Objective To evaluate the differences of the thinnest-point corneal thickness (TCT) decrease after three different corneal crosslinking (CXL) protocols for progressive keratoconus.Methyds Retrospective clinical case study.From August 2010 to November 2015,consecutive 85 patients (110 eyes) with progressive keratoconus were enrolled and treated with CXL in Department of Opthalmology,Navy General Hospital.21 patients of 25 eyes underwent standard epithelium-off corneal crosslinking (S-CXL),14 patients of 22 eyes underwent 1 g · L-1 riboflavin-sodium lactate Ringer's solution iontophoresis-assisted CXL (I-CXLa),and 50 patients of 63 eyes underwent 0.1％ riboflavin-distilled water solution I-CXLb.Preoperative and postoperative TCT were measured by ALLEGRO oculyzer.The differences of TCT decrease after treatment were compared among the three CXL protocols.Results The differences of TCT from baseline after 3 months,6 months and 12 months in the S-CXL group were (-14.93 ±27.16) μm,(-31.94 ±22.89) μm,(-27.71 ±26.01) μm,respectively,the I-CXLa group were (-20.14 ± 19.09) μm,(-10.10 ± 24.28) μm,(-7.11 ± 22.26)μm,respectively,the I-CXLb group were (-28.08 ± 26.14) μm,(-21.08 ± 25.62) μm,(-15.91 ± 19.19)μm,respectively.Three months after treatment,the differences of TCT decrease in the three groups was not statistically significant (P =0.188);Six and 12 months after treatment,the differences between S-CXL and I-CXLa were statistically significant (all P ＜0.05),but the differences between S-CXL and I-CXLb,between I-CXLb and I-CXLa showed no significant difference (all P ＞ 0.05).Conclusion Six and 12 months after treatment,TCT decrease is related to the CXL protocol.TCT decrease degree may reflect the intensity of crossinking.TCT decrease in I-CXLb is smaller than that in S-CXL,but there is no statistical difference.

Objective To investigate the relatio nship between the DNA methylation status of gluco-corticoid receptor (GR) gene promoter and mRNA expression level of GRα gene of peripheral blood mononuclear cells (PBMCs) in patients with systemic lupus erythematosus (SLE). Methods Fifteen new onset SLE patients and fifteen healthy controls were enrolled in this study. The DNA methylation status of GR gene promoter 1 of PBMCs was detected through bisulfite sequencing polymerase chain reaction (PCR). The mRNA expression of GRα, DNA methyltransferases, growth arrest and DNA damage-induced 45α (GADD45α) of PBMCs was detected using the quantitative real-time polymerase chain reaction method. T-test and χ2-test were used to detect the differences between the two groups, Pearson's correlation coefficient was used to analyze the linear correlation between two variables. Results Compared with healthy controls, the mRNA expression of GRα was signi-ficantly declined in SLE patients (10±5, 17±7, t=2.69, P<0.05), and the mRNA expression of DNMT1 and GADD45α was significantly elevated in SLE patients (t=3.11, P<0.05 and t=2.98, P<0.05). The overall mean methylation status of the 142 CpG islands of the four promoters was significantly elevated in SLE patients [(16±8)%vs (11±6)%, t=2.75, P<0.05]. The global methylation status of PBMCs in SLE patients was obviously lower than healthy controls (t=4.39, P<0.05). Conclusion Hypermethylation of GRα promoter may result in GRαgene low expression in PBMCs of patients with SLE.

Objective To evaluate the role of mangled extremity severity score(MESS)in res-ervation and amputation of crush lower limbs in earthquake. Methods There were 122 patients with crush lower limb injuries,with MESS≥8 points in 34 patients who were primarily amputated,M ESS 5-7points in 19 who were principally preserved and MESS＜5 points in 69 who were preserved by means of debridement,external fixators,plast splints and vaeuum sealing drainage technique.Results All pa-tients were survived.with amputation rate of 29.5%. Conclusion MESS is an important reference for evaluation of reservation and amputation of crush limb injuries caused by earthquake.

Objective:To understand the characteristics of the callers with the diagnosis of mental disorders called Beijing Psychological Crisis Hotline for help,in order to provide specific psychological intervention services for them in future.Methods:From December 2002 to December 2008,24217 different callers'data collected from a computer-based operating system of the Beijing Psychological Crisis Hotline were analyzed.According to their self-reported of having the diagnoses of mental disorder or not,the callers were divided into the ones with diagnosis (n=6516)and the ones without diagnosis (n =17701).The callers'demographic characteristics,their main counseling problems and the suicide-related factors in the two groups were compared.Results:The top five main counseling problems in the group with diagnosis were mental problems,the mental illness related knowledge,the problems of family relationships,working problems and interpersonal problems.Mental problem ranked first in both groups.Compared to the group without diagnosis,the diagnosed ones were more likely to be found in such group of people as women,aged between 20 -29 and 30 -44,having 10 or more years of education and the unem-ployed.The results of the assessments of 11 suicide-related risk factors showed that callers with diagnoses had higher prevalence of most suicide-related factors than those in the other group(P <0.001 or 0.05),which included suicidal intention and behavior while calling,history of attempted suicide,severe depressive symptoms,severe physi-cal illness,history of being abused,afraid of being attacked,suicidal history of relatives or associates,severe of hopeless.Conclusion:The hotline counselors should be aware of the necessity of assessing the severity of depres-sion and other suicide-related factors for the callers with mental disorder diagnoses before providing any psychologi-cal intervention.Moreover,except for providing interventions on the callers'psychiatric problems,the hotline coun-selors should also identify and help to deal with the stress events in their lives.

Objective:To compare the results of two different measures assessing prospective memory (PM) in elderly schizophrenia,and explore their diagnostic validity.Methods:Fifty patients who were diagnosed as schiz-ophrenia according to the criteria of Diagnostic and Statistical Manual of Mental Disorders,Fourth Edition (DSM-Ⅳ)and 50 normal elderly people were enrolled in the study.Laboratory paradigm prospective memory task and the Chinese version of the Cambridge prospective memory Test (C-CAMPROMPT)were administered to measure thelevel of EBPM and TBPM.The Wechsler Adult Intelligence Scale-Fourth Edition,Continuous Performance Test-I-dentical Pairs were used to evaluate IQ and attention.Results:Whether in the laboratory paradigm or C-CAM-PROMPT,schizophrenia group performed worse than normal controls on PM total scores[7(0,16)vs.12(0,16),14 (4,34)vs.25(11,36)],EBPM[3(0,8)vs.6(0,8),7(2,16)vs.14(4,18)]and TBPM [3(0,8)vs.6(0,8),6(2,18) vs.12(4,18)],and patients had comparable performances in PM subtypes[-1.0(-2.2,1.0)vs. -1.0(-2.1, 0.8),-1.9(-3.4,0.8)vs. -1.8(-2.9,1.6)].In the C-CAMPROMPT,the scores of EBPM and TBPM were negatively related to age(r=-0.36 --0.40,P<0.001 ),but there was no significant relationship between PM performance and age in the laboratory paradigm task.The area under ROC curve of the laboratory paradigm and C-CAMPROMPT were 0.73 and 0.85.While 8 and 19 as the cut off value,the sensitivity were 0.60 and 0.74,and the specificity were 0.76 and 0.90,respectively.Conclusion:The two measures have confirmed that the elderly schizophrenia have comparable performances in EBPM and TBPM.Both the C-CAMPROMPT and the laboratory paradigm have moderate level of diagnostic validity,but the former is slightly higher and more susceptible to aging.

Objective:By analyzing the norm data results of the Wechsler Adult Intelligence Scale-Fourth Edition (WAIS-Ⅳ) in China,to prove the validity of the procedure and methods during the norming development.Methods:The whole process of the revision of WAIS-Ⅳ,the development of computer-assisted system and norm sampling plan,were introduced in more detail,and the distribution of actual norm data of 1757 cases was analyzed.Results:For area distribution,compared with planned sampling number,the number from North and Northeast China was statistically significant different (x2 =78.02,P ＜0.01).For age stages distribution,most of cases conformed to the requirements of sampling,except that some cases including high-level educational cases aged 16-17 years and above 65 years,and low-level educational cases aged 30-34 years were less than the planned sampling number.For gender distribution,male subjects were more,but there was no statistically significant difference between male and female subjects (x2 =228,P =0.131).For educational degree distribution,the sampling conformed to the requirements of sampling plan (x2 =2.74,P =0.603).For occupation,resident years and registered permanent residence,and the sample was basically representative.Conclusion:The process of the revision of the Chinese version of WAIS-Ⅳ is appropriate,and actual norm sampling basically conforms to planned sample distribution,providing the sufficient representativeness and reliability for national norm data of WAIS-Ⅳ.

Objective: To develop the mental health knowledge questionnaire in order to know about the awareness of mental health knowledge in non-psychiatric clinicians. Methods: A sample of the 641 non-psychiatric clinicians from 2 tertiary general hospitals, 2 second-class general hospitals, and 1 community hospital were used for item analysis and internal consistency test; 38 cases were selected for the re-test interval of 2 weeks to test the test-retest reliability. And totally 99 psychiatrists finished the survey as controls. The awareness rates between the non-psychiatric and psychliatric clinicians were compared. Results: The questionnaire included 46 items and consis-ted of 6 subscales, involving anxiety, schizophrenia, depression, dyssomnia and psychological counseling, or-ganic brain disorder, and recognition for mental health service situation in general hospital The results of confirma-tory factor analysis showed that the ratio of chi-square and degree of freedom was below 3. The fitting indexes except GFI and AGFI were more than 0.90. The Cronbach's alpha coefficients ranged from 0.73 to 0.89, and test-retest Pearson correlation coefficient of reliabifity ranged from 0.59 to 0.78. Awareness rate was 47.6% in general hospital and 90.9% in psychiatric hospitals. Conclusion: The mental health knowledge questionnaire has good psychometric properties and may be applied in clinical studies.

Objective To explore the relationship of intelligence among memory, sustained attention and executive function of schizophrenic patients. Methods 120 schizophrenic inpatients and 60 healthy subjects matched in age, gender and years of education with the patients were assessed with Wechsler Adult Intelligence Scale-fourth edition (WAIS-IV) and Wechsler Memory Scale-fourth edition (WMS-IV), Continuous Performance Test (CPT), Wisconsin Card Sorting Test (WCST). Results The intelligence quotient (IQ), memory quotient (MQ), scores of CPT and WCST were poor in the patients (P<0.05). IQ was correlated with MQ (r=0.837, P<0.01), the scores of CPT (r=0.613, P<0.01) and WCST (r=0.466, P<0.01). The scores of CPT and MQ were the independent factors related with IQ (P<0.001).Conclusion There is intelligence impairment in schizophrenics, which may related with the impairment of memory and sustained attention.

Objective To explore cognitive change in schizophrenic patients with concomitant metabolism syndrome,and to provide theory basis for early intervention and treatment.Methods According to inclusion standard,56 schizophrenic inpatients with metabolism syndrome and 56 schizophrenic inpatients without metabolism syndrome were included.The matrics consensus cognitive battery(MCCB),stroop test,digit span,UPSA-B were used to assess the cognitive function.Results There were significant differences for test scores of symbol coding subtest,verbal memory subtest,digit sequence subtest,Maze subtest,continue performance among MCCB between schizophrenic patients with and without metabolism syndrome(27.07±10.46 vs 32.18±12.12,16.04±5.07 vs18.71±6.02,13.39±5.18 vs 15.79±5.48,1.38±0.66 vs 1.7±0.68,all P＜0.05),as well as stroop test and digit span test(31.14±11.68 vs 36.57±13.32,13.77±3.64 vs 15.82±4.38,P＜0.05 for both).Conclusion The schizophrenic patients with metabolism syndrome have severer cognitive impairment than those without metabolism syndrome.

Objective To investigate the memory characteristics and related factors of patients with mental retardation. Methods 73 patients with mental retardation (patient group) and 73 normal subjects (control group) matched with the patient group were respectively tested with Wechsler Memory Scale-Fourth Edition of Chinese Version (WMS-IV). Results The scores of each subtest and composite scores of WMS-IV were significantly lower in the patient group than in the control group (P<0.01). All the composite scores positively correlated with each other in the patient group (r=0.38-0.90, P<0.01) and in the control group (r=0.31-0.94, P<0.01). Age and education level positively correlated with all the composite scores (except the Visual Working Memory Index) in the patient group (P<0.05). Conclusion The patients with mental retardation present an overall decline in memory, especially in the immediate memory. The memory function in patients is related with their ages and education levels.