Objective:To evaluate the clinical significance of pattern visual evoked potential (P-VEP) parameters on amblyopic patients with normal-vision atfer pleoptic therapy. Methods:We investigated 60 amblyopic children (8-12 years old) who gained normal-vision atfer pleoptic therapy. hTese patients were assigned to a unilateral amblyopia group (40 patients)and a bilateral amblyopia group (20 patients). Another 20 healthy children served as a control group. All patients underwent a full initial ophthalmologic and orthoptic evaluation. P-VEP test was performed in all. Amplitude and latencies were analyzed and compared among groups. The latencies of P100 waves in the amblyopic eyes were used to generate a multiple linear regression formula from sex, ifrst treatment age, baseline visual acuity, and cycloplegic refraction. Results:hTere was no signiifcant difference in the mean levels of best-corrected visual acuity among groups (P>0.05). A signiifcant prolongation of the latency and a decrease of amplitude of P100 waves were observed in the unilateral amblyopia group and the bilateral amblyopia group compared with the healthy control group (P<0.05). Amplitude and latencies of the fellow eyes in the unilateral amblyopia group were abnormal compared with the healthy control group (P<0.05). Multiple linear regression analysis revealed that the latencies of P100 waves were signiifcantly correlated with the ifrst treatment age, baseline visual acuity, and cycloplegic refraction (R2=0.52, P<0.05). Conclusion:Deifcits exist in the fellow eyes and in normal-vision eyes atfer pleoptic therapy. hTe delayed P100 latency is affected by the ifrst treatment age, baseline visual acuity, and cycloplegic refraction. Traditional amblyopic therapy may be not enough for vision function recovery.

Objective To study the correlation between alanie aminotransferase(ALT) unqualified samples and hepatitis B sur‐face antigen(HBsAg) and hepatitis C virus antibody (anti‐HCV) detection and to investigate an effective measure for reducing the discard rate of donated blood .Methods 330 633 blood samples donated by volunteers in Shenzhen Municipal Blood Center from January 1 ,2009 to December 31 ,2013 were performed the ALT ,HBsAg and anti‐HCV detection .Then the correlation between the detection results of ALT and viral hepatitis .Results Among 33 0633 donated blood samples ,there were 932 cases (0 .282% ) of ALT positive and 2 965 cases (0 .897% ) of viral hepatitis positive ,the differences were statistically significant (P<0 .05) .915 cases were unqualified in ALT ,but negative in viral hepatitis ,which accounting for 98 .176% of all ALT unqualified samples ;the blood discard rate generated by ALT disqualification was 0 .277% (915/330633) .Conclusion Our study indicates that the statistical difference exists in the ALT unqualified rate and the viral hepatitis detection rate ,conducting the ALT detection has the lower coin‐cidence rate for expected viral hepatic ,many false positive lead to the discard of normal blood .Therefore ,whether to continue using the ALT detection as the auxillary detection indicator is still being negotiated .

Objective To probe into the reasons for and results of remedial surgical therapy in thoracic aortic dissection patients after first endovascalar repair.Methods From July 2000 to December 2012,12 cases received second interventional surgery.The average time from second therapy to first surgery was ( 14 ± 11 ) months.Main reasons for second endovascular therapy were sustained type Ⅰ endoleak at proximal landing zone and type A dissection caused by retrograde tear.Therapies included hybrid operations in 8 cases and absnlute endovascular therapy in 4 cases.Results The 30 day mortality after the second intervention was 5.6％ ( 1/12),total mortality rate was 16.7％ (2/12).In 7 cases with endoleak,small endoleak remained after remedial therapy (57.1％ ) in 4 cases.Among 4 cases with secondary type A aortic dissection,successful staged hybrid operation with mid-sternal thoracotomy was adopted in 3 cases,one died of pulmonary emtbolism during follow-up period,1 case with Bebcet disease still had proximal type Ⅰ endoleak after second hybrid operation,and died from tear of aorta.Conclusions Endoleak and secondary type A aortic dissection are the main cause necessitating second intervention after primary endovascular therapy for thoracic aortic dissection.Hybrid operation remains the best choice to treat postoperative complications after endovascular therapy for thoracic aortic dissection.

Objective To evaluate early results of Endurant stent-graft in the treatment of abdominal aortic aneurysms (AAAs).Methods From July 2010 to June 2011,68 patients (57 men,11 women; mean age 74.3 years) were treated with Endurant stent-graft at our center.26 cases had hostile proximal neck in the anatomy.According to ASA classification,15 cases were class Ⅱ ; 32 cases were class Ⅲ and 21 cases were class Ⅳ.Results Intraoperative immediate technical success was achieved in all cases.At completion angiography,a type Ⅱ endoleak was detected in 18 (26％) of the 68 patients.The mean operation time was (96 ± 29) min,the mean blood loss was (99 ± 68 ) ml,and the mean contrast usage was (122 ± 65) ml.No intraoperative conversion to open surgery,stent migration,types Ⅰ/Ⅲ endoleak,other major complications,or death was encountered.49 patients (72％) had a postimplantation syndrome with fever,leukocytosis,and increase of C-reactive protein levels,which completely resolved within two weeks.The mean follow-up time was (8 ± 5) months.Conclusions Endurant stent-graft seems to be safe and effective in endovascular aneurysm repair,even in patients with hostile aortoiliac anatomy.

Objective To evaluate the safety and efficacy of endovascular repair(EVR)for type B acute aortic dissection(AAD). Methods Between Feb 2002 and May 2008.39 consecutively admitted patients with the confirmed diagnosis of acute type B aortic dissection were studied.All patients were treated bv EVR.Left comnlon carotid artery were covered after bypass in 2 cases.of which fenestrated stent graft (SG)at innominate artery was used in one;1 case underwent left lower extrernity amputation:13 left subclavian artery(LSA)and 1 aberrant risht subclavian artery were completely covered without bypass.5 LSA were pattially covered.All cases were followed by CTA after EVR.the porfusion status of the false lumen were monitored in the aorta at the level of the stented segment(L1)and distal to the stent graft (L2).Results The procedure Was technically successful in all cases;30-day mortality rate was 10.3%.At the 1-month follow-up,false lumen in L1 thrombosed in 100%,a complete thrombosis of the false lumen Was observed in 21 patients(77.8%).partial thrombosis in 6(22.2%).with complete reabsorption of the thrombus and remodelling of the true lumen in 5(18.5%);False lumen in L2 thrombosed only in 7 patients(28%),complete thrombosis in 2(8%)and partial thrombosis in 5(20%).Conclusions The results of endovascular repair of acute type B dissection Was satisfactory.30-day mortalitv rate was related to severe complications before EVR.

Objective To determine the influence of hostile neck anatomy on type Ⅰ a endoleak development after endovascular aortic aneurysm repair (EVAR) for infrarenal abdominal aortic aneurysmal disease.Methods From July 2008 to July 2011,195 consecutive patients with non-ruptured abdominal aortic aneurysms (AAA) were treated with EVAR.There were 150 males and 45 females,aging from 52 to 95 years with a mean of 69 years.Forty-three patients were with hostile neck anatomy ( HNA ).High-resolution computed tomography was abtained in all patients,with detailed measurement of proximal neck parameters.Univariate and multivariate analyses were used to compare Ⅰ a endoleak and HNA.Follow-up protocol consisted of computed tomography (CT) angiograms or ultrasound at 3,6,and 12 months,and annually thereafter.Results Twenty-three patients had intraoperative type Ⅰ a endoleaks.The adjunctive measures,such as repeated balloon angioplasty,cuff extension,Palmaz stent placement and chimney technique were used for treating type Ⅰ a endoleak.Small endoleak remained in only one patient.The technical success rate was 98.5％ (192/195).The association between type Ⅰ a endoleak development and magnitude of the infrarenal angle was statistically significant.The mean follow-up time was ( 18 ± 3 )months.The survival rates at 1- and 3-year were 97.4％ and 89.2％ respectively.Conclusions The proximal neck angle is related to intraoperative type Ⅰ a endoleak occurrence,but other factors often thought to be indicative of adverse neck anatomy are not significant predictors.Most type Ⅰ a endoleaks in this study were uccessfully eliminated intraoperatively with a satisfactory mid to long term results.

Objective To quantitatively analysis the aortic valve leaf anatomical characteristics in aortic regurgitation(AR) patients by real-time three-dimensional transesophageal echocardiography (RT-3D-TEE),and screening the parameters which significantly affect AR to further reveal the mechanism of AR.Methods 32 patients with AR were enrolled as AR group and 20 cases of non-AR people were involved as control group.RT-3D-TEE was using to collect images in two groups and offline analysis was performed.4 sets of parameters of the aortic valves(left coronary valve,right coronary valve,and non-coronary valve):leaflet edge length(LL,RL,NL),leaflet height (LH,RH,N H),leaflet length/height ratio (LRa,RRa,NRa),leaflet tip plane distance(LTH,RTH,NTH) were acquired.Parameters of two groups were compared,and the parameters were incorporated into the logistic regression model,then the ROC curves were obtained.Results ①Compared with the control group,LL,RL,NL,RH,LRa,NRa,RRa in AR group increased (P ＜ 0.05),while the rest parameters had no statistical differences (P ＞0.05).②Multivariable logistic regression model gradually screening of the significant factors influencing the reflux,and as a result RL and RTH had significant influence on AR,P values were 0.001,0.011.③The ROC curve analysis showed that the area of RL or RTH curve were both greater than 0.5,which were 0.811 and 0.605 respectively.Conclusions The free edge length and free edge length/height ratio have changed unbalanced.Furthermore,right coronary valve parameters changed significantly,and this might be one of the possible mechanism of AR.

BACKGROUND: Parkinson disease(PD) is a series of clinical symptom induced by decreased dopamine (DA) in the striatum due to nigral dopaminergic neuronal degeneration. The intracerebral transplantation of secretory DA can reverse or improve the symptoms to a certain extent, but immunologic rejection is still existed.OBJECTIVE: To probe into cell transplantation with immunoisolation in treatment of in rats without application of immunosuppress and observe its mechanical intensity and the biocompatibility of microcapsule .DESIGN: Randomized controlled experiment was designed.SETTING: Biomedical Material Engineering Group, Dalian Institute of ChemicalPhysics , Chinese Academy of Sciences, and Department of Neurology, Second Hospital of Jilin University.MATERIALS: The experiment was performed in Animal Experimental Center of Second Hospital of Jilin University from August 2003 to February 2004, in which, 40 male Wistar rats were employed. PC12 cell was provided from Shanghai Institute of Cellular Biology of Chinese Academy of Sciences.METHODS: 6-hydroxydopamine solution was infused in the striatum to prepare animal model of Parkinson disease. Twenty-five rats of those had been prepared successfully and were randomized into microencapsulated cell transplantation group (12 rats), in which, 25 μL cell-loading sodium alginate-chitosan-solium alginate(ACA)microencapsul suspension (equal to 2.5×104 cells) was injected stereotaxically on two points of the right (affected side) striatum of animal model; non-microencapsulated cell transplantation group (7 rats), in which, 25 μL PC12 cell suspension (equal to 5×104cells) was injected; and empty microcapsul transplantation group (6 rats),in which, 25 μL empty microcapsules suspension was injected . On the 7th day after transplantation, in every group, apomorphine (APO) prepared with saline solution was injected (0.05 mg/kg) subcutaneously in the neck; afterwards, the revolving behavior was recorded for each rat, once per week,totally for 12 weeks. In the 12th week after operation, the rats were sacrificed with anesthesia. The brain tissue was collected for pathological observation and microcapsule were retrieved to evaluation of biocompatibility and immunoisolation.numbers before and after transplantation of each group.RESULTS:Twenty-five rats entered result analysis and the rest was sule: the retrieved ACA microcapsule was integrative in morphology,munoisolation of microcapsule: microencapsuled PC12 cells were prolifercycles before and after transplantation of each group: the records of lateral revolving of rats in every group before transplantation were not significantly different (P ＞ 0.05). In microencapsuled cell transplantation group, 2weeks later, the average number of revolving was significantly lower than that before the transplantation, or even the revolving stopped; the improved symptoms were maintained till the 12th week after transplantation. In nonmicroencapsulated cell transplantation group, the average revolving number was also significantly lower than that before the transplantation, but that on the 8th and 12th weeks was in tendency of increase, without obvious change compared with that before the transplantation (P ＞ 0.05). The revolving number before and after transplantation in non-microencapsulated transplantation group was similar[(10.5±1.4), (10.5±1.3) cyclos/min, P ＞ 0.05].microcapsule provides immune protection. The grafted encapsulated PC12cells survive for along term in the brain of rats with PD, maintain continuously the normal physiological function and improve the symptoms of PD by synthesizing and releasing DA.

BACKGROUND: Acute coronary syndrome(ACS) are a result of the rupture of unstable atherosclerotic plaques and thrombosis. Matrix metalloprotei nases (MMPs) are believed to play an important role in vascular remodeling and plaque instability by degrading the extracellular matrix.OBJECTIVE: To investigate the possible impact of polymorphisms in matrix metalloproteinase-3 and -12 genes on the risk of ACS in Chinese Han population.DESIGN: A case-control study based on ACS patients as subjects and healthy population as the control group.SETTING: Department of clinical tests of a university hospital and the department of biochemistry and molecular biology of a medical college PARTICIPANTS: A total of 103 patients with ACS(outpatients and inpatients received and hospitalized from March 2002 to December 2003 at the People' s Armed Police Hubei General Hospital,Zhongnan Hospital of Wuhan University and Liyuan Hospital of Huazhong University of Science and Technology) were involved and were divided into ACS group and the normal control group. For the ACS group,there were 73 males and 30 females with an average age of(53±10) years,including 47 cases of acute cardiac infarction and 56 cases of unstable cardiac angina. For the normal control group,there were 100 healthy subjects as controls,including 67 males and 33 females with an average age of(52±12) years. All the subjects were Chinese Han Population in Hubei Province,and they were voluntary to participate in the study.METHODS: Polymerase chain reaction(PCR) and restriction fragment length polymorphism(RFLP) techniques were used to examine the MMP-3-1612 5A/6A and MMP-12 -82 A/G gene polymorphisms respectively.MAIN OUTCOME MEASURES: The genotypes of and the allele frequencies in the patients and the individuals in the control group.RESULTS: The prevalence of 5A/6A +5A/5A genotype(41.7% vs 24%,x2 =6. 447,P<0.05) and5A allele (21.8% vs 13%,χ2 =4. 906,P<0.05) of MMP-3 gene were significantly more frequent in the ACS group than in the control subjects. The odds ratio of the 5A/6A +5A/5A was 2. 269(95% CI,1.241 to 4. 149,P<0.01). No significant difference was detected between the patients and the control group in genotype and allele distribution of the MMP-12 -82 A/G gene polymorphism(P>0.05).CONCLUSION: These findings indicate that the 5A/6A polymorphism of MMP-3 gene is associated with the risk of ACS,and might play an important role in the development of coronary atherosclerosis..This conclusion provides experimental data for gene study of the coronary disease and primary intervention for rehabilitation.

Objective To investigate the variation of biomarker of coagulation, anti-coagulation, fibrinolysis in elderly critical patients and find out whether they are related to the disease severity. Methods Sixty-seven patients were no less than 60 years old. Eligible criteria: coincidence with the diagnostic criteria of systemic inflammatory response syndrome (SIRS) and APACHE Ⅱ score was no less than 10 scores. Blood sample was drawn from the venous for the test of biomarker (APTT, PT, TT, D-D, Fib, AT-Ⅲ , PC, PAI-1). According to the existent status,all the patients were divided into two groups:survival group (43 cases) and death group(24 cases) ,meanwhile,according to the diagnostic criteria of MODSE,all the patients were divided into MODSE group (30 cases) and non-MODSE group (37 cases). Results There were significant differences in APACHE Ⅱ score between MODSE group and non-MODSE group, survival group and death group [(25.83 ± 1.19) scores vs(18.1±20.73) scores and(18.81±0.72) scores vs(26.50 ± 1.42) scores](P <0.01). The PT and D-D in MODSE group anti death group were higher than those in non-MODSE group and survival group, the differences were significant (P <0.05),while the activity of AT-Ⅲand PC in MODSE group and death group were lower than those in non-MODSE group and survival group, the differences were significant (P <0.05). The PT,D-D and PAI-1 were positively correlated to APACHE Ⅱ score (related coefficients were 0.328, 0.308, 0.335,P <0.05). The AT-Ⅲ and PC were negatively correlated to APACHE Ⅱ score (related coefficients were -0.469, -0.559,P <0.01). Conclusions The abnormality of eoagnlation-fibfinolysis system exists in elderly critical patients. The extended PT, elevated D-D and PAI-1 ,descended PC and AT-Ⅲ are the hints of disease severity and poor prognosis.