Objective To discuss the relationship between diabetic macular edema(DME) and visual field defects and evaluatethe therapeutic effect of micro-pulse laser.Methods A total of 117 patients (149 eyes) with diabetic retinopathy(DR) were enrolled in this study and divided into two groups according to early treatment diabetic retinopathy study(ETDRS) DME diagnostic criteria:DME group(n=50,70 eyes) and N-DME group(n=67,79 eyes).Healthy subjects(n=40,80 eyes)were selected as NC group in thisstudy.The clinical data and biochemical index were collectedand visual fields were examined in all the subjects.Then the DME group was further divided into two subgroups:micro-pulse laser subgroup(35 eyes) and conventional laser subgroup(35 eyes).The vision recovery after treatment was evaluated on different time points.Results Diabetes duration,FPG,HbA1c and HOMA-IR were significantly higher in DME group than in N-DME group (P<0.05).RF value was less than 15% in each group,suggestingreliable test results.The levels of MD index[(7.81±0.75) vs (4.32±0.67) vs (1.14±0.22) dB],LV[(20.17±4.85) vs (15.34±3.19) vs (4.72±1.11) dB] and sLV[(10.71±1.37) vs (7.22±1.12) vs (2.35±0.41) dB] were significantly higher in DME group and N-DME group than in NC group,and those in DME group were higher than in N-DME group(P<0.01).After three month's treatment,the levels of MD index,LV and sLV were lower in micro-pulse laser subgroup than in conventional laser subgroup(P<0.05).There were no statistically significant difference in MD index,LV and sLV in conventional laser subgroup on different time points(P>0.05).Multiple logistic regression analysis showed that DM duration,FPG,HbA1c and HOMA-IR were riskfactors for DME(all P<0.01).Conclusion Patients with DME have severe vision loss.Micro-pulse laser therapy is helpful invision recovery,while conventional laser therapy have no obvious effect on it.Longer duration of DM,higher level of FPG,HbA1c,and IR severity may increase the risk of DME.

Protein is involved in a variety of biological activities and associated with disease development,such as cancer.With the development of mass spectrometry-based proteomic technologies,qualitative and quantitative analysis of protein in clinical specimen using mass spectrometry is rapidly progressing in cancer biomarker study.Novel cancer biomarker for early diagnosis and prognosis evaluation is the key to reducing death rate and improving survival rate.This review summarizes mass spectrometry technologies and proteomic studies for cancer biomarker discovery.

Aim To establish a rat aortic calcification sub-chronic model induced by vitamin D3 and nicotine.Methods The vascular calcification model was produced by vitamin D3(300 kIU?kg-1,im) plus nicotine(25 mg?kg-1,5 ml?kg-1,po).Rat body weight and blood pressure were monitored on a regular basis.Ratio of heart to body weight,plasma calcium,plasma phosphate content,vascular calcium content,Von Kossa staining,activity of alkaline phosphatase(ALP) and 45Ca deposition in aorta were measured as the index of calcification at the 8th and the 16th week.Results Compared with control group,the VDN group rats showed higher values of blood pressure from the 3rd week(all P

Objective To explore the ability of advanced oxidation protein products (AOPP)in predicting the progression of diabetic retinopathy (DR)in patients with type 2 diabetes mellitus (T2DM). Methods 363 T2DM patients were enrolled in this prospective cohort study. According to the quartile points of baseline AOPP level,patients were divided into four groups (Q1,Q2,Q3 and Q4 ). The progression rate of DR was calculated according to the changes of non-mydriatic fundus photography after a 5-year follow-up. Results With the increase of baseline AOPP level,the rate of progression of DR increased (19.51% vs 28.42% vs 37.36% vs 47.37%,P <0.01). Logistic regression analysis showed that baseline level of AOPP was an independent risk factor for the progression of DR (OR=1.833,95%CI:1.573~1.982,P<0.05).Area under the curve of AOPP in predicting DR is 0.883 (95% CI:0.842~0.924)with the sensitivity 86.1% and specificity 91.9%. Conclusion AOPP may be one of the biomarkers for the prediction of type 2 diabetic retinopathy progression.

Objective To investigate the effects of a miRNA family member, let-7e, and a combi-nation of miR-106b and miR-20a on the expression of cytokines by THP-1 cells with Luminex xMAP technol-ogy.Methods The efficiency of transfection was evaluated by immunofluorescence assay after transfecting THP-1 cells with micrONTM mimic negative control (Cy3) for 24 h, 36 h and 48 h.The three miRNA mim-ics (let-7e, miR-106b and miR-20a) were respectively used to transfect the THP-1 cells for 24 h, 36 h and 48 h and the expression of each miRNA was analyzed by qRT-PCR analysis for screening out the optimal transfection time.The transfected THP-1 cells were stimulated with1 mg/L of LPS for 1 h.The Luminex xMAP technology was used to detect the expression of IL-8, interferon-inducible protein-10 (IP-10), mono-cyte chemotactic protein 1 (MCP-1), IL-1α, IL-6, IL-10, TNF-α, IFN-αand IFN-βin the supernatants of cell culture.A statistical analysis was performed to analyze the data obtained by using SPSS16.0 software. Results More than 90% of the transfected THP-1 cells were labeled with red fluorescence.The optimal transfection times for let-7e mimic and miR-106b/miR-20a mimics were 48 h and 24 h, respectively.Com-pared with the corresponding negative control (NC), the expression of IL-8, IP-10 and MCP-1 by THP-1 cells were enhanced after the transfection with let-7e mimic, but were inhibited after the co-transfection with miR-106b and miR-20a mimics.Conclusion The expression of IL-8, IP-10 and MCP-1 were enhanced in let-7e transfected THP-1 cells, but were inhibited in miR-106b and miR-20a co-transfected THP-1 cells.

Objective To analyze the policy support of rural doctors for the essential medicine system,and explore the main influence factors and mechanism affecting the support degree.Methods 621 rural doctors from five cities in Shandong province were subject to a stratified random sampling for a quantitative questionnaire,to build a hypothesis model of policy support of rural doctors,which is verified using factor analysis and path analysis.Results 59.1% of rural doctors support the essential drugs policy.It was found that the essential medicine factor,the factor to influence the practitioner,and the supporting policy factor had a direct impact on policy support of rural doctors,with the effect of 0.305, 0.1 59 and 0.135 respectively;Essential medicine factor and the supporting policy factor indirectly influence the policy support of rural doctors through the factor to influence practitioners,with the effect of 0.065 and 0.032 respectively.Conclusion The essential medicine system needs to emphasize such rationality as the quality,list and pricing of essential medicines;it is imperative for the government to better oversee the purchase and supply of essential drugs,to cater to the interests of rural doctors,to encourage the enforcement of the system,and promote the development of village clinics.

Objective To analyse a novel splice mutation in EXT1 gene of hereditary multiple osteochondroma, and study its pathogenic mechanism.Methods In April of 2013, the proband was hospitalized from the outpatient department with multiple joint deformity for more than 20 years, peripheral blood of the proband and his parents were collected and genomic DNA was extracted .Coding regions and adjacent intron sequences of EXT1/EXT2 genes in genomic DNA of the family members were amplified and sequenced.Bioinformatics was used to analyze the mutation from sequencing .cDNA from peripheral blood of the proband ,the mother and normal control was made respectively as a template for amplifying coding regions of EXT1 gene, and the product was T-A cloned and sequenced.The abnormal transcripts of each group were counted and analyzed using chi square test to study the pathogenic mechanism of the mutation .Results Sequencing results of family members revealed that there was a heterozygous deletion mutation ( c.1284 +2del) in the 5′splice site of intron 4 in EXT1 gene of the proband and his mother .Bioinformatics predicted that exon 4 of EXT1 gene was skipping or spliced aberrantly due to the mutation .T-A clone and sequencing results as well as the statistical analysis suggested that there was a significantly higher proportion of transcripts with skipping exon 4 in the proband and his mother compared with the normal control (P=0.000, P<0.01).Conclusions c.1284+2del in EXT1 gene is reported for the first time internationally , which results in a considerable number of abnormal transcripts with skipping exon 4 in EXT1 gene, thereby influences the normal transcription and translation of EXT1 gene.

Objective To evaluate the feeding effect of semi-demand feeding and abdominal massage on the feeding process, feeding performances and clinical safety (including the time of returning to birth weight, feeding tolerance, apnea). Methods A total of 120 preterm infants that met inclusion criteria of the study were randomly assigned to three groups, and each group had 40 cases. Control group:received standard feeding care. Semi-demand feeding group: received 5-10 minutes of oral motor intervention every time before feeding(including oral stimulation and non nutritional sucking), then decided feeding methods according to its consciousness behavior state. Semi-demand feeding combined abdominal massage group: received both semi-demand feeding and abdominal massage before feeding. Observed and recorded the three groups′ transition time, whether there were statistically significant differences in feeding performance and clinical safety. Results The feeding transition time was (11.55± 4.69), (10.98±3.85), (8.50±3.87)d in control group, semi-demand feeding group and semi-demand feeding combined abdominal massage group, and there were significant differences (F=6.088, P=0.003). In terms of feeding performance, the feeding efficiency were (7.27 ± 2.65), (9.74 ± 2.63), (9.52 ± 2.13) ml/min, the feeding proficiency were (66.31 ± 14.51)%, (76.64 ± 12.46)%, (82.26 ± 10.65)%, the volume transfer were (63.99 ± 11.02)%, (80.16 ± 14.41)%, (84.97 ± 11.16)% in control group, semi-demand feeding group and semi-demand feeding combined abdominal massage group, and there were significant differences (F=12.189, 16.383, 31.959, all P < 0.01).Among the clinical safety, the time of restoration of birth weight were (10.55 ± 1.99), (9.28 ± 1.77), (10.05 ± 2.46) d in control group, semi-demand feeding group and semi-demand feeding combined abdominal massage group, and there were significant differences(F=3.759, P=0.026). The incidence of feeding intolerance were 50.0%(20/40), 40.0%(16/40), 22.5%(9/40), and there were significant differences(χ2=6.613, P=0.037). The incidence of apnea were 37.5%(15/40), 20.0%(8/40), 15.0%(6/40), and there were significant differences(χ2=6.093, P=0.048). Conclusions The combined intervention methods could accelerate the feeding process, improve feeding performance as well as reduce the incidence of feeding intolerance and apnea. Hence, semi-demand feeding combined abdominal massage is a recommended choice for clinical use.

OBJECTIVE:To learn the application and tendency of hepatoprotective drugs in a third grade class A hospital dur-ing 2011-2014,and to provide reference for rational drug use. METHODS:DDDs analysis and consumption ordering method were adopted to analyze the change of DDDs,DDC and other index of hepatoprotective drugs in this hospital from 2011 to 2014. RE-SULTS:2011-2014,the amount and DDDs of Hepatoprotective injection in this hospital increased year by year,while oral dosage form decreased year by year. DDC order of each drug kept stable during 2011-2014;DDC and DDDs of drugs for promoting ener-gy metabolism were all in high level,and ornithine aspartate and ademetionine always took up the first 2 places in 4 years. Polyene phosphatidylcholine and Reduced glutathione injection were cheap,but had higher DDDs. Except Glutathione tablet,DUI of other hepatoprotective drugs had no great difference in 3 years,and fluctuated in 2014;hepatoprotective drugs with DUI>1 and DUI<1 occupied a large proportion. From 2010 to 2014,compared with previous year,the drugs with consumption sum/DDDs ratio num-ber close to 1 reduced significantly in the next year,decreasing year by year. CONCLUSIONS:In this hospital,injections are used too frequently,and overuse of drugs for promoting energy metabolism exist. Polyene phosphatidylcholine and Reduced glutathione injection can be used as a valuable drug in the clinic,and their cost are more acceptable,but not in excess.

Objective To study the effect of Chinese medicine combined with large dose interferon in the postoperative adjuvant therapy of malignant melanoma of the skin.Methods A high dose of interferon alpha-2b (GanLeneng) (1200 IU/per day) was used in 20 cases of malignant melanoma of skin for 7 days.One course of treatment was 3 months,8 consecutive courses of treatment and traditional Chinese medicine (0.25 g) were administered 1 hour before meals,2 times a day,taking three weeks per month.Results One patient in 20 cases of patients did not receive timely treatment and resulted in death.The remaining patients were were still live from 2012 to the present.Local and distant metastasis lesions disappeared during the course of treatment.Conclusions Traditional Chinese medicine combined with high-dose interferon in cutaneous malignant melanoma as adjuvant treatment plays an important role.