cells;expression of Bax and Bcl-2 is mainly in the renal tubular epithelial cells,suggesting that the injury of tubular interstitial damage may be one of the important factors for the development of HBV-GN.

Objective To study the clinical manifestation,diagnosis and treatment of the renal myxofibromata.Methods Combined with reviewing the relevant literature,we retrospectively analyzed the clinical data of a case of renal myxofibromata.A 47-year-old female patient was found left renal cystic lesion by ultrasound 8 months before admission.CT showed a 4 cm cystic and solid lesions in the lower pole of left kidney,which was similar to the results of ultrasound.The enhanced abdominal CT and dynamic contrast-enhanced ultrasound showed that the lesions could be enhanced slowly with uneven density.The patient underwent left kidney exploration under the general anaesthesia.During operation,a round solid mass about 5 cm in diameter can been seen in the low part of renal sinus,which was a bit hard.The mass was close with surrounding tissue.Then,the left kidney was excised.Results The surface of the mass was full and smooth with pale yellow luster.In the HE section,the tumor was composed with fibroma like cell,which demonstrated the inhomogeneous size,shape and irregular organization.The nucleus showed the spindle shape,with rare mitosis phase.Large quantity of mucus and vascular tissue could be observed in the tumor.Few fibroblast cells could also be found in the section.The pathological result was myxofibromata (immature) with malignant tendency.No special treatment was given after surgery.Recurrence was not recorded within 6 months following-up.Conclusions Commonly,the myxofibromata is a kind of benign tumor.Only a few can result in the malignant transformation and distant metastasis.Primary renal myxofibromata is extremely rare.The preoperative imagine manifestation is difficult to provide the accurate diagnosis.Pathologic result is the gold standard in diagnosing this disease.Actively surgical treatment and regular following-up after surgery should be considered.

Objective To apply continuous subcutaneous pulse infusion of gonadotropin-releasing hormone (GnRH) to treat patients with central secondary amenorrhea,and to observe the induction of spontaneous ovulation and natural fertilization.Methods Using micro-pulse infusion pumps with each 90-minute infusion of LHRH 10 μg daily,the serum LH,FSH,estrogen,and progesterone levels ; and change in endometrium and ovarian size before and after treatment were monitored.The end point is natural pregnancy.Results The levels of serum LH,FSH,and estrogen were obviously increased after 4 weeks of treatment.The natural menstrual cycle was rebuilt after 8 weeks of treatment.The patient was pregnant and the treatment was stopped by 16 weeks.The experience of pregnancy was favourable.40 weeks later,the patient delivered a healthy female infant via caesarean section.Conclusions It was the first time in China that the technology of micro GnRH pump was applied in patients with secondary central amenorrhea.The result demonstrates that this technology can perfectly simulate the physiology of hypothalamic GnRH secretion.At present,more patients are included in this research to confirm the effectiveness.