AIM: To observe the therapeutic effect and safety of improved extra panretinal photocoagulation ( E - PRP) in the treatment of high risk proliferative diabetic retinopathy (hsPDR).
METHODS: A total of 88 consecutive cases (102 eyes) with hsPDR were diagnosed by fundus fluorescein angiography(FFA) from February 2011 to December 2014 in our hospital . Fifty two eyes had been treated by improved E - PRP with 532nm frequency - doubled laser. Fifty eyes had been treated by standard PRP. All cases were checked by FFA and fundus photocoagulation every 3mo. Patients with persisting neovascularization or non perfusion area were treated with laser again. All cases were followed up 6-36mo.
RESULTS: The postoperative visual acuity had no statistical difference between two groups ( P > 0. 05). In improved E - PRP group, retinal non perfusion area and neovascularization disappeared in 35 eyes ( 67%). Effective rate was 88%. Six eyes (12%) underwent pars plana vitrectomy because of vitreous hemorrhage, fiberosis and stretched retinal detachment. In standard PRP group, retinal nonperfusion area and neovascularization disappeared in 23 eyes ( 46%). Effective rate was 66%. Seventeen eyes(34%) underwent pars plana vitrectomy because of anterior retina bleeding or vitreous hemorrhage. The rate of neovascularization disappeared and effective rate had statistical difference between two groups (P<0. 05).
CONCLUSION: It is a safe and effective methods to treat hsPDR by improved E-PRP and it was more effective than traditional PRP.

Head and Neck Neoplasms ; surgery ; Humans ; Neck ; surgery ; Neck Dissection ; methods ; Thyroid Diseases ; surgery ; Vascular Surgical Procedures ; methods

Objective:To evaluate the security, efficacy and side effects of E_2 transdermal patch (Fem-7) in the treatment of menopausal syndrome. Methods:A total of 60 cases with menopausal syndrome (blood serum FSH >30 U/L,E_2 <109.8 pmol/L) were randomly divided into treatment group ( Fem-7 group) and control group (estrodiol valerate (E_2V) group) for 12 weeks treatment. Fem-7 group changed patch every 7 days and took the 2 mg medroxyprogesterone (MPA) every day. While the E_2V group took the 2 mg MPA and 1.5 mg E_2 V every day. Serum E_2, FSH, lipoprotein and coagulation function were evaluated at baseline and at the 12th week of the treatment. In addition, menopausal symptoms and some other index of security and side effects were also observed. Results:Kupperman indix in both groups was decreased and the mean value of E_2 was increased obviously. Hepatic function, renal function, coagulation function and blood glucose were no obvious change. Lipoproteina was descended markedly in Fem-7 group. Other index of security in both groups was no obvious change. Conclusions:Fem-7 patch is secure and valid for relieving symptom of menopause, especially for the women who is not sutable for oral medication.

Objective To explore the association between estimated glomerular filtration rate (eGFR) based on creatinine and cystatin C and the SYNTAX score in old patients with coronary heart disease. Methods Two hundred and fifty-six consecutive old patients with coronary heart disease were included in this study. The patients were angiographically diagnosed with coronary heart disease between January 2013 and April 2014 at the Department of Cardiology.eGFR was caculated by using BIS2 equation based on creatinine and cystatin C.SYNTAX score was caculated by SYNTAX score algorithm. Multiple linear regression and ordinal logsitic regreesion was used to analyze the association between eGFR and SYNTAX score. Results In patients with normal of renal function [eGFR≥90 ml/(min·1.73 m2), 110 patients], mild renal insufficiency [60 ml/(min · 1.73 m2) ≤ eGFR<90 ml/(min · 1.73 m2), 98 patients], midrange and severe renal insufficiency[eGFR<60 ml/(min · 1.73 m2), 48 patients], with the decrease in renal function of patients, SYNTAX score increased: (15.42 ± 9.65), (25.24 ± 8.34), (33.73 ± 10.15) scores, P<0.01. eGFR was an independent predictor of SYNTAX score (r=-0.059, P<0.01).eGFR was negatively correlated with SYNTAX score (r=-0.457, P<0.01). Conclusions eGFR is an independent predictor of SYNTAX score and negatively correlated with SYNTAX score in old patients with coronary heart disease. This might be helpful to explain the increased risk of coronary heart disease events and mortality in old patients with renal dysfunction.

Animals ; Blood Gas Analysis ; Endothelin-1 ; blood ; Hypertension, Pulmonary ; pathology ; Hypoxia ; blood ; physiopathology ; therapy ; Male ; Oxygen ; administration & dosage ; therapeutic use ; Oxygen Inhalation Therapy ; Swine

BACKGROUND:So far, engineered myocardium is stil facing many problems. Research has demonstrated that bone marrow mesenchymal stem cells can be differentiated into myocardial cells. Polyglycolide and polycaprolactone are commonly used artificial polymers, which have good biocompatibility.
OBJECTIVE:To observe the growth of the poly(glycolic acid)/poly(e-caprolactone) copolymer patch in vitro in normal myocardium and infarcted myocardium.
METHODS:Bone marrow mesenchymal stem cells in Sprague-Dawley rats were separated using adherent separation and selection method, cultured in vitro. The third passage was labeled with DAPI. The bone marrow mesenchymal stem cellsuspensions (2×106/cm2) were produced and planted on poly(glycolic acid)/poly(e-caprolactone) copolymer scaffolds to form poly(glycolic acid)/poly(e-caprolactone) copolymer patch. After culturing for 48 hours, the specimens were observed under electron microscope, stained with hematoxylin and eosin, and then observed under light microscope. Rat models of myocardial infarction were established by ligating left anterior descending coronary artery. Poly(glycolic acid)/poly(e-caprolactone) copolymer patch was implanted into the normal and infarcted myocardium for 5 weeks. The survival of bone marrow mesenchymal stem cells was determined by the detection of pathology.
RESULTS AND CONCLUSION:Results of light microscope and electron microscope demonstrated that bone marrow mesenchymal stem cells grew three-dimensional y on poly(glycolic acid)/poly(e-caprolactone) copolymer patch. cells and patch were adhesive wel . Under laser confocal microscopy, compared with the first week, bone marrow mesenchymal stem cells were marked by DAPI in the myocardium at the fifth week. There were bone marrow mesenchymal stem cells marked by DAPI in the infracted area. Results of hematoxylin-eosin staining exhibited that bone marrow mesenchymal stem cells were detected in the infarct area. These results suggested that bone marrow mesenchymal stem cells adhered to the poly(glycolic acid)/poly(e-caprolactone) copolymer stent wel . The complexes of poly(glycolic acid)/poly(e-caprolactone) copolymer and bone marrow mesenchymal stem cells can be used for reparation of myocardium.

Objective To explore the optimal timing of termination of pregnancy,we analyzed the different gestational age in repeat cesarean delivery and maternal and neonatal outcomes.Methods This was a retrospective study.The information of cesarean sections was collected from maternal obstetric records in the electronic medical recording system of the First Affiliated Hospital of Chongqing Medical University from June 1,2011 to June 30,2013,and women with intrauterine viable singleton pregnancies delivered after 37 weeks of gestation without prenatal complications were selected.They were divided into five groups with different gestational weeks.Maternal general information,perioperative outcome and rate of neonatal adverse event were analyzed with one way ANOVA analysis and Chi-square test.Results A total of 579 cases of elective repeat cesarean at term were performed.The ratios of cesarean section prior to 39 and 39-39+6 weeks of gestation were 64.6％ (374/579) and 29.0％ (168/579),respectively.No fetal,neonatal or maternal death occurred.There were no statistically significant differences in the termination of pregnancy at 37-37+6 weeks,38 38+6 weeks,39-39+6 weeks,40 weeks and ≥ 41 weeks between the two time intervals for cesarean section (P＞0.05).There were statistically significant differences in the length of hospitalization [(4.9±3.0),(4.3 ± 1.3),(4.3 ± 1.0),(4.5± 1.2) and (4.0±0.7) d,respectively; F=2.849,P＜0.05].No significant difference was observed in the maternal BMI,placental membrane residue,maternal perioperative bleeding,premature rupture of membrane (PROM),intensive care unit (ICU) admission and uterine resection (P＞0.05).There were statistically significant differences among the five groups in neonatal weight [(3 082.9±479.2),(3 318.1 ±390.8),(3 415.7±431.1),(3 630.5±475.2) and (3 334.0±242.5) g,F=13.798] and length [(48.8± 1.5),(49.3± 1.5),(49.6± 1.5),(50.0± 1.5) and (47.8±3.9) cm,F=7.460; both P＜0.05].One min and 5 min Apgar scores also showed statistically significant differences [1 min:(9.7±0.7),(9.8±0.6),(9.8±0.4),(9.7±0.5) and (8.8±2.7) ; F=4.432; 5 min:(9.9±0.3),(10.0±0.3),(10.0±0.2),(10.0±0.2) and (9.2± 1.8),F=9.625; all P＜0.05].The overall rates of neonatal adverse events,including the admission to neonatal intensive care units (NICU),the rates of cardiopulmonary resuscitation or ventilator therapy,asphyxiation,as well as the length of stay in NICU ≥ 5 d among the five groups also showed statistically significant differences [overall:5.4％ (5/93),1.8％ (5/281),0.6％ (1/168),0.0％ (0/32) and 2/5,x2=16.812;NICU:3.2％ (3/93),1.1％ (3/281),0.0％ (0/168),0.0％ (0/32) and 1/5; x2=1 1.294; cardiopulmonary resuscitation or ventilator therapy:2.2％ (2/93),0.7％ (2/281),0.0％ (0/168),0.0％(0/32) and 1/5,x2=10.584; asphyxiation:1.1％ (1/93),0.7％ (2/281),0.0％ (0/168),0.0％ (0/32) and 1/5,x2=9.637; NICU ≥ 5 d:3.2％ (3/93),1.1％ (3/281),0.0％ (0/168),0.0％ (0/32) and 1/5,x2=1 1.294; P＜0.05].The risks of neonatal adverse outcomes in delivery at 37-38+6 weeks were:OR=1.1(95％CI:1.0-2.1) at 37 37+6 weeks,OR=1.3 (95％CI:0.9-1.9) at 38-38+6 weeks,compared with delivery at 39-39+6 weeks.Conclnsions The percentage of repeat cesarean delivery prior to 39 weeks of gestation is high in our hospital,early termination of pregnancy would not reduce the maternal perioperative adverse outcome,but may increase the risk of neonatal adverse events.Taking into account the maternal benefit,we suggest 39 39+6 weeks of gestation as the best time of elective repeat cesarean in order to reduce the risk of neonatal adverse events.

Objective: To study the effect of gamma irradiation on the permeability of the blood brain barrier(BBB) in rat brains. Methods:The right caudate nucleuses of Sprague Dawley rats were irradiated by OUR XGD gamma units.Maximum dosages of 20,50,75 and 160 Gy were given using a 4 mm collimator.Immunohistochemistry with antibody of serum albumin was used for detecting the extravasation of endogenous serum components.Ultrastructural changes of BBB were observed through injection of lanthanum nitrate into blood vessels. Results: Extravasation of albumin and BBB opening in the right caudate nucleuses were detected as early as 12 h after irradiation at 50,75 and 160 Gy,and were detected 1 d after irradiation at 20 Gy.Immunoreactivity and emematous water reached their maximum after 3 d, gradually decreased during the following few days,and disappeared by day 7(20,50 Gy) or day 14(75 Gy).Irradiation at 160 Gy elicited persistent extravasation of albumin and BBB opening for 14 d. Conclusion: These are transient impairments to BBB after irradiation at 20,50,75 Gy,and persistent impairments after irradiaton at 160 Gy.

Objective To understand human rhinovirus (HRV) etiology of acute lower respiratory tract infection (ALRTI) in children in Shanghai area and establish a nested reverse transcription- polymerase chain reaction (nested RT-PCR) assay.Methods Three hundred and forty-two naso- pharyngeal secretion (NPS) samples from ALRTI cases who were hospitalized were collected during January 2005—December 2005.Nested RT-PCR techniques were used to detect HRV-specific RNA.The PCR products were sequenced and data of nucleotides were analyzed.The proportion of HRV infection in children with ALRTI,the distribution of gender,age and season,and clinical char- acteristics were also investigated.Results Forty-six (13.5%) of 342 samples were HRV positive detected by nested RT-PCR.The sequences of 15 positive samples shared high homology of 83%- 97% with HRV sequence in GenBank.Within the 15 positive samples,nucleotide homology varied from 64.4% to 98.4%,and the ratio of genetic variation was from 1.6% to 48.3%./00.These 15 ampli- cons attribute to the two branches of HRV cladogram.The sequences of 15 amplieons were highly varied,in which single nucleotide mutation and several nearby nueleotides mutations were found. Ribonucleotide deletion and insertion in the nucleotide sequence was also found.HRV positive sam- ples were detected in 33 boys and 13 girls,respectively.The ratio of infection cases between boys and girls was 2.5:1.Of 46 HRV infected cases,27 (58.7%) were less than 12 months of age and 38 (82.6%) were less than 3 years old.HRV infected ALRTI occured all the year round and peaked from March to May.Of the patients whose NPS samples were HRV positive detected by nested RT-PCR,45 patients were diagnosed with bronchopneumonia and 1 was diagnosed with asthmatic bronchitis.Fever of most patients was moderate.The peripheral blood leukocyte counts in thirty-nine (84.8%) patients were less than 10?10~9/L.Neutrophil percentages in thirty-seven (80.4%) patients were less than 0.50.C-reactive protein of thirty-six (78.3%) patients were less than 8 mg/L. All of these features were the characteristics of viral pneumonia.The complications were not common and conditions of most patients were not severe.All the children were cured.Conclusions This nes- ted RT-PCR technique is highly specific,rapid and convenient for the detection of HRV RNA in NPS of patients with ALRTI and the genome of HRV viruses is highly variable.The incidence of HRV infection predominates in children in Shanghai area.ALRTI of HRV is short of specificity and condi- tions of most patients are not severe and their prognoses are fine.

To explore the clinical characteristics and imaging features of miliary tuberculomas in central nervous system (CNS).A total of 5 cases diagnosed with tuberculosis in CNS first diagnosed by neurologists in Navy General Hospital of PLA were enrolled in the study.All clinical and imaging data were collected and analyzed retrospectively.The main initial symptoms were fever and headache (4/5).Multiple diffused miliary lesions were shown by brain MRI,with maximum diameter ranged from 1-4 mm and ringshape or nodular enhancement after gadolinium injection.As mycobacterium tuberculosis could seldomly be found in serum and cerebrospinal fluid,contrast MRI remains the effective method for detecting miliary tuberculomas in CNS.