The clinical characteristics, therapeutic effects and complications of 32 incipient patients with acute Vogt-Koyanagi-Harada ( VKH) syndrome admitted in Wuxi Second Hospital during October 2010 to September 2013 were retrospectively analyzed.There were 15 males and 17 females with a mean age of (41.3 ±14.1) years (22 -71 years), the time from the disease onset to treatment ranged from 3 to 20 days.Among 32 cases, 30 ( 94%) had premonitory symptoms. The multifocal bullous neurosensory detachment, optic disk hyperemia and edema in posterior pole of fundus were found in all cases, and exudative retinal detachment was found in 4 cases (6 eyes).The results of optical coherence tomography ( OCT) showed the macula neurosensory detachment, thick retinal neuroepithelial layer and wavy RPE layer in all patients.Fundus fluorescein angiography ( FFA) showed that scattered hyperfluorescence dots and cystic fluorescein reservoir was observed in early phase and later period respectively.Patients received intravenous methylprednisolone with the onset dose of 80 mg per day for 3-7 days and oral administration followed, which would gradually decrease later;the average treatment duration was (52.9 ±14.6) weeks. The visual acuity of 40 eyes (22 cases) was recovered to more than 0.8, and no blindness occurred after the treatment.During the treatment hair loss, depigmentation of skin and hair were found in 12 cases (38%) , and 2 cases showed short-term elevated intraocular pressure.These symptoms disappeared after drug therapy ceased.And no recurrence was found during the follow-up of 6 months.However, sunset glow fundus was found in 13 patients (26 eyes).The study shows that the diagnosis of VKH syndrome is based on the typical signs of the fundus presented on OCT and FFA.Early and systemic administration of glucocorticoids is important treatment for patients with VHK syndrome, which could decrease systemic and local complications effectively.

Objective To study the effects of steaming Orange Magnoliavine Fruit with vinegar on the lignan metabolism in rats.Methods The rats were fed with same amount of extracts:Orange Magnoliavine Fruit before and after steaming processing with vinegar. Then plasma samples were collected at different times and determined contents of schisantherin A and deoxyschizandrin by HPLC to draw drug concentration in blood-time curve. The pharmacokinetic parameters were calculated with DAS2.0 analysis software.Results Pharmacokinetic model of schisantherin A and deoxyschizandrin in rats accorded with one compartment model. Plasma concentration in rats under the condition of Orange Magnoliavine Fruit samples before and after steaming processing with vinegar was:Tmax of schisantherin A was determined with (4.250±1.523), (5.750±1.784)h respectively, Cmax with (2.197±0.995), (2.815±0.842)μg/mL respectively, T1/2 with (2.654±0.377), (3.504±0.856)h respectively. Tmax of deoxyschizandrin was determined with (3.250±1.836), (4.250±1.471)h respectively, Cmax with (1.922±0.773), (2.307±0.602)μg/mL, T1/2 with (2.111±1.185), (3.242±2.126)h. Orange Magnoliavine Fruit before and after steaming processing with vinegar exhibited differences in pharmacokinetic parameters in rats.Conclusion The pharmacokinetic parameters of schisantherin A and deoxyschizandrin showed that the steaming processing with vinegar on Orange Magnoliavine Fruit can slow down lignan metabolism in vivo.

Objective To assess the awareness of nutrition issues among patients with type 2 diabetes mellitus (T2DM) and to find effective nutrition education models. Methods According to cluster random sampling method,256 T2DM patients from 2 hospitals in Zhengzhou City were enrolled and randomly assigned to the study or control group. The participants in the study group received traditional nutrition education and real object-based diabetic diet guidance, and those in the control group received traditional nutrition education only. Awareness about nutrition and blood glucose levels were compared between the two groups by using independent t test and Chi-square test Results After the intervention, the study group showed significantly higher nutrition scores ( 86. 5 ± 3.8 vs 71.5 ± 4. 6, P ＜ 0. 05 ) and lower 2 h postprandial glucose level ( ( 9. 15 ± 1.06 ) mmol/L vs ( 11.32 ± 0. 84) mmol/L, P ＜ 0. 05 ). Conclusion Real object-based diabetic diet teaching could foster the awareness in nutrition and decrease postprandial blood glucose level in T2DM patients.

Objective To discuss the application value of multislice CT (MSCT) in diagnosis of ureteral biology variation and diseases.Methods The MSCT data of 51 patients with suspected ureteral biology variation and diseases were retrospectively analyzed.The data of MSCT images included plain scan,renal cortical phase,renal parenchyma phase and excretion phase.The MSCT images of renal cortical phase,renal parenchyma phase and excretion phase were reconstructed respectively to gain the 3D images of renal arteries,veins and urinary passage.Results Among the 51 patients,1 patient with traumatic ureteral rupture,10 patients with ureteral biology variation diseases,14 patients with stone of ureter,2 patients with polyp of ureter,3 patients with non-specificity ureteritis,3 patients with tuberculosis of ureter,1 patient with endometriosis,17 patients with carcinoma of ureter.Satisfied 3D images of renal arteries,veins and urinary passage could be reconstructed.And the imaging diagnosis of 51 patients were all in accord with their clinical diagnosis or pathologic diagnosis.Conclusion MSCT can obtain high qualified images,and this technique should become the preferred inspection item of ureteral biology variation and diseases.

Objective To identify interleukin 17 (IL-17) and B cell activating factor (BAFF) that could influence B cell biology by detecting the expression of BAFF in the serum and labial salivary glands from primary Sj(o)gren's syndrome (pSS) patients and to test the apoptosis rates of B cells cultured with Th17 cells which were transfected with IL-17-siRNA,BAFF-siRNA.Methods A total of 40 patients with pSS who were referred to the Department of Rheumatology and Immunology at Anhui Provincial Hospital from June 2011 to June 2012 were enrolled into this study.The expression of BAFF on salivary gland and serum from pSS patients and healthy controls were detected by ELISA and immunohistochemical examination (22 patients with pSS).Flow cytometry was used to detect B cell's apoptosis,BAFF and IL-17 interfered with amplified Th17 cells,and co-cultured with B cells.Immunoblot was used to detect supernatant antibody in 5 patients with pSS.Independent samples t test was used for statistical analysis.Results In all pSS specimens,infiltrating inflammatory cells expressed BAFF,so did some ductual cells,but acinar cells did not express these markers.There was no expression of BAFF in the controls.BAFF-positive cell numbers in the labial salivary glands of pSS patients with focal infiltrating lymphocytes were more than that with non-focal infiltrating lymphocytes (888±372 vs 164±161,t=5.94,P＜0.05),and the percentage of BAFF-positive lymphocytes over the total infiltrating lymphocytes in the salivary glands of pSS patients with focal infiltrating lymphocytes [(0.18 ±0.08) ％] was higher than those with non-focal infiltrating lymphocytes [(0.09 ±0.07) ％] (t =3.03,P＜0.05).The level of soluble BAFF in patients with pSS [(6.0±2.8) ng/ml] was significantly higher than the controls [(3.8±1.7) ng/ml,t=3.26,P＜0.05].BAFF or IL-17 transfected group,B cell apoptosis rate [(24± 5)％,(23±5)％] were significantly higher than the non-transfected group [(7±4)％],t=4.6,4.4; P＜0.05].And there was no significant difference when compared with cultured B cells (P＞0.05).Compared with the controls,no antibody could be detected in the supernatants.Conclusion BAFF may be involved in the process of local inflammatory damage of the pSS,it may have a synergistic effect with IL-17 on abnormal B cell function.

0.05),Conclusion The possibihty of thymoma should be considered among those late-onset SLE patients.The glucocorticoid-based immunosuppressive therapy is effective for thymoma-associated SLE.To treat SLE is not an indication for thymectomy.

Objective To investigate the satisfaction degree with nursing for discharged patients by telephone interview,and understand the nursing quality improvement during hospitalization of patients.Methods In January and December 2011,24 clinical departments were selected as the research object,10 patients were selected from each department.The questionnaires of satisfaction degree with nursing were adopted to investigate the satisfaction degree of patients by telephone interview.The difference of satisfaction degree with nursing were compared between January and December 2011.Results Compared with the results of January,there were statistical differences in overall mean score of satisfaction degree and the dimensions of service attitude,knowledge information,ward management and working ability.While the means of dimensions of basic nursing care and care-taking patient were in high levels.Conclusions The method of telephone interview to investigate the satisfaction degree of discharged patients is direct,real and objective.It is convenient for the hospital to understand the nursing quality and existing problems during hospitalization of patients,and offers scientific way for continuous improvement of nursing service.

Objective To study the value of needle aspiration biopsy guided by computerized mammography locator in the diagnosis of breast disease. Methods Needle aspiration biopsy was performed in the suspected areas guided by computerized mammography locater. Pathological diagnosis of this tissue taken by needle aspiration biopsy was compared with those taken through operation. Results There were 79 cases in this series. All the 79 specimens taking from needle aspiration confirmed to the requirement of biopy. Of them, 68 cases underwent operation, and the accurat pathologic diagnostic rate of needle aspiration specimens in the 68 cases was 97.2%.Conclusions Computerized mammography locator guiding needle aspiration biopsy is a simple and less invasive procedure.It is very useful for diagnosis of early breast cancer.

Clinic demonstration is the important part of medical education.There are more and more medical students with enlarged university enrolment in recently year.However,the patients for demonstration are relatively fewer.In this condition,we make the best of the available resources to demonstrate clinic pediatrics by teaching at bedside;displaying video products,using human analogue and case record and role playing,thus ensuring the effect of clinic pediatric teaching.

Objective To investigate the effects of H3K9ac hyperacetylation mediated by histone acetylases on the overexpression of MEF2C in the hearts of fetal mice exposed to alcohol during pregnancy,and provide new interven-tion targets for prevention and treatment of cardiac dysplasia caused by alcohol exposure.Methods C57BL/6 mice were divided into 5 groups randomly,blank control group,dimethylsulfoxide (DMSO)group,alcohol group,alcohol +anacardic acid group and anacardic acid group,and then the hearts of fetal mice were collected to be analyzed.Chroma-tin immunoprecipitation and Western blot were used in assaying the binding of histone acetylases and the level of H3K9ac to the promoter of MEF2C in the hearts of fetal mice.The mRNA expression of MEF2C was tested by adopting real -time PCR.Results The level of H3K9ac in the promoter of MEF2C in the hearts of fetal mice exposed to alcohol was higher than that in the hearts of fetal mice exposed to saline (1 .30 ±0.1 9 vs 0.45 ±0.01 ),there was statistically significant difference (P <0.05),while the binding of E1 A -binding protein (p300),p300 /cyclic adenosine mono-phosphate response element binding protein -associated factor (PCAF)and steroid receptor coactivator -1 (SRC1 )to the promoter of MEF2C were abnormally elevated in the hearts of fetal mice treated by alcohol (1 .68 ±0.08 vs 0.82 ± 0.08,1 .08 ±0.05 vs 0.42 ±0.02,1 .1 8 ±0.05 vs 0.39 ±0.08),and there were statistically significant differences (all P <0.05).The expression of MEF2C mRNA in alcohol group was higher than that in blank control group (1 .36 ± 0.1 2 vs 0.29 ±0.03),there was statistically significant difference(P <0.05).However,a pan -acetylases inhibitor, anacardic acid,could decrease significantly the binding of p300 and PCAF to the promoter of MEF2C (1 .52 ±0.05 vs 0.63 ±0.09,1 .1 3 ±0.04 vs 0.45 ±0.04),and correct abnormal hyperacetylation of H3K9ac induced by alcohol (1 .58 ±0.08 vs 0.67 ±0.05),and down -regulate the over -expression of MEF2C in the hearts of fetal mice exposed to alcohol (1 .36 ±0.1 2 vs 0.41 ±0.05 ),and there were statistically significant differences (all P <0.05 ). Conclusions Hyperacetylation of H3K9ac mediated by p300 and PCAF may be a key regulatory factor in the over -expression of cardiac nuclear transcription factor MEF2C in the hearts of fetal mice exposed to alcohol during pregnan-cy.Anacardic acid can significantly attenuate the level of H3K9ac through inhibiting the binding of p300 and PCAF to the promoter of MEF2C,and down -regulate the over -expression of cardiac nuclear transcription factor MEF2C in the hearts of fetal mice.