Objective:To evaluate the functional and anatomical outcomes of autologous single retinal pigment epithelium (RPE) transplantation for severe obsolete submacular hemorrhage (SMH) in late age-related macular degeneration (AMD).Methods:A retrospective clinical study. From January 2012 to December 2015, 11 patients with AMD (11 eyes) with obsolete SMH who were diagnosed and treated by pars plana vitrectomy (PPV) combined with autologous RPE transplantation at the Department of Ophthalmology, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine were included. Among them, there were 9 eyes in 9 males and 2 eyes in 2 females. All the eyes underwent the examinations of best corrected visual acuity (BCVA) and optical coherence tomography; 4 eyes underwent macular fixation function (MAIA) at the same time. The BCVA examination was carried out using the international standard visual acuity chart, which was converted into logarithm of the minimum angle of resolution (logMAR) visual acuity during statistics. All eyes were treated with PPV combined with autologous single-layer RPE transplantation or autologous RPE-choroidal full-thickness transplantation, and were divided into S group and C group, with 5 and 6 eyes respectively. The differences of age ( t=-0.363), gender composition ratio ( χ2=0.549), course and thickness of SMH ( t=0.118, 0.231), average times of anti-vascular endothelial growth factor drug treatments ( t=0.129), times of PPV ( t=-0.452) between the two groups were not statistically significant ( P>0.05). The follow-up period was 6-40 months after the operation, and the BCVA, MAIA, graft status and complications of the eyes after the operation were observed. The comparison of continuous variables between groups was performed by independent-sample t test; the comparison of categorical variables was performed by χ2 test. Results:At the last follow-up, the average logMAR BCVA of the eyes in group S and C were 1.62±0.34 and 1.03±0.20, respectively; group C was better than group S, however, the difference was not statistically significant ( t=1.532, P=0.160). There were 4 eyes (80%, 4/5) and 6 eyes (100%, 6/6) in S group and C group with BCVA better than preoperative, the difference was no statistical significance ( χ2=0.677, P=0.895). There were 2 (40%, 2/5) and 3 (50%, 3/6) eyes with logMAR BCVA better than 1.0 in S group and C group, and the difference was not statistically significant ( χ2=0.572, P=0.423). After the operation, 6 eyes of grafts were in good condition and 5 eyes were in poor condition; the BCVA of grafts in good condition was significantly higher than that of poor condition, the difference was statistically significant ( t=4.894, P=0.001). Among the 4 eyes that underwent MAIA examination, 2 eyes were unstable and diffusely fixed on the graft; the fixation point was located at the normal retina adjacent to the graft area in 2 eyes. Secondary subretinal hemorrhage occurred in 3 eyes after the operation; the intraocular pressure was high in 1 eye after the operation. During the follow-up period, no intraocular infection, secondary retinal detachment, recurrent choroidal neovascularization or low intraocular pressure occurred in all eyes. Conclusions:Both autologous single-layer RPE transplantation and autologous RPE-choroidal full-thickness transplantation can help stabilize or even improve the visual function of eyes with severe SMH secondary to advanced AMD. The visual acuity after surgery is closely related to the state of the graft.

Objective:To investigate the relationship between genotype and phenotype in children with CRB1 mutated Leber congenital amaurosis (LCA) and early onset retinal dystrophy (EOSRD). Methods:A retrospective clinical study. From January 2013 to December 2019, 10 children with CRB1 mutated LCA/EOSRD were enrolled in the study. The patients were identified as CRB1 mutation by the second generation targeted capture sequencing, Sanger sequencing and the family segregation analysis. All children underwent electroretinogram (ERG) and fundus examination. At the same time, 6 cases were examined by optical coherence tomography (OCT); 1 case was examined by fluorescein fundus angiography (FFA), 7 cases were examined by wide-angle laser scanning ophthalmoscope (UWF SLO). Results:There were 6 cases of LCA and 4 cases of EOSRD in 10 patients with CRB1 gene mutations. The average age of first visit was 3.61 years old. The light and dark wave of ERG was flat in 6 cases, and decreased in 4 cases. A total of 19 pathogenic mutations were detected. There were 1 homozygous mutation and 9 compound heterozygous mutations. There were 4, 2 and 1 cases of "copper-coin" like, "salt and pepper" like and "osteocyte" like pigment changes in retina, 1 case of "crystalline pigment" change and 2 cases of macular pigment scar. In 7 cases of UWF SLO examination, different degrees of para-arteriolar pigment epithelium retention (PPRPE) were found in the middle and peripheral fundus. In 6 cases examined by OCT, the outer layer of retina atrophied and the band of ellipsoid disappeared. Symmetrical cystoid macular edema, splitting cystoid macular degeneration and adhesion of epi-macular membrane to optic disc and macular area were found in 1 case, respectively, the retinal structure was rough and thickened, and the fovea became thinner in 3 cases. In FFA examination, 1 case showed uveitis-like changes with late optic disc fluorescein staining, macular fluorescence accumulation, strong fluorescence diffusing along the blood vessels in each quadrant, peripheral PPRPE of "frost-branch" like strong fluorescence. Conclusion:The relationship between genotype and phenotype of CRB1 mutation is complex, and PPRPE is a common characteristic change.

MiR-142-3p has been reported to act as a tumor suppressor in breast cancer. However, the regulatory effect of miR-142-3p on drug resistance of breast cancer cells and its underlying mechanism remain unknown. Here, we found that miR-142-3p was significantly downregulated in the doxorubicin (DOX)-resistant MCF-7 cell line (MCF-7/DOX). MiR-142-3p overexpression increased DOX sensitivity and enhanced DOX-induced apoptosis in breast cancer cells. High-mobility group box 1 (HMGB1) is a direct functional target of miR-142-3p in breast cancer cells and miR-142-3p negatively regulated HMGB1 expression. Moreover, overexpression of HMGB1 dramatically reversed the promotion of apoptosis and inhibition of autophagy mediated by miR-142-3p up-regulation. In conclusion, miR-142-3p overexpression may inhibit autophagy and promote the drug sensitivity of breast cancer cells to DOX by targeting HMGB1. The miR-142-3p/HMGB1 axis might be a novel target to regulate the drug resistance of breast cancer patients.

Objective:To investigate the efficacy of new-type stereotaxic apparatus-assisted transfrontal puncture and drainage in the treatment of hypertensive intracerebral hemorrhage in the basal ganglia.Methods:A retrospective analysis was performed on the clinical data of 60 patients with hypertensive intracerebral hemorrhage in the basal ganglia who received disposable new-type stereotaxic apparatus-assisted transfrontal insertion with soft tunnels for hematoma aspiration drainage in our hospital from August 2017 to September 2019. The treatment efficacy was analyzed.Results:All patients were successfully punctured at one time; the puncture surface was 5-6.5 cm on the basement plane, where the hematoma surface was the largest; the puncture angle was 10-14°, and the puncture depth was 9-11.5 cm. Fifteen patients were operated within 6 h of hemorrhage, and the intraoperative hematoma clearance rate was about 25%; 40 patients were operated 6-24 h after hemorrhage, and the hematoma clearance rate was about 20%; 5 patients were operated one-3 d after hemorrhage, and the hematoma clearance rate was as high as 30%. The first postoperative re-check CT showed that 51 patients had ideal position of the drainage tube, 2 were too deep, one was too shallow, 2 were below the position, 2 were above the position, one was inside the position, and one was outside the position. The Glasgow Coma Scale (GOS) scores of the patients on 3 rd d of operation (9.88±3.998) were significantly higher than those of the patients before operation (6.24±3.159, P<0.05). One month after the operation, GOS showed that 20 patients (33.3%) had good recovery, 28 (46.7%) had mild disability, 7 (11.7%) had severe disability, 3 (5.0%) had plant survival, and 2 (3.3%) died. Conclusion:The disposable new-type stereotaxic apparatus-assisted transfrontal puncture drainage is easy to be conducted and practicable with a reasonable design, accurate positioning, minimal surgical traumas and satisfactory curative effect.

Objective To investigate the clinical values of laryngeal electromyography (LEMG) for evaluating the amyotrophic lateral sclerosis(ALS) patients with swallowing disorder .Methods A total of 25 ALS patients with or without complaining of swallowing disorder were recruited for the study .Their right cricothyroid muscles were taken unilaterally with concentric needle electrodes by anterior cervical approach .Each patient was tested with Kub-ota drinking test too .Results Of all the 25 patients ,11 were found abnormal in the right cricothyroid muscle which presented with typical degeneration patterns ,15 cases were found abnormal by Kubota drinking test .The coinci-dence rate of the two methods was 60% ,the poisitive coincidence rate was 32% .The McNemar test showed there was some consistency between the drinking water test and LEMG (P=0 .344) ,and the Kappa coefficient was 0 .219 . Conclusion The cricothyroid muscle electromyography may also be a potential method to evaluate ALS patients since it seemed to offer an evidence of dysphagia related with abnormal sensory function of laryngeal mucosa .But there may be some limitations .

Objective To observe the image features of high myopia with retinoschisis by spectraldomain optical coherence tomography (SD-OCT). Methods The clinical data of eight patients (eight eyes)of high myopia with retinoschisis were retrospective analyzed. All patients were diagnosed by SD-OCT (Topcon 3D OCT-1000), had no macular holes and underwent vitrectomy including internal limiting membrane (ILM) peeling and gas tamponade. All patients also underwent visual acuity, refraction,pre-mirror fundus examination and A/B-mode ultrasound examination. Visual acuity and SD-OCT were followed up at one, three and six months after surgery. Before surgery, pre-mirror fundus examination revealed shallow foveal detachment in 3/8 eyes, posterior scleral staphyloma in 7/8 eyes. SD-OCT showed concave arc stripes in 7/8 eyes, and outer retinoschisis in 8/8 eyes, middle or inner retinoschisis in 5/8 eyes and foveal detachment in 5/8 eyes. Results Six months after surgery, posterior retinoschisis disappeared in six eyes, foveal detachment still presented in one eye and parafoveal hole occurred in one eye. The corrected visual acuity improved from the 0. 15 to 0. 8 in one eye which had a restored continuous inner segment/outer segmen (IS/OS) line by SD-OCT. The corxected visual acuity improved from 0. 01 to 0. 1 in one eye, from 0. 05 to 0. 15 in one eye, not changed in five eyes. There was no continuous IS/OS line in those patients by SD-OCT. Conclusions SD-OCT shows a variety of morphological features of myopic retinoschisis which could be cured anatomically and functionally by vitrectomy combined ILM peeling. The continuity of IS/OS layer from SD-OCT could help to interpret the vision recovery after the operation.

Choroidal neovascularization is one of the common causes resulting in vision loss in patients with pathologic myopia, and the irreversible central vision lose is often found. This article reviews the epidemiology of pathologic myopia, pathogenesis, clinical manifestation and anti-VEGF therapy of choroidal neovascularization secondary to pathologic myopia.

OBJECTIVE To investigate the resistance of Enterobacter cloacae and its gene of chlorhexidine-sulfadiazine-resistance(qacE△1-sul1) isolated from two hospitals. METHODS Microdilute tests were performed to detect the susceptibility of 20 kinds of antimicrobial agents in 74 strains of E.cloacae.The qacE△1-sul1gene was detected by PCR. RESULTS There was no strain resistant to imipenem and meropenem.The resistant rates to other antimicrobial agents were between 44.6% and 94.6%.The positive rate of qacE△1-sul1gene was 74.3%. CONCLUSIONS The 74 strains were multiple-drug-resistant.There was a high positive rate of qacE△1-sul1gene in E.cloacae isolated from two hospitals.

OBJECTIVE To investigate the prevalence of three kinds of antimicrobial-resistant genes in Enterobacter cloacae. METHODS Antimicrobial susceptibility test was performed by microdiluted method and antimicrobial - resistant genes were detected by PCR methods in 20 clinical strains of E. cloacae. RESULTS Twenty strains of E. cloacae showed multiple-drug resistance.Among 20 strains, the positive rates of ACT-1, DHA and TEM genes were 70.0%, 45.0% and 55.0%, respectively. The positive rates of aac(6′) -Ⅰ , ant(3″)-Ⅰ, ant(2″)-Ⅰ, aac(6′)-Ⅱ, and aac(3)-Ⅱgenes were 50.0%, 15.0%, 10.0%, 5.0% and 5.0%, respectively . The positive rates of sul Ⅰand dfrA1 genes were 50.0%, and 5.0%, respectively. But other genes were not found. CONCLUSIONS This study shows that there are multiple-drug resistance and high positive rate of three kinds of antimicrobial- resistant genes in E. cloacae isolated from our hospital.

Objective To study the effects of dihydroartemisinin and quinine on plasmodium falciparum gametocytes at early stage. Methods Eleven patients with falciparum malaria who had plasmodium falciparum gametocytes at early stage(PFGe) in bone marrow but no matured plasmodium falciparum gametocytes(PFGm) in bone marrow and peripheral blood were allocated to two groups.Group A(n=6) were administered orally with dihydroartemisinin at a total dosage of 480mg for 7 days and Group B(n=5) with quinine sulfate at a total dosage of 10?500 mg for 7 days.The number of gametocytes in bone marrow and peripheral blood was examined at regular time. Results PFGe in bone marrow disappeared in Group A on 10 th day after the first administration while existed in all the cases of Group B on 10 th day and still in 2 cases on 14 th day.The clearance time for peripheral PFGe was 4.8?0.9 days in Group A and 22.0?5.8 days in Group B. Conclusion Dihydroartemisinin can clear PFGe but quinine shows no this action.