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 .

Objective To investigate the value of hysteroscopy combined with B-ultrasonography in the diagnosis and treatmeant of early cornual pregnancy (within 7 weeks of pregnancy). Methods A total of 28 cases of early cornual pregnancy diagnosed and treated by hysteroscopy combined with B-ultrasonography from January 1999 to December 2004 were analyzed retrospectively. Results The operation were carried out successfully on one session in 27 cases, while placental remnants were found after the second curettage in 1 case, in which after an injection of methotrexate was given under hysteroscope, the serum ?-HCG decreased to a normal level 2 week later. No intra- or post-operative complications were recorded. Follow-up observations for 4~36 months (mean, 20 months) in the 28 cases found 6 cases of pregnancy out of 11 patients with childbearing demand. Conclusions Hysteroscopy combined with B-ultrasonography in the diagnosis and treatment of early cornual pregnancy is a preferable method with advantages of highly efficacy, safety and mini-invasion.

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 understand the molecular aberration at whole genomic level,CGH (comparative genomic hybridization) was used to investigate genetic abnormality in lung cancer.Methods Comparative genomic hybridization was performed in 17 cases to detect the global genomic aberration in cancer tissue cells.Results All of 17 cases detected by CGH showed chromosomal aberrations.The average numbers of chromosomal gains and losses in each case were 7.0 and 4.8 in NSCLC and 8.4 and 9.6 in SCLC,respectively.The frequency of gains and losses on chromosome had no significant differences between NSCLC and SCLC.The frequencies of gains on chromosomal arms 3q24 -28 and 11q13(58.3％ and 58.3％ ) in NSCLC were significantly higher than that in SCLC(0％ and 0％ ) ( P ＜0.05 and ＜0.05,respectively).Conclusions The cytogenetic aberration generally existed in lung cancer cells.Several regions ( more than one) of chromosomal aberration were involved in the carcinogenesis of NSCLC and SCLC.The regions and frequencies of chromosomal aberration in NSCLC were somewhat different from that in SCLC,which might result in the different biological behavior of the two types of lung cancer.The chromosomal aberration might be served as a marker to differentiate the two types of lung cancer.

Objective:To observe the relationship between carotid intima-media thickness (CIMT) and hemoglobin A1c (HbA1c) control in type 2 diabetes mellitus (T2DM) patients.Methods:328 cases with T2DM were selected from the endocrinology department of our hospital.All patients underwent assessment,biochemical test and CIMT measurement.According to the value of CIMT,patients were divided into normal CIMT group (＜0.9 mm) and abnormal CIMT group (＞0.9 mm).A multi-factor Logistic regression was performed to analyze the risk factors associated with the abnormal CIMT.Results:(1) Among the 328 T2DM patients,154 cases had normal CIMT and 174 cases had abnormal CIMT.(2) Pearson correlation analysis indicated that the cholesterol and HbA1c levels were positively correlated with CIMT (P＜ 0.05).(3) Univariate analysis showed that the incidence of CIMT was associated with age (t=4.132,P=0.041),systolic blood pressure (t=8.456,P＜0.01),HbA1c≥ 9.0％ (x2=9.912,P＜0.01),cholesterol 0=5.549,P=0.018),triglyceride (t=6.592,P=0.008),UA(t=9.618,P＜0.01),fasting plasma glucose (t=4.592,P=0.037).(4) Multi-factor Logistic regression indicated that age,systolic blood pressure,cholesterol and HbA1c≥ 9.0％ were the independent risk factors for the onset of CIMT (P ＜0.05).Conclusions:The level of HbA1c in T2DM patients was associated with CIMT;And HbA1c≥ 9％ was the independent risk factors for the increase of CIMT.

Objective To analyze the influence of ligaments surrounding sacroiliac joints (SIJs) on stability of SIJs by finite element method. Methods The finite element lumbar spine-pelvis-femur model was established. Based on this normal model, all SIJ ligaments in both sides were removed in turn, to establish models without iliolumbar ligaments, sacroiliac anterior ligaments, sacroiliac posterior ligament, sacrotuberous ligaments, sacrospinous ligaments, sacroiliac interosseous ligaments, respectively. The models were used to simulate physiological motions of the spine. The range of motion (ROM) and average stress on the left and right SIJs were analyzed and compared with the normal models. Results Compared with the normal SIJ model, no significant differences in the ROM of bilateral SIJs were found in the models without sacrotuberous ligaments, sacrospinous ligaments and sacroiliac posterior ligaments; for the model without acroiliacinterosseous ligaments, there was no significant difference in the ROM of the left SIJs under spinal right rotation and ROM of the right SIJs under spinal extension, but the ROM of bilateral SIJs increased significantly under the other spinal physiological activities. Under the physiological activities of the spine, the average stress of the SIJ surface in the left and right sides of the model without acroiliacinterosseous ligaments significantly decreased. Conclusions Of all the sacroiliac ligaments, the sacroiliac interosseous ligaments showed the maximum influences on the stability of SIJs. The research findings are helpful to investigate the mechanism of SIJ subluxation and provide certain theoretical basis for clinical treatment of SIJ subluxation.

Objective:To evaluate the effect of peripheral defocus soft contact lenses (PDSCLs), single-vision spectacles and single-vision contact lenses (SVCLs) on the progression of myopia in children and adolescents.Methods:A meta-analysis was conducted.To collect relevant studies on the myopia control effect of PDSCLs in children, English databases including PubMed, Medline, Embase and Cochrane library were searched with myopia, contact lens, children, adolescents, myopia progression, axial length, refractive error and relevant free English terms as key words.Chinese databases including CNKI, Wanfang and VIP were searched with corresponding Chinese phrases and relevant free Chinese terms as key words.Randomized controlled trials (RCTs) on the myopia control effect in children and adolescents, with PDSCLs wearer as experimental group and single-vision spectacles or SVCLs wearer as control group, were independently collected by two researchers.Quality of included studies was evaluated with the Cochrane tool to assess risk of bias for RCTs.Combined effects of change in refraction and axial length between experimental and control groups was calculated by weighted mean difference (WMD) and 95%confidence interval ( CI). The heterogeneity of included studies was evaluated by I2 statistic.The refraction and axial length of experimental and control groups were compared by Z test.Myopia control effect of different PDSCLs add powers was analyzed by subgroup analysis.The experimental data with add power ≤+ 2.00 D, low aberration and low depth of focus were assigned to low-medium add power subgroup, and the experimental data with add power >+ 2.00 D, high aberration and high depth of focus were assigned to high add power subgroup. Results:A total of 378 publications were retrieved.Finally, 10 high-quality RCTs and 14 groups of data were included in this meta-analysis.In these studies, 1 645 myopic children aged from 6 to 18 years were enrolled, including 808 cases in experimental group and 837 in control group.The follow-up ranged from 10 to 36 months.Among the 10 studies, there were two crossover trials without a washout period, so only the first intervention results were included.According to the meta-analysis, the change in refraction in experimental group was significantly less than that in control group (WMD=0.22 D, 95% CI: 0.15-0.30, Z=5.65; P<0.05). The change in axial elongation was significantly less in experimental group than control group (WMD=-0.10 mm, 95% CI: -0.12--0.09, Z=12.28; P<0.05). Subgroup analysis showed that the WMD of refraction change and axial elongation between experimental and control groups were 0.21 D (95% CI: 0.10-0.31) and-0.10 mm (95% CI: -0.13-0.08) in the low-medium add power subgroup, respectively, and were 0.26 D (95% CI: 0.13-0.38) and -0.13 mm (95% CI: -0.15--0.10) in the high add power subgroup, respectively. Conclusions:PDSCLs have better myopia control effect than single-vision spectacles and SVCLs in children and adolescents.When the add power is higher, PDSCLs can slow the progression of myopia more effectively.

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.

OBJECTIVE：To study the toxic effect of the extract from Tripterygium hypoglaucum on pregnant animal and embryo-fetal development . METHODS ：Successfully mated New Zealand female rabbits were randomly divided into solvent control group，positive control group （cyclophosphamide，20 mg/kg）and T. hypoglaucum extract high-dose ，medium-dose and low- dose groups（15.0，7.50，3.75 g/kg，by the amount of crude drug ）according to their body weight ，with 18 rabbits in each group at least. The female rabbits in solvent control group and T. hypoglaucum extract groups were given water or the corresponding T. hypoglaucum extract solution from 6th to 18th day of pregnancy ，5 mL/kg，once a day. Positive control group was given cyclophosphamide subcutaneously into the neck from 10th to 13th day of pregnancy ，1 mL/kg，once a day. According to the related requirements of Technical Guidelines for the Study of Drug Reproductive Toxicity ，the general situation ，body weight ，body weight increase and food intake of female rabbits were observed and recorded during the experiment ，and euthanasia was carried out on 28th day of pregnancy ；the relative indexes of main organs ，fetal uterus ，placenta uterus ，placenta，ovary，implantation gland ， absorption fetus ，stillbirth，live fetus and corpus luteum were observed and recorded after anatomy ；the relative indexes of body weight，appearance，visceral and skeletal alterations of the fetus were detected . RESULTS ：Compared with solvent control group ， the body weight ，body weight increase ，food intake ，main organs ，pregnancy of pregnant rabbits ，as well as reproductive function，embryo formation ，fetal growth and development ，appearance，visceral and skeletal development indexes in T. hypoglaucum extract groups had no significant abnormal changes （P＞0.05）；above indexes in the positive control group had significant changes （P＜0.05），and significant maternal toxicity and embryotoxicity were found. CONCLUSIONS ：T. hypoglaucum extract 15.00-3.75 g/kg（by the amount of crude drug ）have no significant maternal toxicity ，embryotoxicity or fetal development toxicity to New Zealand rabbits.