Objective To observe the effect of micro-pulse laser in the treatment of acute central serous chorioretinopathy (CSC).Methods 105 cases (114 eyes) with clinically diagnosed acute CSC were included in the study,including 78 males (86 eyes) and 27 females (28 eyes) with an average age of (40.40±7.80) years,and mean duration of 26 days.All patients were examined for best corrected visual acuity (BCVA),slit lamp microscope and pre-lens,direct ophthalmoscopy,color fundus photography,fluorescein angiography combined with indocyanine green angiography (ICGA),and micro-perimetry.Patients were randomly divided into micro-pulse laser treatment group (treatment group,61 eyes) and control group (51 eyes).The age (Z ＝-0.374),gender ratio (x2=0.010),disease duration (Z=-0.525),BCVA (t=1.885),foveal thickness (CFT) (t=-1.754) and macular light sensitivity (t=1.255) were similar between the two groups.The micro-pluse laser treatment was performed with an 810 nm infrared diode laser at the active leakage site on retinal pigment epithelium guided by ICGA.The exposure time was 0.2 s,effective working time was 15％,the laser spot diameter was 100 μm,and the distance between 2 spots was 100 μm.The control group received pseudo-treatment using the same laser parameters.After 2 weeks,1month,3 months and 6 months of treatment,all patients were examined with BCVA,ocular fundus,optical coherence tomography and micro-perimetry.These parameters were compared between the 2 groups.Results The subretinal fluid of 39 eyes in the micro-pulse laser group and that of 3 eyes in the control group were absorbed completely.The cure rates in the micro-pulse laser group (61.9％) was higher than that in the control group (x2 =38.015,P＜0.01).In the micro-pulse laser group,the mean BCVA was 67.81±11.70 at baseline,which increased significantly to 75±9.91,76.78± 9.43,78.56 ± 8.57 and 78.52 ± 8.60 at 2 weeks,1 month,3 months and 6 months after treatment respectively.In the control group,that was 63.86±10.35,64.20±11.43,63.90±10.88,64.55±11.04,64.10±11.12 at baseline,2 weeks,1 month,3 months,6 months post-treatment respectively.The mean post treatment BCVA at each time point were significantly higher in the micro-pulse laser group than that in the control group (P＜ 0.01).The mean CFT was (380.94 ± 50.73) μm at baseline,which reduced to (268.44±44.20),(242.78±41.31),(235.46±38.44),(235.56±38.71) μm at 2 weeks,1 month,3 months and 6 months post-treatment respectively in the nmicro-pulse laser group.In the control group,that was (397.98±52.61),(334.55±59.15),(316.16±55.25),(314.47±53.27),(321.51±55.74) μm at baseline,2 weeks,1 month,3 months,6 months post-treatment respectively.The mean post-treatment CFT at each time point in the micro-pulse laser group were decreased significantly compared to that in the control group (P＜0.01).The mean central retinal sensitivity was (15.03 ± 2.00) dB at baseline,which enhanced to (17.06 ± 1.71),(17.37 ± 1.61),(17.56 ± 1.58),(17.48 ± 1.53) dB at 2 weeks,1 month,3 months and 6 months post-treatment respectively in the micro-pulse laser group.In the control group,that was (14.54±2.22),(14.80±2.16),(14.88±2.09),(14.82±2.07),(14.69±2.11) dB at baseline,2 weeks,1 month,3 months and 6 months post-treatment respectively.The mean central retinal sensitivity at each time point of post-treatment in the micro-pulse laser group were enhanced significantly compared to that in the controlled group(P＜0.01).Conclusion In the treatment of acute CSC,micro-pulse laser can improve BCVA,reduce the mean CFT and improve the mean central retinal sensitivity.It is an effective and safe method to treat acute CSC.

Background Hypoxia is an important cause resulting in many retinal diseases,such as retinal edema,diabetic retinopathy,proliferative retinopathy and so on.ObjectiveThis study is to investigate the effects of hypoxia on the expression of AQP-4 in Müller cells in vitro.MethodsMüller cells were isolated from New Zealand white rabbits and primarily cultured in DMEM containing 20% fetal bovine serum by the explant culture method.The cells were identified by immunostaining for the glial fibrillary acidic protein(GFAP).Generation 2 of cells was cultivated with the chemical hypoxia inducer,CoCl_2,for 24 hours in the hypoxic group and only with DMEM in the control group.The expression of the AQP-4 protein in Müller cells was detected by immunocytochemistry.The expression of AQP-4 mRNA was determined by semi-quantitative reverse transcription-polymerase chain reaction (RT-PCR).ResultsAbout 90% of Müller cells(generation 2) presented a positive immunoreactivity for GFAP,showing a brown staining in the cytoplasm.Cultured cells displayed the presence of intermediate filaments,microvillus and various cellular organs.The Integralabsorbance of the AQP-4 protein in Müller cells was markedly increased 24 hours after incubation with CoCl_2 in comparison with the control group (t=6.74,P＜0.05).The expression level of AQP-4 mRNA in Müller cells was significantly enhanced 24 hours after incubation with CoCl_2 in comparison with the control group (t=21.79,P＜0.05). ConclusionHypoxia enchances the expression of AQP-4 in Müller cells and further increases fluid accumulation in the retina.These results suggest that Müller cells play an important role in the formation of retinal edema in diabetic retinopathy or proliferative retinopathy.

Objective To evaluate the efficacy of intravitreal injections of conbercept in choroidal neovascularization (CNV) secondary to pathologic myopia (PM).Methods A retrospective case series of 37 eyes of 37 patients affected with CNV secondary to PM treated by intravitreal injections of Conbercept.All the patients were examined with best-corrected visual acuity (BCVA) of Early Treatment Diabetic Retinopathy Study (ETDRS) chart,central macular thickness (CMT) of optical coherence tomography (OCT) at baseline.The initial average letters of ETDRS BCVA was 49.86±8.87,CMT was (306.38±31.01) μm.All eyes were treated with intravitreal Conbercept 0.05 ml (10 mg/ml).Follow up visits were performed monthly after injection.The mean follow-up time was 16.8 months.Injections were repeated according to the situation of BCVA,CMT,subretinal fluid and CNV leakage in follow-up.All eyes received an average of 4.8 injections.BCVA,CMT and ophthalmoscope examination were assessed monthly.The relationship of BCVA improvement and CMT reduction with the data at baseline and number of treatments were analyzed by Spearman Rho correlation respectively.Results During the 1,3,6 and 12 months after treatment,the mean BCVA were all improved with statistically significant difference (t=17.629,P＜0.01).At 12 months,15 eyes (45.9％) had improvement of 15 letters or more,32 eyes (86.5％) had improvement of 5 letters or more,and 1 eye (2.7％) had decreased more than 5 letters.During the 1,3,6 and 12 months after treatment,the mean CMT were all decreased with statistically significant difference (F=43.726,P＜0.01).At 12 months,the retinal fluid of 34 eyes (91.9％) were absorbed completely;33 eyes (89.2％) had angiographic closure at that time.There was no significant relevance between BCVA improvement and sex,age and course of the disease (P＞0.05),but a significant negative correlation was found between the BCVA improvement and BCVA at baseline,injection times (P＜0.05).There was no significant relevance between CMT reduction and sex,age,course of the disease and injection times (P＞0.05),but a significant positive correlation was found between CMT reduction and CMT at baseline (P＜0.05).There were no systemic or ocular serious side effects during the follow up.Conclusions Intravitreal injections of Conbercept showed BCVA improvement and CMT reduction.It appeared to be effective and safe for choroidal neovascularization secondary to pathologic myopia.Intravitreal Conbercept for CNV secondary to PM showed BCVA improvement,CMT reduction and safety.

Objective:To confirm the least practice times to eliminate the practice effect in the Working Memory Test Method: Four volunteers from college students practiced the Working Memory Test many times in two consecutive days Their scores were analyzed Result:Comparing their results before and after practice, there were significant practice effects with two types, three levels In order to eliminate these effects, the practice times before formal test was no less than 18 Conclusion:Practice effect is one of the factors affecting the results of the Working Memory Test, which can be eliminate after at least 18 times practice

Noise is a common occupational hazardous factor in the workplace. In addition to the specific damage to the auditory ， system of workers it can also harm the cardiovascular system and cause a serious disease burden. The mechanism of ， occupational noise on the cardiovascular system of workers is mainly oxidative stress inflammation and vascular endothelial ， - - - damage. As a stressor noise mainly leads to the changes of sympathoadrenal medullary system and hypothalamic pituitary ， ， ， - ， adrenal axis. The substances that play an important role include catecholamines cortisol angiotensin Ⅱ endothelin 1 - endothelial nitric oxide synthase and interleukin 6. The population epidemiological studies have shown that occupational noise ， exposure can lead to elevated blood pressure abnormal electrocardiogram and elevated blood lipids in workers. The influencing （ ， ， ） factors include noise characteristics intensity cumulative noise exposure and frequency and noise combined with other （ ， ， ， - ， occupational hazards such as high temperature welding fumes organic solvents hand transmitted vibration and work ） ， ， ， shifts . However due to the influence of research conditions experimental design and other factors some research conclusions still have limitations. More prospective and comprehensive studies are needed to verify the relevant conclusions in the future.

AIM:To compare the efficacy and safety of intravitreal ranibizumab to those of triamcinolone acetonide ( TA ) injection for the treatment of macular edema secondary to central retinal vein occlusion ( CRVO) .
METHODS:This retrospective study included 40 eyes of 40 patients with macular edema associated with CRVO. Twenty patients 20 eyes were treated with intravitreal injection of triamcinolone acetonide (1mg, 0. 1mL), the other 20 patients 20 eyes accepted intravitreal ranibizumab (0. 5mg, 0. 05mL). The change of best corrected visual acuity ( BCVA ) , central macular thickness ( CMT ) , and intraocular pressure ( IOP ) before treatment and at 1, 2wk, 1, 2,3,6mo post-injection in the two groups were observed.
RESULTS:BCVA was improved at 1, 2wk, 1, 2,3,6mo post-injection in the TA group (P<0.05) and ranibizumab group ( P<0. 05 ). No significant difference was found between the two groups ( P > 0. 05 ). CMT decreased significantly within each group ( P < 0. 05 ), and no significant difference between groups was found ( P >0.05). In the TA group, the IOP was significantly higher at 2wk and 4wk than before treatment (P<0. 05). In the ranibizumab group, no elevated IOP was observed at 1, 2wk, 1, 2,3,6mo (P>0. 05). However, the IOP at 1mo was significantly higher in the TA group than that in the ranibizumb group (P<0. 05).
CONCLUSION:Intravitreal ranibizumab is an effective and safe treatment method for macular edema secondary to CRVO. It can effectively improve BCVA and reduce CMT without ocular and systemic complications compared with intravitreal TA.

?AlM: To compare clinical efficacy between Ahmed glaucoma valve implantation and trabeculectomy in patients with primary open angle glaucoma ( POAG) .
?METHODS: This retrospective study included 58 eyes from 45 patients with primary open angle glaucoma. And 32 eyes underwent penetrating trabeculectomy ( group A), while 26 eyes were performed Ahmed glaucoma valve implantation ( group B) . lntraocular pressure ( lOP) , best-corrected visual acuity ( BCVA ) , visual field and post-operative complications were observed between these two groups.
?RESULTS:(1) lOP:the lOP of post-operation in group A were (13. 56±4. 91), (14. 47±4. 03), (17. 56±5. 74), (18. 25±5. 49), (18. 13±4. 24), (19. 68±4. 55) mm Hg at 2d, 1, and 2wk, 1, 3 and 6mo respectively; and that were (13.58±4. 16), (16. 00±4. 83), (18. 00±5. 05), (19. 42±5. 41), (18. 42±3. 37), (20. 00±5. 37) mm Hg in group B. There was no statistically significant difference in lOP between the two groups ( P> 0. 05 ). ( 2 ) BCVA: the number of visual acuity decreased eyes, with 6mo follow-up, was 7 (22%) in group A; and that was 5 in group B (19%). There was no statistically significant difference in vision loss postoperatively between the two groups (χ2=0. 061, P>0. 05). (3) Visual field: with 6mo follow-up, there were 13 eyes ( 41%) which had constricted visual field in group A, while those were 10 eyes (38%) in group B; the difference of visual field loss between the two groups was not statistically significant (χ2 = 0. 028, P>0. 05 ) . ( 4 ) Complications: six-month follow-up after operation, there were 4 eyes with shallow anterior chamber, 4 eyes with complicated cataract and 1 eyes with Descemet’s membrane detachment in group A, while that was 1 eyes with shallow anterior chamber and 1 eyes with complicated cataract in group B; there was statistically significant difference in the rate of complications between the two groups (χ2 = 4. 144, P<0. 05 ) . ( 5 ) Surgical success rate: six month after operation, the completed success rate was 37% (12 eyes) in group A, and that was 35% (9 eyes) in group B. The partial success rate was 19% (6 eyes) and 15% (4 eyes) in group A and group B respectively. The difference of success rates between the two groups was not statistically significant (χ2=0. 225, P>0. 05).
? CONCLUSlON: Both Ahmed glaucoma valve implantation and trabeculectomy are effective methods for the treatment of POAG. The clinical efficacy was no difference between the two methods. However, compared with trabeculectomy, Ahmed glaucoma valve implantation was safer and had fewer complications.

Objective To analyze the correlation of visual acuity and metamorphopsia with foveal morphology before and after vitrectomy with internal limiting membrane peeling (ILMP) in idiopathic macular epiretinal membrane (IMEM) eyes.Methods This is a retrospective case series of 47 IMEM patients (49 eyes).All the patients underwent 25G pars plana vitrectomy with IMEM removal and ILMP.The best corrected visual acuity (BCVA) was measured using the international standard visual acuity chart,and the results were converted to the logarithm of the minimum angle of resolution (logMAR) visual acuity.The severity of metamorphopsia was measured using M-charts.The central macular thickness (CMT),inner nuclear layer thickness (INT),inner retinal layer thickness (IRT),outer retinal layer thickness (ORT),the status of ellipsoid zone (EZ) were assessed with spectral-domain optical coherence tomography at baseline and each month postoperatively.The differences in BCVA,CMT,INT,IRT,ORT and status of EZ before and after surgery were analyzed,so did the correlations between these indexes at the same time.Results Compared with baseline,the postoperative BCVA was significantly increased (F=6.133,P＜0.001),but the M value,CMT,INT,IRT,ORT were significantly decreased (F=12.481,10.565,15.739,6.046,10.569;P＜0.001);the integrity of EZ was improved significantly (x2=12.309,P＜0.001).Preoperative BCVA was positively related to the CMT (r=0.720) and ORT (r=0.720,0.887;P＜0.05),while negatively related to preoperative integrity of EZ (r=-0.295,P＜0.05).The postoperative BCVA was positively related to the preoperative BCVA and postoperative CMT,ORT (r=0.774,0.754,0.842;P＜0.05),while negatively related to postoperative integrity of EZ (r=-0.676,P＜0.05).The preoperative M value was positively related to the preoperative CMT,INT,IRT,and ORT (r=0.931,0.668,0.840,0.637;P＜ 0.05).The postoperative M value was positively related to the preoperative M value and postoperative CMT,INT,IRT,and ORT (r=0.723,0.722,0.767,0.825,0.387;P＜0.05).Conclusions Vitrectomy with ILMP for IMEM can improve the visual acuity,metamorphopsia and foveal morphology.Both visual acuity and metamorphopsia correlate with foveal morphology.

Objective To evaluate the safety and effectiveness of vitrectomy combined with internal limiting membrane (ILM) tamping on macular hole and retinal detachment (MHRD) in highly myopic eyes.Methods 23 patients (23 eyes) were retrospectively reviewed,who were diagnosed as MHRD through examination of the ocular ftmdus,optic coherence tomography (OCT) and B-mode ultrasonography.There were 5 males (5 eyes) and 18 females (18 eyes).The mean age was (62.35 ± 8.28) years.The mean course of disease was 1.1 months.The logarithm of the minimum angle of resolution (logMAR) best-corrected visual acuity (BCVA) was 2.31 ± 0.72.The mean axial length was (28.66 ± 1.99) mm.All patients underwent 23G microincision vitrectomy.After vitreous gel and cortex were gently resected,the ILM around the edges of the macular hole was stained with indocyanine green,and was folded and pushed to fill the macular hole gently.Then silicone oil or C3F8 gas tamponade was applied in 18 eyes and 5 eyes,respectively.The silicone oil was removed after 3 months.The follow-up was 6 months.The BCVA,macular hole closure,retinal anatomical reattachment were retrospectively observed,and were used to evaluate the safety and effectiveness of the surgery.Results At the 6 months after surgery,the logMAR BCVA was improved to 1.13 ± 0.38,the difference was significant (t=l 5.33,P=0.00).The postoperative macular hole closure rate and retinal anatomical reattachment rate were 100％.There were no ocular or systemic adverse events observed in all patients.Conclusion Vitrectomy combined with ILM tamping is an effective and safe treatment for the high myopic eyes with MHRD.

Objective: To observe the effect of compound preparation of milkvetch root and breviscapine (HDs) on the activity of superoxide dismutase (SOD) and lactate dehydrogenase(LDH), the concentration of malondialdehyde (MDA) in blood and brain and memory impairment in Alzheimer's disease rats.Methods: The rats were randomly divided into 5 groups (10 rats /group): the normal control group, Alzheimer's disease (AD) model group induced by AlCl3(5 mg·kg -1·d-1,ig) and D-gal (40 mg·kg-1·d-1,ip), and 3 AD groups respectively treated with different drugs including piracetam (0.15 g·kg-1·d-1,ig), HDs1(1.5 ml·kg-1·d-1,ip) and HDs2 (3 ml·kg-1·d-1,ip).After 90-day treatment, the step-down test was used to detect the learning and memory ability, and SOD and LDH activity and MDA concentration in blood and brain were examined as well.Results: Compared with that in AD model group, the ability of learning and memory was improved, the activity of SOD and LDH increased significantly, the concentration of MDA decreased significantly in blood and brain in HDs treated groups.The differences were statistically significant (P<0.05 or P<0.01), but they were not restored to normal levels.Some indexes of HDs2 group were better than those of piracetam positive control group and HDs1 group (P<0.05 or P<0.01).Conclusion: HDs can effectively reduce MDA concentration, increase SOD and LDH activity in blood and brain, and improve the ability of learning and memory of AD rats.