AIM:To compare the accuracy of conventional contact A-scan and IOL Master in measuring axial length and anterior chamber depth, and to evaluate the characteristics of these two different methods.METHODS:Totally 145 cases (189 eyes) who underwent phacoemulsification and intraocular lens implantation in our hospital from January 2015 to December 2016 were observed prospectively.They were divided into five groups according to ocular axial length measured by IOL Master(Group A:AL≤22mm, Group B:22mm28mm).The axial length and anterior chamber depth were measured by A-scan and IOL Master respectively before operation, corneal curvature was measured by IOL Master.AL≤22mm using Hoffer Q formula to calculate the crystal degree, AL>22mm using Haigis formula to calculate the crystal degree.Analysis of axial length, anterior chamber depth and mean absolute refractive error at 3mo after surgery.RESULTS:The axial length measured by A-scan and IOL-master:Group A were 21.48±0.41mm and 21.46±0.40mm (P>0.05);Group B were 23.13±0.62mm and 23.14±0.63mm(P>0.05);Group C were 25.24±0.56mm and 25.27±0.59mm(P>0.05);Group D were 26.97±0.59mm and 27.03±0.64mm(P>0.05);Group E were 30.76±1.40mm and 31.01±1.53mm(P<0.05).Mean absolute refractive error (MAE) at 3mo after surgery by A-scan and IOL Master:Group A were 0.50±0.30D and 0.43±0.27D(P>0.05);Group B were 0.48±0.34D and 0.45±0.32D(P>0.05);Group C were 0.56±0.32D and 0.49±0.40D(P>0.05);Group D were 0.64±0.16D and 0.50±0.22D(P>0.05);Group E were 0.91±0.47D and 0.62±0.29D(P<0.05), MAE≤±0.50D were 38.7% and 65%(P<0.05), MAE≤±1.00D were 69.2% and 83.3%(P>0.05).Anterior chamber depth measured by A-scan and IOL Master:Group A were 2.81±0.35mm and 2.82±0.41mm (P>0.05);Group B were 3.04±0.50mm and3.10±0.47mm (P>0.05);Group C were 3.55±0.62mm and 3.60±0.52mm (P>0.05);Group D were 3.42±0.24mm and 3.51±0.30mm(P>0.05);Group E were 3.50±0.28mm and 3.61±0.34mm(P>0.05).CONCLUSION:IOL Master and contact A-scan have a high degree of consistency in the biological measurement, IOL Master has higher accuracy for patients with high myopia and long axis.It is a simple, accurate, good-repeatable and non-contact measurement tool.

Objective:To learn from the experiences of environmental impact assessment,and explore the theories and practices of health impact assessment.Methods:With suitability analysis of reference to environmental impact assessment and literature research,the current situation,practices and problems of environmental impact assessment were summarized.Results and Conclusion:Drawing on experiences in environmental impact assessment,it needed to start the establishment and implementation of health impact assessment system with healthy cities,healthy towns and villages,improve relevant laws and regulations,strengthen supervision and management of health impact assessment.

This article introduced the experiences of nongovernmental capital running hospitals in US,Germany,India and Israel and put forward some suggestions that need to be considered in China, such as innovating supply model of health care service,treating social capital running hospitals equally and strengthening supervision.

ner. Furthermore, IL-10 and TGF-β1 showed a synergic effect. Conclusion IL-10 and TGF-β1, the cytokines of regulatory T cells, suppress the formation and bone resorption function of the osteoclasts.

Background: It is reported that 30% to 80% schizophrenia patients suffered from hypersalivation when taking clozapine. Some investigations of the use of formulas of traditional Chinese medicine (TCM) to treat clozapine-induced hypersalivation suggested their potential treatment effects. In these formulas, Suoquan Pill (SQP) and Wuling Powder (WLP) were suggested to have therapeutic effects in improving clozapine-induced hypersalivation. Methods and design: A prospective, double-blind, randomized, placebo-controlled study will be conducted to test the therapeutic effects of SQP and WLP in relieving hypersalivation in patients taking clozapine. A total of 45 patients will be enrolled into this study with 15 in each treatment group. Patients will receive medication according to their assigned group. Either SQP 10 g per oral dose twice daily, WLP 10 g per oral dose twice daily or placebo powder 10 g per oral dose twice daily will be prescribed to the patients for 8 weeks. The Drooling Severity Scale, Nocturnal Hypersalivation Rating Scale and sialoscintigraphy will be used as the primary outcome measures; the Clinical Global Impressions Severity, the Positive and Negative Syndrome Scale, the Abnormal Involuntary Movement Scale, the Simpson-Angus Scale and the TCM constitutional scale will be used as the secondary outcome measures Discussion: It is hypothesized that SQP and WLP will have a beneficial effect in controlling clozapine-induced hypersalivation symptoms. It may also improve the life quality of psychotic patients by improving their mental status. Trial registration: ClinicalTrials.gov (Identifier: NCT01045720).

Objective To construct nursing needs scale for school-age children with acute leukemia (AL) during lumbar puncture by using Delphi technique.Methods A certain number of experts were chosen for consulting to form a consulting scale.Two-round consultations were conducted and the results were analyzed.Results The effective response rate of the experts' questionnaire for 2 rounds was 100％ (17/17).The specialist group authority coefficient was 0.85.The coordination coefficients for 2 rounds were 0.437 and 0.516 respectively (P ＜ 0.01).The nursing needs scale for school-age children with AL during lumbar puncture comprised of 5 first-level indicators and 30 second-level indicators.Conclusions This scale can scientifically and quickly evaluate the nursing needs of school-age children with AL during lumbar puncture,it provides a research tool to develop individualized interventions with demand as the direction.

Objective We aimed to explore the real experience of parents of children with acute leukemia during lumbar puncture,so as to provide the theoretical and practice evidence for development of individualized nursing measures.Methods Twenty parents of children with acute leukemia participated in semi-structured interviews regarding their experience of lumbar puncture.The data were colected and analyzed by the Colaizzi phenomenological methodology.Results Three themes were extracted including heavy psychological burden,lack of related knowledge of lumbar puncture and demand of multipolarity.Conclusions Attention should be paid closely to parents of children with acute leukemia during lumbar puncture.The individualized nursing measures should be taken by medical workers in order to truly meet their needs,make them stay in a good state and cooper-ate with medical workers to complete the treatment of children.

Objective Studies show that the ERCC1 gene may be involved in secondary cisplatin resistance.This article aims to investigate the effects of shRNA targeting silencing excision repair cross-complementation group 1 (ERCC1-shRNA) on the proliferation and apoptosis of lung cancer A549/DDP cells treated with different concentrations of cisplatin.Methods Lung cancer A549/DDP cells were divided into a negative control, a blank control, an ERCC1-shRNA1, and an ERCC1-shRNA2 group.Human interfering RNA (RNAi) targeting the human ERCC1 gene was constructed and transfected into the A549/DDP cells using Lipofectamine 2000.The mRNA and protein expressions of ERCC1 in the A549/DDP cells were detected by real-time PCR and Western blot respectively, the proliferation-inhibition rate was assessed by MTT, and their cell cycle and apoptosis were determined by flow cytometry.Results ERCC1-shRNA was successfully constructed and transfected into the A549/DDP cells.Both the mRNA and protein expressions of ERCC1 were significantly lower in the ERCC1-shRNA1 (0.20±0.04 and 0.24±0.10) and ERCC1-shRNA2 (0.47±0.28 and 0.37±0.11) than in the negative control (0.96±0.12 and 1.32±0.13) and blank control groups (0.84±0.07 and 1.45±0.23) (P<0.01).Compared with the negative and blank control groups, the ERCC1-shRNA1 group showed a significantly decreased IC50 value (16.71±2.33 and 16.69±1.69 vs 7.78±0.54, P<0.01) and an increased proportion of G0/G1 phase cells ([72.87±3.23] and [71.75±4.56] vs [82.99±4.23]%, P<0.05), with the cell cycle arrested in the G0/G1 phase.The apoptosis rate of the cells in the ERCC1-shRNA1 group was remarkably lower after treated with cisplatin at the concentrations of 6.25 and 12.5 μg/mL than at 0 μg/mL ([8.17±0.65] and [11.91±1.41] vs [29.97±3.14]%, P<0.05).Conclusion ERCC1-shRNA can inhibit the proliferation and enhance the apoptosis of A549/DDP cells by silencing the expression of the ERCC1 gene.

Objective:To investigate parents′ knowledge and attitude toward post-operative pain management in pediatric orthopedics and analyze influencing factors.Methods:A total of 170 parents of 6 to 16 years old children who underwent selective surgeries and were hospitalized because of limb fracture were conveniently selected in Children′s Hospital of Soochow University from April to December in 2019, They were investigated using the general data questionnaire, Pain Management Knowledge and Attitudes Questionnaire.Results:There were 167 parents completed questionnaires in our study. The mean score of parents′ knowledge, general attitude and negative attitude to pain medication were 15.0(3.00), 24.0(4.00) and 17.0(3.00) respectively. There were statistical differences between different educational levels of parents′ knowledge ( χ2 value was11.599, P=0.021), as well as different age of parent′s general attitude ( χ2 value was 7.053, P=0.029). Spearman-related results showed that parents′ cognition was positively correlated with general attitudes ( r value was 0.394, P<0.01). Conclusions:The majority of parents are at moderate to high level of knowledge, general attitude and negative attitude to pain medication. Pediatric nurses should pay more attention to parents′ knowledge deficit of and negative attitude toward pain assessment tools and pain-drugs to develop targeted educational intervention programs for promoting parental involvement.

Objective:To determine the expression of matrix metalloproteinase 13 (MMP13) in patients with psoriasis, and to evaluate the effect of tazarotene and narrow-band ultraviolet B (NB-UVB) on the expression of MMP13 in mice with psoriasis-like dermatitis.Methods:Lesional skin tissues and normal skin tissues were collected from 18 patients with psoriasis vulgaris and 10 healthy controls respectively, who were enrolled from General Hospital of Tianjin Medical University between May 2019 and August 2019, and serum samples were collected from all the subjects. A total of 25 specific pathogen-free (SPF) male BALB/c mice were randomly divided into control group, imiquimod group, imiquimod+NB-UVB group, imiquimod+tazarotene group and imiquimod+tazarotene+NB-UVB group. The control group received topical vaseline cream on the back once every morning; imiquimod group and imiquimod+NB-UVB group received imiquimod cream on the back once every morning; imiquimod+tazarotene group and imiquimod+tazarotene+NB-UVB group received imiquimod cream on the back once every morning, and tazarotene cream on the back once at night; imiquimod+NB-UVB group and imiquimod+tazarotene+NB-UVB group received NB-UVB irradiation on the back every other day at noon, with the dose being 300 mJ/cm 2 in the first session and increasing by 50 mJ/cm 2 in every session. The modeling lasted 7 days. After successful modeling, blood samples were obtained from the eyeballs of the mice, and skin tissues were resected from the back of the mice after being sacrificed by cervical dislocation on day 8. Changes in the epidermal thickness and pathological manifestations were observed by hematoxylin and eosin (HE) staining, protein expression of MMP13 in skin tissues was determined by immunohistochemical study, and the serum level of MMP13 was detected by enzyme-linked immunosorbent assay. Comparisons between 2 groups were performed by using two-independent-sample t test, comparisons among several groups by using one-way analysis of variance, multiple comparisons by using least significant difference- t test, and comparisons of enumeration data by using chi-square test. Results:The skin lesions of the patients with psoriasis were strongly positive for MMP13, and the MMP13 expression levels in the epidermis and serum (84.11±17.16, 13.29±3.95 μg/L, respectively) were significantly higher in the patients with psoriasis than in the healthy controls (11.98±4.08, 7.46±1.58 μg/L, respectively, both P< 0.01) . Compared with the control group (1.26±0.04 μm, 25.40±2.34, 185.76±7.22 μg/L, respectively) , a significant increase was observed in the epidermis thickness (7.93±0.59 μm, P< 0.01) , as well as MMP13 levels in the epidermis and serum in the imiquimod group (147.14±5.53, 215.98±15.17 μg/L, respectively, both P< 0.01) . Compared with the imiquimod group, the imiquimod+tazarotene group, imiquimod+NB-UVB group, and imiquimod+tazarotene+NB-UVB group all showed significantly decreased epidermal thickness (3.56±0.37 μm, 3.83±0.39 μm, 2.14±0.34 μm, respectively, all P< 0.05) , MMP13 levels in the epidermis (120.42±3.23, 91.08±0.46, 71.12±7.11, respectively, all P< 0.05) and serum (197.39±3.92 μg/L, 196.13±11.76 μg/L, 183.21±14.99 μg/L, respectively, all P< 0.05) . Conclusions:MMP13 protein expression markedly increased in the skin lesions and sera of patients with psoriasis, and decreased in skin lesions and sera of mice with psoriasis-like dermatitis after the treatment with tazarotene and NB-UVB. MMP13 may be involved in the development of psoriasis, and tazarotene and NB-UVB may inhibit the development of psoriasis by reducing the expression of MMP13.