Background Choroidal neovascularization (CNV) of macular zone is one of blinding eye diseases.Conventional treatment methods include photodynamic therapy and intravitreal injection of anti-vascular endothelial growth factor (VEGF) drugs.However,there are some adverse effects following these treatments.Researches showed that fiajianzhujing decoction,a Chinese herbal medicine,can inhibit CNV.Objective This study was to investigate the impact of drug serum offiajianzhujing decocation (drug serum) on the proliferation of rat choroidal vascular endothelial cells (RCVECs).Methods Jiajianzhujing decoction (0.525 g/ml) was used by intragastric administration with the dosage 20 ml/kg for 3 days,and the abdominal aortic blood was collected 2 hours after last dosage to prepare the drug serum.Cultured RCVECs were divided into 4 groups.CoCl2 with the concentration of 100 μmol/L (100 μl) was added in the medium to establish the anoxic models in the CoCl2 group,and 20％ drug serum was added in the anoxic culture medium in the drug serum+CoCl2 group.Regular culture medium was used in the blank control group,and 20％ pure serum was added in the anoxic culture medium in the pure serum+CoCl2 group.The cells were incubated for consecutive 24 hours,and the growth of the cells was detected by monotetrazolium (MTT) assay as absorbance (A).The expressions of gene and protein of hypoxia-inducible factor-1 α (HIF-1 α) and VEGF in the cells were detected by reverse transcription PCR and Western blot,respectively.This study was approved by the Ethics Committee of Eye Hospital of China Academy of Chinese Medical Sciences.Results Cultured cells grew well with fusiform shape.Hypoxic cell models were created by adding CoCl2.The mean A values were 0.659± 0.051,0.757±0.553,0.683±0.037 and O.731 ±O.038 in the blank control group,CoCl2 group,drug serum+CoCl2 group and pure serum+CoCl2 group,respectively,and the A value in the CoCl2 group was significantly elevated in comparison with the blank control group and drug serum+CoCl2 group (both at P＜0.O1).The significant differences were found in the relative expressions of HIF-1 α and VEGF among the blank control group,CoCl2 group,drug serum+ CoC12 group and pure serum+CoCl2 group (HIF-1 α:F =3.100,P＜0.05;VEGF mRNA:F =3.420,P＜0.05;HIF-1 α protein:F=470.600,P =0.000;VEGF protein:F =146.700,P =0.000),and the relative expressions of HIF-1α mRNA,VEGF mRNA,HIF-1α protein and VEGF protein in the CoCl2 group were significantly higher than those in the blank control group and drug serum+CoCl2 group (all at P＜0.05).Conclusions Drug serum ofjiajianzhujing decoction can inhibit the growth and proliferation of hypoxic RCVECs by down-regulating the secretion of HIF-1α and VEGF.

Objective To study the chemical constituents from the exocarp of Juglans mandshurica.Methods The compounds were isolated by Diaion HP-20,Sephadex LH-20,MCI CHP-20,and silica gel column chromatography.Their structures were identified by physicochemical properties and spectroscopic analysis.Results Twelve compounds were elucidated as pinostrobin (Ⅰ),quercetin (Ⅱ),quercetin-3-O-?-D-glucoside (Ⅲ),chrysophanol (Ⅳ),gallic acid (Ⅴ),4-hydroxyl-cinnamic acid methyl ester (Ⅵ),vanillin (Ⅶ),caffeic acid (Ⅷ),4-hydroxylcinnamic acid (Ⅸ),?-sitosterol (Ⅹ),daucosterol (Ⅺ),and 5-hydroxyl-1,4-naphthoquinone (ⅩⅡ).Conclusion The compounds Ⅰ,Ⅳ,and Ⅵ—Ⅸ are isolated from J.mandshurica for the first time.

Objective To evaluate the image quality and obtained by the tube current modulation base on time bolus peak in low voltage in CTPA.Methods 30 consecutive patients suspected pulmonary embolism(PE)were prospectively enrolled,and satisfy the following conditions.The study was performed by 64-slice spiral CT system (lightspeed VCT-XT,GE healthcare),Tube voltage was set at 80 kV.Tube current settings related to the attenuation of ROIs by test bolus peak.The injection parameters were set up by injection flow rate (4 mL/s),contrast medium dose (28 mL),and saline flushing dose (40 mL).All images were evaluated by two observers blinded to pulmonary CTA protocol,including attenuation,noise,SNR and CNR.The image quality was evaluate by 4-score.To evaluate the relationship between influential factor and image quality using Pearson correlation analysis.A P-value <0.05 was considered to indicate a statistically significant difference.Results The time bolus peak was statistically significant influence on attenuation(r=0.398,P =0.029).There was no statistically significant influence on noise (r=0.104,P =0.583),signal-to-noise ra-tio (r=0.263,P =0.1 60)and contrast-to-noise ratio(r=0.299,P =0.109).The other factors(BM,BMI and BSA)was no statisti-cally significant influence on the image quality(P > 0.05 ).The mean attenuation,noise,SNR and CNR on pulmonary trunk was (628.63±146.46)HU,(53.92±14.07)HU,12.02±3.1 7 and 10.81±3.10,respectively.The percentage of assessable pulmonary arteries was 95.82%.Conclusion The tube current modulation base on time bolus peak in low voltage could offer assessable image quality and raise image stability.

Objective:To explore the clinical signiifcance of the protection of superior petrosal vein (SPV) in the microneurosurgery for acoustic neuroma. Methods:From January 2009 to July 2011, 149 cases of acoustic neuroma microsurgery were observed. hTe difference in hematoma in surgical area, cerebellar hematoma and cerebellar edema were compared between a SPV without protection group (SPVWP group, n=8) and a SPV protection group (SPVP group, n=141). Results:In the 149 patients with acoustic neuroma, the SPV was reserved in 141 patients. In the SPVWP group (8 patients), hematoma in the surgery area occurred in 4 patients, cerebellar edema in 5, and cerebellar hemorrhage in 3. In the SPVP group (141 patients), hematoma in the surgery area occurred in 40 patients, cerebellar edema in 56, and cerebellar hemorrhage in 12. hTere was signiifcant difference in the incidence of cerebellar hemorrhage (χ2=3.84, P=0.05), no signiifcant difference in the incidence of hematoma in the surgical area (χ2=0.646, respectively, P=0.422), and no significant difference in the incidence of cerebellar edema (χ2=0.611, P=0.434) between the SPVWP group and the SPVP group. Conclusion:In acoustic neuroma surgery, the SPV should be protected, which may reduce the risk of cerebellar hemorrhage.

Objective To explore the relationship between thoracolumbar disc herniation (TLDH) and Scheuermann1's disease (SD),as well as the role of SD in the etiology of TLDH.Methods From June 2006 to June 2010,45 patients with TLDH (T10-11-L2-3) underwent surgery in our department.Forty-five patients with lower lumbar disc herniation (LDH,L3-4-L5S1) acted as controls.The incidence of SD and Scheuermann's signs of these patients were examined by reviewing CT,MRI and Ⅹ-ray films.The thoracolumbar kyphotic angles of the two groups were compared.Furthermore,in TLDH group,the incidence of disk herniation within segments with the Scheuermann's signs was compared to that within segments without Scheuermann's signs.Results All except one patient in TLDH group(97.8%) had been associated SD while the incidence of SD in LDH group was only 26.7%.The incidence of all Scheuennann's signs was higher in TLDH group than that in LDH group.The average thoracolumbar kyphotic angle of TLDH group was 15.8°±6.9° while that of LDH group was 4.8°±4.0°.In TLDH group,the incidence of disc herniation within segments with Scheuermann's signs was all higher than that within segments without Scheuermann's signs.Conclusion There is a close relationship between TLDH and SD,suggesting that TLDH is probably a manifestation of SD.Schmorl's node,irregular end plate,wedge-shaped vertebra and especially,posterior bony edge separation,are associated with disc herniation.

Objective To summarize the experience of the ventriculoperitoneal shunt (VPS) in communicating hydrocephalus and its complications. Methods The clinical features, operative techniques and outcome of 100 patients with hydrocephalus were analysed retrospectively. Results Ninety-five (95%) cases had a good result. Postoperative complications were found in 6(6%) cases including shunt apparatus blockage (4 cases) and shunt infection (2 cases). All the cases improved after taking the corresponding measures. Conclusion VPS is the most common shunt style for communicating hydrocephalus. The shunt apparatus blockage and infection are common postoperative complications. Intraoperative aseptic technique, the minimally invasive procedure, and the optimal placement of shunt tube may play an important role in improving the outcome of cerebrospinal fluid shunting surgery for communicating hydrocephalus.

Objective To discuss the preservation and clinical significance of petrosal vein in microsurgical operation of acoustic neuroma. Methods 147 patients with acoustic neuroma were operated, with internal decompression of the tumor firstly then dissected the tumor with surrounding structures, the petrosal vein were protected well in 143 cases and failed to protect in 4 cases. Results No hemorrhagic infarction in cerebellar was observed in 143 cases with intact petrosal vein. One case occurred with extensive cerebellar edema, which has gait disturbance after 18 months follow-up. The other three cases occurred with vein infarction and hemorrhagic edema after petrosal vein damage. One was dead and the other two were recovered well after decompression of posterior cranial fossa. One has no significant neurological deficit after 33 months follow-up, while the other has difficulty in line walking after 12 months follow-up. Conclusion Petrosal vein should be well protected in the operation of acoustic neuroma, the decompression of posterior cranial fossa should be considered if petrosal vein failed to protect.

Objective To study the distribution of Nogo-A in the retina and the changes after the optic nerve(ON) injury in hamsters. Methods In this experiment,ON was crushed at 2?mm behind of the eyeball.After 3?d,5?d and 7?d post-axotomy,the Nogo antiserum immunoreactive staining on section of the retina was performed. Results Nogo was expressed at every layer of the retina with the strongest expression on 3?d post-axotomy.The numbers of Nogo-A positive RGCs decrease as the survived time increased.Conclusion Nogo-A in the retina is not unique secretion from the neuroglia.The change in the distribution and level of expressed of Nogo-A in the retina is correlated with time advancement after injured of ON.

This study examined the mRNA expression of NALP3 in the spleen of the mice with hypersplenism due to portal hypertension (PH). The mouse hypersplenism models were established by oral administration of tetrachloromethane (2 mL/kg/week for 12 weeks by oral gavage). All the mice were randomly divided into a control group and an experimental group. The blood routine test was conducted, spleen index was calculated and spleen was histologically examined. Portal vein sera were taken for detection of the level of uric acid. The mRNA expressions of NALP3 and IL-1beta in the spleen were detected by reverse transcriptase-polymerase chain reaction (RT-PCR). The results showed that the platelet count was significantly lower in the experimental group [(674+/-102)x10(9)/L] than in the control group [(1307+/-181)x10(9)/L] (P<0.05), while the spleen index was significantly higher [(9.83+/-1.36) mug/g] in the experimental group than in the control group [(4.11+/-0.47) mug/g] (P<0.05). The histopathological changes of spleen followed the pattern of congestive splenomegaly. No significant difference was found in the uric acid level in the portal vein between the control group and the experiment group. The mRNA expressions of NALP3 and IL-1beta were up-regulated significantly in the spleen in the experimental group as compared with those in the control group (P<0.05). It was concluded that NALP3 and IL-1beta may play important roles in the pathogenesis of hypersplenism.

Objective To compare sedated water exchange and conventional colonoscopy in the recovery time,rates of reaching ileocecal valve and adenoma detection.Methods A total of 200 newly diagnosed patients undergoing colonoscopy with routine bowel preparation and propofol intravenous anesthesia were randomly divided into 2 groups:water exchange group (WE) and conventional group,100 patients in each group.The operations were performed by two experienced physicians.The recovery time,rates of reaching ileocecal valve and adenoma detection of each group were analyzed and compared after operation.Results The recovery times of patients in water exchange and conventional groups were 8.08±0.58 min and 12.34±0.72 min,respectively (F =2 147.33,P＜ 0.05).Rates of reaching ileocecal valve were 100.00％(100/100,WE group) and 96.00％ (96/100,conventional group),respectively(x2 =4.17,P＜0.05).Adenoma detection rates of whole colon were 43.00％ (43/100,WE group) and 29.00％ (29/100,conventional group) (x2=4.25,P＜0.05),of which small adenomas (＜ 1.0 cm) accounted for 83.96％ (89/106,WE group) and 70.59％ (48/68,conventional group) (x2 =4.43,P ＜ 0.05),respectively.Adenoma detection rates of proximal colon were 28.00％ (28/100,WE group) and 20.00％ (20/100,conventional group) (x2 =1.75,P＞ 0.05),of which small adenomas (＜ 1.0 cm) accounted for 90.41％ (66/73,WE group) and 74.47％ (35/47,conventional group) (x2 =5.45,P ＜ 0.05),respectively.Conclusion Water exchange colonoscopy can not only shorten the recovery time of patients,but also increase rates of reaching ileocecal valve and adenoma detection.