Objective o observe the expression of Notch1 and Delta-like ligand 4 (Dll4) on the fibrovascular membranes in proliferative diabetic retinopathy (PDR),and investigate its relationship with vascular endothelial growth factor receptor 2 (VEGFR2).Methods Fifty-seven PDR patients (60 eyes) who underwent vitrectomy were enrolled in this study.The PDR patients were divided into non-injection group (30 patients,32 eyes) and injection group (27 patients,28 eyes).The eyes in injection group received intravitreal injection with ranibizumab at 2 to 7 days before surgery.The preretinal fibrovascular membranes were obtained from the PDR patients during vitrectomy.Eighteen epiretinal membranes were obtained from the non-diabetic patients was served as controls.The real-time polymerase chain reaction (RT-PCR) and immunohistochemical methods were used to detecting the expression ofNotch1,Dll4 and VEGFR2.In the meantime,the numbers of the nucleus of vascular endothelial cells in the membranes stained with hematoxylin were counted.Results The immunohistochemical staining revealed that there were positive expression ofNotch1,Dll4 and VEGFR2 in all PDR membranes,regardless of the injection of the ranibizumab.The levels ofNotch1,Dll4 and VEGFR2 protein in non-injection group were higher than those of injection group (t=3.45,6.01,4.08;P=0.030,0.008,0.023).In injection group,the number of endothelial cells in the membranes reduced (17.17 ± 2.48) compared with that of the non-injection group (41.50± 5.57).There was significant difference in the number of endothelial cells in the membranes between the two groups (t=9.58,P＜0.05).RT-PCR showed that the differences of the mRNA expression ofNotch1,Dll4 and VEGFR2 were all statistically significant among the PDR group and control group (H=12.50,12.50,12.02;P＜0.05).The expression ofNotch1,Dll4 and VEGFR2 in the PDR membranes was higher than that of epiretinal membranes from non-diabetic patients.In the PDR group,the expression of Notch1,Dll4 and VEGFR2 of non-injection group was higher than that of injection group.Spearman correlation analysis showed that the expression of mRNA between VEGFR2 and Dll4 (r=0.83),VEGFR2 and Notch1 (r=0.81),Notch1 and Dll4 (r=0.87) were all significantly correlated (P＜0.05).Conclusions The expression of Notch1 and Dll4 in the PDR membranes are higher than that of the control group,and it is positively correlated with the expression of the VEGFR2.Notchl and Dll4 play a regulatory rule in the neovascularization in PDR,the acting way may be correlated with VEGFR2.

AIM: To investigate the effects of uric acid sodium salt (UANa) as adjuvant on humoral and cellular immune response in BALB/c mice. METHODS: BALB/c mice were immunized with trichosanthin (TCS) as antigen together with UANa suspension as adjuvant. The antibody titers of IgG were detected by enzyme-linked immunosorbent assay. Dendritic cells (DC) were induced in vitro, the phenotypes of DC were analyzed by flow cytometry and the effect of UANa on DC maturity was evaluated. A delayed-type hypersensitivity (DTH) model was used to analyze the effect of UANa on cellular immune responses in vivo. The in vitro proliferation of lymphocytes was determined by ConA stimulation. RESULTS: Freunds adjuvant greatly enhanced the antibody response of mice to TCS, while UANa adjuvant failed to promote the antibody response but significantly reduced the antibody response as compared to TCS only. No effect of UANa on the expression of CD11c and CD83 in DC was observed by flow cytometry analysis. However, UANa significantly enhanced the expression of MHC II molecule. In the DTH model, UANa enhanced the degree of allergen-induced ear swelling and promoted the ability of lymphocyte proliferation in vitro. CONCLUSION: UANa suspension as adjuvant significantly enhances the cellular immune response but inhibits the humoral immune response to a certain degree, suggesting that UANa has potential application in the vaccine research.

AIM:To investigate the effects of uric acid sodium salt (UANa) as adjuvant on humoral and cellular immune response in BALB/c mice. METHODS:BALB/c mice were immunized with trichosanthin (TCS) as antigen together with UANa suspension as adjuvant. The antibody titers of IgG were detected by enzyme-linked immunosorbent assay. Dendritic cells (DC) were induced in vitro,the phenotypes of DC were analyzed by flow cytometry and the effect of UANa on DC maturity was evaluated. A delayed-type hypersensitivity (DTH) model was used to analyze the effect of UANa on cellular immune responses in vivo. The in vitro proliferation of lymphocytes was determined by ConA stimulation. RESULTS:Freund's adjuvant greatly enhanced the antibody response of mice to TCS,while UANa adjuvant failed to promote the antibody response but significantly reduced the antibody response as compared to TCS only. No effect of UANa on the expression of CD11c and CD83 in DC was observed by flow cytometry analysis. However,UANa significantly enhanced the expression of MHC II molecule. In the DTH model,UANa enhanced the degree of allergen-induced ear swelling and promoted the ability of lymphocyte proliferation in vitro. CONCLUSION:UANa suspension as adjuvant significantly enhances the cellular immune response but inhibits the humoral immune response to a certain degree,suggesting that UANa has potential application in the vaccine research.

OBJECTIVETo observe the difference in the analgesic effect on primary dysmenorrheal between acupuncture and sham acupuncture at Sanyinjiao (SP 6) during menstrual pain and evaluate the impact of psychological effect on acupuncture analgesia.

METHODSSixty subjects were randomized into an acupuncture group and a sham acupuncture group, 30 cases in each one. The conventional acupuncture and sham acupuncture were applied to Sanyinjiao (SP 6) on bilateral sides when menstrual pain began to attack and needles were retained for 30 min each time. Three menstrual cycles were required. The visual analogue scale (VAS) was adopted to determine the scores before and 0. 5 h, 1 h, 3 h, 6 h and 12 h after acupuncture during menstrual pain in each cycle separately.

RESULTSIn the acupuncture group, VAS score at each time point after acupuncture was reduced as compared with that at the previous one during menstrual pain in each menstrual cycle, indicating the significant difference (all P<0. 05). In the sham acupuncture group, the scores in 6 h and 12 h of acupuncture were reduced as compared with the previous one, indicating the significant difference (all P<0. 05). After acupuncture, VAS score at each time point in the acupuncture group was lower than that in the sham acupuncture group (all P<0. 05).

CONCLUSIONThe conventional acupuncture at Sanyinjiao (SP 6) achieves the significant analgesic effect on primary dysmenorrheal. The psychological placebo effect of sham acupuncture has no obvious impact on acupuncture analgesia.

Acupuncture Analgesia ; Acupuncture Points ; Acupuncture Therapy ; Adult ; Dysmenorrhea ; physiopathology ; therapy ; Female ; Humans ; Menstrual Cycle ; Placebo Effect ; Young Adult

Objective To explore a better method to repair cervical cicatricle contracture deformity.Methods The cervicai cicatrical contraction deformity was repaird by the cervico-shoulder island skin flap with blood supply crossing and abundant anastomotic branches of the neck-shoulder blood vessels. After removing the cervical scar, the flaps were designed according to the size of the wound to be repaired, and the clinical anatomy of crossing and abundant anastomotic branches of the neck-shoulder blood vessels. The secondary wound of donor site was closed directly if the donor region was small, or closed by skin graft. Results Sixteen patients in this clinic were operated with this method, and venous return dysfunction occurred in 1 case, but blood circulation was improved after treatment. All the flaps survived with good appearance and texture. The extensive flap was created and transferred to the anterior neck by one stage without pre-expansion which met some patients'requirement of repairing cervical cicatricle contracture deformity. Conclusion The cervico-shoulder island skin flap, with abundant blood supply, is a new method to repair cervical cicatricle contracture deformity.

Objective To study the clinical application of finger reconstruction by transplantation of two second toes and evaluate the postoperative appearance and function regarding the reconstructed hand and donor feet. Methods Defect of fingers were treated by transplantation and reconstruction with a total of 74 cases,including two second toes transplantation for both thumbs in 2 cases,thumb with index finger in 10 cas es, index finger with middle finger in 8 cases and middle finger with ring finger in 17 cases. Results Sevetythree fingers survived except 1 failed. During the follow up examination made from 3 to 36 months, the reconstructed fingers could move, write and dress with ease, pinch forcefully, show good recovery of manual work and the sensation of pain and warmth. Two-point discrimination found to be between 5 to 10 mm. Both donor feet have symmetrical appearance with normal gait and satisfactory motion. Also, no pain was complained.Conclusion Transplantation of two second toes from both feet is a good method to reconstruct defect of multiple fingers, and has little effect on the appearance and motion of feet.

Objective To evaluate the role of spinal AMP-activated protein kinase (AMPK) signaling pathway in reduction of neuropathic pain (NP) by dexmedetomidine in rats.Methods One hundred twenty adult male Sprague-Dawley rats, weighing 180-220 g, were randomly divided into 4 groups (n=30 each) using a random number table: sham operation group (group S);group NP;dexmedetomidine group (group Dex) and AMPK inhibitor group (group AI).The animals were anesthetized with intraperitoneal 10％ chloral hydrate 350 mg/kg.The right sciatic nerve was exposed, and 4 loose ligatures were placed on the sciatic nerve at 1 mm intervals with 4-0 silk thread in NP and Dex groups.In group Dex, dexmedetomidine 50 μg/kg was injected intraperitoneally once a day starting from the end of operation until the animals were sacrificed.In group AI, AMPK inhibitor Compound C 20 mg/kg was injected intraperitoneally at the end of operation, and the other treatments were similar to those previously described in group Dex.The equal volume of normal saline was given instead of dexmedetomidine in S and NP groups.The mechanical paw withdrawal threshold to von Frey filament stimulation (MWT) and thermal paw withdrawal latency (TWL) were measured at 1 day before operation (baseline) and 2, 8 and 14 days after operation (T0-3).Results Compared with group S, the MWT was significantly decreased, and the TWL was shortened at T1-3 in NP, Dex and AI groups (P＜0.05).Compared with group NP, the MWT was significantly increased, and the TWL was prolonged at T1-3 in group Dex (P＜0.05) , and no significant change was found in MWT and TWL in group AI (P＞0.05).Conclusion Spinal AMPK signaling pathway is involved in reduction of NP by dexmedetomidine in rats.

Objective: To comparatively study the atrial ifbrillation (AF) in patients with Han, Uygur, Kazak and Hui ethnic groups in Urumqi city.
Methods: A total of 1510 AF patients treated in 12 hospitals in Urumqi city from 2008-01 to 2012-12 were retrospectively studied. There were 1310 patients enrolled in our research including the 4 ethnic groups of Han, n=995 (75.95%), Uygur, n=168 (12.82%), Kazak, n=55 (4.20%) and Hui, n=92 (7.02%).
Results: ①The gender ratios were similar in 4 ethnic groups, P>0.05, while the AF type, cardiac function and risk factors were different, all P<0.05.②The blood pressure was similar in 4 ethnic groups, P>0.05, while the blood routine test, biochemistry and cardiac ultrasound examination were different, all P<0.05.③The treatments were different among 4 ethnic groups, all P<0.05.
Conclusion: The AF patients were different in AF type, biochemistry, cardiac ultrasound and function, anti-coagulation treatment among 4 ethnic groups of Han, Uygur, Kazak and Hui in Urumqi city.

Objective To investigate the clinical features and current therapy of atrial fibrillation (AF) of inpatients in Urumqi,China.Methods The clinical data of inpatients diagnosed with AF from January,2008 to December,2012,in 12 hospitals in Urumqi were retrospectively analyzed.Results Totally 1 310 AF inpatients were enrolled in this study with the age of (64.8 ±3.3) years old and a men to women ratio of 1.39.Most patients were in age groups of 61-70 years (26.5％) and 71-80 years (27.6％).More patients with paroxysmal AF were at cardiac function class Ⅰ-Ⅱ (75.2％),while more patients with persistent AF were at cardiac function class Ⅲ-Ⅳ (31.0％) (both P values ＜ 0.05).The most common co-morbidities of AF were hypertension (49.2％),coronary heart disease (38.5％),diabetes mellitus (20.1％).Compared with patients of chronic AF,the patients of paroxysmal AF had higher success rates in amiodarone conversation and sinus rhythm maintenance after ablation (44.8％ vs 29.9％,87.5％ vs 68.9％,P values ＜ 0.05).Among the 1 310 inpatients,992 patients (75.7％) received antithrombotic therapy.There were statistically significant differences in CHA2DS2 score and incidence rate of cerebral infarction among patients receiving aspirin,warfarin or rivaroxaban/other anticoagulation drugs [2 (1,3) vs 3 (2,4) vs 3 (2,5) and 6.3％ vs 23.8％ vs 30.2％,both P values ＜0.05].Conclusion Our results of AF inpatients' age,gender,related disease distribution,AF types,incidence of stoke,therapeutic and epidemiological features are in accordance with the domestic and abroad reports.

Objective To observe the influence of human umbilical cord mesenchymal stem cells (hUCMSC) transplanted into the tail vein of diabetic rats on apoptosis of retinal neurons and the retinal expression level of glial fibrillary acidic protein (GFAP).Methods Seventy clean male Sprague-Dawley rats were randomly divided into the normal control group (group A),diabetes mellitus (DM) only group (group B),DM + balanced salt solution (BSS) group (group C),DM + hUCMSC group (group D),with 10 rats in each group.DM rats were induced by intraperitoneal injection of streptozotocin.Apoptosis of retinal cells was assayed by dUTP nick end labeling.Immunohistochemistry and Western blot was performed to detect the retinal expressions of GFAP in rats.Results Compared with group A,large numbers of apoptotic cells could be found in the retinal ganglion cell layer (GCL) and inner nuclear layer (INL) of group B and group C,however the apoptotic cells in group D were significantly reduced than group B and C.The expression of GFAP was mainly located in the retinal GCL and retinal nerve fibre layer (RNFL) in group A,throughout the inner plexiform layer (IPL) in group B and C,only distributed in RNFL and GCL in group D.It was obvious that the expression of GFAP in group B and C was higher than group A.Compared with group B and C,the expression of GFAP in group D was significantly reduced.The difference of GFAP expression among the 4 groups was significant (F=79.635,P＜0.05).Conclusion hUCMSC could inhibit the apoptosis of retinal cells and activation of glial cells in early DM rats.