Background Insulin-like growth factor-1 (IGF-1) participates in the regulation of the biological activity of cells.Researches showed that the serum IGF-1 level is significantly raised in the patients with Graves diseases.Thyroid associated ophthalmopathy (TAO) is one of Graves diseases,and orbital adipose cells are the target cells of thyroid autoantigens.However,whether IGF-1 is associated with TAO is still unclear.Objective This study was to investigate the expressions of IGF-1 in both circulating blood and orbital adipose tissue in TAO patients.Methods A retrospective cohort study was performed.Eighty-six TAO patients were enrolled in West China Hospital of Sichuan University from August 2009 to February 2014.According to the clinical activity score criteria(CAS) ,the patients were divided into active stage (CAS ≥ 4,35 patients) and inactive stage (CAS ＜4,51 patients).Eighty-six health adult persons were enrolled as the controls.The periphery blood of 3 ml was collected from each subject to detect the serum IGF-1 level by ELISA.Orbital adipose tissues were obtained during the surgery from 35 TAO patients and 35 patients with benign orbital tumor or orbital adipose prolapse from August 2009 to February 2014.The histopathological examination of orbital adipose tissue was carried out to evaluate the pathological characteristics, and the expression of IGF-1 in orbital adipose tissue was assessed by immunochemistry.This study protocol was approved by Ethic Committee of West China Hospital of Sichuan University, and informed consent was obtained from each subject before entering the cohort.Results The mean serum IGF-1 level was (0.862±0.026)ng/ml in the TAO patients,and that in the normal controls was (0.767 ± 0.480) ng/ml, without significant difference between them (P=0.281).The mean serum IGF-1 level was (0.877±0.355) ng/ml and (0.803±0.031) ng/ml in active stage and inactive stage of patients, respectively, and no significant difference was found between them (P =0.834).IGF-1 expression located in cellular membrane and cytoplasm.The expressing intensity of IGF-1 in orbital adipocytes was significantly enhanced in the TAO patients with the positive rate of 74.29% , and that in the controls was 45.46％ ,showing a statistical difference between the two groups (x2=5.289,P=0.021).Conclusions Serum IGF-1 level dose not rise in TAO patients, but the expression of IGF-1 in orbital adipocytes up-regulates, indicating that mature orbital adipocytes of TAO are regulated mainly by IGF-1.

Objective To evaluate the effectiveness and safety of orbital decompression for compressive optic-neuropathy. Methods Fourteen eyes of twelve cases with Graves opthalmopathy and compressive optic-neuropathy undergone two orbital walls decompression with the follow-up period of more than 3 months were analyzed. Results The effect of complete closure of palpebral fissure was attained in all of the postoperative eyes and the visual acuity was increased in eleven eyes, remained no change in two eyes and decreased in one eye. The mean value of the recession of exophthalmic eyes after operation was mean 4 0 mm. Conclusion Two orbital walls decompression is an effective method for compressive optic-neuropathy in Gaves ophthalmopathy.

Objective To probe the clinical character,the histopathological classification and misdiagnoses of intraocular tumors. Methods The clinical and pathological data of 359 patients with intraocular tumor diagnosed clinically between 1980～2000 were retrospectively analyzed. Results There were 300 cases of malignant tumor and 23 cases of benign tumor respectively. Non oncologic malady and benign tumor misdiagnosed as tumor or malignant tumor were 40 cases. The two leading malignant tumors were retinoblastoma and melanoma. Conclusion The clinical and pathological analysis of intraocular tumor is beneficial to the correct clinical diagnosis and treatment.

Objective To establish a HPLC method for the determination of kaempferol-7-O-?-D-glucopyranoside in Hosta ventricosa stearn.Methods HPLC ana1ysis was carried out on a Phenomenex Luna C18(250 mm?4.6 mm,5 ?m) column,gradient elution with the mobile phase of 0.5 % phosphate acid in water-methanol.The detective wavelength was set at 364 nm.Results calibration curve was linear within the range of 0.113 ～ 2.260 ?g for kaempferol-7-O-?-D-glucopyranoside,coefficient correlation being 1.The average recovery was 101.1 %(RSD= 2.58 %,n=6).Conclusion The content of kaempferol-7-O-?-D-glucopyranoside in Hosta ventricosa stearn is 0.2 mg/g(0.02 %) on average.This method is simple,accurate and practical for the determination of kaempferol-7O-?-D-glucopyranoside.

Background Thyroid associated ophthalmopathy (TAO) is an autoimmune disease.Current research on the pathogenesis focuses on common autoantigen.Insulin-like growth factor-1 receptor (IGF-1R) is necessary for the function of IGF-1,also IGF-1 plays an important role in signaling pathway of thyroid stimulating hormone receptor (TSHR).Objective This study was to investigate the effects of IGF-1 on the proliferation,expression of IGF-1R and TSHR on cultured orbital fibroblasts (OFs) derived from TAO.Methods Human orbital tissue was obtained from 17 TAO patients who received orbital adipectomy and 4 normal controls who received cosmetic surgery in West China Hospital from March 2016 to June 2016.OFs were cultured by explant culture with DMEM/F12 containing 5％ fetal bovine serum and identified by immunochemistry.The OFs were treated with different concentrations of IGF-1.IGF-1 at different concentrations (0,50,100,125 μg/L) was added into the medium,respectively,and the proliferation of the cells (absorbancy) was detected by MTS.The percentages of IGF-1R and TSHR expressions in the cells were assayed by flow cytometry.Results Cultured cells appeared to be spindle-like in shape and grew well with abundant cytoplasm.The characteristics of the cells derived from TAO patients were consistant with normal ones.The cells showed the positive response for vimentin and absent respose for desmin,S-100,myoglobin and cytokeratin.The proliferative values of OFs were gradually elevated with the increase of IGF-I dose in both TAO group and normal group (Fgroup =219.639,P＜0.001;F ion =17.752,P＜0.001) with the optimal effects in 100 μg/L IGF-1.The expression levels of IGF-1R in the OFs were (0.009 1 ±0.008 7)％,(0.095 3±0.023 3) ％,(0.083 7±0.022 7) ％ and (0.070 9 ± 0.024 1) ％ in the TAO group,and those in the normal group were (0.0023± 0.0006)％,(0.0093±0.0012)％,(0.0073±0.0015)％ and (0.0083±0.0012)％ after treatment of 50,100,125 μg/L IGF-1.The expression levels of IGF-1 R were significantly higher after treatment of 50,100 and 125 μtg/L IGF-1 than those treatment of 0 μg/L IGF-1 in both TAO group and normal group,and the expression levels of IGF-1R in the OFs were significantly increased in the TAO group compared with the normal group (all at P＜0.05).No statistical difference was seen in the TSHR expression between the TAO group and normal group after treatment of 0,50,100 and 125 μg/L IGF-1 (Fgroup =0.133,P ＞ 0.05;F ion =0.004,P ＞ 0.05).Conclusions IGF-1 can promote the proliferation of OFs and up-regulate the expression of IGF-1R in OFs.However,IGF-1 dose not play a regulating effect on the expression of TSHR in OFs.

Background Thyroid-associated ophthalmopathy (TAO) is characterized by increased amount of orbital fat tissue.Leptin is a specific adipocytokine,and it may play an important role in the pathogenesis of TAO.Objective The present study investigates the effect of rh-leptin on the differentiation of orbital preadipocytes in subjects suffering from thyroid-associated ophthalmopathy (TAO).Methods The orbital fatty tissue was obtained from 7 patients with TAO during orbital decompression surgery.Orbital preadipocytes were cultured using the explant method and differentiated cells were identified with oil red staining.The subcultured preadipocytes were incubated with different concentrations of rh-leptin,and no rh-leptin was added in the control group.The average optical density of cytoplasm/nucleolus in differentiated adipocytes was measured by oil-red staining to evaluate the influence of different concentrations of rh-leptin on lipid formation of orbital adipocytes.Results Cultured preadipocytes in vitro were identified to be of mesenchymal origin by immunohistochemical staining.The average optical density of cytoplasm/nucleolus was 1.07±0.22,0.80±0.17,0.56±0.11,0.25±0.10,and 0.17±0.08,respectively in the control group,10μg/L of leptin group,50μg/L of leptin group,100μg/L of leptin group and 500μg/L of leptin group,showing a significant difference among the five groups (F=20.64,P=0.00).Compared to the control group,the lipid formation of orbital adipocytes gradually declined in various concentrations of rh-leptin (P＜0.05,P＜0.01).Conclusion Rh-leptin may suppress the differentiation and lipid formation of TAO orbital preadipocytes in vitro in a dose-dependent manner.Leptin may be a feedback modulator in TAO pathogenesis.

Objective　To investigate the prevalence of anxiety and depression in epilepsy patients in rural areas,and to explore the influencing factors.Methods　The Hamilton Anxiety Scale (HAMA) and Hamilton Depression Scale (HAMD) were used to evaluate depression and anxiety of 388 epilepsy patients in rural areas From March 2020 to March 2021.Univariate analysis was performed on factors that may cause comorbid anxiety and depression of epilepsy patients,and logistic regression was used to analyze the possible influencing factors.Results　Among the 388 rural epilepsy patients,there were 198 (51.03%) patients comorbid with anxiety,159 (40.98%) comorbid with depression,and 130 (33.51%) comorbid with both anxiety and depression.Multivariate logistic regression analysis showed that patients，educational level,age of onset,seizure frequency,the cost of treatment and compliance were the influencing factors of anxiety.The seizure frequency,the cost of treatment and compliance of patients were the influencing factors of epilepsy comorbid depression.Conclusion　Epilepsy patients in rural areas have a higher prevalence of anxiety and depression.Low education level and age of onset between 21 and 30 years old are risk factors for comorbid anxiety in epilepsy patients.The seizure frequency,treatment cost and poor compliance are risk factors for comorbid anxiety and depression.Targeted interventions should be carried out for the epilepsy patients in rural areas.

Objective:To optimize the ethanol extraction technology for Xiaoluo granules. Methods:The extraction technology for the ethanol dissolvable ingredients in 10 kinds of medicinal materials was optimized by orthogonal experiment. The weighted sum of ba-icalin content and the dry extract rate as the index, 4 influencing factors with 3 levels each were optimized by L9 (34 ) orthogonal table. Results:The optimal ethanol extraction conditions were as follows:the medicinal material was soaked by 10-fold 50% ethanol solution for 45min, and then extracted by heating reflux for 3 times with 1. 5h each time. Conclusion: The method can effectively extract the ethanol dissolvable ingredients in 10 kinds of medicinal materials, which can be used as the ethanol extraction technology for Xiaoluo granules.

A questionnaire was used to survey the perspective of the 22 mentors,24 students, 27 graduate students and 27 public health units on the competence of MPH student. The result showed that the practice skill,analyzing skill,program plan and practice skill,and emergency reaction abil-ity got more attention. This suggested that to the training of MPH,the training objective should focus on the ability to resolve problems; the curriculum should focus on the characters of public health and on the practice training.

Objective: To study the feasibility of closed and three-dimensional reconstruction of maxillary defects with titanium mesh and free forearm flap. Methods: Maxillary defects, 3 of type Ⅱ and 7 of type Ⅲ, due to tumor or trauma were closely reconstructed with titanium mesh to restore the profile of maxilla and with radial flap to close the oral and the nasal wound surfaces following total maxillectomy (in 3 cases) and subtotal maxillectomy(in 7 cases). Results: 10 cases were followed up for 3～18 months. All the flaps were alive. The maxilla nasal and oral cavity were restored in all the cases and denture was applied in 3 cases. No neoplasm were fond by CT. Mouth opening was 2.5～4.0cm. Epithelium on the surface of the titanium mesh was found by nasopharyngoscope in 2 cases. Conclusion: The closed and three-dimensional reconstruction of maxillary defect with titanium mesh and free forearm flap can restore the shape and the function of maxilla.