Objective To observe the latency and amplitude characteristics of event-related potential P300 under different target stimu-lus. Methods During January to December, 2014, 35 patients with memory impairment received P300 test under the percentage of target stimuli of 0.10 and 0.25. The latency, amplitude and area under amplitude were compared. Results There was no significant difference in la-tency (t<0.256, P>0.800), but the amplitude and area under amplitude increased under 0.10 compared with those under 0.25 (t>4.259, P<0.05). Conclusion Less target stimulation may improve the patients' attention and increase amplitude of P300, but no more interference in la-tency, suggesting latency of P300 is more stable for assessment of cognitive function.

Hepatitis B virus (HBV)-related liver failure is an end-stage liver disease with a high mortality.Biomarkers,which are of interest,are helpful for diagnosis and treatment of liver failure.The purpose of this review is to highlight the recent advances in this field.Although many new biomarkers can improve the prognostic efficacy,the dynamic biochemical function of liver and kidney as well as the function of coagulation are still the most practical and common indexes for the development and prognosis evaluation of liver failure.

The current status and training requirements for general practitioner (GP) were surveyed with questionnaires in 84 trainees from the first Beijing GP retraining program.Results showed that three most demanded skills of health service in community were electrocardiogram (98.8％),clinical lab results reading (96.4％),dressing change (90.5％).The services not provided but should be provided in community were aerosol rebreathing method (23.8％),resection of small superficial lumps (22.6％) and reading X-ray films (20.2％).The reasons for services not provided were insufficient resources (41.7％),lack of skilled personnel (35.7％) and staffing shortage (20.2％).The most required training skills were reading X-ray films (64.3％),electrocardiogram (54.8％) and laboratory results reading (51.2％).There were some skills inadequately trained including cricothyroid membrane puncture,suprapubic bladder puncture and resection of superficial small lumps.The results indicate that the required skills in community health service and individual demands of general practitioners should be the priority of the future training programs.

Objective To evaluate the cost-effectiveness of entecavir and lamivudine in treatment of early stage acute on chronic liver failure (ACLF),and analyze the predictive factors.Methods Forty nine patients with early ACLF were enrolled.Of which,28 patients were treated with entecavir,and 21 patients were treated with lamivudine.Mortality,length of hospital stay,cost,liver function,coagulation function,and model for end-stage liver disease (MELD) score were compared between two groups.Pharmacoeconomic evaluation was taken using cost-effectiveness analysis and cost minimization analysis.Results Mortality,length of hospital stay and cost had no significant difference between two groups.Ratio of costeffectiveness in lamivudine group was higher than that in entecavir group.Cox analysis showed that primary peritonitis and MELD score at the end of the second week were the main predictive factors.Conclusions Entecavir cannot improve the survival rate of early stage ACLF compared to lamivudine,but may provide economic benefit to patients with early stage ALCF.

Aim This study aimed to assess the protection of recombinant human erythropoietin (rhEPO) in light-induced injuries in human retinal pigment epithelial(RPE)cells by researching the inhibition of rhEPO for apoptosis in human RPE cells by light-induced injuries.Methods Cultured human RPE cells were exposed to light of 8 w (2 000?500) lux for 12hours,then the culture were stopped at 24 hours after 12hours light stimulation. The effect of inhibiting apoptosis of rhEPO was detected by AnnexinV-flunorescein isothiocyanate/Propidium iodium labeling and flow cytometry. The enzyme linked immunosorbant assay(ELISA)and immunocytochemical staining were used to assess the expressions of caspase-3 and Bcl-2 treated by different doses of rhEPO in light-induced injury on human RPE cells and research the protective mechanism of rhEPO by adding AG490(the special inhibitor of Jak2).Results There was a obviously increased effects on inhibiting apoptosis in every rhEPO group, which was the most conspicuous in 40 IU?ml-1 rhEPO group,and the value was (4.93?1.45)?ml-1. The decrease of expression of caspase-3 was most obvious in 40 IU?ml-1 rhEPO group, and the value was (0.125?0.029) ?g?L-1. The increase of expression of Bcl-2 was the most obvious in 40 IU?ml-1 rhEPO group and the value was 168.21?3.87. But these effects on inhibiting apoptosis in rhEPO group were restrained by adding AG490, the value of apoptosis was (11.29?2.11)?ml-1 and the density of caspase-3 increased to (0.362?0.042) ?g?L-1,the expression of Bcl-2 dropped.Conclusion It is suggested that rhEPO can inhibit the apoptosis of human RPE cells in the light-induced injuries and inhibit the expression of caspase-3 and up-regulate the expression of Bcl-2, so rhEPO can protect the light-induced injuries for human RPE cells. Its protective mechanism is accomplished principally by the pathway of combining EPO with EPOR ,then the combination activates Jak2.

Objective: Epi-LASIK appeared to be effective and safe in the treatment of high myopia,but some patients complain about visual symptoms postoperation.The purpose of this study was to evaluate the high order aberrations(HOAs) of the vision-decreased eyes treated by Epi-LASIK,and to analyze the causes of postoperative glare,scieropia and monocular diplopia.Methods: We evaluated 76 eyes of 49 patients treated by Epi-LASIK with a questionnaire three months after surgery,and from them selected 34 eyes of 27 patients who scored less than 80 points and complained of postoperative visual symptoms,including glare(25 eyes in 20 patients),scieropia(7 eyes in 5 patients)and monocular diplopia(2 eyes in 2 patients).Another 42 symptom-free eyes of 22 patients treated by Epi-LASIK were included in the control group.The root mean square(RMS) of total HOAs,coma and SA were determined with the iTrace Visual Function Analyzer from the central 6.0 mm zone,and the modulation transfer function(MTF) was simulated with the iTrace 3.1 software.Results: Significant differences were found in the RMS of total HOAs,coma and SA between the eyes with visual symptoms and those without,and the values of ablation zone decentration were significantly higher in the former than in the latter(P

BACKGROUND: Basic fibroblast growth factor (bFGF), a kind of polypeptide growth factor possessing multifunctional biological activities,can protect neurons and promote the growth of nerves. It has been corfirmed that bFGF has therapeutic effects on retina ischemia/reperfusion injury (RIRI).OBJECTIVE: To establish RIRI model and analyze the effects of bFGF on cellular apoptosis of retina and the expression of regulatory gene protein.DESIGN: Randomized grouping and validating trial.SETTING: Department of Ophthalmology, the Affiliated Hospital of Medical College of Qingdao University.MATERIALS: The experiment was conducted at the Research Laboratory of Pathology, Department of Ophthalmology, Medical College of Qingdao University, from April 2002 to December 2003. Twenty-eight healthy Wistar rats were enrolled in this experiment. Four rats were randomly chosen for normal control group, the left eyes of the other 24 rats were set as normal saline control group, and the right eyes were set as bFGF group.METHODS: Normal saline control group and bFGF group adopted the rat RIRI models established by transiently elevating intraocular pressure. Normal saline of 12 μL was injected into the vitreous cavity of the left eyes of the rats in normal control group. 12 μL bFGF was injected into the vitreous cavity of the right eyes of the rats in bFGF group, 4 rats once. No administration was given in normal control group. The expression of apoptotic cells was detected and apoptosis indexes were calculated with the terminal deoxynucleotidyl transferase-mediated dUTP-biotin nick-end labeling (TUNEL) method and immunohistochemical staining method at the 1st, 6th,12th, 24th,48th and 72nd hours after reperfusion and ischemia for 1 hour.MAIN OUTCOME MEASURES: ① The detection results of apoptotic cells in situ of retina tissuesat different time points after reperfusion. ②The expression of Fas and caspases-2 in retina tissues at different time points after reperfusion.RESULTS ① Comparison of apoptosis indexes of retina tissues at different time points after ischemia reperfusion: There were no apoptotic cells in the retina tissues of the rats in normal control group. As compared with those in normal saline control group, apoptosis indexes in bFGF group were significantly decreased at ischemia 1 hour and reperfusion 1, 6, 12, 24, 48and 72 hours, especially at the 12th, 24th and 48th hours after reperfusion (t =5.362-5.595, P ＜ 0.05). ② The change of Fas expression at different time points after ischemia reperfusion: There was hardly any Fas expression in normal control group. As compared with that in normal saline control group, Fas expression in bFGF group was significantlydecreased at ischemia 1 hour and reperfusion 1, 6, 12, 24, 48 and 72 hours, especially at the 6th, 12th and 24th hours after reperfusion (t=3.954-9.327, P ＜ 0.05). ③The changes of caspase-2 expression at different time points after ischemia reperfusion: There was no caspase-2 expression in normal control group.Compared with that in normal saline control group, the number of caspase2 positive cells in bFGF group was significantly decreased at the 6th,12th,24th, 48th and 72nd hours after ischemia for 1 hour and reperfusion (t=4.125-15.641, P ＜ 0.05).CONCLUSION: bFGF can significantly inhibit the expression of apoptosis gene Fas and caspase-2 in the ischemia and reperfusion of retina, thus reducing cellular apoptosis of ganglion cells and exerting therapeutic effects on the ischemia and reperfusion of retina.

Background Fungal keratitis is one of primary infectious ocular diseases in China.Conventional diagnostic method is fungal cultivation.In vivo laser confocal microscope is a noninvasive examination of ocular surface.However,the study on features of in vivo laser confocal microscope images of frequent fungal keratitis is still not thorough.Objective This study was to analyze laser confocal microscope imaging features of four typical fungal keratitis.Methods The clinical data of 65 eyes from 65 patients with fungal keratitis were retrospectively analyzed.The patients were initially diagnosed in Nanjing General Hospital of Nanjing Military Command PLA from January 2007 to November 2011, and laser confocal microscope examination of ocular surface and fungal cultivation were performed.The characteristics of laser confocal microscope images were investigated,including shape and type of hypha,distribution of spores and the relationship of hypha with lesion.The differentiation between fungal hypha and other corneal tissues was summarized.Results Fungal cultivation showed that among the 65 patients,Fusarium,Aspergillus,Candida and Alternaria were common pathogenic fungus with the infected proportion 63.0％ , 16.9％,3.0％ and 4.6％ ,respectively, and 12.5％ patients were infected by other fungus.In the images of laser confocal microscope,hyphae of Fusarium presented the branch-like high reflective structure in the corneal superficial stromal layer and thinning line shape in the deep stromal layer.Few inflammatory cells were found.The peudohyphae and spores from Candida were seen in corneal superficial and mid stroma layers, with few inflammatory cells and many proliferating stromal fibers in the lesions.The hyphae of Aspergillus presented worm-like, showing the thinner and shorter shapes in comparison with those of Candida.The hyphae of Alternaria were long,straight and thick in shape,and spherical chlamydospores were found on the hyphal tip.The hyphae, subepithelial plexus, dendritic cells, fibrosis of the cornea all showed high reflection under the laser confocal microscope, but evidently differences appeared in shape,distribution and course in corneas.Conclusions Hyphae are the main basis to diagnose fungal keratitis and differentiate fungi.As a non-invasive examination method,laser confocal microscope can provide useful information for the early diagnosis and treatment of fungal keratitis in vivo.

Objective To evaluate skin barrier function in patients with atopic dermatitis (AD),and to assess its relationship with claudin-1 expression.Methods Totally,11 patients with AD and 11 healthy human controls were recruited in this study.A Tewameter TM210 was used to measure transepidermal water loss (TEWL) value,and high-frequency ultrasound to determine epidermal thickness and density,in lesional and non-lesional skin of the patients and normal skin of the healthy controls.A double-antibody sandwich enzyme-linked immunosorbent assay (ELISA) was performed to determine the serum level of free claudin-1 in these subjects.One-way analysis of variance and t test were carried out to compare these parameters in different groups,and Pearson's correlation analysis to estimate the relationship between different parameters.Results The TEWL value was significantly higher in lesional skin than in nonlesional skin of patients with AD and normal skin of the healthy controls ((36.9 ± 34.2) vs.(9.1 ± 6.0) and (4.4 ± 3.1) g·m-2·h-1,both P＜ 0.05).The epidermal thickness in AD lesions was (0.23 ± 0.04) mm,significantly higher than that in nonlesional skin ((0.18 ± 0.03) mm,P ＜ 0.01) and normal control skin ((0.18 ± 0.02) mm,P ＜ 0.01).Ultrasound images revealed a characteristic subepidermal low echo-genic band in the AD lesions.The patients with AD showed a significantly lower serum level of claudin-1 compared with the healthy controls ((0.80 ± 0.88) vs.(1.73 ± 1.85) μg/L,P ＜ 0.05).Moreover,the serum level of claudin-1 was negatively correlated with epidermal thickness (r =-0.61,P ＜ 0.01),but positively correlated with the inverse of TEWL (1/TEWL,r =0.44,P ＜ 0.05).Conclusions The impaired skin barrier function,which may be evaluated by TEWL,1/TEWL and epidermal thickness,is associated with the expression of claudin-1 in patients with AD.