A total of 60 myopia patients (120 eyes) who were going to undergo myopia LASIK were selected in this study. The patients were divided into two groups of anisometropia and non-anisometropia,each group had 30 patients (60 eyes). Checked vision, fusion range,near and distant stereoscopic at 10 day pre-operation and at 1,3 and 6 month in post operation. After the LASIK, all of 60 patients' anisometropia were significantly reduced, binocular stereopsis were obviously improved than pre-operation, especially the anisometropia group; the binocular fusion range also got better,but there was no significant difference between the two groups. This study clarified that the visual function of anisometropia could be improved after LASIK.

Objective To investigate the relationship between cognitive impairment and the other clinical features of subcortical damage in patients with magnetic resonance imaging(MRI)-defined subcortical ischemic vascular disease(SIVD).Methods The cohort for this study included 110 SIVD patients who were divided into 3 groups according to cognitive status:patients with noncognition impairment(SIVD-NCI group,n=34),patients with mild cognitive impairment(SIVD-MCI group,n =47) and patients with vascular dementia (SIVD-VaD group,n =29).The cognitive functions were evaluated by the mini-mental state examination (MMSE) and Montreal cognitive assessment(MoCA),the Cambridge cognitive examination-Chinese version(CAMCOG-C),activity of daily living scale(ADL) and clock drawing task(CDT),etc.Depression symptoms were assessed by the geriatric depression scale (GDS),while the other clinical features of subcortical damage were assessed by the timedGet-Up and Go test,etc.Results There were statistically significant differences in the MMSE,MoCA,CAMCOG-C,CDT and ADL scores among the three groups(H=85.36,F=50.32,55.03,H=27.39,40.87,respectively,all P＜0.05).Gait disturbance,urinary disorder,pseudobulbar palsy,depression and falls were statistically significantly different among the threegroups(x2=21.69,21.41,25.51,6.91,21.87,all P＜0.05).In addition,gait disturbance was increasingly aggravated with the severity of cognitive impairment.In SIVD-MCI group,urinary disorder,pseudobulbar palsy and falls were significantly increased as compared with SIVD-NCI group (x2 =15.57,16.31,8.92,both P＜0.017).Depression was statistically significant different between SIVD-NCIandSIVD-VaD group(x2 =6.90,P＜0.017).Among the three groups,there was no significant difference in the feature of emotional incontinence.Conclusions With the decline in cognitive function,the patients with SIVD can present with different clinical features of subcortical damage.Gait disturbance is gradually aggravated with the decline in cognitive function.Urinary disorder,pseudobulbar palsy,and falls can reflect the cognitive impairment from normal to mild on the other hand.Depression can be used as one of the signs that show cognitive impairment reached to dementia.

Objective To analyze the application effect of disposable surgery retractor which made of high polymer medical plastic.Methods From January 2016 to October 2016,80 patients of HCC who were treated with hepatectomy under general anesthesia in our hospital were randomly divided into the control group and the observation group according to different retractor during surgery.The control group used the traditional abdominal retractor during the sugery.Meanwhile,the observation group used disposable surgery retractor.The application effect between the two groups were compared.Results The satisfaction rate of surgical exposure and effect in surgeon of the observation group were higher than those of the control group.The wound pain time of patients in perioperative period and 1 month after surgery and chronic pain incidence in postoperative 6 months between the two groups were evaluated.It turned out that the difference in average pain score was statistically significant (P<0.05).Conclusion The disposable surgical retractor can improve the satisfaction rate of surgeons with better surgical exposure,and it can significantly reduce the damage of wound tissue,which effectively relieves the postoperative pain,shortens the time of postoperative pain,and reduces the incidence of chronic pain.

Objective To investigate whether 17β-estradiol (E2) can stimulate the proliferation,migration,and secretion of trefoil factor family 1 (TFF1) in papillary thyroid cancer K-1 cells and explore the molecular mechanisms.Methods ELISA was used to detect the content of TFF1 in the supernatant of K-1 cells after the treatment of E2,propylpyrazoletriol (PPT,ERα agonist) or diarylpropionitrile (DPN,ERβ agonist).The expression of ERα and ERβ in the untreated cells was measured by Western blotting.ERα siRNA and ERβ siRNA by RNA interference were designed and synthesized,and the change of TFF1 was measured by ELISA again after the transfection.The interaction between TFF1 promoter and ER was evaluated by chromatin immunoprecipitation analysis (CHiP).The proliferation and migration were detected in the K-1 cells after E2 treatment by MTT assay and Transwell chamber test respectively.Festults After E2 treatment,the TFF1 content in the supernatant of K-1 cells was increased gradually,reached peak at 24 h,and then declined slowly.PPT treatment enhanced the secretion of TFF1 but DPN decreased it in the K-1 cells.Transfection of ERα siRNA obliterated the inductive effect of E2 on the secretion of TFF1,but that of ERβ siRNA increased the inductive effect in the K-1 cells.Western blotting showed that the expression level of ERα was higher than that of ERβ in the K-1 cells.ChIP results confirmed that ERα protein was bound to the promoter of TFF1 gene in K-1 cells.E2 treatment promoted cell proliferation and improved cell migration in the K-1 cells.Conclusion E2 induces the expression and secretion of TFF1 in K-1 cells through ERα-dependent manner,and thus promotes the proliferation and migration of the cells.

Objective To propose a new N staging system for nasopharyngeal carcinoma based on intensity-modulated radiotherapy (IMRT) and Radiation Therapy Oncology Group (RTOG) guidelines for cervical lymph node levels.Methods A retrospective analysis was performed in 324 patients with newly diagnosed nasopharyngeal carcinoma who had no distant metastasis confirmed by pathology and received IMRT in the Department of Radiation Oncology in The First Affiliated Hospital of Guangxi Medical University from January 2010 to December 2011.They were restaged according to the 7thedition of UICC/AJCC staging system for nasopharyngeal carcinoma.The survival rates were estimated using the Kaplan-Meier method and the log-rank test was used for univariate prognostic analysis.The Cox proportional hazards model was used for multivariate prognostic analysis.Results Of 324 patients,269(83.0%) had lymph node metastasis.The median follow-up was 58 months (6-77 months).The 5-year overall survival,disease-free survival,relapse-free survival,and distant metastasis-free survival rates were 84.8%,77.1%,92.7%,and 80.5%,respectively.Univariate and multivariate analyses of patients with positive cervical lymph nodes revealed that retropharyngeal lymph node status,cervical lymph node level,and laterality were evaluated as independent prognostic factors for nasopharyngeal carcinoma.According to the hazard ratio calculated,the N staging system was revised as follows:N0:no regional lymph node metastasis;N1:VⅡ a or/and unilateral levels (I,Ⅱ,Ⅲ,Va) involvement;N2:bilateral levels (I,Ⅱ,Ⅲ,Va) involvement;N3:levels IVa,Vb,and IVb+Vc involvement.Conclusions The proposed N staging system is based on IMRT and RTOG guidelines for lymph node levels and more practical,and can provide highly objective prediction of outcome and guide treatment in nasopharyngeal carcinoma.

Objective:To investigate the value of proton magnetic resonance spectroscopy (1H-MRS) on the diagnosis of SCA3/MJD,and to calculate the correlation between 1H-MRS ratio and the clinical score.Methods:Sixteen patients with SCA3/MJD and 19 healthy volunteers were scanned with 1H-MRS.The data of N-acetyl aspartate,creatine,choline-containing compounds,myoinositol,NAA/Cr,Cho/Cr,and mI/Cr ratio were collected,which were grouped for comparative study.The onset patients with SCA3/MJD were evaluated with the International Cooperative Ataxia Rating Scale and Scale for the Assessment and Rating of Ataxia,the correlation between NAA/Cr,Cho/Cr or mI/Cr ratio and the clinical score was calculated.Results:The NAA/Cr in the pons and cerebellar dentate nucleus from the onset patients with SCA3/MJD was significantly reduced compared to that in the normal control group.The NAA/Cr in the cerebellar dentate nucleus of onset patients with SCA3/MJD was obviously correlated with ICARS.Conclusion:SCA3/MJD lesions are mainly located in the cerebellum and brainstem,where gray and white mater are also involved.The cerebellar dentate nucleus may be the earliest involved area.There is a correlation between the ICARS and the cerebellar lesion degree.The ICARS reflects the severity of clinical manifestations.1H-MRS is useful in the diagnosis of SCA3/MJD.

ObjectiveTo establish the reference value of inhibin-A in the serum of pregnant women with gestational age from 15 to 20+6 weeks in Guangdong province,and assess the efficiency of inhibin-A and quadruple test in Down syndrome screening.Methods A total of 2802 singleton pregnancies receiving triple test screening in Guangzhou Women and Children's Medical Center from March 2008 to December 2010 were included in this study.Inhibin-A was measured by automatic enzyme-linked immunosorbent chemiluminescence assay. The concentration of inhibin-A was expressed as multiples of the median (MoM),and adjusted with maternal weight and gestational age.Parameters of SURUSS were used to recalculate the risk of Down syndrome.The efficacy of single marker and combination were evaluated by receiver operating characteristic curve and the area under the curve. Results(1) In normal singleton pregnancies,the median concentration of inhibin-A was 286.60,267.10,249.10,243.40,242.30 and 256.60 pg/ml respectively for each week of gestational age from 15 to 20+6 weeks.The distribution of inhibin-A in each gestational week was relatively stable.The mean concentration [(852.83±370.04) pg/ml] and MoM (2.82) of inhibin-A in twelve pregnant mothers with Down syndrome fetuses were significantly higher than those without [(293.28±149.46) pg/ml (t=5.37,P＜0.05) and 1,respectively].(2) The detection rate was 83.3％ (10/12) by using the quadruple test including free human chorionic gonadotropin-β,alphafetoprotein,unconjugated estriol and inhibin-A at false positive rate of 5.8％; while when the detection rate of triple test including alpha-fetoprotein,free human chorionic gonadotropin-β and unconjugated estriol was 83.3％,the false positive rate was 7.7％.When the false positive rate was set to 5.0％,the area under the curve of inhibin-A,alpha-fetoprotein,free human chorionic gonadotropin-β and unconjugated estriol was 63.7％,20.5％,46.1％ and 4.8％,respectively,and the relative area under the curve of routine triple test and quadruple test was 45.5％ and 63.1％,respectively.ConclusionsInhibin-A is suggested to be the most effective marker used for secondtrimester screening,which could be used for second trimester Down syndrome screening in Chinese population combined with existing three markers.

Objective To explore the correlation of the anti-stress ability of nuclear power plant operators with their heart rate,blood pressure and mental health.Methods A total of 136 male nuclear power plant operators received the continuous performance test (CPT) and mental health test (MHT),while 37 male senior students were used as the control group.Heart rate and blood pressure were recorded before and after the test.The nuclear power plant operators were divided to high score group and low score group by CPT scores.The correlation of the anti-stress ability and blood pressure,heart rate and their mental health was analyzedd.Results The scores of CPT and MHT test with the operators were significantly higher than those of the control group(t =- 1.25,6.25,P ＜ 0.05).After the test,the heart rate,systolic pressure and diastolic pressure of the operators were all significantly lower than those of the control group ( t =- 2.07,3.28,2.74,P ＜ 0.05 ).The CPT score of the high score group was lower in the heart rate,systolic pressure and diastolic pressure than the low score group(t=-3.15, -2.78, -2.54,P ＜0.05),while the scores of CPT and MHT were better(t =0.63,6.90,P ＜ 0.05).CPT scores were negatively correlated with the increasing range of the heart rate,systolic pressure and diastolic pressure( r =- 0.69,- 0.94,and - 0.62,P ＜ 0.05 ),and positively correlated with the MHT scores ( r =0.54,P ＜ 0.05 ).Conclusions To a certain extent,CPT and MHT test can reflect the anti-stress ability and be used as one of the bases to select nuclear power plant operators and to assess their competence.

Objective To explore the status of nuclear power plant operators in mental health and its correlation with emotional stability,liveliness,anxiety and urgency.Methods 255 male operators were randomly selected from three nuclear power bases,meanwhile 61 undergraduates were used as control group.The mental health and neurobehavioral evaluation system of Chinese nuclear power plant operators was developed by Second Affiliated Hospital of Soochow University,which was used to assess mental health of the subjects.The scores of mental health personality factors were recorded,together with four main personality factors including emotional stability,liveliness,anxiety and urgency.Results The score of lie was lower than 8 which showed all inspected groups were normal. 1.57％ (4/255) operators had psychological disorders,3.92％ ( 10/255 ) had poor mental health,27.84％ ( 71/255 ) had general mental health,66.7％ (170/255) had excellent mental health,whereas 9.84％ (6/61)for control group had psychological disorders.Obvious difference was observed in the final scores between the nuclear power plant operators and control group.The former gained higher scores on mental health,emotional stability,and lower scores on anxiety and urgency ( t =3.437,4.423,- 2.493,- 2.093,P ＜ 0.05 ).Both groups aged over 27 years and with length of service over 5 years were awarded higher scores on mental health,emotional stability( t =2.585,2.349 ; t =2.606,2.947,P ＜ 0.05 ),lower scores on anxiety and urgency (t =- 3.407,- 2.138 ; t =- 2.941,- 2.256,P ＜ 0.05).The mental health was positively correlated with emotional stability and liveliness ( r =0.721,0.650,P ＜ 0.05),but negatively correlated with anxiety and urgency(r =- 0.809,- 0.693,P ＜ 0.05 ).Conclusions The majority of nuclear power plant operators had excellent psychological quality,but some factors should be paid more attention,such as different ages and length of service time.

Objective To discuss the clinical features and treatment of isovaleric academia (IVA) patients,and to gain more comprehensive understanding of isovaleryl-CoA dehydrogenase(IVD) mutation in 2 siblings in order to raise awareness to prevent the occurrence of IVA.Methods The clinical history and laboratory test of 2 cases of children with IVA were carried out.The exons and neighboring introns of IVD gene of the whole family were PCR-amplified for DNA sequencing.The literature review of IVA in China was also conducted.Results Organic acid analysis of urine by GC/MS for both siblings showed extremely elevated concentrations of isovaleric glycine.For the older sibling,an acute episode of IVA caused severe metabolic stress and eventually death in the neonatal period.However,the disease was well-controlled for the younger sibling due to timely treatment and follow-up care for 2 years.The DNA sequencing of the IVD gene in the family revealed a novel c.1016G ＞ A(C339Y) heterozygous mutation in mother and both of the siblings.No IVD mutation was detected in father or in any of the 50 cases of healthy controls.According to literature review,15 cases of IVA were reported in recent 15 years in China,including neonatal onset (11 cases),acute episode (12 cases),odor of sweaty feet (12 cases),pancytopenia (9 cases),hyperammonemia (5 cases),hypocalcemia (6 cases),and 6 cases of death were reported.Additionally,5 cases that received treatment of BCAA-free formula milk showed positive outcome.However,only 2 cases were followed up for more than 2 years.Conclusions Two new IVA patients carrying c.1016G ＞ A(C339Y) mutation were reported in China.The mutation may lead to conformational change and functional deficient of the IVD protein.It is also necessary to point out that using direct DNA sequencing can not identify all patients with IVA due to limitations of this technology,and thus clinicians should be aware of the possibility of genetic misdiagnosis.Moreover,there is a trend of increasing IVA in China in recent years.