Background The measurement of the extraocular muscle is critical for the diagnosis of extraocular muscle diseases,but conventional medical imaging techniques present some shortcomings because of the contact pattern.The anterior segment optical coherence tomography (OCT) is thought to be an in vivo noninvasive optical diagnostic imaging method.Objective This clinical study attempted to seek an available approach to the evaluation of the anatomic structure of human horizontal rectus insertion with Visante OCT.Methods One hundred and fourteen eyes of 58 subjects were included in this study and were divided into the low refractive power group (≤-3.00 D) with 43 eyes,moderate refractive power group(＞-3.00 D-≤-6.00 D) with 49 eyes and high refractive power group(＞-6.00 D) with 22 eyes.The horizontal rectus insertion distance to the scleral spur and its thickness were measured by Visante OCT.The correlation of the refractive power with the rectus insertion distance or thickness was analyzed.Written informed consent was obtained from each subject before medial assessment.Results The average distance from the scleral spur to the lateral and medial rectus insertion were (5.23±0.50)mm and (3.81±0.46)mm respectively.The average thickness of the lateral and medial rectus insertions were (0.39±0.06)mm and (0.39±0.06)mm respectively,showing no significant differences in comparison with those of ultrasound biomicroscopy (P=0.338,P=0.759).The lateral and medial rectus insertion distances were (5.25±0.45)mm and (3.74±0.53)mm in the low refractive power the group,(5.22±0.60)mm and (3.81±0.42)mm in the moderate group and (5.20±0.35)mm and (3.90±0.42)mm in the high refractive power group,presenting inconsiderable difference among these three groups(lateral rectus: χ2=0.054,P=0.974;medial rectus: F=0.508,P=0.604).The thickness of the lateral and medial rectus insertions were (0.41±0.06)mm and (0.40±0.06)mm in the low refractive power group,(0.40±0.07)mm and (0.37±0.07)mm in the moderate refractive power group,(0.36±0.05)mm and (0.39±0.05)mm in the high refractive power group with a significant difference among lateral rectus (F=4.922,P=0.009) but not medial rectus (F=2.152,P=0.125).The lateral rectus insertions thickness in the high refractive power group was thinner than that in low refractive power group (P＜0.05).A positive correlation was found between refractive power and the thickness of lateral or medial rectus insertions (r=0.284,P＜0.01).Conclusion Visante OCT is a uscful way in measuring the distance and thickness of the extraocular muscles.Lateral rectus insertions thickness tends to be thinner with the worsening of myopia,which is obvious in high myopia.

To further analyze immunoglobulin (Ig) properties of panel reactive antibodies (PRA) and their potential harmful effects on allogeneic renal transplants. Methods Since dithiothreitol (DTT) is able to crack disulphuric bond of Ig and to depoly-merize IgM with heavy molecular weight, PRA study was performed with treatment of DTT. Thus, a DTT-ERA method was established, which can identify immunoglobulin class in sera of high PRA patients. Results Among 701 recipients, whose sera were positive by the standard PRA, the positive rate of DTT-PRA was 33.2% . Besides, positive PRA patients could be divided into three groups according to their sera's sensitivity to DTT: Group 1 consisted of patients whose sera contained exclusively IgM antibodies; Group 2 consisted of patients whose sera contained of IgG antibodies only; Group 3 consisted of patients whose sera were found to contain both IgM class antibodies and IgG antibodies. Conclusion IgM class antibodies are not associated with posttrans-plant rejection, while IgG antibodies alone and mixture of IgG and IgM antibodies may mediate acute, or even hyperacute rejection.

Objective To establish a novel flow cytometric crossmatch assay allowing detection of complement-fixing donor specific anti-HLA IgG alloantibodies (Flow cytometry complement-dependent crossmatch,Flow-CDC). Methods One hundred pretransplant crossmatchings were performed using Flow-CDC and NIH-CDC between 62 patients awaiting renal transplantation and 33 donor cells.These crossmatchings were divided into two groups according to PRA.Group 1 consisted of 25 sera with negative PRA,and group 2 consisted of 75 sera with positive PRA.All of the sera were pretreated with DTT to inactivate IgM. Lymphocytes were isolated from peripheral blood (or,in a few instances,from the spleen) of the cadaveric donors. The correlation between different techniques for detection of donor specific anti-HLA antibodies was evaluated.The effect of both methods on clinical transplantation outcome was observed. Results In group 1,NIH-CDC and Flow-CDC were negative for all 25 sera.In group 2,24 (32.0%) had a positive NIH-CDC,31 (41.3%) had a positive Flow-CDC.There was a significant difference between two methods (?2=5.14, P= 0.016 ).Overall concordance between both tests was 93% with 69 concordant negatives and 24 concordant positives. The correlation coefficient (r) was 0.80.In group 2,5 patients received transplantation. One of them with negative NIH-CDC and positive Flow-CDC suffered from acute rejection after transplantation and lost the graft,and the other patients with negative NIH-CDC and Flow-CDC had good outcome. Conclusions Flow-CDC can detect specifically complement-fixing IgG alloantibodies against donor HLA and is more sensitive than NIH-CDC.Additionally,the computer printouts represent a permanent record of the crossmatch for retrospective review.Flow-CDC may become the standard crossmatch method as a possible alternative to conventional NIH-CDC testing.

Objective To investigate the correlation between microalbuminuria (MAU) and obesity and its indexes, including BMI, waist circumference(WC), and waist-to-hip ratio(WHR) , among partial community population in Beijing. Methods A total of 2080 subjects who took physical examination in Beijing, including 810 men and 1270 women with a mean age of(50. 9 ± 13. 1 )years, were enrolled. The informed consent has been achieved from each patients. BMI and WHR were calculated based on collected data of height, weight, WC, and hipline. Urine albumin-creatinine ratio(ACR) within the range of 30-300mg/g was classified as MAU. The subjects were divided into normal albuminuria ( NAU ) group and MAU group. The correlations between MAU and different obesity indexes including BMI, WC and WHR, were analyzed. Results Among the 2080 subjects, there was a positive correlation between BMI (r = 0. 1276,P＜0.01) and ACR, and WC (r = 0.0840, P ＜0.01) and ACR. WHR and ACR was irrelevant ( P ＞ 0. 05 ). In univariate analysis, there was significant difference in BMI ≥ 28 kg/m2 ( OR = 2. 02 ) and WC ≥85 cm (male) or≥80 cm (female) (OR = 1.69 ) between NAU group and MAU group (P ＜ 0. 05 ).There was no significant difference in BMI 24-＜ 28 kg/m2, and WHR ≥0. 90 (male) or ≥0. 85 (female)between NAU group and MAU group( P≥0. 05 ). Multivariate logistic regression analysis revealed that BMI ( OR = 1.06) was an isolated independent risk factor of MAU from age ( OR = 1.01 ), female ( OR = 1.42),systolic blood pressure (OR=1.01), TC (OR=1.93) and HDL-C (OR=0.54). Conclusions Obesity is an independent risk factor of MAU among partial community population in Beijing. The correlation between different obesity indexes and MAU also differs.

Background Diabetes is one of the risk factors that leads to corneal neuropathy.Silent signal regulatory factor 1 (Sirt1) plays an important role in glucose metabolism,lipid metabolism,regulation of insulin secretion and is closely related to the nervous system disease.The relationship between Sirt1 and diabetic corneal neuropathy is not fully understood.Objective This study was to detect the expression of Sirtl in cornea and trigeminal ganglion with type 1 diabetes model mice and explore the association of Sirt1 expression with diabetic corneal neuropathy.Methods Eight C57BL/6-Ins2Akita/J male mice and eight wild-type C57BL/6 male mice in the same litter were selected as type 1 diabetes model group and control group,respectively.The mice of two groups were sacrificed in overdose anesthesia method at 12-month old.Histological examination of cornea and trigeminal ganglion was performed using hematoxylin and eosin staining.Expression and localization of Sift1 protein in cornea and trigeminal ganglion were detected using immunohistochemistry.Western blot assay and fluorescine quantitative PCR were respectively used to quantitatively analyze the expression of Sirt1 protein and Sirt1 mRNA.Results Trigeminal ganglion cells were uneven in size and shape with the loosened cellular arrangement and disorder neurofibrosis alignment,and the corneal epithelial cells were less in the C57BL/6-Ins2Akita/J mice,but the trigeminal ganglion cells and corneal epithelial cells were normal in wild-type C57BL/6 mice.Immunochemisty exhibited that Sirtl protein was expressed mainly in corneal epithelium and the expression of Sirtl protein was stronger in the C57BL/6 mice than that in C57BL/6-Ins2Akita/J mice.Fluorescine quantitative PCR assay showed that the gray scale value of Sirt1 mRNA in cornea in C57BL/6-Ins2Akita/J mice was lower than that of the wild-type C57BL/6 mice(0.56±0.03 vs.0.98±0.13) with significant difference (t =5.853,P =0.010).Western blot showed that the expression of Sirt1 protein in cornea was lower in C57BL/6-Ins2Akita/J mice than that of the wild-type C57BL/6 mice(0.78±0.017 vs.1.300±0.012) with significant difference(t =33.140,P =0.001).However,no significant differences were seen in the gray scale value of Sirt1 mRNA(2.45±0.18 vs.2.51±0.22) (t=0.587,P=0.599) and protein level(1.100±0.015 vs.1.110±0.017) (t =0.430,P=0.709) in trigeminal ganglion tissues between C57BL/6-Ins2Akita/J mice and wide-type C57BL/6 mice.Conclusions The corneal nerve and structure is abnormal in 12-month-old C57BL/6-Ins2Akita/J mouse.Sirt1 is involved in the pathogenesis of diabetic keratoneuropathy,suggesting that it may be a potential target.

Protein tyrosine phosphatase (PTP) 1B is a potential target for the treatment of diabetes and obesity. Phosphotyrosine (pTyr) is the substrate for PTP1B dephosphorylation. Malonic acid moiety was used herein as a mimic of the phosphate group in pTyr, and novel malonic acid derivatives 1-7 were designed, synthesized and evaluated as PTP1B inhibitors. Results from enzymatic assays indicated that compounds 3 and 4 exhibited potent inhibition against human recombinant PTP1B with IC50 values of 7.66 and 1.88 micromol x L(-1), respectively.

Objective To investigate the clinical effect of IFNα combined with mannan peptide in treatment of patients with HBeAg-positive chronic hepatitis B ( CHB ). Methods Eighty HBeAg-positive CHB patients with HBV DNA quantity ranging from 10 to 10 eopies/mL were enrolled and randomized into the treatment group and the control group ( n = 40 for each ). Patients in treatment group were given daily subcutaneous injection of IFNα-2b 5,000,000 U for 52 weeks, and received mannan peptide 10 mg per intravenous injection or 2. 5 mg per intramuscular injection for a total of 2 to 3 treatment courses (12 weeks for each). The control group received only IFNα-2b treatment. Liver function, serum markers of hepatitis B, HBV DNA quantity and blood tests were performed before the treatment and at 2, 4, 8, 16, 26 and 52-week during the treatment; and the adverse effects were recorded. Results The rates for ALT normalization, negative HBsAg, negative HBeAg, HBeAg seroconversion and negative HBV DNA were 91. 8% , 17. 5% , 52. 5% , 27. 5 % and 47. 5% at 52nd week in the treatment group, while those in the control group were 80. 0% , 12. 5% , 30. 0% , 10. 0 % and 25. 0% , respectively. There were significant differences in HBeAg-negative, HBeAg-seroeonversion and HBV DNA-negative rates between two groups (χ2 = 4. 178, 4.021 and 4.381, P < 0. 05 ) , and these indexes in the treatment group were increased to 57. 5% , 30. 0% and 50. 0 respectively at 52nd week after drug withdraw. White blood cells began to be elevated at 4th week and were restored to the normal levels at 8th week in the treatment group, while the count in the control was lower than the normal value even at 52nd week of the treatment with the average of (3.45±1. 18)×109/L. Conclusion Alpha-interferon combined with mannan peptide therapy is effective for patients with HBeAg-positive CHB, which may restore the declined peripheral WBC counts induced by interferon and improve the compliance.

Objective To investigate the importance of plasmid-mediated quinolone resistance in the development of quinolone resistance in clinical isolates of gram-negative bacteria.Methods A total of 541 consecutive clinical isolates of gram-negative ba- cilli resistant or intermediate to ciprofloxacin were screened for the qnrA gene by PCR.Conjugation experiments were carried out with azide-resistant E.coli J53 as a recipient.The aac(6')-Ib-cr gene was detected.The mutations in the quinolone-resist- ance-determining region (QRDR) of the gyrA and parC genes were identified in qnrA positive strains.Results qnrA was identi- fied in 7 of the 541 strains.Among the qnrA positive strains,5 were Enterobacter cloacae.No qnrA was detected in nonfer- menters.Quinolone resistance was transferred in 4 of 7 qnrA positive strains.Transconjugants had 12-to 125-fold increases in MIC of ciprofloxacin relative to that of the recipient.Seven strains contained qnrA with a nucleotide sequence identical to that originally reported.Two transconjugants with higher ciprofloxacin MICs contained aac(6')-Ib-cr gene.Mutations occurred in the QRDR of the gyrA and parC genes in 5 PCR-positive clinical strains.Conclusions Transferable plasmid-mediated quinolone resistance associated with qnrA is highly prevalent in clinical strains of Enterobacter spp.aac(6')-Ib-cr gene and mutations in the quinolone targets may co-exist with qnrA,which may contribute to the further increase of resistance to quinolones.

Objective To study the difference in therapeutic effects and side effects of ibuprofen versus indomethacin for symptomatic patent ductus arteriosus (PDA) in the premature infants.Methods Meta analysis was used to qualitatively and quantitatively evaluate the data extracted from 6 public papers about comparative study of ibuprofen and indomethacin.Results The rate of ductal closure was similar with the two treatment regimes (intravenous ibuprofen and indomethacin).In side effects on PDA,the incidence of oliguria induced by ibuprofen was significantly lower than that of indomethacin though there were no difference in other side effects.Conclusions The efficacy of ibuprofen for the early treatment of PDA in preterm infants is similar with indomethacin,and has low incidence of oliguria.

Objective To evaluate the diagnostic value of contrast-enhanced digital subtraction MRI in vertebra]metastatic tumors.Methods Forty-four vertebral metastatic tumors in thirty patients were scanned by routine MRI including SE T_1WI,SE T_2WI,STIR and enhanced T_1WI with an injection of Gd-DTPA(0.1 mmol/kg).Digital subtraction was performed between pre-contrast and enhanced T_1 weighted images.All the images of vertebral malignant tumors were evaluated by means of signal intensity ratio(SIR) and nose ratio(NR).The quality of images was also evaluated by comparing subtraction MRI with routine MRI.Results SIR and NR of subtraction MRI was 2.93,0.98 respectively.SIR of routine MRI (enhanced T_1WI,SE T_1 WI,SE T_2WI,STIR)was as follows:1.15,1.16,1.26,1.69.While NR of those was 5.25,3.44,4.56,23.32 respectively.SIR and NR of subtraction MRI images had significant statistical differences from those of routine MRI images(P