BackgroundCycloplegia is well accepted for the first refraction estimate in childhood.Yet no good evidence is offered in terms of which cyclopegia is preferable for the different ages and refractive status in children. ObjectiveThis study aimed to compare the effectiveness of cycloplegia between 1％ cyclopentolate and 1％ atropine sulphate before optometry in ametropia children. Methods This was a prospective clinical trail.The self matched-pairs control randomly observation was designed.One hundred and sixty eyes of 80 children of 4-9 years old with refractive error were recruited in this study.1％ cyclopentolate eye drops were topically administered once per 5 minutes for 3 times and 1％optometry was performed 45 minutes after eye dropping.Three days after that,1％ atropine then was used 3 times per day for consecutive 3 days and again the refractive diopter was obtained.The differences of the results in autorefraction,retinoscope and residual accommodation were compared between 1％ cyclopentolate and 1％atropine eye drops.This trail was approved by the Ethic Committee and written informed consent was obtained from each custodian. Results The autorefraction values were ( 0.55 ±3.52 ) D and ( 2.22 ±3.52) D before and after the administration of 1％ atropine with the difference value( 1.66± 1.62) D (t =13.02,P =0.00 ).The autorefraction value was( 1.74±3.46 ) D after dropping of 1％ cyclopentolate and the difference value from that of 1％ atropine was (0.48 ± 0.46) D ( t =13.08,P =0.00 ).The cy(e)lplegic autorefractions of atropine and cyclopentolate have strong correlation ( R2 =0.98,P =0.000 ).The residual accommodation values were ( 0.32± 0.44 )D and(0.05±0.41 ) D after dropping of 1％ cyclopentolate and 1％ atropine with the difference( 0.27±0.55 ) D ( t =4.56,P =0.00 ).The difference value of refractive diopter was (0.31 ± 0.37 )D in myopic group,(0.56±0.48 )D in moderate hypermetropic group and(0.59±0.50)D in high myopic group,and that of myopic group was significantly lower than the moderate hypermetropic group ( t =- 3.14,P =0.00 ).No significant difference was found in the autorefraction difference between 4-6 years group and 7 -9 years group [ ( 0.61 ±0.53 ) D vs ( 0.49 ±0.39 ) D ] ( t =1.21,P=0.23 ).The hidden value because of accommodation had weak correlation with the difference value between atopine and cyclopentolate(r=0.43,P=0.00). ConclusionsBoth 1％ atropine and 1％ cyclopentolate have the cycloplegic effects.This study suggestes that 1％ atropine should be used for the optometry of hypermetropia children.

Objective To establish a time resolved fluoroimmunoassay (TRFIA) method for detecting Glypican 3 (GPC3) and to explore the diagnostic value of serum GPC3 for hepatic carcinoma (HCC). Methods Microplate coated with anti-GPC3 monoclonal antibody 7C8 and GP9 labeled with Eu3+ were used to establish TRFIA kit. The serum concentrations of GPC3 in 41 HCC patients and 44 chronic hepatitis (CH) patients were quantitatively analyzed. AFP was detected by with lowest limit of 2.06 μg/L. The CV of inter and intra assay were 12.25% and 12.91%, respectively. The average serum concentration of GPC3 in HCC patients was (86.68±110.39) μg/L (median: 56.98 μg/L). But in CH patients it was only (14.77±29.48) μg/L, which was significantly lower than that in HCC (Wilcoxon W=1335.00, Z=-4.99, P<0.001). With diagnostic cut-off value set at 42.94 μg/L, the diagnostic sensitivity and specificity of TRFIA GPC3 for HCC were 58.5% (24/41) and 95.5%(42/44) respectively. The diagnostic sensitivity of AFP was 46.3% (19/41) in 41 HCC patients, and was raised to 78.0% (32/41) when combined with GPC3. Conclusions Serum GPC3 assay by TRFIA is established and it could increase the diagnostic sensitivity for HCC when combined with AFP.

Background The evaluation of visual function after laser in situ keratomileusis(LASIK) mainly focuses on the study of contrast sensitivity funetion (CSF).However,CSF measurement is a subjective method and therefore has a limiting in application.A point spread function (PSF) is becoming a study topic because of its objectivity in assessing visual quality.Objective Present study was to evaluate the change of the modulation transfer function (MTF) of eyes and compare the optical and visual quality of human eyes after LASIK.Methods Thirty-six patients(72 eyes) were included in this study.The patients were divided into low myopia(-2.72±0.52 D),moderate myopia (-4.89+0.80 D) and high myopia (-8.00+0.98 D) groups according to the spherical equivalent (SE)diopter before the sugery.The uncorrected visual acuity (UCVA),best corrected visual acuity (BCVA) were examined before and after operation,and PSF data was obtained with Topoeon PSF-1000 analyzer under the 3.0 mm and 6.0 mm pupil size conditions.The follow-up visits of the patients were scheduled at the 7th days,1 st and 3rd months.Written informed consent was obtained from each patient before this study. ResuIts The MTF values among the three refractive groups were significantly different between 3 mm and 6 mm pupil preoperatively (P＜0.05).Under the condition of 3 mm pupil size,the MTF values in the spatial frequencies of 2.98 cpd and 14.88 cpd were significantly declined in different time points after operation in comparison with preoperative ones (P＜0.05).However,the MTF changes had no statistical significance in the spatial frequencies from 18.85-37.70 cpd among various time points(P＞0.05).Under the condition of the 6 mm pupil size,MTF values in low and moderate myopia groups were reduced after operation in comparison with before operation at the spatial frequencies from 2.98-7.44 cpd(P＜0.05),however,there were no obvious difference was found in the spatial frequencies of 9.42-37.70 cpd(P＞0.05).The MTF values of high myopia group was decreased significantly at all spatial frequencies(P＜0.05).The MTF values improved gradually as the prolong of time after operation but was still lower at the 3rd postoperative month than that of preoperation. Conclusion The postoperative visual quality is associated with refractive power and pupil diameter.PSF is a feasible method in assessing the early visual quality after LASIK.

Background Nd: YAG laser posterior capsulotomy is an important way for after cataract.Usually the patient will use glucocorticoid eye drops to treat the anterior chamber inflammation after operation,but there is potential risk of elevating intraocular pressure (IOP).Objective This study was to compare the clinical effectiveness and safety of loteprednol etabonate ophthalmic suspension,tobramycin+ dexamethasone eye drops and fluorometholone eye drops following Nd: YAG laser posterior capsulotomy.Methods A randomized-controlled clinical trail was performed.One hundrcd and seventy-onc cycs of 127 paticnts who received Nd: YAG laser posterior capsulotomy for after cataract were randomly divided into four groups.Loteprednol etabonate ophthalmic suspension,fluorometholone eye drops,tobramycin+dexamethasone eye drops and systane eye drops was topically administered respectively in the four groups after laser posterior capsulotomy and 6 times per day for 5 days.IOP was measured with Goldmann tomometer 1 hour before operation and 1 hour,1 day,3 days and 7 days after operation.The ocular anterior segment inflammatory response was examined under the slit lamp and scored based on the Peizeng criteria.Written informed consent was obtained from each patient before any relevant medical procedure.Results The IOP was (18.2 ±4.7),(20.1 ±5.7),(18.7±5.5),(19.0 ±4.1),(19.5 ±3.5) mmHg in various time points in the loteprednol etabonate group; (18.7 ±5.3),(20.9±5.7),(21.3±4.5),(21.0±4.9),(22.5±6.5) mmHg in the fluorometholone eye drops group ; (17.9± 6.3),(20.3 ± 6.1),(23.0 ± 3.7),(24.7 ± 4.9),(24.5 ± 6.5) mmHg in the tobramycin +dexamethasone group and(18.4±6.3),(20.7±3.7),(22.7±6.5),(19.6±4.8),(18.5±3.5) mmHg in the systane group,showing a significant difference among the 4 groups (Fgroup =3.876,P =0.023).With the time lapse,the IOP was gradually reduced in the loteprednol etabonate group and systane group,but that in the fluorometholone group and tobramycin+dexamethasone group was elevated,showing a significant difference among them (Ftime =3.801,P =0.031).No any ocular and systemic adverse effect was found in various groups.The percentage of grade 1 and 2 of aqueous inflammatory cells was lower in the loteprednol etabonate group and tobramycin+dexamethasone group than the fluorometholone group and fluorometholone group and systane group(H =8.276,P =0.012).The percentage of Ⅰgrade of aqueous flare was 8％ in the loteprednol etabonate group,22％ in the fluorometholone group,18％ in the tobramycin+dexamethasone group and 30％ in the systane group,with a significant difference among them (H=9.305,P=0.000).Conclusions The use of corticosteroid eye drops can relieve the inflammatory response of ocular anterior chamber after Nd: YAG laser posterior capsulotomy.Loteprednol etabonate ophthalmic suspension has a better anti-inflammatory effect and less influence on IOP.

Background Hypoxia is a crucial factor of neovascularization.Many researches found that stromal cell-derived factor-1 (SDF-1) and integrin-linked kinase (ILK) play an important role in the neovascular disease.However,effect of SDF-1 and ILK in eye neovascular disease is below understood.Objective The aim of this study was to investigate the effect of hypoxia on the expressions of SDF-1 and ILK in cultured retinal pigment epithelium(RPE) cells in vitro.Methods RPE tissue was isolated from 4-week-old C57BL/6 mouse and was digested and cultured in DMEM/F12 with 10％ fetal bovine serum (FBS).The cells with 80％ confluence were collected and passaged.The third generation of cells were identified with cytokeratin 18 (CK18) antibody by immunochemistry.The cells were inoculated at the density of 5×104 cells/ml to free-serum DMEM/F12 for 24 hours and then were cultured in regular medium in the normoxic control group.RPE cells were cultured for 1 hour and 3,6,12,24,48,72 hours with 200 μmol/L CoCl2 in the hypoxia group.Reverse transcription-PCR(RT-PCR) was used to evaluate the expressing change of SDF-1 mRNA and ILK mRNA in RPE cells,and Western blot was used to assay the expressing change of SDF-1 protein and ILK protein in RPE cells in different time points.The detected outcomes were represented as the ratio of target gene A value/β-actin A value.Results Cultured cells showed the polygon in shape with the black pigment granules in cytoplasm.Over 90％ cells were positive response for CK18.Expressions of the SDF-1 mRNA and ILK mRNA were increased in different time points after CoCl2 co-cultured(SDF-1 mRNA:F=281.875,P=0.000 ;ILK mRNA: F=187.566,P=0.000),with the highest expressing value in hypoxia at 12 hours.No significant change in the expression of SDF-1 mRNA and protein was found 1 hour after CoCl2 co-cultured,but expressions of SDF-1 mRNA and ILK mRNA were significantly higher in 3,6,12,24,48 and 72 hours than the normoxic control group(P＜0.01).The expressions of SDF-1 protein and ILK protein were gradually ascended with the time increase of CoCl2 co-culture,showing a significant difference among different time points(SDF-1: F=44.719,P =0.000 ; ILK: F =144.481,P =0.000),and the up-regulation of SDF-1 protein and ILK protein expression was seen mainly in 3,6,12,24,48 and 72 hours after CoCl2 co-cultured in comparison with the normoxic control group (P＜0.01).Conclusions SDF-1 and ILK are involved in the hypoxic response of RPE cells and may play a potential role in ischemic/hypoxic retinopathy.

Background Both functional and morphological changes in amblyopic development are known to occur at various levels in the central visual pathway.However,whether the retina is involved or not during amblyopic progression remains controversial.Objective This study was designed to compare the thicknesses of the fovea and retinal nerve fiber layer (RNFL) of the normal fellow eye of amblyopic eye using optical coherence tomography (OCT) in children with myopic anisometropia.Methods Twenty-two patients with unilateral myopic anisometropic amblyopia were included as the anisometropia amblyopia group.Ten unilateral myopic anisometropic amblyopia subjects received treatment and recovered were used as the amblyopic cure group,and 11 individuals with simple myopic anisometropia without amblyopia were enrolled as the control group.OCT was performed on both eyes of all the subjects with informed consent.Fovea retinal thickness and RNFL thickness from the superior,inferior,nasal and temporal quadrants in the peripapillary region were evaluated.The measurement parameters were bilaterally compared in all the individuals by paired t test.The multiple regression model was used to analyze the correlation of retinal thickness with amblyopia patients.This study was approved by the Ethic Committee of this hospital.Written informed consent was obtain from each subject prior to the eye examination.Results Fovea retinal thickness increased in the amblyopic eyes compared with the fellow eyes,showing a statistically significant difference between them (P =0.001).However,no significant differences were found in the fovea retinal thickness between both eyes in the amblyopic cure group and simple myopic anisometropia without amblyopia group (P =0.778,0.943).Among the anisometropia amblyopia group,amblyopia cure group and simple myopic anisometropia without amblyopia group,the RNFL thicknesses of the temporal quadrant was significantly thicker in the higher myopic lateral eyes than those of the fellow eyes (P＜0.001,P =0.003,P =0.046).However,the differences in the superior,inferior,nasal and the average RNFL thickness were not statistically significant between the two eyes (P＞0.05).A negative correlation was found between the inferior retinal thickness with age (r=-0.559,P=0.016).Conclusions The fovea may be affected in unilateral myopic anisometropic amblyopia.There is no significant difference in the RNFL thickness between simple myopic eye and unilateral myopic anisometropia amblyopic eye.Improvement in amblyopia is coming along with the reduction of the thickness of the fovea.

Objective To observe the protein and gene expression of immunoglobulin binding protein (BiP) in the femur of fluoride-treated rats, and preliminarily study the possible role of endoplasmic reticulum stress in the pathogenesis of skeletal fluorosis. Methods Sixty Wistar rats were divided into 4 groups according to body weight, n =15. The control and low-calcium groups were fed with normal diet(0.79％ calcium) and low-calcium diet(0.063％ calcium), respectively, and both drank tap water(fluoride concentrations ＜ 1 mg/L). High-fluoride and coexpesure to low-calcium groups were fed with conventional feed (0.79％ calcium) and low-calcium diet (0.063％ calcium), respectively, and both drank tap water containing sodium fluoride (sodium fluoride concentration of 221 mg/L). During experimental period, rats were measured body weight once a week with a stand diet and water available ad libitum. The experiment lasted for 12 weeks. The immunohistochemical and reverse transcription polymerase chain reaction(RT-PCR) techniques were used to detect the protein and gene expression of BiP in the femur of fluoride-treated rats and control subjects. Results The bone mineral contents of high fluoride, lowcalcium and coexposure groups[(0.131 ± 0019), (0.097 ± 0.011 ), (0.083 ± 0.007)g/cm] were lower than those of the control group[(0.159 ± 0.029)g/cm, all P ＜ 0.05]; the bone mineral density of low calcium and coexpesure to fluoride group[(0.243 ± 0.018), (0.223 ± 0.022)g/cm2] was lower than that of the control group[(0.296 ± 0.046)g/cm2, all P ＜ 0.05]. The immunohistochemical staining showed that the anti-BiP antibody positive osteoblasts were significantly increased in the low calcium diet and coexposure to fluoride groups than that in the control, and coexposure to fluoride elevated the positive cells than that in only low calcium diet group. The mRNA expression of osteopontin(OPN) and osteocalcin(OCN) in coexposure to fluoride with low-calcium group(1.36 ± 0.20, 1.31 ±0.11 ) was higher than that of the control groups (0.82 ± 0.16, 0.85 ± 0.15, all P ＜ 0.05) ; moreover, OPN expression significantly increased in this group than that of the only high fluoride group (0.97 ± 0.29, P ＜ 0.05). The mRNA expression of BiP in the low calcium and coposure to fluoride group (1.38 ± 0.24,1.35 ± 0.12) was significantly higher than that of the control group ( 1.14 ± 0.06, all P ＜ 0.05 ). Conclusions Higher fluoride or coexposure to low calcium diet stimulates the gene and protein expression in rat femur BiP, indicating that varying degrees of endoplasmic reticulum stress is likely involved in the pathogenesis of rat skeletal fluorosis.

Objective To detect the Yersinia pestis plasmid and molecular weight along the Qinghai-Tibet Railway.Methods Yersinia pestis plasmids molecular weight detected and analyzed using alkaline lysis,phenol-chloroform extraction of Yersinia pestis plasmid by agarose gel electrophoresis.Results The 18 Yersinia pestis strains of Qinghai-Tibet Railway contained 6×106,45×106,52×106,65×106,92×106plasmid,varing in the range of the 52×106-92×106.Conclusions The Yersinia pestis of Qinghai-Tibet Railway has a standardplasmid graphics,with the biggest Yersinia pestis plasmid changing in a certain regular degree,which providessignificance in the study of plague natural foci of the spatial structure and the genetic.characteristics of Yersiniapestis.

ObjectiveTo evaluate the functional changes of stunned myocardium before and after coronary artery bypass graft(CABG) treatment,and clear the meaning of revascularization which CABG has brought to patients with diffused vascular changes.MethodsA total of 36 patients with 99％ diffused coronary artery stenosis in left anterior descending branch underwent non-pump CABG treatment in the Department of Cardiothoracic Surgery the First affiliated hospital of Harbin Medical University.Real-time three-dimensional echocardiography (RT3DE) was repeatedly performed 1 week before operation and 10 days,1 month,and 3 months after CABG.Regional diastolic volumes,systolic volumes,ejection fractions,regional stroke volume to global diastolic volume and the values of abnormal segments before and after CABG were studied.ResultsOne week before operation and 10 days,1 month and 3 months after CABG,the differences of volumes between groups in the last phases of diastole and systolic were statistically significant in anterior wall basement segment,anterior septal basement segment,anterior wall intercalary segment,anterior septal intercalary segment,anterior wall of apex cordis and septation of apex cordis(F =3.51,3.55,4.08,4.05,2.98,3.01,all P ＜ 0.05; F =4.51,4.55,4.08,3.00,2.96,2.99,all P ＜ 0.05).The values of the six segments mentioned above,3 months after operation[(6.74 ± 1.23),(6.64 ± 1.21),(6.02 ± 1.10),(5.95 ± 1.09),(5.82 ± 1.06),(5.10 ± 0.93)ml; (2.74 ± 0.50),(2.69 ± 0.49),(2.51 ± 0.46),(2.32 ± 0.42),(2.36 ± 0.43),(2.03 ± 0.37)ml] were compared with those of 1 week before operation[(8.33 ± 1.52),(8.20 ± 1.50),(7.43 ± 1.36),(7.36 ± 1.34),(7.19 ± 1.31),(6.29 ± 1.15)ml; (4.94 ± 0.90),(4.85 ± 0.88),(4.53 ± 0.83),(4.18 ± 0.76),(4.25 ± 0.78 ),(3.65 ± 0.67)ml],the differences were statistically significant (all P ＜ 0.05); the differences between groups in regional ejection fractions,regional-global ejection fractions were statistically significant(F =4.56,4.88,4.28,3.15,2.93,2.88,P ＜ 0.01 or ＜ 0.05; F =5.56,5.28,4.98,5.15,3.03,2.78,P ＜ 0.01 or ＜ 0.05).Compared with 1 week before the operation, 1 month after the operation in regional ejection fractions,10 days,1 month in regionalglobal ejection fractions after the operation,4 segments of them were significantly improved(all P ＜ 0.05) and 3 months after operation,all the 6 segments had been improved significantly(all P ＜ 0.05).The maximum volume of the sum of group difference of the 6 segments and the 4 segments in the last phase of diastole was statistically significant(F =2.58,5.81,P ＜ 0.05 or ＜ 0.01 ),and the summation began to decrease 10 days after the operation.The values of 3 months after operation[ (36.27 ± 1.10),(25.35 ± 1.16)ml] were compared with that of 1 week before operation[ (44.80 ± 1.36),(31.32 ± 1.43)ml ] the difference was statistically significant (all P＜ 0.05).The maximum volume summafion comparisons of 6 segments and 4 segments in the last phase of systolic had statistical significance(F =5.77,5.57,all P ＜ 0.01 ),and 10 days after the operation,the summation began to decrease.The values of 1 month[(16.4 0 ± 0.48),(11.58 ±0.51 )ml],and 3 months after operation[ (14.65 ± 0.45),(10.26 ± 0.46)ml],were compared with those of 1 week before operation[ (26.40 ± 0.80),(18.50 ± 0.84)ml],the differences were statistically significant (all P ＜ 0.05).ConclusionsStunned myocardium can be improved through CABG in myocardium systolic,diastole function and ejection fractions of the relevant segments and all of this have proved that patients undergoing CABG revascularization can improve the heart function of the ischemic area.

Objective To investigate the reasons of higher result of CK-MB than the total CK with the immune suppression method for deteting serum CK-MB and solution methods.Methods Selected 68 cases of inpatients with myocardial infarc-tion from Department of Cardiology,32 cases of malignant tumor from Internal Medicine-Oncology,including 8 cases of liver cancer,6 cases of lung cancer,6 cases of gastric cancer,5 cases of neuroblastoma,4 cases of breast cancer and 3 cases of o-varian cancer and 16 cases of cirrhosis from Department of Gastroenterology,and at the same time,selected 100 cases of healthy persons as control group from Out-patient Health Examination Center of Shaanxi Provincial People’s Hospital.Used Roche MODUALR automatic biochemical analyzer to detected the activity of serum CK-MB with the immune suppression method and the activity of total CK with the enzyme coupling rate method.Results In 68 cases of inpatients with myocardial infarction,the activity of serum CK-MB of 2 1 cases were individually increased,the activity of total CK of 3 9 cases were in-creased,and the two indexes of 30 cases were increased in the same period.In 32 cases of inpatients with malignant tumor, the activity of serum CK-MB of 1 1 cases were individually increased,the activity of total CK of 3 cases were increased and the two indexes of 3 cases were also increased.The activity of serum CK-MB of 6 cases were individually increased in 1 6 ca-ses of cirrhosis.Conclusion The immune inhibition assay for the detection of CK-MB as the diagnosis index of myocardial infarction had certain defects,and the higher activity of CK-MB could be highly associated with some severe inflammation, malignant tumor.