Background Conventional studies showed that the primary pathological change of diabetic retinopathy (DR) is retinal microangiopathy.However,recent studies found that the disorder of visual function appears prior to retinal microangiopathy in diabetic patients.Thereby,this findings can not be explained by conventional view.Objective The aim of the study was to find the change of retinal nerve fiber layer (RNFL) by frequency domain optical coherence tomography(OCT) in the diabetic patients without retinal microangiopathy and with non-proliferative DR (NPDR) and investigate the relationship between the change of RNFL thickness and DR.Methods Sixty eyes of 56 patients with 2 type diabetes mellitus were enrolled in Shanxi Eye Hospital from October 2012 to September 2013.The patients were divided into the non-diabetic retinopathy (NDR) group (30 eyes of 26 patients) and NPDR group (30 eyes of 30 patients) depending on the findings of fundus fluorescine angiography (FFA) according to the DR International Clinical Classification System.Thirty normal eyes of 30 age-and gendermatched healthy volunteers were included as controls.RNFL thicknesses around optical disc and macular zone were measured by OCT,including average RNFL thickness in 360°,superior nasal,superior temporal,temporal,inferior temporal,inferior nasal and nasal RNFL thicknesses.The measuring results were compared between the three groups.Results The total average thickness values of RNFL around the optic disc for the NDR group,NPDR group and the control group were (97.46-± 8.65) μm,(100.69 ± 16.35) pm and (109.22 ± 8.69) μm,respectively,and the parameters in the NDR group and NPDR group were significantly lower than those in the normal control group (P=0.001,0.006).The RNFL thicknesses were thinning at the superior temporal,temporal,inferior temporal,inferior nasal quadrants around optical disc in NDR group compared with the normal control group (P=0.001,0.001,0.001,0.010),and RNFL thickness values of all the quadrants were decresed in the NPDR group compared with the normal control group,and significant differences were seen in superior temporal and nasal quadrants (P =0.001,0.046).The total average thickness values of RNFL around macular zone for the NDR group,NPDR group and the normal control group were (33.47±3.39),(36.81±3.21) and (38.18±2.16) μm,and parameters in the NDR group was significantly lower than that in the normal control group (P =0.001).The RNFL thicknesses of all the quadrants around macular zone in the NDR group were thinned in comparison with the normal control group (all at P＜0.01),and the RNFL thicknesses at the superior nasal,superior temporal and temporal quadrants were significantly decreased in comparison with the normal control group (P=0.026,0.015,0.001).Conclusions The thinning of the RNFL thickness occurs prior to retinal microangiopathy in diabetic patients,and it may be an early pathological stage for DR.

Pancreatic cancer is a one of the most malignant digestive cancer.Because the lack of effective methods for early diagnosis,most patients have been ineligible for surgical resection when diagnosed.Kallikrein family is a group of serine proteases,because of its ability to decompose the extracellular matrix proteins,it may be closely related to the invasion and metastasis of various cancers.And some members of kallikrein family may become cancer diagnostic biomarkers.This paper reviews all the recent articles about kallikrein family study in pancreatic cancer.

Objective To study the correlation between alanie aminotransferase(ALT) unqualified samples and hepatitis B sur‐face antigen(HBsAg) and hepatitis C virus antibody (anti‐HCV) detection and to investigate an effective measure for reducing the discard rate of donated blood .Methods 330 633 blood samples donated by volunteers in Shenzhen Municipal Blood Center from January 1 ,2009 to December 31 ,2013 were performed the ALT ,HBsAg and anti‐HCV detection .Then the correlation between the detection results of ALT and viral hepatitis .Results Among 33 0633 donated blood samples ,there were 932 cases (0 .282% ) of ALT positive and 2 965 cases (0 .897% ) of viral hepatitis positive ,the differences were statistically significant (P<0 .05) .915 cases were unqualified in ALT ,but negative in viral hepatitis ,which accounting for 98 .176% of all ALT unqualified samples ;the blood discard rate generated by ALT disqualification was 0 .277% (915/330633) .Conclusion Our study indicates that the statistical difference exists in the ALT unqualified rate and the viral hepatitis detection rate ,conducting the ALT detection has the lower coin‐cidence rate for expected viral hepatic ,many false positive lead to the discard of normal blood .Therefore ,whether to continue using the ALT detection as the auxillary detection indicator is still being negotiated .

Objective To explore the possible mechanism of miR 34a/Bcl-2 apoptotic pathway in the mouse model of age-related hearing loss.Methods A C57BL/6 mouse model of age-related hearing loss was conducted,and 4-week-old and 12-month-old mice were considered as the objects.The auditory brainstem response (ABR) was used to test the hearing function.The TdT-mediated dUTP nick end labeling (TUNEL) was used to observe the apoptosis of neuron in auditory cortex.The mRNA and protein levels of miR-34a,Bcl-2 and caspase 3 were detected by real-time PCR and Western bloting,respectively.Results The ABR showed that the hearing threshold level at 4,8,16,32 kHz were higher in 12-month-old mice than in 4-week-old mice [(80.0±2.5) dBHL vs.(32.0 ±4.5) dBHL,(74.0±3.5) dBHL vs.(51.0±1.2) dBHL,(86.0±4.6) dBHL vs.(51.0±3.5) dBHL,(87.0±6.6) dBHL vs.(56.0±1.5) dBHL,all P＜0.05].Compared with 4 week-old mice,the total number of neurons in auditory cortex was decreased,the number of apoptosis neurons was increased,the expressions of miR-34a (t=6.02,P=0.001),Bax (t=6.51,P=0.012) and Caspase 3 (P=0.023) rised,and the expression of Bcl-2 (t=7.12,P=0.032) declined in 12 month-old mice.Conclusions The activation of miR-34a/Bcl-2 apoptotic pathway may be one of the mechanisms of age-related hearing loss.

OBJECTIVE: To assess the diagnosis and therapeutic effects for fungal otitis externa by clinical symptoms, endoscopic findings, and fungus culture of the ear discharge. METHOD: Sixty outpatients diagnosed with otitis externa were enrolled in the study. All patients were treated with a thorough debridement of the ear and one antifungal medication regimens (compound resorcinol solution) in case of a positive fungus culture. One subgroup of patients treated with daub glycerol during 2 weeks of follow-up. RESULT: Positive cultures were found in 42 cases. The efficacy was observed in all patients even in those who received only ear endoscopy. CONCLUSION Fungal otitis externa could be easily diagnosed by ear endoscopy. A thorough debridement of the ear and utility of compound resorcinol solution is an easy and effective approach for treatment of fungal otitis externa.
Antifungal Agents ; therapeutic use ; Debridement ; Fungi ; Glycerol ; Humans ; Otitis Externa ; diagnosis ; microbiology ; Otomycosis ; diagnosis ; Outpatients

Objective To investigate cranial decompression under temporal muscle in very-low position with large bone flap combined with mild hypothermia for severe cranial trauma.Methods 88 severe brain injury patients (GCS ≤ 8 ) were randomly divided into two groups,mild hypothermia group( n =48) and non-mild hypothermia group ( n =40),both presented with cranial decompression under temporal muscle in very-low position with large bone flap.Data of patients,GCS increment,rate of brain cistern display,rate of pupil shrink and therapeutic effect were ananlyzed.Results The treatment group showed better effect compared with the oontrol group(P＜0.05).Condusion The therapy of cranial decompression under teniporal muscle in very-low position with large bone flap combined with mild hypothennia showed the advantage of depressing intracranial pressure,reducing crerebral edema and improving the therapeutic effect of severe brain injury patients.

Apoptosis play an important role in the process of secondary spinal cord injury(SCI). Bcl-2 is a multigene family, which have fifteen members. Bcl-2 and Bcl-xL can inhibit apoptosis, but Bax, Bad, Bak, and Bcl-xS can promote apoptosis. Bcl-2 and Bax is the most representative gene in Bcl-2 gene family, Bcl-2/Bax determine cells whether goes to die. In this paper, we reviewed the latest developments in Bcl-2/Bax adjustment for SCI.

Objective: To investigate the trends in incidence of HIV/AIDS in China from 1990 to 2019 and to examine the effect of age, period and cohort on the incidence of HIV/AIDS, so as to provide insights into the improvements of the HIV/AIDS control measures. Methods: Data pertaining to incidence of HIV/AIDS in China from 1990 to 2019 were extracted from the Global Burden of Disease Study 2019 (GBD 2019) datasets, and the trends in incidence of HIV/AIDS in China from 1990 to 2019 was analyzed with annual percentage change (APC) and average annual percentage change (AAPC) using a jointpoint regression model. The effects of age, period and cohort on the incidence of HIV/AIDS in China were examined with an age-period-cohort model. Results: The age-standardized incidence of HIV/AIDS appeared an overall tendency towards a rise in China from 1990 (0.80/105) to 2019 (2.21/105) (AAPC=3.209%, P<0.05), and the incidence of HIV/AIDS showed a tendency towards a rise from 1990 to 1997 (AAPC=9.044%, P<0.05) and from 1997 to 2003 (AAPC=17.598%, P<0.05), a decline from 2006 to 2014 (AAPC=-8.412%, P<0.05) and remained relatively stable from 2003 to 2006 and from 2014 to 2019 (both P>0.05). The incidence of HIV/AIDS appeared a tendency towards a rise with age, and peaked among patients at ages of 25 to 29 years (4.93/105) and 75 to 79 years (7.38/105). The risk of HIV/AIDS appeared a tendency towards a rise followed by a decline with time, and a reduced risk of HIV/AIDS was found from 1990 to 1994 (RR=0.297), from 1995 to 1999 (RR=0.523), from 2005 to 2009 (RR=0.737), from 2010 to 2014 (RR=0.412) and from 2015 to 2019 (RR=0.351) in relative to the period from 2000 to 2004. The risk of HIV/AIDS appeared a tendency towards a rise with the cohort, and a higher risk of HIV/AIDS was found in the 1930-1934 cohort (RR=1.880) and 2000-2004 cohort (RR=2.978) in relative to the 1955-1959 cohort. Conclusions The incidence of HIV/AIDS appeared a tendency towards a rise followed by a decline in China from 1990 to 2019, and remained at a low level since 2014. The adolescents and elderly were high-risk groups of HIV/AIDS. A variety of health education interventions and intensified active HIV/AIDS screening are recommended.

This study was aimed to establish an HPLC method to simultaneous determine 6 kinds of monoester and diester aconitum alkaloids. The content of alkaloids in aconite roots, black and white prepared lateral root of aconite and the compatibility of aconite roots with rhubarb were determined. This study provided reference for the interpreta-tion of the attenuation of processing and compatibility of medicines from chemical component aspect. The HPLC analysis was performed on a Phenomenex Gemini C18 (4.6 mm í 250 mm, 5 μm) with 40 mmol·L-1 ammonium ac-etate (adjusted to pH 9.8 with ammonia water) and acetonitrile as mobile phase, with a gradient elution at the flow rate of 1.0 mL·min-1 and a detection wavelength of 235 nm. The results showed that 6 alkaloids in aconite roots achieved favorable separation and a good linearity relationship (r > 0.999) over the studied concentration range. The extraction recoveries were ranged from 96.9% to 102.4% for the 6 alkaloids. The content of diester alkaloids de-creased markedly in processed products and the compatibility of aconite roots with rhubarb compared with the raw a-conite roots. It was concluded that this method was stable, reliable, simple and practical. It can be used for the si-multaneous determination of 6 kinds of monoester and diester aconitum alkaloids in aconite roots. This processing and compatibility can significantly reduce the content of alkaloids in aconite roots in order to reduce its toxicity.

A UPLC-MS/MS method based on metabonomic skills was developed to study the serum metabolic changes of rats after acute liver injury induced by CCl4 and to evaluate the action mechanism of Si-Ni-San. The integrated data were exported for principal components analysis (PCA) by using SIMCA-P software, in order to find the potential biomarkers. It showed that clear separation of healthy control group, model group, silymarin group, Si-Ni-San group was achieved by using the PCA method. Nine significantly changed metabolites were identified as potential biomarkers of acute liver injury. Compared with the health control group, the model group rats showed higher levels of phenylalanine, tryptophan and GCDCA together with lower levels of LPC 16 : 0, LPC 18 : 0, LPC 18 : 1, LPC 16 : 1, LPC 20 : 4 and LPC 22 : 6. These changes of serum metabolites suggested that the disorders of amino acid metabolism, lipid metabolism, bile acid biosynthesis and anti-oxidative damage were related to acute liver injury induced by CCl4. Si-Ni-San might have the anti-liver injury effect on all these four metabolic pathways.