Objective To evaluate quantification of metamorphopsia in eyes with idiopathic macular hole (IMH) before and after surgical treatment, and investigate its relationship between postoperative visual acuity, the macular hole index (MHI), and the macular hole prognostic factor (HPF). Methods Thirty eyes of 30 patients, who underwent successful vitrectomy and internal limiting membrane (ILM) peeling for IMH and were followed up more than 6 months, were included in the study. The uncorrected visual acuity of the fellow eyes was better than 20/25 and there was no metamorphopsia in that eye. The macular hole closure was confirmed by optical coherence tomography (OCT) scans. Metamorphopsia was evaluated by metamorphopsia-charts (M-chart). OCT, best corrected visual acuity (BCVA) and metamorphopsia were obtained before and after surgery. Vertical (MV) and horizontal (MH) metamorphopsia, macular hole index (MHI, the ratio of the height to the diameter of the base) , and macular hole prognostic factor (HPF,the ratio of the height to the minimum diameter) were measured. The metamorphopsia score was the average value of MV and MH. SPSS 16. 0 statistical analysis software was used for data analysis. Results Preoperative MV and MH were (1.82±0.04)° and (1.81±0.04)°, respectively. Six months after surgery,the MV and MH were (0.17±0.03)° and (0.11±0.03)° respectively. There was significant difference between pre- and post-operative metamorphopsia results (Z=-0.788, P＜0.05). The metamorphopsia score at 6 months after surgery were positively correlated with the value of the postoperative BCVA (LogMAR) (r=0.540, P=0.004) and negatively correlated with the values of preoperative MHI and HPF (r=-0.676,-0.518; P＜0.05). Conclusions Successful vitrectomy and ILM peeling can improve metamorphopsia of IMH. Postoperative metamorphopsia was correlated with the postoperative BCVA and the preoperative macular hole contour.

Objective To evaluate metamorphopsia and vision-related quality of life (VRQoL) and its influencing factor after vitrectomy for idiopathic macular hole (IMH).Methods This is a prospective and nonrandomized clinical cohort study.Thirty eyes of 30 IMH patients who received vitrectomy and inner limited membrane (ILM) peeling were included.The best-corrected visual acuity (BCVA),medical refraction test and optical coherence tomography (OCT) were performed.BCVA was recorded as logarithm of the minimum angle of resolution (logMAR).The macular hole index (MHI) was measured using OCT.The average logMAR BCVA and MHI in suffering eyes at baseline were 1.02± 0.07 and 0.47 ± 0.02,respectively.The uncorrected visual acuity of the fellow eyes was less than 0.1.Follow-up period was longer than 6 months.At 6 months after surgery,the central retinal thickness (CRT) was measured by OCT;vertical and horizontal metamorphopsia were measured by metamorphopsia charts;VRQoL was evaluated by Chinese VRQoL-25.Spearman correlation analysis was performed to analyze the relationship of VRQoL and postoperative BCVA,metamorphopsia and preoperative MHI.Results At 6 months after surgery,macular hole closure was confirmed by OCT in all patients.The vertical and horizontal metamorphopsia were (0.17± 0.03)° and (0.11 ± 0.03)°,respectively.The VRQoL-25 composite score was 79.81 ± 1.29.The average BCVA was 0.59±0.05.The average CRT was (155.10± 6.27) μm.The postoperative VRQoL was positive correlated with preoperative MHI (r=0.491,P=0.002),and negative correlated with preoperative BCVA (r=-0.445,P=0.014),postoperative BCVA (r=-0.530,P=0.003) and postoperative metamorphopsia (r=-0.532,P=0.006),but not correlated with the postoperative CRT (r=0.231,P＞0.05).Conclusions IMH patients improved their visual acuity after surgery,but still have metamorphopsia.VRQoL was negative correlated with metamorphopsia,positive correlated with preoperative MHI.

ObjectiveTo evaluate the efficacy of intravenous and intra-arterial thrombolysis with urokinase for acute cerebral infarction.Methods Fifty patients with acute cerebral infarction occurred within 6 hours were divided into two groups by random digits table method with 25 cases each:intravenous and intra-arterial thrombolysis group and intravenous thrombolysis group.The patients in intravenous and intra-arterial thrombolysis group were given 200 000 U urokinase by intravenous infusion for 30 minutes immediately after being hospitalized,and arterial thrombolysis was prepared at the same time.With cerebrovascular angiography,the thrombolytic therapy was carried out in the target vessel blocking points through micro-catheter.Urokinase dissolved in 0.9％ sodium chloride was infused at the rate of 10 000 U per minute,the total volume would not be more than 1 000 000 U.The patients in intravenous thrombolysis group were given 1 000 000 U urokinase in 100 ml 0.9％ sodium chloride by intravenous infusion within 60 minutes.The clinical efficacy after thrombolysis was assessed according to the National Institutes of Health stroke scale (NIHSS) score,the quality of life was judged by Barthel index (BI) score and the prognosis was evaluated by modified Rankin scale (mRS) score of 90 days after thrombolysis.ResultsThere was no significant difference between two groups before thrombolysis according to the NIHSS score (P ＞ 0.05).After thrombolysis,NIHSS scores in two groups showed a downward trend,but they were obviously lower in intravenous and intra-arterial thrombolysis group after 24 h,7 d and 14 d than those in intravenous thrombolysis group [(8.97±4.56) scores vs.(11.01±3.65) scores,(6.88±2.31) scores vs.(8.34±3.05) scores,( 4.06±3.02 ) scores vs.( 6.73±2.15 ) scores ] ( P ＜ 0.05 or ＜ 0.01 ).BI scores before thrombolysis between two groups had no significant difference(P ＞0.05),while BI score of 90 days after thrombolysis in intravenous and intra-arterial thrombolysis group [(79.55±19.64) scores] was higher than that in intravenous thrombolysis group [(69.31±21.35) scores](P=0.0162).The rate of mRS score 0-2 (good efficscy) in intravenous and intra-arterial thrombolysis group [72.0％(18/25) ] was obviously higher than that in intravenous thrombolysis group [ 52.0％ ( 13/25 ) ] (P =0.0198 ).ConclusionsIt is significantly effective to treat acute cerebral infarction by superselective intravenous and intra-arterial thrombolysis.Therefore,it is supposed to be an optimal option for treating acute cerebral infarction in the future.

As a vital component in an overall laboratory animal care and use program , development of a disaster plan plays a critical role for every research institution .Currently, most of domestic institutions would draw up an“emergency operation plan , EOP”, but ignoring a practicable “business continuity plan , BCP” in establishing a disaster plan.In this article, we will discusse about the definition of disaster , how to set up an EOP, and how to establish a thorough BCP , in order to show an integrated and professional disaster plan in laboratory animal care and use program .

Objective To investigate the clinical value of MRI in evaluating the cardiac structures and function of congenital heart diseases.Methods Fifteen cases with surgically proved different types of CHD were examined by the techniques of magnetic resonance imaging ( MRI) and echocardiography (ECG).The results were compared to determine their values in showing the abnormalities of cardiac structures and function.Results In 15 cases,20 malformations were diagnosed correctly by MRI within 24 abnormalities confirmed by operation(20/24),21 by ECG (21/24).MRI was better than ECG in displaying great vascular diseases, while ECG was better in valvular diseases.There was no significant difference between MRI and ECG in examining cardiac function.Conclusion MRI can clearly show the abnormalities of cardiac anatomy and function.

OBJECTIVE To study the effect of nano-alumina(nano-Al2 O3 )on mitophagy in primary cortical neuronal cells from Wistar newborn rats. METHODS The purity of neuronal cells was detected by immunohistochemistry,and the lactate dehydrogenase(LDH)assay was performed to determine the viability of the cells treated with 13 nm nano-Al2 O3 0.5 mmol·L-1 for 12,24 and 48 h,respectively. The mitochondrial membrane potential(MMP)was detected by flow cytometry analysis . The ultrastructure of mitochondria and mitophagy vacuoles was observed by transmission electron microscopy(TEM). Auto-phagic vacuoles were observed by dansylpentanediamine(MDC)staining and the expression of autoph-agy related protein Beclin1 and LC3Ⅱ/ Ⅰ was determined by Western blotting. Mitophagy was observed by Lysotracker and Mitotracker staining respectively. RESULTS More than 95% cells were neuronal cells. The activity of LDH in the supernatant liquid exposed to nano-Al2 O3 for 12 and 24 h groups was sig-nificantly increased compared with the control group(P﹤0.05). After exposure to nano-Al2 O3 ,the mito-chondrial membrane potential was significantly decreased compared with the control group( P ﹤0.01). The results of TEM displayed mitochondrial swelling and the formation of vacuoles and mitophagy in nano-Al2 O3 groups. MDC positive fluorescence particles were observed and the expression of autophagy related protein Beclin1 and LC3Ⅱ/ Ⅰ was increased in nano-Al2 O3 groups compared with the control group( P ﹤ 0. 05 ). The result of Lysotracker and Mitotracker colocalization showed the fusion of mitochondria and lysosomals. CONCULSION Nano-Al2 O3 may induce autophagy and mitochondria damage in neuronal cells while the damaged mitochondria may be removed by mitophagy.

Objective:To assess the safety,effectiveness and acceptability of oral midazolam sedation for dental treatment in children.Methods: Twenty-three health children aged 4 to 14(ASA Ⅰ),who were classified as 4 or 5 by modified Venham's clinic anxiety and cooperative behavior rating scale,referred for dental treatment were included in the study.Each child was treated under sedation with oral midazolam(0.15-0.70 mg/kg),and totally 45 sedations were conducted.At each visit,heart rate,arterial oxygen saturation,respiration rate,sedation and behavioral scores were recorded.The level of acceptance and satisfaction of the patients and their guardians were recorded after the treatment.Results: Among the 23 children,19 were boys and 4 were girls with mean age of 6.2 years old.In all the 45 treatments,the heart rate,respiratory rate and arterial oxygen saturation levels were within acceptable clinical limits.Forty planned treatments were completed satisfactorily.Oral sedation was ineffective in 3 children,and they were treated under general anesthesia.Only 2 guardians refused to have oral midazolam sedation again.Six of seven children who had regular dental check-up could be treated under normal condition.Conclusion: Oral midazolam(0.15-0.70 mg/kg) could be a safe and acceptable approach of sedation for pediatric dental patients.

Objective nvestigate the propofol combined with fentanyl anesthesia in orthopedic manual reduction applications.MethodsAugust 2015 to December 2016 in our hospital treated 120 cases of acute long bone closed fracture and ankle, shoulder dislocation and other patients, efficient analysis anesthesia, surgery time, patient recovery time, propofol is added volume and total volume, and detection 3min, 1min, 3min, 5min and waking SpO2, HR, MAP, RR values.Two groups of patients after treatment, were given nursing intervention, such as routine diet guidance, nutrition support, health education.after administration before it is administered.Resultsanesthetic effect experimental group total efficiency is higher, the difference was statistically significant (P<0.05);after simultaneous administration of all patients 1min, 3min, 5min signs were lower than prodrug 3min signs, the difference statistically significant (P<0.05), after clear signs of its former administration 3min with no significant difference;experimental group recovery time, propofol bolus of propofol than with total control were lower, the difference was statistically significant (P<0.05);and the two groups were similar to the operation time, the difference was not statistically significant.ConclusionIn summary, propofol combined with fentanyl anesthesia for patients to take the treatment of orthopedic manual reduction obviously worthy of clinical use.

Objective To study the changes in mRNA and protein expression of ubiquitin and to explore the relationship of apoptosis in the skeletal muscle of mouse with emphysema.Methods Emphysema model was established by passive cigarette smoking in mouse.Apoptosis was detected with TUNEL staining.The reverse transcriptase-polymerase chain reaction (RT-PCR) and immunohistochemical assay were used to determine the mRNA and protein level of ubiquitin.Results Apoptotic cells were increased in skeletal muscle of mouse with emphysema.The mRNA and protein level of ubiquitin were significantly higher in mouses with emphysema (0.48±0.02 and 0.23+0.05,respectively) than in control group (0.17±0.01 and 0.14+0.01,t=6.223、4.093,both P ＜0.05).Conclusions The increase of apoptosis in skeletal muscle of mouses with emphysema may be associated with high expression of ubiquitin.

Objective To investigate the atypical appearances of small hepatocellular carcinoma(SHCC) with triple-phase spiral CT enhanced scan, and its correlation with the histopathology .Methods The atypical CT signs in triple-phase and histopathologic changes of SHCC confirmed pathologically in 30 cases (32 lesions) were analysed.Results 32 atypical lesions were found in 30 patients,of them,14 lesions were hypodense in hepatic arterial phase(HAP),portal venous phase(PVP) and delayed phase(DP).10 lesions enhanced markedly in the AP,while these lesions became isodense or slight hyperdense in the PVP and DP.8 lesions were enhanced as ring like or punctual shape in the AP,and constant enhancement in PVP and DP.Conclusion The atypical appearances are present in triple- phase spiral CT scan in SHCC,the pattern of blood supply and the base of histopathology are usually the cause of these findings .