AIM:To explore the learning curve of the Indian standardized manual small-incision cataract surgery(SICS).METHODS:Totally 253 cases(295 eyes)of senile cataract were divided into three groups (Group A: training group, Group B and C: strengthened groups) according to the operation time from December 2012 to December 2014.All cases were performed with manual SICS by the same trainee ophthalmologist.To research the learning curve of manual SICS and evaluate surgical effects, the best corrected visual acuity and complications were observed. RESULTS: At 1wk postoperatively, the rate of relief from blindness in all three groups after operation were 100%, the rate of relief from visual handicap in group A, B, C were 93.7%,93.0% and 91.0% respectively.Complication rates were 2.1%, 7.0% and 3.0% respectively in three groups.Posterior capsular rupture accounted for 50% of all complications.No severe postoperative complications were found, such as nucleus or IOL falling into vitreous cavity, endophthalmitis, corneal endothelial function dysfunction and expulsive choroidal hemorrhage.CONCLUSION: Manual SICS is safe and effective.Because of helping to shorten the learning curve and decrease the incidence of complications, the standardized manual SICS training is worth using for reference.

The paper firstly introduces the research status of autism and analyzes the gap between China and the US in autism net-work service, proposes using the mainstream socialized Q&A community data in foreign countries to construct an autism Q&A knowledge base.It introduces data collection, management, service process and key issues of the knowledge base and gives application examples of the knowledge services.Construction of this knowledge base can provide targeted and valuable knowledge services to users and can help enhance the retrieval efficiency.

Objective To observe the effects of mirtazapine to improve the life quality of malignant tumor patients with moderate or severe depres-sion. Methods Patients with mood disorders screened by the physician were then graded by the Hamilton Depression Scale(HAMD)under the tu-telage of ward psychological consultant. Fifty patients with moderate or severe depression were selected by psychological doctors and recruited for the study. After obtaining consent,the patients received 15-60 mg/d mirtazapine every night for 9 weeks. According to the Quality of Life Rating Scale (QOL),the scores of these patients were evaluated at the pretreatment,the 3rd week and the 9th week of the post-treatment. Then,the life quality conditions before and after treatment were revaluated. Results The scores of HAMD were 33.16±7.25,28.74±6.24,and 22.58±6.71 at the pretreat-ment,the 3rd week and the 9th week of the post-treatment,respectively. There were significantly different among the HAMD scores at the pretreat-ment,the 3rd week and the 9th week of the post-treatment.(F=30.99,P<0.01). The scores of HAMD were improved significantly between the pre-treatment and the 3rd week of the post-treatment(P<0.05). The scores of HAMD were also improved significantly between the 3rd week and the 9th week of the post-treatment(P<0.05). After treatment by mirtazapine,the appetite,spirit,sleep,fatigue,pain,the reorganization of cancer,the attitude towards treatment,the side effect of treatment and the facial expression were significantly improved(P<0.01). Conclusion Mirtazapine could improve the life quality of malignant tumor patients with moderate or severe depression.

Abstract?AIM: To characterize the effects of sodium iodate on mouse retinal morphology and function.?METHODS: Sodium iodate at 35mg/kg ( body weight) was administered by tail vein injection into adult 6-8wk C57BL/6J mice. Morphological and functional changes of the retina were assessed at 6h, 1, 3, 5 and 8d after injections by fundus imaging, optical coherence tomography (OCT), ERG and histology. Mice in control group were give tail vein injection of equivalent dose of normal saline. All the eyeballs were removed for paraffin section and H-E staining.?RESULTS: The fundus photographs images at 6h after injection showed obvious changes, which were light red in retina and showed retinal blood vessels radial arranged. At 6h after injection, off-white drusen-like change was found at fundus. While there were no observable changes in OCT image and ERG. At 1d after injection, the fundus lesion aggravated and the drusen increased gradually. There were retinal pigment epithelial ( RPE) disorders, photoreceptors and outer nuclear layer (ONL) damage through OCT. At 3d after injection, the retina lesion aggravated further and the retina became edema. At 5d after injection, the retina edema cleared away, the optic nerve became white and the fundus lesions increased. At 8d after injection, the RPE layer, photoreceptors and ONL were destroyed obviously. In the process, ERG showed the amplitudes of a- and b-wave decreased in a time-dependent manner. H-E staining showed that cells in retina of mice in control group were neatly arranged and well- distributed. The outer layer retina of sodium iodate injection group was wave-like, the normal structure of RPE disappeared and black round sediment could be seen which increased with time. At 8d after injection, there were any normal RPE.?CONCLUSION: The tail vein injection of sodium iodate can well simulate the pathogenesis of age - related macular degeneration which can provide a good animal model for AMD.

OBJECTIVE:To provide reference for improving the rational drug use of China. METHODS:By referring to In-dia,South Africa and Argentina's policy in this regard,the rational drug policy rules and supporting measures in the national drug policy of these states were analyzed and summarized to put forward related policies for China. RESULTS & CONCLUSIONS:Pro-moting the rational drug use required multi-angle managements towards the supply-side,the demand-side as well as third-party, and relevant supporting measures needed to be improved. Firstly,the managements on the supply-side is particularly important,in-cluding measures such as strengthening prescription management,formulating and implementing the standard treatment guidelines, intensifing the functions of pharmacists,establishing serious irrational drug use and specific diseases medication management sys-tem;then,the demand-side needs the investigation and feedback about the patients with drug use to eliminate irrational drug use, and through the internet and other media to raise public awareness of the medicine information as well;besides,the third-party needs to establish a non-profit organization to regulate pharmaceutical advertisements,and increase information about rational drug use;finally,improving the rational drug policy also needs to improve needs to promote the separation of medicine,reform Medi-care payment and other supporting measures.

Objective In order to understand and evaluate the significance and action of the whole body's regulation in the organism's heat shock response, this paper analyzed the difference between the anaesthetic and sober mice in the same heat shock condition. Methods The anaesthetic and sober mice were treated respectively in 40, 42,44 and 46℃ for 30?min and then recovered for 24?h in normal raise. The heat shock protein 70(HSP70) in mouse livers were checked by Western blot.The acid and neutral proteinase activities in mouse livers were checked by renatured electrophoresis of proteinases. Results HSP70 synthsis in the sober mouse livers was decreased by 44\|46℃, but it was stronger in the anaesthetic mouse livers. The acid proteinase activities in the sober and anaesthetic mouse livers basically indicated a positive relationship with HSP70 synthesis, but the neutral proteinase activities showed a negative relationship.Conclusion Based on the results, it was inferred that the anaesthetic mouse livers had a higher heat\|resistance than that of the sober mouse livers, and that the stress response of the mouse livers was regulated by two levels of cells and whole body, which also involved in other physiological and biochemical actions except the heat shock protein synthesis. [

Objective: To investigate the loneliless situation of the elderly, and explore the relationship between loneliness,filial expectations and intergenerational social support among the elderly. Methods: Using UCLA Loneliness Scale, Intergenerational Social Support and Fealty Expectation Questionnaire, we investigated 423 samples of old people aged 60 ～94 of Changsha City. Results: The mean score of loneliness was 39.8 (s =7.3). Ordinal regression analysis indicated that the loneliness of the elderly was significantly related to received adult children social support (OR=2.208, P=0.006),afforded adult children social support(OR=2.056,P=0.01) and filial expectation(OR=1.872,P=0.027),controlled by age, sex, level of education, marriage, level of family income, and residence status. Filial expectation directly affected loneliness and indirectly affected loneliness through received adult children social support and afforded adult children social support. Conclusion: The loneliness of the elderly are significantly related to filial expectation and intergenerational support.

Adolescent ; Child ; Female ; Follow-Up Studies ; Humans ; Kidney Transplantation ; Male ; Prognosis

Objective To investigate whether emergency rooms in major general public hospitals are reasonably designed and convenient for patients. Methods 78 major public hospitals were selected from all over China, except Hong Kong, Macau and Taiwan, for emergency room convenience analysis. The standards in use were the "Standards of Hospitals" of Joint commission International Accreditation. Results The investigation found in such hospitals the following: poor road conditions outside the clinic and insufficient guides in the clinic; long-than-expected distance (normally over 50 meters) from ER to imaging departments (such as X-ray and CT scan service); ERs in provincial capital cities are significantly more convenient than those in non-capital cities; distance from ERs to CT service is significantly shorter in hospitals in eastern China than those middle and western China. Conclusions Parameters on ER's service quality from "Standards of Hospitals" could serve as a guideline to emergency medicine in China. ERs in China need to improve with conspicuous ER signs, unblocked passageways, and convenient access to inspection departments.

Objective To obtain the incidence of “clopidogrel low response”( CLR ) of acute coronary syndrome ( ACS ) patients after percutaneous coronary intervention ( PCI ) by Thrombelastography ( TEG) and Light transmission aggregometry( LTA) ,and explore the correlation of CLR with clinical related factors and major adverse cardiac events.Methods This study is a cohort study.214 ACS patients in the Department of Cardiology of Peking University People′s Hospital,who were ready to treat with PCI between May 2014 and November 2014 were enrolled.Among them, 168 cases(78.5%) were male with an average age of (61.32 ±10.79) years;46 cases(21.5%) were female with an average age of (68.72 ±8.38) years.The clinical data were recorded, such as history of present illness, the past medical history, clinical medication, and the results of coronary angiography.After taken clopidogrel 75 mg per day at least for 4 days,all patients were detected the contribution from ADP-stimulated platelets to maximal clot strength by TEG( TEG-ADP-Inhib), and detected ADP induced maximal platelet aggregation ratio by LTA ( LTA-ADPMAX ) .The occurrence rate of CLR was calculated, and the correlation between results of the two assays were anylysed.Patients were divided into two groups according to CLR.Univariate analysis was used to compare the difference of clinical data between CLR group and non-CLR group, then Logistic regression analysis was conducted to find out the related risk factors that may influence the occurrence rate of CLR.Compare the correlation between CLR and MACE according to 6-month followed-up.Results There was negative correlations between LAT and TEG in the adenosine diphosphate induced platelet reactivity ( r=-0.282,P=0.000).CLR was found in 115 (53.7%) patients by LTA and in 74(34.6%) patients by TEG and the difference between the two CLR ratio was significant (χ2 =10.486, P =0.001 ) .There were significant differences in age,smoking history and prior PCI/CABG history between CLR group and non-CLR group according to LTA grouping(t=2.829,P=0.005;χ2 =11.058,P=0.001;χ2 =4.252,P=0.039), and there was significant differences in history of cerebrovascular accident between CLR group and non-CLR group according to TEG grouping (χ2 =4.584, P=0.032 ).Logistic regression analysis showed smoking history was the protective factor for CLR ( OR=0.390,P=0.001) , while history of cerebrovascular accident was the independent risk factor (OR=2.499,P=0.037) for CLR.According to 6-month followed-up, the incidence of clinical ischemic events and bleeding events in CLRLTA group was 5.2%and 0 respectively, in N-CLRLTA group was 10.1% and 3% respectively;the occurrence rate of clinical ischemic events and bleeding events was no significant difference between two groups(χ2 =1.834,P=0.176;χ2 =1.682,P=0.195).The incidence of clinical ischemic events and bleeding events in CLRTEG group was 8.1% and 0 respectively, in N-CLRTEG group was 7.1%and 2.1%respectively;the occurrence rate of clinical ischemic events and bleeding events was no significant difference between two groups(χ2 =0.065,P=0.798;χ2 =0.432,P=0.511 ).Conclusions The correlation between the testing results of TEG and LTA in ACS patients treated with clopidogrel was poor, CLR ratios detected by two assays were significantly different.Smoking history was the protective factor for CLR , while history of cerebrovascular accident was the independent risk factor for CLR.CLR was not the risk factor for MACE in ACS patients.