AIM: To investigate the preoperative binocular visual function of intermittent exotropia and the rebuilding and recovery of the postoperative binocular visual function, and analyze the effect of binocular visual function on orthophoria after surgery.
METHODS:From January 2011 to January 2014, 47 basic intermittent exotropia patients caming for treatment were collected in the clinical data. The changes in their near stereopsis, binocular visual function, binocular fusion and distance stereopsis after operations were recorded in the form of data. The preoperative binocular vision and the postoperative rebuilding were analyzed and contrasted with each other. In addition, the effect on the postoperative maintaining of orthophoria due to the existence, recovery and rebuilding of binocular visual function were observed.
RESULTS:Intermittent exotropia patients got damage in different levels on their binocular visual functions, especially on distance stereopsis, which was the heaviest and earliest. After the operation, all functions were obviously recovered and reconstructed and the improvements were statistically significant compared against those before the operation (P<0. 01). Patients having binocular visual function or part of it before the operation had a higher ratio of orthophoria compared against the patients who had lost binocular visual function before the operation and the difference was statistically significant (P<0. 01). The recovery and reconstruction of the postoperative binocular visual function played an important role in maintaining the orthophoria.
CONCLUSION: The intermittent exotropia cause damage to the stereopsis which happened the earliest. Obvious recovery and reconstruction of binocular visual function can be observed after the surgery. A relatively good preoperative binocular visual function may lead to the increase in the ratio of orthophoria or cure the intermittent exotropia. Performing an operation when distance stereopsis is damaged can increase the success rate for the surgery and reduce the recurrence rate.

Objective: To investigate the prevalence and influencing factors of adolescent depression symptoms in Zhejiang, so as to provide reference for improving their mental health. Methods: The middle school and university students in 11 cities of Zhejiang Province were selected by stratified cluster random sampling method. The depression symptoms of the adolescents were assessed by Center for Epidemiological Survey-Depression Scale ( CES-D ) and the influencing factors were analyzed by multivariate logistic regression model. Results: A total of 25 855 students were investigated, and 25 614 ( 99.07% ) valid questionnaires were collected. The detection rate of depressive symptoms was 26.86%(6 879 cases). The detection rate of depressive symptoms in girls was 29.75%, which was higher than 24.12% in boys ( P<0.05). The detection rate of depressive symptoms in high school students was 31.74%, the highest compared with other grades. The multivariate regression analysis showed that female students ( OR=1.690, 95%CI: 1.592-1.794 ), resident students ( OR=1.071, 95%CI: 1.010-1.137 ) , internet addiction ( OR=2.948, 95%CI: 2.527-3.439 ) , attempt smoking ( OR=1.516, 95%CI: 1.359-1.690 ), drinking ( OR=1.624, 95%CI: 1.525-1.729 ), bullied in the past 30 days ( OR=3.143, 95%CI: 2.938-3.363 and having serious injuries within a year ( OR=1.369, 95%CI: 1.263-1.543 ) were associated with adolescents who had depressive symptoms. Conclusions The detection rate of depressive symptoms is relative 26.86% among adolescents of Zhejiang Province. The students who are female, live on campus, have internet addiction, have been bullied or seriously injured, smoke and drink are more likely to have depressive symptoms.

OBJECTIVETo explore relationship between HBV DNA level and peripheral blood follicular helper T lymphocyte (Tfh) in patients with chronic hepatitis B (CHB) and its significance.

METHODSHBV DNA levels of 179 cases of CHB patients with positive HBV DNA, positive HBeAg and positive human leukocyte antigen(HLA)-A2 were tested with real time fluorescent quantitative PCR. Tfh and HBV specific CTL were tested with flow cytometry. IL-21 was also tested. 179 cases of CHB patients were divided into group A and group B based on HBV DNA levels, 86 cases in group A, HBV DNA levels were 10(4)-10(5) copies/ml, 93 cases in group B, HBV DNA levels were 10(6)-10(7) copies/ml. Above testing indexes of the two groups were compared.

RESULTSHBV DNA levels of group A were (4.85 +/- 0.37) log10 copies/ml, HBV DNA levels of group B were (6.83 +/- 0.31 ) log10 copies/ml, t = 27.31, P < 0. 001; Tfh of group A was (5.96 +/- 1.59)%, higher than that of group B (3.71 +/- 2.15)%, t = 4.92, P < 0.01; IL-21 of group A was (42.61 +/- 15.11)ng/L, higher than that of group B (14.91 +/- 3.15) ng/L, t = 8.62, P < 0.01; HBV specific CTL of group A was (0.36 +/- 0.08)%, higher than that of group B (0.18 +/- 0.06)%, t = 19.99, P < 0.001.

CONCLUSIONSerum HBV DNA level of CHB patients is related to the level of peripheral blood Tfh level: patients with low HBV DNA level have high Tfh level, high IL-21 level and high HBV specific CTL level. Patients with high HBV DNA level have low Tfh level, low IL-21 level and low HBV specific CTL level. The mechanism of baseline HBV DNA level affecting anti-viral therapy may be related to Tfh level.

Adult ; CD4 Lymphocyte Count ; DNA, Viral ; blood ; genetics ; Female ; HLA-A2 Antigen ; immunology ; Hepatitis B virus ; genetics ; isolation & purification ; Hepatitis B, Chronic ; blood ; immunology ; virology ; Humans ; Interleukins ; immunology ; Male ; T-Lymphocytes, Helper-Inducer ; cytology

Objective To study needs of training of trainers(ToT)in mini-clinical evaluation exercise(mini-CEX)and its effectiveness.Methods One hundred and fourteen doctors involved in TOT for mini-CEX were interviewed with questionnaire before and after training for their satisfaction of training and fifty of them scored the training videos.Results Before the training.39%(44/114)of doctors involved in TOT knew mini-CEX and 97%(111/114)of them hoped to know how to carry out mini-CEX thronsh training.When the training finished,30%(34/114)tO 55%(63/114)of them could completely understand seven items of examinations of mini-CEX.Fifty doctors involved in TOT scored the training videos after the training.There was signifieant difference in scores between TOT and standard scoring on training video 1 for teaching of coronary heart disease and video 2 for teaching of hematochezia(P<0.05).No significant difference Was found in scores between TOT and standard scoring on the video 3 for teaching of abdomihal pain(P>0.05).as well as those between TOT with five or less years experience and those with more than five years experience(P>0.05).Conclusions Currently,doctors involved in TOT have more demands on mini-CEX.However,effectiveness of short-course training for mini-CEX is not satisfactory,and pattern of its training should be improved further.

Thirty four residents of general practice and 11 students of junior college to undergraduate program were evaluated with the mini-clinical evaluation exercise (mini-CEX) when they were rotated to community clinics or the ward of general practice in Zhongshan Hospital from September 2009 to February 2010. The reliability and validity of mini-CEX for rotation examination in general practice training was assessed. Forty five trainees and 9 clinical faculty members completed 81 mini-CEX evaluations. The Cronbach's alpha coefficient was 0. 932. Criterion-related validity for mini-CEX overall competence with the end examination of rotation was O.53 ( P ＜ 0.001 ). The results indicate that mini-CEX may be an appropriate evaluation tool for rotation examination in general practice training.

Objective: To explore the influencing factors for the primary and secondary school students with abnormal angle of trunk rotation for the prevention. Methods: The students of Grade Four to Nine in Jiashan County of Zhejiang Province were selected by cluster sampling method. A self-designed questionnaire was used to collect social demographic data, diet behaviors, physical activities, reading and writing habits. The angle of trunk rotation was measured by scoliometer. Logistic regression model was used to investigate the influencing factors for abnormal angle of trunk rotation. Results: This study included 2 942 schoolchildren, with 1 582 ( 53.78% ) boys and 1 360 ( 46.23% ) girls. The incidence rate of abnormal angle of trunk rotation was 7.82%. The incidence rate of abnormal angle of trunk rotation in girls was 10.74%, which was higher than 5.31% in boys ( P<0.05 ). Grade ( OR=1.485, 95%CI: 1.058-2.085 ), gender ( OR=2.084, 95%CI: 1.536-2.828 ), frequency of eating fresh vegetables in the past week ( OR=0.749, 95%CI: 0.633-0.887 ) and watching electronic screen in the dark ( OR=1.188, 95%CI: 1.002-1.408 ) were the influencing factors for abnormal angle of trunk rotation in primary and secondary school students. Grade ( OR=2.664, 95%CI: 1.481-4.791 ) and watching electronic screen in the dark ( OR=1.325, 95%CI: 1.030-1.704 ) were influencing factors for abnormal angle of trunk rotation in boys. Frequency of eating fresh vegetables in the past week ( OR=0.714, 95%CI: 0.574-0.887 ) and uncorrected eyesight less than 5.0 ( OR=1.795, 95%CI: 1.164-2.767 ) were influencing factors for abnormal angle of trunk rotation in girls. Conclusion The abnormal angle of trunk rotation in primary and secondary school students is related to gender, grade, reading and writing behaviors as well as diets; and the influencing factors are different in male and female students.

OBJECTIVETo explore relationship between different HBV genotypes and peripheral blood HBV specific and nonspecific CTL of patients with cirrhotic hepatitis B and its significance.

METHODSHBV genotypes were tested in 91 patients with cirrhotic hepatitis B, differences of HBV specific and nonspecific CTL between patients infected with genotype B and C were compared and its significance was explored.

RESULTSIn 91 cases of cirrhotic hepatitis B, 55 cases (60.44%) belong to genotype C, 35 cases (38.46%) belong to genotype B, 1 case (1.1%) belongs to mixture genotype B and C. In genotype C, 27 cases (49.09%) had positive (HLA)-A2, HBV specific CTL was 0.18% +/- 0.03%. In genotype B, 18 cases (51.43%) had positive HLA-A2, HBV specific CTL was 0.38% +/- 0.04%, higher than that in genotype C, t = 5.01, P < 0.01. Nonspecific CTL: genotype C (11.87% +/- 1.50%); genotype B (11.90% +/- 1.51%), t = 0.14, P < 0.05. HBV DNA level: genotype C (6.01 +/- 0.81) log10 copy/ml, higher than that in genotype B (5.01 +/- 0.54) log10 copy/ml, t = 5.01, P < 0.01. ALT: genotype C (251.13 +/- 131.11) U/L, higher than that in genotype B (121.25 +/- 63.21) U/L, t = 3.61, P < 0.01. TBil (45.61 +/- 15.11) micromol/L, higher than that in genotype B (28.11 +/- 6.25) micromol/L, t = 3.05, P < 0.01.

CONCLUSIONCompared with patients infected with genotype B of cirrhotic hepatitis B, HBV specific CTL of patients infected with genotype C was lower, resulting in higher level of HBV DNA and more severe damage of liver function.

Adult ; DNA, Viral ; genetics ; Female ; Flow Cytometry ; Genotype ; Hepatitis B ; genetics ; immunology ; Humans ; Liver Cirrhosis ; immunology ; virology ; Male ; Middle Aged ; T-Lymphocytes, Cytotoxic ; immunology

OBJECTIVETo explore the association of serum HBV DNA level with HBV-specific and nonspecific cytotoxic T lymphocytes (CTL) in patients with HBV-induced hepatic cirrhosis.

METHODS120 patients with HBV-induced hepatic cirrhosis who were positive for HBV DNA, HBeAg and human leucocyte antigen (HLA)-A2 were enrolled in this study. The level of HBV DNA was determined by real time fluorescence quantitative polymerase chain reaction (PCR). HBV-specific and nonspecific CTL were detected by flow cytometry. Liver function tests were done in the 120 patients. The 120 patients were divided into group A and B based on their HBV DNA levels. In group A, there were 68 patients with HBV DNA level of 3-4 log10 copy/ml, and in group B, 52 with 5-6 log10 copy/ml. HBV-specific and nonspecific CTL and liver function were compared between the two groups.

RESULTSHBV DNA levels were (3.68 +/- 0.19) and (5.97 +/- 0.32) log10 copy/ml in Group A and B respectively with P < 0.001. HBV-specific CTL was higher in group A (0.33% +/- 0.04%) than in group B (0.11% +/- 0.01%) with P < 0.001. HBV-nonspecific CTL were (11.99% +/- 1.51% ) and (11.91% +/- 1.61%) in group A and B respectively with P > 0. 05.

CONCLUSIONThe level of serum HBV DNA is related to the levels of HBV-specific CTL in patients with HBV-induced hepatic cirrhosis. Patients with higher HBV DNA had lower levels of HBV-specific CTL, and the damage to liver function was severe because of higher levels of HBV DNA. Patients with lower HBV DNA had higher levels of HBV-specific CTL which predict good anti-viral effect.

Adult ; Case-Control Studies ; DNA, Viral ; blood ; Female ; HLA-A2 Antigen ; genetics ; Hepatitis B e Antigens ; blood ; Hepatitis B virus ; genetics ; immunology ; physiology ; Humans ; Liver Cirrhosis ; blood ; immunology ; virology ; Liver Function Tests ; Male ; Middle Aged ; T-Lymphocytes, Cytotoxic ; immunology ; Young Adult

OBJECTIVETo explore relations between ALT level and hepatitis B virus (HBV) specific CTL and non-specific CTL in patients with chronic hepatitis B (CHB).

METHODS148 cases of CHB were divided into three groups according to ALT level. 35 cases in group A, ALT > or =2 x upper limit of normal value (ULN)--5 x ULN (100-250 IU/L); 53 cases in group B, ALT > 5 x ULN-- < or =10 x ULN (251-500 IU/L); 60 cases in group C, ALT > 10 x ULN ( > 500 IU/L). Flow cytometry is used to determine non-specific CTV. HBV specific CTL was tested on 74 cases of CHB (17 in group A, 27 in group B and 30 in group C) with positive (HLA)-A2. Compare HBV specific CTL, non-specific CTL, HBV DNA levels and positive rate of HBeAg.

RESULTSHBV specific CTL: Group A (0.42 +/- 0.10)% is higher than group B (0.25 +/- 0.08)%, t = 6.37, P < 0.01, group B is higher than group C (0.17 +/- 0.004)%, t = 5.14, P < 0.01; Non-specific CTL: Group A (15.01 +/- 3.01)% is lower than group B (18.1 +/- 5.02)%, t = 2.81, P < 0.01, group B is lower than group C (21.5 +/- 6.11)%, t = 3.07, P < 0.01; HBV DNA level: Group A [(4.97 +/- 0.86) log10 copies/ml] is lower than group B [(5.92 +/- 0.92) log10 copies/ml], t = 4.87, P < 0.01. Group B is lower than group C [(6.37 +/- 0.71) log10 copies/ml], t = 2.92, P < 0.01; Positive HBeAg: Group A (15 cases, 42.86%) is lower than group B (32 cases, 60.38%), chi2 = 2.59, P > 0.05. Group B is lower than group C (41 cases, 68.33%), chi2 = 0.78, P > 0.05. Group A is lower than group C, chi2 = 5.929, P < 0.05.

CONCLUSIONThe higher the non-specific CTL of patients with CHB is, the higher the ALT level would be, whereas the lower the HBV specific CTL is, the stronger the HBV replication would be.

Adult ; Alanine Transaminase ; metabolism ; Female ; Hepatitis B virus ; genetics ; immunology ; physiology ; Hepatitis B, Chronic ; enzymology ; immunology ; virology ; Humans ; Lymphocyte Count ; Male ; T-Lymphocytes, Cytotoxic ; immunology ; Virus Replication ; Young Adult

Adult ; Case-Control Studies ; Female ; Hepatitis B, Chronic ; immunology ; metabolism ; Humans ; Male ; Middle Aged ; T-Lymphocyte Subsets ; cytology ; T-Lymphocytes, Cytotoxic ; cytology