Objective:To investigate the rat retinal DNA damage induced by acute hypobaric hypoxia and the protective effect of Radix Astragali seu Hedysari compound on it. Methods:Seventy-two healthy clean grade male Sprague Dawley (SD) rats were randomly divided into normal oxygen control group, hypoxic model group and Radix Astragali seu Hedysari compound gavage group by computer random number distribution, with 24 rats in each group.The rats in the normal oxygen control group were fed in normal condition, while the rats in the hypoxic model group and Radix Astragali seu Hedysari compound gavage group were fed in a hypobaric oxygen chamber, which simulated an altitude of 5 kilometers, and the rats were administered intragastrically with Radix Astragali seu Hedysari compound (0.1 g/kg) or the same volume of normal saline once a day according to grouping.Retinal tissue was obtained on the 7th day of continuous administration of drugs after the rats were sacrificed by euthanasia.Histopathological staining was performed to observe the pathological morphology of retina in each group.Immunohistochemistry was used to identify the expressions of p53 and histone family 2A variant ( γH2AX). Real time-PCR was used to determine the relative expression levels of 8-oxoguanine nucleoside triphosphatase (MTH1) and 8-hydroxyguanine glycolsylase (OGG1) mRNA.The use and care of the animals followed Regulations of the Administration of Affair Concerning Experimental Animals by State Science and Technology Commission. Results:The retina of hypoxic model group was thicker than that of the normal oxygen control group and Radix Astragali seu Hedysari compound gavage group, especially the nerve fiber layer and the ganglion cell layer.The positive staining intensities of p53 and γH2AX were stronger in the retinas of the hypoxic model group than those in the the normal oxygen control group and Radix Astragali seu Hedysari compound gavage group.The relative expression levels of MTH1 and OGG1 mRNA in the hypoxic model group were 0.573±0.081 and 0.772±0.136, which were significantly lower than 0.846±0.160 and 1.013±0.168 in the normal oxygen control group, respectively (both at P<0.05). The relative expression level of MTH1 mRNA was 0.748±0.114 in the Radix Astragali seu Hedysari compound gavage group, significantly higher than that in the hypoxic model group ( P<0.05). No significant difference was detected in OGG1 mRNA expression level between the Radix Astragali seu Hedysari compound gavage group and the hypoxic model group ( P=0.743). Conclusions:The intervention of Radix Astragali seu Hedysari compound plays a protective role in hypobaric hypoxia-induced retinal DNA damage through modulating the expression of p53, γH2AX, OGG1 and MTH1.

OBJECTIVE:To investigate the utilization of microbioecologics in outpatient department of pediatrics of our hospital.METHODS:Prescriptions were randomly collected from outpatient department of pediatrics of our hospital in Dec.2009 to analyze the utilization of microbioecologics.RESULTS:Of total 8 858 prescriptions,microbioecologics were used in 486 cases,accounting for 5.48%;bifidobacterium combined with lactobacillus,enterococcus and bacillus cereus tablets(live) accounted for 59.26%.Microbioecologics combined with antibiotics accounted for 8.49% but the combination of tow kinds of microbioecologics hadn't been found.CONCLUSIONS:The utilization of microbioecologics is rational in outpatient department of pediatrics of our hospital on the whole.

Objective To evaluate the long-term results of vitreoretinal surgery without use of intraocular silicone oil or gas in patients with diabetic tractional retinal detachment (DTRD).Methods The clinical interventional case series study included 104 patients (112 eyes) with DTRD,who were consecutively treated by pars plana vitrectomy without use of intraocular silicone oil or gas.Among the eyes,there were 6 eyes with iris neovascularization (INV),1 eye with neovascular glaucoma (NVG) and 50 eyes with macular retinal detachment.There were no pre-existing retinal holes or breaks prior to surgery nor any iatrogenie retinal breaks developed during vitrectomy.Cataract removal combined with intraoeular lens implant surgeries were performed on 15 eyes.Follow-up duration varied from 12 to 65 months (mean: 29 months).Results Subretinal fluid was completely absorbed within 2 months after surgery.In 107 eyes (95.54%),the retina reattached after surgery and remained attached till the end of follow-up period.Best corrected visual acuity (BCVA) improved in 79 eyes (70.53%),remained unchanged in 14 eyes (12.500%) and got worse in 19 eyes (16.79%).The BCVA improving rate was lower in the macular detached group (33 eyes/50 eyes,66.00% Vs 46 eyes/62 eyes,74.19%,χ2=0.89,P=0.344).No obviously aggravated opacity of lens was observed after vitreoretinal surgeries in the eyes without cataract surgeries.Seven (6.25%) eyes showed INV (5 new onset eyes),and none of them developed into NVG.In multivariate logistic regression,factors associated with postoperative rubeosis iridis were pre-existing rubeosis iridis I-adjusted odds ratio (OR)= 10.2],low preoperative BCVA (OR= 11.1) and low postoperative BCVA (OR = 16.7).Conclusions Vitreoretinal surgery for DTRD may not necessarily be combined with silicone oil or gas tamponade if there are no preoperative or intraoperative retinal breaks,and only using irrigation fluid could access a good long-term prognosis result.

ObjectiveTo evaluate and compare the prognosis of idiopathic macular holes (IMH) and traumatic macular holes (TMH) treated by pars plana vitrectomy (PPV). Methods The clinical data of 72 IMH eyes and 55 TMH eyes, which were treated by PPV between November 2001 and December 2007,were retrospectively reviewed. The visual outcomes and macular anatomic closure were evaluated, and their relationships with prognostic factors including the size of macular hole (MH), preoperative visual acuity (VA) and duration of disease were analyzed. Results The closure rate of IMH (100. 0%) was significant higher than that of TMH (85.5%) (P=0. 001). The postoperative VA of IMH and TMH were (0. 25±0.02) and (0. 21±0. 21) respectively, both significantly increased compare to their preoperative VA (t=-6. 841, -4. 093; P=0.000). VA-increased IMH and TMH eyes had same VA (χ2=3. 651, P=0.07).Pre-PPV VA≥0. 1 IMH eyes had better outcomes than Pre-PPV VA＜0. 1 IMH eyes (χ2 = 12.04, P=0. 001), while Pre-PPV VA had no effects on TMH outcomes (χ2=0. 371, P=0. 486). IMH eyes with small holes had better outcomes (t=2. 476, P=0. 016), and TMH eyes with small holes had better closure (t= -4. 042, P＜0. 001). The duration of disease had no significant influence on TMH visual (χ2=0. 704,P = 0. 401 ) and anatomic (χ2 = 0. 166, P= 0. 684) outcomes. Conclusions PPV is an effective treatment for MH. The closure rate of IMH is higher than that of TMH. The diameter of MH and preoperative VA are major factors for IMH outcomes, and the duration of disease and preoperative VA have no effects on postoperative VA in TMH.

Objective To observe the change of diffusion upper limit of macromolecules through pathological retina and the difference between the layers of retina. Methods Retinal edema was emulated by establishing branch retinal vein occlusion(RVO)model in miniature pig eyes under photodynamic method.Two days later,the retinas of both eyeballs were peeled off.The diffusion test apparatus was designed by ourselves.FITC-dextrans of various molecular weights(4.4,9.3,19.6,38.9,71.2 and 150 kDa)and Carboxyfluorescein(376 Da)were dissolved in RPMI-1640 solutions and diffused through inner or outer surface of retina.The rate of transretinal diffusion was determined with a spectrophotometer.Theoretical maximum size of molecule(MSM)was calculated by extrapolating the trend-linear relationship with the diffusion rate.In separate experiments to determine the sites of barrier tO diffusion,FITC-dextrans were applied to either the inner or outer retinal surface,processed as frozen sections.and viewed with a fluorescence microscope. Results FITC-dextrans applying tO inner retinal surface,4.4 kDa dextrans were largely blocked by inner nuclear layer(INL);19.6-71.2 kDa dextrans were blocked by the nerve fiber layer(NFL)and inner plexiform layer;150 kDa dextrans were blocked by NFL.FITC-dextrans applying to outer retinal surface,most dextrans with various molecular weights were blocked before outer nuclear layer(ONL).No matter applying to the inner or outer surface,Carboxyfluorescein can diffuse through the whole retina and aggregate at INL and ONL.After RVO,the inner part of retina became edema and cystoid,loosing the barrier function.Compared with the normal retina,the MSM in RVO tissues increased(6.5±0.39nm Vs 6.18±0.54nm,t=4.143,P=0.0001). Conclusions After RVO,the barrier function of inner part of retinal is destroyed and the upper limit of diffusion macromolecule size increased.which is nevertheless limited.ONL acts as bottle-neck barriers to diffusion,if the outer part of retina is damaged,the change of the diffusion upper limit will be prominent.

This study was aimed to evaluate the efficacy and safety of acupuncture treatment for diabetic peripheral neuropathy.MEDLINE, EMBASE, China National Knowledge Infrastructure (CNKI), and Wanfang database were searched. The study endpoints included clinical total efficacy, peripheral nerve conduction velocity and adverse reactions. The Review Manager software 5.2 was used in the bias and risk assessment as well as efficacy. GRADE profiler software was used to evaluate quality of evidences. The results showed that there were 18 randomized controlled trials (RCTs) with 1158 patients included. The clinical total efficacy rate of acupuncture treatment was obviously better than the drug control group [RR: 1.38, 95%CI (1.25, 1.53),P < 0.000 01]. The sensory nerve conduction velocity was that for nervus medianus, the acupuncture treatment group was superior to the drug control group [MD = 2.55, 95%CI (1.23, 3.87),P = 0.000 1]; for nervus peroneus communis, the acupuncture treatment group was superior to the drug control group [MD = 3.42, 95%CI (2.56, 4.28),P < 0.000 01]. The motor nerve conduction velocity was that for nervus medianus, the acupuncture treatment group was superior to the drug control group [MD= 4.10, 95%CI (1.01, 7.19),P = 0.009); for the nervus peroneus, the acupuncture treatment group was superior tothe drug control group [MD = 3.09, 95%CI (1.99, 4.19),P < 0.000 01]. The adverse reactions and safety indicators were that no adverse reaction was reported in both studies with no abnormal safety indicator. The quality of evidence showed that the sensory nerve conduction velocity for nervus peroneus communis was moderate; the motor nerve conduction velocities for nervus medianus and nervus peroneus communis were low. While, the clinical efficacy rate and the quality of evidence for sensory nerve conduction velocity of nervus medianus were relatively low. It was concluded that the current clinical evidences were uncertain for the efficacy and safety of acupuncture in diabetic peripheral neuropathy treatment.

Objective To evaluate improvement of visual acuity for advanced proliferative diabetic retinopathy eyes with different complications after vitrectomy. Methods Four groups of advanced proliferative diabetic retinopathy (APDR) in 314 eyes with diabetes type Ⅱ and type Ⅰ were analyzed retrospectively: vitreous hemorrhage with limited traction retinal detachment (VH), extensive fibrovascular membranes with traction retinal detachment (TD), combined rhegmatogenous and traction retinal detachment (CRT) and cataract with vitreous hemorrhage or and traction retinal detachment (CHD). Results 0.1 or better postoperative visual acuity was achieved in 59.5% of type Ⅱ and 66.7% of type Ⅰ in the VH group; 39.4% of type Ⅱ and 52.6% of type Ⅰ in the extensive TD group; 31.6% of the CRT group; 62.5% of the CHD group. The major intraoperative complication is iatrogenic retinal breaks. The causes of postoperative visual loss in present study included neovascular glaucoma (2.8% of type Ⅰ and 0.4% of type Ⅱ in aphakia, 25% of type Ⅱ in aphakia and 4.2% in pseudophakia), retinal detachment and CRAO. Conclusion The majority of APDR eyes obtained better visual improvement after vitrectomy and photocoagulation.

Objective To evaluate the success rate and the risk of impairing vision for epimacular surgery. Methods A retrospective analysis of 57 eyes with epimacular membrane after surgery was made, and the changes in visual acuity and near visual acuity, in different etiology, improvement in distortion, as well as intraoperative and postoperative complications were compared. Results The eyes of 78 8% achieved a visual improvement of more than 2 lines. The visual improvement after surgery of epimacular membranes was the most in buckling group, then in macular hole with epimacular membrane and idiopathic eyes, the change was very limited in macular traction syndrome. The improvement of near visual acuity is usually better than distant visual acuity. The improvement rate of distortion is of 65 0%. The main intraoperative complication was reopen of the primary hole(4 eyes) and the formation of new hole(5 eyes). Conclusion Surgical peeling for epimacular membranes can improve the visual acuity and distorted vision,particularly in epimacular membrane after buckling surgeries, with macular hole and idiopathic eyes. possible risks might be present in surgical manipulation.

Objective To investigate the difference of curative effect of various surgical methods for the treatment of idiopathic senile macular hole. Methods A retrospective analysis was made for 86 eyes with stage Ⅱ Ⅳ idiopathic full thickness macular hole treated with various modes of operation,ie, single vitrectomy (7 eyes),vitrectomy combined with autologous platelet concentrate (APC) as an adjuvant (40 eyes), vitrectomy with internal limiting membrane (ILM) peeling (14 eyes), vitrectomy with both ILM peeling and APC treatment (25 eyes). The main outcome measures included anatomic reattachment rate,change of visual acuity,findings of optic coherence tomography (OCT), Amsler grid and intra or postoperative complication evaluations. Results (1) In visual acuity improvement, the APC group (80.0%) was significantly better than anyone of the other three groups ( P

Objective To study the characteristics of organ function and structural injuries in the elderly with multiple organ dysfunction syndrome. Method 50 Wistar rats (25 three-month-old rats and 25 twenty-month-old rats) were anaesthetized and experienced cecal ligation puncture (CLP) operation, which were defined as MODSE group and MODS group respectively. 40 Wistar rats (20 three-month-old rats and 20 twenty-month-old rats) were anaesthetized and not experienced cecal ligation puncture operation, which were used as SOGE (sham operation group in the elderly) and SOG (sham operation group). At 6 h, 12h, 24h, 48h or 72h after operation, serum levels of alanine aminotransferase, aspartate aminotransferase, blood urea nitrogen, creatinine and total bilirubin were measured by automatic biochemistry analyzer. Organs (hearts, brains, lungs, livers, kidneys) were harvested. Paraffin sections were made and stained by conventional H.E procedure for histological examination. Results Based on histological investigations, physiological and biochemical measurements, organ dysfunction in MODSE group occurred at 6h after operation and peaked at 24 h after operations. Otherwise, organ injuries with MODS occurred at 24 h and peaked at 48 h after operation. Conclusion According to histological investigations, physiological and biochemical measurements, damages of organ dysfunction and structural damages in MODSE group occurred much earlier and more seriously. which may provide an experimental evidence for medico-legal certification of the death caused by MODS.