The accommodating intraocular lens (AIOL) is designed to simulate the accommodation of the crystalline lens and satisfy patients by its ability to focus on an object at any distance independent of spectacles.However,near vision in the short-term or long-term future of some patients with AIOLs is not good in clinical practice and there is still no consistent conclusion as to whether they can restore sufficient accommodation.Most clinical evaluations of AIOL performance have been based on visual function, such as the testing of near visual acuity and subjective measurements of accommodation,but these tests may not determine whether the lenses are actually working according to the principle of their design.With the rapid development of imaging technologies, the performance of AIOLs can be observed from the perspective of morphology.This article described the biometry of the anterior segments in the subjects with AIOL during accommodation in order to understand the actual clinical effects of AIOLs.

Objective To investigate the effects of Sulfotanshinone Sodium Injection (SSI) on neuropathic pain in rats.Methods One hundred and eight adult male Wistar rats,aged 6-8 weeks,weighing 180-220 g,were randomly divided into 3 groups (n =36 each):sham operation group (group S) ; chronic constrictive injury (CCI)group; group SSI.The animals were anesthetized with intraperitoneal 10% chloral hydrate 350 mg/kg.In groups CCI and SSI,4 ligatures were placed on the right sciatic nerve at 1 mm intervals with 4-0 silk thread according to the method described by Bennett et al.In group S,the right sciatic nerves were exposed,but not ligated.In group SSI,SSI 25 mg/kg was injected intraperitoneally once a day starting from the end of operation until one day before the animals were sacrificed,while the rats received the equal volume of normal saline (5 ml/kg) instead of SSI in groups S and CCI.Twelve animals in each group were chosen at 1 day before operation and 3,7 and 14 days after CCI (T1-4) to measure mechanical paw withdrawal threshold to yon Frey stimuli (MWT) and paw withdrawal latency to thermal nociceptive stimulus (TWL).Six rats in each group were sacrificed at T2-4 after measurement of pain threshold,and their lumbar segnents (L4-6) of the spinal cord were immediately removed for determination of Bcl2 and caspase-3 expression in spinal dorsal horn (by immune-histochemistry),and MDA content and SOD activity (by spectrophotometry) in spinal cord.Results Compared with group S,PWT was significantly decreased,PWL was shortened,the expression of Bcl-2 and caspase-3 was up-regulated,MDA content was increased and SOD activity was decreased at T2-4 in groups CCI and SSI (P ＜ 0.05).Compared with group CNP,PWT was significantly increased,PWL was prolonged,the expression of Bcl-2 was up-regulated,the expression of caspase-3 was downregulated,MDA content was decreased and SOD activity was increased at T2-4 in group SSI (P ＜ 0.05).Conclusion SSI can mitigate neuropathic pain in rats and inhibition of oxidative stress in spinal cord tissues and reduction of apoptosis in spinal dorsal horn neurons are involved in the mechanism.

Objective To evaluate the effect of dexmedetornidine on the expression of Toll-like receptor 4 (TLR4) and nuclear factor kappa B (NF-κB) in the spinal cord in rats with neuropathic pain (NP).Methods One hundred and eight male Wistar rats,aged 6-8 weeks,weighing 180-220 g,were randomly assigned into 3 groups (n =36 each):sham operation group (group S),NP group and dexmedetomidine group (group D).NP was induced by chronic constrictive injury in anesthetized rats.Sciatic nerve was exposed and 4 loose ligatures were placed on the sciatic nerve at 1 mm intervals with 4-0 silk thread.In group S,the right sciatic nerves were exposed,but not ligated.Dexmedetomidine 50 μg/kg was injected intraperitoneally once a day from the onset of operation to one day before the rats were sacrificed in group D,while the equal volume of normal saline was injected in groups S and NP.Mechanical withdrawal threshold (MWT) and thermal pain threshold (TPT) were measured on the day before operation (T0) and 3,7,and 14 days after operation (T1-3).After measurement of pain threshold at T1,T2 and T3 after operation,the L4-6 segments of the spinal cord were removed for determination of the expres-sion of TLR4 and NF-κB mRNA (by RT-PCR) and the expression of TLR4 and NF-κB in spinal dorsal horn (by immuno-histochemistry).Results Compared with group S,MWT and TPT were significantly decreased and the expression of TLR4,NF-κB and TLR4 and NF-κB mRNA was up-regulated after operation in groups NP and D (P ＜ 0.05).Compared with group NP,TPT and MWT were significantly increased and the expression of TLR4,NF-κB,TLR4 mRNA and NF-κB mRNA was significantly down-regulated after operation in group D (P ＜ 0.05).Conclusion The mechanism by which dexmedetomidine attenuates NP in rats is related to inhibition of the expression of TLR4 and NF-κB in rat spinal cord.

Objective To discuss perioperative rehabilitative care for flexor tendon injuries by examples of successful treatment of 30 cases of rupture of flexor tendon pollicis longus at ZoneⅡ.Methods From March 2001 to March 2006,30 cases of rupture of flexor tendon pollicis longus at ZoneⅡwere treated in our department by suture with double loops and crossing six strands before external fixation.Patients were encouraged to do rehabilitation exer- cises for functional recovery under the guidance and supervision of orthopaedists.Results All the patients were followed up for 6 to 16 weeks (mean,8 weeks).According to TAM (Total Active Motion) criteria,12 cases were rated as excellent,10 cases as good,6 cases as fair,and 2 cases as poor.The excellent to good rate was 73.3%.The 22 excellent and good cases could perform daily-life activities with affected fingers,such as writing,holding chopsticks and doing and undoing buttons.No patient experienced rerupture.Conclusion In perioperative rehabilitative care for rupture of flexor tendon pollicis longus at ZoneⅡ,it is important to have correct diagnosis,noninvasive and secure suture,safe external fixation and functional exercises under the guidance of orthopaedists.

Objective: To study the effect of new photosensitizer Chlorophyl-derivative (CPD4) combined with Adriamycin on cell cycle and cell proliferation of MCF-7 breast cancer cell line and to investigate the mechanism of combination therapy. Methods: A new type of photosensitizer and traditional chemotherapy drug Adriamycin (ADM) were used to treat breast cancer cell line MCF-7. Flow cytometry was employed to detect apoptosis rate and cell cycle distribution in ADM group, group with photodynamic effect and the combined group. The influence of ADM on the mean fluorescence intensity and the changes in the mean fluorescence intensity after CPO4 (1.5μg/mL) treatment were analyzed. Results: The apoptosis rate of the combination group was higher than that in the other two groups, with statistical significance (P＜0.01). Photodynamic effect caused G_0/G_1 phase arrest in MCF-7 cells. Low concentration of ADM increased the number of G_2/M phase cells. The percentage of G_2/M phase cells was increased in the combination group. No significant difference was found in the mean fluorescence intensity between ADM pretreated MCF-7 cells for 24 hours and 48 hours and the control group (P＞0.05). Pretreatment of MCF-7 cells with ADM increased the volume of photosensitizer CPD4 into the cells. The mean fluorescence intensity at 2 hours after CPD4 incubation was the highest. Conclusion: ADM can increase the amount of CPD4 into the MCF-7 cells. Photodynamic therapy com-bined with Adriamycin has a synergistic effect on MCF-7 cells.

Objective To evaluate the effect of dexmedetomidine and small dose of ketamine on the expression of P2X4 receptor (P2X4 R) mRNA and P2X7 receptor (P2X7R) mRNA in the dorsal root ganglion of rats with neuropathic pain.Methods Ninety male Sprague-Dawley rats,aged 6-9 weeks,weighing 180-220 g,were randomly divided into 5 groups (n =18 each):sham group (group S),chronic constrictive injury group (group CCI),dexmedetomidine group (group D),ketamine group (group K) and dexmedetomidine + ketamine group (group DK).The animals were anesthetized with intraperitoneal 10％ chloral hydrate 400 mg/kg.Neuropathic pain was induced by CCI in CCI,D,K and DK groups.The sciatic nerve was exposed and 4 loose ligatures were placed on the sciatic nerve at 1mmintervals with 4-0 silk thread.In group S,the sciatic nerves were only exposed but not ligated.In D,K and DK groups,dexmedetomidine 50μg/kg,ketamine 10 mg/kg and dexmedetomidine 25μg/kg + ketamine 5 mg/kg were injected intraperitoneally,respectively,while the equal volume of normal saline was injected in S and CCI groups,once a day for 14 consecutive days after CCI.Mechanical paw withdrawal threshold (MWT) and thermal paw withdrawal latency (TWL) were measured at 1 day before CCI,and 3,7 and 14 days after CCI.Six animals were sacrificed after measurement of pain threshold at 3,7 and 14 days after CCI and the lumbar segments (L4-6) of the dorsal root ganglion were removed for determination of P2X4 R mRNA and P2X7 R mRNA expression by RT-PCR.Results Compared with group S,MWT and TWL were significantly decreased at 3,7 and 14 days after CCI in groups CCI,D,K and DK,the expression of P2X4R mRNA and P2X7R mRNA was up-regulated at 3,7 and 14 days after CCI in groups CCI,D and K,and the expression of P2X4 R mRNA and P2X7 R mRNA was up-regulated at 3 and 7 days after CCI in group DK (P ＜ 0.05).Compared with group CCI,TWL and MWT were significantly increased and the expression of P2X4 R mRNA and P2X7 R mRNA was down-regulated at 3,7 and 14 days after CCI in groups D,K and DK (P ＜ 0.05).Compared with D and K groups,TWL and MWT were significantly increased and the expression of P2X4 R mRNA and P2X7 R mRNA was down-regulated at 3,7 and 14 days after CCI in group DK (P ＜ 0.05).Conclusion The mechanism by which the combination of dexmedetomidine and small dose of ketamine produces a synergistic antinociception in rats with neuropathic pain may be related to down-regulation of the expression of P2X4 R mRNA and P2X7 R mRNA.

OBJECTIVE To observe the preventive effect of and to study the immunomechanism of Fangan 1 prescription (traditional Chinese medicine prescription) on repetitive upper respiratory infection in aged people. METHODS Sixty five old patients with repetitive upper respiratory infection as study objects were divided randomly into treatment group and control group and their T lymphocyte subset was detected. RESULTS CD3 and CD4 were decreased in different degree among them, the difference was significant in comparison with the healthy aged (P

Background Evaluation of intra-retinal layer thickness plays an important role in the diagnosis and monitor of various eye diseases,and spectral domain optical coherence tomography (OCT) is a frequently used tool.Software analysis method was used to measure the retinal thickness in previous study,but the study on the reliability of automatic layered software is lack.Objective This study was to evaluate the repeatability and reproducibility of thickness profile measurement of intra-retinal layers determined by an automated algorithm applied to OCT images from RTVue100 OCT instrument.Methods In this prospective cross-sectional study,retinal thickness images at 6 mm around fovea were obtained from 18 right eyes of 18 normal subjects with RTVue100 OCT instrument.The retinal images were segmented into retinal nerve fiber layer (RNFL),ganglion cell layer and inner plexiform layer(GCL+IPL),inner nuclear layer (INL),outer plexiform layer (OPL),outer nuclear layer (ONL),inner segment (IS),outer segment (OS) and retinal pigment epithelial (RPE) layer using automated algorithm method.Then Matlab software was used to analyze the measuring outcome.Interclass correlation coefficient (ICC) and coefficients of reproducibility (COR) were calculated from the results of two-time examination by the same examiner to evaluate the repeatability and from the results of two different examiners to assess the reproducibility.Written informed consent was obtained from each subject prior to any medical procedure.Results The entire retinal thickness measured by RTVue-OCT was (303.22± 14.10) μm in the horizontal meridian and (306.68 ± 13.32) μm in the vertical meridian,with the maximum values of retinal thickness in the GCL+ IPL and ONL.Whether in the horizontal meridian or in the vertical meridian,the ICC and COR were ＜0.60 in the OPL,IS and OS;while those in the RNFL,GCL+IPL,INL,ONL and RPE layer were ＞0.70.Conclusions RTVue OCT with automated algorithm is a useful and reliable approach to the measurement of intra-retinal layer thickness.Automated segmentation can offer accurate and repeatable thickness profile of OCT retinal image.This method may improve the diagnosis and monitoring of retinal diseases.

Objective To evaluate the effects of dexmedetomidine on the activity of cAMP response element binding protein (CREB) and c-fos in the spinal dorsal horn in a rat model of neuropathic pain.Methods Fifty-four adult male Wistar rats,aged 6-8 weeks,weighing 180-220 g,were randomly divided into 3 groups (n =18 each):sham operation group (group S),chronic neuropathic pain group (group C) and dexmedetomidine group (group D).The animals were anesthetized with intraperitoneal 10％ chloral hydrate 350 mg/kg.The sciatic nerve was exposed and 4 ligatures were placed on the right sciatic nerve at 1 mm intervals with 4-0 silk thread in C and D groups.In group D,dexmedetomidine 50 μg/kg was injected intraperitoneally once a day starting from the end of operation until 1 day before the animals were sacrificed,while the equal volme of normal saline was injected instead of dexmedetomidine in S and C groups.Paw withdrawal threshold to mechanical stimulation with yon Frey filament (MWT) and paw withdrawal latency to thermal stimulation (TWL) were measured on 1 day before operation and 3,7 and 14 days after operation.The animals were sacrificed after measurement of MWT and TWL.Their lumbar segments (L4-6) of the spinal cord were removed for measurement of the expression of phosphorylated CREB (pCREB) and c-fos by immunohistochemistry.Results Compared with group S,MWT was significantly decreased,TWL was shortened,and the expression of pCREB and c-fos was up-regulated on 3,7 and 14 days after operation in C and D groups (P ＜ 0.05).Compared with group C,MWT was significantly increased,TWL was prolonged,and the expression of pCREB and c-fos was down-regulated on 3,7 and 14 days after operation in group D (P ＜ 0.05).MWT was significantly lower,and TWL was shorter on 3,7 and 14 days after operation than on 1 day before operation in C and D groups (P ＜ 0.05).MWT was significantly lower,TWL was shorter,and the expression of pCREB and c-fos was higher on 7 and 14 days after operation than on 3 days after operation in C and D groups (P ＜ 0.05).MWT was significantly higher,TWL was longer,and the expression of pCREB and c-fos was lower on 14 days after operation than on 7 days after operation in C and D groups (P ＜ 0.05).Conclusion The mechanism by which dexmedetomidine reduces neuropathic pain is related to inhibition of the activity of CREB and c-fos in the spinal dorsal horn of rats.

Objective To explore the effect of community comprehensive rehabilitation on quality of life in patients with stroke sequelae under the family medical service mode. Methods From October, 2013 to October, 2014, 51 patients with stroke sequelae received compre-hensive rehabilitation intervention for three months, including rehabilitation training, rehabilitation guidance, health education and psycho-logical counseling. They were assessed with modified Barthel index (MBI), WHO-Disability Assessment Schedule (WHO-DASⅡ), Short Form 36 Health Survey Questionnaire (SF-36), Brain Injury Community Rehabilitation Outcome Scales (BICRO-39), Self-rating Anxiety Scale (SAS), Self-rating Depression Scale (SDS) before and after intervention. Results The scores of physical functionning, role physical, general health, mental health, social functioning and the total score in SF-36 increased after intervention (t>2.072, P<0.05). The scores of so-cial contact, locomotivity, self handling transaction ability and the total score in BICRO-39 decreased after intervention (t>2.434, P<0.05), as well as the scores of getting along with people, housework and society and participation in WHO-DAS II (t>2.507, P<0.05). Conclusion In the community health service, comprehensive rehabilitation guided by multidisciplinary rehabilitation team can facilitate to improve the quality of life in patients with stroke sequela.