OBJECTIVE: To study the stability of dexamethasone sodium phosphate(DSP) eye drops and predict its validity duration.METHODS: The content of DSP in eye drops was determined by HPLC and its validity duration was predi-cated using initial average rate method.RESULTS: The linear concentration range of DSP was 18～70 ?g?mL-1(r=0.999 9) with an average recovery rate of 99.74%(RSD=0.37%).The content of DSP in the eye drops decreased as its storing temperature increased and the storing time prolonged,but its pH was stable. The validity duration of the eye drops was computed to be 70 days at 25 ℃ and 438 days at 4 ℃.CONCLUSION: This eye drops were stable at 4 ℃.

Objective To investigate the effect of astragalus polysaccharide,a component of an aqueous extract of Astragalus Membranaceus roots,on differentiation and maturation of dendritic cells in vitro. Methods 30 BALB/c mice were randomly divided into three groups,normal control group,100,200 mg/kg APS intraperitoneal injection groups. After one week,weight the mouse spleen,account the splenetic index. Collect the mouse bone marrow cell,induced and cultured with rmGM-CSF and rmIL-4. With inverted microscope to investigate the morphous of DC cell. The phenotypes of DC were detected by flow cytometry and the expression of the GM-CSF protein in serum was tested by ELISA. Results Astragalus polysaccharide injection had obvious effects on the spleen weight of mice. The degree of CD11c and MHC-Ⅱ expression in 100 mg/kg and 200 mg/kg groups on flow cytometry were advanced significantly compared with that in normal control group,but the degree of CD80 and CD86 was not increased. And the expression of the GM-CSF protein in serum in 100 mg/kg group and 200 mg/kg group were both not increased significantly compared with nomal control group. Conclusion The intraperitoneal injection of astragalus polysaccharide could stimulate the proliferation of the pre DC in bone marrow. The angtigen presentation of DC might be enhanced,but this effects was not positive correlation with concentration of GM-CSF.

BACKGROUND: Tissue engineering plays an important role in treating rotator cuff injury. Promoting the healing of injured rotator cuff and preventing adhesion by regulating growth factor expression are main functions. OBJECTIVE:To compare the effects of corticosteroids and hyaluronic acid on the expressions of epidermal growth factor (EGF),platelet-derived growth factor (PDGF),transforming growth factor ? (TGF-?) and basic fibroblast growth factor (bFGF) in injured rotator cuff. DESIGN,TIME AND SETTING: The randomized controlled animal experiment was performed at the Animal Experimental Center,School of Medicine,Shanghai Jiao Tong University from July to September 2007. MATERIALS: Totally thirty-six Sprague-Dawley (SD) rats were randomly assigned into four groups: normal group (n=6),rotator cuff injury group (n=6),hyaluronic acid group (n=12) and corticosteroids group (n=12). METHODS: Full-thickness defects across 50% of the total width (5 mm) of the bilateral infraspinatus tendon were excised. Models of rotator cuff injury were created at the synovium. 0.05 mL hyaluronic acid was injected into the subacromial bursa mucosa in the hyaluronic acid group,whereas 0.05 mL corticosteroids in the corticosteroids group. MAIN OUTCOME MEASURES: At three and six weeks after injury,the infraspinatus were harvested to detect EGF,PDGF,TGF-? and BFGF by reverse transcription-polymerase chain reaction (RT-PCR). RESULTS: By using corticosteroids treatment,the expression of EGF remained greater at the six weeks than twofold at the three weeks; the expression of EGF after hyaluronic acid treatment greatly decreased at six weeks (P

Objective To observe the treatment effect of minimally invasive surgery on bone defects. Methods Bone defect model was established in bilateral shaft of radius in 30 rabbits. Forefoots of each rabbit were then randomized into open grafting group(group A) and minimally invasive grafting group(group B). Minimally invasive bone grafting was performed in group B with self-made instruments. DEXA and electron microscopy were investigated in radial bone defect after six rabbits were sacrificed randomly at different time after bone grafting. Results DEXA showed bone density increased gradually in both groups, the bone density in minimally invasive group was higher than that in open group with significant difference(P

Objective To investigate the clinical manifestations,imaging features,molecular genetic characteristics and possible pathogenic mechanisms of hereditary cerebral small vessel disease (CSVD) caused by heterozygous mutation of HtrA serine protease-1 (HTRA1) gene.Methods The clinical data of a Chinese Han family with CSVD carrying a heterozygous mutation of HTRA 1 gene,which came from the Department of Neurology,Henan Provincial People's Hospital in March 2018,were analyzed retrospectively.The clinical and radiographic features were summarized.Several high-throughput whole exon high-throughput sequencing was used to capture the mutation sites and the Sanger sequencing was used to validate the results.The family diagram was drawn and the 3D model construction and mutation function prediction were performed using silico tools.The relevant literature was reviewed and the pathogenesis was explored.Results The pedigree map showed that the family had an autosomal dominant inheritance pattern.Three generations of the family were investigated,and three family members in the same generation suffered from the disease.The first symptom of the proband was diplopia at the age of 39,accompanied by recurrent stroke,cognitive impairment and mood disorders,without alopecia.Head magnetic resonance imaging revealed bilateral diffuse,symmetric lesions,multiple lacunar infarcts,perivascular space,and microbleeds.The elder sister of the proband developed symptoms of left limb weakness at the age of 46,whose other clinical and imaging features were similar to those of the proband.The proband's mother died at the age of 59 due to repeated strokes.Whole exon sequencing indicated heterozygous missense mutation at c.821G＞A locus of HTRA1 gene in the proband and her 4th elder sibling,which was a new pathogenic mutation after consulting several mutation sites of databases.Function prediction suggested pathogenicity.Conclusions The heterozygous mutation of c.821G＞A in HTRA1 gene may lead to autosomal dominant CVSD.This genetic type should be given clinical attention.

Objective To explore and establish a method for quantitative evaluation of facial skin pores based on dermoscopy,and to evaluate the scientificity and practicability of this method.Methods Totally,30 patients with enlarged facial skin pores were enrolled from Department of Dermatology,Peking University Third Hospital between June 2017 and December 2017,and treated with 2 940 nm Er pixel laser.Photographs were taken,and dermoscopic images were collected before and after treatment.According to the standard photographs of facial pores,the improvement of enlarged facial pores was evaluated by comparing the photos before and after the treatment.A dermoscope-based pore detection system was established,and quantified indices for pore area and color difference before and after the treatment were evaluated by using this system.A pre-post self-contrast study was conducted,and statistical analysis was carried out by using paired t test for the comparison of measurement data and paired non-parametric test (Wilcoxon signed-rank test) for the comparison of ranked data.Results After the treatment,the standard photograph method for the assessment of facial pores showed score reduction by 3 grades in 1 of the 30 patients (3.3％),by 2 grades in 7(23.3％),by 1 grade in 21(70％),and no changes of grades in 1 (3.3％).Additionally,the differences between pre-and post-treatment grades were significant (Z =-4.94,P ＜ 0.01).The detection rate of skin pores by using the detection system was (70.59 ± 3)％.After the treatment,the quantified values of pore area and color difference both significantly decreased compared with those before the treatment (pore area:712.95 ± 87.45 vs.831.45 ± 88.92,t =5.70,P ＜ 0.05;color difference:23.82 ± 9.43 vs.28.92 ± 9.91,t =2.76,P ＜ 0.05).Conclusion The dermoscopy-based method for quantitative evaluation of skin pores after the treatment with 2 940 nm Er pixel laser showed highly consistent results with the standard photograph method,which can be further verified and popularized in the evaluation of enlarged skin pores.

Objective To observe the incidence of spontaneous clearance of hepatitis B virus (HBV) DNA in chronic hepatitis B (CHB) patients ,and to investigate the related factors of the spontaneous clearance of HBV DNA and to determine the time to start antiviral therapy .Methods Patients who met the inclusion criteria were recruited from the follow-up cohort of chronic HBV infection from January 2008 to August 2017 for observation .The liver function including alanine aminotransferase (ALT) levels ,HBV DNA load and serum markers of HBV were measured at baseline ,month 1 ,month 3 and month 6 of follow-up . Evaluation index included cumulative HBV DNA negative conversion rate and cumulative HBeAg negative conversion rate .Multivariable analysis was used to analyze the factors associated with the spontaneous clearance of HBV DNA .Results A total of 116 patients were recruited in this study .All the patients showed ALT level elevation at baseline .Without antiviral treatment ,the cumulative HBV DNA negative conversion rate was 12 .9％ after 6-month observation .HBeAg negative conversion rate was 22 .5％ .Multivariable analysis showed that patients without a family history of HBV infection ,baseline ALT level >3 times the upper limit of normal (ULN) and HBV DNA level <6 lg copies/mL had higher cumulative HBV DNA spontaneous clearance rate .HBV DNA negative conversion rate in patients whomet all the above three conditions was up to 75％ .Conclusions In CHB patients and ALT level elevation for the first time , some patients could achieve spontaneous clearance of HBV DNA without antiviral therapy .Patients without a family history of HBV infection ,baseline ALT level >3 ULN and HBV DNA level <6 lg copies/mL have higher rate of cumulative HBV DNA spontaneous clearance .

Objective To investigate the safety and efficacy of 177Lu-prostate specific membrane antigen (PSMA)-617 in the treatment of metastatic castration-resistant prostate cancer (mCRPC).Methods From August 2017 to September 2018,11 patients(average age 70.6 years) with mCRPC who underwent 177Lu-PSMA-617 therapy in Nanjing First Hospital were studied.All patients underwent 68Ga-PSMA-11 PET/CT before therapy to assess the tumor radioactive uptake.Blood routine examination and renal function test results were documented before and after therapy to assess the safety.The efficacy was reflected by the changes of prostate specific antigen (PSA) levels and maximum standardized uptake value (SUVmax) on 68Ga-PSMA-11 PET/CT imaging.Paired t test and Wilcoxon's sign rank test were used to analyze the data.Results No acute side effects were observed after therapy of 177Lu-PSMA-617.There were no statistically significant differences after therapy in WBC counts,RBC counts,and PLT,as well as Hb levels (t values:-0.28-1.11,all P＞ 0.05).No kidney toxicity was found.The PSA level after 177Lu-PSMA-617 therapy was significantly lower than that before therapy (80.70 (14.29,1 538.00) μg/L vs 604.60 (88.41,3 980.00) μg/L;u =59,P =0.023).Of the 11 patients,only 2 had elevated PSA levels and disease progression,while the other 9 patients had varying decreases,of which 2/11 decreased by ＞30％ and 7/11 decreased by ＞50％.After therapy,SUVmax of metastatic lesions and metastatic lymph nodes were decreased in 9 and 2 patients respectively.Conclusions 177Lu-PSMA-617 has a good therapeutic value for mCRPC.It is safe and has no obvious side effects.

Objective:To retrospectively analyze the risk factors for the development of liver cancer in patients with hepatitis B-related liver cirrhosis (LC) treated and fully managed with long-term nucleos(t)ide analogues (NAs).Methods:The study subjects were derived from the follow-up cohort of chronic hepatitis B and liver cirrhosis who received antiviral therapy in the Department of Infectious Diseases of the First Affiliated Hospital of Guangxi Medical University from February 2004 to September 2019. LC patients who met the inclusion criteria were enrolled. The life-table method was used to calculate the incidence of liver cancer. Multivariable Cox regression model was used to analyze the risk factors that may affect the development of liver cancer in patients with LC. A subgroup analysis was conducted in liver cirrhotic patients who developed liver cancer to evaluate the effectiveness of antiviral treatment compliance. The 2 test was used for rate comparison. Results:The median follow-up time of 198 LC cases treated with NAs was 6.0 years (1.0-15.3 years). By the end of the visit: (1) 16.2% (32/198) of LC patients had developed liver cancer, and the cumulative incidence of liver cancer in 1, 3, 5, 7, and 9 years were 0, 8.9%, 14.3%, 18.6%, and 23.4%, respectively, with an average annual incidence of 3.1%. Among the 32 cases with liver cancer, 68.7% had developed small liver cancer (22/32). (2) Univariate Cox model analysis showed that the development of liver cancer was related to four factors, i.e., the presence or absence of LC nodules, whether the baseline was first-line medication, the family history of liver cancer, and patient compliance. The results of multivariate Cox model analysis showed that poor patient compliance and baseline non-first-line medication were risk factors for liver cancer. (3) The results of log-rank test subgroup analysis showed that the 5-year cumulative incidence of liver cancer in patients with hardened nodules was significantly higher than that of patients without hardened nodules (21.7% vs. 11.5%, P = 0.029). The 5-year cumulative incidence of liver cancer in patients with non-first-line drugs was significantly higher than that of patients with first-line drugs (22.0% vs.8.2%, P = 0.003). The 5-year cumulative incidence of liver cancer in patients with poor compliance was significantly higher than that of patients with good compliance (21.3% vs. 12.7%, P = 0.014). The 5-year cumulative incidence of liver cancer in patients with a family history of liver cancer was significantly higher than that of patients without a family history of liver cancer (22.3% vs. 8.1%, P = 0.006). (4) Compared with patients with poor compliance, patients with good compliance had higher HBV DNA negative serconversion rate (98.7% vs. 87.8%, P = 0.005), and a lower virological breakthrough rate (12.1% vs. 29.3%, P = 0.007). Conclusion:The long-term NAs antiviral therapy can reduce the risk of liver cancer, but it cannot completely prevent the development of liver cancer, especially in patients with a family history of liver cancer and baseline hardened nodules (high risk of liver cancer). Furthermore, the complete management can improve patient compliance, ensure the efficacy of antiviral therapy, and reduce the risk of liver cancer development, so to achieve secondary prevention of liver cancer, i.e., early detection, diagnosis and treatment.

Objective:To retrospectively analyze the serological, virological, biochemical, liver histological status and clinical outcomes in HBeAg-negative chronic hepatitis B (CHB) patients with low HBV viral load, and to explore the necessity of antiviral therapy for these patients.Methods:A total of 99 HBeAg-negative CHB patients with HBV DNA level < 4 lg copies/ml who performed liver biopsy at the baseline were enrolled from the follow-up cohort. Among them, 23 cases received the second liver biopsy during follow-up. The relationships among the degree of inflammation and fibrosis of liver tissues, the status of HBsAg and HBcAg, age, gender, family history, HBV DNA load, serological markers and other indicators were analyzed. The pathological differences between two liver biopsy examinations were compared. The effect of nucleos(t)ide analogues (NAs) treatment on patient’s clinical outcomes were analyzed. For multivariate analysis, a binary logistic regression model was performed. Log-rank test was used to compare the cumulative incidence of hepatocellular carcinoma (HCC) in NAs-treated and non-NA streated patients.Results:Baseline liver histology status showed that 58.6% (58/99) patients had obvious liver tissue damage in their baseline liver tissue pathology (G≥2 and /or S≥2). Univariate logistic regression analysis showed that a liver cirrhosis (LC) family history, a HBsAg-positive family history, baseline alanine aminotransferase and aspartate aminotransferase levels were positively correlated factors for liver tissue damage. Multivariate logistic regression analysis showed that a LC family history was the main risk factor for liver tissue damage. Twenty-three cases had received a second liver biopsy after an interval of 4.5 years. In 10 untreated cases, the second liver biopsy results showed the rate of obvious liver tissue damage (G≥2 and/ or S≥2) increased from 50.0% to 90.0%. In the other 13 cases who received NAs treatment, the second liver biopsy showed improvement in liver histology, and the rate of obvious liver tissue damage decreased from 61.5% to 46.2%. The 5-year HCC cumulative incidence in non-NAs-treated patients was significantly higher than that of in NAs-treated patients (17.7% vs. 3.8%, P = 0.046). Conclusion:For most HBeAg-negative CHB patients with low viral load, liver tissue pathology result suggests that it meets the indications for antiviral therapy, especially in patients with a LC familial history. Without antiviral therapy, liver tissue damage for these patients will progressively worse with the high incidence of HCC. Therefore, it is suggested that antiviral therapy should be started as soon as possible for the HBeAg-negative CHB patients with low viral load regardless of the alanine aminotransferase level, especially in patients over 30 years-old with a LC or HCC family history.