Objective To investigate the effect of recombinant human erythropoietin (rhEPO) on the expression of glutamine synthetase (GS) of cultured rat retinal Müller cells in high glucose environment in vitro.Methods Mtüller cells were isolated from retinas of 10 Sprague-Dawley rats at postnatal day three to five by trypsin digestion,and were randomly divided into six groups,including normal control group,high glucose group,high glucose +5 U/ml rhEPO group,high glucose+ 10 U/ml rhEPO group,high glucose+ 20 U/ml rhEPO group,high glucose+40 U/ml rhEPO groups.After 48 hours,the apoptosis of retinal Müller cells were assayed by terminal transferase-mediated DNA end labelling assay,and the expression levels of GS protein were detected with semi-quantitative immunocytochemistry.Results Compared with the normal control group,the cell viability and GS protein were reduced while the cell death increased in Müller cells cultured in high glucose,the difference was statistically significant (t =27.4,P ＜ 0.01).Compared with the high glucose group,rhEPO treatment reduced the apoptotic Müller cells (t=857.2,2 374.6,2 473.2,2 537.7; P＜0.01),induced the expression of GS proteins (t=3.2,18.0,22.5,26.4; P＜0.05).Conclusions rhEPO can protect Müller cells from apoptosis under high glucose condition.The mechanism may be related to its function to up-regulate the GS protein expression,promote glutamic acid cycle,and reduce the excitotoxicity effects of high concentration of glutamate.

AIM:To evaluate the clinical effects of femto-LASIK using new Ziemer LDV Z6 femtosecond laser machine (Z6).
METHODS: Two - hundred cases ( 400 eyes ) was randomly separated into two groups: Group A included 200 eyes which corneal flaps were made by Z6, and Group B included rest of 200 eyes which corneal flaps were examined by a traditional Ziemer LDV CrystalLine femtosecond laser machine (CrystalLine). Visual acuity, slit lamp, refraction, Sim-K average, intraocular pressure (IOP), non-invasive tear break-up time (NIAvg-BUT), operation difficulty and complications were compared between two groups preoperatively and postoperatively.RESULTS:There was no significant differences between two groups in visual acuity, refraction, Sim-K average, IOP and NIAvg - BUT either preoperatively or 6mo postoperatively (P>0. 05). Although there were significant differences in operation difficulty and complications were found between two groups ( P< 0. 05 ), there was no serious complication in any group. Furthermore, a clear demarcation line could be observed in the cornea of Group A postoperatively.
CONCLUSION:More careful and strict requirements are needed when using the new Z6 femtosecond laser for corneal flaps.

Objective To discuss the protective effect of doxofylline on radical surgery for esophageal cancer.Methods Under elective general anesthesia, 60 cases, 35 males and 25 females, aged 45-70 years, BMI 20-30 kg/m2, ASA physical status Ⅰ or Ⅱ, FEV1%>50%, underwent radical surgery for esophageal cancer at middle and distal parts.Random number table was employed to divide these patients into two groups: doxofylline group (group D) and control group (group C) with 30 cases in each.After a routing intravenous induction in the two groups, mechanical ventilation was conducted after bronchial intubation with double channel catheter on the right side.The intravenous injection of doxofylline 4 mg/kg in group D was administrated 30 min after bronchial intubation with double channel catheter.Equal normal saline was instilled to the patients in group C.Blood samples were taken from radial artery to detect the levels of TNF-α, IL-6, IL-10, MDA and SOD at four time points: 10 min (T0) before the one-lung ventilation, 60 min after OLV (T1), after two-lung ventilation (T2) and the end of the operation (T3).Meanwhile, the blood and breath at these time points were tested.The occurrence of OLV, blood loss volumes, fluid input quantities, urine volumes, postoperative hyoxemia and pulmonary inflammation were observed.Results Compared with T0, the activity of SOD in serum and PaO2 in the two groups at T1-T3 decreased (P＜0.05).The concentrations of TNF-α, IL-6, IL-10 and MDA increased significantly (P＜0.05).Compared with group C, the activity of SOD activities and PaO2 in group D at T1-T3 increased while concentrations of TNF-α, IL-6, IL-10 and MDA decreased significantly (P＜0.05).The occurrence rates of postoperative hyoxemia and pulmonary inflammation in group D were obviously lower than those in group C (P＜0.05).Conclusion Doxofylline can suppress patients' inflammatory response and oxidative stress response after OLV and reduce the incidence rates of postoperative hyoxemia and pulmonary inflammation as well as alleviate lung injury triggered by radical surgery for esophageal cancer.

[Objective]To investigate the feasibility of screening for velamentous umbilical cord insertion in early pregnancy by ultrasound.[Methods]A total of 2,796 cases of pregnant women,2 998 cases of fetuses that underwent prenatal ultrasound screening in the early and middle stage pregnancy and delivered in Dalian Women and Children Healthcare Center were included. The results of ultrasound screening of umbilical cord insertion during early pregnancy(11~13+6 w)were divided into three groups. GroupⅠ:it is clear that the placenta of the umbilical cord is located in the fetal membranes ,and then along with the fetal membranes for a long distance,and then enter the placenta. GroupⅡ:The placenta of the umbilical cord is located at the edge of the placenta,and then insert point is not distinguished between the placenta and fetal membranes. Group Ⅲ:It is clearly shows that the umbilical cord inserted into the placenta.[Results]1. The display rate of the umbilical cord in early and mid pregnancy ultrasound examinationearly pregnancyan examination showed that the rate of 99.23%(2 975/2 998). The single child display rate of 99.77%(2 590/2 596),twindisplay rate of 95.96%(380/396),three fetal the rate of 83.33%(5/6).In the second trimester of pregnancy(22~26 w)and examination showed that the rate of 86.99%(2 608/2 998). The single child display rate of 90.99%(2 362/2 596),twin display rate of 61.61%(244/396),three fetal the rate of 33.33%(2/6). 2. The results of early pregnancy,pregnancy,the examination of after birth Regard?ing to early pregnancy,28 cases were included in GroupⅠ,42 cases in GroupⅡand 2928 cases in GroupⅢ. Regarding to second pregnancy,37 cases were evaluated as velamentous umbilical cord insertion,30 cases were evaluated as battledore placenta and 2931 cases were evaluated as normal placenta. The results of postnatal examination were as follows:36 cases were identified as velamentous umbilical cord insertion,30 cases were evaluated as battledore placenta and 2932 cases were evaluated as normal placenta. 3. Comparison of 3 groups,early pregnancy examination results and pregnancy and after the birth. In early pregnancy,28 cases of GroupⅠwere diagnosed as velamentous umbilical cord insertion in the examination during the second trimester of pregnancy and after delivery. In the 42 cases of early pregnancy in Group Ⅱ,7 cases were diagnosed as velamentous umbilical cord insertion ,22 cases were diagnosed as battledore placenta and 13 cases were normal placenta. After birth ,6 cases were diagnosed as diagnosed as velamentous umbilical cord insertion ,23 cases were battledore placenta and 13 cases were normal placenta. In the 2928 cases of early pregnancy of Group Ⅲ,2 cases were diagnosed as diagnosed as velamentous umbilical cord insertion ,8 cases were battledore placenta and 2918 cases were normal placenta. After birth ,2 cases were diagnosed as diagnosed as velamentous umbilical cord insertion,7 cases were battledore placenta and 2919 cases were normal placenta.The diagnostic accuracy of early pregnancy was 98.29%.[Conclusion]Application of HD-Flow blood flow pattern in early pregnancy can make a diagnosis of some of the sail-shaped placenta.

The liquid-chromatography-mass technology was used in the metabolomic analysis of mouse's blood 1 hour after exhaustive exercise,in order to explore the potential mechanism of Rhodiola in fatigue elimination of exhaustive exercise mouse.The exhaustive mouse model was made by loaded-swimming.A total of 24 mice were randomly divided into theRhodiola + exercise group,exercise group andno-exercise group.The dose of Rhodiola was 0.4375 g·kg-1·d-1.The loaded-swimming was conducted after two successive weeks of medication.Blood was collected 1 h after swimming for the sample preparation.The enzyme assay and anthrone colorimetry were used to test blood lactate acid and glucose,respectively.UFLC-Q-TOF was used to detect metabolic profiles of each group.The principal component analysis (PCA),orthogonal partial least squares discriminant analysis (OPLS-DA) and heat map analysis were used to compare differences among groups with score chart and to obtain the characteristics biomarkers by load chart.The results showed that the blood lactate acid level of theRhodiola+ exercise group was significantly lower than that of theexercise group.And the glucose level of theRhodiola+ exercise group was significantly higher than that of theexercise group.The metabolomic analysis showed that there were no obvious changes on 1,25-(OH)2D3,diacylglycerol (DG) and inositol triphosphate (IP3).All three materials in theRhodiola + exercise group were significantly lower than those of theexercise group.They were much closer to theno-exercise group.And all three materials were related to the increasing of muscle tension.It was concluded that Rhodiola had the function of promoting fatigue eliminating.This effect may be related to cell membrane protection,regulation of 1,25-(OH)2-D3→IP3,DG pathway,and relieving of muscle tension after exercises.

The application of cerebrovascular intervention brings the diagnosis and treatment of cerebrovascular disease into a brand-new domain. Many neurological physicians have become physicians of cerebrovascular intervention by training. In the big teaching hospitals carrying out cerebrovascular intervention, advanced physicians are the hard strength in the lot of cerebrovascular intervention. The training aiming at cerebrovascular intervention and comprehensive abilities affects both the training results and the therapeutic results of cerebrovascular intervention. Therefore, it is an important issue to explore how to consummate and standard the training methods of advanced physicians studying cerebrovascular intervention.

Objective:To investigate the diagnostic value of mitochondrial associated protein fumarylacetoacetate domain containing protein 1 (FAHD1) and growth differentiation factor-15 (GDF-15) in sepsis.Methods:Based on the database of the whole process of sepsis early warning, diagnosis and treatment management, which was established on the study of sepsis early warning and standardized diagnosis and treatment system, adult patients with suspected infection admitted to the department of critical care medicine of Zhejiang Hospital, Second Affiliated Hospital of Zhejiang University, the First Affiliated Hospital of Sun Yat-Sen University, West China Hospital of Sichuan University, Ningbo First Hospital from May 2014 to October 2015 were enrolled. The basic vital signs, and the main blood routine results, liver and kidney function, blood gas, acute physiology and chronic health evaluation Ⅱ (APACHEⅡ) and sequential organ failure assessment (SOFA) score at the time of diagnosis of patients with or without sepsis were analyzed. The preserved serum samples were taken, the levels of procalcitonin (PCT), C-reactive protein (CRP) were detected by electrochemiluminescence method, immunoturbidimetry respectively, and FAHD1 and GDF-15 were detected by enzyme linked immunosorbent assay (ELISA). Univariate and multivariate Logistic regression were used to analyze the risk factors for sepsis diagnose. The indexes' diagnostic efficacy in sepsis were analyzed by receiver operating characteristics curve (ROC curve).Results:A total of 132 patients were enrolled, including 76 cases of sepsis and 56 cases of non-sepsis. Compared with the non-sepsis group, the heart rate in the sepsis group was increased (bpm: 116.4±17.8 vs. 97.4±19.1), while the mean arterial pressure (MAP), platelet count (PLT), arterial partial pressure of oxygen (PaO 2) were significantly decreased [MAP (mmHg, 1 mmHg = 0.133 kPa): 65.8±9.7 vs. 74.7±10.3, PLT (×10 9/L): 120 (69, 204) vs. 163 (117, 239), PaO 2 (mmHg): 83.0 (66.6, 108.0) vs. 108.0 (84.4, 130.0), all P < 0.05], direct bilirubin (DBil), serum creatinine (SCr), lactic acid (Lac), APACHEⅡ score and SOFA score were significantly increased [DBil (μmol/L): 13.00 (5.55, 55.31) vs. 6.20 (2.20, 21.90), SCr (μmol/L): 118.00 (70.00, 191.73) vs. 77.20 (59.65, 110.86), Lac (mmol/L): 2.90 (1.50, 4.10) vs. 1.90 (1.20, 2.80), APACHEⅡ score: 20.0 (16.0, 25.0) vs. 16.0 (10.0, 21.0), SOFA score: 12.0 (8.0, 16.0) vs. 8.0 (5.0, 13.0), all P < 0.05]. In addition, the serum levels of FAHD1, GDF-15, PCT and CRP in sepsis group were significantly higher than those in non-sepsis group [FAHD1 (μg/L): 3.96 (2.25, 5.92) vs. 2.47 (1.03, 3.54), GDF-15 (μg/L): 8.46 (4.37, 19.68) vs. 4.32 (1.74, 10.39), PCT (μg/L): 3.79 (1.37, 11.32) vs. 0.42 (0.12, 2.14), CRP (mg/L): 154.43 (61.33, 283.20) vs. 65.95 (28.15, 144.69), all P < 0.01]. Multivariate Logistic regression showed that serum FAHD1 [odds ratio ( OR) = 1.135, 95% confidence interval (95% CI) was 1.045-1.234], GDF-15 ( OR = 1.090, 95% CI was 1.029-1.155) and CRP ( OR = 1.007, 95% CI was 1.002-1.011) were risk factors for sepsis (all P < 0.05). ROC curve analysis of sepsis showed that the areas under ROC curve (AUC) of serum mitochondrial associated proteins FAHD1 and GDF-15 were 0.727 (95% CI was 0.641-0.802) and 0.677 (95% CI was 0.588-0.757), respectively; and the AUC of classical infection indexes PCT and CRP were 0.767 (95% CI was 0.683-0.837) and 0.680 (95% CI was 0.59-0.760), respectively. There was no significant difference between the AUC of mitochondrial associated proteins and classical infection indexes. The combination of FAHD1, GDF-15, PCT and CRP had the largest AUC, which was 0.809 (95% CI was 0.730-0.874), and the sensitivity was 75.00%, and the specificity was 80.00%. Conclusion:Mitochondrial associated protein FAHD1 and GDF-15 are associated with sepsis, and the diagnostic efficiency is improved when combined with PCT and CRP, which might provide experimental basis for screening diagnostic markers of sepsis.

Objective To study the clinical characteristics and imaging features of perinatal autosomal recessive polycystic kidney disease ( ARPKD) and a systematic review of the literature was performed to improve awareness of the disease. Methods A newborn with infantile ARPKD admitted to the neonatal department of our hospital was studied and her clinical data and imaging features retrospectively reviewed. CNKI, CBMdisc, MEDLINE and Embase databases were searched using autosomal recessive, perinatal and polycystic kidney as keywords. 9 case reports were retrieved from 2005 to 2015 and a total of 9 patients were analyzed. Results The gestational age of patients with infantile ARPKD was from 33 to 37 weeks. 6 of them were diagnosed using prenatal ultrasound and one patient was diagnosed using genetic sequencing. One of 10 infants had a family history, 4 patientsˊ mothers had abnormal pregnancy history (spontaneous abortion or miscarriage) and 7 (70. 0%) patients with respiratory failure needed mechanical ventilation. The ultrasound of all the patients showed enlarged and hyperechogenic kidneys. 9 patients died, and only one patient was alive after renal transplant. Conclusions The characteristics of perinatal APRKD are enlarged and polycystic kidneys, hepatic cysts and liver fibrosis. Infants with this disease have poor outcomes and high mortality rate. Respiratory failure and renal failure are the main causes of death in the neonatal period and early diagnosis and treatment are necessary.

Objective:To study the abnormal suppressive capacity of regulatory T cells ( Tregs) to effector cells,Th17 cells and Th9 cells in patients with mild to moderate asthma attack.Methods: Recruited asthmatic patients (n=30) and healthy control (n=30),collected peripheral venous blood from healthy control and asthmatic patients in mild to moderate attack stage respectively,and then isolated CD4+CD25+CD127-/low Tregs and CD4+CD25-T effect cells with immunomagnetic beads method ( purity was above 90%).The effect cells were cultured with PHA stimulation with or without Tregs.Measured the proliferation (3H-Thymidine), expression of RORC and PU.1 ( RT-PCR) genes,production of IL-17 and IL-9 ( LUMNEX) in effect cells with or without Tregs inter-vention.Analyzed the abnormality of Th17 and Th9 cells and the supressive capacity of Tregs on Th17 and Th9 cells in patients with asthma attack,comparing with control group.Results:Tregs of asthmatic patients could suppress the proliferation of effector cells,but less effectively than healthy control (P=0.03).In asthmatic patients,RORC expression and IL-17 production increased (P<0.05), and the suppressive capacity of Tregs to RORC expression decreased, when compared with healthy group ( P<0.05 ) .In asthmatic patients,IL-9 production of effector cells increased significantly (P<0.05),but PU.1 expression was higher than healthy group only with intervention of Tregs ( P=0.04 ) .And the suppressive capacity of Tregs to the expression of PU.1 and production of IL-9 in patients with asthma attack did not decrease (P>0.05).Conclusion:The suppressive capacity and amount of Tregs decreased,but the specific gene expression and cytokines production of Th17 cells and Th9 cells were upregulated in patients with mild to moderate asthma attack.This deficiency for the suppressive capacity of Tregs to Th17 but not Th9 cells may indicate some pathogenesis of asthma devel-opment.

Tumor is a seriously disease that endanger human health.Gastrointestinal cancer is one of the most prevalent types of digestive system cancers among the Chinese population.While radiotherapy and chemotherapy kill cancer cells,their toxicity to normal cells cannot be ignored.Hence,polysaccharides from Chinese materia medica (CMM) have been the focus of anti-tumor research,as they can improve functions of the immune system and do not harm to normal cells.In this review,we have analyzed the recent advances in the study of the effects of polysaccharides from CMM on human gastric cancer cell lines (MGC-803 and SGC-7901) and intestinal tumor cell lines (LoVo,HCT-116,and HT-29) in vitro.The purpose of this study is to provide a material basis for clinical research of polysaccharides from CMM.