Objective To explore the effect of the vitreoretinal surgery on the complicated retinal detachment.Methods We collected the clinical data of 50 cases with complicated retinal detachment treated by vitreoretinal surgery combined with the methods of vitrectomy,membrane excision,perfluorocarbon liquids,retinal coagulation of laser or condensate,exchange between silicon oil and gas perfluorocarbon liquids,silicon oil fill.The period of follow up was 3 to12months.Results The retina was attached completely in 46 cases(92%).4 cases did not reset auownting for 8%.The sight of all eyes was improved in varying degrees.Conclusion Vitreoretinal surgery is an effectial way for treat complicated retinal detachment.

Objective To investigate the effects of different doses of remifentanil on the renal ischemiareperfusion (I/R) injury in rats. Methods Sixty male SD rats weighing 220-250 g were randomly divided into 5 groups ( n = 12 each): sham operation group (group S), model group (group M), low, median and high doses of remifentanil groups (RL, RM and RH groups). The rats were anesthetized with intraperitoneal 5% chloral hydrate 6 ml/kg. Renal ischemia was induced by clamping the bilateral renal arteries for 45 min using an atraumatwere infused via the caudal vein 15 min before ischemia respectively and the infusion was stopped at 30 min of reperfusion, while S and M groups received equal volume of normal saline instead. Blood samples were collected from the femoral vein at 30 min and 24 h of reperfusion for measurement of serum creatinine (Cr) and blood urea nitrogen (BUN) concentrations. The rats were sacrificed at 24 h of reperfusion and the renal tissues were removed for determination of MDA content, SOD and Ca2+ -ATPase activities. Pathological changes in renal tissues were observed with light and electron microscopes. Results Compared with group S, the concentrations of serum Cr and BUN and content of MDA were significantly increased, while activities of SOD and Ca2+ -ATPase were significantly decreased in the other 4 groups ( P ＜ 0.05 or 0.01). Compared with group M, the concentrations of serum Cr and BUN and content of MDA were significantly decreased, activities of SOD and Ca2+ -ATPase were significantly increased (P ＜0.05 or 0.01) and the pathological changes were reduced in RH, RM and RL groups. The plasma BUN and Cr concentrations and MDA content were decreased gradually and SOD and Ca2+ -ATPase activities were increased gradually with the increase in the doses of remifentanil in RL, RM and RH groups ( P ＜ 0.05 or 0.01 ).Remifentanil infusion significantly attenuated the pathologic changes in a dose-dependent manner. Conclusion Remifentanil can reduce the renal I/R injury in a dose-dependent manner by inhibiting lipid peroxidation and increasing Ca2+ -ATPase activity.

Objective To examine the consistency between asthma children's self-assessment health-related quality of life and their proxies' assessment, to give theoretic basis of clinical treatment for asthma children. Methods Parents and asthma children completed the PedsQLTM 4.0 Generic Core Scales and PedsQLTM 3.0 Asthma Module during an outpatient visit or in the hospital. Wilcoxon signed rank test and ICC were used to compare the difference between asthma children's self-report and their proxies' report. Results The findings indicated that neither the total scores nor domain scores (except physiological domain) between asthma children's self-reports and proxies' reports (parents most of all)showed inconsistency. The value of ICC was not less than 0.7 except physiological dimension and showed consistency. Some different information in several domains was founded by the scores after layered by age. Conclusions There are consistency between children's self assessment of health-related quality of life and their proxies' assessment based upon results of PedsQLTM scale.

UNLABELLEDThis experiment was aimed to study the effects of different concentrations of medroxyprogesterone acetate (MPA) on proliferation, migration and apoptosis of endothelial progenitor cells (EPCs) in vitro and to provide experimental evidence for the use of MPA as anti-angiogenesis drug. We separated EPCs from bone marrow of a beagle dog and identified the expression of progesterone receptor (PR) in EPCs by immunocytochemistry. Proliferation tests (MTT analysis) were performed with EPCs in response to different concentration of MPA every 24 h for 7 consecutive days, the growth curve of these EPCs was obtained then. The inhibition rates were also obtained from MTT assay performed with EPCs exposed to different concentration of MPA. The migration tests were performed with EPCs in response to different concentrations of MPA. The cell cycle and apoptosis of EPCs exposed to different concentrations of MPA were analyzed by use of flow cytometry.

RESULTSImmunohistochemical staining showed that EPCs were positive to PR. High concentration of MPA had significant inhibition effect on the growth of EPCs. This effect was time- and dose-dependent. But the low concentration of MPA had not have such effect, EPCs exposed to high concentration of MPA were found arrested in S phase, and the apoptosis rate increased. The migration ability of EPCs exposed to high concentration of MPA was also damaged.

CONCLUSIONHigh concentration of MPA can induce EPCs' apoptosis and inhibit their growth and migration. All these biological effects of MPA may be achieved through PR on EPCs.

Angiogenesis Inhibitors ; pharmacology ; Animals ; Apoptosis ; drug effects ; Cell Movement ; drug effects ; Cell Proliferation ; drug effects ; Cells, Cultured ; Dogs ; Dose-Response Relationship, Drug ; Endothelial Cells ; cytology ; Female ; Medroxyprogesterone Acetate ; pharmacology ; Neovascularization, Physiologic ; drug effects ; Stem Cells ; cytology

This study was aimed to assess the effects of fluid shear stress on the bone resorption in rat osteoclasts. The osteoclasts were derived from the lumbar vertebrae marrow cells which were isolated from the 6-month-old female Sprague Dawley rats, cultured on the slide at 1 x 10(6) cell/ml, and induced with 1, 25 (OH)2 Dihydroxyvitamin D3. The slide containing osteoclasts was taken out on day 7 after culture and then put into the flow chamber. The loads of fluid shear stress applied to the osteoclasts were 5.97, 11.36, 16.08 and 20.54 dyne/cm2, respectively, for 30 minutes. The osteoclasts unloading fluid shear stress were used as control. The bone resorptive pits were studied by light microscopy and scanning electron microscopy. The tartrate-resistant acid phosphatase (TRAP) secreted by osteoclasts was detected with ultraviolet spectrophotometry. The results showed that fluid shear stress can increase the activity of TRAP and significantly increase the number and area of bone resorptive pits made by osteoclasts,and the effect of fluid shear stress on the bone resorption of osteoclasts is the same as that on the activity of TRAP. The reaction of the osteoclasts to the fluid shear stress in this study also suggested that the bone resorption of osteoclasts be increased in a magnitude of fluid shear stress-dependent manner, and that the changes of TRAP activity be closely related to the changes of the number and area of resorptive pits of the osteoclasts.
Acid Phosphatase ; metabolism ; Animals ; Bone Resorption ; physiopathology ; Calcitriol ; pharmacology ; Cells, Cultured ; Female ; Isoenzymes ; metabolism ; Lumbar Vertebrae ; cytology ; Osteoclasts ; cytology ; enzymology ; physiology ; Rats ; Rats, Sprague-Dawley ; Shear Strength ; Tartrate-Resistant Acid Phosphatase

Objective To evaluate the effect of dexmedetomidine pretreatment on expression of se-cretion protein of Clara cell secretory protein(CC16)during endotoxin-induced acute lung injury(ALI) in rats.Methods One hundred and twelve healthy Wistar rats of both sexes, aged 8-12 weeks, weighing 250-350 g, were divided into ALI group(n=56)and dexmedetomidine pretreatment group(group DEX, n= 56)using a random number table.ALI was induced by intravenously injecting lipopolysaccharide (LPS)5 mg∕kg over 1 min.Dexmedetomidine 10 μg∕kg was intravenously infused over 10 min starting from 10 min before LPS in group DEX.At 10 min before LPS injection and 0.5, 1, 2, 4, 6 and 24 h after LPS injection, 8 rats were sacrificed and lungs were removed for examination of the pathological changes(with a light microscope)and ultrastructure of Clara cells(with a transmission electron microscope)and for deter-mination of CC16 expression in bronchioles(by immunohistochemistry). Results Compared with the baseline at 10 min before LPS injection, the expression of CC16 in bronchioles was significantly down-regu-lated at 1, 2, 4, 6 and 24 h after LPS injection in group ALI and at 1, 2, 4 and 6 h after LPS injection in group DEX(P<0.01), the pulmonary small arterial hyperemia, alveolar septa edema, red blood cell exudation and inflammatory cell infiltration were found, the Clara cells in bronchioles were reduced, the secretory granules in the cytoplasm were reduced, and the mitochondria were swollen and deformed after in-jection of LPS.Compared with group ALI, the expression of CC16 in bronchioles was significantly up-regu-lated at 1, 2, 4, 6 and 24 h after LPS injection(P<0.01), the pathologic changes of lung tissues were significantly attenuated, and the number of Clara cells was increased in group DEX.Conclusion The mechanism by which dexmedetomidine pretreatment reduces endotoxin-induced ALI may be related to up-regulating CC16 expression in rats.

Objective To evaluate the safety and efficacy of endoscopic ultrasound (EUS) guided ethanol ablation of benign insulinoma and compare its' advantages and disadvantages with surgical treatment. Methods From April 2011 to February 2016, clinical data of 38 patients with benign insulinoma treated by EUS-guided ethanol ablation or surgical treatment were retrospectively analyzed. Results 97.4% (37/38) patients had a typical clinical manifestation of Whipple's triad, and the I/G ratio of 82.9% patients (29/35) was more than 0.3 with their onset of hypoglycemia. The positive preoperative etiologic diagnosis rates of transabdominal ultrasonography, CT, MRI, PET/CT and EUS were 50.0%, 67.6%, 66.7%, 75.0%, 89.7% respectively. In the current study, 18 patients underwent EUS-guided ethanol ablation (EUS-FNI group) and 20 patients received surgicaltreatment (surgical group). Compared with the surgical group, the operation time, intraoperative hemorrhage volume, postoperative complications, length of stay and hospitalization costs were significantly reduced in the EUS-FNI group (P < 0.05). No treatment-related complications was observed in EUS-FNI group, while 40.0% (8/20) patients in surgical group had complications. During the follow-up period, all these patients maintained stable blood glucose without taking medication, and there's no recurrence of insulinoma in EUS-FNI group after the last treatment with alcohol injection; In surgical group, only 90.0% (18/20) patients had no recurrence, episode of hypoglycemia was less after the operation in 10.0% (2/20) patients. Conclusion EUS-guided ethanol ablation of benign insulinoma is safe and effective, compared with traditional surgical treatment, EUS-guided ethanol ablation is minimally invasive, costs less, recovers fast after treatment and has fewer complications.

Objective: To study the correlation between fractional exhaled nitric oxide (FeNO) and lung function in young children for acute attack of wheezing, and to compare the FeNO in different stages in order to explore the best suitable time for the experiment of FeNO in young children by the method of on-line tidal breathing. Methods: Recurrent wheezing children aged 1-5 year old were selected who were underwent the test at lung function laboratory from January 2016 to March 2018, at Guangzhou Women and Children′s Medical Center.The children aged less than 5 years old were detected for FeNO in both stages of acute exacerbation and 2 weeks after treatment, and the children aged less than 3 years were also detected for the tidal lung function in the acute exacerbation stage.According to time ratio of reaching tidal peak flow to total expiratory time(TPTEF/TE )and ratio of volume at tidal peak flow to total tidal volume (VPEF/VE), the children aged less than 3 years were divided into 4 groups (normal group, mild group, moderate group and severe group). Results: The FeNO of the normal group[9.85(5.17, 19.62) ppb] and mild group[13.00(7.00, 23.30) ppb] were significantly higher than that of the severe group [3.10(2.20, 5.25) ppb], and the differences were statistically significant(all P<0.05). And there was a positive correlation between TPTEF/TE and FeNO(r=0.304, P<0.05), VPEF/VE and FeNO(r=0.320, P<0.05), tidal volume per kilogram(VT/kG)and FeNO(r=0.293, P<0.05)and a negative correlation between respiration rate(RR)and FeNO(r=-0.449, P<0.05). The FeNO in the stage of acute exacerbation was significantly lower than that in the stage of 2 weeks after treatment[(10.49±8.49) ppb vs.(20.41±9.13) ppb], and there was a significant difference among them(t=-5.79, P<0.01). Conclusions If researchers want to use the method of on-line breathing to test FeNO in young children with wheezing, they should choose the time of 2 weeks after treatment, and analyze the results combined with the lung function.

Objective To evaluate the feasibility and safety of tracheal extubation in operating room for patients with end-stage chronic obstructive pulmonary disease (COPD) after single-lung transplantation. Methods Clinical data of 57 recipients who underwent single-lung transplantation due to end-stage COPD were retrospectively analyzed. According to the evaluation indexes of tracheal extubation in operating room established by our hospital, 17 recipients eligible for tracheal extubation in operating room were assigned into the operating room extubation group (OR extubation group) and 40 recipients receiving tracheal extubation in intensive care unit (ICU) were allocated in the ICU extubation group. The evaluation results of intraoperative tracheal extubation and postoperative recovery were compared between two groups. Results Compared with the ICU extubation group, recipients in the OR extubation group had higher oxygenation index, lower arterial partial pressure of carbon dioxide (PaCO₂), lower blood lactic acid level, less fluctuation range of blood pressure and fewer cases receiving extracorporeal membrane oxygenation (ECMO) during operation (all P < 0.05). Two recipients in the OR extubation group received repeated tracheal intubation at 6 and 8 h after returning to ICU, and tracheal extubation at postoperative 6 and 9 d. In the OR extubation group, time of postoperative mechanical ventilation, length of postoperative ICU and hospital stay of the recipients were shorter than those in the ICU extubation group (all P < 0.05). The incidence of grade 3 primary graft dysfunction (PGD), atrial tachyarrhythmia, continuous renal replacement therapy and 1-year survival rate did not significantly differ between two groups (all P > 0.05). Conclusions The tracheal extubation regimen in the operating room for COPD patients after single-lung transplantation established by our hospital is safe and feasible, which shortens the time of postoperative mechanical ventilation, the length of postoperative ICU and hospital stay, whereas does not increase the incidence of postoperative complications.

Objective:To investigate correlation between neutrophil extracellular traps(NETs) formation and T cell subsets in mice with experimental autoimmune thyroiditis(EAT) and the impact of active vitamin D intervention.Methods:Six-week-old female BALB/c mice were randomly divided into Control group, EAT group and 1, 25 dihydroxy vitamin D 3[1, 25(OH) 2D 3] treatment group(VitD group; n=6/group). HE staining was used to observe thyroid pathology. Plasma thyroglobulin antibody(TGAb), thyroid peroxidase antibody(TPOAb), and 1, 25(OH) 2D 3 were measured by ELISA. Peripheral NETs formation, Th1, Th2, and Th17 cell ratio from spleen were measured by flow cytometry. Correlation between NETs formation rate and Th1, Th2, and Th17 cell ratio was analyzed. Results:Compared with Control group, mice in EAT group had significantly increased thyroid inflammation scores, thyroiditis morbidity, TPOAb, TGAb levels, NETs formation rate, Th2(CD4 + IL-4 + or CD4 + IL-13 + )and Th17 cell proportions( P were <0.001, 0.002, 0.007, <0.001, <0.001, 0.003, 0.001, and 0.002, respectively), and significant decreased 1, 25(OH) 2D 3, Th1 cell proportions, Th1/Th2(CD4 + IL-4 + ), Th1/Th2(CD4 + IL-13 + ), and Th1/Th17 ratios( P were 0.010, 0.018, 0.010, 0.005, and 0.007, respectively). Compared with the EAT group, the VitD group had lower thyroid inflammation scores, TPOAb, TGAb levels, NETs formation rate, Th2(CD4 + IL-4 + or CD4 + IL-13 + ) and Th17 cell proportions( P were 0.044, 0.007, <0.001, 0.001, 0.014, 0.008, and 0.001, respectively), and significant higher Th1 cell ratio, Th1/Th2(CD4 + IL-13 + ) and Th1/Th17 ratio( P were 0.011, 0.009, and 0.003, respectively). The Th1/Th2(CD4 + IL-4 + ) was not significantly increased in VitD group compared with EAT group( P=0.174). NETs formation rate was positively correlated with Th2(CD4 + IL-4 + or CD4 + IL-13 + ) and Th17 cell proportion( r were 0.65, 0.59, and 0.61; and P were 0.004, 0.010, and 0.007, respectively), but not with Th1 cell proportion( r=-0.47, P=0.051). Conclusion:EAT mice were more prone to NETs formation. Active vitamin D may relieve immune imbalance with increased Th2 and Th17 cell ratio and decreased Th1 cell ratio by reducing the formation of NETs in EAT mice. Vitamin D played the protective role in thyroid by reducing thyroid pathological damage and thyroid autoantibody levels, and relived overall lymphocyte imbalance.