AlM:To determine the changes of regional macular retinal thickness ( RT ) with spectral domain optical coherence tomography ( SD-OCT ) after successful pars plana vitrectomy ( PPV ) surgery with inner limiting membrane ( lLM ) peeling in patients with idiopathic macular hole.
METHODS:A non-randomized retrospective case study on 17 patients ( 17 eyes ) who were hospitalized between March 1, 2011 and June 30, 2013. All 17 eyes had been diagnosed with idiopathic macular hole and thereafter underwent 25G-PPV surgeries performed by the same surgeon with lLM peeling and short - term gas tamponade. ln the 6mo-plus follow-up after surgery, these eyes were found to have successful closure in the macular hole. The macular RT of the nine areas in the Early Treatment Diabetic Retinopathy Study was measured by SD-OCT. All patients were applied by SD-OCT with linear scan of the macular. At least four examinations on the operated eye were conducted in contrast to the other normal eye: before the surgery, 3~5wk after the surgery (stage A), 2~3mo after the surgery (stage B), and >6mo after the surgery (stage C).
RESULTS:ln stage A, the macular RT of operated eyes in the areas of C, lS, ll, lN, OS, Ol, ON (263. 00±39. 48, 313. 92±18. 35, 311. 00±18. 02, 335. 67±19. 91, 280. 83±33. 74, 269. 92 ± 23. 32, 307. 00 ± 28. 40 ) were significantly thicker than the corresponding areas of the normal fellow eyes (220. 51 ± 23. 94, 292. 08 ± 21. 93, 282. 50 ± 20. 30, 288. 33 ± 20. 76, 251. 25±17. 60, 247. 75±21. 48, 265. 17±24. 76ü m) (P<0. 01) with the exception of the lT (291. 58±18. 97, 280. 33± 20.82üm) and OT (250.83±21.21, 242.08±24.02üm) (P>0. 01). ln Stage B, the macular RT in the areas of ll, lN, OS (335.67±19.20,319.75±19.20, 273.50±16.89üm) were significantly thicker than the corresponding areas of the normal fellow eyes (286. 33±20. 46, 293. 42±17. 64, 252. 50± 16.32üm) (P<0. 01). However, the macular RT of the operated eyes in the areas of C, lS, lT, Ol and OT had no statistically significant difference compared with the corresponding areas of the normal fellow eyes (P> 0. 01). ln Stage C, the macular RT of operated eyes with the areas of lN (321. 17 ± 19. 71ü m) were significantly thicker than the corresponding areas of the normal fellow eyes (296.25±19.57üm) (P<0.01). Meanwhile the other areas of the operated eyes were not significantly different from the normal fellow eyes (P>0. 01). Moreover, the macular RT of operated eyes in the areas of ON, lT (307. 00±28. 40, 291. 58 ± 18. 97ü m ) in stage A significantly decreased compared to that of the corresponding areas in stage C (276. 08±32. 39, 278. 75±10. 19ü m) (P<0. 01).
CONCLUSlON: SD-OCT is a convenient tool for the observation of macular regional changes after macular hole surgery. Macular RT had persistent changes after vitrectomy on eyes with macular hole by SD-OCT. lLM peeling may have caused microstructural changes in wide areas of the macular region after PPV surgery. More support and evidence were provided to the further study of the long - term observation for the structural and function of macular after macular hole surgery.

Objective To evaluate the value of minimally invasive technique in treatment of severe traumatic intracranial hematoma at emergency department.Method From January 1995 to December 2005,126 patients were treated by using the minimally invasive technique in Affiliated Chaoyang hospital once patients were diagnosedas severe traumatic cerebral hernia resulted from intracranial hematoma and also those whose clinical data were retrospectively analyzed.In the emergency department,the per-operative plan was done according to the CT imaging,including the sute of burr hole on the skull,the direction and depth of carmulation,and the drainage cannula was put into the hematoma cavity for external drainage under local anesthesia.Results The successful rate of puncture was 100%.The patients's dukated oyouk contracted immediately after drainage.There are 79/ 95 patients(83.1%)had single pupil dilated and 17/31(54.8%)patients had bilateral pupils dilated.The immediately clinical effective was 76.2%.According to Glasgow outcome scale,43 of 126 patients had good recovery,26 had moderate deficits and 18 had severe sequelae,16 patients were in vegetative state,18 died. Conclusions Clinical prospective study proves that minimally invasive technique can ameliorate the cerebral hernia,prolong the operative therapie window time.

Objective: To investigate the differences of biochemical markers between the patients with pulmonary hypertension related to left heart disease (PH-LHD) and LHD; to explore the sensitive bio markers which may predict PH in LHD patients. Methods: A total of 355 LHD patients admitted to our hospital from 2014-01 to 2015-05 were enrolled. According to 2009 ESC/ERS guidelines, PH was deifned by pulmonary artery systolic pressure (PASP)>50 mmHg and patients were divided into 2 groups: LHD group,n=224 and PH-LHD group,n=131. The basic information with blood levels of biomarkers was recorded and their accuracy for predicting PH was analyzed. Results: The pathogenesis of LHD included 184 (51.83%) patients of coronary heart disease, 90 (25.35%) of dilated cardiomyopathy and 81 (22.81%) of cardiac valve heart disease. Compared with LHD group, PH-LHD group had increased ratio of NYHA III and IV degree (89.31% vs 45.54%), decreased LVEF [42.0 (33.0, 59.0) % vs 60.0 (42.0, 65.0) %], all P<0.001; PH-LHD group presented elevated blood levels of BNP, bilirubin, red cell distribution width (RDW), uric acid and cystatin C, while reduced lipoprotein (HDL), allP<0.001. PASP was positively related to biomarkers as BNP, bilirubin, RDW, uric acid and cystatin C, while negatively related to HDL. With the combination of BNP, direct bilirubin and RDW, the predictive value for PH-LHD under ROC curve was 0.828 with the sensitivity at 0.813, speciifcity at 0.708. Conclusion: Blood levels of biochemical markers were statistically different between the patients of PH-LHD and LHD; the combination of BNP, direct bilirubin and RDW showed the higher accuracy for predicting PH occurrence in LHD patients.

Objective To investigate the related factors of clinical stage and prognosis in the patients with endometrial carcinoma and their relation with proto-oncogene Wip1 expression level.Methods The paraffin samples of resected endometrial carcinoma in 120 cases of endometrial carcinoma in our hospital from January 2002 to January 2012 were collected as the experimental group,the samples were verified by pathology.Contemporaneous 120 samples of biopsy normal endometrial tissue served as the control group.The expression leve of Wipl were detected in turo groups.Results (1) In the Wip1 immunohistochemical staining results:Wip1 immunohistochemical staining was negative or weak in normal endometrial tissue cells,while showed pale yellow to yellowish-brown in endometrial cancer tissue.The positive expression rate of Wip1 protein in endometrial carcinoma tissue was 77.5%(93/120),which was higher than 22.5%(27/120) in normal endometrial tissue,the difference was statistically significant (P<0.05).(2)In the Western blot results of Wip1 protein in endometrial cancer tissue and normal endometrial tissue:the relative amount of Wip1 protein in endometrial carcinoma tissue was 0.635±0.023,which was significantly higher than 0.325±0.018 in normal endometrial tissue,the difference between the two groups was statistically significant (P<0.05).(3)In the real time quantitative qRT-PCR results of various samples:Wip1 mRNA expression level was higher than that in normal endometrial tissue,which were 0.628±0.053 and 0.191±0.009 respectively,the difference between the two groups was statistically significant(P<0.05).(4) The expression level of Wip1 had no correlation with age,estrogen and progesterone status,HER2,lymph node status and TNM stage,but had correlation with P53 expression level.Conclusion (1) The Wip1 expression amount is high in endometrial carcinoma and low in normal endometrial tissue.(2)The Wip1 expression level has no relation with age,estrogen and progesterone status,HER2,lymph node status and TNM stage,while has association with P53 expression level.

Objective To study the effect of fat emulsion intravenous infusion on serum free fatty acids(FFAs) in rats.Methods 24 male Wistar rats were divided randomly into 3 groups,8 rats in each group.(1)Control group(NS),the rats were infused with normal saline intravenously and regular chow;(2)Group LCT,infused with 10% intralipid fat emulsion intravenously;(3)Group MCT/LCT,infused with 10% lipofundin fat emulsion. Group LCT and group MCT/LCT were continuously received equal calorie,nitrogen and volemin in 'All-in-One'solutions. Serum samples were drawn on the 8th day after PN for fatty acid determination. Results The FFAs in Group LCT and group MCT/LCT were remarkably higher than that in control group, but no difference between Group LCT and group MCT/LCT. Conclusions Fat emulsion intravenous infusion can increase the serum free fatty acids considerately.

The mechanism of spinal cord injury and repair therapy after nerve injury is currently a hotspot of neuroscience research.Duplicating animal models plays a key role in experimental therapeutics of spinal cord injury.This review systematically describes the progress in animal models for spinal cord injury including contusion, compression, transection, ischemic,distraction and chemical-mediated injury,which have been established at home and abroad.Based upon the aforementioned models,some applications in experimental therapeutics are simultaneously enumerated.All these information provides scientific guidance for the experimental novel drugs′screening.

Objective To evaluate and analyze the clinical application value of detection of Warfarin-related gene polymorphisms,cytochrome P450 2C9 (CYP2C9) and Vitamin K epoxide reductase complex subunit 1 (VKORC1) polymorphisms.Methods From July of 2011 to July of 2012,the blood samples were randomly collected from 140 lung cancer patients from Department of Oncology in Renmin Hospital of Wuhan University.These lung cancer patients were diagnosed through imaging examination and pathological examination.CYP2C9 and VKORC1 polymorphisms were detected in 70 patients (studied group) but not detected in the other 70 patients (control group) before they used warfarin.According to known gene sequences of CYP2C9 and VKORC1,specific primers were designed to genotype the CYP2C9 *2 and CYP2C9 * 3 alleles as well as the VKORC1-1639G ＞ A polymorphism through PCR amplification and DNA sequencing.Meanwhile,the distribution of these alleles in the studied group was analyzed.The clinical significance of detection of these polymorphisms was evaluated by comparing the proportion of patients within the therapeutic INR (International Normalized Ratio) range between control and genotype-guided dosing groups using Chi square test after 2 and 4 weeks of Warfarin therapy.Results Based on the results of agarose gel electrophoresis of PCR products and DNA sequencing,the primers for CYP2C9 and VKORC1 polymorphisms were indeed specific to these SNPs (CYP2C9 * 1,CYP2C9 * 2 and CYP2C9 * 3 ;VKORC1-1639GG,VKORC1-1639AG and VKORC1-1639AA) and both of the specificity and sensitivity of these primers are 100％,thus contributiug for genotyping these alleles.The distribution of CYP2C9 * 1/* 1 was 100％,CYP2C9 * 1/* 2,CYP2C * 1/* 3,CYP2C9 * 2/* 2,CYP2C9 * 3/* 3 and CYP2C9 * 2/* 3 were 0％.The distribution of VKORC1-1639AG,VKORC1-1639AA and VKORC1-1639 GG were 10％,90％ and 0％ respectively.2 weeks after the treatment of Warfarin,85.7％ patients in the genotype-guided dosing group reached the stable therapeutic INR range,which was significantly higher than that in the control group (48.6％,x2 =21.9,P ＜ 0.01); 4 weeks later,all patients (100％) were inside the stable therapeutic INR range whereas only 65 patients (92.9％) in the control group reached the therapeutic INR range.No haemorrhage or thromboembolic events occurred in both groups.Conclusions CYP2C9 and VKORC1 polymorphisms can be accurately detected by PCR reaction with the designed primers and the subsequent DNA sequencing in patients with lung cancer.This method is validated to be reliable.The genotyping of the Warfarin-related genes detective method can effectively guide Warfarin-dosing.

Objective To investigate effects of metabotropic glutamate receptor subtype 5 (mGluR5) antagonist MTEP on the nociceptive behavior and the expression of glial fibrillary acidic protein (GFAP) in spinal cord associated with bone cancer pain. Methods C3H/HeNCrlVr 60 male mice were randomly divided into 5 groups: ( 1 ) normal control group: the mice were given food and water ad libitum; ( 2 ) MTEP + Tumor group: the mice were treated by intrathecal gdministration ( once daily on the days 14 ～20 after inoculation of tumor cells)with MTEP (150 nmol); (3) physiological saline + Tumor group:the tumor mice were treated with the same volume of physiological saline; (4) MTEP + Sham group: the sham mice were treated with the same dose of MTEP;(5) physiological saline + Sham group: the sham mice were treated with the same volume of physiological saline.the mice pain behaviors were assessed with the paw withdrawal thermal latency (PWTL) at the corresponding time points, then the mice were killed and the samples of spinal cord were used to real-time PCR and western blot detection of GFAP mRNA and protein expression. Results The basic values of PWTL had no significant differences among all groups (P＜0.05). At day 14 after operation,no significant difference was found in the PWTL value between normal control group and the sham operation group. But in tumor group, the PWTL value was significantly lower than in the normal control group (P＜ 0.05 ). At day 21 after operation,the PWTL and the level of GFAP expression in the spinal cord had no significant differences among normal control group, MTEP + Sham group and physiological saline + Sham group (P ＞ 0.05 ); the PWTL ( (6. 18 ± 1.29 ) s) in physiological saline + Tumor group was significantly lower than in normal control group ( ( 15.91 ± 1.65 )s), physiological saline + Sham group ( ( 16.57 ± 1.86) s) and MTEP + Sham group ( ( 17.05 ± 2.43 ) s) (P ＜ 0.05 ), but the level of GFAP expression was higher than in the above three groups. In MTEP +Tumor group ,the PWTL (9.39 ± 1.94s) was higher than in physiological saline + Tumor group, and the level of GFAP expression was lower than in physiological saline +Tumor group (P ＜ 0.05 ). Conclusion Inhibiting spinal activation of astrocytes may be one of the MTEP anticancer pain mechanisms.

Objective The article was to evaluate the efficacy of intra-articular tranexamic acid injection in reduction of blood loss and blood transfusion in total hip arthroplasty (THA). Methods 60 patients hospitalized from July 2011 to July 2013 were selected as research subjects , among whom 38 males and 22 females with 2-10 years'( an average of 6 years) duration of femoral head aseptic necrosis were treated with initial unilateral THA using the posterolateral approach .The patients were randomly divided into 2 groups:experimental group were treated with 100 mL intra-articular tranexamic acid injection after intraoperative suture of incision , control group received no topical tranexamic acid .Intraoperative blood loss , postoperative visible blood loss , blood transfusion , blood transfusion number , postoperative hemoglobin were taken as evaluation indexes to make comparison between the two groups . Results No significant differences were found in intraoperative blood loss between the two groups ( [ 200 ±60 ] mL vs [ 200 ±53 ] mL, P >0.05), but in comparison to control group, postoperation visible blood loss([140 ±45]mL vs [362 ±53]mL, P<0.05), blood transfusion([400 ±25]mL vs [750 ±50]mL, P<0.05) and blood transfusion number in group A were significantly decreased (P<0.05), and in terms of postoperative hemoglobin value ([95 ±15]g/L vs [81 ±12]g/L, P<0.05), experimental group was signifi-cantly higher than control group(P<0.05). Conclusion Topical tranexamic acid in total hip arthroplasty can significantly lower blood loss and blood transfusion in patients .

To study the clinical efficacy of Pihui Fanggan Sachet (PHFGS), a sachet of traditional Chinese herbs, in preventing influenza and its immune regulation on mice.