?AlM: To discuss the differences in accommodative lag of different stimulation between the adolescent myopes who wore rigid gas permeable contact lens ( RGPCL ) and spectacles for one year.
?METHODS: Totally 85 myopes between 10-16y were enrolled in the study. Every subject was examined with the visual function test, medical optometry, corneal topography and ocular health check etc. of eyes. According to the above measurements and the compliance of children and their parents, 41 subjects were selected to wear RGPCL, 44 subjects were chosen to wear spectacles. Based on maximum plus to maximum visual acuity ( MPMVA) , accommodative lag was determined by dynamic retinoscopy method in two groups. The subjects were examined once every 3mo, accommodative lag was measured again using the same method for comparative analysis after one year. Wearing a year later, myopia progression of the two groups was measured and compared.
?RESULTS: There was no significant difference between two groups of initial accommodative lag (P>0. 05). After wearing one year, there was also no significant difference between the accommodative lag examined and the initial lag in RGPCL group (P>0. 05), the results demonstrate significant difference between the accommodative lag examined after wearing one year and the initial lag in spectacles group ( P < 0. 05 ). One year later, the differences were significant in accommodative lag between RGPCL and spectacles wearers stimulated by 2D, 3D and 4D ( P < 0. 05 ), and the accommodative lag increased with increasing stimulation in both groups. After wearing a year, the myopia progression of RGPCL group was less than spectacles wearers, and the differences were significant (P<0. 05).
?CONCLUSlON:After wearing RGPCL and spectacles one year in high accommodative stimulus, there is an obviously decreased in accommodative lag in RGPCL group, which suggests that RGPCL can control the progression of myopia in adolescents. The accommodative lag of the two groups increase obviously with increasing stimulation, which suggest that the adolescents need keeping good habits of reading.

Objective To explore a novel operative management for irreducible atlantoaxial dislocation. Methods Fifty-four patients, which as 32 males and 22 females aged from 7 to 63 years old with a mean of 32 years, were diagnosed with irreducible atlantoaxial dislocation, including 18 patients with os odontoideum, 22 occipitalization, 5 malunion of odontoid fracture and 9 relaxation of transverse ligament of atlas. Forty patients presented signs and symptoms of myelopathy or spinal cord injury. All of the patients underwent the operation of open reduction and release by transoral approach. The longus collies muscles, longus capitis muscles, anterior longitudinal ligament, atlantoaxial articular capsules, the apical odontoid ligament and alar odontoid ligaments may be included, were transected, followed by arthrodesis via posterior approach in one stage. Different methods of posterior arthrodesis were conducted as followed: C1,2 transarticular screw fixation in 5 cases, occipitocervical fixation using pedicle screws of axis and occipitocervical plate in 37 cases, and C1,2 joint fixation with plates and screws in the lateral masses of the atlas and axis in 12 cases. Results A complete reduction was achieved in 41 cases, and the other 13 patients obtained partial reduction. Forty-eight patients were followed up from 4 to 40 months, 15.7 months at the average. All of them achieved solid arthrodesis. According to Odom's scoring system, among the 38 patients with preoperative upper cervical myelopathy, 15 patients were assessed as excellent, 14 good, 8 fair and 1 poor. During the operation, cerebral spinal fluid leakage occurred in 1 case, and pedicle screwing failed in 1 case. After the operation, respiratory failure was found in 1 case, nasal sound in 3 cases, dysphagia in 1 case. One patient became quadriplegia due to myelitis caused by septicemia at two weeks after the operation. The internal fixation loosened in 1 case at 2 months postoperatively. Conclusion Transorally surgical release for reduction and posterior arthrodeses could achieve satisfactory outcomes in patients with irreducible atlantoaxial dislocation.

University of Manchester who first introduced Problem based learning(PBL)to the UK medical education,and adopted this new curriculum in 1994.Notably,Cambridge and Oxford have always had a high proportion of student-centred and self-directed learning,and have therefore not introduced PBL.Other medical schools have followed the example of Manchester,now PBL has become the mainstream curriculum in British medical edacation.First,this article is going to introduce how PBL curriculum is structured at Manchester medical school,and then reflect and give some thoughts on its current practice.

Objective To investigate the species composition and quantitative dynamic state of rodent and parasitic flea in Huairou District of Beijing City,and to carry out serologic monitoring of animal plague.Methods Rodent density was investigated at different habitats in eight villages and towns between 2009 and 2011.Serum samples from captured rodents were detected by indirect hemagglutination test,and genotypes of collected parasitic fleas were identified.Results A total of 709 rodents which belong to eight different kinds were captured with a rodent density of 2.52％ (83/3 300),and Rattus niviventer and Apodemus peninsulae were dominant species,acounted for 46.4％ (329/709) and 18.1％(128/709),respctively.Five hundred and sixty-three serum samples of rodents were tested by plague indirect hemagglutination,and all of them were plague antibody negative.Two hundred fleas were checked with a flea infected rate of 29.63％ (48/162),and a flea index of 1.23; Paraceras crispus and Leptopsylla pavlovskii were dominant flea species,a total of 30 and 27,respectively.Conclusion Some environment conditions are suitable for rodents survival,even though there is no sign of animal plague epidemic.

Objective To explore the relationship between phosphatidylinositol 3 kinase (PI3K)/protein kinase B (Akt)/mammals target protein rapamycin (mTOR) signal transduction pathway and Barrett esophagus genesis.Methods A total of 140 rats were divided into sham operated group (n=10),iron group (n =10),esophageal duodenal side anastomosis group (n =30),esophageal duodenal side anastomosis plus iron group (n-30),esophageal gastric duodenal side anastomosis group (n=30) and esophageal gastric duodenal anastomosis plus iron group (n=30).In the end,10 normal esophagus tissue specimens,62 reflux esophagitis tissue specimens and 34 Barrett's esophagus tissue specimens were obtained.The expression levels of epidermal growth factor receptor (EGFR),Akt,phospho Akt (p-Akt),phospho-mTOR (p-mTOR) protein were detected by immunohistochemistry.Single factor analysis of variance,SNK between two groups and nonparametric correlation analysis were performed for statistical analysis.Results The protein expression levels of EGFR,Akt,p-Akt,p-mTOR in Barret(s esophagus tissues were higher than those in reflux esophagitis tissues and normal esophagus tissues (EGFR 0.1799±0.0367 vs 0.0438±0.0025 and 0.0277±0.0069,q=6.79,4.13; Akt 0.1874±0.0250 vs 0.0986±0.0093 and 0.0383±0.0048,q=6.51,3.56; p-Akt 0.1418±0.0130 vs 0.0592±0.0027 and 0.0281 ±0.0017,q=7.68,3.99; p-mTOR 0.1591±0.0275 vs 0.0674 ±0.0059 and 0.0112±0.0017,q=5.62,4.11; all P＜0.05).The protein expression levels of EGFR,Akt,p-Akt,and p-mTORin reflux esophagitis tissues were higher than those in normal esophagus tissues(q=4.67,4.29,4.27,4.03; all P＜0.05).Conclusion PI3K/Akt/mTOR signal transduction pathway were activated in reflux esophagitis and Barrett's esophagus,which provided theoretical basis for clinical multi-target treatment for diseases.

Objective To develop a sheet to assess infection risks in children with malignant tumors after chemotherapies.Methods A risk assessing sheet (to consult) was designed and used to consult 24 experts from 9 hospitals located in 6 provinces.After 3 rounds of expert consultation,a sheet (to try) was developed and tried by nurses in the clinic.And then a sheet (to use) was developed.Results The authority coefficient of experts was 0.79,the positive coefficient of experts was 1.00 and 0.96.The sheet (to try) developed after 3 rounds of expert consultation consisted of 30 items and was divided into 2 parts,one was about static items and the other was about dynamic items.Depending on the trying of the sheet (to try),the sheet (to use) was constituted by 8 fundamental immune state assessing items and 16 infection risk screening items.Conclusions Experts consulted in the study were quite reliable,representative and positive.The sheet (to use) seemed to have good pertinence and practicability.Further studies should be done to verify whether the sheet (to use) may help nurses to prevent children with malignant tumors from infections after chemotherapies.

Objective To observe the applicated value of recombinant human growth hormone ( r-hGH) ther-apy in improving difficult weaning .Methods 40 patients with difficult weaning were randomly divided into the treat-ment group (20 cases) and control group (20 cases).The control group received routine ICU treatment .The treat-ment group was given the conventional treatment and subcutaneous injection of r -hGH 8IU,1 time a day,a total of 14 days.The serum total protein,albumin,oxygenation index,peak of blood glucose,independent tidal volume changes were observed before and after treatment , the success rate and mortality rate were compared .Results After treat-ment,the total protein,albumin,tidal volume of the treatment group were (68.1 ±13.4) g/L,(40.8 ±6.0) g/L, (432 ±57)mL,which were significantly higher than those before treatment [(52.3 ±12.5)g/L,(28.4 ±4.5)g/L, (278 ±54)mL](t=3.856,7.394,8.771,all P<0.05).While after treatment,the total protein,albumin,tidal vol-ume in the control group were (58.4 ±14.2)g/L,(31.0 ±5.8)g/L,(398 ±48)mL,compared with before treatment (53.2 ±13.3)g/L,(28.1 ±4.2)g/L,(271 ±49)mL,the differences were not statistically significant (all P>0.05).The success rate was 85% in the treatment group,which was higher than 50% in the control group(χ2 =4.103,P<0.05).In the treatment group,3 cases died,in the control group 9 cases died,there was statistically signif-icant difference between the two groups (χ2 =4.286,P<0.05).Conclusion r-hGH can improve the nutritional sta-tus of critically ill patients ,increase the strength of the respiratory muscles ,improve lung function ,help to improve the weaning rate .

Purpose To investigate the effect of small interfering RNA on the increase of myocyte enhancer factor 2A(MEF2A) expression in PC12 cells exposed to hypoxia.Methods PC12 cells were cultured under normal conditions or were exposed to hypoxic conditions.Small interfering RNA targeted MEF2A gene (MEF2A-siRNA) was chemically synthesized. Eukaryocytic expression vector was built and transfected into PC12 cells with liposome. The expression of MEF2A mRNA was detected by real-time PCR. Western blot was used to detect the MEF2A protein.Results Compared with normal control(2~(-△△CT)=1.01±0.02), the mRNA level of MEF2A gene in PC12 cells with the treatment of MEF2A-siRNA was down-regulated significantly by 88%(2~(-△△CT)=0.12±0.03, P＜0.01).The expression of MEF2A protein in hypoxia-treated PC12 cells was markedly higher than that of normal control(98.4±11.7 and 47.5±7.6,P＜0.01).However, MEF2A-siRNA could significantly suppress the increase of MEF2A protein (P＜0.01).Conclusion MEF2A gene silence induced by siRNA might inhibit the increase of MEF2A protein by hypoxia in PC12 cells.

Bacteremia ; etiology ; Female ; Humans ; Infant, Newborn ; Listeria monocytogenes ; isolation & purification ; Male

OBJECTIVETo investigate the effect of SIRT6/NF-κB signal axis in delaying hematopoietic stem/progenitor cell senescence with ginsenoside Rg1, in order to provide theatrical and experimental basis for looking for methods for delaying HSC senescence.

METHODSca-1 + HSC/HPC was isolated by magnetic cell sorting (MACS) and divided into five groups: the normal control group, the aging group, the positive control group, the Rg1 anti-senescence group, and the Rg1-treated group. Senescence-associated β-galactosidase (SA-β-Gal) staining, cell cycle analysis and hemopoietic progenitor cell mix (CFU-Mix) were adopted to determine the effect Rg1 in delaying or treating Sca-1 + HSC/HPC senescence biology. The mRNA and protein of senescence regulation molecules SIRT6 and NF-KB were examined by realtime fluorescence quantitative PCR (FQ-PCR) and western blotting.

RESULTCompared with the senescence group, the Rg1 anti-senescence group and the Rg1-treated group showed lower percentage in SA-β-Gal-stained positive cells, decreased cell proportion in G1 phase, increased number of CFU-Mix, up-regulated in SIRT6 mRNA and protein expression, down-regulation in NF-KB mRNA and protein expression. The Rg1 anti-senescence group showed more evident changes in indexes than the Rg1-treated group.

CONCLUSIONRg, may inhibit Sca-1 + HSC/HPC senescence induced by t-BHP by regulating SIRT6/NF-KB signal path.

Animals ; Antigens, Ly ; analysis ; Cellular Senescence ; drug effects ; Female ; Ginsenosides ; pharmacology ; Hematopoietic Stem Cells ; drug effects ; Male ; Membrane Proteins ; analysis ; Mice ; Mice, Inbred C57BL ; NF-kappa B ; physiology ; Signal Transduction ; physiology ; Sirtuins ; physiology