Pachychoroid disease is a relatively novel concept proposed in ophthalmology in recent years, which describes a series of pathological conditions including chronic persistent choroidal thickening and choroidal vasodilatation, with choroid blood capillary layer capacity attenuation, choroidal vasodilation, focal or disseminated choroidal thickening, progressive retinal pigment epithelial dysfunction and choroid retinal neovascularization as characteristic symptoms.Nowadays, the definition of pachychoroid disease has gradually changed from the previous emphasis on the simple thickening of choroid to the morphological description of complex pathological conditions.The clinical manifestations of certain pachychoroid diseases have been clearly described including central serous chorioretinopathy (CSC), pachychoroid neovasculcularization (PNV), polypoid choroidal vasculopathy (PCV), focal choroidal excavation (FCE), peripapillary pachychoroid syndrome (PPS). These entities have certain characteristic choroidal vasculopathy, which may represent different clinical manifestations of the same type of pachychoroid diseaseor indicate that they have similarpathogenesis .In this article, the existing literature and recent findings about pachychoroid disease, as well as the classification and treatment of pachychoroid diseases spectrum were summarized and discussed.

Aim: To investigate the changes of endothelin( ET) receptors by isoproterenol in myocardial cells, and the invervention effects of CPU86017 and its RS isomer. Methods: Primary cultures of neonatal rat cardiomyo-cytes were prepared, and isoproterenol was added to each group for modeling, followed by drug interventions with propranolol, CPU86017 and RS chiral isomer respectively. Results: The expressions of ET_A and ET_B were increased by isoproterenol, in which the level of ET_B was higher than ET_A . This phenomenon was adjusted to different degrees by using propranolol, CPU86017 and RS chiral isomer in a dosage-relevant manner. The infervention effect of RS isomer was better than that of CPU86017 at the high dosage( 10 μmol/L). Conclusion: The cardiovascular effects of CPU86017 and RS chiral isomer could be correlative to the inhibition of the over-expressions of ET_A and ET_B.

Objective To make a nationwide external quality assessment of tests for isolation and identification of N.gonorrhoeae in medical and healthcare facilities at different levels,and to analyze current problems.Methods Lyophilized quality control samples were uniformly delivered to 252 medical and healthcare facilities providing sexually transmitted disease (STD) services at different levels.Test results were analyzed by the National Center for STD Control,China Center for Disease Control and Prevention,and evaluation results were fed back to participating laboratories.Results Finally,test results were received from 203 (80.56％) facilities.The comprehensive score averaged at 87.14,and facilities achieving a comprehensive score of 80 or greater amounted to 80.30％ (163/203).The coincidence rate was 53.69％ (109/203) for all of the 5 quality control samples,82.76％ (168/203) and 87.68％ (178/203) respectively for two quality control samples containing only N.gonorrhoeae,86.21％ (175/203) and 96.06％ (195/203) respectively for a sample containing Neisseria sicca and a sample containing Enterococcus faecalis,69.46％ (141/203)for a sample containing different species of Neisseria.Conclusion The external quality assessment reveals a disparity in the capability to isolate and identify Neisseria among medical and healthcare facilities providing STD services at different levels.

Objective To make a nationwide external quality assessment for drug sensitivity testing of Neisseria gonorrhoeae, analyze the problems in and factors associated with the drug sensitivity testing, and to enhance the quality of drug sensitivity testing of N. gonorrhoeae at different monitoring sites. Methods Samples were uniformly delivered to monitoring sites by express mail service. Test results were analyzed in the National Center for STD Control, and the evaluation results were fed back to these monitoring sites. Results A total of 105 quality control samples were delivered from 2007 to 2009, with a response rate of 88.57% (93/105). Thirteen monitoring sites were enrolled in the external quality assessment, including 9 laboratories in 2007, 9 in 2008 and 13 in 2009. The total percentage amounted to 77.42% (24/31) for qualified laboratories during the 3 years, including 6 laboratories in 2007, 7 in 2008 and 11 in 2009. The coincidence rate increased for the detection of penicillinase-producing N. gonorrhoeae (PPNG), N. gonorrhoeae with chromosome-mediated ciprofloxacin resistance, and N. gonorrhoeae with chromosome-mediated spectinomycin resistance, and declined for the detection of N. gonorrhoeae with plasmid-mediated high level tetracycline-resistance (TRNG) and N. gonorrhoeae with chromosome-mediated ceftriaxone resistance. Conclusions The 3-year external quality assessment reveals an improvement in the overall quality of drug sensitivity testing of N. gonorrhoeae at national monitoring sites; the accuracy is improved markedly for the detection of PPNG, N. gonorrhoeae with resistance to spectinomycin and ciprofloxacin, but is needed to increase for the detection of ceftriaxone-resis- tant N. gonorrhoeae and TRNG.

Objective: To provide anatomical basis for the chemotherapy of lingual arterial embolization in clinic. Methods: The origin, course, branch distribution and anastomosis of the lingual artery were observed in 15 cases of adult head specimens. Results: As one of principal branches, the lingual artery arises from the external carotid artery at the level of the major cornu of hyoeides, approaches to the carotid bifurcation. With original diameter of (2.4?0.3) mm, it runs upward and passes deepwards to the hyoglossus muscle, gives off the dorsal lingual artery and the terminal branch -profunda lingual artery. Limited in each side of intrinsic muscles, two profunda lingual arteries creep tortuously along the muscular fibers and anastomose freely to structure submucous arterial rete. Conclusion: With concentrated origins, wide vascular diameter, constant course and enrichment of submucous arterial rete, the lingual artery is an ideal blood vessel for arterial chemoembolization.

The leucoanthocyantin reducase (LAR) gene, an important functional gene of catechins biosynthesis pathway, was cloned from Fagopyrum dibotrys (D.Don) Hara by degenerate PCR and rapid amplification of cDNA ends (RACE). The full-length cDNA of FdLAR is 1 581 bp (GenBank accession: JN793953), containing a 1 176 bp ORF encoding a 391 amino acids protein, and its 3'-untranslated region has an obvious polyadenylation signal. The recombinant plasmid containing FdLAR completed ORF was transformed into E. coli BL21 (DE3). The target fusion peptide with molecular weight of 66 kD was expressed under the condition of 16 degrees C and induced by IPTG at final concentration of 1.0 mmol x L(-1). Bioinformation analysis indicated that the amino acid sequence of FdLAR showed great homology to other LAR with the NADB-Rossmann conversed domain in the N-terminus. Real-time quantitative PCR was used to detect the expression levels of FdLAR gene during different development periods. The determination of flavonoids contents in appropriate rhizomes showed that the relationship between FdLAR gene expression and the accumulation of flavonoids displayed different trends during vegetative growth and reproductive growth stages, suggesting that the FdLAR gene may be involved in the pathway of flavonoid metabolisms in Fagopyrum dibotrys.

Objective To explore the effect of Buyang Huanwu decoction(BYHWD)on protein kinase B1 (AKT1)and c-Jun amino terminal kinase 1/2(JNK1/2)in rats after focal cerebral ischemia. Methods According to the random number table method,48 Sprague-Dawley(SD)rats were randomly allocated to four groups:normal control group,sham-operated group,model group,traditional BYHWD group(each n=12). The rat model of right focal cerebral ischemia was established by the method of middle cerebral artery occlusion(MCAO). The rats in BYHWD group were ingested with the decoction of BYHWD 14.2 g/kg after 2 hours of the operation(the main ingredients of BYHWD including astragalus mongholicus 120 g,Chinese angelica 6 g,radix paeoniae rubra 4.5 g, rhizoma ligustici wallichii 3 g,safflower 3 g,peach kernel 3 g,earthworm 3 g),once a day for 7 days. Other groups of animals were given the same amount of normal saline orally. After operation,on the 7th day,the animals were killed,and their brains were taken out. The reverse transcription-polymerase chain reaction(RT-PCR)assay was used to detect AKT1 mRNA expression,and immunohistochemical method was applied to measure JNK1/2 protein expression. Results Compared with normal control and sham-operated groups,the level of AKT1 mRNA expression〔absorbance(A)〕was decreased obviously(0.48±0.08 vs. 0.63±0.11,0.61±0.09,both P<0.05),and the number of JNK1/2 positive cells(cell/mm2)was increased significantly(34.13±4.57 vs. 16.15±1.09,16.23±2.05,both P<0.05)in model group;compared with model group,the AKT1 mRNA expression in brain tissue(0.93±0.11)and the number of JNK1/2 positive cells(45.04±5.68)was increased significantly in BYHWD group,the differences being statistically significant(P<0.05 or P<0.01). Conclusion BYHWD can up-regulate expressions of AKT1 mRNA and JNK1/2 positive cells in ischemic brain tissue that is one of the mechanisms in the protection of brain.

ObjectiveBoth kilovolt (KV) cone-beam computed tomography (CBCT) and KV radiography can determine set-up errors for patients with head-and-neck cancer.This study is to compare their performance.Methods16 patients with head and neck cancer were enrolled in this study.There were 160 sets of CBCT and corresponding orthogonal radiography images.Through registration of CBCT images with the planning CT images,and registration of radiography images with the digitally reconstructed radiographs,translational set-up errors were determined along left-right (x),super-inferior (y),and anterior-posterior (z) directions.Pearson correlation analysis was performed to evaluate the correlation of the set up errors determined by the two methods,and Bland-Altman plot analysis was used to assess the coincidence of these two methods.ResultsThe Pearson coefficient of correlation along all three directions was less than 0.01,and R2 was 0.95,0.84,0.81 on x,y,z,respectively.That means high correlation for two methods.The Bland-Altman plot analysis showed that the 95％ agreement limits of agreement were within preset 2 mm tolerance (x[ 1.3mm,- 1.2mm],y[ 1.6mm,- 1.1mm],z[0.8mm,-1.4 mm] ),which indicates an agreement exists for two methods.ConclusionsFor determination of set-up errors for patients with head and neck cancer,KV radiography is equivalent to CBCT.Considering CBCT delivers higher dose than KV radiography,but provides more soft tissue information.We suggest to use these two methods combinative in clinic.

Objective To compare the expression level of interferon regulator factor 5 (IRF5) of the health controls and systemic lupus erythematosus (SLE) patients and analyze the relationship between IRF5 and SLE disease activity. Methods Peripheral blood monoeytes (PBMCs) from SLE patients and healthy donors were separated with Ficoll density gradient eentrifugation and total cellular RNA was isolated with Trizol from the PBMCs, the mRNA was reverse transcripted to cDNA. Real-time PCR was applied to determine the expression level of IRFS. The expression level of IRF5 between the two groups were compared. The correlations of expression level of IRF5 with SLE disease activity and other laboratory or clinical parameters of SLE patients were analyzed. Results The level of IRF5 was (2.1±2.2) in SLE patients and (1.5±1.2) in healthy controls, the difference was not statistically significant (P=0.161). And the levels of IRF5 in SLE patients were significantly correlated with their SLEDAI (r=0.616,P<0.01), but not correlated with other parameters such as bemoglobulin complements, immunoglobulin etc. Anti-dsDNA antibody positive patients had significantly higher expression of IRF5 compared to the anti-dsDNA-antibedy-negative patients. The IRF5 mRNA levels of SLE patients with fever or neuropsyehiatric symptoms were significantly higher than those of patients free of neuropsychiatrie involvement. Conclusion High expression level of 1RF5 may contribute to the pathogenesis of SLE in disease activity and antibody production.

Objective: To explore the application of extensive pterional approach combined with cutting of the zygomatic arch for the resection of large sphenoid ridge meningioma. Methods: Thirty-three patients with large sphenoid ridge meningioma underwent operation using the extensive pterional approach combined with cutting of the zygomatic arch. Twenty patients with large sphenoid ridge meningioma received operation with the traditional pterional approach as the control. The resection rate, operative time, intraoperative blood loss, and postoperative complications were compared between the groups. Results: Two groups of patients underwent craniotomy under microscope. The Simpon grade I resection and grade Ⅱ resection rate was 93.9％ in the cutting of the zygomatic arch approach group and 60.0％ in the control group (P<0.01). The operative time was (325.2±121.3) min in the cutting of the zygomatic arch approach group, which was significantly shorter than that in the control group with (406.4±182.9) min (P<0.05). The intraoperative blood loss was (502.5±101.8) mL and (697.7±115.4) mL in the two groups (P<0.05). In addition, postoperative complication rate was 15.2％ and 45.0％ in the cutting the zygomatic arch approach group and the control group, respectively (P<0.05). No death was reported in both groups. Conclusion: Extensive pterional approach combined with cutting of the zygomatic arch can fully expose the anatomical structures of the skull base and the sellar region to eliminate the influence of temporal muscle in the exposure of the surgical area. The operative field is exposed to reduce the stretch injury to only the frontotemporal brain tissue, which might be helpful for the complete resection of large sphenoid ridge meningioma, and is more conducive to neurovascular anatomy and relevant functional protection.