Choroidal neovascularization is one of the common causes resulting in vision loss in patients with pathologic myopia, and the irreversible central vision lose is often found. This article reviews the epidemiology of pathologic myopia, pathogenesis, clinical manifestation and anti-VEGF therapy of choroidal neovascularization secondary to pathologic myopia.

Objective To observe the image features of high myopia with retinoschisis by spectraldomain optical coherence tomography (SD-OCT). Methods The clinical data of eight patients (eight eyes)of high myopia with retinoschisis were retrospective analyzed. All patients were diagnosed by SD-OCT (Topcon 3D OCT-1000), had no macular holes and underwent vitrectomy including internal limiting membrane (ILM) peeling and gas tamponade. All patients also underwent visual acuity, refraction,pre-mirror fundus examination and A/B-mode ultrasound examination. Visual acuity and SD-OCT were followed up at one, three and six months after surgery. Before surgery, pre-mirror fundus examination revealed shallow foveal detachment in 3/8 eyes, posterior scleral staphyloma in 7/8 eyes. SD-OCT showed concave arc stripes in 7/8 eyes, and outer retinoschisis in 8/8 eyes, middle or inner retinoschisis in 5/8 eyes and foveal detachment in 5/8 eyes. Results Six months after surgery, posterior retinoschisis disappeared in six eyes, foveal detachment still presented in one eye and parafoveal hole occurred in one eye. The corrected visual acuity improved from the 0. 15 to 0. 8 in one eye which had a restored continuous inner segment/outer segmen (IS/OS) line by SD-OCT. The corxected visual acuity improved from 0. 01 to 0. 1 in one eye, from 0. 05 to 0. 15 in one eye, not changed in five eyes. There was no continuous IS/OS line in those patients by SD-OCT. Conclusions SD-OCT shows a variety of morphological features of myopic retinoschisis which could be cured anatomically and functionally by vitrectomy combined ILM peeling. The continuity of IS/OS layer from SD-OCT could help to interpret the vision recovery after the operation.

Objective To describe the morphological characteristics of foveal retinoschisis and retinal detachment in highly myopic eyes. Design Retrospective observational case series. Participants Twenty-nine patients (38 eyes) of high myopia with foveal retinoschisis and retinal detachment. Methods All patients with foveal retinoschisis and retinal detachment were performed complete ophthalmic examinations, B-scan and studied cross-sectional images of the maculae with optical coherence tomography (OCT). 10 eyes underwent vitreous surgery. Main Outcome Measures Morphological characteristics. Results On biomicroscopy, the maculae of all 38 eyes had a microcystic appearance and shallow elevation without macular hole. B-scan showed posterior retinal edema or with 0.5 to 2mm detachment. OCT disclosed foveal retinoschisis and retinal detachment in all eyes. The neuroretina splitted into a thick inner layer and a thin outer layer or a thin inner layer and a thick outer layer or a thin inner layer, a thick inter layer and a thin outer layer. A hyperreflective preretinal structure resembling the posterior hyaloid was stretched over the retinoschisis and drew the retina. Vitreous surgery performed on 10 eyes, including posterior vitreous detachment, removal of the premacular vitreous cortex. In all eyes, foveal detachment and retinoschisis gradually decreased in height, and attained foveal attachment finally. Conclusion Foveal retinoschisis and retinal detachment in highly myopic eyes with staphyloma is better characterized with OCT than with biomicroscopy. Vitreomacular traction forms the posterior hyaloid and the staphyloma maybe the major cause of it.

OBJECTIVE To investigate the resistance of Enterobacter cloacae and its gene of chlorhexidine-sulfadiazine-resistance(qacE△1-sul1) isolated from two hospitals. METHODS Microdilute tests were performed to detect the susceptibility of 20 kinds of antimicrobial agents in 74 strains of E.cloacae.The qacE△1-sul1gene was detected by PCR. RESULTS There was no strain resistant to imipenem and meropenem.The resistant rates to other antimicrobial agents were between 44.6% and 94.6%.The positive rate of qacE△1-sul1gene was 74.3%. CONCLUSIONS The 74 strains were multiple-drug-resistant.There was a high positive rate of qacE△1-sul1gene in E.cloacae isolated from two hospitals.

OBJECTIVE To investigate the prevalence of three kinds of antimicrobial-resistant genes in Enterobacter cloacae. METHODS Antimicrobial susceptibility test was performed by microdiluted method and antimicrobial - resistant genes were detected by PCR methods in 20 clinical strains of E. cloacae. RESULTS Twenty strains of E. cloacae showed multiple-drug resistance.Among 20 strains, the positive rates of ACT-1, DHA and TEM genes were 70.0%, 45.0% and 55.0%, respectively. The positive rates of aac(6′) -Ⅰ , ant(3″)-Ⅰ, ant(2″)-Ⅰ, aac(6′)-Ⅱ, and aac(3)-Ⅱgenes were 50.0%, 15.0%, 10.0%, 5.0% and 5.0%, respectively . The positive rates of sul Ⅰand dfrA1 genes were 50.0%, and 5.0%, respectively. But other genes were not found. CONCLUSIONS This study shows that there are multiple-drug resistance and high positive rate of three kinds of antimicrobial- resistant genes in E. cloacae isolated from our hospital.

AIM:To develop the method for analyzing bulleyacinitine A in plasm from mice through the treatment of subcutaneous injection of bulleyacinitine A by liquid chromatography tandem mass spectrometry(LC-MS/MS).METHODS:50 ?L mouse plasma sample added zolpidem as internal standard and pH 9.2 buffer solution was extracted with ethylether,followed by liquid chromatography and mass spectrometric detection.The mobile phase was consisted of methanol-buffer solution(85∶15)(buffer solution consisted of 20 mmol/L ammonium acetate and 0.1% formic solution).The flow rate was 300 ?L per minute.The separation column was C_ 18 column.The electrospray ionization tandem mass spectrometry and the multiple reaction monitoring mode were applied to detecting the bulleyacinitine A in plasma.RESULTS:The assay was linear from 0.1 to 1 000 ng/mL.The recovery rate was more than 80%.CONCLUSION:The method could be used to detect bulleyacinitine A level in mouse plasma,which offers advantages of sensitiveness,specificity and simpleness.

Objective To identify the genotype of merozoite surface protein 1 (MSP1) of Plasmodium falciparum isolates from Hainan Province. Methods Nested PCR was applied to amplify the MSP1 of Blocks 2 and 3 Plasmodium falciparum isolates from Hainan Province. Two allelic family representitive gene fragments were sequenced.Results From 36 out of 39 blood samples from Plasmodium falciparum patients, 44 gene fragments of blocks 2 and 3 of the MSP1 were amplified, of which the MAD20 type allele was dominant(75%). followed by K1 type allele. No RO33 type allele was found. The mixed infection rate of the two different allelic type was 19 4%. Sequence analysis showed that the sequences of MAD20 and K1 type isolates from Hainan Province were highly homologous to that of the MAD20 and K1 allelic prototypes.Conclusion Two principal allelic types of MSP1 gene, MAD20 and K1 type, exist in malaria endemic areas in Hainan Province, the MAD20 type being the dominant.

Objective:To investigate the relationship between genotype and phenotype in children with CRB1 mutated Leber congenital amaurosis (LCA) and early onset retinal dystrophy (EOSRD). Methods:A retrospective clinical study. From January 2013 to December 2019, 10 children with CRB1 mutated LCA/EOSRD were enrolled in the study. The patients were identified as CRB1 mutation by the second generation targeted capture sequencing, Sanger sequencing and the family segregation analysis. All children underwent electroretinogram (ERG) and fundus examination. At the same time, 6 cases were examined by optical coherence tomography (OCT); 1 case was examined by fluorescein fundus angiography (FFA), 7 cases were examined by wide-angle laser scanning ophthalmoscope (UWF SLO). Results:There were 6 cases of LCA and 4 cases of EOSRD in 10 patients with CRB1 gene mutations. The average age of first visit was 3.61 years old. The light and dark wave of ERG was flat in 6 cases, and decreased in 4 cases. A total of 19 pathogenic mutations were detected. There were 1 homozygous mutation and 9 compound heterozygous mutations. There were 4, 2 and 1 cases of "copper-coin" like, "salt and pepper" like and "osteocyte" like pigment changes in retina, 1 case of "crystalline pigment" change and 2 cases of macular pigment scar. In 7 cases of UWF SLO examination, different degrees of para-arteriolar pigment epithelium retention (PPRPE) were found in the middle and peripheral fundus. In 6 cases examined by OCT, the outer layer of retina atrophied and the band of ellipsoid disappeared. Symmetrical cystoid macular edema, splitting cystoid macular degeneration and adhesion of epi-macular membrane to optic disc and macular area were found in 1 case, respectively, the retinal structure was rough and thickened, and the fovea became thinner in 3 cases. In FFA examination, 1 case showed uveitis-like changes with late optic disc fluorescein staining, macular fluorescence accumulation, strong fluorescence diffusing along the blood vessels in each quadrant, peripheral PPRPE of "frost-branch" like strong fluorescence. Conclusion:The relationship between genotype and phenotype of CRB1 mutation is complex, and PPRPE is a common characteristic change.

Objective To investigate the clinical values of laryngeal electromyography (LEMG) for evaluating the amyotrophic lateral sclerosis(ALS) patients with swallowing disorder .Methods A total of 25 ALS patients with or without complaining of swallowing disorder were recruited for the study .Their right cricothyroid muscles were taken unilaterally with concentric needle electrodes by anterior cervical approach .Each patient was tested with Kub-ota drinking test too .Results Of all the 25 patients ,11 were found abnormal in the right cricothyroid muscle which presented with typical degeneration patterns ,15 cases were found abnormal by Kubota drinking test .The coinci-dence rate of the two methods was 60% ,the poisitive coincidence rate was 32% .The McNemar test showed there was some consistency between the drinking water test and LEMG (P=0 .344) ,and the Kappa coefficient was 0 .219 . Conclusion The cricothyroid muscle electromyography may also be a potential method to evaluate ALS patients since it seemed to offer an evidence of dysphagia related with abnormal sensory function of laryngeal mucosa .But there may be some limitations .

Objective To study the effects of dihydroartemisinin and quinine on plasmodium falciparum gametocytes at early stage. Methods Eleven patients with falciparum malaria who had plasmodium falciparum gametocytes at early stage(PFGe) in bone marrow but no matured plasmodium falciparum gametocytes(PFGm) in bone marrow and peripheral blood were allocated to two groups.Group A(n=6) were administered orally with dihydroartemisinin at a total dosage of 480mg for 7 days and Group B(n=5) with quinine sulfate at a total dosage of 10?500 mg for 7 days.The number of gametocytes in bone marrow and peripheral blood was examined at regular time. Results PFGe in bone marrow disappeared in Group A on 10 th day after the first administration while existed in all the cases of Group B on 10 th day and still in 2 cases on 14 th day.The clearance time for peripheral PFGe was 4.8?0.9 days in Group A and 22.0?5.8 days in Group B. Conclusion Dihydroartemisinin can clear PFGe but quinine shows no this action.