AIM: To evaluate the value of OCTA in the diagnosis and treatment of retinal vein occlusion.

METHODS: A retrospective case-control study was conducted to select 38 patients(38 eyes)with retinal vein occlusion diagnosed in ophthalmology clinic of Dalian Third People's Hospital from January to October 2018. The affected eyes were group A and the contralateral healthy eyes were group B. All patients underwent OCTA mode scanning of macular retina in the range of 3 mm×3 mm. Four layers of macular blood flow density maps were obtained, including surface retina, deep retina, outer retina and choroidal capillary layer. The area of vascularized area(FAZ)in the central fovea of the surface retina was measured. Image J software was used to calculate four layers of macular blood. Flow density(MVD)and OCT were used to measure the horizontal and vertical fovea thickness(CFT).

RESULTS: There were differences in FAZ measurements in superficial retina between group A and group B(P<0.01), and in horizontal and vertical CFT measurements(P<0.01). There were differences in MVD between group A and group B(P<0.01). There was no difference in MVD results in outer retina(P=0.542)and choroidal capillary layer(P=0.489). BCVA was positively correlated with surface retinal FAZ, horizontal CFT and vertical CFT, and negatively correlated with surface retinal MVD and deep retinal MVD, respectively(r=-0.486, -0.465,all P<0.01).

CONCLUSION: The application of OCTA examination has important guiding significance in indicating macular retinal microcirculation disorder and visual prognosis in patients with retinal vein occlusion.

Objective: To analyze the correlation between WT1 gene polymorphism and multiple myeloma (MM) susceptibility in 168 patients. Methods: One hundred and sixty eight MM patients, who were hospitalized in our hospital and Hebei Provincial People&#39;s Hospital from January 2013 to December 2017, were researched in this study. There were 121 males (72%) and 47 females(28%) with a median age of 62.4 years old (36~83 years old). Polymorphism of WT1 gene of the samples was detected and analyzed by SSP-PCR and SBT-PCR. Results: Eleven WT1 alleles were detected in MM patients, WT1*010 and WT1*012 alleles occupied a higher frequency in MM group (WT1*010: OR=6.13, 95%CI:3.5~10.75, PC<0.000; WT1*012: OR=2.06, 95%CI:1.23~1.44, PC<0.051). STR genotype frequency of WT1*A5 markedly increased (OR=1.62, 95%CI:1.18~2.23, PC<0.05). Genotype frequency of WT1*010/010 also obviously increased (OR=6.28, 95%CI:1.81～21.76, PC<0.05). Conclusion: WT1 allele is highly polymorphic in MM patients and homozygote WT1*010/010 is a susceptible genotype of MM, indicating that the occurrence and development of MM are related to the polymorphism of WT1 gene.

Objective: To investigate the effect and mechanism of AMP-activated protein kinase α (AMPKα) over-expression on proliferation, migration, invasion and epithelial mesenchymal transition (EMT) of bladder cancer T24 cells. Methods: A bladder cancer T24 cells over-expressing AMPKα was established and divided into T24 group, pc-DNA group and pc-AMPKα group according to different plasmid transfection. Western blotting was used to verify the over-expression ofAMPKα and detect the expressions of EMT-related proteins and EMT pathway-related molecules. Hoechst staining was used to detect apoptosis of transfected T24 cells. CCK8 assay was used to detect cell proliferation. Cell scratch test was used to detect cell migration. Transwell assay was used to detect cell invasion. Results: The bladder cancer cell line T24 over-expressingAMPKα was successfully constructed. Compared with the T24 group and the pc-DNA group, the level of E-cadherin in the pc-AMPKα group was significantly increased (P<0.01) while the levels of Vimentin and N-cadherin were significantly decreased (all P<0.01), and the activities of P38 and STAT3 which related to EMT pathway were significantly inhibited (all P<0.01); cell proliferation, migration and invasion were significantly decreased while cell apoptosis was obviously enhanced (all P<0.01). Conclusion: Over-expression of AMPKα can inhibit the activity of EMT pathway-related molecules, which leads to obvious apoptosis, limited proliferation, reduced invasion and migration of bladder cancer T24 cells, and accompanied by the reversal of EMT.

嵌合抗原受体T（chimeric antigen receptor T， CAR-T）细胞是一种通过基因工程表达受体的T细胞，能够识别特定的抗 原，是目前最具潜力的靶向肿瘤治疗方法。然而，作为抗癌免疫系统中主要效应细胞之一的CD8+T细胞在肿瘤中发挥作用时， 通 常处于耗竭状态，而这种功能缺陷的CD8+T细胞是杀伤肿瘤的障碍。肿瘤微环境（tumor microenvironment，TME）中存在许多抑 制性因素，例如耗竭性T细胞表面高表达的抑制性受体、免疫抑制细胞群、抑制性因子、转录因素、代谢因素等都对T细胞的分化 及耗竭有重要影响。当然， CAR的结构和共刺激域也对CAR-T细胞整体功能发挥着重要作用。本文着重总结近年有关CD8+T 细胞耗竭的机制及改善策略的研究进展，为增强CAR-T细胞的抗肿瘤效应提供了潜在思路。

Objective： ：To study the regulatory effect of mogrol (MO) on lipid metabolism of hepatic cancer cells and its molecular mechanism. Methods: Oleic acid (OA) was used to induce fat accumulation in hepatocellular carcinoma HepG2 cells and to establish a steatosis cell model. CCK-8 method was used to detect the cytotoxicity of MO to HepG2 cells, and an experimental working concentration without obvious cytotoxicity of MO was chosen. After being treated with different concentrations of MO, lipid accumulation in the cells was observed by oil red O staining, and the contents of triglyceride (TG) and cholesterol (TC) in the cells were measured. Key genes involving in lipid metabolism were screened out by high-throughput transcriptome sequencing qPCR was used to detect the mRNA expressions of ,SREBP-1c and FASN, while Western Blot was used to detect the protein expressions of p-AMPKα, SREBP-1c and FASN in cells of model group and treatment group. Results: After OA induction, a large amount of lipids accumulated in HepG2 cells, the contents of TG and TC increased significantly. Three key genes (SREBP-1c, FASN and p-AMPK α) involving in lipid metabolism of hepatic cancer cells were screened out. After OA induction, the mRNA expressions of SREBP-1c and FASN increased, the protein expression of p-AMPK α decreased while the protein expressions of SREBP-1c, FASN and other proteins increased significantly. After intervention with working concentration of MO, intracellular lipid accumulation, contents of TG and TC, mRNA expressions of SREBP-1c, FASN and protein expressions of SREBP-1c, FASN decreased significantly, while the expression of p-AMPKα increased. Conclusion: Mogrol can inhibit the synthesis of fatty acids by activating the expression level of AMPK signaling pathway related factors SREBP-1c and FASN, so as to play the role of regulating lipid metabolism.

Objective: To investigate the expression of metastasis-associated protein 2 (MTA2) in human bladder cancer tissues and its effect on the malignant biological behaviors of bladder cancer T24 cells, as well as to explore the effect of MTA2 on the progression of bladder cancer. Methods: Sixty-two cases of human bladder cancer tissues and 28 cases of normal bladder tissues (from patients with cystitis, and pathologically confirmed as normal tissue) were collected at People’s Hospital of Hebei Province during December 2012 and December 2014. The expression of MTA2 in bladder cancer tissues and normal bladder tissues was detected by immunohistochemical staining, and the correlation between MTA2 expression and clinicopathological characteristics of patients was also analyzed. The bladder cancer T24 cell line stably expressing MTA2 was constructed. The effects of MTA2 on the proliferation, colony formation, migration and invasion of bladder cancer T24 cells were detected by MTS, clone formation, scratch healing and Transwell assay, respectively. Results: Immunohistochemical staining showed that MTA2 expression was significantly up-regulated in bladder cancer tissues as compared with normal bladder tissues (P<0.01). The high expression of MTA2 in bladder cancer tissues was not related to gender, age and tumor volume (P>0.05), but was associated with higher TNM stage, histological grade, and lymphatic infiltration and metastasis (all P<0.05). After over-expression of MTA2 in bladder cancer T24 cell line, the proliferation activity of the cells was significantly increased (P<0.05), and the colony formation, scratch healing, migration and invasion ability were significantly increased (all P<0.01). Conclusions: MTA2 is up-regulated in human bladder cancer tissues and can promote the proliferation, tumor formation, migration and invasion of T24 cells.

Objective: To investigate the effects of Wilms’tumor 1-associating protein (WTAP) on proliferation, migration and invasion of human lung adenocarcinoma A549 cells. Methods: Human lung adenocarcinoma cell line A549 and HEK293T cells were chosen for this study. Two sets of shWTAP interference sequences were designed to construct lentiviral vector plasmid. Human lung adenocarcinomaA549 cells were infected after packaging lentivirus in HEK293T cells, and the control group was transfected with 277 empty vector plasmid. The mRNAand protein expression levels of WTAPinA549 cells were detected by qPCR and WB. Changes in proliferation, migration and invasion of A549 cells were detected by BrdU assay, cell scratch healing assay and Transwell assay, respectively. Results: Two plasmids, shWTAP-1 and shWTAP-2, were successfully constructed. Compared with the control group, the mRNA and protein expression levels of WTAP were significantly down-regulated inA549 cells with WTAP knockdown (both P<0.05), and the proliferation, migration and invasion ability of cells were significantly decreased (all P<0.05). Conclusion: Knockdown of WTAP significantly inhibited the proliferation, migration and invasion of human lung adenocarcinoma A549 cells. The expression of WTAP gene is associated with the occurrence and development of lung adenocarcinoma. WTAP may be a potential target for the diagnosis and treatment of lung adenocarcinoma.

AIM:To observe the clinical effects of intravitreal injection of conbercept combined with complex trabeculectomy and panretinal photocoagulation(PRP)in the treatment of neovascular glaucoma.

METHODS: Eleven patients(11 eyes)with neovascular glaucoma were injected with conbercept 0.50mg/0.05mL in vitreous chamber. Complex trabeculectomy was performed after the neovascularization dissipated, and PRP was performed in all cases at the right time. The follow-up time was 6mo. The vision, intraocular pressure(IOP)and complications were observed after complex trabeculectomy.

RESULTS: The IOP were all decreased at 1wk, 1, 3 and 6mo after operation, and the difference was statistically significant(P<0.01). After 6mo, the best-corrected visual acuity of 2 eyes(18%)was improved, 8 eyes(73%)were stable, and 1 eye(9%)was declined. The postoperative complications included hyphema, shallow anterior chamber, and vitreous hemorrhage.

CONCLUSION: Intravitreous injection of conbercept combined with complex trabeculectomy and PRP can control the IOP and preserve the visual function effectively in patients with neovascular glaucoma.

Objective    To compare the subaxillary small incision thoracotomy (SSIT) with video-assisted thoracic surgery (VATS) for patients with lung cancer. Methods    Retrospective analysis of 142 patients with lung cancer in Department of Thoracic Surgery, The First People&#39;s Hospital of Neijiang from January 2014 to April 2016 was conducted. There were 86 males and 56 females, aged 40-77 years. Patients were divided into a VATS group (n=72) and a SSIT group (n=70). The following postoperative data were evaluated: operation time, number of dissected lymph nodes, intraoperative bleeding, postoperative chest drainage volume, drainage duration, postoperative ambulation time, average hospital stay, postoperative complications, hospitalization cost, early postoperative incision pain (visual analogue scale, VAS) and other indicators. Results    There were no statistically significant differences between the two groups in the operation time (120.8±20.4 min vs. 126.2±21.6 min, P=0.124), the dissected lymph node (11.1±2.0 vs. 11.4±1.9, P=0.333) and the postoperative complications rate (13.9% vs. 15.7%, P=0.759). Laparoscopic intraoperative bleeding and postoperative drainage volume were significantly less in the VATS group than those in the SSIT group (123.2±26.9 ml vs. 156.4±24.0 ml, P<0.001; 227.0±75.5 ml vs. 334.3±89.1 ml, P<0.001). Postoperative drainage duration, postoperative ambulation time and hospital stay were shorter in the VATS group than those in the SSIT group (2.5±0.5 d vs. 3.1±0.6 d, 1.5±0.5 d vs. 2.2±0.6 d, 6.5±0.5 d vs. 7.4±0.6 d, all P<0.001). The average hospitalization cost of the VATS group was significantly higher than that of the SSIT group (42 338.9±8 855.7 yuan vs. 32 043.7±7 178.1 yuan, P<0.001). There was no significant difference in the operation cost and anesthesia cost between the two groups (P>0.05). The early postoperative pain of laparoscopic group was less, but the difference was not statistically significant (P>0.05). Conclusion    The hospitalization cost of the SSIT is lower than that of thoracic surgery, which may be beneficial to the appilication in primary hospitals.