AIM: To observe the effect of intraocular lens ( IOL) implantation on visual acuity and contrast sensitivity in patients with cataract.
METHODS: Fifty - eight cases ( 72 eyes ) cataract patients with regular cornel astigmatism, in our hospital from May 2014 to May 2015 were randomly divided into two groups to undergo phacoemulsification and IOL implantation: the observation group: 29 cases (36 eyes) received multifocal toric IOL implantation; the control group: 29 cases (36 eyes) received monofocal toric IOL implantation. Uncorrected distance visual acuity ( UCDVA), uncorrected near visual acuity ( UCNVA), best corrected distance visual acuity (BCDVA), the best corrected near visual acuity ( BCNVA ), total eye astigmatism, and the dark contrast sensitivity were observed for these patients at 1 and 6mo after cataract surgery.
RESULTS: There were no statistical significant difference between the two groups at postoperative 1, 6mo on UCDVA, BCNVA, BCDVA and total eye astigmatism(P>0. 05). UCNVA of observation group at 1 and 6mo were better than those of control group ( P <0. 05); there were statistically significant difference in high frequency comparison at the sixth postoperative months (P<0. 05).
CONCLUSION: Both monofocal toric IOL implantation, and aspheric multifocal toric IOL implantation for cataract with regular corneal astigmatism are effective to improve visual acuity. But the latter treatment would contribute to the improvement of uncorrected near visual acuity and the dark contrast sensitivity.

Objective To study the relationship between efflux pump MexAB‐OprM and carbapenem resistance of Pseudomonas aerginosa strains .Methods The minimum inhibitory concentrations of imipenem and meropenem were determined by agar dilution method for 75 strains of P .aerginosa in the absence or presence of MC207110 to screen the phenotypes of active efflux pump .Reverse transcriptase‐polymerase chain reaction (RT‐PCR) method was used to determine the mRNA expression level of mexA which encodes the membrane fusion protein in active efflux pump MexAB‐OprM and the reference (housekeeping) gene rpoD .PCR method was used to amplify the regulatory genes mexR ,nalC ,and nalD of active efflux pump MexAB‐OprM in the strains overexpressing the efflux pump . The PCR products were subject to DNA sequencing and BLAST analysis . Results Of the 75 P .aeruginosa strains ,13 (17 .3% ) were positive for efflux pump MexAB‐OprM .Overexpression of the efflux pump was identified in 10 of the 13 strains and associated with positive regulatory genes mexR ,nalC and nalD .A Gly71→Glu mutation in nalC was found in 9 strains ,and a Ser209→Arg mutation in nalC was identified in 8 strains .Only one strain had a Thr158→Ile mutation in nalD .Eight strains had mutation in mexR .Conclusions Overexpression of multidrug efflux pump MexAB‐OprM plays an important role in carbapenem resistance of P .aeruginosa .High level expression of MexAB‐OprM is related to the mutations of its regulatory genes .

Functional constipation (FC) is a common functional bowel disorder disease that affects life quality of a large number of people. This study aimed to explore the impact of different intensities of electro-acupuncture (EA) treatment for FC patients. Totally, 111 patients with FC meeting the Rome III criteria were randomly assigned to different intensities of EA groups (low and high intensity of EA groups) and medicine-controlled (MC) group. In EA groups, patients were treated with EA at quchi (LI11) and shangjuxu (ST37) bilaterally for 4 weeks, 5 times/week in the first 2 weeks, and 3 times/week in the last 2 weeks. In MC group, 5 mg mosapride citrate was administered orally 3 times/day for 4 weeks. Spontaneous bowel movement frequency each day was recorded using a constipation diary. Self-rating anxiety scale (SAS) and self-rating depression scale (SDS) were used to assess the patients' psychological state. Cortisol (CORT), substance P (SP), and vasoactive intestinal polypeptide (VIP) were evaluated at baseline and at the end of 4 weeks after treatment. As compared with the baseline, there was statistically significant increase in stool frequency every week (P<0.01), but there was no statistically significant difference among the three groups. As compared with the baseline, after 4 weeks of EA therapy, the scores of SDS and serum levels of CORT were decreased significantly in low intensity of EA group (P<0.01), and the serum levels of SP and VIP were increased significantly (P<0.05); the scores of SAS and SDS and serum levels of CORT were decreased significantly in high intensity of EA group (P<0.05), and the serum levels of SP and VIP were increased significantly (P<0.05); the serum levels of CORT and VIP were increased significantly in MC group (P<0.05). As compared with MC group, after 4 weeks of treatment, the serum levels of SP were signifcicantly increased in low intensity of EA group (P<0.01). Low and high intensities of EA could increase the stool frequency, improve the FC patient's anxiety and depression, reduce the serum levels of CORT, and increase the serum levels of SP and VIP effectively. It is concluded that both low and high intensities of EA are effective for FC patients, but there is no significant difference between the low and high intensities of EA.

AIM: To evaluate the efficacy of combined therapy for amblyopia in children by making use of pattern visual evoked potential ( P-VEP) game.
METHODS: This was a prospective case control study. These asthenopic children were divided into two groups. The control group ( 66 eyes of 49 patients ): occlusive therapy with glasses, cover, precision work, red light treatment and so on, later the stereo vision training was added. The experimental group (72 eyes of 52 patients):conventional methods mentioned above with P - VEP games.
RESULTS: The total effective rate and cure rate of experimental group in 6mo were higher than those of control group. The overall effective rate was 94. 4% in the experimental group and 83. 3% in the control group. There was a statistically significant difference between them (P<0. 05).
CONCLUSION: The comprehensive therapy by making use of P-VEP game is an individualized effective new way in treating amblyopia.

Ultrasonic microbubbles were used to open blood-brain barriers (BBB) with a reversed and limited behavior feature in the study, which could improve the brain-targeted delivery of anti-tumor drugs. The glioma rat model was prepared. Low-frequency ultrasound was combined with microbubbles to affect the permeability of BBB compared with the permeability of independently administered Evans blue (EB) crossing BBB. Time point and length of ultrasound were investigated whether they affect the permeability of BBB and the damage of brain tissue. The effect of the growth time of glioma on BBB permeability was explored. Only glioma had a very little impact on BBB permeability. However, ultrasonic microbubbles opened the BBB with the features of temporary, limited and reversed behavior and improved EB and magnetic resonance imaging contrast agent penetrating BBB. A length of 30 s ultrasound is appropriate for opening BBB and no damage of brain tissue. Drugs should be injected before ultrasound so that they enter into brain as BBB opening. Ultrasonic microbubbles can open BBB effectively and safely, which improve drugs penetrating BBB under proper time point and length.
Animals ; Blood-Brain Barrier ; Contrast Media ; Drug Delivery Systems ; Glioma ; drug therapy ; Magnetic Resonance Imaging ; Microbubbles ; Permeability ; Rats ; Ultrasonics

Background The mechanism of both selenite-induced cataract and age-related cataract is oxidative damage.N-acetylcysteine (NAC) is one of the effective antioxidants,but the literature is little about the preventive and treating effects of NAC on cataract. Objective This study attempted to investigate the preventive and therapeutical effects of NAC on the selenite-induced cataract,and to discuss the possible mechanism. Methods Sixty 10-day-old clean SD rats were randomly divided into normal control group-1,normal control group-2,selenite-induced cataract group,NAC preventive group,NAC+normal saline group and NAC treatment group.Selenite cataract models were induced by subcutaneous injection of 3.46 mg/kg sodium selenite once daily for three days.The rats of NAC preventive group received the intraperitoneal injection of 2 mmol/L NAC 30 minutes before the injection of sodium selenite once daily for 6 days.In NAC treating group,2 mmol/L NAC was intraperitoneally injected 1 day after the injection of sodium selenite for 30 days,and the normal saline solution was injected at the same method in the NAC+normal saline group.Lens opacification was graded according to LOCS Ⅲ criteria.Histopathological change of lens epithelium was examined under a light microscope after hemotoxylin and eosin staining,and the ultrastructure was observed under the scanning electron microscope.The expression of caspase-3 in lens was assayed using immunochemistry.The levels of superoxide dismutase ( SOD ),malonaldehyde ( MDA ) in rat lens were detected respectively in corresponding time points.The use of the experimental animals complied with the Regulation for the Administration of Affairs Concerning Experimental Animals by State Science and Technology Committee. Results In 7 days after experiment,lenses were completely clear in the normal control group.Lens opacification of Ⅴ grade was found in 11 eyes in selenite cataract model group,but no lens opacification of Ⅴ grade was seen in NAC preventive group,showing a significant difference(x2 =40.000,P＜0.05 ).In 30 days after experiment,Ⅳ- Ⅴ grades of cataracts were found in 20 eyes both in NAC + normal saline group and NAC treating group (x2=0.153,P＞ 0.05 ).Histopathological examination showed that lens structure was normal,and the separation between LECs and anterior capsule,the rupture of cellular membrane,deformation of cellular nuclei and the feature of lens fiber were seen in selenite cataract group,but the damage of lens was mild in the NAC preventive group.Ultrastructure of lens was obviously abnormal in selenite cataract group,NAC+normal saline group and NAC treating group.Expressions of caspase-3 and SOD in lens were significantly lower,but that of MDA was significantly higher in the selenite cataract group than the normal control group (P＜0.05) ;while those of the NAC preventive group were significantly different from selenite cataract group(P＜0.05).No significant difference was found in the expressions of caspase-3 and the levels of SOD and MDA between NAC+normal saline group and NAC treating group (P＞0.05 ). Conclusions Selenite can induce the apoptosis of LECs.NAC can evidently postpone formation of selenite cataract by increasing the activity of SOD,decreasing the level of MDA and the expression of caspase-3.However,NAC could not reverse selenite-induced lens damage.

To discuss the effective method of decreasing the postoperative recurrence rate of recurrent pterygium.
●METHODS:Totally 126 cases (126 eyes) with recurrent pterygium were randomly divided into A group (56 cases) and B group ( 70 cases ). Group A was treated by pterygium conjunctive reverse transplantation combined with amniotic membrane transplantation, group B was treated by amniotic membrane transplantation. The followed-up time after surgery was 6-24mo.
●RESULTS:ln group A, postoperative 5-7d (average 5. 62± 1. 38d), cornea epithelium was repaired. ln group B, postoperative 7- 10d ( average 7. 38 ± 1. 12d), the corneal wound was healed. There was statistical significant difference between two groups (t = 4. 307,P<0. 05). Three cases recurrence were noted in A therapeutic group (56 cases), the recurrent rate was 5. 4%; Twelve cases recurrence were noted in B compared group (70 cases), the recurrent rate was 17. 1%. There was statistical significant difference between two groups(P<0. 05).
●CONCLUSlON: lt is suggested that pterygium conjunctive reverse transplantation combined with amniotic membrane transplantation is effective in the treatment of recurrent pterygium.

BACKGROUNDCaspases are important in the signaling pathway of cellular apoptosis. Caspase-3 protein expression has been shown to increase and parallel to neuronal apoptosis in retinal ischemia injury. This study was to determine whether caspase-1 is involved in neuronal cell death or in retinal ischemia and reperfusion injury.

METHODSIn twenty-one adult mice, ischemia was induced by increasing the intraocular pressure. The animals were sacrificed at 1 hour, 3 hours, 6 hours, 1 day, 3 days and 7 days after reperfusion. Frozen sections were used for caspase-1 immunostaining and TUNEL labeling.

RESULTSIn normal retina, no caspase-1 positive cells were seen. One hour after ischemia, numerous positive cells were noted in the ganglion cell layer (GCL) and inner side of inner nuclear layer (INL). At 3 hours, caspase-1 positive cells continued to increase and peaked at 6 hours, then decreased significantly at 1 day. TUNEL positive cells were detected at 3 hours and peaked at 1 day after ischemia. Double labeling of caspase-1 and TUNEL only showed few cells with co-localization after ischemia.

CONCLUSIONCaspase-1 immunoreactivity preceds to the TUNEL labeling in the GCL and INL after retinal ischemia and reperfusion injury and its early activation may play an important role in the initiation of neuronal apoptosis.

Animals ; Caspase 1 ; analysis ; metabolism ; Enzyme Activation ; Immunohistochemistry ; In Situ Nick-End Labeling ; Ischemia ; enzymology ; Male ; Mice ; Mice, Inbred C57BL ; NF-kappa B ; metabolism ; Reperfusion Injury ; enzymology ; Retinal Diseases ; enzymology

Background High myopia can be corrected using laser therapy and intraocular lens(IOL)implantation.IOL implantation is more suitable than laser therapy for high myopia if the patients suffer from thinner cornea.Objective This clinical trail was to assess and compare the visual quality following phakic iris-claw intraocular lens (IOL) and implantable contact lens(ICL) implantation for high myopia.MethodsIris-claw phakic intraocular lens was implanted in 17 eyes of 10 patients with high myopia,and age-,refractive-matched 17 eyes of 9 patients were in implantable contact lens (ICL) implantation group.Uncorrected visual acuity,best correct visual acuity,contrast sensitivity under the 3,6,12 and 18 c/d spatial frequencies,wave-front aberrations,including RMS3,RMS4 and RMSh,were examined in 6 months after operation.Written informed consent was obtained from each patient before surgery.Results There were no significant difference in uncorrected visual acuity,best correct visual acuity between two groups(t=0.489,P>0.05;t=0.853,P>0.05).Non-glare CS under the 3 c/d,6 c/d,12 c/d and 18 c/d spatial frequencies were insignificantly different between two groups ( t = 0. 906, P > 0.05 ; t = 0. 103, P > 0. 05 ; t =0. 694 ,P>0. 05 ; t = 1. 583, P>0. 05), and the similar outcomes were found in glare CS ( t = 0. 323, P>0.05, t =0.041 ,P>0. 05, t = 0.024, P>0. 05; t = 0. 363, P>0.05) in postoperative 6 months. RMS3 and RMSh were significantly elevated in PIOL group compared with ICL group ( t = 11.40, P< 0. 05 ; t = 11.35, P < 0.05), but no evident difference was found in RMS4 between two groups( t = 0. 24,P>0. 05). Conclusion Both PIOL and ICL implantation for high myopia can achieve an equal visual acuity. But clinical outcomes of ICL implantation is much better than PIOL group. A long-term effect should be observed for the further evaluation.

Background Implantation of phakic posterior chamber intraocular corrective lens(ICL)is a new choice for correction of high myopia.Different from laser assisted in situ keratomileusis,implantation of phakic posterior chamber ICL will allow the good imaging quality because it remaines the matched relationship between cornea and lens.But its visual quality after operation is concerned by patient and ophthalmologists.ObjectiveThis study was to observe the effectiveness of implantation of posterior chamber phakic ICL on visual quality in patients with high myopia.Methods Eighty-four high myopia eyes of 42 patients accepted implantation of posterior chamber phakic ICL and follow-up of 6-month duration.The visual acuity,refractive status,wavefront,contrast sensitivity and accommodation were examined and compared before and after surgery.This clinical study complied with Declaration of Helsinki.The written informed consent was obtained from each patient before operation.Results A prospective observational trial design was used.The uncorrected visual acuity and best corrected visual acuity after operation were better than preoperative ones in all of the patients.The eye numbers of ＞ 0.3 were increased after operation in comparison with before operation with a stable result among 1 day,1 month and 6 months after surgery (x2 =10.70,P＞0.05).Spherical equivalent refraction was(-15.38 ± 1.03)D before surgery and(+0.55 ±0.06)at 1 day,(-1.22±0.09)D at 1 month and(-0.68 ± 0.06)D after 6 months,showing a significant difference among them(F=16 559.90,P＜0.05).Total aberrations and higher-order aberrations were 11.00±0.25 and 0.43 ±0.05 before surgery,the wavefront aberrations were 2.21 ± 0.56 and 0.47±0.04 at 6 months after surgery with significant difference(t =1.65,P =0.10).Each spatial frequency contrast sensitivity and glare sensitivity on photopic and seotopie conditions in postoperation were higher compared with the preoperative(P＜0.05).The accommodation in 1 month and 6 months after surgery was greater than that of preoperative in the patients ＜-16 D(preoperation:2.75 ± 1.20 ; postoperation 1 month:5.75 ± 1.44,postoperation 6 months:6.00 ± 1.52)(P＜ 0.05),however,in the ＞-16 D group,no considerably change in accommodation was seen after surgery(F=1597.70,P＜0.05).No significant difference was found in accommodation between before and after surgery in ＞-16 D group(F=2.67,P＞0.05).Conclusions Visual quality of high myopia is obviously improved after implantation of posterior chamber phakic ICL,but its long-term outcome is need to further study.