Homeobex gene,derived firstly from Drosophila, has the ability of regulating normal embry-onic development and proliferation and differentiation of adult tissue cells. Recent studies demonstrate that HOXA7 can be high and low expressed in adult tumor tissues by means of genetic fusion and genetic silencing to regulate genesis and development of tumor cells. To study its expression and regulation in tumor will be helpful for tumor diagnosis ,treatment and prognosis.

By observing the arthroscopy cleaning technique with postoperative oral administration with reinforcing kidney and activating blood Chinese herbal medicine in the treatment of knee osteoarthritis (KOA), this article was aimed to evaluate the clinical curative effect and its influence on serum C endⅡ collagen type (CTX-Ⅱ) and cartilage oligomeric matrix protein (COMP). Patients who met the diagnostic criteria were randomly divided into the treatment group and control group, with 30 cases in each group. Joint limited debridement was firstly applied. And the degree of articular cartilage degeneration, synovial hyperplasia and inflammatory degree were observed and recorded. Preoperative venous blood was collected. The contents of CTX-Ⅱ and COMP were detected with ELISA method. After surgery, in the treatment group, surgery plus postoperative oral administration with reinforcing kidney and activating blood Chinese herbal medicine was given. In the control group, surgery plus oral administration with celecoxib capsules was given. Four weeks before and after the treatment, the WOMAC knee function score was used in the evaluation of clinical curative effect. The contents of postoperative serum CTX-Ⅱ and COMP were determined. The results showed that the effectiveness of the treatment group was higher than that of the control group (P < 0.05). In the treatment group, the WOMAC score in pain, rigidity, difficulty of activity and total score had significant differences compared with the control group (P < 0.05). There were statistical significances on serum CTX-Ⅱ and COMP in the treatment group before and after the treatment, as well as the comparison between the treatment and control group both before and after the treatment (P < 0.05). Serum CTX-Ⅱ and COMP had positive correlation with the degeneration of cartilage and synovial hyperplasia with statistical significances (P < 0.05). It was concluded that joint limited debridement under arthroscopy combined with reinforcing kidney and activating blood method had synergistic effect in the treatment of KOA. It can effectively relieve the clinical symptoms and improve the knee joint function. It can also obviously reduce the contents of serum CTX-Ⅱ and COMP. There was internal close relation between the articular cartilage degeneration, synovial hyperplasia under the arthroscopy in KOA and cytokines of CTX-Ⅱ and COMP. The cytokines of CTX-Ⅱ and COMP provided important references for the estimation of articular cartilage degeneration and synovial hyperplasia.

Objective: To observe the clinical effect of tuina for cervical intervertebral disc herniation. Methods: Eighty seven cases were randomized into a treatment and a control group. 39 cases in the treatment group were treated with tuina manipulation, while 48 cases in the control group were treated with combined cervical traction and medium-frequency impulse. Cases in both groups were treated 3 times a week, and 10 times constitute a course of treatment. Results: Of 39 cases in the treatment group, 22 obtained recovery, 13 obtained marked effects and 4 obtained improvement, manifesting a marked effect rate of 89.7% and an effective rate of 100.0%. Of 48 cases in the control group, 23 obtained recoveries, 17obtained marked effects, 7 obtained improvements and 1 saw no improvement, manifesting a marked effect rate of 83.3% and an effective rate of 97.9%. There were no statistical differences in the marked effect rate and total effective rate. Cases in the treatment group were treated 17.8 times on average, while cases in the control group were treated 26.6 times on average. Conclusion: Despite the equivalent effects in the treatment of cervical intervertebral disc herniation, tuina is superior to combined traction and medium-frequency impulse in terms of a faster effect and shorter course of treatment.

OBJECTIVE To study the differences of quinolones-resistant determining region(QRDR) in DNA gyrase A(gyrA) subunit between drug-resistant Klebsiella pneumoniae induced by fluoroquinolone in vitro and strains isolated from clinical isolates.Furthermore,to reveal the relation between different QRDR gene mutations and drug-resistance. METHODS Ten sensitive K.pneumoniae strains were selected and induced into drug-resistant strains by ciprofloxacin.The QRDR in gyrA by polymerase chain reaction(PCR) was amplified and compared their DNA sequences with clinically isolated quinolone-resistant K.pneumoniae. RESULTS We had found several gene mutations of QRDR in fluoroquinolone-resistant K.pneumoniae induced by ciprofloxacin,including Ser 83(TCC)→Phe(TTC) and Ile(ATC);and Gln106(CAG)→Leu(CTG).And the alteration of Gln106(CAG)→Leu(CTG) was a new discovery. CONCLUSIONS There are gene mutations of QRDR in fluoroquinolone-resistant K.pneumoniae induced by ciprofloxacin.The mutation of Ser 83(TCC) and Gln106(CAG) is probably the molecular basis of inducing drug-resistant strains.

Neurological complications of viral hepatitis mainly include hepatic encephalopathy,hepatic myelopathy,peripheral neuropathy,meningoencephalitis,and epilepsy.Hepatic encephalopathy is a common complication with mature diagnosis and treatment methods,and the other complications are relatively uncommon and lack treatment methods.This article introduces the classification,clinical manifestation,and treatment of each complication,in order to find the optimal therapies for neurological complications of viral hepatitis.

To evaluate the clinical effect of therapeutic soft corneal contact lens in combination with fresh amniotic membrane transplantation in the treatment of pterygium and its clinical value.
●METHODS: This study was a retrospective analysis of 200 pterygium excision patients (200 cases, 220 eyes) in hospital from January 2010-June 2011. The patients were divided into two groups. Group 1 (100 cases, 110 eyes) were patients treated with fresh amniotic membrane transplantation and therapeutic soft corneal contact lens while group 2 ( control group, 100 cases, 110 eyes) did not use corneal contact lens. The clinical outcomes in these two groups were compared in a 6 - 18mo postoperative follow-up observation.
●RESULTS: ln control group using corneal contact lens the epithelium repair time ranged from 2 - 7d with an average time of 3. 8d; in group 1 the epithelial repair time ranged from 1 - 5d with an average time of 2. 5d. The patients were followed up for 6 - 18mo, 9 recurrent eyes were found in control group, the recurrence rate was 8. 2%; 5 recurrent eyes were found in experimental group the recurreat rate was 4. 5%. There were significant differences in the 2 groups comparing treatment outcomes (P< 0. 05). Early stimulative symptoms after surgery can be reduced by wearing contact lenses.
●CONCLUSlON:The therapeutic effect of fresh amniotic membrane transplantation after pterygium excision is enhanced by the therapeutic application of corneal contact lens. The epithelial repair time is shortened, the recurrence rate is reduced after pterygium excision and stimulative symptoms including photophobia, tearing, foreign body sensation and ophthalmodynia caused by corneal epithelial defect can be relieved.

AIM:To investigate the changes of subfoveal choroidal thickness ( SFCT ) in central serous chorioretinopathy ( CSCR) eyes and to compare them with normal control eyes.
METHODS: This was a case-control study and a Meta-analysis. Forty - six CSCR patients diagnosed by the fundus pre - set lens, fundus fluorescein angiography (FFA) and indocyanine green angiography (ICGA) were enrolled in this study. Sixty two age-, sex-, diopter- and axial length-matched 62 normal subjects ( 62 eyes ) were enrolled in this study as the control group. Using enhanced depth imaging optical coherence tomography ( EDI-OCT) , SFCT of CSCR eyes and normal control eyes were measured and compared. Univariate and multivariate linear regression analysis were performed to assess the association between SFCT and clinical factors. The Meta - analysis were conducted using the Stata software package to calculate the summary weighted mean differences ( WMDs) .
RESULTS:The mean SFCT of the CSCR group and the normal control group was 397. 34±83. 91μm and 274. 48±62. 57μm, respectively. The CSCR eyes had a thicker choroid than the control eyes at the SFCT (P<0. 01). Univariate and multivariable linear regression analysis showed that the SFCT was significantly thicker in association with the CSCR diagnosis. The result of our case-control study was consistent with the results of the further Meta-analysis with the pooled WMD of 156. 13μm (95% CI:137. 43, 174. 83) for SFCT.
CONCLUSION:Along with the comprehensive Meta-analysis, SFCT in CSCR eyes was thicker than that of normal control eyes. Increased SFCT might be associated with CSCR.

Objective To explore the common clinical features and mechanism of HenochSchonlein purpura (HSP) in children,and provide evidence and guidance for clinical diagnosis,therapy and prognosis of HSP.Methods Prospective study.Totally 1 232 HSP children blood samples were collected during January 2010 to December 2013 in the Children's Hospital of Zhejiang University School of Medicine,and the levels of immunoglobulin,complement,T lymphocyte subsets and CRP were detected in the acute phase of HSP.The clinical data were analyzed with these indexes to explore the function of cellular and/or humoral immunity in the pathogenesis of HSP.In addition,this study detected serum IgA levels in 200 cases of sepsis rash,200 cases of urticarial and 200 cases of thrombocytopenic purpura patients and 400 cases of healthy children over the same period to our hospital respectively,in order to find out whether IgA is capable of differentiating allergic purpura rash from other similar skin rashes.Results Compared with healthy children,the IgA level was significantly higher [IgA:2.0 (0.6-7.5) g/L vs 1.1(0.6-2.1) g/L,Z =5.928,P =0.03].When IgA ＞ 1.44 g/L,the diagnostic sensitivity and specificity to differentiate allergic purpura patients from sepsis patients were 77.43 ％ (954/1 232) and 80.00％ (160/200),respectively.When IgA ＞ 1.53 g/L,the diagnostic sensitivity and specificity to distinguish from allergic purpura with urticaria patients were 72.57％ (894/1 232) and 74.51％ (149/200).When IgA ＞0.91 g/L,it had a 95.14％ sensitivity (1 172/1 232) and a 79.45％ specificity (159/200) for the differential diagnosis of allergic purpura and thrombocytopenic purpura patients.When IgA ＞ 1.33 g/L,the sensitivity of distinguishing allergic purpura patients from healthy children was 81.25％ (1 001/1 232),while the specificity was 95.00％ (380/400).Conclusions HSP children show cellular immune dysfunction.Th1/Th2 imbalance and over-activation of Th2 cells result in the increased synthesis and release of immune globulin,causing abnormalities in humoral immune.An increase in serum IgA level of HSP patients can differentiate HSP from other similar rashes.

Objective To investigate the clinical value of serum soluble intercellular adhesion molecule-1 (sICAM-1 )in patients with primary biliary cirrhosis (PBC)and autoimmune hepatitis (AIH).Methods Sixty-one PBC patients and 59 AIH patients,who were hos-pitalized or visited the outpatient department from June 2012 to September 2013,as well as 50 healthy controls,were included in the study. The PBC patients included 29 incipient cases,21 cases in remission,and 11 recurrent cases;the AIH patients included 26 incipient cases, 20 cases in remission,and 13 recurrent cases.Serum sICAM-1 level was measured by double-antibody sandwich enzyme-linked immu-nosorbent assay,and serum levels of alanine aminotransferase (ALT)and total bilirubin (TBil)were determined by biochemical enzyme as-say.Comparison between groups was made by analysis of variance;Pearson correlation analysis was performed.Results Among PBC pa-tients,the incipient group and recurrent group had significantly higher serum sICAM-1 levels than the remission group and control group (P=0.000 for all);there was no significant difference in serum sICAM-1 level between the incipient group and recurrent group (P=0.484);the remission group had a significantly higher serum sICAM-1 level than the control group (P=0.000).Among AIH patients, the incipient group and recurrent group had significantly higher serum sICAM-1 levels than the remission group and control group (P=0.000 for all);there was no significant difference in serum sICAM-1 level between the incipient group and recurrent group (P=0.802);no significant difference in serum sICAM-1 level was seen between the remission group and control group (P=0.281).For patients with PBC and AIH,serum sICAM-1 level was positively correlated with serum levels of ALT (r=0.664,P=0.000;r=0.784,P=0.000) and TBil (r=0.715,P=0.000;r=0.580,P=0.000).Conclusion Serum sICAM-1 may be involved in the immunologic injury in PBC and AIH.In patients with PBC and AIH,the elevation of serum sICAM-1 level is closely correlated with the severity of liver damage. Clinical monitoring of serum sICAM-1 level may play an important role in severity assessment,prognostic evaluation,and therapy guidance among patients with autoimmune liver diseases.

AIM: To comprehensively investigate the current status of cataract surgery in Leshan city, and find the existing problems according to the survey results as a guide to cataract prevention and treatment in future.
METHODS: We surveyed the status of cataract surgery containing equipments, surgeons and surgery conditions in 17 ophthalmology departments of general hospitals from Leshan including 6 counties, 1 county-level city and 4 districts during 2012. Cataract surgery methods, according to various surgery financial resources, surgical performances and surgical incision, were divided into phacoemulsification and intraocular lens implantation ( Phaco + IOL ) , extracapsular cataract extraction and intraocular lens implantation ( ECCE + IOL ) , and each method contained 2 groups. We analyzed the outcomes following preoperative examination, surgeons, surgical methods, surgical equipments, types of IOL, surgical quantity, surgical results, and intraoperative complication.
RESULTS: In whole city there were 16 operating microscopes, 43 slit lamp microscopes, 12 non-contact tonometers, 1 intraocular lens Master, 8 optical A/B type ultrasonic examination systems, 4 YAG lasers and 12 phacoemulsification instruments. There 15 doctors could complete cataract surgery independently, and 5 of them were phacoemulsification surgeons. The total number of completed cataract surgeries reached 6 211 eyes, containing 3 564 eyes for Phaco+IOL ( 57%) ( preoperative visual acuity ≥0. 3 in Phaco+IOL1 were 1 520 eyes, 24%) and 2 647 eyes for ECCE+IOL ( 43%) ( 1 533 eyes in ECCE+IOL1, 25%). In various groups, off-blindness rate was 94. 80%-100%, off-disability rate was 90. 41%-100%, and 94. 96% - 100% received intraocular lens implantation, intraoperative complication rate was 1. 00%-15. 10%.
CONCLUSION: The distribution of surgeons and equipments in the whole city is unbalanced, and the utilization rate of phaco equipment is low. The levels are different in various hospitals on surgical technique, surgical quantity and surgical results. Phacoemulsification and intraocular lens implantation is considered as the main therapy for cataract, and as a transition to dioptric and personalized cataract surgery. The surgical condition of the city is good, but the proportion of cataract surgery for prevention of blindness in Leshan city is low, and the surgical technique remains to be further improved.