AIM: To analyze the control effect of orthokeratology(OK)combined with atropine of low concentration on moderate to low myopia in adolescents.

METHODS: Totally 76(152 eyes)adolescents with moderate to low myopia who were admitted to the department from January 2016 were enrolled. According to the voluntary principle, they were divided into orthokeratology group(OK group, n=36 cases, 72 eyes)and orthokeratology combined with atropine of low concentration group(combination group, n=40 cases, 80 eyes). The OK glasses were given for the two groups. The combination group was additionally given 0.1g/L atropine eye drops. All were followed up for 1a. The changes of uncorrected visual acuity, diopter, axial length, intraocular pressure, tear film function and corneal parameters were measured before and after wearing glasses. The incidence of complications was statistically analyzed.

RESULTS: There were no significant differences in uncorrected visual acuity, diopter, axial length and intraocular pressure between the two groups before wearing glasses and at 1a of wearing glasses(P>0.05). The change of uncorrected visual acuity before wearing glasses and at 1a of wearing glasses of combination group was higher than that of OK group while the differences in diopter and axial length were lower than those of OK group(P<0.05). Before wearing glasses, there were no significant differences in the lipid layer thickness(LLT), object scattering index(OSI)or tear film rupture time(tear film break-up time, BUT)between the two groups(P>0.05). At 1a of wearing glasses, LLT and BUT of combination group were higher than those of OK group while OSI was lower than that of OK group(P<0.05). Before wearing glasses, there were no significant differences in corneal curvature, corneal thickness or anterior chamber depth between the two groups(P>0.05). At 1a of wearing glasses, the changes of above indexes of combination group were lower than those of OK group(P<0.05). There was no significant difference in the incidence of complications between the two groups(P>0.05).

CONCLUSION:OK glasses combined with atropine of low concentration can improve the uncorrected visual acuity of adolescents with moderate to low myopia, control the increase of diopter and axial length. And there is significant negative influence on corneal morphology and tear film function, and with high safety.

AIM:To explore the effects of femtosecond laser-assisted cataract surgery(FLACS)on corneal astigmatism and surgically induced astigmatism(SIA)value in patients with age-related cataract.

METHODS: Totally 152 cases of age-related cataract patients(233 eyes)admitted to our hospital were divided into the study group(n=70, 107 eyes, given the FLACS)and the control group \〖n=82, 126 eyes, given the traditional phacoemulsification cataract surgery(TS)\〗 according to the economic conditions and voluntary principles. Corneal astigmatism degree and SIA value were compared between the two groups.

RESULTS: The effective ultrasound time, average ultrasound energy, and total operative time in the study group were less than those in the control group(P<0.05). There was no significant difference in the intraocular pressure between the two groups before operation and at 1 and 3mo after operation(P>0.05). The difference in intraocular pressure was statistically significant of the two groups at different time points(P<0.05). The two groups showed a downward trend in intraocular pressure(P<0.05). There were statistically significant differences in the accumulated energy complex parameter(CDE)values of phacoemulsification between the two groups of grade Ⅱ nuclear and grade III nuclear surgery, and the intraoperative CDE value of grade Ⅲ nuclear in the two groups was higher than that of grade Ⅱ nuclear(P<0.05). The difference in visual acuity and best corrected visual acuity between the two groups at different time points was statistically significant(P<0.05). The uncorrected visual acuity and best corrected visual acuity were significantly improved in the two groups(P<0.05). The uncorrected visual acuity and best corrected visual acuity in the study group were better than those in the control group at 1mo after operation(P<0.05), but there was no significant difference at 3mo after operation(P>0.05). There was no significant difference in corneal astigmatism between the two groups and at different time points(P>0.05). There was no significant difference in surgical astigmatism between-groups at 1 and 3mo after operation(P>0.05).The surgical astigmatism at 3mo after operation was lower than that at 1mo after operation(P<0.05). There were significant differences in corneal endothelial cell counts between the two groups at different time points(P<0.05). There was no significant difference in corneal endothelial cell counts in the study group before operation and at 1mo after operation(P>0.05). The corneal endothelial cell counts in control group at 1mo after operation was lower than that before operation(P<0.05). There was no significant difference in the corneal endothelial cell counts between the two groups before operation and at 1mo after operation(P>0.05). The corneal endothelial cell counts in the study group were significantly more than those in the control group at 3mo after operation(P<0.05). The corneal endothelial loss rate was significantly lower in the study group at 1 and 3mo after operation than that in the control group(P<0.05).

CONCLUSION: FLACS can effectively improve the postoperative visual acuity in patients with age-related cataract, and it will not increase the postoperative corneal astigmatism and SIA.

Objective To summarize the clinical features of children with congenital Rett variant caused by mutation of FOXG1 and provide the reference for the diagnosis and treatment of the disease. Methods The clinical data of a patient diagnosed as congenital Rett syndrome variant type were summarized. The DNA samples of peripheral blood from the patient and her parents were extracted. The targeted high-throughput sequencing technology was used to detect the sequence of targeted genes, which were associated with the symptoms of the child. Genes were then verified by sanger sequencing. Chromosomal microarray analysis was performed to detect chromosome microdeletions and microduplications. Results The child carried the c.506dupG, p.G169Gfs＊ 286 heterozygous mutations on FOXG1 gene, which located in 14q12, and her parents were wild-type. After querying the HGMD, Clinvar and dbSNP databases, we found that it was not reported. This case was clearly diagnosed as congenital Rett syndrome variant type. We confirmed that the mutation locus was a new mutation. Conclusion For cases with congenital Rett variant manifestations, FOXG1 gene mutation examination is recommended, and preventive treatment of partially predictable dysfunction should be carried out.

AIM: To investigate the relationship of TNF-α and IL-6 with the pathogenesis and development of the neovascular glaucoma(NVG).

METHODS: Totally 64 eyes of 64 NVG patients, 58 eyes of 58 primary open angle glaucoma(POAG)patients and 56 eyes of 56 age-related cataract(ARC)patients were enrolled in our Hospital from January 2017 to January 2018. The periphery blood was collected from all the patients and 0.3mL aqueous humor was collected during the surgery from each eye. The levels of TNF-α and IL-6 in serum and aqueous humor of the three groups were measured by ELISA.

RESULTS: The concentrations of TNF-α and IL-6 in aqueous humor and serum in NVG patients were higher than those in POAG patients as well as in ARC patients, with significant differences among the three groups(P<0.05). The TNF-α and IL-6 in aqueous humor and serum in NVG patients were significantly positively correlated(r=0.642, 0.415; P<0.05).

CONCLUSION: The aqueous and serum TNF-α and IL-6 are considerably higher in NVG patients than those in POAG patients and ARC patients, suggesting that TNF-α and IL-6 play important roles in the pathogenesis and development of the NVG.

Objective: To investigate the clinical characteristics and the effectiveness of surgical treatment of adrenal cysts. Methods: The clinical data of adrenal cysts in Affiliated Zhangye people′s Hospital, Hexi College from May 2005 to July 2018 were retrospectively analyzed, including clinical manifestations, diagnosis, surgical methods, postoperative pathological results and follow-up process. Seventeen patients with adrenal cysts were identified including 10 males and 7 females. The median age was 45.6 ranging from 30 to 75. There were 12 left lesions and 5 right lesions. Only 4 patients (23.5%) had clinical symptoms, including low back pain, abdominal pain and dizziness caused by hypertension. Ultrasound, CT and MRI were the main imaging methods for preoperative diagnosis. Results: All patients underwent surgical treatment. Laparoscopic surgery was adapted in 14 cases. The average operation time was (70.2 ± 18.5) min and the average bleeding was (47.0 ± 12.1) ml. For open surgery in 3 cases, the average operation time was (103.5 ± 25.0) min and the average bleeding was (85.6 ± 20.5) ml. Postoperative pathological results showed endothelial cysts in 11 cases, epithelial cysts in 3 cases and pseudocysts in 3 cases. No recurrence of cysts or hypoadrenalism occurred in 3-75 months′ follow-up. Conclusions Adrenal cysts are relatively rare and generally benign lesions. Imaging examination, especially abdominal enhanced CT is essential for diagnosis. Laparoscopic surgery is a safe and effective method for the treatment of adrenal cysts.

Objective: To construct indocyanine green-loaded silica nanoparticles (ICG@MSNs) and evaluate their killing effect on cervical cancer HeLa cells. Methods: Mesoporous silica nanoparticles (MSNs) were synthesized by template method, and indocyanine green (ICG) containing photothermal agent was loaded to prepare ICG@MSNs with photothermal effect, which were applied in the research of HeLa cells in vitro. Results: The particle of ICG@MSNs was uniform and in regular spherical shape with the size about 200 nm. ICG@MSNs was similar photothermal effect with pure ICG. Cell endocytosis experiments showed that ICG encapsulated in silica nanoparticles is more likely to be endocytosed by tumor cells, and then played a photothermal role in killing cervical cancer HeLa cells. On the other hand, cytotoxicity experiments showed that under the irradiation of 808 nm laser, ICG@MSNs significantly increased cytotoxicity, which could significantly kill cervical cancer HeLa cells. Conclusion: ICG@MSNs has good stability and biocompatibility, as well as good thermogenesis. It’s photothermal treatment effect on tumor is obvious, which has a good prospect for the treatment of cervical cancer.

AIM: To investigate camera-assisted measurement in evaluating the accuracy of Hirschberg Test in measuring squint angle of concomitant strabismus.

METHODS:The clinical data of 105 patients with concomitant strabismus who were admitted to the hospital during the period from January 2016 to January 2018 were collected. After admission, they were given traditional Hirschberg Test and picture Hirschberg Test for squint angle examination.Taking the prism cover test as golden standard, the deviation values between squint angle measured by golden standard and those measured by the traditional Hirschberg Test and the picture Hirschberg Test were recorded.The influence of Kappa angle on the deviation value was analyzed.The application value of camera-assisted measurement in squint angle of concomitant strabismus was analyzed.

RESULTS:There was a significant difference in the value of squint angle measured by traditional Hirschberg Test, picture Hirschberg Test and prism cover test test(P<0.05), and the squint angle measured byprism cover test test was higher than that of picture Hirschberg Test method(P<0.05), and the angle in picture Hirschberg Test method was higher than that in traditional Hirschberg Test method(P<0.05), and the consistency of picture Hirschberg Test method and prism cover test test in measuring squint angle was higher than that of Traditional Hirschberg Test method(P<0.05).There were significant differences in the deviation values of squint angle measured by traditional Hirschberg Test among the 4 examiners(P<0.05).The deviation values of all examiners measured by traditional Hirschberg Test were higher than those by picture Hirschberg Test(P<0.05).The deviation degree of picture Hirschberg Test was lower than that of traditional Hirschberg Test in terms of the examination of squint angle in patients with positive and negative Kappa angle(P<0.05).

CONCLUSION: The deviation of camera-assisted measurement picture Hirschberg Test is lower than that of traditional Hirschberg Test for the measurement of squint angle of concomitant strabismus, and it is more suitable for young patients who cannot cooperate with.

Objective: To simulate the hypoxic environment of cells in vivo more approximately, a hypoxia control device which can control oxygen concentration automatically for cell culture in vitro was developed. Methods: In vitro cell cultur e hypoxia control device consisted of hardware and software which were controlled by computer. The hardware was composed of oxygen detection and control system, nitrogen gas pipeline, cell culture and anti-jamming device, and the software was based on Clanguage. When oxygen controlle rreads the oxygen concent ration more than the set value, the nitrogen gas pipeline opens and nitrogen enter into the incubator; when reaching the set value, the nitrogen gas pipeline closes and nitrogen is not allowed to pass through. Circularly, a constant oxygen concentration was reached and maintained. This device was further verified by comparing the set value of the equipment with figures of the oxygen meter and by monitoring fluctuation condition after the oxygen concentration reaching the set value. Results : There was no significant difference between the oxygen concentration set in the in vitro cell culture hypoxia control device and the actual oxygen concentration in the measured box (P > 0.05), and the accuracy of the device to set the value of the simulation up to ± 0.5% of the requirements to meet the system accuracy requirements, and can remain stable for a long time. Conclusion The device can effectively control the oxygen concentration to the required requirements, to meet the conditions in the hypoxic conditions for in vitro cell culture.

Objective: The aim of the study was to explore the influencing factors of exercise tolerance in patients with myocardial infarction (MI) after percutaneous coronary intervention (PCI) revascularization in acute state. Methods: A total of 112 patients with first MI undergoing PCI revascularization in acute state and completing cardiopulmonary exercise testing (CPET) were enrolled. Exercise capacity was evaluated by peak oxygen consumption percentage (VO_{2 peak}%) in CPET. Patients were divided into normal exercise capacity (NEC) group (n=40) and abnormal (AEC) group (n=72) according to VO_{2 peak}% value. Clinical manifestations, histories of hypertension and diabetes, medications, coronary arterial angiography and echocardiography findings of patients were compared. The onsets of diabetes and blood glucose levels during the period of CPET were evaluated in the MI patients with diabetes. The patients were followed up for major adverse cardiovascular events (MACE) (admission due to chest pain, re-revascularization, re-infarction and all-cause death) within 24 months after PCI. Multivariate logistic regression analyses were conducted to examine influencing factors for exercise tolerance. Results: The ratio of diabetes, type C lesions in the AEC group were higher than those in the NEC group (diabetes: 37.5% vs. 17.5%; type C lesions: 69.4% vs. 42.5%, respectively, all P<0.05). The left ventricular ejection fraction (LVEF) in patients in the AEC group was lower than that in the NEC group [(60.6±10.0)% vs. (65.0±8.2)%, P=0.019]. Multivariate logistic regression analyses showed that history of diabetes and history of type C lesions were the independent risk factors for the declined exercise capacity in the MI patients after PCI revascularization (OR=3.14, 95%CI 1.167-8.362, P=0.023; OR=3.32, 95%CI 1.444-7.621, P<0.01). Among the MI patients with diabetes, the duration of diabetes in the AEC group was significantly longer than that in the NEC group[(7.7±3.6)years vs. (5.0±2.4)years] and the proportions of subjects reaching target levels of fasting plasma glucose (40.7% vs. 57.1%) and glycosylated hemoglobin A1c(HbA1c) (55.6% vs. 71.4%) in this group were significantly lower than those in the NEC group (all P<0.05). A multivariate logistic regression analysis showed that reaching HbA1c target was an independent predictor of improved exercise tolerance in MI patients with diabetes who received PCI (OR=2.518, 95%CI 1.395-7.022, P=0.021). No significant differences were observed in incidence of admission due to chest pain, re-revascularization and re-infarction between the two groups within 24 months after PCI between the groups. Conclusions Diabetes and type C lesions are independent risk factors of declined exercise capacity in patients with first myocardial infarction who received revascularization in acute state. Reaching target HbA1c is independent factor of improved exercise capacity in patients with myocardial infarction and diabetes.