Corneal endothelial transplantation has achieved good results in domestic and foreign clinical applications , which has become the preferred method for treatment of severe corneal endothelial lesion .Corneal endothelial transplantation retained the patients′autologous healthy corneal epithelum , Bowman′s membrane and the strooma , as far as possible to ensure the integrity of the ocular sur-face, reduce the astigmatism.It had some advantages such as small invasiveness , less rejection, and faster visual recovery .Descemet stripping endothelial keratoplasty is the mianstream mode of operation , then the advanced femtosecond laser Descemet′s membrane en-dothelial keratoplasty were developed .We review the development course , operation methods , and complications of corneal endothelial transplantation in this paper .

Background Herpes stromal keratitis (HSK) is a common infectious ocular surface disease,with a higher recurrent rate,especially in necrotizing HSK.The diagnosis of HSK primarily depends on signs and symptoms,and specific laboratory diagnostic is lack.Objective This study was to clarify the expression of herpes simplex virus (HSV) in the corneal epithelium scrapings and tears of necrotizing HSK patients.Methods Thirty eyes of 30 patients with necrotizing HSK were enrolled in Nanjing Hospital of Nanjing Medical Hospital from September 2012 to September 2013 under the patient's informed consent.The eyes were examined by slit lamp microscope and scored.HSK patients received local and systemic therapy for 8 weeks and then an oral maintenance dose for 6 months.Corneal epithelial scrapings and tears samples were collected for HSV DNA detection by real-time PCR before and the 1 st,2nd,4th,6th and 8th week after therapy respectively.The difference of HSV positive rate was compared between corneal epithelium scrapings and tears samples using Chi-square test.Multilevel mixed effective model was employed to evaluate HSV concentration change in the samples at various time points in the HSV-positive patients of initial visit.The correlation between HSV concentration and clinical score was analyzed by Spearman rank correlation.Results HSV-positive rate was 46.4％ (13/30) in the corneal epithelial scrapings and 13.3％(4/30) in the tear samples,showing a significant difference between them (P =0.006).HSV-positive rate was significantly lower in the corneal epithelial scrapings 1 week,2 weeks and 4 weeks after treatment than before (P =0.001,0.003,0.004),and no HSV was detected 6 weeks and 8 weeks after treatment.No significant change in HSV-positive rate in tear samples in 1 week and 2 weeks after treatment in comparison with before treatment (P =1.000,0.583),and no HSV was detected after 4 weeks following treatment.The HSV concentration was 2460 (2 165-636500)/ml in initial 13 HSV-positive eyes of corneal epithelial scrapings and 0 (0-1150)/ml in initial 13 HSV-positive eyes of tear samples.Multilevel mixed effective model determined that HSV concentration was significantly lower in corneal epithelial scraping than that in tear (P =0.005),and HSV concentration was reduced with the lapse of time (P =0.001),with the faster rate of decline in the corneal epithelial scrapings (P =0.049).A positive correlation was found between initial HSV concentration and clinical scores (rs =0.844,P =0.000).Conclusiors Real-time PCR appears to be a powerful molecular tool for the detection of HSV in the HSK,especially in corneal epithelial scrapings of lesion.The initial positive outcome of viral DNA in corneal epithelial scrapings predicts a severe clinical procedure.

Objective To investigate the effect of total glucosides of paeong (TGP) on the liver lipid infiltration and fibrosis in rats with non-alcoholic fatty liver disease (NAFLD) induced by fructose and high-fat diet. Methods Fructose-high-fatty induced NAFLD rat model was established. Metformin ( MET,200 mg · kg-1 ) and TGP (200,100 mg · kg-1 ) was intragastrically given to the rats in the treatment group,TGP high dose and low dose group,respectively. Normal control group and model control group was intragastrically treated with equivalent distilled water (10 mL·kg-1 ). At the fourth week after the treatment,all the rats were sacrificed and the indices such as serum fasting blood glucose(FBG),INS,insulin sensitivity index (ISI),triglycerides(TG),apelin-36,visfatin,alanine aminotransferase(ALT),aspartate aminotransferase(AST),free fatty acid (FFA),collagen Ⅲ(COLⅢ),collagen Ⅳ(COLⅣ) were determined. Hepatic content of TG was determined and the pathological changes in the liver tissues were observed under the microscope. Results As compared with the model control group,TGP effectively decreased FBG,INS,TG in serum and liver tissues,activity of ALT and AST in serum and content of FAA,Apelin, Visfatin,COLⅢ and COLⅣ,with significant differences (P<0. 05 or P<0. 01). TGP alleviated lipid infiltration and fibrosis in rat liver tissues. Conclusion TGP can inhibit effectively lipid infiltration and fibrosis of NAFLD rats,probably through improving glucolipid metabolism and antogonizing insulin resistance.

Objective To investigate the effects of Dermatophagoides pteronyssinus ( Der p) on the expression of TLR4 and IL-4 in P815 mast cells and to further analyze the immunoregulatory effects of 1,25-(OH)2D3 on Der p treated P815 mast cells.Methods Different concentrations of Der p and 1,25-( OH) 2 D3 were used alone or in combination to stimulate P815 mast cells.The supernatants of the stimulated cell culture were analyzed by enzyme-linked immunosorbent assay ( ELISA) for the detection of IL-4.The stimulated cells were collected and analyzed by real-time PCR and Western blot assays for the detection of TLR4atmRNAandproteinlevels,respectively.Results (1)TLR4expressionwasdetectedinP815 cells.The expression of TLR4 was enhanced in P815 cells treated with various concentrations of Der p.A significant dose-dependent up-regulation of TLR4 was observed in P815 cells after incubation with Der p for 36 h.(2) Der p promoted the release of IL-4 in P815 cells (P<0.05).(3) No significant differences with the expression of TLR4 and IL-4 were observed among 1,25(OH)2D3 treatment groups as compared with the control group (P>0.05).(4) 10-8 mol/L of 1,25(OH)2D3 promoted the Der p-induced expression of TLR4 in P815 cells (P<0.01).However, 1,25(OH)2D3 inhibited the release of IL-4 in a dose-dependent manner(P<0.05orP<0.01).Conclusion (1)Derpcouldpromotetheinflammationandallergicreac-tion through up-regulating TLR4 and IL-4 in mast cells.(2) The possible mechanism for the inhibitory of 1, 25(OH)2D3 on Der p-induced immune responses was due to the suppression of Th2-type immune responses through inhibiting the synthesis and secretion of IL-4 in mast cells.

Objective To observe the human papillomavirus(HPV) prevalence and its distribution character among females in Changzhou and to provide epidemiological data for the prevention of cervical cancer and development of HPV vaccine .Methods The clinical material consisted of 32215 women ,who were from Changzhou Hospital T .C .M ,Changzhou Maternal and Child Health Care ,The Second People's Hospital of Changzhou and Changzhou Wujin Hospital from January 2014 to June 2016 .17 kinds of high-risk subtypes (HPV16 ,18 ,31 ,33 ,35 ,39 ,,45 ,51 ,52 ,53 ,56 ,58 ,59 ,66 ,68 ,73 ,82) and 6 kinds of low-risk subtypes (HPV6 ,11 ,42 ,43 ,81 ,83) were detected .All cases were divided into six groups according to the age (<20 ;>21 to 30;31 to 40 ;41 to 50 ;51 to 60 ;and>61) and the age distribution of women infected with HPV and genotypes of HPV were analyzed .Results Out of 32215 cervical cell specimens ,8396 cases were detected HPV infections with the position rate of 26 .06% .In seventeen types of high-risk HPV ,HPV 16 (4 .55% ) were the most common subtype ,followed by 52 (4 .43% ) ,58 (2 .75% ) ,53 (2 .42% ) ,51 (2 .16% ) ,68 (1 .85% ) ,56 (1 .73% ) ,33 (1 .40% ) ,18 (1 .38% ) ,66 (1 .33% ) ,59 (1 .26% ) ,39 (1 .08% ) ,31 (1 .02% ) ,35 (0 .89% ) ,45 (0 .42% ) ,73 (0 .26% ) ,and 82 (0 .15% ) .Six types of low-risk HPV were detected ,of which HPV 81 (2 .96% ) was the most common subtypes ,followed by 43 (1 .86% ) ,42 (1 .62% ) ,6 (1 .27% ) ,11 (0 .80% ) and 83 (0 .26% ) .Conclusion The predominant genotypes of HPV 16 and ,52 infection in female reproductive tract are the highest .

Objective To investigate the effect and safety of orthokeratology lens on myopia control in adolescents and children with different diopters.Methods Ninety-three patients(171 eyes)with myopia who received orthokeratology lens treatment in the Affiliated Jiangning Hospital of Nanjing Medical University from February to August 2021 were selected for the study.They were divided into a low degree group(88 eyes,-0.5D to-3.0D)and medium degree group(83 eyes,-3.0D to-6.0D)according to the equivalent spherical lens degree.The naked eye distant vision,diopter,optic axis,breakup time of tear film(BUT),corneal endothelial cell count and complications were compared between two groups.Results After 1 year of lens wear,growth of optic axis in low degree group was significantly greater than that in medium degree group(Z=-2.035,P=0.042).After 1 year of lens wear,naked eye distant vision of both groups was significantly higher than that before lens wear(P<0.05),and increase of visual acuity in medium degree group was significantly greater than that in low degree group(P<0.05).The equivalent spherical degree of two groups was significantly lower than that before lens wear(P<0.05),and reduction of equivalent spherical lens degree in medium degree group was significantly greater than that in low degree group(P<0.05).After 1 year of lens wear,BUT in both groups was significantly shorter than that before lens wear,and corneal endothelial cell count was lower than that before lens wear(P<0.05),but there were no significant differences in BUT and corneal endothelial cell count between two groups(P>0.05).There was no statistically significant difference in complication rate between two groups(χ2=2.000,P=0.157).Conclusion Orthokeratology lens has good control effect and safety for adolescents and children with different diopters,and the effect is more prominent for moderate myopia.

About 1% of the patients with acute hepatitis B can progress to acute liver failure， and 75% of the patients with hepatitis B virus （HBV）-related acute liver failure need to undergo liver transplantation or face death. This article reports a patient with HBV infection-related acute liver failure who achieved clinical cure and HBsAg seroconversion after antiviral therapy and symptomatic/supportive treatment， and dynamic monitoring was performed for immunological markers in peripheral blood.