Recently more and more ophthalmologists selected a multifocal intraocular lens (IOL) for their cataract patient in order to get good unaided reading vision. Although the design of IOL have made a great progress, we are still dissatisfied compared with our natural crystal lens. Understanding the design theory and improving our surgery technique are basic for better utilization the multifocal IOL. Does the multifocal IOL reduce contrast sensitivity? Should we implant the multifocal IOL in pediatric cataract surgery? How can we deal with the residual refractive error after multifocal IOL implantation? In this editorial, we try to clarify these problems to make us select and use multifocal IOL better.

Cell division cycle 42 (Cdc42)has been shown as an important regulator of many biological processes.Studies have suggested the role of Cdc42 in the diseases of digestive tract,but the mechanisms remain unclear.More studies are needed to advance the knowledge of roles of Cdc42 in the pathogenesis of digestive tract diseases,which may lead to therapeutic improvements.

Objective To observe the clinical efficacy of grain-sized moxibustion in treating cancer-related fatigue and improving the quality of life of patients with malignant tumor. Method Forty-six patients with malignant tumor were randomized into a grain-sized moxibustion group and a control group. The grain-sized moxibustion group received grain-sized moxibustion plus regular treatment, while the control group received the regular treatment only. The cancer-related fatigue intensity [Karnofsky Performance Status (KPS), European Organization for Research on Treatment of Cancer Core Quality-of-life Questionnaire (EORTC QLQ-C30), Piper Fatigue Scale (PFS)], white blood cell count, hemoglobin level, lymphocyte count, and neutrophil count were compared before and after treatment between the two groups. The correlation between cancer-related fatigue and the observed indexes was also analyzed. Result The grain-sized moxibustion group was better than the control group in mitigating the cancer-related fatigue, up-regulating hemoglobin level, and improving the symptoms (P<0.05). Conclusion Grain-sized moxibustion can effectively mitigate cancer-related fatigue via improving anemia condition and the symptoms of malignant tumor patients, and it can also enhance the quality of life of the patients.

Objective To assess renal perfusion of chronic renal failure(CRF) at different stages in rabbits by contrast-enhanced ultrasound. Methods Fifteen rabbits were injected cationic bovine serum albumin(C-BSA) intravenously for 8 weeks to establish CRF models. Serum creatinine(Scr) and blood urea nitrogen(BUN) were determined before injection and 2,4,6,8 weeks after C-BSA injection respectively. The size of kidney was measured by two-dimensional ultrasound and contrast-enhanced ultrasound was performed on bilateral kidneys at the same time points. Renal perfusion was analyzed quantitatively with the time intensity curve. Results Renal cortical perfusion reduced started at 4weeks after injection,manifested as the peak signal intensity(PSI) of the time-intensity curve parameters decreased(P<0.05 or P <0.01). The speeds of perfusion and clearance of kidney were slower,showed as the time to peak intensity(PIT) and the time to half of peak intensity(HPT) delayed (P <0.05 or P <0.01). Compared with pre-injection, there were no differences in terms of the area under the curve(AUC) at 2,4 and 6 weeks after injection (all P> 0.05). And compared with pre-injection,2,4,6 weeks after injection, the AUC decreased at 8 weeks (P < 0.05 or P <0.01 ). The level of Scr and BUN of rabbits had increased since 6 weeks after injection (P< 0.05 or P <0.01). Two-dimensional ultrasound showed the renal volume was enlarged and the cortex was thickened from 2 weeks to 6 weeks after injection (P<0.05 or P <0.01). At 8 weeks after injection, the renal size had decreased as well (P < 0.05). These ultrasound changes were in accordance with its pathological changes. Conclusions Contrast-enhanced ultrasound in combination with time-intensity curve can quantitatively analyze the renal perfusion of CRF at different stages. The reduction of renal perfusion was earlier than the changes of routine laboratory indexes in rabbits with CRF. The haemodynamic changes of CRF rabbit were closely related with its pathological changes.

Objective To analyze the serum samples of young and middle-aged patients with hypertension of different syndromes and healthy patients by means of metabonomics; To confirm its biomarker; To reveal the nature of phlegm dampness retention syndrome in essential hypertension. Methods The syndrome types of 34 hypertension patients were differentiated into 14 cases of liver-fire hyperactivity syndrome group, 14 cases of phlegm dampness retention syndrome group and 6 cases of yin deficiency and yang hyperactivity syndrome group. 15 healthy volunteers were selected as control group. 1H-NMR technique combined with partial least squares-discriminate analysis (PLS-DA) method was used to look for the biomarkers. And the levels of UA, TC and TG were recorded. Results The level of UA in phlegm dampness retention syndrome group was significantly higher than the other three groups (P<0.05). The level of TC in yin deficiency and yang hyperactivity syndrome group was higher and had significantly difference with the control group (P<0.05). The level of TG in phlegm dampness retention syndrome group was higher and had significantly difference with control group (P<0.05). The metabonomics study based on the 1H-NMR method could distinguish the phlegm dampness retention syndrome group from the normal control group, liver-fire hyperactivity syndrome group and yin deficiency and yang hyperactivity syndrome group. Compared with the control group, the levels of acetone, VLDL, and LDL were significantly higher and the levels of lactate, serine, glucose, methionine, alanine were significantly lower in phlegm dampness retention syndrome group; compared with the liver-fire hyperactivity syndrome group, levels of citrate, alanine, VLDL, and LDL were significantly higher and the levels of glucose, lysine, glutamate, proline lactate were significantly lower; compared with yin deficiency and yang hyperactivity syndrome group, the level of creatinine was significantly higher. Conclusion There are lipoprotein metabolism, amino acid metabolism and glucose metabolism disorder in the young and middle-age hypertensive patients with phlegm dampness retention syndrome.

Background Age-related macular degeneration (AMD) is a heritable,progressive degenerative disorder that triggers central visual impairment.Research demonstrated that the single nucleotide polymorphisms (SNPs) of vascular endothelial growth factor 1 (VEGFR1) gene is associated with AMD in different population.However,the results varied among diversified ethnic origin composition and distinct regions.Objective This study was to investigate the associations between the SNPs of VEGFR1 genetic variants along with smoking exposure and the risk of AMD in Hui and Han ethnics in the Ningxia population in China.Methods A case-control study was conducted.Four hundreds and thirty-two AMD patients including 325 Han ethnic patients and 107 Hui ethnic patients were recruited from March 2011 to June 2015,and 906 ethnicity-and gender-matched age-related cataract patients were contemporaneously recruited as control group,including 698 Han ethnic patients and 208 Hui ethnic patients.Periphery blood sample of 5 ml was collected from the subjects and genomic DNA was prepared.Eight tagging SNPs loci were acquired to cover rs2281827,rs3936415,rs7337610,rs7981680,rs9554320,rs9554322,rs9582036 and rs9943922,and the genotypes of SNPs were detected by using MassARRAYTM time-of-flight mass spectrometry system.Chi-square test and multi-factor Logistic regression analysis were utilized to estimate the discrepancy of allele frequency and genotype distribution in Hui and Han AMD patients.Moreover,the correlation of AMD with smoking and age statue were further analyzed.This study protocol complied with Helsinki Declaration and was approved by Ethic Committee of Ningxia Eye Hospital.Written informed consent was obtained before any relevant medical examination.Results There were significant differences in the age between AMD group and control group in both Han and Hui ethnicity (Han:P =0.000;Hui:P =0.009).The smoking exposure was significantly different between AMD group and control group in Han ethnicity (P =0.000),and smoking was the independent risk factor of AMD disease in Han ethnicity of N ingxia region (odds ratio [OR] =2.622,95％ confidence interval [CI]:1.899-3.619).The allele frequencies of SNPs were not significantly different in the AMD patients between Han and Hui ethnicity (all at P＞0.05).However,the allele frequencies and genotype distribution of rs7337610 and rs9554322 SNPs were significantly different between the AMD group and control group in both Han and Hui ethnicity (all at P=0.00).The genotype distribution of rs9582036 and rs9943922 SNPs was significantly different between the AMD group and control group in Han ethnicity (P=0.02,0.00).Allelic G of rs7337610 was the protective factor of AMD disease in Han and Hui ethnieity (OR=0.354,95％ CI:0.288-0.435;OR=0.446,95％ CI:0.315-0.632),while allelic C of rs9554322 was the risk factor of AMD disease in Han and Hui ethnicity (OR=1.671,95％ C1:1.234-2.262;OR=3.661,95％ CI:2.156-6.218).Allelic A of rs9582036 was the risk factor of AMD disease in Han ethnicity (OR =1.477,95％ CI:1.124-1.940).Conclusions Smoking is the independent risk component for Han population with AMD.Of the eight SNPs tagged,the genotypes and alleles of rs9554322 and rs7337610 seems to confer susceptibility to AMD in both Han and Hui ethnicity,the genotypes and alleles of rs9582036 and rs9943922 confer susceptibility to AMD in only Han ethnicity.

OBJECTIVE:To observe the effect of Maren pills combined with lactulose preventing opioid-induced constipation (OIC) in patients with cancer pain. METHODS:281 cases of advanced cancer pain were selected and divided into Maren pills group,lactulose group and drug combination group. 3 groups were given opioid to relieve pain,and additionally received Maren pills,lactulose or drug combination(lactulose for 3 d and then Maren pills for 3 d instead,repeated in the same way)to treatment OIC prophylactically. The constipation conditions of 3 groups were observed and recorded at 2,4 and 6 weeks after the therapy. And then the data were analyzed statistically. RESULTS:The regular doses of Maren pills and lactulose alone or combination had prevention effect on OIC. Drug combination showed better long-term prevention effect;there were statistically significant difference in constipation conditions between grug combination group and other 2 groups after 4 and 6 weeks of therapy (P<0.05 or P<0.01). CONCLUSIONS:Maren pills combined with lactulose are obvious benefit for constipation prevention and relief in cancer pain patients who use opioid for a long time.

Objective The aim of this study was to explore the inhibitory effect of alcohol extracts of Narcissus bulb on melanogenesis in zebrafish embryos.Methods Zebrafish embryos were exposed to different concentrations of alcohol extracts of Narcissus (0, 50, 100, 200, and 500 μg/mL), and then the formation of melanin was observed.Furthermore, we measured the enzyme activity of tyrosinase (TYR), which plays a pivotal role in melanogenesis.Meanwhile, the spatial and temporal pattern of melanin-specific marker genes were detected.Arbutin (Ar) was used as a positive control in all these experiments.Results The treatment of alcohol extracts of Narcissus bulb inhibited melanogenesis in the zebrafish embryos in a dose-dependent manner.Furthermore, the mRNA expression levels of melanin-related genes such as tyrosinase (TYR), silver (SILV) and Mitfa were significantly reduced after treatment with different concentrations of Narcissus extracts by in-situ and semi-quantitative PCR.Finally, the enzyme activity of tyrosinase was also gradually decreased with increasing concentrations of the alcohol extracts.Conclusions Narcissus alcohol extracts can effectively inhibit the production of melanin in zebrafish embryos.This study provides potential evidence and approaches for the screening of natural whitening compounds using zebrafish models.

OBJECTIVETo explore the clinical and radiological features of severe acute respiratory syndrome (SARS).

METHODSAnalysis of the clinical presentation, chest radiographs, course of disease and features of severe pneumonia in 45 SARS patients diagnosed at our hospital in Beijing between April 5 - 20, 2003. Also included is a summation of the clinical features of SARS.

RESULTS(1) SARS appears to have high infectivity; (2) the most common symptom is fever; (3) the count of leukocyte is normal or decreased; (4) most patients (35/45, 77.8%) had experienced a 24-hour fever prior to the abnormal chest X-ray changes which showed progression of pulmonary infiltrates within 48 hours in 71.1% (32/45) of the patients and, (5) the percentage of patients who developed severe pneumonia (24.4%) is higher than those who developed typical pneumonia.

CONCLUSIONSARS is a disease with high infectivity and has its own clinical and radiological features. Early recognition, prompt isolation, and appropriate therapy are the key to combat this infection.

Adult ; Female ; Humans ; Male ; Middle Aged ; Radiography, Thoracic ; Severe Acute Respiratory Syndrome ; diagnosis ; mortality ; therapy

Objective To discuss the effect of functional electric stimulation (FES) on motor evoked potential(MEP),glial fibrillary acidic protein (GFAP) expression and muscle wet weight in rats after spinal cord injury (SCI).Methods Seventy-two adult male SD rats were chosen and randomly divided into 3 groups:sham-operated group,FES group and model group (n=24).T9 spinal cord complete injury animal models in the FES group and model group were induced by NYU blow.Rats in the FES group were performed FES at posterior thigh and rats in the model group only placed electrode without electricity.7,14,28 and 56 d after FES,potentiometer test was performed to detect the MEP latency; immunohistochemical staining was employed to detect the GFAP expression; and hind leg extensor muscle wet weight was measured.Results The MEP latency in the FES group was detected 14,28 and 56 d after FES,which was significantly longer than that in the sham-operated group (P＜0.05); the MEP latency in the FES group 28 and 56 d after FES was significantly shortened than that in the model group (P＜0.05).Muscle wet weight in the FES group 28 and 56 d after FES was significantly increased than that in the model group (P＜0.05).GFAP-positive cells in the FES group 28 and 56 d after FES were significantly decreased than those in the model group (P＜0.05).Conclusion FES in the treatment of spinal cord injury can not only inhibit the expression of GFAP and shorten MEP latency,but also inhibit paralyzed limb muscle atrophy and promote motor function recovery.