Objective To observe the imaging features of ultra-wide field short wave fundus autofluorescence (SW-FAF) in eyes with multiple evanescent white dot syndrome (MEWDS),and analysis the correspondence to conventional images.Methods It was a retrospective case series study.Thirteen patients (14 eyes) diagnosed with MEWDS were enrolled.There were 12 females and 1 male,aged from 22 to 57 years,mean age was 34.5 years.All the eyes underwent fundus color photography,optical coherence tomography (OCT) and ultra-wide field autofluorescence (FAF).Simultaneous fundus fluorescein angiography (FFA) and indocyanine green angiography (ICGA) were performed in 6 eyes.The characteristic changes of SW-FAF in studied eyes were observed and compared with the images of FFA and ICGA.All the eyes were followed up every 1 to 2 weeks,with an average of 16.7 weeks.The characteristic images of SW-FAF and corresponding OCT were studied during follow up.Results MEWDS presented with numerous multiple hyper-autofluorescent spots,sized from 50-500 μm,with a vague boundary in ultra-wide field SW-FAF.These spots located mainly at the peripapillary area and the posterior pole with a confluent pattern.The lesions extended to the mid-peripheral retina as well and became more scattered.The distribution of the hyper-autofluorescent lesions in SW-FAF corresponded roughly to that of the greyish-white spots seen in color photograph and the hyper-fluorescent spots detected by FFA.It was consistent with the distribution of hypo-fluorescent spots in late-phase ICGA as well.But the number of the spot showed in FAF is much more than that in FFA,and slightly less than that in ICGA.The OCT scans through the hyper-autofluorescent lesions in SW-FAF showed impairment of outer retina.After the recovery,the hyper-autofluorescent spots disappeared with the outer retina structure repaired completely.Conclusions MEWDS presented with numerous multiple hyper-autofluorescent spots which located mainly at the peripapillary area in ultra-wide field SW-FAF.The distribution of the hyper-autofluorescent lesions in SW-FAF corresponded roughly to color photograph,FFA and ICGA in late-phase.The OCT scans through the hyper-autofluorescent lesions in SW-FAF showed impairment of outer retina.

Objective Based on animal model of left ventricular pressure overload induced cardiac fibrosis,to investigate the specific role and molecular mechanism of KLF15 gene in this process.Methods To establish rat animal model of pressure overload induced cardiac hypertrophy by aortic coarctation under non artificial ventilation conditions,and then release the constriction,to observe the rat heart color Doppler images,myocardial interstitial fibrosis features and protein expression level changes of KLF15、Transforming growth factor-β (TGF-β) 、Connective tissue growth factor (CTGF)、Myocardin-related transcription factor A(MRTF-A) in overload-unload corresponding time points.Results We successfully completed aortic banding and debanding operations by use of SD rats without artificial ventilation.Through color Doppler echocardiography detection,from images to know:the effect of constriction and loosening is definite.The expression of collagen type Ⅰ,collagen type Ⅲ,TGF-β,CTGF,MRTF-A were significantly higher and myocardial hypertrophy was aggravated but the KLF15 protein expression level was significantly lower in pressure overloaded rats than in Sham rats(all P ＜ 0.05).All values were in an increasing tendency with the constrictive time prolonged (P ＜ 0.05).The response to unloading was opposite,the sooner to loose the better to the recovery to normal.The differences of indicators are very notable (P ＜ 0.05).Conclusion By feedback regulation TGF-β,KLF15 inhibited the effect of CTGF and MRTF-A,reducing myocardial interstitial fibrosis.

Objective The purpose of this study was to study the correlation between dental fluorosis, saliva and plaque fluoride levels and urinary fluoride values in adolescents dental fluorosis. Methods A middle school was chosen as a survey point in the study. Two hundred adolescents were examined the degree of dental fluorosis by Dean's method. These adolescents were divided into four groups according to the severity of fluorosis (n = 52, 40, 28 and 80). Fluoride ion specific electrode was used to measure the fluoride levels in dental plaque, saliva, urinary and drinking water. The differences were analyzed b y ANOVA. Correlation of the fluoride levels between dental plaque, saliva, urine and the degree of dental fluorosis were analyzed by the method of multiple linear regression. Results The average fluoride content of drinking water was (2.20 ± 0.40) mg/L. Compared with controls, the fluoride concentrations in dental plaque, saliva and urine were higher in light, medium and severe dental fluorosis groups [(1.55 ± 0.88), (1.94 ± 0.77), (2.74 ± 0.83) than (0.32 ± 0.20) mg/L; (4.44 ± 1.62), (8.09 ± 0.93), (10.72 ± 0.99) than (0.02 ± 0.01) mg/L;(31.77 ± 6.09), (57.98 ± 1.83), (65.98 ± 2.78) than (13.06 ± 2.11) μg/g, all P<0.05]. Urinary fluoride was correlated with fluoride in saliva and dental plaque (r=0.245, 0.440, all P<0.05). Saliva fluoride was correlated with fluoride in dental plaque (r=0.849, P<0.01). The degree of dental fluorosis was correlated with fluoride in urine and saliva (r = 0.497, 0.896, 0.924, all P< 0.01). The multiple linear regression equation between fluoride in urine and the degree of dent al fluorosis, fluoride in dental plaque and saliva was as follow: y = 1.357 + 1.618x1 + 0.001x2 - 0.331x3 ± 0.69. Conclusions The metabolism of fluoride in body is related with oral fluoride repository in adolescents dental fluorosis. Fluoride in urine is influenced by plaque fluoride level, saliva fluoride concentration and the degree of dental fluorosis.

Objective:To study the effects of dental fluorosis on the tooth movement following extraction of adjacent tooth in adoles-cents for orthodontic treatment.Methods:50 adolescents were divided into mild(n =1 3),moderat(n =1 0),severe(n =7)and healthy control(n =20)groups according to the fluorosis severity using Dean's index.4 4 were extracted and appliance was applied. X-ray image was taken 1 week and 1 ,2 and 3 months after appliace activation.Tooth movement was measured cephalometrically by Auto CAD.Results:Tooth moving distance was more(P <0.01 )and the alveolar bone resorption area was smaller in fluorosis group than those in healthy control group(P <0.01 )1 ,2 and 3 months after appliance activation.The moving distance was negativelly relat-ed with bone remodling area(P <0.05).Conclusion:Adolescent dental flurosis play an important role in bone remdodeling in extra-tion sites and tooth movement during orthodontic treatment.

The expression of Attractin mRNA and protein in testis and semen of human and male mice was investigated. Human testis and semen samples were all collected from Reproductive Center of Renmin Hospital, Wuhan University in December, 2012. Testis samples were collected from 7 cases of obstructive azoospermias when they were subjected to diagnosed testis biopsy, and 30 normal human semen samples were obtained from those cases of semen analysis. Adult mice testis tissues were obtained from 10 2-month-old male BALB/c mice, and 60 male mice at different ages were classified into 10 groups (day 1, 5, 10, 15, 21, 28, 35, 42, 56, and 120 respectively, n=6 each). The expression of Attractin mRNA and protein in testis was detected by RT-PCR and Western blotting respectively. Human semen samples were centrifuged into sperm plasma (SP) and sperm extract (SE), and mice sperm samples were collected from the epididymis of 10 adult male BALB/c mice. Western blotting was used to determine the Attractin protein expression level. Attractin mRNA and protein were expressed in the testis of both patients with obstructive azoospermias and adult Bcl/B mice. Quantitative RT-PCR revealed that no Attractin mRNA was detectable in day 1 male BALB/c mice group. The Attractin mRNA and protein levels were low on the day 10, and increased with age until day 56. On the day 120, the expression levels of Attractin were decreased. As for human semen samples, Attractin protein was expressed in both SP and SE, but didn't exist in samples from the epididymis of male BALB/c mice. It was suggested that Attractin acted as a novel active substance and was involved in male reproduction in both human and BALB/c mice, but it exerted a different expression profile in different mammal species.

Objective To explore the cinical ,endoscopic and endoscopic ultrasonography (EUS) manifestations of upper gastro-intestinal heterotopic pancreas(HP) and the treatment value .Methods The clinical data in 35 cases of upper gastrointestinal HP confirmed by pathology in our hospital were retrospectively analyzed for summarizing its clinical symptoms ,endoscopic and EUS manifestations and the treatment effect under endoscopy .Results Among all the 35 cases ,the cinlincal symptoms were in 30 cases , upper abdominal pain in 18 cases ,abdominal distension in 5 cases ,belching in 4 cases ,melena in 3 cases ,the lesion was located in gastric antrum in 23 cases ,in gastric body in 3 cases ,in gastric fundus in 3 cases ,in gastric angle in 2 cases ,in the junction of gastric antrum and corpus ventriculi in 2 cases ,in durodenal bulb in 2 cases ,most HP were represented by protuberant lesions under endos-copy ,the diameter of the lesions ranged 0 .5-2 .0 cm .20 cases were centrally umbilicated hollow with ducts opening on the top of the protuberant lesion .Under EUS ,the lesions involved submucosa in 28 cases ,mucosa in 2 cases ,muscularis mucosae in 4 cases , and muscularis propria in 1 case .4 cases appeared as the midium echo ,24 cases as hypoecho and 7 cases as mixed echo ,among them ,the tubular structure echo within the lesions were found in 10 cases .20 cases were treated by endoscopic mucosal resection (EMR) ,15 cases were performed the ligation combined with the high frequency electroresection .Intraoperative bleeding occurred in 3 cases and no other complicntions such as perforation occurred .Conclusion The clinical manifestations of upper gastrointestinal HP have no specificity .Gastroendoscopy combimed with EUS has the important value in the diagnosis and endoscopis therapy .En-doscopic EMR and ligation combined with the high frequency electroresection are the safe and effective means for treating upper gastrointestinal HP .

Objective To investigate the risk factors of multiple recurrent bile duct stones in patients with common bile duct (CBD) stones and received endoscopic sphincterotomy (EST ) treatment . Methods From June 1st ,2007 to June 1st ,2011 ,the patients received EST treatment were followed up , the follow‐up time was three to seven years .A total of 2 738 patients were successfully followed up , including 24 patients with two or more than two times of recurrent bile stone after EST who were enrolled in multiple recurrence group .One hundred patients without recurrence were randomly selected by table of random number as control group .The clinical data of two groups were compared by t test or Chi‐square test .The factors were analyzed with multivariate Logistic regression analysis and try to find out the risk factors of multiple recurrence .Results The comparative analysis between two groups showed that the three factors of juxtapapillary duodenal diverticula [17 .0% (17/100 ) vs 41 .7% (10/24 )] ,history of biliary tract surgery [13 .0% (13/100) vs 45 .8% (11/24)] and the angle enclosed between the horizontal portion of the CBD and the horizontal plane (angleofbile duct) less than 45° [2 .0% (2/100) vs 20 .8% (5/24)] were statistically significant (χ2 = 6 .914 、13 .37 、9 .595 ,all P < 0 .01 ) . Furthermore , logistic regression analysis indicated that juxtapapillary duodenal diverticula (B = 1 .421 ,OR = 4 .142 ,P = 0 .01) , history of biliary tract surgery (B = 1 .612 ,OR = 5 .011 ,P= 0 .004) and the angle of bile ductless than 45° (B= 2 .661 ,OR= 14 .31 ,P= 0 .005) were risk factors of multiple recurrence .Conclusion Juxtapapillary duodenal diverticula , history of biliary tract surgery , and the angle of bile duct less than 45° are independent risk factors of multiple recurrence of CBD stones .

In recent years, through the measurement and analysis of size ratio(SR), inflow angle (IFA), volume-to-ostium ratio(VOR), flow angle(FA), parent-daughter angle(PDA), A1- A2 diameter ratio(A1/A2), a ratio of aneurysm volume to bounding sphere volume(AVSV), a ratio of aneurysm surface to bounding sphere surface (AASA), some international scholars assessed aneurysm rupture risk, and had made some preliminary progress. Research showed that the geometry parameters had the objective significance for the evaluation of the risk of aneurysm rupture, and the bigger the SR, IFA, VOR, FA, A1/A2, AVSV, AASA, the easier the rupture of aneurysms. The smaller the PDA, the easier the rupture of the aneurysms.

Objective To assess the risk factors of intradialytic-hypotension (IDH) and the prognosis of IDH among maintenance hemodialysis (MHD) patients for the prevention and treatment of IDH.Methods 276 MHD patients were enrolled during Jan.2009 to Mar.2009.Intradialytic blood pressure was monitored during a 3-month period.IDH was defined as an event characterized by a sudden drop in systolic BP more than 20 mmHg or in mean artery pressure (MAP) more than 10 mmHgassociated with clinical events and need for interventions.Dialysis-related information was collected.Kaplan-Meier method,log-rank test,logistic regression and Cox regression analyses were performed to examine the association between IDH and survival,using a follow-up through 31 May 2014.Results A total of 276 patients were recruited.The incidence rate of IDH was 40.9％.163 patients with no-IDH (＜ 1/10 hypotensive events/3 months) served as controls.113 patients with IDH (≥ 1/10 hypotensive events/3 months) were identified among all 276 patients.Multivariate logistic regression analysis showed that age,ultrafiltration rate,gender,serum NT-proBNP,serum albumin and aortic rool inside dimension (AoRD) were associated with IDH among MHD patients.During the 5-year follow-up,74 patients died,with a mortality rate 5.2 per 100 person-year.Kaplan-Meier survival curve showed significant difference of overall and CV mortality rates between 2 groups.The multivariate Cox regression model indicated that IDH increased the risk of death (HR=1.572,95％CI 1.077-2.293,P=0.019).So did the rise of LVMI (HR=1.010,95％CI 1.009-1.085,P=0.020).Conclusion Elderly,female,high ultrafiltration rate,high level of serum NT-proBNP,hypoalbuminemia and shorter AoRD are independent risk factors for IDH among MHD patients.LVMI can predict the outcome of MHDpatients.Intradialytic hypotension is an independent risk factor for long-term mortality in MHD patients.

Objective To assess the risk factors of intradialytic-hypotension (IDH) among maintaining hemodialysis (MHD) patients and to explore the relation between NT-proBNP and IDH,thus to provide clinical evidence for the prevention and treatment of IDH.Methods A total of 202 MHD patients during March 2009 to May 2009 in our dialysis center were enrolled in the study.Intradialytic blood pressure (BP) was measured during a 3-month period.IDH was defined as an event characterized by a sudden drop in systolic BP more than 20 mm Hg or in mean artery pressure (MAP) more than l0 mm Hg.Logistic regression analysis was used to assess the risk factors of IDH.ROC curve was used to evaluate the diagnostic efficacy of serum NT-proBNP.Results The incidence of IDH was 42.1％.One hundred and seventeen patients with no-IDH (＜1/10 hypotensive events per 3 months) were served as controls.Fifty-five patients with o-IDH (≥ 1/ 10 but ≤1/3 hypotensive events per 3 months) and 30 patients with f-IDH (＞1/3 hypotensive events per 3 months) were identified among 202 patients.Multivariate regression analysis showed that age,gender,ultrafiltration rate,serum NT-proBNP,serum albumin,aortic root dimension (AoRD) were associated with IDH among MHD patients.Serum NT-proBNP was positively correlated with IDH.The area under the ROC curve (AUC) of NT-proBNP was 0.76 (95％ CI 0.69 to 0.83,P＜0.01).The cut-off value of serum NT-proBNP for IDH was 1746.5 ng/L,with a sensitivity of 88.61％ and a specificity of 51.10％.Furthermore,the AUC of NT-proBNP for f-IDH was 0.65 (95％ CI 0.53 to 0.763,P＜0.01).The cut-off value of serum NT-proBNP for f-IDH was 8208.0 ng/L,with a sensitivity of 33.33％ and a specificity of 91.30％.Conclusions Elderly,female,high ultrafiltration rate,high level of serum NT-proBNP,hypoalbuminemia,shorter AoRD are independent risk factors of IDH among MHD patients.Serum NT-proBNP can be used as a predictor of IDH.