Background Image clarity during near work is influenced by several factors,such as accommodative lag,pupil size and monochromatic aberrations.Since image clarity during extended reading at near distance has been cited as a possible inducement of myopia in childhood and a possible difference between myopic and emmetropic people throughout life,it is important to examine these factors in myopic and emmetropic myopic juvenile during reading at near distance. Objective The aim of this study was to investigate the relationships among wavefront aberrations,accommodative response and pupil size in early onset and progressive myopes eyes under the different reading status and explore the possible mechanism of the development of myopia as well. Methods Fiflyseven subjects aged from 12 to 16 years were enrolled and grouped as emmetropes,the onset of myopes and progressive myopes.Reading material were Chinese novels presented by rapid serial visual presentation at a distance of 25 cm. Accommodative response and pupil size were recorded by a Grand Seiko WV-500 autorefractor.The Image J software was used to calculate the pupil diameter.Wavefront aberrations were then measured with a WASCA wavefront analyzer. Results Aberrations and accommodative response showed large inter-subjeet variability.With accommodative stimulus of 4 diopter,the accommodative lag in the early-onset of myopes group and progressive myopes group were ( 1.72 ±0. 53) D and ( 1.74 ±0. 44) D, showing larger value in comparison with ( 0. 96 ±0. 55) D of emmetropes group( t＝4.25 ,t=4.47 ,P<0. 001). However,there were no significant differences in accommodative lag between the early-onset of myopes group and progressive myopes group( t = 0. 18, P>0. 05). The mean value of pupil diameter, total RMS value, high-order RMS value, spherical aberration and coma were all significantly reduced with the stimulus varied from 0 D to 4 D( P<0. 01). However,none of the pupil sizs,total RMS value,high-order RMS value,spherical aberration and coma had significant difference among different refractive groups( P>0. 05). Conclusion The early-onset of myopes and progressive myopes had larger accommodative lag. The lower sensitivity to defocus at near reading distance,inducing the larger accommodative lag and hyperopic defocus may be linked to the developing myopia.

Background RhoA/ Rho kinase (ROCK) pathway is involved in pulmonary arterial hypertension (PAH) and pulmonary artery smooth muscle cell (PASMC) proliferation. Inhibition of ROCK has been proposed as a treatment for PAH. But the mechanism of RhoA/ROCK pathway and its downstream signaling in proliferation of human PASMCs is unclear. We investigated the effect of fasudil, a selective ROCK inhibitor, on platelet-derived growth factor (PDGF) induced human PASMC proliferation, and the possible association between RhoA/ROCK and extracellular signal-regulated kinase (ERK),p27KiP1.Methods Human PASMCs were cultured with the stimulation of 10 ng/ml PDGF, and different concentrations of fasudil were added before the addition of mitogen. Cell viability and cell cycle were determined with MTT and flow cytometry respectively. ROCK activity, ERK activity and protein expression of proliferating cell nuclear angigen (PCNA) and p27Kip1 were measured by immunoblotting.Results By MTT assay, PDGF significantly increased the OD value that represented human PASMC proliferation, and pretreatment with fasudil significantly reversed this effect in a dose-dependent manner. After PDGF stimulation, the percentage of cells in S phase increased dramatically from 15.6％ to 24.3％, while the percentage in G0/G1 phase was reduced from 80.6％ to 59％. And pretreatment with fasudil reversed the cell cycle effect of PDGF significantly in a dose-dependent manner. PDGF markedly induced ROCK activity and ERK activity with a peak at 15 minutes, which were significantly inhibited by fasudil. In addition, fasudil significantly inhibited PDGF-induced PCNA expression and fasudil also upregulated p27Kip1 expression in human PASMCs, which decreased after PDGF stimulation.Conclusion RhoA/ROCK is vital for PDFG-induced human PASMC proliferation, and fasudil effectively inhibited PDGF-induced human PASMC proliferation by up-regulation of p27Kip1, which may be associated with inhibition of ERK activity.

Objective To investigate the morphological characteristics and types of ventricular wall with dysplastic development and their associations to primary cardiomyopathy.Methods Ninety-two hearts from heart transplant patients were studied soon after explanation from 2004 to 2007.Gross examination/measurement,histopathology and photography were performed.Results Dysplastic development of ventricular wail could be evidenced in patients with various heart diseases but more often in patients with primary cardiomyopathy,though the extension and distribution of dysplastic development of ventricular wall varied between patients with or without primary cardiomyopathy.Severe dysplastic development of ventricular wall is associated with clinical dysplastic cardiomyopathy.The range of extension and degree of dysplasia in the ventricular wall correlated positively to heart dilation/failure and time point of heart failure development.The incidence of severe vantricular wall dysplasia was 27.17% in all transplanted hearts and was 43.1%(25/58) in hearts diagnosed as primary cardiomyopathy (P＜0.05).The main pathological changes of dysplastic hearts were:(1) extensive proliferative hypertrophy of the heart wall,(2) fibrous/fat or fat/fibrous tissue replacement of normal myocardium,(3) disarrangement of myocardial fibers,(4)dysplastic change in the medium-sized intramural arteries.Dysplastic cardiomyopathy was presented mainly as a combination of several forms of dysplasia.The same clinical manifestations of dysplastic cardiomyopathy patients did not always show the same pathologic changes.Fibrous-fat tissue replacement was commonly found in dilated cardiomyopathy and arrhythmogenic right ventricular eardiomyopathy.Disarrangement of myocardium was often accompanied by hypertrophic cardiomyopathy.Dysplasia of intramural arteries could result in heart dilatation due to myocardial ischemia.Conclusion Dysplasia of ventricular wall is a common variation of heart structure.Only severe or diffuse types of dysplasia is associated with cardiomyopathy,especially primary cardiomyopathy.

Objective To investigate the antibacterial resistance in nationwide's tietiary hospitals and understand the trend of antimicrobial resistance.Methods All the clinical isolates were collected from 18 hospitals and the minimal inhibitory concentrations (MICs) were tested using agar dilution method recommended by Clinical and Laboratory Standards Institute (CLSI) in central laboratory.The susceptibilities of isolates to antimicrobial agents were determined by using CLSI or European Committee on Antimicrobial Susceptibility Testing (EUCAST) 2017 guideline.Results A total of 4333 pathogenic isolates from 18 tertiary hospitals in 18 cities nationwide over the period from July 2015 to June 2016 were studied.Based on the MIC results,Escherichia coli and Klebsiella pneumoniae showed extended spectrum β-lactamase (ESBLs) phenotype rates of 59.4％ and 27.5％,respectively;decreased by 7 to 10 percentage points comparing the last time.Carbapenems,amikacin,moxalactam,β-lactam/β-lactamase inhibitor combinations,tigecycline,and fosfomycin displayed desirable antibacterial activity against Enterbacteriaceae,but a significant increasing of carbapenems resistance Klebsiella pneumoniae were noted.For non-fermenting Gram-negative isolates,resistance rate of Pseudomonas aeruginosa and Acinetobacter baumannnii to imipennnem were 29.5％ and 69.8％ and multidrug-resistant (MDR) detection rate were 35.6％ and 78.3％,extensively drug-resistant (XDR) were 10.2％ and 72.5％,respectively.Klebsiella pneumoniae isolated from children were more resistant to β-lactam than those from adults and the old people,so bacterial resistance in children is an important problem in China.Conclusion Though the decline of ESBLs detection rate,carbapenem non-susceptible Klebsiella pneumoniae rates continued to increase,which should be paid more attention.

Objective To investigate the gram-positive coccus resistance in nationwide's tietiary hospitals and understand the trend of antimicrobial resistance.Methods All the clinical isolates were collected from 18 hospitals and the minimal inhibitory concentrations (MICs) were tested using agar/broth dilution method recommended by Clinical and Laboratory Standards Institute (CLSI) in central laboratory.The susceptibilities of isolates to antimicrobial agents were determined by using CLSI or European Committee on Antimicrobial Susceptibility Testing (EUCAST) 2017 guideline.Results A total of 2301 Gram-positive cocci isolated from 18 hospitals in 18 cities nationwide were studied.Based on the MIC results,the prevalence of methicillin resistant Stapylococcus aureus (MRSA) and methicillin resistant Stapylococcus epidermidis (MRSE) were 39.9％ and 86.6％ respectively.No vancomycin insensitive Staphylococcus was detected.Staphylococcus aureus were 100％ susceptibile to linezolid and teicoplanin,but resistant or insensitive for drugs other than vancomycin were observed among Coagulase Negative Staphylococci (CoNS).Antibiotic resistance rate of Enterococcus faecalis and Enterococcusfaecium to ampicillin were 4.5％ and 85.1％.The detectation rate of vancomycin resistant Enterococcus(VRE) was 2.1％.Nonsusceptibility rate of Enterococcus faecalis to linezolid was 7.8％,showing slight increase than last time.The prevalence of penicillin nonsusceptible Streptococcus pneumoniae (PNSSP) was 6.6％ based on non-meningitis and parenteral administration criterion;while for cases of oral penicillin,the rate was 70.0％,was as flat as last time.There were no significant differenees of resistance rates of Stapylococcus aureus,Stapylococcus epidermidis Enterococcus faecalis and Enterococcus faecium among various groups such as different department,age,or specimen source.Conclusion Compared with past surveillance result,VRE detection ratio was steady,while MRSA detection ratio decreased.The emergence of resistance and non-susceptible strains to new antibiotics such as linezolid,tigecycline and daptomycin should be payed more attention.