Diabetic retinopathy ( DR ) due to disturbance of carbohydrate metabolism is the most serious ocular complication in patients with diabetic disease, and diabetic macular edema ( DME) is one of the main causes of vision loss. lt is considered that many factors are involved in DME pathological process. DME is defined as an abnormal thickening of the macular associated with the accumulation of excess fluid in the extracellular space of the neurosensory retina. Nowadays, the main treatment methods of DME include pharmacotherapy, laser photocoagulation and surgery. lnflammatory components within the vascular tissue play an important role in the development of DME, so drug therapy is an important method for DME. ln this review, we summarized the risk factors and the current pharmacotherapy situation of DME.

Objective To find out the status of prevention and control of iodine deficiency disorders and evaluate the iodine nutritional status of Jinan residents,to explore appropriate iodine level in drinking water,and to provide a scientific basis for adjustment of intervention strategies.MethodsAccording to the Monitoring Program of the National Iodine Deficiency Disorders (Trial),qualified iodized salt consumption rate,drinking water iodine content and urinary iodine levels of women of childbearing age were determined in iodine deficiency areas from 2003 to 2010.Salt iodine was detected by direct titrimetry,urinary iodine by As-Ce catalytic spectrophotometric assay and iodine in drinking water by cerous sulfate catalytic spectrophotometric method.Results Intake rate of qualified iodized salt was up to 90％ and above from 2003 to 2010,median water iodine was 13.65 μg/L in the 10 counties(cities,districts),of which less than 100 μg/L accounted for 79.82％(4560/5713 ) and ＞ 150 μg/L accounted for 12.73％(727/5713).With the increase of water iodine(0 ～ ＜ 10,10 ～ ＜ 50,50 ～ ＜ 100,100 ～ ＜ 150,150 ～ ＜ 300 and ≥300 μg/L),urinary iodine levels of women of childbearing age increased successively(median 156.56,175.81,267.04,349.00,524.22,583.20 μg/L,respectively,x2 =121.20,P ＜ 0.05),while the ratio of urinary iodine ＜ 100 μg/L was significantly lower.The ratio of urinary iodine between 100 and 300 μg/L was decreased gradually,but the ratio of great than 300 μg/L was gradually increased.ConclusionsIodine deficiency areas in Jinan have reached the standard of elimination of iodine deficiency disorders.We should insist to carry out our measures to suit local conditions,classified guidances and scientific principals of iodine supplementation.

Objective To evaluate the effects of hyperbaric oxygen (HBO) combined with drug therapy on patients with delayed encephalopathy caused by carbon monoxide poisoning ( COP). Methods Twenty to forty sessions of HBO therapy were used to treat 34 COP patients. Assessment relied on 99mTc-ethyl cysteinate dimer (~(99m)Tc-ECD) single photon emission computed tomography (SPECT) imaging of cerebral perfusion before and after treatment. Results After HBO therapy, cerebral perfusion in the COP patients improved significantly. There was a significant difference of the SPECT images before and after treatment. Conclusions SPECT imaging of cerebral perfusion can play an important role in the diagnosis of delayed encephalopathy caused by carbon monoxide poisoning, and it can be used for the therapeutic surveillance of HBO treatment.

Objective To explore the application of interferon(IFN)response-related genes in predicting the outcome of antiviral treatment in chronic hepatitis C. Methods SuperArray microarray was used to detect the expression of IFN response-related genes in peripheral blood monocytes(PBMC)from chronic hepatitis C patients before treatment. SPSS 12.0 was used for statistical analysis. Results Ten patients were classified as rapid responders(RVR)and seven patients as non-RVRs according to the serum HCV RNA level after 4 weeks of treatment in 17 patients. Compared with healthy controls, nine differentially expressed genes were found in RVR patients, one up-regulated and eight down-regulated; eighteen differentially expressed genes were found in N-RVR patients, all down-regulated. Five differentially expressed genes were found between the patients with RVR and N-RVR: four up-regulated genes were PRKCZ, PRKRA, IRF5 and TNFSF10(t =5.44, 3.13, 5.24 and 2.30, P=0. 000, 0.010, 0.005 and 0. 044); one up-regulated gene was IFIT5(t = 2.43, P = 0. 035). Of seventeen patients, 12 were HCV genotype 1b, 5 were HCV genotype 2a. Compared with HCV2a, IFI6 and IFI44 gene in HCV1b were downregulated(t = 2.42 and 2.45, P = 0. 038 and 0. 033). Conclusions The expression of IFN responserelated genes is associated with response to IFN treatment. HCV genotype 1 b is more successful in inducing the down-regulation of IFN response-related genes than that of HCV genotype 2a, thus leading to the resistance to IFN.

Objective To investigate the feasibility and superiority of local anaesthesia video-assisted thoracoscopic surgery (LA-VATS) in diagnosis and treatment of open thoracic trauma (OTT).Methods Seventy-eight patients with OTT emergently admitted from February 2007 and June 2012 were randomized into LA-VATS group (n =37) and conventional treatment group (n =41) by the toss of a coin.In the LA-VATS group,further treatment was determined following LA-VATS.Volume of chest tube drainage,duration of chest tube placement,average length of hospital stay,and postoperative complications were measured and compared between groups.Results In the LA-VATS group,23 patients completed LA-VATS and 14 were transferred for simple VATS-assisted mini-thoracotomy under general anesthesia.In the conventional treatment group,24 cases completed debridement and chest drainage and 17 cases were transferred for thoracotomy under general anesthesia.Volume of chest tube drainage [(195.0 ± 150.8) ml/d∶ (480.0 ±212.3)ml/d] (t =-2.675,P ＜0.05),duration of chest tube placement [(2.6 ± 1.4) d∶ (3.8 ± 1.9) d] (t =-2.318,P ＜ 0.05),average length of hospital stay [(6.4 ±2.3) d ∶ (10.9 ± 3.3) d] (t =-2.471,P ＜ 0.05),and incidence rate of postoperative complications (10.8％ ∶22.0％) (x2 =4.132,P ＜0.05) were all significantly different between LA-VATS and conventional treatment groups.Conclusion LA-VATS is safe and feasible for diagnostic exploration and simple treatment of OTT.

Objective To investigate whether the donor's glomerular filtration rate (GFR) to recipient's weight ratio (Dg/Rw) is a useful tool to predict early clinical outcome in living-related do-nor transplantation.Methods A total number of 108 living donor transplant recipients in the Chinese Military 309th Hospital from Jan.2014 to July 2015 were enrolled in this study.The patients who had multi-organ transplantation or developed grafts rejection,delayed graft function,hydronephrosis or renal vascular stenosis were excluded.The 90 qualified recipients were divided into G1 group (Dg/Rw ≤0.81),G2 group (Dg/Rw 0.81～1.11),and G3 group (Dg/Rw≥1.12).We respectively analyzed the relationship between recipient's serum creatinine Scr and Dg/Rw at 3-,7-,30-day and 1 year after transplantation.Results Scr at 3-,7-,30-day and 1 year after transplantation had linear correlation with Dg/Rw.As compared with G1 and G2 groups,Scr level was significantly reduced in G3 group at different time points (P＜0.05).Conclusion Dg/Rw has a negative relationship with Scr level after renal transplantation.Pre-transplant Dg/Rw is a potential index to predict the early clinical outcome in living-related donor transplantation.

Objective To investigate the correlation between de nove anti-endothelial cell antibodies (AECA) and adverse events after renal transplantation and the effect of transplanted renal function within six months after operation.Methods The expression of AECA in serum of 85 renal transplant recipients was detected by indirect immunofluorescence assay (ⅡF) before and 1 day,3 days,7 days,15 days and 1 month after renal transplantation.The patients were divided into double positive group (AECA positive before and after surgery),single positive group (postoperative de nove AECA positive) and negative group (preoperative and postoperative AECA negative) according to AECA test results.The occurrence of adverse events in each group such as DGF,rejection,infection and so on,as well as the serum creatinine levels were recorded at each time point within six months.Results Of the 85 recipients,29 were positive for AECA,including 19 in the double positive group,10 in the single positive group,and 56 in the negative group.The incidence of rejection in single positive group (30％) was higher than that in the rest two groups (5.3％ for double positive group,and 17.9％ for negative group),but there was no statistically significant difference (P =0.21).The incidence of DGF in the single positive group,double positive group and negative group was 70.0％,26.3 ％ and 32.1 ％ respectively.The positive rate of the single positive group was significantly higher than that of the rest two groups (P =0.04),and the duration of DGF was significantly longer in the single positive group than that of the rest two groups (P＜0.01).The incidence of infection in the single positive group,double positive group and negative group was 20.0％,21.1％ and 8.9％respectively,and there was no significant difference among the three groups (P =0.31).As compared with the double positive group and the negative group,the serum creatinine level was significantly increased in the single positive group at 1st week,1st month,3rd month and 6th month after operation (P =0.02,P =0.04,P =0.04 and P =0.02 respectively).Conclusion Postoperative AECA can increase the risk of DGF,prolong the duration of DGF,and affect the recovery of renal function within 6 months after renal transplantation.

Objective To investigate the correlation between CT perfusion parameters of pulmonary carcinoma and standardized uptake values(SUV)derived from ~(18)F-fluoro-deoxyglucose positron emission tomography(~8F-FDG PET)and tumor microvessel density(MVD),and to determine the validity of CT perfusion in assessing tumor angiagenic activity of pulmonary carcinoma.Methods Fifty patients(mean age 57.5,17 females)with pulmonary carcinoma underwent CT perfusion using 16-slice helical CT.Blood flow(BF,ml?100g~(-1)?min~(-1)),blood volume(BV,ml?100g~(-1)),mean transmit time(MTF,s)and permeability surface area product(PS,ml?100g~(-1)?min~(-1))were analyzed.SUV of PET was calculated in 14 patients.The CD34 immunohistochemical staining was used for tumor microvessel counting.CT perfusion parameters of pulmonary carcinoma were correlatively studied with SUV and tumor MVD.Pearson's correlation analysis was performed to evaluate the association between CT perfusion parameters and SUV and MVD.Results The average values of BF,BV,MTT and PS were 97.30 ml?100g~(-1)?min~(-1), 8.86 ml?100g~(-1),6.75 s and 34.52 ml?100g~(-1)?min~(-1),respectively.The average value of MVD was 61.82/FOV.The mean value of SUV was 5.96.There was positive correlation between BF and SUV(r= 0.727,P

Objective To analyze the clinical techniques of renal artery control in laparoscopic donor nephrectomy.Methods 211 relative living renal transplantations were performed from June 2003 to June 2012,and 136 donors underwent laparoscopic donor living nephrectomy (LDN) since 2007.Forty donors were subjected to the Hem-o-lock clips for renal artery control by open surgery,87 donors to the Hem-o-lock clips for renal artery control by laparoscope,5 donors to the Endo GIA stapler for renal artery control by laparoscope,and 4 donors to the Hem-o-lock clips by laparoscope combined with hand-assisted suture transfixion for renal artery control.Results The warm ischemia time of renal artery control was shortest (1.1 ± 0.3 min) by Hem-o-lock clips in open surgery,and longest (3.2 ± 0.8) min by the Hem-o-lock clips with laparoscope.There was significant difference in the warm ischemia time of renal artery between open group and other groups,the differences (P＜0.05).The comparison of prognostic factors in the transplant renal outcome showed no significant difference among groups.The renal arterial stump-rrhexis-caused massive secondary bleeding occurred in 1 case subject to Hem-o-lock clips for renal artery control by laparoscope,with conversion to open surgery urgently,the operation was successful at last.Other renal artery control ways were all safe without any adverse reaction.Conclusion The warm ischemia time of renal artery control by Hem-o-lock clips in open surgery was shortest in laparoscopic donor nephrectomy.The renal artery control way by Endo GIA stapler in laparoscope or by Hem-o-lock clips with hand-assisted suture transfixion is safest.The utilization of Hem-o-lock clips should be careful in high risk population such as severe atherosclerosis etc.

Objective To study effect of bufalin on invasion and metastasis of gastric cancer cells and related mechanism.Methods AGS human gastric cancer cell line was used for in vitro experiments.Cultured cells were treated by negative control group,bufalin group and oxaliplatin group.Cell proliferation was determined by MTT.Invasion and metastasis were observed by Wound-Healing Assay and Transwell Assay.Expression levels of E-cadherin,matrix metalloproteinases (MMP)-2,MMP-9 were detected by Western blotting.Results Bufalin was found to significantly inhibit the proliferation of AGS cells in a dose and time dependent manner.Wound-Healing Assay and Transwell Assay showed that as compared with the blank control group,bufalin inhibited invasion and metastasis of AGS cells (P＜ 0.05),but there was no statistically significant difference between bufalin group and oxaliplatin group (P＞0.05).Western blotting showed the expression of E-cadherin was increased in bufalin group as compared with the blank control group while the expression levels of MMP-9 and MMP-2 were down-regulated (P＜0.05),but there was no statistically significant difference between bufalin group and oxaliplatin group (P＞ 0.05).Conclusion Bufalin has anti-cancer activity on gastric cancer cells,and it has the ability of inhibiting cancer cell invasion and metastasis,and regulating the expression of some related gene.