Objective To evaluate the therapeutic effects of recombinant expression plasmid containing hepatocyte growth factor (HGF) and augmenter of liver regeneration (ALR) on rats with hepatic fibrosis. Methods Ninety Sprague-Dawley rats, which had been established into hepatic fibrosis models, were equally divided into 6 groups: blank group, pcDNA3.1 therapy group,pcDNA3.1-HGF therapy group, pcDNA3. 1-ALR therapy group, pcDNA3.1-HGF and pcDNA3. 1-ALR combined therapy group, and pcDNA3. 1-HGF-ALR therapy group. Zero point one μmol of blank or plasmid was injected into model rats in each group by tail vein once a day for 3 days. Model rats in blank group didn't receive any treatment. Additional 10 rats were chosen as control group, which were not given any interference during the experiment. All rats were sacrificed 4 days after end of treatment. Liver tissues were reserved for observing pathologic changes after HE staining and detecting proliferating cell nuclear antigen (PCNA) and c-jun by immunohistochemistry. Measurement data were compared by single-factor analysis of variance. Comparison between groups was done by SNK test. Enumeration data were analyzed by Fisher's exact test. Results In blank group and pcDNA3.1 therapy group, hyperplasia of fibrous connective tissue was very obvious, false lobules were formed. There was no significant difference between these two groups (x2 =0. 317,P= 1. 000).In the 4 remaining groups, hepatic fibrosis all achieved different degree of amelioration, and the therapeutic effect of pcDNA3.1-HGF-ALR was optimal. In control group, the expressions of PCNA and c-jun in liver tissues were low, with absorbance value of 8.6±1.9 and 3.2 ± 1.2, respectively. In blank group and pcDNA3. 1 therapy group, the expressions of PCNA and c-jun were obviously increased, with absorbance value of 24. 1±3.0, 24.5±4.3 and 23.8±3.1, 24.9±4.2, respectively,which were significant different from control group (all P＜0.01). In the 4 remaining groups, the expressions of PCNA were all obviously increased, and expressions of c-jun were all obviously decreased. The maximum change scope was observed in pcDNA3. 1-HGF-ALR therapy group.Conclusions The recombinant expression plasmid pcDNA3. 1-HGF-ALR can effectively ameliorate experimental hepatic fibrosis of rats. The anti-fibrosis effects are achieved probably by up-regulating PCNA expression and down-regulating c-jun expression.

Objective To identify the risk factors of Burkholderia cenocepacia associated nosocomial lower respiratory tract infections (NLRTIs),and to investigate the drug resistance of Burkholderia cenocepacia strains.Methods A total of 138 patients with Burkholderia cenocepacia associated NLRTIs and 40 patients with non-Burkholderia cenocepacia associated NLRTIs were enrolled in the study.All patients were collected from the Second Affiliated Hospital of Wenzhou Medical University during January 2009 and December 2012.Clinical data and results of drug sensitivity tests were retrospectively reviewed.Chi-square test and Logistic regression analysis were performed to identify the risk factors of Burkholderia cenocepacia associated NLRTIs.Results Logistic regression analvsis showed that combination use of 2 or more antimicrobial agents,mechanical ventilation,stay in intensive care unit (ICU) for more than two weeks,use of antacid H2 antagonist and deep venous puncture were the independent risk factors of Burkholderia cenocepacia associated NLRTIs (OR =6.315,5.957,5.254,4.585 and 2.017,P ＜0.05).Burkholderia cenocepacia strains were sensitive to levofloxacin,ceftazidime and sulfamethoxazole; More than 40％ strains were resistant to cefotaxime,ceftriaxone,cefepime,aztreonam and tetracycline; And nearly 100％ strains were resistant to gentamicin,amikacin and tobramycin.Conclusion Burkholderia cenocepacia associated NLRTIs are more likely to occur in patients with combination use of 2 or more antimicrobial agents,mechanical ventilation,and those who stay in ICU for more than two weeks,or received antacid and deep venous punctures,and most Burkholderia cenocepacia strains are multiple drug resistant.

Objective To investigate the correlations of extracellular matrix and hepatic ultramicrostructural changes with clinical manifestations in patients with mild chronic hepatitis B (CHB).Methods Patients with chronic HBV infections were enrolled and were divided into mild CHB group (n=66) and HBV carrier group (n=10).Serum samples were collected from patients, and serum HBV markers, HBV DNA load and liver fibrosis indexes were measured.All subjects received liver biopsy, and the tissue samples were observed by light microscope and electron microscope.T test and χ2 test were performed for measurement data and enumeration data, respectively.Spearman test was used for ranked data.Results The differences on ALT and AST levels between mild CHB group and HBV carrier group were significant (t=12.42, 7.06, P＜0.05), but there was no significant difference on HBV DNA load between two groups (t=0.24, P ＞ 0.05).Serum liver fibrosis indexes (hyaluronic acid, type Ⅲ collagen,type Ⅳ collagen and laminin protein) in mild CHB group were not significantly higher than those in HBV carrier group (t=0.45, 0.95, 0.76 and 1.21, P ＞0.05).In mild CHB group, there were 33 patients with ≥G2 and ≥S2, but in HBV carrier group were only 2 patients (χ2=4.17, P ＜ 0.05).Seventeen patients in mild CHB group were with S3-4, while that was not observed in HBV carrier group (χ2=4.75, P ＜0.05).In mild CHB group, hepatic ultramicrostrutural changes on fat storing cell, collagen protein and portal area were correlated with fibrosis grades, and the correlation coefficients were 0.351, 0.675 and 0.301, respectively (P=0.004, 0.000 and 0.014).Conclusion Electron microscope is of higher sensitivity than light microscope in observing hepatic ultramicrostructural changes, which is effective in evaluating the severity of mild CHB.

Abstract The prevalence of myopia among children and adolescents in China remains high. Currently, the prevention and control of myopia among children and adolescents has risen to the level of national health strategy and has attracted extensive attention from the society. Although the role of outdoor activities in preventing myopia is significant, it also has many limitations. Therefore, it is necessary to explore more effective methods for comprehensive intervention. Based on current evidence, in addition to ongoing investigatation of the role of daytime outdoor activities in myopia prevention, emerging controllable environmental and behavioral factors, e.g. increase of indoor high frequency visual information, regulation of sleep and biological rhythm and dietary supplement of polyunsaturated fatty acids ω-3, warrents further attention and active transformation into appropriate technologies for myopia prevention and control.

Abstract The choroid is a multifunctional dynamic structure located between the sclera and the Bruch membrane, which may be involved in the regulation of eye growth and the development of myopia. Choroidal thickness may serve as an important biomarker for predicting the development of myopia and the effectiveness of myopia control treatments in children and adolescents. The study reviews and summarizes the physiological structure and measuring methods of the choroid, and discusses its influencing factors including age, physiological changes, refractive status, axial length, drug effects, optical environment and so on. The review points out the potential applications of choroidal thickness in myopia research among children and adolescents.

Objective: To investigate the prevalence and associated factors of unaided visual impairment and myopia among primary and secondary school students in Yunnan Province, and to provide scientific basis for myopia prevention. Methods: The study was conducted among primary and secondary school students in Mangshi, Yunnan Province from March to August, 2014. All the 7 681 subjects underwent detailed eye examinations and a questionnaire survey. Myopia was defined as spherical equivalent value of less than -0.5 diopters. Unaided visual impairment was analyzed on the basis of the better and the worse-seeing eye, respectively. Results: The prevalence of myopia and high myopia were 39.1% and 0.6%. The prevalence of unaided visual impairment was 11.4% based on the worse-seeing eye. Refractive errors accounted for 87.3% of the participants with unaided visual impairment. Prevalence of myopia was higher in girls than in boys (χ2=29.74, P<0.01), but there was no gender difference in high myopia (P=0.19). The prevalence of myopia and high myopia increased significantly with increasing age (χ2=351.23, 22.56, P<0.01). Besides, prevalence of myopia was 63.7% in Dai nationality students and 36.6% in Yi nationality students (χ2=78.14, P<0.01), which was higher than other ethnic minorities. After adjusting for the effects of sex, age and ethnicity, the presence of myopia was associated with increasing height (OR=1.02, 95%CI=1.01-1.03), computer use (OR=1.17, 95%CI=1.03-1.32), having a myopic father (OR=1.56, 95%CI=1.24-1.94), having a myopic mother (OR=1.33, 95%CI=1.08-1.63) and more time reading(OR=1.18, 95%CI=1.09-1.28). High myopia was found to be more prevalent in children who had a myopic father (OR=3.98, 95%CI=1.72-9.22) and using computers (OR=2.31, 95%CI=1.17-4.57). Conclusion Myopia and unaided visual impairment is prevalent in school students in rural China (Yunnan), though the prevalence is relatively lower compared with other areas in China. Attention should be paid to the formulation and input of primary eye care policies.

Abstract China has one of the world’s highest prevalence of myopia in children and adolescents, and children are developing myopia earlier. Myopia has become a important issues affecting children and adolescents health, as well as a significant public health concern. There has been continuing debate over the role of nature and nurture in the aetiology of myopia, growing evidence showed that environmental factors has a determine effect on myopia.The randomized controlled trials has assured the relationship between time outdoors and myopia. Based on reviewed published articles, survey and intervention studies and school health practices, according to the principle of school organization, student participation and family cooperation, the authors proposed outdoors activities as initiative for myopia prevention and control in children and adolescents. The detail recommendation contents, levels were list out.

Abstract In recent years, the state has paid greater attention to the prevention and control of myopia in children and adolescents, as well as to the issuance of corresponding policies, which means that this issue has once again become the focus of work in the fields of school health and ophthalmology. It should be noted that the prevalence of myopia has continued to rise for many years and it has reached a very high level. Therefore, reducing its prevalence requires long-term evidence-based prevention and treatment strategies, and a shift from “quantitative change” to “qualitative change”. However, there is still a lack of high-quality research evidence regarding many aspects of myopia prevention and control. This paper summarizes the existing evidence and identifies limitations, proposes a direction for future efforts, and puts forward some suggestions regarding key aspects, such as the selection of evaluation indicators for myopia prevention and control, interventions that aim to increase the time spent on outdoor activities, standardized screening and closed-loop management, and the exploration of effective prevention and control measurements, so as to provide a referential framework that can be used to scientifically develop and implement myopia prevention and control strategies, as well to evaluate their efficacy.

Objective: To understand the correlation between myopia related health belief and screen time of primary and secondary school students in Jing-an District of Shanghai, and to provide suggestions for reducing screen time and preventing myopia. Methods: Using the method of cluster sampling,1 585 students from grade one to grade eight of a primary school and a junior high school in Jing-an District were selected for a questionnaire survey regarding myopia related health belief, screen time and the correlation between them. Results: About 18.8%-44.4% of the students perceived themselves as myopia susceptible,which increased with grade (χ 2=33.25,P<0.01), 51.5%-78.0% of the students were aware of the adverse health impart of myopia, 39.3%-55.6% of the students were aware of unhealthy behaviors associated with myopia and 48.7%-77.5% of the students. More than 47.6% of the students daily screen time was more than 2 h/day, and daily screen time increased with grade (χ 2=12.18, P<0.01). Perceived susceptibility for myopia, awareness on adverse health impact of myopia and unhealthy behaviors associated with myopia, as well as self-efficacy associated with myopia prevention were associated with screen time of students. Conclusion The primary and middle school students in Jing an District show low lever of knowledge on myopia susceptibility and threat, but higher lever of knowledge on myopia severity and self-efficacy of preventing myopia. nearly half of the students use electronic screens too long or too close to their eyes. Awareness on myopia susceptibility, myopia-related behaviors and health impacts of myopia and self-efficacy, combined with screen time reduction might help myopia prevention.

Objective: To investigate the prevalence of myopia and sleep quality among adolescents in Baoshan District of Shanghai, and to further analyze the association between different degree of myopia on sleep quality. Methods: A total of 777 adolescents aged 9-16 years were selected by stratified cluster random method, and ophthalmology examination and Pittsburgh Sleep Quality Index (PSQI) Chinese version scale and related factors questionnaire were conducted. Results: The prevalence rates of myopia and sleep disorders were 68.08% and 13.77% respectively in Baoshan District of Shanghai. With the increase of age and grade, the prevalence of myopia and sleep disorder increased(χ 2=139.58, 114.17；58.00, 56.41, P＜0.01).There were significant differences in sleep disorders among different degree of myopia groups (χ 2=24.57,P<0.01), including sleep time, progressive function and PSQI total score were statistically significant (F=9.65, 7.22, 4.38, P<0.01). Logistic regression analysis showed that moderate to high and high myopia were risk factors for sleep quality of adolescents (β=0.87, 0.95, OR=2.38, 2.59, P<0.05). Conclusion The prevalence of myopia and sleep disorder among adolescents in Baoshan District of Shanghai is high, myopia shows impacts on sleep quality of adolescents at a certain level. Adolescents with high myopia have a higher risk of sleep disorders.