Corneal endothelial transplantation has achieved good results in domestic and foreign clinical applications , which has become the preferred method for treatment of severe corneal endothelial lesion .Corneal endothelial transplantation retained the patients′autologous healthy corneal epithelum , Bowman′s membrane and the strooma , as far as possible to ensure the integrity of the ocular sur-face, reduce the astigmatism.It had some advantages such as small invasiveness , less rejection, and faster visual recovery .Descemet stripping endothelial keratoplasty is the mianstream mode of operation , then the advanced femtosecond laser Descemet′s membrane en-dothelial keratoplasty were developed .We review the development course , operation methods , and complications of corneal endothelial transplantation in this paper .

Background Herpes stromal keratitis (HSK) is a common infectious ocular surface disease,with a higher recurrent rate,especially in necrotizing HSK.The diagnosis of HSK primarily depends on signs and symptoms,and specific laboratory diagnostic is lack.Objective This study was to clarify the expression of herpes simplex virus (HSV) in the corneal epithelium scrapings and tears of necrotizing HSK patients.Methods Thirty eyes of 30 patients with necrotizing HSK were enrolled in Nanjing Hospital of Nanjing Medical Hospital from September 2012 to September 2013 under the patient's informed consent.The eyes were examined by slit lamp microscope and scored.HSK patients received local and systemic therapy for 8 weeks and then an oral maintenance dose for 6 months.Corneal epithelial scrapings and tears samples were collected for HSV DNA detection by real-time PCR before and the 1 st,2nd,4th,6th and 8th week after therapy respectively.The difference of HSV positive rate was compared between corneal epithelium scrapings and tears samples using Chi-square test.Multilevel mixed effective model was employed to evaluate HSV concentration change in the samples at various time points in the HSV-positive patients of initial visit.The correlation between HSV concentration and clinical score was analyzed by Spearman rank correlation.Results HSV-positive rate was 46.4％ (13/30) in the corneal epithelial scrapings and 13.3％(4/30) in the tear samples,showing a significant difference between them (P =0.006).HSV-positive rate was significantly lower in the corneal epithelial scrapings 1 week,2 weeks and 4 weeks after treatment than before (P =0.001,0.003,0.004),and no HSV was detected 6 weeks and 8 weeks after treatment.No significant change in HSV-positive rate in tear samples in 1 week and 2 weeks after treatment in comparison with before treatment (P =1.000,0.583),and no HSV was detected after 4 weeks following treatment.The HSV concentration was 2460 (2 165-636500)/ml in initial 13 HSV-positive eyes of corneal epithelial scrapings and 0 (0-1150)/ml in initial 13 HSV-positive eyes of tear samples.Multilevel mixed effective model determined that HSV concentration was significantly lower in corneal epithelial scraping than that in tear (P =0.005),and HSV concentration was reduced with the lapse of time (P =0.001),with the faster rate of decline in the corneal epithelial scrapings (P =0.049).A positive correlation was found between initial HSV concentration and clinical scores (rs =0.844,P =0.000).Conclusiors Real-time PCR appears to be a powerful molecular tool for the detection of HSV in the HSK,especially in corneal epithelial scrapings of lesion.The initial positive outcome of viral DNA in corneal epithelial scrapings predicts a severe clinical procedure.

Objective To observe the effects of propylene glycol mannate sulfate(PGMS) on the expression of ICAM-1 and VCAM-1 in kidney of diabetic rats, and explore the protective effect of PGMS on kidney. Methods Diabetes was induced by injecting STZ. Then the rats were randomly divided into four groups: normal control group, diabetic modal group, treatment group with high-dose and low-dose of PGMS. 8 weeks later, the blood glucose concentrations, HbA1c, the ratio of kidney weight to body weight, urinary albumin excretion rate (UAE ) in 24 hours were examined. The ICAM-1 and VCAM-1 located were detected by immunohistochemistry, while the expression of ICAM-1 and VCAM-1 were detected by Western blot method and the levels of ICAM-1 and VCAM-1 mRNA by RT-PCR.Results PGMS could reduce kidney hypertrophy and lower urinary albumin excretion rate (UAE)of 24-hour significantly. Immunohistochemical study with light microscopy demonstrated that the levels, both ICAM-1 and VCAM-1 in the kidney of test groups decreased obviously. PGMS down-regulated the mRNA and protein levels of ICAM-1 and VCAM-1 significantly . A positive correlation between expression of ICAM-1,VCAM-1 and kidney lesion was observed. Conclusion: PGMS decreased the expression of ICAM-1 and VCAM-1 in diabetic rats.

Objective To investigate the relationship between the levels of intedeukin(IL)-6, IL-15 and endometriosis (EM). Method The levels of IL-6, IL-15 in the peritoneal fluid (PF) and serum of 74 patients with EM (EM group) and 46 patients without EM (control group) were measured by double-an-tibody ELISA. Results Higher levels of IL-6 in PF and serum were observed in EM group [(1017.81±361.98) ng/L,(455.47±161.52) ng/L]than those in control group [(284.63±70.50) ng/L,(149.37± 43.09) ng/L], and there was significant difference (P<0.01). The levels of IL-6 in PF and serum in EM group with stage Ⅲ-Ⅳ [(1253.44±189.63) ng/L, (556.50±93.34) ng/L]were significantly higher than those in patients with stage Ⅰ-Ⅱ [(582.81±107.75) ng/L, (268.96±63.48) ng/L](P < 0.01). There was positive relationship between the levels of IL-6 in PF and serum (r=0.950, P=0.01). The levels of IL-15 in PF in EM group [(333.45±63.94) ng/L]were significantly higher than those in control group[(203.85± 70.52) ng/L](P<0.01). No significant difference was found in the levels of serum IL-15 between EM group and control group (P>0.05). No significant difference was observed either in the levels of IL-15 in PF and serum between patients with stsge Ⅲ-Ⅳ and stage of EM Ⅰ-Ⅱ (P>0.05). Conclusions The increase of IL-6, IL-15 in PF may contribute to the development of EM. Serum IL-6 levels are of clinical diagnostic value in patients with EM.

Objective To investigate the effects of Dermatophagoides pteronyssinus ( Der p) on the expression of TLR4 and IL-4 in P815 mast cells and to further analyze the immunoregulatory effects of 1,25-(OH)2D3 on Der p treated P815 mast cells.Methods Different concentrations of Der p and 1,25-( OH) 2 D3 were used alone or in combination to stimulate P815 mast cells.The supernatants of the stimulated cell culture were analyzed by enzyme-linked immunosorbent assay ( ELISA) for the detection of IL-4.The stimulated cells were collected and analyzed by real-time PCR and Western blot assays for the detection of TLR4atmRNAandproteinlevels,respectively.Results (1)TLR4expressionwasdetectedinP815 cells.The expression of TLR4 was enhanced in P815 cells treated with various concentrations of Der p.A significant dose-dependent up-regulation of TLR4 was observed in P815 cells after incubation with Der p for 36 h.(2) Der p promoted the release of IL-4 in P815 cells (P<0.05).(3) No significant differences with the expression of TLR4 and IL-4 were observed among 1,25(OH)2D3 treatment groups as compared with the control group (P>0.05).(4) 10-8 mol/L of 1,25(OH)2D3 promoted the Der p-induced expression of TLR4 in P815 cells (P<0.01).However, 1,25(OH)2D3 inhibited the release of IL-4 in a dose-dependent manner(P<0.05orP<0.01).Conclusion (1)Derpcouldpromotetheinflammationandallergicreac-tion through up-regulating TLR4 and IL-4 in mast cells.(2) The possible mechanism for the inhibitory of 1, 25(OH)2D3 on Der p-induced immune responses was due to the suppression of Th2-type immune responses through inhibiting the synthesis and secretion of IL-4 in mast cells.

Aim To study the effects of smoking and glonoine on intracellular free Ca2+ concentration([Ca2+]i) in vascular smooth muscle cell in rabbits with atherosclerosis,and to explore the effects of smoking on atherosclerosis and biologic action of glonoine.Methods An atherosclerosis in rabbits was produced.The vascular smooth muscle cells were isolated.The cells were loaded by Fluo-3/AM.[Ca2+]i in vascular smooth muscle cell was measured by flow cytometer(FCM).The spatial distribution and the dynamic changes of [Ca2+]i in single vascular smooth muscle cells were determined by laser scanning confocal microscopy(LSCM).Results Atherosclerosis plaques in arteriae aorta were observed and the degrees were different in various groups.[Ca2+]i in vascular smooth muscle cells in rabbits with atherosclerosis markedly increased[(48.45?5.31) vs that in saline control(38.09?2.57),P

Objective To investigate the effect and safety of orthokeratology lens on myopia control in adolescents and children with different diopters.Methods Ninety-three patients(171 eyes)with myopia who received orthokeratology lens treatment in the Affiliated Jiangning Hospital of Nanjing Medical University from February to August 2021 were selected for the study.They were divided into a low degree group(88 eyes,-0.5D to-3.0D)and medium degree group(83 eyes,-3.0D to-6.0D)according to the equivalent spherical lens degree.The naked eye distant vision,diopter,optic axis,breakup time of tear film(BUT),corneal endothelial cell count and complications were compared between two groups.Results After 1 year of lens wear,growth of optic axis in low degree group was significantly greater than that in medium degree group(Z=-2.035,P=0.042).After 1 year of lens wear,naked eye distant vision of both groups was significantly higher than that before lens wear(P<0.05),and increase of visual acuity in medium degree group was significantly greater than that in low degree group(P<0.05).The equivalent spherical degree of two groups was significantly lower than that before lens wear(P<0.05),and reduction of equivalent spherical lens degree in medium degree group was significantly greater than that in low degree group(P<0.05).After 1 year of lens wear,BUT in both groups was significantly shorter than that before lens wear,and corneal endothelial cell count was lower than that before lens wear(P<0.05),but there were no significant differences in BUT and corneal endothelial cell count between two groups(P>0.05).There was no statistically significant difference in complication rate between two groups(χ2=2.000,P=0.157).Conclusion Orthokeratology lens has good control effect and safety for adolescents and children with different diopters,and the effect is more prominent for moderate myopia.

Early childhood caries (ECC) is not only harmful to children's oral cavity and even the whole body, the government and relevant health departments pay more and more attention to the prevention and treatment of early childhood caries. However, at present, the primary treatment for ECC is the traditional filling therapy. The chronic disease management model can conduct regular testing of chronic non-communicable diseases and their risk factors, and provide long-term and effective professional management to patients by supervision and advice by doctors, nurses and pharmacists. This model has a good effect on slowing down the development of the disease, improving the quality of life of patients and saving public health resources. As a common chronic non-communicable disease, ECC is very suitable for prevention and treatment through chronic disease management. In recent years, chronic disease management models have also been increasingly used in the management of caries. The current common chronic disease management models include the chronic care model, innovative care for chronic condition, and British chronic disease management system models. And above models have certain applications in the management of ECC. How to establish the caries risk assessment system suitable for the diagnosis and treatment model of our country, and how to screen the children with high risk of caries by step-by-step prevention and control network for personalized prevention needed to be further studied in the future.

Machine Learning ; Image Processing, Computer-Assisted/methods*