Accommodation of the human eye ian extremely complex and dynamiprocess,which iaccomplished by the interaction between the central nervousystem and variouoculastructurethaare relevanto accommodation.Varioumechanismof accommodation have been puforward since the beginning of the 19th century,among which Helmhohz'theory ithe mosfamous.However,iistill challenged by othetheories.So far,the mechanism of accommodation hanobeen fully understood.The mosdirecmethod to study accommodation ito observe changein the biometry of the oculastructureduring accommodation,which ialso the mosobjective interpretation of accommodative mechanisms.The rapid developmenof imaging technologiein regardto ophthalmology makethipossible.Thiarticle aimto describe the use of variouimaging technologiein oculaaccommodative studiein vivo from the perspective of morphology.

Objective To investigate the correlation of serum interleukin-6 (IL-6) and IL-18levels to carotid artery intimal-medial thickness (IMT) in patients with acute cerebral infarction (ACI).Methods In 64 patients with ACI and 30 healthy volunteers, serum IL-6 and IL-18 levels were detectedusing radioimmunoassay and enzyme-linked immunosorbent assay (ELISA), respectively. Carotid arteryIMT were measured in the two groups using color Doppler ultrasound, and the ACI patients were dividedinto two groups with carotid IMT greater or lower than 1.0 mm. Results The ACI patients and thehealthy volunteers showed significant differences in serum IL-6 (P<0.05) and IL-18 levels (P<0.05),which were also significantly different between ACI patients with carotid IMT ≥ 1.0 mm and those withIMT<1.0 mm (P<0.05). The ACI patients with IMT<1.0 mm had comparable serum IL-6 and IL-18 levelsto those in the healthy volunteers. In patients with carotid IMT ≥ 1.0 mm, the serum IL-18 level waspositively correlated to IMT (r=0.549, P=0.001), but the IL-6 level was not related to IMT (P>0.05).Conclusion The serum levels of IL-6 and IL-18 are elevated in ACI patients with increased carotid IMT.

Objective To study the infection of MP-Ab IgM (MP) in serum,bronchial lavage fluid,pleural effusion and cere brospinal from pediatric patients with Mycoplasma Pneumoniae Pneumonia (MPP).Methods From March to June 2013,278 cases of patients suspected MP infection in Children's Hospital Affiliated to Capital Medical University were selected and the MP-Ab IgM of thcire serum,bronchial lavage fluid,pleural effusion and ccrebrospinal fluid specimens were detected with the method of particle agglutination test.Results 181 cases (104 cases of boys,77 cases of girls) of different specimens in (MP) were positive.All the serum samples,278 cases were detected positive serum specimen of 170 cases,the overall detection rate was 61.2％ (170/278),144 cases of bronchial lavage fluid was investigated at the same time,check out the posi rive 62 cases,and the detection rate was 43.1％ (62/144).19 cases for pleural effusion samples at the same time,checked out the positive 13 cases,and detection rate was 68.4％ (13/19).15 cases of cerebrospinal fluid specimens was investigated at the same time,checked out the positive in 1 case,and the detection rate was 6.7％ (1/ 15).Positive rate between different age groups was respectively:6 months～1 year group 29.0％ (9/31),～3 year group 51.0％ (25/49),～5 year group 56.1％ (23/41),～16 year group 79.0％ (124/157),6 months～1 year witb other age groups was statistically significant difference (P＜0.05).In 0.5～1 year,～3 year,～5 year,16 year～four age groups,different types of MP-Ab IgM positive specimens of the same patients,the corresponding results for A:serum type (111 cases) 7,21,13,70.B:serum and bronchoalveolar lavage fluid type (45 cases) 0,2,5,38.C:Serum pleural effusion (7 cases) 0,1,2,4.D:serum and cerebrospinal fluid (1 cases) 0,0,0,1;E:serum and bronchoalveolar lavage fluid and pleural effusion type (6 cases):0,0,2,4.F:bronchoalveolar lavage fluid type (11) 2,1,1,7.Conclusion MP infection varied,have atrend of younger age,and has a tendency to increase year by year,and the patient's infection rates have different characteristics.Positive serum of different age groups was gradually increased with age,infants and young children positive detection rate increased significantlychildren with severe multiple in older children.

Objective To identify the impact of age and gender on cardiac structure and left ventricular function in normal Chinese by echocardiography. Methods Cardiac structure, valve flow velocity and cardiac function were measured by echocardiography in 15 692 healthy volunteers. Subjects were grouped by age at 5 years interval in population older than 5 years. Children under 5 years were divided into 3 age groups(<1 years,1-3 years,4-5 years). Hierarchical cluster analyses were performed for ages, based on indexes of cardiac structure and function respectively. Results Six groups (< 1 years, 1-3 years,4-5 years, 6-10 years, 11-20 years, ≥21 years) were generated after the age hierarchical cluster analyses based on index of cardiac structure. Four groups (≤30 years, 31-50 years, 51-80 years,≥81 years) were generated based on spectral current flow. Six groups (< 1 years,1-3 years,4-5 years, 6-10 years, 11-15 years, ≥16 years) were generated baaed on left ventricular systolic function and five groups (≤15 years, 16-30 years, 31-50 years, 51-80 years, ≥81 years) were generated based on left ventricular diastolic function. Cardiac structure index were similar between male and female in age groups ≤ 10 years and significantly lower in females than males in age groups ≥ 11 years (P < 0.05). Valve flow velocity was similar between male and female in various age groups (P >0.05). Left ventricular systolic function was similar between male and female in age groups ≤10 years but was significantly higher in males than females in age groups ≥11 years(all P <0.05). Left ventricular diastolic function was similar between female and male in various age groups (P > 0.05) and equally decreased with aging in both female and male subjects. Conclusions The cardiac development in Chinese population can be divided in 6 phases and becomes stable in subjects older than 21 years, left ventricular systolic function becomes stable in subjects older than 16 years and the left ventricular diastolic function declines physiologically with aging.

Objective To evaluate the effectiveness of health education on iodine deficiency disorders (IDD) in Hebei, and to provide basic information for development of control strategies. Methods A total of 34 project counties were selected in Hebei province, and 3 townships were chosen in each project county. Heath educational activities were carried out in the classes of grade 5 in the central primary school of each selected township. In the meantime, 3 villages were chosen in each selected township where the health education for women of childbearing age in the community was carried out. Sureys on knowledge of IDD control were conducted in the 34 project counties before and after the health educational activities. Results The knowing rates of IDD control among pupils in all 34 project counties increased from 71.10%(7835/11 019) to 94.84%(10 840/11 430) after health education, with a average increase of 23.74%. The knowing rates of IDD control among housewives increased from 77.02%(4531/5883) to 95.32%(5902/6192), with a average increase of 18.30%. Of which, the knowing rates of IDD control among pupils in Hengshui city increased from 55.56% (750/1350) to 94.89% (1281/1350),with a average increase of 39.33%. The knowing rates of IDD control among housewives in Handan city increased from 65.68%(532/810) to 96.50%(909/942), with a average increase of 30.82%. Conclusions The knowing rates of IDD control among pupils and housewives are remarkably increased after implementing the health education projects. They have better life and health habits, and the project achieves desired effect.

Objective To investigate the clinical outcome of patients receiving stereotacticcannula placement for hypertensive intracerebral hematoma drainage and the relationship between thedrainage cannula and the cerebral angioarchitecture. Methods Sixty-three patients with hypertensiveintracerebral hematoma underwent operations for stereotactic placement of a soft tube for hematomadrainage. CT angiography and CT venography were performed prior to cannula withdrawal after thepatients' condition was stabilized or complete hematoma drainage. The relationship between the drainagecarmula, cerebral angioarchitecture and the entry route of the cannula were observed. ResultsPostoperative CT angiography and CT venography showed that the entry route of the cannula allowedsafe passage of the cannula along the cerebral arteries and veins, and the position of the cannula wasaccurate in all the patients. Satisfactory hematoma drainage and good postoperative recovery wasachieved in all the patients, and no significant injuries to the adjacent cerebral arteries or veins occurredin these cases. Conclusion Stereotactic cannula placement with the minimally invasive technique forhemotoma drainage causes minimal injury and is safe, effective, cost-effective and convenient fortreatment of hypertensive intracerebral hematoma.

Objective To explore the health-related quality of life(QOL)status of patients with chronic rhinosinusitis. Methods Sixty four patients with chronic rhinosinusitis and twenty healthy volunteers were enrolled, and their QOL scores were assessed by using SF-36 questionnaire(Chinese version)and SNOT-22 questionnaire translated into Chinese. Results The feasibility, reliability,validity,and responsibility of Chinese version of SNOT-22 questionnaire all passed the test. It showed that by Chinese version of SNOT-22 questionnaire the most five important items affecting health status were nasal obstruction,runny nose,loss of smell or taste,dizziness and post-nasal discharge respectively. The coefficient of correlation was 0.233 between the SNOT-22 questionnaire and the Lund-MacKay CT score of Patients with chronic rhinosinusitis. Conclusions Chinese version of SNOT-22 questionnaire can effectively assess the QOL status of patients with chronic rhinosinusitis. It showed less correlation between the SNOT-22 questionnaire and the Lund-MacKay CT score of patients with chronic rhinosinusitis.

Objective To explre the techniques, advantages and disadvantages, indications and cautions of a surgical approach for the resection of nasopharyngeal tumor. Methods Ten cases with nasopharyngeal tumors were recruited in this study, of them, 3 cases with residual nasopharyngeal carcinoma after chemoradiotherapy, 2 cases with cavernous angioma, 2 cases with benign mixed tumor, 1 malignant mixed tumor, 1 adenoid cystic carcinoma, and 1 chordoma. All patients underwent endoscopic resection of posteroinferior quarter part of nasal septum, and then the removal of nasopharyngeal tumors through bilateral transnasal approach. Results Total resection of the tumor was achieved for all cases without severe surgical complications. All cases with benign tumors, with following-up of 6 -18 months, showed no recurrence. Of 6 cases with malignant tumors, with following-up of 12 -48 months, 5 cases showed no recurrence, and 1 case was suspected to relapse one year postoperatively, but not with any lesion enlargement after another 6 month follow-up. Conclusions Posteroinferior quarter part of nasal septectomy is preferred for endoscopic resection of nasopharyngeal tumors because it can provide a panoramic view on nasopharyngeal cavity and tumors, thus, facilitating the removal of nasopharyngeal tumors.

Objective The aim of this study was to investigate the heating and facial nerve preservation in the middle fossa approach surgery for the removal of small acoustic tumor (vestibular schwannomas,VS).Methods A prospective database was established,and data were retrospectively reviewed.Between January 2004 and February 2013,13 patients with acoustic tumor underwent surgery via middle fossa approach for heating preservation.The patients consisted of six men and seven women with a mean age of 48 years.Tumor size ranged from 0.8 cm to 1.5 cm.Heating loss was categorized as American Academy of Otolaryngology Head and Neck Surgery (AAO-HNS) class A,class B,class C and class D.Facial nerve function was evaluated according to House-Brackmann (HB) Grade Ⅰ-Ⅵ.Results Grosstotal resection was accomplished in 12 of 13 patients.Preoperative heating as class A in ten,class B in two,and class C in one patient respectively.Postoperatively,heating was graded as class A in eight patients,class B in 3,and class C in 2 patients.Facial nerve function was House-Brackmann(HB) grade Ⅰ in twelve patients,grade Ⅱ in one patient preoperatively.Postoperatively,facial nerve function was HB Grade Ⅰ in twelve patients and Grade Ⅲ in one patient.The overall heating preservation rate was at least 80％ (8/10)and HB Grade Ⅰ facial nerve outcome of 100％ (12/12).All cases were followed up for 0.5 to 5 years,no complications were abserved.Conclusions The middle fossa approach for the resection of small VS with heating preservation is a viable and relatively option.It should be considered among the various options available for the management of small and growing VS.

Objective The impact of late incomplete stent apposition(ISA)post sirolimus eluting stent(SES)implantation in patients with acute coronary syndrome(ACS)on long-term clinical outcomes remainB controversial.The alm of the present study was to eva]uate the association between late ISA and clinical outcomes in patients with ACS compared with that with stable angina(SA).Methods From February 2005 to March 2007,54 ACS patients and 83 SA patients were enrolled in this study,late ISA was determined by meallS of threc-dimensional volumetric intravaaculair ultrasound(IVUS)analyses one year after SES implantation and clinical outcomes one year post IVUS were obtained in these patients.Results In 219 treated lesions of the 137 patients,late ISA wag documented in 25 lesions in 16 patients(20 ISA in 12 ACS patients vs.5 ISA in 4 SA patients,P＜0.001).Thoush lunlen area in reference and stented segment,neointimal hyperplasia(NIH)area and percentage of NIH in stented segment,and external elastic membrane(EEM)area in reference segment were similar between two groups,EEM area in stented segment [(15.34±5.44)mm2vs.(13.83±4.51)mm2,P=0.026],stented/reference segment EEM area ratio (1.13±0.22 vs.1.02±0.18,P＜0.001),plaque and media area[(8.43±3.93)mm2vs.(7.01±2.93)mm2,P=0.002]was significantly lager in ACS group than that in SA group.Multivariable logistic analysis showed that ACS(OR 6.477 with 95%CI from 2.297 to 18.263,P＜0.001)and stent length≥23 mm(OR 3.680 with 95% CI from 1.181 to 11.469,P=0.025)were main independent factors of occurrence of late ISA.Incidence of main adverse cardiac events(MACE)one year post IVUS Wag similar between the two groups.Conclusion Compared with patients with SA,ACS patients had larger stented segment EEM area,plaque and media areaas well as increased incidence of ISA.However,the incidence of MACE was similar in ACS and SA patients one year after IVUS.