Diabetic macular edema ( DME ) is a major cause of visual impairment in patients with diabetes mellitus, the central retinal thickness ( CRT ) is correlated with the visual impairment and the changes of visual function before and after treatment. Furthermore, CRT is related to the changes of macular microstructure. The subtle changes of retinal microstructure can be qualitative and quantitative analyzed by spectral- domain OCT ( SD -OCT) . In this study, the changes of retinal microstructure in patients with DME are reviewed, what is of great meaning to explore mechanism, observe disease progress, guide clinical treatment and prospect prognosis of DME.

Internet-based tendering system makes equipment purchase convenient,rapid,effective,economical and fair. This system guarantees the legal benefits of the medical organizations and suppliers to the most. At the same time this article introduces some issues that should be noticed by medical organizations and suppliers when they participate the on-line bid.

The medical equipment on-line bid is a newborn method for bid,which unites the modern computer technology,communication technology and electronic commerce technology. When the on-line bid system is applied,except for the make of comprehensive and standard tender documents,the followings also claim attention: how to correctly open the webpage of video meeting inserter,how to suitably adjust video acoustics,and how to properly adjust video images.

To detect the expression of p16 protein and Ki-67 antigen in gastric mucosa-associated lymphoid tissue lymphoma(MALTL)and normal gastric mucosa and to investigate the clinical significance of their expression in the occurrence and development of gastric MALTL.Methods 47 samples of gastric MALTL diagnosed pathologically in the department of pathology of the PLA General Hospital from March 1993 to June 2005 were collected.By using immunohistochemial methods,the expression of p16 protein and Ki-67 antigen was detected in 20 samples of normal gastric tissue and the 47 samples of gastric MALTL.Results The positive rate of p16 protein Was 21.3%(10/47)and 90.0% in gastric MALTL and normal gastric tissue respectively.The positive rate of p16 protein in gastric MALTL was lower than that in normal gastric tissue(P<0.05).The expression of p16 was related to the degree of lymph node metastasis.The positive rate of Ki-67 labelling index(LI)in gnstric MALTL was hiigher than that in normal gastric tissue.A negative correlation was found between the expression of p16 protein and Ki-67 LI(P<0.05). Conclusions Detection p16 and Ki-67 may help to predict the possibility of lymph node metastasis and prognosis in gastric MALTL.

Animals ; HSP72 Heat-Shock Proteins ; metabolism ; Hypoxia ; metabolism ; physiopathology ; Male ; Motor Activity ; physiology ; Muscle, Skeletal ; metabolism ; Oxygen ; metabolism ; Physical Exertion ; physiology ; Rats ; Rats, Sprague-Dawley ; Time Factors

OBJECTIVETo analyze the neglected hidden blood loss before and after operations in the elderly patients with intertrochanteric fractures and strengthen the treatment and clinical nursing in the perioperative period in order to ensure clinical effects.

METHODSThe clinical data of 99 patients with intertrochanteric fracture treated with intramedullary nailing from January 2010 to January 2014 were retrospectively analyzed (47 males and 52 females). Forty-seven cases got blood transfusion supporting and 52 cases were not (blood transfusion group and no-blood transfusion group respectively). According to the Gross equation, the average hemoglobin (Hb) and hematocrit (HCT) were used to analyze blood loss in perioperative period and assess the patients' hidden blood loss situation.

RESULTSThere were 22 males and 30 females in blood transfusion group. The average operative time was (62.13±4.01) min; intraoperative visible blood loss and postoperative drainage were 215 ml, totally; preoperative Hb was (103.22±9.01) g/L and postoperative was (81.13±6.20) g/L; preoperative HCT was (96.93±3.38) I/L and postoperative was (308.00±11.81) I/L. There were 25 males and 22 females in no-blood transfusion group. The average operative time was (60.12±3.27) min; intraoperative visible blood loss and postoperative drainage were 196 ml, totally; the average blood transfusion were 621 ml; preoperative Hb was (92.15±5.46) g/L and preoperative was (95.20±8.93) g/L; preoperative HCT was (96.52±3.63) I/L and preoperative was (392.70±14.03) I/L. According to the Gross equation, the blood loss of no-blood transfusion group and blood transfusion group in peroperative period were (937.29±63.04) ml and (706.43±35.02) ml, respectively. The hidden blood loss was dominant. At 1, 3 months after operation, Harris score of blood transfusion group was better than that of no-blood transfusion group, and 12 months after operation, there was no significant difference between two groups.

CONCLUSIONThe hidden blood loss of intramedullary nailing for intertrochanteric fracture should be emphasized in perioperative period, it can avoid the perioperative complications caused by anemia and affect the prognosis of patients.

Aged ; Blood Loss, Surgical ; Blood Transfusion ; Case-Control Studies ; Female ; Fracture Fixation, Intramedullary ; adverse effects ; methods ; Hip Fractures ; surgery ; Humans ; Male ; Middle Aged ; Operative Time ; Perioperative Period ; Retrospective Studies

Objective:To investigate the application of lateral upper arm free flap in the repair of postoperative soft tissue defects after operation in the patients with tongue cancer, and to evaluate its survival rate and repair effect. Methods:Ten patients with tongue cancer, having a desire to repair soft tissue defect after tongue cancer operation, and their systemic state could tolerate the long time operation, were selected to repair tongue cancer postoperative defects with lateral upper arm flaps. Among them, 7 cases were male, 3 cases were female;aged 45-67 years old, average 52.1 years old.Radical resection of tongue cancer was primarily finished, then the flaps were designed and prepared to repair the defects of tongue according to the location and size of defects.After the operation, the survival rate of the flap was observed, and the effect of repair was evaluated according to the shape, size, volume and movement of the tongue.Results:The lateral upper arm flaps were stable and simple to prepare, the donor sites were concealed, and the upper limbs were not abnormal.All of flaps survived, and all of wounds healed primarily.The shape, size, and texture of tongues were satisfied, and the movements of tongue were not significantly restricted.After repair, the voice, mastication and swallowing function of the patients were good without obvious influence.Conclusion:The survival rate of lateral flap of upper arm is high, and the tongue shape and function were good after tongue defect repair.It is an ideal free flap for repairing the tongue tissue defect of tongue cancer after operation.

A lactoferrin-containing PEGylated liposome system (Lf-PLS) was developed and tested in vitro as a hepatoma-targeting drug delivery system. PEGylated liposomes (PLS) were successfully prepared using the thin film hydration method with peglipid post insertion. Lf was covalently conjugated onto the carboxyl terminal of DSPE-PEG2000-COOH on liposomes. Coumarin-6 was used to trace Lf-PLS with fluorescence. The cellular uptake of this system was carried out in asialoglycoprotein receptor (ASGPR) positive HepG2 cells via confocal microscopy and flow cytometry. The Lf-PLS liposome was observed as spherical or oval vesicles with the particle size around 130 nm, zeta potential about -30 mV and encapsulation efficiency more than 80%. The confocal microscopy images and flow cytometry data demonstrated that Lf-PLS resulted in significantly higher cell association by ASGPR positive HepG2 cells compared to PLS. The association between Lf-PLS and cells were dependent on the concentration, time and temperature, which was inhibited by pre-incubation with excessive free Lf. The results suggest that Lf-PLS has a good targeting effect on HepG2 cells in vitro. The targeting mechanism may be related to the specific binding of Lf and ASGPR on HepG2 cells, which guides Lf-PLS to the cell surface to induce an active endocytosis process. All these results demonstrated that Lf-PLS might be a potential drug delivery system in targeting hepatocellular carcinoma, which deserves more research on its targeting ability, antitumor efficiency, and metabolism in vivo for treatment of hepatomacellular carcinoma.
Asialoglycoprotein Receptor ; metabolism ; Carcinoma, Hepatocellular ; pathology ; Coumarins ; Drug Delivery Systems ; Endocytosis ; Hep G2 Cells ; drug effects ; Humans ; Lactoferrin ; pharmacology ; Liposomes ; Liver Neoplasms ; pathology ; Particle Size ; Phosphatidylethanolamines ; Polyethylene Glycols ; Thiazoles

Objective:To determine the law of dose variation in nasopharyngeal carcinoma patients treated with helical tomotherapy by observing the difference between the actual and planned doses of targets and at-risk organs in these patients. Methods:Ten naso-pharyngeal carcinoma patients were treated with helical tomotherapy. Each single dose distribution and the corresponding computed tomography (CT) images were transmitted to the commercial software MIMvista 6.50, which was used to perform deformable image registration on the CT images. The sum of the actual dose was then obtained by accumulating the single doses. The image-guided actu-al dose was denoted as Plan 2, and the initial plan was called Plan 1. The dose-volume histogram of the dose distribution of targets and at-risk organs in Plans 1 and 2 were compared. Results:The D98 and D95 doses of the planning gross target volume (PGTV) in Plan 2 were significantly lower than those in Plan 1. Compared with Plan 1, the Dmean and D50 doses of double parotids in Plan 2 were higher by 42.23%and 63.82%(P<0.001, P=0.001) on average, respectively, for the left parotid, as well as by 38.64%and 66.76%(P=0.002, 0.004), respectively, for the right parotid. The D2 dose of spinal cord in Plan 2 was significantly higher than that in Plan 1. The doses were higher by 16.49%on average (P=0.026). Conclusion:To achieve precise and individually adaptive radiotherapy, correcting the error between anatomy and placement during tomotherapy for nasopharyngeal carcinoma patients is necessary.

Objective To investigate the effect of early-stage acupuncture therapy on local glucose metabolism in model rats with cerebral ischemia. Methods Eighty three-month-old SD rats were randomly divided into 4 groups,namely normal group,model group,2-h acupuncture group and 24-h acupuncture group,20 rats in each group. Craniotomy was used to establish the rat model of acute cerebral ischemia. Acupuncture treatment was carried out on acupoint of Baihui(GV20)and Renzhong(DU26)with reducing method,needle twirling and rotating frequency being 120 times per minute,once every other 4 min and for one min,and the total needling time for 30 min. Rats in 2-h acupuncture group were given acupuncture 2 h after the successful modeling,and once again after 24 h,two times in total;rats in 24-h acupuncture group were given acupuncture only for one time 24 h after successful modeling. At the end of treatment,the rat neurological function was scored,and the infarction area was measured by 2,3,5-triphenyltetrazole chloride (TTC)staining. The protein expression levels of glucose transporter(GLUT)1 and 3 in ischemic brain tissue were detected by immunohistochemistry. Results Compared with the normal group, the scores of neurological function in the model group were increased;TTC staining results showed that the left hemisphere was swollen,and the infarct volume was significantly larger than that of the contralateral side;immunohistochemical results showed that the GLUT1 and GLUT3 expression levels in the ischemic brain tissue were increased(P < 0.01). Compared with the model group,2-h acupuncture group and 24-h acupuncture group could effectively improve the cerebral ischemia, reduce the neurological function indexes and infarction area showed by TTC staining,and increase the expression levels of GLUT1 and GLUT3 in ischemic brain tissue significantly (P<0.05). And the therapeutic effect of 2-h acupuncture group was superior to that of 24-h acupuncture group(P<0.05). Conclusion Acupuncture can effectively improve cerebral ischemia in rats with acute cerebral ischemia. Acupuncture can improve the energy metabolism of ischemic brain tissue by up-regulating the protein expression of cerebral GLUT1 and GLUT3 and by increasing the blood-brain barrier transport efficiency for glucose,thus to promote glucose metabolism and provide energy for ischemic brain tissue to relieve relatively inadequate energy, and to protect against cerebral ischemic injury. Early acupuncture intervention exerts a positive effect on regulating energy metabolism of rats with cerebral ischemia.