Diabetic macular edema (DME) is thickening retina with two disc diameter,which is the leading cause of blindness in diabetic retinopathy patients.The initial studies demonstrated that laser treatment of DME prevented further visual deterioration but did not improve visual acuity.Although glucocorticoid slow-release system can extend the time of effective drug concentration,to help glucocorticoid better carry out its biological effect,further studies are needed to warrant their safety due to increasing intraocular pressure and cataract progression.Novel studies identifying the presence of vascular endothelial growth factor (VEGF) in the eye with DME allowed for the development of an alternative anti-VEGF therapy,which revolutionized the management of DME by not only preventing vision loss,but also improving overall vision.Anti-VEGF therapy is becoming the first-line treatment of DME.However,present treatment modalities including anti-VEGF for DME had limitations,which build on the current understanding of DME pathogenesis.Further in-depth study of the development and outcome of DME is needed to optimize the therapeutic schemes,based on objective and scientific observation of treatment response.Finally we need to fully utilize the public health services and clinical management resources for diabetic patients,to prevent the visual impairment of DME before its occurrence.

Objective:To observe the effects of acupuncture at the follicular phase on ovarian blood supply and pregnancy outcomes in patients who received in vitro fertilization/intracytoplasmic sperm injection-embry transfer (IVF/ICSI-ET) of assisted reproductive technology (ART).Methods:A total of 169 IVF/ICSI-ET female recipients from the Reproductive Center of Xiehe Hospital,Tongji Medical College,Huazhong University of Science & Technology were randomized into an observation group (57 cases),a placebo group (54 cases) and a control group (58 cases).The observation group received acupuncture during the follicular phase,meanwhile the placebo group received placebo-acupuncture,and the control group did not receive acupuncture.The hemodynamic index,biochemical pregnancy rate and clinical pregnancy rate of each group were observed,respectively.Results:As to the ovarian arterial hemodynamic index,the pulsatility index (PI),resistance index (RI),and the systolic-to-diastolic peak velocity ratio (S/D) of the observation group were (0.819±0.131),(0.552±0.055) and (2.306±0.512),respectively,obviously lower than those in the placebo group and the control group,and the differences were statistically significant (all P＜0.05),but there were no statistically significant differences between the placebo group and the control group (all P＞0.05).As to the biochemical pregnancy rate and clinical pregnancy rate,the biochemical pregnancy rate in the observation group was 64.9％ and the clinical pregnancy rate was 52.6％,which were significantly higher than those in the placebo group and the control group,and the differences were statistically significant (all P＜0.05),while there were no significant differences between the placebo group and the control group (both P＞0.05).Conclusion:Acupuncture treatment during the follicular phase can improve ovarian blood supply and pregnancy rate in those receiving IVF/ICSI-ET.

The hydrogen peroxide low temperature plasma sterilization technology solved the problems of thermo-sensitive materials' disinfection and sterilization based on its development and unique characteristics. This paper introduced the researches of clinical application quality control, and showed the hydrogen peroxide low temperature plasma sterilizers were being widely used in hospitals and highly recognized. According to the clinical data and the literatures of the domestic equipment in preliminary application, it could be concluded that the technology maturity of domestic hydrogen peroxide low temperature plasma sterilizers was in a high level. The advantages of using domestic hydrogen peroxide low temperature plasma sterilizers to do disinfection and sterilization included lower cost, safer, faster and non-toxic, etc. Also the management system should be improved and the clinical staff should master the technical essentials, obey the procedures strictly, verify periodically and offer full monitoring to upgrade the quality of sterilization.
Cold Temperature ; Disinfection ; instrumentation ; Hydrogen Peroxide ; chemistry ; Plasma Gases ; chemistry

Objective To study the synergism effect of 131 I-Herceptin and high-energy X-ray on HER2 overexpressed breast cancer SK-BR-3 cells.Methods The protein expression and gene amplification of human epidermal growth factor receptor-2 ( HER2 ) in SK-BR-3 cells were identified by immunohistochemistry and fluorescence in situ hybridization ( FISH ) method, 131 I-Herceptin was prepared by iodogen method, and the IC15 concentration of 131 I-Herceptin on SK-BR-3 cell were selected by MTT method.The cells were divided into control group and drug group according to 131 I-Herceptin used or not, and were delivered five different doses of external irradiation (0,2,4 and 6Gy), and the synergism effect was detected by colonogenic assay.The cells were divided into blank group, drug group(131I-Herceptin), X-ray group(2 Gy external irradiation) and combination group (131I-Herceptin+2 Gy external irradiation), the apoptosis rate and death rate were detected by AO/EB method and cell cycle were detected by flow cytometry.Results The labling rate, radiochemical purity and specific radioactivity of 131 I-Herceptin were 86.8%, 93.9% and 868.3 μci/mg, respectively.The IC15 of 131 I-Herceptin was 15.625μci/mL.131 I-Herceptin and high-energy X-ray significantly reduced surviving fraction ( SF) ( F=628.888,F=964.97,P<0.05) and there were interactions between them (F=113.046,P<0.05).There were significant differences in apoptosis rate and death rate among blank group, drug group, X-ray group and combination group(F=103.324,F=13.33,all P<0.05),and there were significant differences of pairwise comparison (P<0.05).After irradiation and 131I-Herceptin administration, the cell cycle changed obviously from G1-phase to G2-and S-phase.Conclusion 131 I-Herceptin combined with high-energy X-ray has the synergism effect on HER2 overexpressed breast cancer SK-BR-3 cells.

10.3969/j.issn.1007-3969.2013.05.005

Objective To investigate the cerebral CT appearances of toxic encephalopathy of tetramine and improve the recognition on this disease. Methods Four cases of toxic encephalopathy of tetramine were collected and their cerebral CT appearances were retrospectively analyzed. Results Cerebral CT appearances in acute phase (within 8 days): (1) cerebral edema in different degree. CT abnormalities consisted of cortical hypodensities and complete loss of gray-white matter differentiation. The CT value were in 11-13 HU, and to be watery density in serious case,(2)subarachnoid hemorrhage. It demonstrated the signs of poisoning hypoxic ischemic encephalopathy in chronic phase. Conclusion The cerebral CT appearances of toxic encephalopathy of tetramine had some character in acute phase and it can predict the serious degree of intoxication, but there was no characteristic findings in chronic phase.

Objective:To investigate the efficacy and safety of ketogenic diet (KD) therapy in the epilepsy of infancy with migrating focal seizures (EIMFS) associated with TBC1D24 gene mutation.Methods:Clinical data of two children with TBC1D24 gene-related EIMFS were collected retrospectively, who were admitted to Department of Pediatrics, Fujian Medical University Union Hospital from 2019 to 2020. Their clinical characteristics and the efficacy and safety of KD therapy were analyzed, and literature review was conducted.Results:Seizures were onset before six months old in the two children with TBC1D24 gene-related EIMFS. Multifocal myoclonic seizures were manifested and happened frequently, lasting for more than 30 minutes sometimes. Developmental retardation was obvious in the two children. A small amount of focal sharp, spike, sharp-slow complex, and spike-slow complex waves were showed in the interictal electroencephalography (EEG). TBC1D24 gene mutations were found in the two children, one with a compound heterozygous mutation (c.1025C>T, p.S342L; c.229_c.240delATCGTGGGCAAG,p.I77_K80del), and the other with a homozygous mutation [c.119G>A,p.R40H(Arg40His)]. Both of those were potentially pathogenic. A variety of anti-epileptic drugs showed poor outcome for the two children. The epilepsy was drug-refractory one. After four to 17 months of KD therapy, the epilepsy in the two children was controlled effectively. There was not obvious adverse reactions. Among six children with TBC1D24 gene-related EIMFS in the literature review, four cases were effective or partially effective for KD therapy, one was discontinued due to insufficient ketogenic ratio, and one was discontinued without effect. There were no obvious adverse reactions in the six children.Conclusions:TBC1D24 gene-related EIMFS is mostly drug-refractory epilepsy. Early KD therapy may help to control seizures.

Objective:To explore the clinical characteristics of patients with pituitary thyrotropin-secreting adenoma and evaluate the effect of preoperative short-acting octreotide treatment on hyperthyroidism.Methods:A retrospective analysis was performed in 40 patients with pituitary thyrotropin adenoma diagnosed in Beijing Tiantan Hospital from January 2008 to January 2018. The general data, laboratory examinations and imaging findings were reviewed and analyzed. The clinical effect of preoperative octreotide on hyperthyroidism was evaluated.Results:The age of onset year of the 40 patients (male: female = 24∶16) was (30.5±5.1) years. Among them, 35 patients (87.5%) were with macroadenoma. The most common symptoms were thyroid hypermetabolism syndrome, followed by headache, dizziness, visual field damage and hypogonadism. The thyroid function of 30 patients (75%) recovered to normal within 3-5 days after the octreotide treatment. The total effective rate of the octreotide was 90.0%. The level of free thyroxine (FT 4) before treatment in patients with more than 10 times of effective cumulative dose was significantly higher than that in patients with less than 10 doses. Conclusions:Thyroid hypermetabolism syndrome and pituitary occupying effect are the most common clinical manifestations of thyrotropin-secreting adenoma. Preoperative octreotide treatment can effectively control hyperthyroidism. The level of FT 4 is a crucial factor affecting the efficacy of octreotide.

Objective To investigate the effects of electrical stimulation on the expression of glial fibrillary acidic protein (GFAP) andinterleukin-1 alpha (IL-1α) in adult rats with spinal cord injury. Methods 72 adult SD rats were randomly divided into damage group (n=24), electrical stimulation group (n=24) and normal group (n=24). The spinal cord incomplete injury model on T9 was made with Allen'smethod in the former 2 groups. The rats in electrical stimulation group accepted electrical stimulation for 7 d. All the rats were evaluatedwith the Basso, Beattie & Bresnahan locomotor rating scale (BBB scale), and the expression of GFAP and IL-1α were determined with immunohistochemistry.Results The BBB scores in both the damage group and electrical stimulation group were significantly less than that inthe normal group (P<0.05), and it was more in the electrical stimulation group than in the damage group 5 and 7 d after injury. The expressionsof the GFAP significantly increased after injury to the peak on 5th day, while it was less in the electrical stimulation group than in thedamage group 5 and 7 d after injury (P<0.05). The expressions of the IL-1α increased continually after injury, while it was less in the electricalstimulation group than in the damage group 5 and 7 d after injury (P<0.05). Conclusion Electrical stimulation can inhibit the expressionof GFAP and IL-1α, that reduce inflammation and glial scar formation.

AIM: To evaluate the efficacy of combined therapy for amblyopia in children by making use of pattern visual evoked potential ( P-VEP) game.
METHODS: This was a prospective case control study. These asthenopic children were divided into two groups. The control group ( 66 eyes of 49 patients ): occlusive therapy with glasses, cover, precision work, red light treatment and so on, later the stereo vision training was added. The experimental group (72 eyes of 52 patients):conventional methods mentioned above with P - VEP games.
RESULTS: The total effective rate and cure rate of experimental group in 6mo were higher than those of control group. The overall effective rate was 94. 4% in the experimental group and 83. 3% in the control group. There was a statistically significant difference between them (P<0. 05).
CONCLUSION: The comprehensive therapy by making use of P-VEP game is an individualized effective new way in treating amblyopia.