Background The studies on intravitreal ranibizumab for diabetic macular edema (DME) primarily focuses on the absolute change of central retinal thickness, while the affection of the relative change of central retinal thickness (RCRT) or relative change of central retinal thickening (RCRTing) on visual prognosis has not been elucidated completely.Objective This study aimed to evaluate the effect of RCRT and RCRTing in assessing visual prognosis in DME patients following intravitreal injection of ranibizumab.Methods A self-controlled observational study was designed.Thirty eyes of thirty patients with clinically significant DME (CSDME) were recruited in Beijing 401 Hospital of China Nuclear Industry from November 2013 to October 2014.Ranibizumab of 0.05 ml (10 mg/ml) was intravitreally injected by 30G syringe needle at 3.5 mm posterior corneal limbus.Best corrected visual acuity (BCVA) far 2.5 meters away modified ETDRs visual chart was examined before injection and 3 and 6 months after injection,and the BCVA difference value between before injection and 6 months after injection was calculated as the absolusion BCVA (ABCVA).Spectral domian optical coherence tomography (SD-OCT) system was employed to measure the central retinal thickness (CRT) and to calculate the RCRT and RCRTing value.The correlations of RCRT or RCRTing with ABCVA was analyzed.Results The LogMAR values were (0.66±0.20) ,(0.40±0.25) BCVA and (0.37±0.25) before injection and 3,6 months after injection respectively in the CSDME patients,with a significant difference among them (F =36.79,P＜0.05).The values were obviously improved 3 and 6 months after injection compared with before injection (both at P＜0.05).The mean ABCVA (LogMar) of the patients was (0.30±0.21).The CRT 3,6 ,pmyjd sgyrt omkrvyopm values were (508.63±130.44), (331.07±71.84) and (311.77±64.47)μm before injection and respectively in the CSDME patients, showing a significant difference among them (F=49.78,P＜0.05).The CRT values were evidently reduced 3 and 6 months after injection in comparison with before injection (both at P＜0.05) ,and the mean ACRT value was (196.87±140.59) μm.The ABCVA values were (0.13±0.13),(0.44±0.14),(0.07±0.09) and (0.41±0.15) LogMAR in the RCRT＜35％ group,RCRT≥ 35％ group,RCRTing＜69％ group and RCRTing ≥ 69％ group, respectively.Significant differences were found in ABCVA between the RCRT＜35％ group and RCRT≥35％ group (t=-6.27,-8.65,both at P＜0.05).RCRT and RCRTing showed the positive correlations with ABCVA in the CSDME patients (r =0.86,0.79, P ＜ 0.05).Conclusions RCRT and RCRTing can identify well the optimal responders to intravitreal ranibizumab and predict BCVA improvement after treatment.RCRT has better association with ABCVA than RCRTing.RCRTing may be preferable when retinal thickening is more severe.

As a kind of breast cancer surgery choice,the nipple-sparing mastectomy (NSM)saves the patients′nipple-areola complex (NAC)which has significant meaning for patients′cosmetic results and posto-peration reconstruction.However,the clinical application of NSMis still in controversial.Some hot topics about oncological safety of NSM have appeared in recent years,such as the screening criterion of the enrolled patients,the situation of NAC involvement and the complications after NSM and handing methods.

Objective To study the regional cerebral blood flow (rCBF) and correlated factors in patients with hepatolenticular degeneration (HLD).Methods The rCBF of lentiform nucleus,thalamus and other sites in 14 patients with HLD of cerebral type (cerebral type group) and 10 patients with HLD of non-cerebral type (non-cerebral type group) were determined by magnetic resonance-perfusion imaging technology,meanwhile 13 healthy volunteers were selected as control group,and calculated the relative regional cerebral blood flow (rrCBF) for avoiding perfusion time lag.The correlation between the clinical symptom scores,the content of urinary copper,duration and rrCBF in HLD patients were evaluated.Results The rrCBF of cerebral type group in the left and right frontal lobe,temporal lobe,lentiform nucleus,caudate nucleus,thalamus,midbrain,pons and the left hippocampus,cerebellar cortex,dentate nucleus were lower than those of control group (1.91 ±0.35 vs.2.44 ±0.64,1.80 ±0.30 vs.2.37 ±0.65,1.37 ±0.35 vs.2.14 ±0.91,1.58 ±0.52 vs.2.39 ±0.99,1.61 ±0.38 vs.2.59 ±0.74,1.52 ±0.64 vs.2.63 ±0.73,1.88 ±0.32 vs.2.61 ±0.67,1.70 ±0.40 vs.2.35 ±0.50,1.48 ±0.13 vs.2.01 ±0.59,1.46 ±0.38 vs.2.38 ±0.99,1.47 ±0.55 vs.2.02 ±0.72,1.27 ±0.48 vs.1.91 ±0.51,1.24 ±0.38 vs.1.47 ±0.29,1.25 ±0.39 vs.1.53 ±0.37,1.74 ±0.27 vs.2.40 ±0.89,1.79 ±0.50 vs.2.22 ±0.66,2.15 ±0.41 vs.2.64 ± 0.61),and there were significant differences (P ＜ 0.05 or ＜ 0.01).There were no significant differences in the rrCBF of the parietal and occipital lobe,etc between cerebral type group and control group (P ＞ 0.05).The rrCBF of cerebral type group in the left and right lentiform nucleus were lower than those of non-cerebral type group (1.61 ± 0.38 vs.1.94 ± 0.58,1.52 ± 0.64 vs.1.99 ± 0.59),and there were significant differences (P ＜ 0.05).The clinical symptom scores were positively correlated with the rrCBF of the left and right lentiform nucleus in 24 patients with HLD (r =-0.792 and-0.764,P ＜ 0.01),the content of urinary copper and duration had no correlation with the rrCBF of the left and right lentiform nucleus(P ＞ 0.05).Conclusions The rCBF of cerebral type and non-cerebral type HLD is significantly reduced,cerebral type patients have lower rCBF than non-cerebral type patients.The rCBF is correlated with the clinical symptom scores.

Since intra-arterial chemotherapy with the help of implantation of port-catheter system (PCS) was first used in the surgical field in 1981, PCS has been widely employed in the field of interventional radiology. Intra-arterial chemotherapy by implantation of PCS has some certain advantages such as minimal invasion, no need of general anesthesia, etc. Ten randomized clinic trails have been already reported, which indicate that intra- arterial chemotherapy with PCS is obviously superior to systemic chemotherapy in treating hepatic metastasis form colorectal cancer. As for the treatment of advanced biliary tract cancer, pancreatic carcinoma and hepatocellular carcinoma, the relevant reports can be found only in several phaseⅠ/Ⅱclinical trials or in some retrospective cohort studies. This paper aims to make a comprehensive review about the indications, clinical applications and complications of PCS in treating abdominal tumors in order to improve the clinical practice.

Objective To discuss the effectiveness of standardized management of hypertension and its significance of economics.Methods Taking prospective,randomized and controlled trial design to screen hypertension in four communities of Changping Town.The patients in the four communities were randomly divided into an intervention group and a control group.The intervention group was taken the standardized management and the control group was taken conventional management.Results The treatment rate and control rate of the intervention group was higher than the control group.Necessary inputs of per capita administration costs for every 1％ increase of treatment or control rate in the intervention group were less than the control groups by 1.08 and 1.36 Yuan respectively.The per capita administrative costs of intervention group were higher than control group,while the per capita comprehensive costs of intervention group were lower than control group.Compared with the control group,every 1 Yuan of per capita administrative costs increases,the comprehensive costs would be reduced 7.58 Yuan in the intervention group.Conclusion Standardized management of hypertension in community can significantly improve the prevention and treatment effects.Moreover,it has good cost-effective value and saving social resources.

Objective To study their chemical components of Eclipta prostrata and identify their chemical structures. Methods The compounds were isolated by chromatography, purified by Sephadex LH-20 gel, identified by spectral analyses, and compared with the published data. Results Ten compounds were isolated and identified as 2, 2', 5″, 2″-terthiophene-5-carboxylic acid (Ⅰ), ?-sitosterol (Ⅱ), apigenin (Ⅲ), quercetin (Ⅳ), luteolin (Ⅴ), wedelolactone (Ⅵ), demethyl wedelolactone (Ⅶ), ecliptasaponin C (Ⅷ), luteoloside (Ⅸ), and linarin (Ⅹ). Conclusion Compound Ⅰ is a new compound from nature and compound Ⅹ is obtained from E. prostrata for the first time.

Objective To compare the glucose levels and associated factors among the normal glucose tolerance subjects with different age.Methods Totally a community-based population of 2098 residences aged above 30 years Were tested with OGTT,and classified into normal glucose tolerance group(NGT),impaired glucose tolerance group(IGT),impaired fasting glucose group(IFG),both IGT and IFG group(ICT/IFC),anddiabetes group(DM) according to fasting and 2 hours glucose level(2 hPG).The subjects in NGT group were further divided into 5 groups according to different ages.The levels of blood glucose and HBCI in different groups and subgroups were measured and analyzed statistically. Results For patients in NGT,the FPG([5.17.±0.48]mmol/L vs.[5.09±0.44]mmol/L,P<0.05)and HbA1c([6.01±0.62]%vs.[5.95±0.66]%.P<0.05)in group aged 60-69 Were higher than that in group aged 50-59.The FPG in group aged 60-69 was also higher than those in group aged 40-49([5.17±0.48]mmol/L vs.[5.00±0.47]mmol/L,P<0.01),and the FPG in group aged 50-59 Was also higher than those in group aged 40-49([5.09±0.44]mmol/L vs..[5.00±0.47]mmol/L,P<0.01).There was no correlation between age and FINS,while a tendency of decreasing HBCI could be observed along with increasing of age(F=33.75,P<0.05).Conclusion In NGT subjects,the FPG and HbA1 C inereased along with age.

BACKGROUND: More attention has been paid upon the injury effect resulted from the decrease of superoxide dismutase(SOD) activity and increase of malonaldehyde (MDA) content in brain. Whether pig brain peptide solution can pass blood-brain barrier and penetrate into brain tissue and protect brain nerve is still found in limited cases reports. Relevant reports are still rare both in China and abroad.OBJECTIVE: To explore the effect of pig brain peptide solution on SOD activity and MDA content in brain and liver of senile model mice made by D-galactose.DESIGN: Experimental animals-based randomized and controlled experimental observation.SETTING: Institute of Senile Medical of General Hospital of Chinese PLA.MATERIALS: The experimant was made in the Institute of Senile Medical (Chinese PLA key laboratory) of General HosPital of Chinese PLA from February to April 2001. Totally 82 NH mice, weighted from 18 to 22 g, half male and half female, were provided by the Medical Experimental Animal Center of General Hospital of Chinese PLA. These mice were randomly divided into the control group, hige dose group, middle dose group, low dose group, aniracetam group (positive control group), and D-galactose group.METHODS: Each group was given drugs seperately for 6 weeks. The senile mice model was induced by D-galactose. SOD activity of each group was checked with chemiluminescence method and MDA content examined with thiobarbituric acid colourimetry method.MAIN OUTCOME MEASURES: SOD activity and MDA content of mice in each group.RESULTS: Pig brain peptide solution with high and middle doses significantly increased SOD activity[ (30.23 ± 5.23), (29.65 ± 4. 88 );(19. 84 ± 5.79), (16.75 ± 5.32) μkat/g respectively], and decreased MDA content[ (630.00 04; 8(34): 7748-50CONCLUSION: Pig brain peptide solution has obvious antioxidative effect, and has certain protective effects on brain nerve cells and liver cells of senile mice.

Objective To investigate the value of stretched-exponential model of DWI in differential diagnosis of benign and malignant breast lesions.Methods Totally 58 patients with 63 breast lesions (33 benign,30 malignant lesions) were enrolled.All the patients underwent multiple b value DWI and dynamic contrast enhancement MRI (DCE-MRI) scans.The values of ADC,DDC and water molecular diffusion heterogeneity index (α) were calculated,and the time signal intensity curve (TIC) was obtained.All the parameters were compared between benign and malignant breast lesions.The diagnostic performance of different parameters was evaluated with ROC curve.Results ADC,DDC and α value of malignant lesions was (1.01±0.19)×10-3 mm2/s,(0.89±0.23)×10-3 mm2/s and 0.75±0.09,while of benign lesions was (1.41±0.27)× 10-3 mm2/s,(1.49±0.29)× 10-3mm2/s and 0.87±0.07,respectively.All 3 parameters in malignant lesions were lower than those in benign lesions (all P＜0.01).Taking 1.22 × 10-3 mm2/s as the optimal threshold,the area under the curve (AUC) of DDC was the largest as 0.958,and the corresponding diagnostic sensitivity and specificity was 96.67％ and 81.82％,respectively.AUC value was 0.976 by combining DDC with TIC,and the corresponding diagnostic sensitivity and specificity was 93.33％ and 93.94％,respectively.Conclusion The stretched-exponential model DWI can differentiate breast lesions,and diagnostic performance of combination of DDC and TIC is better than ADC or DCE.

Objective To examine the brain metabolic changes in WD patients receiving copper chelation by us?ing 1H-MRS. Method Thirty-nine patients with WD was randomly divided into four groups: non-brain type group (18 cases), brain type prior-treatment group and short-term treatment group (21 cases), long-term treatment group (20 cases) from short-term treatment group, and 20 healthy volunteers served as a control group. 1H-MRS and MRI were performed on patients on 1.5/MR/MRS system to detect these above-mentioned items before and after treatment. Result The mean of NAA/Cr was significantly lower in the left putamen and head of the caudate nucleus than in the left basal ganglion in the 39 patients with WD. The mean of NAA/Cr and Cho/Cr in the left putamen and basal ganglion was significantly lower in non-brain type group than in control group(P<0.01). The mean of NAA/Cr Cho/Cr and NAA/Cho in the left putamen,head of the caudate nucleus and basal ganglion were significantly lower in brain type group than in control group(P<0.01 or P<0.05). The mean of NAA/Cr in the left putamen was much lower in brain type group than in non-brain type group (P<0.01). The mean of NAA/Cr, Cho/Cr and NAA/Cho of short-term treatment group in the left putamen, head of the caudate nucleus and basal ganglion was not significantly different between brain type group and short-term treatment group(P>0.05). The mean of NAA/Cr and NAA/Cho in the left putamen and basal ganglion was much higher in long-term treatment group than in brain type group(P<0.01 or P<0.05). The mean of Cho/Cr in the left head of caudate nucleus were much higher after treatment compared with prior-treatment group(P<0.05). The mean of NAA/Cr in the left putamen, head of the left caudate nucleus and basal ganglion in all groups was negatively correlated with course of the disease. Conclusion There are significant differences in brain metabolism among different type of WD. The long-term but not short-term copper chelation significantly improves brain metabolism. NAA/Cr may be used as a non-invasive indicator to examine the efficacy of treatment.