[摘 要] 目的：探讨1, 25-二羟维生素D3（VD3）对人乳腺癌MCF-7细胞凋亡的影响及其作用机制。方法：取体外培养的人乳腺癌MCF-7细胞，随机分为6组：对照组、2-脱氧葡萄糖（2-DG，葡萄糖抑制剂）组、1 µmol/L VD3组、10 µmol/L VD3组、2-DG+1 µmol/L VD3组和2-DG+10 µmol/L VD3组。药物干预6组细胞48 h后，以葡萄糖摄取测定试剂盒检测细胞的葡萄糖摄取量、ATP试剂盒检测细胞中ATP含量和乳酸试剂盒检测细胞的乳酸水平，WB法检测MCF-7细胞中细胞色素C（Cyt c）和凋亡相关蛋白（Bcl-2、BAX、PARP1、caspase9和caspase3）的表达水平。结果：与对照组比较，VD3干预后，MCF-7细胞的凋亡率明显增加（P<0.05或P<0.01），同时细胞的葡萄糖摄取量、ATP含量及乳酸水平均明显降低（P<0.05或P<0.01），Cyt c、BAX、PARP1、caspase9及caspase3蛋白表达量明显升高（均P<0.05），Bcl-2蛋白表达量降低（P<0.05或P<0.01）；VD3联合2-DG干预后，各组细胞检测指标的变化更为明显（P<0.05或P<0.01）。结论：VD3可通过抑制人乳腺癌MCF-7细胞的糖酵解过程并以线粒体的Cyt c途径促进细胞凋亡。

Objective: To investigate the effects of retinoid-related orphan receptor γ (RORγ) gene on proliferation and metastasis of human colon cancer cells． Methods: RORγ knockdown cell lines were constructed and the knockdown efficiency was detected by RT-qPCR and Western blot assays ; MTT，colony formation，Transwell and wound healing assays were used to detect cell proliferation and metastasis ; the expression of epithelial-mesenchymal transition (EMT) related proteins was detected by Western blot．The relationship between RORγ gene expression and immune cell infiltration in tumor microenvironment was analyzed using TIMER 2. 0 database. Results : The knockdown of RORγ enhanced the viability (F = 157. 40，P＜0. 01) ，clonogenesis (F = 61. 35，P＜0. 01) ，migration (F = 13. 00，P＜0. 01) ，invasion (F = 21. 26，P＜0. 01) and wound healing ability (F = 877. 2，P＜0. 01) of colon cancer cells，inhibited the expression of E-Cadherin，and promoted the expression of vimentin and N-Cadherin．TIMER 2. 0 database analysis showed that RORγ expression in colon adenocarcinoma ( COAD) tissues was associated with multiple immune cell infiltrates． Conclusion Downregulation of RORγ expression promoted the proliferation and metastasis of colon cancer cells.

AIM: To observe and analyze the efficacy of Conbercept combined with 577nm yellow subliminal micropulse laser photocoagulation in the treatment of macular edema(ME)secondary to ischemic branch retinal vein occlusion(BRVO).

METHODS: Totally 71 patients(71 eyes)diagnosed as ME secondary to ischemic BRVO during the period from March 2016 to March 2019 were retrospectively included, and they were divided into laser group(n=33, 33 eyes)and combined group(n=38, 38 eyes)according to the different treatment methods. The patients in the laser group all received 577nm yellow subliminal micropulse laser photocoagulation, and the patients in the combined group all received Conbercept combined with 577nm yellow subliminal micropulse laser photocoagulation. The best corrected visual acuity(BCVA), central macular thickness(CMT)and total macular volume(TMV)were compared between the two groups before treatment and at 1, 2, 3, 6, 9 and 12mo after surgery, and the therapeutic efficacy was observed and the occurrence of complications were recorded.

RESULTS:There were statistically significant differences in the BCVA, CMT and TMV between the two groups before and after treatment(P<0.05), and the BCVA, CMT and TMV in the two groups at 1, 2, 3, 6, 9 and 12mo after treatment were significantly lower than those before treatment(P<0.05), and the differences between the two groups were statistically significant(P<0.05). During follow-up, there were 30 eyes with once laser photocoagulation, 7 eyes with twice and 1 eye with 3 times in combined group, and there were 16 eyes with once laser photocoagulation, 14 eyes with twice and 3 eyes with 3 times in laser group(Z=2.670, P<0.05). There were 3 eyes of corneal epithelial exfoliation on the 1d after vitreous injection in combined group, and the symptoms disappeared after symptomatic treatment. All patients did not have serious complications such as persistent intraocular pressure increase, retinal detachment and intraocular inflammation.

CONCLUSION: Conbercept combined with 577nm yellow subliminal micropulse laser photocoagulation has a significant efficacy in the treatment of ME secondary to ischemic BRVO, and it can effectively improve the visual acuity and promote the macular edema absorption, and it is safe and reliable.

Major depressive disorder (MDD) is a common but complex illness that is frequently presented in the primary care setting. Managing this disorder in primary care can be difficult, and many patients are underdiagnosed and/or undertreated. The Malaysian Clinical Practice Guidelines (CPG) on the Management of Major Depressive Disorder (MDD) (2nd ed.), published in 2019, covers screening, diagnosis, treatment and referral (which frequently pose a challenge in the primary care setting) while minimising variation in clinical practice.
Depression ; Depressive Disorder, Major ; Primary Health Care ; Therapeutics

A 71-year-old lady with rheumatoid arthritis developed painful peripheral vasculitic neuropathy of the lower limbs and was treated with high dose steroid and cyclophosphamide. Eight months later, she presented with left hip and back pain for a week, with minimal relief from regular analgesia. Although the initial pelvic radiograph was normal, a repeat film performed two weeks later showed a destructive lytic lesion in the left pubic bone, confirmed as osteomyelitis with intramuscular collection by MRI. Cloxacillin was started empirically, and when the blood culture isolated methicillin-sensitive Staphylococcus aureus (MSSA), it was planned to be given for six weeks via a peripherally inserted central catheter. Despite an initial response, she became febrile on the fifth week of antibiotic therapy. Subsequent blood culture isolated Trichosporon asahii. Her condition deteriorated, and she succumbed on the fourth day of antifungal therapy. In conclusion, the diagnosis of osteomyelitis pubis, a rare complication of MSSA bacteremia, could be delayed in an atypical presentation.
Bacteremia ; Osteomyelitis ;

AIM: To evaluate the interocular aberration root mean squares(RMS)characteristics among different severities of hyperopic anisometropic amblyopia.

METHODS: Sixty hyperopic anisometropic amblyopia were enrolled and divided into mild, moderate and severe groups. Each group was then divided into amblyopic eye(AE)and fellow eye(FE)subgroups according to the corrected visual acuity of each subject. All patients underwent wavefront analysis with iDesign^© wavefront aberration system(AMO, USA)in mydriasis condition. Paired t-test was used to compare interocular differences of aberration parameters within groups.

RESULTS: Paired t-test showed that significant differences in defocus equivalent(DE), BCVA between AE and FE in mild, moderate and severe anisometropic amblyopia(all P<0.01). No significant interocular difference was noticed in mild group except for forth-order aberration RMS(P<0.01). And No significant interocular differences were noticed in moderate and severe group except for total aberration RMS(both P<0.01). One-way ANOVA showed that significant interocular differences were noticed in third-order aberration RMS among the groups(P<0.01). LSD showed that interocular difference of third-order aberration RMS in moderate group was significant lower than that in mild and moderate groups(both P<0.05).

CONCLUSION: In mydriasis condition, mild anisometropic amblyopia showed higher forth-order aberration RMS in AE than that in FE, moderate and sever amblyopia showed higher total aberration RMS in AE than that in FE. Moderate anisometropic amblyopia manifested lower interocular differences of third-order aberrations RMS than mild and severe amblyopia, but no significant interocular differences observed between mild and severe amblyopia.

Odontoma is one of the most common odontogenic tumors in the jaws, and it is widely considered as tooth hamartomas. This article reports a rare compound odontoma with 39 denticles which was checked and diagnosed radically by CBCT, and relevant literatures are reviewed.

AIM: To evaluate the clinical effect of pars plana vitrectomy in patients with ocular injuries involving the posterior segment.

METHODS:A total of 90 patients(90 eyes)with ocular injuries involving the posterior segment underwent pars plana vitrectomy in our hospital from March 2014 to June 2015 were recruited to carry out a retrospective study. We recorded the age, gender, occurrence site of trauma, visual acuity, anatomical site, nature of injury, wound length, the presence of an afferent pupillary defect, and the timing of vitrectomy. The Ocular Trauma Score was measured. The minimum follow-up from presentation was 6mo.

RESULTS:The mean duration of follow up was 198d, ranged from 182 to 240d. There were 77 males and 13 females of all, with a mean age of 32.7±15.8 years old and 47 patients(52.2%)injured in the workplace, 14 patients(15.6%)at home. The mean visual acuity(LogMAR)of patients were significantly improved from 2.36±0.72 preoperatively to 1.50±1.14 postoperatively. There were 23 patients whose preoperative vision were better than 2.0 LogMAR, the postoperative visual acuity of these patients were significantly better than others(P<0.01). No significant difference of visual improvement was found between groups with early vitrectomy(<7d)or delayed vitrectomy(>7d)(P>0.05). There was no significant difference of postoperative visual acuity between patients with injury in Zone I and II(P>0.05), but visual acuity of patients with injury in Zone III were significant poorer(P<0.05). The postoperative visual acuity of patients with relative afferent pupillary defect were significant poorer(P<0.05). Preoperative visual acuity, the difference of preoperative and postoperative visual acuity, and postoperative visual acuity were significantly different between groups with different ocular trauma scores(P<0.01).

CONCLUSION:Trauma is more likely to occur in men under 40 years of age and in the workplace. The favorable final visual outcome is associated with the absence of afferent pupillary defect, ocular trauma score and presenting visual acuity as well as the zone of injury, and not associated with the timing of vitrectomy.