Objective To understand the vision functioning related quality of life in rural residents of Shanxi province,and explore its related factors.Methods By using a multi-stage stratified cluster sampling method,237 rural residents from four township of Shanxi Province were conducted a questionnaire survey of vision functioning related quality of life.Using single factor and multiple factor regression model,the factors related to vision functioning related quality of life were explored.Results There were effective survey of 223 people,including 65 males (29.10％) and 158 females (70.9％).The age of residents was (35.8 ±14.2) years old.As the three aspects of vision functioning related quality of life (general health and vision acuity,grades of activity disabilities,reflections of vision problems) scores were 70.87 ± 17.19,91.56 ±9.13,85.20 ± 19.73 respectively.The visual functioning of general health and visual acuity scores and ophthalmic use and ocular history was negatively correlated; grades of activity disabilities scores and family history and history of drug was negatively correlated; reflections of vision problems scores were negatively correlated with age,but positivley related with mental state.Conclusion Vision functioning related quality of life is related with multiple factors,including age,ophthalmic use,ocular history,medication history,family history of ocular disease,and state of mind can affect vision functioning related quality of life score.Health education need strengthen to the residents according to the actual situation.

Background Different depthes or distances are prompted with many visual cues on the flat screen.Which kind of depth cues plays a major role in the accommodation of human eyes,in addition,whether this effect exists in the different distance are still below understood.Objective This study was to research the effect of the monocular space depth perception on accommodative response at different distances,and to analyze the effect of linear perspective and size-constancy perceptual depth cues on the level and amplitude of accommodative fluctation.Methods Four groups of visual targets were designed by FLASH software and placed at the front of eyes with the distance of 50 cm or 33.3 cm,representing static change from far to near and dynamic change from far to near,from near to far respectively.Twenty-six healthy volunteers aged 22-26 years were included in this study,with the spherical power of (-4.06± 1.99) D and cylindrical power of (-0.38±0.41) D under the informed consent.The accommodative response and accommodative fluctuations during monocularly watching the targets were recorded at 5 times/second by Grand Seiko WAM 5500 automatic infrared refractor.This study was approved by Ethic Committee of Wenzhou Medical University,and written informed consent was obtained from each subject before entering the study group.Results At the distance of 50 cm,the accommodative response caused by the depth perception of near was (1.52±0.46) D,the one of distance was (1.37±0.46) D,with a significant difference of 0.15 D under the combined effect of linear perspective and size-constancy (P =0.016).The accommodative response caused by the depth perception of big car was (1.43 ± 0.35) D,and the one of small car was (1.43 ± 0.36) D,without statistically significant difference under the effect of size-constancy alone (P =0.467).At the distance of 33.3 cm,the accommodative response caused by the depth perception of near was (2.40±0.53)D,and the one of distance was (2.35 ±0.51) D,without significant difference under the combined effect of linear perspective and size-constancy (P=0.379).The accommodative response caused by the depth perception of big car was (2.38±0.48)D,the one of small car was (2.39±0.52)D,without statistically significant difference under the effect of size-constancy alone (P =0.820).In addition,the total curve of accommodative microfluctuation showed apparent fluctuation periodically caused by the distance perception involving linear perspective only.Conclusions Monocular space depth perception has some impacts on the accommodative response at certain distance.Linear perspective,which is one of the depth cues of space perception,plays a major role in the accommodative response.Compared with the size-constancy,linear perspective can provide depth perception at higher level.The size-constancy has a little or contrast impact to the accommodation,because it depends on the assistance from other depth cues like linear perspective.

Traditional Chinese medicine placebo has been put more and more attention to. However, there is no ac-cepted quality evaluation method for TCM placebo. How to evaluate TCM placebo objectively and quantitatively is a common problem in the industry of Chinese medicine. New technologies such as the Intelligent Sensory Technique have been used to establish the placebo evaluation methods which are suitable for TCM characteristics. This article provided the basis for establishing scientific, rational and objective evaluation guiding principles for TCM.

Objective· To investigate the clinical features of macrophage activation syndrome (MAS) associated with adult-onset Still's disease (AOSD),and provide the basis for clinical diagnosis and treatment of the disease.Methods· The clinical data of 42 patients with AOSD,including 14 patients with AOSD-induced MAS (the MAS group) and 28 AOSD patients paired by age and sex (the non-MAS group),diagnosed in Department of Rheumatology,Renji Hospital,Shanghai Jiao Tong University School of Medicine from October 2013 to June 2016 were collected and then retrospectively analyzed.Results· There was no significant difference in age,sex and duration of AOSD between two groups.The mortality rate of patients in MAS group was significantly higher than that of patients in non-MAS group,as well as the rates of rash,splenomegaly and hemophagocytosis.The levels of ALT and serum ferritin in MAS group were higher than those in non-MAS group,while the level of FDP is lower.Glucocorticoids were used in all 42 patients,and the dosage of glucocorticoids was significantly higher in MAS group than non-MAS group.Only 1 patient with AOSD-induced MAS received MTX,the percentage of patients receiving MTX was significantly lower in MAS group than non-MAS group.Five patients with AOSD-induced MAS received IVIG,the percentage of patients receiving IVIG was significantly higher in MAS group than non-MAS group.Two patients with AOSD-induced MAS received VP-16.Conclusion · The mortality rate of patients in MAS group was significantly higher than that of patients in non-MAS group,as well as the rates of rash,splenomegaly and hemophagocytosis.The levels of ALT and serum ferritin in patients with AOSD-induced MAS were higher than patients without MAS,while the level of FDP was lower.Early diagnosis and active treatment is the key point to improve clinical outcome.

AIM: To observe the effect of osthole on tricalcium phosphate (TCP) particles-induced calvarial osteolysis in vivo.METHODS:Male ICR mice were randomly divided into sham group , TCP group and osthole group .A mouse calvarial model of osteolysis was established by TCP particles .On the second postoperative day , osthole (20 mg/kg) was locally injected into the calvarium under the periosteum 3 times a week.Two weeks after osthole treatment , blood and calvaria were collected to determine the level of bone turnover markers such as alkaline phosphatase ( ALP) , osteocalcin and tartrate-resistant acid phosphatase ( TRACP) .The periosteum was performed to examine the release of tumor necrosis factor-α(TNF-α), interleukin-6 (IL-6) and IL-1βby ELISA.The calvaria was obtained for histological and molecular analyses.RESULTS:Data from HE and TRACP staining revealed that osthole prevented TCP particles-induced obvious increase in osteoclastogenesis and resorption area in the metaphysis of mouse calvaria .Osthole treatment increased ALP ac-tivity and osteocalcin level , and dncreased the activity of TRACP in the mouse serum compared with TCP group .Further-more, TCP particles-induced the releases of TNF-α, IL-6 and IL-1βwere significantly suppressed by osthole treatment .In addition, Western blot demonstrated that endoplasmic reticulum ( ER) stress markers such as glucose-regulated protein 78 (GRP78) and CAAT/enhancer binding protein homologous protein (CHOP) were significantly up-regulated in TCP parti-cles-implanted calvarial mice , indicating that TCP particles triggered an ER stress response in the mouse calvarial osteolysis model , which obviously attenuated by osthole .CONCLUSION:Osthole inhibits TCP particles-induced calvarial osteolysis in mice, which is mediated by inhibition of ER stress signaling pathway .

Objective To understand environmental quality status of clean operating rooms in municipal hospitals of Xi’an,and provide reference for ensuring the clean quality of operating rooms.Methods On-site specimen collec-tion and detection were conducted to detect and analyze the cleanlinss of air in clean operating rooms in 15 hospital of Xi’an.Results A total of 51 operating rooms were monitored,secondary and tertiary hospitals had 24 and 27 operating rooms respectively;26 were grade-I and 25 were grade-Ⅲ operating rooms.The qualified rates of dust particle≥0.5μm/particle size in grade-I and grade-Ⅲ clean operating rooms were 76.92% and 80.00% respective-ly,≥5μm/ particle size were 73.08% and 88.00% respectively.The qualified rates of dust particle counts in grade-I and grade-Ⅲ clean operating rooms were 61 .54% and 80.00% respectively,difference was not significant(χ2=2.092,P >0.05 ).The qualified rate of dust particle counts in clean operating rooms in tertiary hospitals was significantly higher than secondary hospitals(85.19% vs 58.33%,χ2 =4.600,P <0.05 ).The qualified rates of airborne microbes in operating zone of secondary and tertiary hospitals were 87.50% and 92.59% respectively(P >0.05),in surrounding zone were 95.83% and 92.59% respectively (both P >0.05).Conclusion Dust particle and airborne microbes in some clean operating rooms in municipal hospitals of Xi’an are beyond the standard,supervi-sion and management should be strengthened.

Objective To understand the current situation of pressure steam sterilization in medical institutions in Xi'an city,and provide reference for the monitoring and quality control of pressure steam sterilization.Methods Central sterile supply departments(CSSDs) in medical institutions in Xi'an in 2012-2014 were investigated.Physical,chemical,and biological monitoring methods were used to evaluate the pressure steam sterilizers.Results A total of 135 medical institutions in Xi' an were monitored,including 40 tertiary medical institutions and 95 secondary and below medical institutions.A total of 540 specimens were collected,454 were qualified,overall qualified rate was 84.07 ％.Qualified rate of monitoring result of pressure steam sterilization of tertiary medical institutions was higher than secondary and below medical institutions(93.13 ％ vs 80.26 ％,x2 =13.91,P＜0.01).Qualified rates of chemical PCD and biological test pack of tertiary as well as secondary and below medical institutions were 100％ and ＞90％ respectively.The qualified rate of recoded temperature in secondary and below medical institutions was 88.42 ％,but actually measured temperature was 38.95 ％,which was significantly lower than 72.50 ％ of tertiary medical institutions(x2 =12.68,P＜0.01).The rates of the measured temperature＞ 134℃ of pressure steam sterilizer in each year were all low,but measured temperature＜132℃ was about 50.00 ％,difference between actually measured temperature and recorded temperature was-4℃-1 ℃,difference between-2.5 ℃-0.5℃ accounted for 80.00％,the main unqualified temperature was 130℃-131 ℃,accounting for 82.61 ％.Conclusion Efficacy of pressure steam sterilization is different in different levels of medical institutions in Xi'an,physical monitoring measures are not standardized,the supervision of physical parameters in key sectors should be strengthened to ensure the sterilization quality of medical institutions and reduce the occurrence of iatrogenic infection.

Objective To compare the outcomes of in-vitro maturation (IVM) and in-vitro fertilization (IVF) after early follicular phase gonadotropin-releasing hormone agonist (GnRH-a)down-regulation in infertile patients with polycystic ovary syndrome (PCOS).Methods From July 2010 to December 2012,72 infertile patients with PCOS undergoing assisted reproductive technology treatment in the Affiliated First Hospital of Wenzhou Medical University were enrolled in this study.The patients were divided into 2 groups,which were patients with early follieular phase down-regulation IVM (36 cases) at IVM group and early follicular phase down-regulation long protocol IVF (36 cases) at IVF group.The laboratory parameters and clinical outcomes were compared between two groups.Results (1) Lab parameters:a total of 442 oocytes were retrieved in group IVM,and 560 were in group IVF.The rate of mature oocytes of 83.8％ (469/560) and high-quality embryos of 70.9％ (212/299) at group IVF were significantly higher than that of group IVM [54.1％ (239/442) and 50.7％ (73/144),retrospectively,P ＜0.01].In group IVM,the average duration of gonadotropin (Gn) was (2.8 ± 1.5) days and the average dosage of Gn was (285 ± 169) U,which were significantly lower than (11.0 ± 1.0) days and (1499 ±165) U in group IVF (P ＜0.01).The mean number of oocytes retrieved 12.8 ± 2.5,fertilization rate of 64.8％ (155/239),and implantation rate of 31％ (23/74) in group IVM and 15.6 ±3.1,65.5％ (307/469),31％ (23/74) in group IVF,which did not reach statistical difference (P ＞0.05).(2) Clinical outcomes:the clinical pregnancy rate (17/31,55％) of IVF group was not significantly higher than that 44％ (14/32) at IVM group (P ＞ 0.05).The abortion rate was 1/17 at Group IVF and 1/14 in group IVM,which did not show statistical difference.Women at IVM group has no ovarian hyper-stimulation syndrome (OHSS) cycle,group IVF has 31％ (11/36) cycles presented moderate and severe OHSS.Conclusions Infertile patients with PCOS undergoing IVM and IVF treatment after early follicular phase GnRH-a down-regulation can get satisfactory laboratory and clinical outcome.In addition to short treatment cycle,IVM can also avoid the occurrence of OHSS completely,but it has a rising trend in the abortion rate.IVF has a high incidence of OHSS,meanwhile,it increases the dosage of gonadotropins.

Objective To compare the laboratory and clinical results between unstimulated in vitro maturation (IVM) and IVM converted from in vitro fertilization (IVF) in polycystic ovarian syndrome (PCOS) and non-PCOS patients.Methods We divided 591 IVM cycles in the First Affiliated Hospital of Wenzhou Medical Univesity from Jan.2008 to Dec.2013 into 4 groups:group A1B1,PCOS patients underwent unstimulated IVM protocol,240 cycles; group A1B2,PCOS patients underwent IVM converted from conventional stimulated IVF protocol,153 cycles; group A2B1,non-PCOS patients underwent unstimutlated IVM protocol,103 cycles; group A2B2,non-PCOS patient underwent IVM converted from conventional stimulated IVF protocol,95 cycles.Multiple linear regression method and binary logistic regression method were used to assess the influence of PCOS and protocols for IVM on laboratory and clinical outcomes.Results The mean number of oocytes retrieved was positively related with PCOS [partial regression coefficient (B)=3.37,P＜0.01].The maturation rate of oocytes was positively related with hCG-prime prior to oocyte aspiration (B=0.05,P=0.010).High-quality embryo rate was positively related with PCOS and IVM converted from IVF (B=0.08,P=0.010; B=0.09,P=0.001),as well as implantation rate related with them (B=0.07,P=0.010; B=0.10,P＜0.01).PCOS and IVM converted from IVF improved hCG positive (hCG＞10 U/L) rate (OR=1.636,95％CI:1.113-2.204,P＜0.05; OR=1.861,95％CI:1.307-2.649,P＜0.05) and the clinical pregnancy rate (OR=1.507,95％CI:1.041-2.240,P＜0.05; OR=1.881,95％CI:1.312-2.696,P＜0.05).IVM converted from IVF protocol decreased the spontaneous abortion rate (OR=0.490,95％CI:0.245-0.978,P＜0.05).Multiple gestation rate and ectopic pregnancy rate were not affected by PCOS condition and protocol used (P＞0.05).Conclusions PCOS and IVM converted from IVF protocol improved the high-quality embryo rate,implantation rate,hCG positive rate and clinical pregnancy rate.IVM converted from IVF protocol reduced the spontaneous abortion rate.PCOS patients may be more suitable for the IVM treatment.No matter PCOS or non-PCOS patients,IVM converted from IVF protocol had better pregnancy outcome than that of unstimulated cycle.

Objective To investigate the current status of hand hygiene(HH) among health care workers(HCWs) in clinical laboratories in medical institutions in Xi'an City.Methods HH status of HCWs in clinical laboratories in medical institutions in Xi'an was performed random on-the-spot sampling and monitoring.Results A total of 240 HH specimens of HCWs in clinical laboratories in 80 medical institutions in Xi'an City were collected, 127 detected results were qualified, the total qualified rate was 52.92%.The qualified rates of medical institutions were as follows: municipal hospitals 62.67%,workers' hospitals 55.95%,private hospitals 40.74%;comprehensive medical institutions 67.68%,specialized medical institutions 42.55%;tertiary medical institutions 79.63%(n=43),secondary and below medical institutions 45.16%(n=84),there were significant differences in HH qualified rate among HCWs in different types of medical institutions(all P<0.01).Of different HH detection items, detection rates of Escherichia coli and Staphylococcus aureus were 0.83% and 8.33% respectively.There were significant differences in HH compliance rates among HCWs of all age groups(χ2=9.103,P<0.05), HCWs aged≥50 years had the highest qualified rate of HH(71.43%), followed by those aged<30 years (67.82%),HCWs in 40~ year age group had the lowest HH qualified rate (39.66%).Conclusion The qualified rate of HH of HCWs in clinical laboratory of medical institutions in Xi'an City is low, it is necessary to enhance the procaution awareness of HCWs in clinical laboratories, strengthen quality control of HH, strictly implement standard hand-washing procedures to reduce occurrence of HAI.