Diabetic retinopathy ( DR ) is one of the main blinding eye diseases for people over the age of 50, and diabetic macular edema ( DME) is the leading cause of vision loss is DR patients. The early diagnosis and early treatment is important. As OCT and FFA, mfERG, especially the retinal thickness, volume, retinal edema index quantitative indicators such as objective evaluation of macular edema, embodies the new progress of retinal imaging technology in recent years. OCT is a non -contact clinical application in recent years, noninvasive, high resolution of ophthalmic imaging examination, can do it on retinal ultrastructure observation and quantitative analysis, and the technology is relatively mature, become a routine inspection diagnosis of macular edema. Laser photocoagulation, intravitreous injection with Ranibizumab and vitrectomy is nowadays the important means for the treatment of intractable macular edema.

In order to assess the feasibility of subcutaneous administration of Triptorelin with 6-week intervals for the suppression of pituitary-gonadal axis and changes of clinical signs in girls with idiopathic central precocious puberty (ICPP), 46 girls with ICPP were treated with GnRHa. Triptorelin (Decapeptyl, 3.75 mg) was administered subcutaneously (SC) at 6-weeks intervals or intramuscularly (IM) at 4-weeks intervals randomly for more than 12 months consecutively. During GnRHa therapy, clinical parameters and laboratory data, including height, weight, pubertal stage, bone age, uterine volume and ovarian size, serum levels of luteinizing hormone (LH), follicle stimulating hormone (FSH) and estradiol (E2), were monitored and analyzed. It was found that both treatment regimes led to regression of precocious puberty and reversal of secondary sexual characteristics. Breast developments regressed. Uterine volume was decreased after treatment, but there was no statistically significant difference. Mean ovarian volume did not change significantly during treatment. The height velocity was decreased significantly from 6.3+/-1.4 cm/year to 5.8+/-1.2 cm/year in group SC and 6.7+/-1.3 cm/year to 5.4+/-1.0 cm/year in group IM, respectively. The rate of bone maturation was reduced significantly during treatment. The ratio of deltaBA/deltaCA was 1.2+/-0.2 or 1.3+/-0.3 at the onset of therapy and decreased significantly after the treatment to 0.7+/-0.2 or 0.9+/-0.1, respectively. The predicted adult height was increased significantly and progressively during therapy. The levels of serum LH, FSH and E2 returned to the prepubertal condition. No significant side effects of therapy were noted. The most common side effect during SC treatment was that a non-irritating, 1 cm in diameter mass was palpated at the site of subcutaneous injection in the abdominal wall of patients, which disappeared after 6-12 weeks. Two girls had minimal withdrawal vaginal bleeding episodes after the first injection. It was concluded that both IM and SC triptorelin administrations were clinically effective. They induce profound suppression of hypothalamic-pituitary-gonadal axis while stabilizing height velocity, slowing bone maturation and increasing predicted adult height. These results suggest that subcutaneous injection of triptorelin in 6-weeks intervals at a dosage of 3.75 mg be a safe and acceptable regimen for ICPP

Objective To obtain more information concerning polymorphism of the thyrotropin (TSHR) in Graves diseases(GD). Methods (1)A family of GD was studied (including 3 patients and 9 healthy family members)to examine SNPs of TSHR through direct sequencing of all 10 exons and part of introns. (2)In the current case-control study, 30 patients with familiar GD, 48 sporadic patients and 96 healthy control individuals were used to assess whether SNP of TSHR was associated with GD. Genomic DNA was extracted from peripheral leukocytes isolated from ACD-anticoagulated blood. Ten exons were amplified by PCR, using primers designed by ourselves. After purifying, the products were sequenced. Results Eight polymorphisms were found. There was a novel polymorphism in exon 8. There were no significant differences between patients and controls. Conclusions These findings suggested that the novel and other polymorphisms of the TSHR gene may not be responsible for GD. There are racial differences in the distribution of polymorphisms of TSHR gene.

Objective To investigate the CT perfusion imaging and the pathological features on the disturbance of regional cerebral microcirculation in a pre-infarction period, and to evaluate the relationship between the astrocytes and regional cerebral microcirculation. Methods Dynamic CT perfusion imaging of the models with regional cerebral hypoperfusion and astrocytic swelling in rats was performed to assess the presence or absence of the disturbance of regional cerebral microcirculation. Then, the histopathologic examination was made for both models, respectively. The ratios of side-to-side were measured at hypoperfusion areas in the models of regional cerebral ischemia. Results Regional hypoperfusion was revealed by regional cerebral blood flow (rCBF) and mean transit time (MTT) maps in the group of hypoperfusion for 6 hours. Regional cerebral blood volume (rCBV) and time-to-peak (TTP) maps were normal in that group. The ratios of rCBF, rCBV, MTT and TTP were 0 39-0 55, 0 92-1 00, 1 20-1 50 and 1 00-1 00 respectively. Astrocytic swelling pressing the capillary wall was obvious and subtle neuronal reversible degeneration was occasionally found. TTC stain was normal. In the tACPD group of astrocytic swelling, the abnormal hemodynamic regions on rCBF and MTT maps were found. The rCBV maps of 3 rats in the tACPD group showed the area of reduced rCBV. In 2 rats of tACPD group, the areas of delayed TTP were also found. The ratios of rCBF, rCBV, MTT and TTP were 0 25-0 44, 0 70-1 01, 1 20-2 00 and 1 02-1 45 respectively. TTC stain was negative. Electron microscope study revealed remarkable swelling of astrocytes, especially endfoot processes of astrocytes around capillaries. The abnormal hemodynamic region on rCBF and MTT maps matched with abnormal extent on histopathologic examination. The rCBV and TTP maps appeared normal. Conclusion The astrocytes can react in a way faster than the neurons in the pre-infarction period, viz. astrocytic swelling. The swelling of astrocytic foot, which pressed capillary vessel, induced the disturbance of regional cerebral microcirculation, and then aggravated hypoxic ischemic state in regional brain parenchyma. Perfusion CT and its parameters' analysis may play an increasing role to delineate the reversible hypoperfusion areas in pre-infarction period. Analyzing the relationship of rCBF and rCBV is very helpful to know the status of the capillary vessels in regional cerebral hypoperfusion area.

Objective: To compare the efifcacy and safety of circumferential pulmonary vein antecourt isolation (CPVAI) ablation and stepwise linear (SL) ablation in treating the patients with atrial ifbrillation (AF) Methods: A total of 136 AF patients with catheter ablation under EnSite 3000 guidance in our hospital were retrospectively summarized. The patients included 93 paroxysmal AF and 43 persistent AF and divided into 4 groups. Paroxysmal AF with CPVAI ablation,n=45, Paroxysmal AF with SL ablation,n=48 and persistent AF with CPVAI ablation, n=18, persistent AF with SL ablation,n=25. The differences of left atrium diameter, ablation time, X-ray exposure time, the success rate and complication were compared among different groups. Results: For 12 months follow-up study, the success rate and complication were similar between 2 ablation methods for treating both Paroxysmal AF and persistent AF patients. For Paroxysmal AF patients, both ablation methods could effectively reduce left atrium diameter,P<0.01. The SL ablation had less procedural time than CPVAI ablation,P<0.01, while the X-ray exposure time was similar between 2 ablation methods. Conclusion: Both CPVAI and SL ablation methods were effective and safe for treating AF patients.

Objective To investigate the effects of puerarin(Pur)on myocardial perfusion and ventricular wall motion in patients withacute coronary syndrome(ACS).Methods Thirty-seven patients with ACS were randomly divided into two groups:conventionaltreatment group(n=17,11 males,range of age:32-80 years,average age:60.9±4.9 years)and Purtreatment group(n=20,12 males,rangeof age:40-76 years.average age:62.7±3.5 years).Patients in the conventional treatment group received standard treatment according tothe current guidelines,while patients in the Pur treatment group received intravenous administration of Pur(500 mg/day)for 10 daysplus conventional treatment.Real-time myocardial contrast echocardiography (RT-MCE) was performed to evaluate the change inmyocardial perfusion index (MPI)and veiltricular wall motion index(VWMI)at admission and 10 days after treatment.Results At10 days after treatment,MPI was significantly higher(P＜0.01)and VWMI significantly lower(P＜0.01)in the Pur group comparingwith those in the conventional group.Conclusions Puerarin might improve myocardial microcirculation perfusion and ventricularwall motion in patients with ACS.

Neuritin is a new neurotrophic factor found recently. In order to identify the function of Neuritin clearly, the coding sequence of human neuritin was amplified by PCR from neuritin cDNA , this fragment digested by NocI and NotI was inserted into pET32a by T4 ligase and transformed into E. coli BL21 then the recombinant plasmid named pET32a-neuritin was constructed successfully . Neuritin was expressed distinctly after inducing by EPTG. The product was identified as neuritin by SDS-PAGE and Western blot analysis . The expression production was purified on Ni2+-NTA column.

Silk fibroin is a natural polymer with certain water solubility, structural modification, good biocompatibility and biodegradability, which can be used as a drug delivery carrier material. As a promising drug delivery system, drug-loaded silk fibroin nanoparticles can control drug release, reduce toxicity and improve therapeutic effects. In this paper, the basic characteristics of silk fibroin, the preparation methods of drug-loaded silk fibroin nanoparticles and the application of silk fibroin in nanoparticulate drug delivery systems are reviewed, and on this basis, the further development of drug-loaded silk fibroin nanoparticles is prospected.

OBJECTIVETo observe clinical therapeutic effect of electric heat needle therapy on senile gonarthritis.

METHODSSixty-five patients were divided into a treatment group and a control group. The treatment group of 35 cases were treated by electric heat needling at Dubi (ST 35), Neixiyang (EX-LE 4), Yanglingquan (GB 34) and Yin-lingquan (SP 9), and the control group of 30 cases by simple acupuncture at the same acupoints as in the treatment group. In the two groups, the treatment was given once every other day, 10 sessions constituting one therapeutic course. After treatment of 2 courses, their therapeutic effects were compared.

RESULTSThere was a very significant difference between the two groups in the total effective rate (P < 0.01).

CONCLUSIONElectric heat needle therapy has a better clinical therapeutic effect on senile gonarthritis, better than simple acupuncture therapy.

Objective To explore the clinical signiifcance of combined detection of thyroid stimulating hormone (TSH) and free thyroxin (FT4) in dried blood spots in screening for congenital hypothyroidism (CH) in neonates. Methods The TSH and FT4 levels in dried blood spot were measured by time-resolved lfuorescence immunity in live born neonates from June to December 2013. If the screening was positive, the blood was drawn and the serum TSH and FT4 were measured and compared with the results from dried blood spots. Results In a total of 31 199 neonates screened, 12 cases were diagnosed with CH and the prevalence rate of CH was 1/2 600;4 cases were hyperthyropinemia and no pituitary CH was detected. There was no signiifcant difference between TSH or FT4 levels in dried blood spot and those in serum in neonates diagnosed with CH (P>0.05). Conclusions Combined detection of TSH and FT4 in dried blood spot can be used for neonatal screening of CH. It can be applied for early distinguishing CH from hyperthyropinemia, and also helpful for early diagnosis and treatment of central CH.