84 eyes that underwent femtosecond laser-assisted laser in situ keratomileusis ( FS-LASIK) , and 110 eyes that underwent small incision lenticule extraction ( SMILE) surgery were included in this prospective case se-ries study. HOAs included ( total HOAs, spherical aberration, horizontal coma aberration, and vertical coma aber-ration) were measured preoperatively after 1 week, 1 month , and 3 months postoperatively by Pentacam. The ab-errations were described as Zernike polynomials. Significantly increased total HOAs and SA and significantly de-creased vertical coma were noted at 1 week, 1 month, and 3 months after FS-LASIK ( P<0.05 ) . However, no significant increase was found in postoperatively horizontal coma. There were significant increases in total HOAs, SA, and horizontal coma and a decrease in the vertical coma at each postoperative examination in SIMLE group ( P<0.05 ) . The total HOAs and SA were significantly smaller in SMILE group than that in FS-LASIK group at 1 week, 1 month, and 3 months postoperatively. The changes in total HOAs and SA were also significantly smaller in SMILE group than that in FS-LASIK group at each postoperative examination. Compared with FS-LASIK, SMILE can induce fewer total higher-order aberrations and spherical aberration after operation.

Objective To establish the reference range of serum human serum insulin levels in our laboratory and investigate measurement stability, Methods The automated Architect i2000 chemiluminescence immunoassay, calibrator and quality control materials were used to measure concentration of serum insulin. Totally 413 cases of healthy adults were enrolled. The physiologic characteristics and the influence of laboratory markers on insulin levels were analyzed. Then the reference range in our laboratory was established. The thermal stability of insulin at different temperatures was investigated. Results Within-run imprecision and between-day imprecision of the automated Architect i2000 insulin assay were 1.67% and 2. 6%, which indicated that this system had good analytical performance. The subjects were classified into 4 groups according to age range ( 10 years). There was no significant difference among four age groups (the median is 5. 6, 5.2, 5.3 and 5. 7 mU/L) (X<'2> = 1. 929,P >0.05). However, the insulin levels were higher in female ( median = 5.7 mU/L) than male ( median = 5.0 mU/L) ( Z = 3.696, P < 0.01 ). The reference range was established based on the 2. 5 and 97.5 percentile values. The reference range of insulin for female was 2. 6-11.8 mU/L and 2. 3-11.6 mU/L for men, which differed from that of other insulin assay. Insulin had a positive correlation with BMI (r =0. 115 ,P =0. 019) and triglyeeride (r =0.143 ,P = 0. 004), and a negative correlation with high density lipoprotein (r = -0.179, P = 0.000). Insulin was stable at 25 ℃ for at least 4 hours or 4 ℃ for 24 hours or could be extended to at least 7 days when stored at -20 ℃. Conclusion Gender is an important physiologic characteristic which has an impact on human serum insuhn level. Insulin reference range should be established according to gender. Insulin immunoreactivity was not very stable at different temperatures.

Objective To investigate the role of ghrelin promoting proliferation of pancreatic β cells and the mechanism of it. Methods Mouse pancreatic β cells(NIT-1)were treated with different concentrations of ghrelin.NIT-1 cells proliferation was measured by MTT incorporation assay,and the cell cycle was measured by Flow Cytometry,and the expression of ERK1/2 and the level of ERK1/2 phosphorylation were determined by Western blot assay.Results With the increase of concentration and the time of treatment,ghrelin promotes cell survival of pancreatic β cells.The S-phase portion was changed after treatment of ghrelin on NIT-1 for 48 hours.The S-phase percentage in the groups where ghrelin concention change from 0 tO 10-9,10-8,10-7 mol/L were(34.5±6.5)%,(42.1±7.4)%,(50.6±5.8)%,(71.4±9.4)%,respectively.Ghrelin also induces phesphorilation of ERK1/2 in NIT-1 cell,and a doseeffect relationship was demonstrated.Conclusion Ghrelin could promote proliferation of pancreatic β cells through activating the MAPK/ERK1/2 signaling pathway and changing the cell cycle.

Due to lack of the practical technique to measure the biomechanical properties of the ocular cornea in vivo, clinical ophthalmologists have some difficulties in understanding the deformation mechanism of the cornea under the action of physiological intraocular pressures. Using Young's theory analysis of the corneal deformation during applanation tonometry, the relation between the elasticity moduli of the cornea and the applanated corneal area and the measured and true intraocular pressures can be obtained. A new applanation technique has been developed for measuring the biomechanical properties of the ocular cornea tissue in vivo, which can simultaneously acquire the data of the applanation area and displacement of the corneal deformation as well as the exerted applanation force on the cornea. Experimental results on a rabbit's eyeball demonstrated that the present technique could be used to measure the elasticity moduli and creep properties of the ocular cornea nondestructively in vivo.
Animals ; Biomechanical Phenomena ; Cornea ; Elastic Modulus ; Intraocular Pressure ; Muscles ; Rabbits ; Tonometry, Ocular

Objective To investigate the value of initial absolute lymphocyte counts (ALC) in predicting the prognosis of children with primary immune thrombocytopenia(ITP).Methods The initial clinical data of 214 children with incipient ITP were retrospectively analyzed and followed up for more than one year.Statistical analysis was made to find out the influence factors for the prognosis of patients with ITP in children to evaluate the predictive value of ALC on assessing the prognosis of ITP in children,and to analyze the association between ALC and outcomes and the clinical value of prognostic stratification.Results The remission rate of children with ITP was 71.5％ in 12 months.Multivariate unconditioned Logistic analysis showed that disease duration,the infection history,response to treatment and ALC were independent risk factors for chronic ITP(all P ＜ 0.05).Cutoff value of initial ALC was 3.005 × 109/L,sensitivity and specificity of value were 71.9％,83.6％.Three months and 12 months no remission rate of ITP in children between ALC ＞ 3.005 × 109/L and ≤ 3.005 × 109/L had statistical significant difference (24.2％ vs 64.9％,8.3％ vs 54.2％,x2 =42.13,P ＜0.001).There was no statistical difference in therapy efficacy between 2 groups(x2 =5.098,P ＞ 0.05).Remission rate between the ≤5 years old group and ＞ 5 years old group was statistical difference based on age stratification(x2 =22.371,22.177,all P ＜ 0.01).ITP in children were stratified into low risk group,intermediate risk group,high risk group based on the initial ALC and infection history,with remission rates in 3 month respectively 75.8％,54.1％,22.8％,respectively,and 91.6％,68.4％,31.6％ in 12 months,respectively;there were statistically significant differences (x2 =44.867,68.802,all P ＜ 0.001).Conclusions Initial ALC is an independent effecting factor in the prognosis of children with ITP.Initial ALC could be used for stratifying patients with the infection history before 6 weeks and supposed to be a predictive index for the prognosis of ITP in children.

Objective To explore the expression of chemerin and chemerin receptor ( chemokine-like receptor 1, CMKLR1) during different periods of non-alcoholic fatty liver disease ( NAFLD) rat model induced by methionine- and choline-deficient ( MCD) diet. Methods Thirty-six Wistar rats were divided into control group and MCD group in random. After one week quarantine and acclimation period, these two groups were fed either normal chow or MCD diet. The animals were respectively sacrificed at the first week, the forth week, and the tenth week. The levels of alanine transaminase (ALT), blood lipid profile, liver function, and the content of triglyceride in liver were detected. HE staining was done to observe the morphologic change of liver. The mRNA expression changes of chemerin and CMKLR1 in liver were measured using real-time PCR, and the change in chemerin mRNA level was further confirmed in liver by Northern blot. Finally, the concentration of chemerin in serum was measured by Western blot. Results The mRNA level of chemerin decreased significantly after four and ten weeks MCD feeding, although no obvious changes were found at first week, similar changes were found in serum chemerin (1.00±0.11 vs 0.96±0.39; 1.00±0.12 vs 0.21 ±0.77; 1.00±0.42 vs 0.21 ±0. 11). Contrasting with the change of chemerin(1.00±0.08 vs 0.72±0.10;1.00±0.24 vs 0.63±0. 31 ;1.00±0.05 vs 0.50±0.13), the mRNA level of CMKLR1 increased after MCD feeding( 1.00±0. 14 vs 0. 84±0. 26; 1.00±0. 38 vs 1. 51 ±0. 33; 1. 01 ±0. 13 vs 1. 84 ± 0. 39 ). Conclusion The change of chemerin and its receptor may participate in the process of the nonalcoholic fatty liver disease.

Objective To investigate the effects of alcohol on hepatitis C virus( HCV) replication and type I interferon signaling pathway in human hepatocytes .Methods Primary hepatocytes were treated with different concentrations of alcohol , and then infected with HCV .The infected cells were collected to measure the level of HCV RNA .The alcohol-treated hepatocytes were also collected to detect the expression of HCV Core, IFN-α, IFN-β, IRF-7, suppressor of cytokine signaling SOCS-2 and SOCS-3 at mRNA and protein levels by real-time quantitative PCR and ELISA or Western blot , respectively .Results Alcohol treatment enhanced HCV infection and replication in primary hepatocytes at concentrations higher than 10 mmol/L in a dose-dependent manner (P<0.05).Treatment with 40 mmol/L of alcohol significantly reduced the expression of IFN-α, IFN-βand IRF-7 at mRNA and protein levels , and increased the expression of SOCS-2 and SOCS-3 at mRNA and protein levels .Conclusion Alcohol treatment could damage the host in-nate immunity in human hepatocytes and promote HCV replication by reducing the expression of type Ⅰinter-feron ( IFN-αand IFN-β) and IRF-7 and increasing the expression of negative regulators including SOCS-2 and SOCS-3.These results demonstrated that the impairment of innate immunity in liver of alcohol abusers might contribute to the enhancement of HCV infection and result in poor therapeutic effect of IFN -α.

Objective To study the phylogenetic evolution and genetic variations of gag gene among the prevalent human immunodeficiency virus (HIV )‐1 strains in Guangxi Zhuang Autonomous Region . Methods Plasma samples of 158 HIV‐1 infected patients in Guangxi area were collected during October 2011 to March 2012 .The gag gene fragments of HIV‐1 were amplified by reverse transcription/nested‐polymerase chain reaction and then sequenced .MEGA 5 .03 was utilized to construct phylogenetic tree and to calculate the genetic distances and selection pressures (globle ω) of gag gene and its coding regions . The comparisons between two groups were tested by Student′s t test ,and the comparisons of multiple groups were tested by one‐way ANOVA .Results A total of 140 amplification products of gag gene were obtained from 158 samples .Four subtypes of HIV‐1 were found ,including CRF01_AE (80 ,57 .1% ) , CRF08_BC (46 ,32 .9% ) ,CRF07_BC (10 ,7 .1% ) ,and subtype B (B′) (4 ,2 .9% ) .The genetic distances of gag gene of the above subtypes were 0 .036 ± 0 .001 ,0 .031 ± 0 .002 ,0 .043 ± 0 .003 and 0 .102 ± 0 .006 ,respectively ,with statistical significance (F=220 .62 ,P<0 .01) .The p17 and p24 coding regions suffered negative selection pressure (globleω<1) .Neither the globle ω in p17 region nor that in p24 region had significant differences among different subtypes (F=0 .761 ,P=0 .469 and F=0 .037 ,P=0 .964 , respectively ) . Conclusion CRF01_AE is the major subtypes of HIV‐1 in Guangxi Zhuang Autonomous Region .The coding regions of gag gene are relatively conserved during evolution .Changes of HIV‐1 prevalence ,however ,may affect the genetic variation of gag gene ,which should be continuously monitored .

Objective: To probe the incidence and risk factors for thrombosis in Chinese immune thrombocytopenia through a retrospective analysis of the inpatients referred to the Blood Disease Hospital, CAMS & PUMC. Methods: A retrospective survey of 3 225 patients with ITP from October 2005 to December 2017 was performed, the clinical data of the patients with thrombosis were collected to analyze the causes, diagnosis, treatment and prognosis. Results: A total of 46 patients experienced a thrombotic event with a prevalence of 1.43%(46/3 225 cases) with the median age of thrombosis as 54 years (26-83) years, the prevalence of thrombosis was 3.37% (40/1 187 cases) in>40 years old, which was significantly higher than 0.58% (6/1 030 cases) in those under 40 years old, in adults (P=0.00). There were 20 males and 26 females, there was no statistical difference in the incidence of thrombosis between males and females[1.53% (20/1 309) vs 1.36% (26/1 916), P=0.187]; The prevalence of arterial thrombosis was 1.12% (36/3 225) higher than venous thrombosis[0.22% (7/3 225), P=0.00]when 82.61%(38/46 cases) of patients with PLT<100×10⁹/L. Post-splenectomy are risk factors for thrombosis in ITP patients, P values was 0.022, There was no statistical difference in the presence or absence of thrombotic events whether received glucocorticoid or TPO/TPO-Ra treatment, the P values were 0.075 and 0.531, respectively. Conclusions In Chinese population, ITP disease maybe with a higher risk of thrombosis, there was no positive correlation between thrombosis and platelet level; and had obvious age distribution characteristics. The history of tobacco, hypertension, diabetes and post-splenectomy are risk factors for thrombosis in ITP patients.

Objective: To investigate the safety and efficacy of eltrombopag for adult patients with chronic immune thrombocytopenia (cITP). Methods: It was a randomised, single-centre, 6 weeks, placebo-controlled study. Beginning in January 29^th, 2013, 35 patients were enrolled, and the trial was completed on May 16^th, 2014. 17 patients were assigned to receive eltrombopag (starting dose 25 mg/d) and 18 were assigned to receive placebo. Results: A total of 35 cases of adult cITP, 6 males and 29 females with a median age of 42(22-66) years were enrolled. One patient withdrew from eltrombopag treatment group for the adverse event (AE) and discontinued treatment. In first two weeks, 27.78% (5/18) of placebo-treated compared with 64.71%(11/17) of eltrombopag-treated patients achieved platelet counts ≥ 30×10⁹/L(P=0.031); Treatment 6 weeks, the proportion of platelet counts reached ≥50×10⁹/L and ≥ 30×10⁹/L in eltrombopag-treated were higher than placebo-treated ones with statistically significant differences in both groups [64.71%(11/17) vs 11.11% (2/18), P=0.001; 76.47% (13/17) vs 38.89% (7/18), P=0.028]; The study also indicated a statistically significant difference in favour of eltrombopag compared with placebo in the odds of achieving the outcome of a platelet count ≥ 50×10⁹/L at least once during 6-week treatment (94.11% vs 33.33%, P<0.001), and 70.59%(12/17) of patients with the platelet count continuously ≥ 50×10⁹/L in 50% of treatment time in eltrombopag-treated group was more than placebo-treated one [11.11%(2/18), P<0.001]. Proportions of patients who required rescue treatment were 44.44% in placebo group and none in eltrombopag-treated one, respectively (P=0.002); The odds of bleeding symptoms with the WHO bleeding scale had no difference in both groups after 6 weeks (P=0.066). Adverse events that occurred more frequently due to eltrombopag than placebo included increased transaminase (3/17) and blood bilirubin (5/17), cerebral infarction(1/17). Conclusions The thrombopoietin receptor agonist eltrombopag was a suitable therapeutic option for Chinese adults with cITP.