Age-related macular degeneration ( AMD ) is one of a leading worldwide cause of blindness. AMD is a multifactorial disease, and major risk factors include increasing age, current smoking, previous cataract surgery, environmental factors, nutritional factors, genetic markers through genetic regulate complement, lipid, angiogenesis and extracellular matrix. In addition to treatment, epidemiology, risk factors and genetics research of AMD have been significantly progressed. This article will review risk factors of AMD.

Objective To investigate the current situation of maternal self- efficacy of breastfeeding and explore its influencing factors in Zhengzhou. Methods Using the general condition questionnaires, breast feeding self-efficacy scale, perceived social support scale and Edinburgh postnatal depression scale to assess the situation of 180 puerperas by the convenience sampling in one obstetric hospital of Zhengzhou. Results The total score of maternal breast feeding self-efficacy was(114.04 ± 21.57)points.The frequency of delivery, the way of delivery and feeding ways, the average income of family were effected with breastfeeding self-efficacy. The total score of social support was(68.87 ± 10.43) points, the total score of puerperas depression was(7.61 ± 4.25) points.The social support score had positive correlation with breastfeeding self-efficacy(r=0.423, P<0.01). Puerperas depression had negative correlation with breastfeeding self- efficacy(r=- 0.342, P<0.01). Conclusions The maternal breastfeeding level in Zhengzhou was at a lower level. The level of maternal breastfeeding self-efficacy scale was impacted by maternal social support degree, the degree of depression. Measures should be taken to enhance maternal social support degree, reduce the degree of depression, in order to improve the level of maternal breastfeeding self-efficacy.

OBJECTIVE: To evaluate and compare whole exome sequencing (WES) and targeted panel sequencing in the clinical molecular diagnosis of the Chinese families affected with inherited retinal dystrophies (IRDs). METHODS: The clinical information of 182 probands affected with IRDs was collected, including their family history and the ophthalmic examination results. Blood samples of all probands and their relatives were collected and genomic DNA was extracted by standard protocols. The first 91 cases were subjected to the WES and the other 91 cases were subjected to a specific hereditary eye disease enrichment panel (HEDEP) designed by us. All likely pathogenic and pathogenic variants in the candidate genes were determined by Sanger sequencing and co-segregation analyses were performed in available family members. Copy number variations (CNVs) detected by HEDEP were further validated by multiplex ligation-dependent probe amplification (MLPA). As PRGR ORF15 was difficult to capture by next generation sequencing (NGS), all the samples were subjected to Sanger sequencing for this region. All sequence changes identified by NGS were classified according to the American College of Medical Gene-tics and Genomics and the Association for Molecular Pathology (ACMG/AMP) variant interpretation guidelines. In this study, only variants identified as pathogenic or likely pathogenic were included, while those variants of uncertain significance, likely benign or benign were not included. RESULTS: In 91 cases with WES, pathogenic or likely pathogenic variants were determined in 30 cases, obtaining a detection rate of 33.00% (30/91); While in 91 cases with HEDEP sequencing, pathogenic or likely pathogenic variants were determined in 51 cases, achieving the diagnostic rate of 56.04% (51/91), and totally, the diagnostic rate was 44.51%. HEDEP had better sequencing coverage and read depth than WES, therefore HEDEP had higher detection rate. In addition, HEDEP could detect CNVs. In this study, we detected disease-causing variants in 29 distinct IRD-associated genes, USH2A, ABCA4 and RPGR were the three most common disease-causing genes, and the frequency of these genes in Chinese IRDs population was 11.54% (21/182), 6.59% (12/182) and 3.85% (7/182), respectively. We found 43 novel variants and 6 cases carried variants in RPGR ORF15. CONCLUSION NGS in conjunction with Sanger sequencing offers a reliable and effective approach for the genetic diagnosis of IRDs, and after evaluating the pros and cons of the two sequencing methods, we conclude that HEDEP should be used as a first-tier test for IRDs patients, WES can be used as a supplementary molecular diagnostic method due to its merit of detecting novel IRD-associated genes if HEDEP or other methods could not detect disease-causing va-riants in reported genes. In addition, our results enriched the mutational spectra of IRDs genes, and our methods paves the way of genetic counselling, family planning and up-coming gene-based therapies for these families.
DNA Copy Number Variations ; Humans ; Mutation ; Pedigree ; Retinal Dystrophies/genetics* ; Whole Exome Sequencing

Background Oxidative stress-induced apoptosis of human lens epithelial cells (LECs) is associated with c-Jun N terminal kinase (JNK) pathway.Quercetin possesses the antioxidation by inhibiting the JNK pathway.However,whether quercetin can protect LECs from the oxygen-induced damage is still not proved.Objective This study attempted to invatigate the effects and its mechanism of quercetin against hyperbaric oxygeninduced LECs apoptosis. Methods Human LECs line SRA01/04 was cultivated and passaged in MEM medium containing 10％ fetal bovine serum and 0.5％ non-essential amino acids for 2 hours,with or without 20 μmol/LSP600125 or 1 μmol/L quercetin prior to exposure to hyperbaric oxygen.Each exposure session remained 6 hours in 99％ O2 and 1％CO2 with a pressure chamber at 588 kPa.The viability of human LECs was detected by MTT.Cell apoptosis was assessed by flow cytometer using Annexin V-FITC apoptosis detection.The expression of JNK/p-JNK,c-Jun/p-c-Jun,caspase 3 and caspase 9 were detected by Western blot. Results LECs viability (A570 ) was 0.835 ±0.082,0.450±0.083,0.654±0.079,0.649±0.090 respectively in the blank control group,hyperbaric oxygen exposed group,hyperbaric oxygen+SP600125 group and hyperbaric oxygen+quercetin group.The A570 in the hyperbaric oxygen exposed group was significantly lower than the blank control group ( P =0.000),but those in hyperbaric oxygen + SP600125 group and hyperbaric oxygen+quercetin group were significantly higher than the hyperbaric oxygen exposed group ( P =0.003,0.002 ).The numbers of apoptosis cells were 3.17 ±0.74,19.77 ± 1.44,8.45 ±0.93,7.79 ±0.78 respectively in the blank control group,hyperbaric oxygen exposed group,hyperbaric oxygen+SP600125 group and hyperbaric oxygen+quercetin group.Apoptotic LECs were significantly increased in the hyperbaric oxygen exposed group compared with the blank control group ( P=0.000),but those in the hyperbaric oxygen+SP600125 group and hyperbaric oxygen+quercetin group were significantly reduced in comparison with hyperbaric oxygen exposed group (both P=0.000).In additional,expressions of p-JNK,p-c-Jun,caspase 3 and caspase 9 proteins in the cells were elevated in the hyperbaric oxygen exposed group compared with the blank control group (all P =0.000 ),however,those in the hyperbaric oxygen + SP600125 group and hyperbaric oxygen + quercetin group were declined when compared with the hyperbaric oxygen exposed group( all P＜0.05 ). Conclusions JNK pathway is involved in the apoptotic procedure of human LECs induced by oxygen stress.SP600125 and certain concentration of quercetin can interdict the JNK signal pathway and endogenous apoptosis of LECs and further alleviate hyperbaric oxygen-induced damage of LECs.

Objective To prepare novel alkanethiol modified magnetic silver flower nanoparticles as SERS substrate to chloramphenicol for Raman detection and to determine their enhancement effect.Methods An alkanethiol was chosen as a surface modifier of the substrate and was self-assembled onto the magnetic silver flower nanoparticle surface.The chloram-phenicol molecules were enriched to the surface of the substrate by hydrophobic interaction and the effect for detection of chloramphenicol SERS signal was enhanced.Results It was found that the 1-hexanethiol-modified SERS substrate was able to lead to stronger enhancement than 1-dodecanethiol and octadecanethiol.Fe3 O4@SiO2-Ag-C6 was used to detect the chloramphenicol (10 -3 -10 -10 mol/L) and chloramphenicol in milk (10 -3 -10 -9 mol/L) by surface-enhanced Raman spectroscopy.The detection limits were 0.1 nmol/L (32 ppt) and 1 nmol/L (323 ppt) respectively.Conclusion Alkanethiol modified magnetic silver flower nanoparticles are a highly active SERS substrate, which can be used for detection of low concentrations of analytical substances.

OBJECTIVETo provide evidence for Chinese medical treatment of children with EB virus infection by exploring its clinical efficacy from multiple angles.

METHODSTotally 81 children patients were randomly assigned to the treatment group (46 cases) and the control group (35 cases). Patients in the treatment group took Chinese medical decoction, while those in the control received intravenous dripping of Ganciclovir and oral administration of pidotimod. The treatment period for the two groups was 2 weeks. Patients were followed-up till the 12th week. Clinical symptoms such as fever, lymphadenopathy and hepatosplenomegaly, as well as lab indices such as abnormal lymphocyte percentage, EB virus antibody, virus DNA load, T cell subsets, immunoglobulin, and so on were observed before and after treatment, at week 4 and 12 of follow-ups.

RESULTS(1) The total effective rate at week 2 was 95.6% in the treatment group, higher than that of the control group (94.3%), but there was no statistical difference between the two groups. (2) The time for defervescence, duration of pharyngeal hyperemia, duration of swollen tonsils was shorter in the treatment group than in the control group (P<0.05). The subsidence of lymphadenopathy, hepatomegaly, and abnormal lymphocytes was better in the treatment group than in the control group (P < 0.05). (3) The positive cases of peripheral blood hetero-lymphocyte was significantly reduced after treatment, at week 4 and 12 of follow-ups both in the treatment group and the control group (P < 0.01). The expression of IgA and IgM decreased after treatment in the two groups when compared with before treatment in the same group (P < 0.05, P < 0.01). IgG in the treatment group also obviously decreased after treatment, at week 4 and 12 of follow-ups (P < 0.05, P < 0.01), while it decreased only after treatment in the control group (P < 0.05). Activities of AST and ALT in the treatment group and the AST activity in the control group were markedly improved when compared with those before treatment (P < 0.05). Compared with the control group, the abnormal lymphocyte positive case number obviously decreased in the treatment group after treatment, at week 4 and 12 of follow-ups (P < 0.05). (4) After treatment, at week 4 and 12 of follow-ups, CD3+ and CD8+ significantly decreased; CD4+, CD4/CD8, and B cells significantly increased in the two groups, when compared with before treatment (P < 0.05). NK cells significantly increased more in the treatment group after treatment, at week 4 and 12 of follow-ups, higher than before treatment as well as the control group (P < 0.05). (5) EB viral DNA and EB viral CA-IgM negative conversion case numbers significantly increased in the two groups after treatment, at week 4 and 12 of follow-ups (P < 0.05). Compared with the control group, EB viral DNA and EB viral CA-IgM negative conversion case numbers significantly increased in the treatment group after treatment and at week 4 of follow-ups (P < 0.05).

CONCLUSIONSTreatment of EB virus infection by Chinese medical treatment was effective. It could promote the recovery of EB viral infection, and reduce the risk of vicious disease after EB viral infection.

Adolescent ; Child ; Child, Preschool ; Drugs, Chinese Herbal ; therapeutic use ; Epstein-Barr Virus Infections ; drug therapy ; immunology ; Female ; Herpesvirus 4, Human ; Humans ; Infant ; Male ; Phytotherapy ; T-Lymphocyte Subsets ; immunology

Bacterial Infections ; drug therapy ; Child ; Drug Resistance, Bacterial ; Humans ; Microbial Sensitivity Tests ; beta-Lactamases ; biosynthesis

Objective To investigate the effects of different dose of tranexamic acid in fibrinolysis during liver transplantation. Methods Sixty ASA Ⅱ~ Ⅳ liver transplant recipients, were randomly, double-blind assigned to one of 3 groups (n = 20): group control (group C), group tranexamic acid 1 (group T1) and group tranexamic acid 2 (group T2). The patients in group C received a loading dose of normal saline 10 mL, then continued infuse normal saline at 20 mL/h until neohepatic phase 120 min, while in other two groups, patients received a loading dose of tranexamic acid 1 g, totally 10 mL, followed by continuous infusion at 10 mg/(kg·h) in group T1 or 20 mg/(kg·h) in group T2 until neohepatic phase 120 min. Prothrombin time, fibrinogen, fibrin degradation product and D-dimers were measured before operation (T0), 120 min after the skin incision (T1), nonhepatic phase 30 min (T2), neohepatic phase 120 min (T3). Blood loss, fresh frozen plasma dosage, fibrinogen dosage and thromboembolic events were recorded. Results The plasma concentration of fibrin degradation product and plasma concentration of D-dimers were different in the 3 groups, group T2< group T1 0.05). Conclusions Continuous infusion of tranexamic acid can inhibit fibrinolysis during liver transplantation. No adverse event of thrombosis was detected. Larger dose of tranexamic acid can reduce blood loss and fresh frozen plasma transfusion.

Objective: To search for a best method for management mandible fractures by evaluating the effects of different treatments.Methods: We retrospectively analyzed 148 cases of mandible fractures treated in our department from January 1996 to June 2007.Results: Among the total number,134 cases were restored to normal occlusion,while 6 cases experienced local occlusive disfunction and 8 malocclusion.The effect of treatment was correlated with the types of fracture and methods of diaplasis.Conclusion: Mandible fractures should be treated with a new concept of combined and sequential multidisciplinary methods.Sound diaplasis followed by reliable fixation can produce a satisfying curative effect.At present,intermaxillary elastic traction with internal titanium plate fixation is the most effective method for the management of mandible fractures.

OBJECTIVE To identify the antibiotic resistance,homology and the carbapenemases determinants of imipenem-resistant strains of Acinetobacter baumannii isolated from elderly in the Zhejiang Hospital.METHODS All 142 strains of A.baumannii were isolated from Zhejiang Hospital through Jan 2005 to Jan 2007.K-B method was used to screen imipenem-resistant strains.The MICs of imipenem-resistant strains to 14 antimicrobial agents were determined by agar dilution method.The homology of these isolates was analyzed by pulse-field gel electrophoresis(PFGE).The coding genes of carbapenamases and the gene environments were investigated by PCR,clone,and sequencing.RESULTS Ninety-seven strains of imipenem-resistant A.baumannii were isolated from 142 strains.All of the strains of carbapenem resistant A.baumannii belonged to 4 epidemic PFGE-clones.Ninety carbapenem resistant strains contained OXA-23-like carbapenemase gene and 91 isolates were positive for OXA-51-like gene. OXA-23-like gene of 86 strains was just on the down-stream of insert sequence ISAba1.OXA-51-like gene of 6 strains had an ISAba1 sequence just on the up-stream.CONCLUSIONS All imipenem-resistant strains of A.baumannii are pan-resistant isolates.Clone dissemination is the most important style of strains spread.No OXA-24-like,OXA-58like,IMP-like,and VIM-like gene are detected.OXA-23-like and OXA-51-like gene are the most popular carbapenemases coding genes of these strains in the Zhejiang Hospital.ISAba1 has close relationship with OXA type carbapenemases genes in Zhejiang Hospital.