Objective To observe the protective effect on retinal ganglion cells (RGC) and the safety of intravitreal injected acteoside in rats.Methods A total of 50 male Sprague Dawley rats with the weight of 190-210 g were used in this study.Fifteen rats were used for safety experiment of intravitreal injection of acteoside.The rats were divided into group A,B,C,control group and blank group,three rats in each group.The rats in group A,B and C were received intravitreal injection of 5 μl acteoside at the concentration of 1,2,and 5 mg/ml,respectively.Phosphate buffer solution (PBS) was injected in rats of control group.No treatment was performed for blank group.The retinal structure was examined by hematoxylin-eosin (HE) staining of retinal frozen sections at one,two and three weeks after injection.The retinal ultrastructure was examined by ultrathin section under transmission electron microscope at one and three weeks after injection.Others 35 rats were used for experiment of protective effect of acteoside on RGC.The rats were divided into operation group A and B (n=8),sham operation group C and D (n=8),and blank group (n=3).The optic nerve of rats in operation group was clamped for 10 seconds after optic nerve exposure,while the optic nerve of rats in sham operation group was exposed only.The rats in operation group A and B were received intravitreal injection with 5 μl acteoside (1 mg/ml) and 5 μl PBS respectively.The rats in sham operation group C and D were received intravitreal injection with 1 μl acteoside (1 mg/ml) and 1 μl PBS respectively.No treatment was performed for blank group.The retinal structure was examined by HE staining of retinal frozen sections at one,two and four weeks after injection.Immunohistochemistry was used to measure the expression of growth associated protein 43 (GAP-43).RGC apoptosis was assessed by the terminal deoxynucleotidyl transferase mediated dUTP-biotin nick-end labelling (TUNEL) method.Software of SPSS 13.0 was used for the data statistical analysis in this study.Results In the safety experiment of intravitreal injected acteoside,there was no abnormity of cornea,anterior chamber,lens,vitreous cavity and retina after injection.At one,two and three weeks after injection,the retina structure was normal without significant apoptosis,necrosis and inflammatory cell infiltration.The ganglion cell layer showed slightly edema; there was no obvious change of retinal ultrastructure after injection of acteoside with 5 mg/ml and 2 mg/ml,but slight change with the format of 1 mg/ml.Transmission electron microscopy showed that intravitreal injection of 5μl acteoside at the concentration of 2 or 5 mg/ml can induce significant changes of micro-structures of retina,while injections at 1mg/ml can only induce minor changes.In the experiment of protective effect of acteoside on RGC,light microscope revealed that the cell showed typical changes of apoptosis in operation group,but not in sham operation group and blank group.At the first and second week after injection,compared with the sham operation group and blank group,the RGC number was decreased in operation group.The difference of RGC numbers between operation group A and B was statistically different (F=26.206,P＜0.05).The RGC numbers in operation group continues to decrease at the fourth week after injection,there was obvious difference compared with the first and second week after injection (F=17.364,P＜0.05),but there was no difference of RGC numbers among sham operation intra-group and between sham operation group and blank group at all the time points.Immunohistochemistry showed that at the first week after injection,the integrated absorbance (IA) value in operation group was higher than that in other groups (F=33.466,P＜0.05) ; there was no difference of IA value between operation group A and B.At the second week after injection,IA value in operation group A had slightly declined,but higher than that in operation group B (F=14.391,P＜0.05).At the fourth week after injection,IA value in operation group A declined further,but also higher than that in other groups (F=4.178,P＜0.05).TUNEL showed that on the first week after injection,RGC apoptosis rate in operation group was increased than that in other groups (F=15.365,P＜0.05).At the second week after injection,RGC apoptosis rate in operation group was decreased,and it in operation group A was lower than that in operation group B (F=15.365,P＜0.05).At the fourth week after injection,RGC apoptosis rate in operation group was decreased obviously,there was no difference compared with other groups (F =2.057,P ＞ 0.05).There was no difference of RGC apoptosis rate between sham operation group and blank group at all the time points.Conclusion Intravitreal injection of 5 μl acteoside (1mg/ml) is safe for rat retina,and can up-regulate GAP-43 expression and inhibit RGC apoptosis in optic nerve crush rats.

Objective To discuss the effective surgical treatment of intrahepatic lithiasis combined with high hepa-t ic duct strictures. Methods Two hundreds and sixteen cases of intra hepatic lithiasis and high hepatic duct strictures treated in this hospital fr om January 1993 to October 2002 were analysed retrospectively.Results One hundred and eighty- three cases underwent different selective operation by selected time; 33 case s complicated with acute obstructive suppurative cholangitis underwent emergency were performed single biliary drainage, in which 30 cases were re-operated. Th e operative procedure were: hepatic lobectomy,high cholangiotomy and plastic repair,exposure of hepatic duct of the 2nd and the 3rd order,and plastic re pair with own patch and choledochojejunostomy.Two hundreds and six cases w ere cured,the curative rate was 95.4%; 8 cases improved (3.7 %), and 2 cases died (0.9%).Conclusion The best effective surgical treat ment of intrahpatic lithiasis is hepatic lobectomy. Exposure of hepatic duct of the 2nd and the 3rd order is a satisfactory to release the hepatic duct str ictures and to clear the intrahepatic lithiasis. For patients with normal extr ahepatic bile duct and Oddi's function, plastic repair of bile duct with own patch is possible to keep the normal form and function. Cholang ioscopy may play an important role in the treatment of intrahepatic tr act lithiasis during operation.

OBJECTIVE To investigate the two treatment methods for obstructive sleep apnea hypopnea syndrome(OSAHS)patients.METHODS 1.Four patients with habitual snoring and two patients with mild OSAHS accepted pillar palatal implant.2. Eleven patients with habitual snoring and fifteen patients with mild to moderate OSAHS accepted temperature- controlled bipolar radiofrequency(RF)ablation in both tonsils.RESULTS The postoperative examination was performed after 6 months.Pillar palatal implant: snoring VAS was reduced from 6.9?0.68 preoperatively to 3.8?0.54 postoperatively in 4 patients with habitual snoring,snoring VAS was down from 9.2?1.21 to 3.1?0.52 in 2 patients with mild to moderate OSAHS.Seven of 11 cases with habitual snoring were cured by RF,and 2 cases were effective,the other 2 cases were failed. Ten of fifteen cases with mild to moderate OSAHS were cured,3 cases were effective,and 2 cases were failed. The effective rate was 84.6%(22/26).CONCLUSION 1.The pillar palatal implant system is a safe method for patients with simple snoring and mild OSAHS in a short time observation.2.Temperature-controlled bipolar radiofrequency ablation is effective for mild to moderate OSAHS duo to hypertrophy of the tonsils.3.According to the clinical characteristics of the patients to select suitable method is the key to get a satisfactory curative effect.

Objective:To explore family environment of children with lea rning disorder.Method:153 children with learning disorder and 153 control were tested with FES(family environment scale),SCL-90 and PCCS(parentin g locus of control scale).Results:The scores of cohesion,expressive ness,achievement orientation,and intellectual-culture orientation were lower tha n control(p

Objective To discuss the feasibility of stone removal in laparoscopic choledocholithotomy by routine laparotomic instruments. Methods A total of 73 patients with common bile duct stones were divided randomly into 2 groups: the Experimental Group received laparoscopic stone removal by routine laparotomic instruments; the Control Group received stone removal by choledochoscopic net-basket. The stone-free rate, operative time, total hospitalization costs and postoperative complications between the two groups were compared. Results There were no statistical significances in stone-free rate between the Experimental Group ( 94.4% , 34/36) and the Control Group (94.6%, 35/37) ( ? 2=0.000, P =1.000). The operative time in the Experimental Group (150.9 min?26.8 min) was shorter than that in the Control Group (172.3 min?28.6 min) ( t=3.297, P =0.002), whereas the total hospitalization costs in the Experimental Group (4400 yuan?1100 yuan) was lower than that in the Control Group (5000 yuan?1300 yuan) ( t=2.126, P= 0.037). No severe operation-related complications were observed in both of the groups. Conclusions Laparoscopic choledocholithotomy by either routine laparotomic instruments or choledochoscopy is safe and effective. Stone removal by routine laparotomic instruments has the advantages of low costs and short operative time.

Practicing and learning platform was preliminary established by teachers to explore the feasibility and availability of ‘ interest-oriented research team’ in promoting professional competence among public health students.Public health students interested in interest-oriented research were recruited.Through this platform,students can learn professional knowledge and conduct practice earlier and complete their study facing the society,community and public.After four years' practice and exploration,students indeed improved the abilities of researching and practicing,therefore,the training model of ‘interest-oriented research team’ needs promoting.

Objective To investigate the clinical and laboratory characteristics of SSc patients in China. Method The data of 119 consecutive SSc patients based on EUSTAR DATABASE in Peking Union Medical College Hospital from February 2009 to January 2010 were prospectively collected and analyzed. All patients fulfilled ACR classification criteria in 1980 for SSc. Thex2 test and t-test were used to analyze the data. Results (1) Demographic data. Sex ratio (F/M) was 109/10 and the age rang was (44±12) years. There were 65 diffuse cutaneous SSc (dcSSc) patients and 54 limited cutaneous SSc (1cSSc) patients. 112 patients (94.1%) had Raynaud's phenomenon (RP), and the age of RP occurrence was 36 years (13～76 years), among which it was the initial presentation in 91 patients (81.3%) and the disease duration from RP to other manifestation was 12 months.(2) Clinical manifestations. ① The gastrointestinal manifestations (70.6%), especially esophageal involvement (56.3%), articular involvement (54.6%), pulmonary interstitial fibrosis (PIF) (58.8%) were frequently observed, but renal crisis (2.5%), heart block (0) and reduced LVEF (0) were rarely detected. ② Twenty cases (28.6%) out of 70 PIF patients denied any respiratory symptom and were confirmed by HRCT screening. The disease duration from RP to PIF was 34 months(3～352months); 3 case of 24 pulmonary artery hypertension (PAH) patients had no clinical manifestations. The disease duration from RP to PAH was 25 months (4～343 months). Nineteen patients had PIF and PAH simultaneously. ③Peripheral artery disease: SSc patients had a lower ankle brachial index (ABI) level (0.91± 0.19 vs 1.09±0.08, P<0.00l). (3) Laboratory finding. All patients had positive ANA. The positive rate of anti-Scl-70 antibody and ACA was 56.0% and 14.7% respectively. There was no serum sample positive for anti-Scl-70 antibody and ACA. The positive rate of anti-RNA polymerase Ⅲ antibody was 13%. (4) Compared the clinical characteristics and laboratory findings between dcSSc and lcSSc patients, we found that there were significant differences between dcSSc and lcSSc patients in finger ulcer (40.0% vs 20.4%), ACA positive rates (7.7% vs 23.3% , P<0.05). Conclusion The system involvements besides skin in SSc is common, especially PIF and gastrointestinal involvement. According to our data, there are fewer cases with renal crisis and heart block. Because part of patients with PIF have almost no clinical manifestations, so early screening for PIF/PAH is important for early diagnosis and intervention.

OBJECTIVE:To observe clinical efficacy and safety of Brucea javanica oil combined with gemcitabine and cisplat-in in the treatment of advanced non small cell lung cancer(NSCLC). METHODS:Totally 131 advanced NSCLC patients selected from Huanggang Hospital of TCM during Feb. 2014 to Jan. 2016 were divided into observation group(71 cases)and control group (60 cases)according to random number table. Control group was given Gemcitabine for injection(1st and 8th day)+Cisplatin injec-tion (2nd day),every 21 days,twice as a treatment course. Observation group was additionally given Breucea javanica oil oral emulsion 20 mL,po,2-3 times/d,for consecutive 14 d (3 days before chemotherapy). Both groups received treatment for 87 d and followed up until Jul. 1,2016. Clinical efficacy,the levels of T cell subsets (CD3+,CD4+,CD8+),survival time were ob-served in 2 groups. Single factor and multiple factor analysis was conducted for survival time. The occurrence of ADR was record-ed. RESULTS:The total response rate of observation group (32.39%) was higher than that of control group (25.00%),without statistical significance(P>0.05). Before treatment,there was no statistical significance in the levels of CD3+,CD4+ and CD8+ be-tween 2 groups(P>0.05). After treatment,the levels of CD3+ and CD4+ in observation group were increased significantly,while CD8+ level was decreased significantly;there was statistical significance compared to control group at corresponding period (P<0.05). Four patients withdrew from the study in observation group and 3 patients in control group. The survival time of observation group [(14.02 ± 4.10) months] was longer than control group [(13.21 ± 5.22) months],without statistical significance (P>0.05). Single factor analysis showed that the survival time of patients aged <70 were significantly longer than those of patients aged ≥70;those of patients with pleural effusion were significantly shorter than those of patients without pleural effusion;there was statis-tical significance (P<0.05). Multiple factor analysis showed that with or without pleural effusion,age were influential fac-tors for survival time of patients with advanced NSCLC(OR=1.685 and 0.647,P=0.012 and 0.043). There was no statistical significance in the incidence of ADR between observation group (50.70%) and control group (53.33%)(P>0.05). CONCLU-SIONS:Brucea javanica oil combined with gemcitabine and cisplatin in the treatment of advanced NSCLC patients,although not significantly improve the therapeutic effect,but can significantly improve the cellular immune function. With or without pleural effu-sion and age are infuential facters for survival time of advanced NSCLC patients.

Objective:To evaluate the value of CT findings in the diagnosis of laryngeal carcinoma infiltration extent.Method:The data of comparison of CT findings and clinico-pathologic stages on 61 patients with laryngeal carcinoma were analyzed from 1995 to 1999.There were 58 males and 3 females ,ranging in age from 37 to 83 years old which stages were T1N0M0 in 11,T2N0M0 in 21,T2N1M0 in 9,T2N2M0 in 1,T2N3M0 in 1,T3N0M0 in 10,T3N1M0 in 2,T4N0M0 in 4 and T4N1M0 in 2,respectively.And the supraglottic cancer was 11(18.0%,11/61),glottic cancer 47(77.1%,47/61),transglottic cancer 3(4.9%,3/61),respectively.The CT examination and surgical treatment were made in all 61 patients.Results:The correct rate at CT findings was 91.8%(56/61),and the accurate rate of clinical stage was 73.8%(45/61).These results showed different significance (P＜0.05).Conclusion:The CT findings showed valuable in the diagnosis to infiltration extent of laryngeal carcinoma and clinical significance for surgical treatment of patients with laryngeal carcinoma.

Objective To evaluate the feasibility and accuracy of real-time three-dimensional transesophageal echocardiography(TEE) in assessment of left atrial appendage(LAA) function. Methods Forty-two atrial fibrillation patients underwent real-time three-dimensional TEE. LAA ejection fraction based on two-dimensional area measurements(EFA-2D), three-dimensional area measurements(EFA-3D) and three-dimensional volume measurements(EFv-3D) were calculated and related to LAA peak empty velocity (PEV). The variability within observer and interobserver were tested. Results EFA-2D was significantly higher than EFA-3D[(62.84 ± 17.27)% vs (45.39 ± 16.58)%, P = 0.000] and EFv-3D [( 62.84 ±17.27) % vs (48.35 ± 19.37) %, P = 0.001 ], whereas EFA-3D and EFv-3D had no significant difference ( P = 0.158). In a simple linear correlation,the degree of association between EFv-3D and PEV was higher as between EFA-3D and PEV ( r = 0.662 vs 0.604,both P ＜0.05). No significant correlation was observed between EFA-2D and PEV ( r = 0.529, P = 0.130). Variabilities within observer and interobserver were no significant differences by the three methods( P ＞0.05). Conclusions LAA ejection fraction calculation by real-time three-dimensional TEE is feasible and more accurate than by 2D TEE.