Background Amblyopia is a developmental disorder of spatial vision that results in both monocular and binocular deficits.Conventional therapy for amblyopia which focuses on monocular training can improve visual acuity.However,how to improve the binocular function,especially stereopsis is rarely studied.Objective This study was to evaluate the outcome of perceptual learning based on cloud services of improving stcreopsis and visual acuity for amblyopia.Methods A randomized-controlled clinical study was performed.One hundred and seven amblyopic patients (178 eyes) with the age of 5-18 years old were recruited in The Second Affiliated Hospital of Anhui Medical University from July 2013 to March 2014.The patients were randomized into the perceptual learning group and the conventional therapy group.A perceptual learning based on cloud services with computer under the best corrected visual acuity was carried out in the perceptual learning group with 30-day duration as a course for 5-6 cycles,and training feedback data was obtained after each cycle for the regulation of following treatment.The dominant eye was covered during the training process.In the conventional therapy group,a training regimen of health eye covering that combined with eyesight training of amblyopic eye was performed.The stereopsis and visual acuity of the patients were estimated after training.Written informed consent was obtained from the parents or custodians of the children before entering the cohort.Results The total effective rate of visual acuity improvement is significantly higher in the perceptual learning group than that in the conventional therapy group after training (Z =6.368,P=0.012).The mean stereopsis value of the amblyopic eyes in the perceptual learning group and the conventional therapy group was (127±53) and (174±67) after training,which was significantly higher than (273 ±95) and (311 ±103) before training,respectively,and the increasing range of the mean stereopsis was considerably larger in the perceptual learning group than that in the conventional therapy group(t=12.329,9.557,15.649;all at P＜0.05).In the perceptual learning group,the improving range of mean stereopsis was larger in the severe or moderate amblyopic eyes than that in the mild amblyopic eyes,and the improving range of mean stereopsis in ametropic amblyopia was larger than that in anisometropic amblyopia (all at P ＜ 0.05).Conclusions Both perceptual learning based on cloud services and conventional therapy can improve stereopsis and visual acuity in amblyopic eyes.However,perceptual learning based on cloud services can improve the treating compliance of children.

Objective To establish fingerprints of cultured Cordyceps Militaris, Cordyceps Sinensis and Fermental Cordyceps.Methods Water soluble components in Cordyceps Sinensis were extracted by ultrasonic method. The characteristic fingerprints were established by HPLC, with Agilent ZORBAX SB-Aq (4.6 mm × 250 mm, 5μm) as column and acetonitrile (A)-0.04 mol/L KH2PO4 (B) as mobile phase;gradient elution (0-16 min, 0%A;16-38 min, 0→10%A;38-58 min, 10%→15%A;58-65 min, 15→0%A);the flow rate was 1.0 mL/min;column temperature was 25℃;the detection wavelength was 260 nm;the injection volume was 20μL. The HPLC characteristic fingerprint of mycelium was developed, and the components of adenosine, uridine, guanosine, inosine, uracil, adenine and cordycepin were identified and compared.Results This method is with high degree of precision, good repeatability and stability. With adenosine as reference peak, similarity of 11 batches of Cordyceps Sinensis collected from different habitats, 10 batches of cultured Cordyceps Militarise and 12 batches of Fermental Cordyceps were 0.889-0.982, 0.781-0.980 and 0.502-0.970, respectively.Conclusion There were good similarities between the standard fingerprint and each fingerprint of the eleven samples of Cordyceps Sinensis. There were low similarities between the standard fingerprint and each fingerprint of the ten samples of cultured Cordyceps Militaris and the twelve samples of Fermental Cordyceps. This method can be reference base for the evaluation of quality of cultured Cordyceps Militaris and Cordyceps Sinensis.

OBJECTIVE: To analyze the effects of social and psychological factors on rehabilitation status of end stage renal disease (ESRD) patients under peritoneal dialysis. METHODS: From August in 2005 to March in 2007, 171 patients experienced peritoneal dialysis were diagnosed at the Center of Peritoneal Dialysis, Department of Nephrology, First Hospital, Peking University, including 66 males and 105 females, aged (60±13) years, with an average dialysis time of 22.8 months. They were studied with questionnaires and interview. Rehabilitation status was investigated from two aspects of activity and participation by Karnofsky activity index, Social Dysfunction Screening Scale. Hamilton depression and anxiety scales, Medical Coping Modes Questionnaire and Social Supporting Rating Scale were used to investigate social and psychological factors.RESULTS: A total of 200 questionnaires were handed out and 171 (85.5%) of them were drawn in. 134 patient had normal activity status, 78.4% of them had Dysfunction and 129 patients (75.4%) had normal social function status. Forty-two (24.5%) of patients had the symptom of anxiety, 15 (8.2%) had depression. The score of "Acceptance-Resignation" was significantly higher in this group than patients with other chronic diseases. There were no significant differences in scores of "Confrontation" and "Avoidance". Activity of rehabilitation outcome and participation index served as dependent variable, whereas depression and anxiety, coping mode and social supporting as independent variable. Using multiple stepwise regression analysis, factors that affected patient rehabilitation were found, including depression, utilization of social support and the facing coping mode. CONCLUSION: Depression, utilization of social support and the facing coping mode have important effects on patient rehabilitation.

An artificial liver support system (ALSS) is a body circulatory system aims to blood purification, which consists of plasma exchange, hemodialysis, hemoperfusion, in combination with hemodiafiltration. The clinical application of non-biological artificial liver, especially plasma exchange technology, can solve the problem such as hyperbilirubinemia, endotoxemia, toxic substance accumulation and disorder of amino acid metabolism, which would save patients’ lives. ALSS can significantly improve the general physical condition, reduce operative risk, as well as relieve physiologic derangement after liver transplantation. Therefore, artificial liver serves as a bridge for liver transplantation. This paper analyzes the characteristics of ALSS, explores the methods of ALSS application in perioperative period of liver transplantation, and discusses its developing orientation.

Objective To investigate the relationship between hepatocyte growth factor (HGF) and vascular endothelial cells (VEC) in pregnancy induced hypertension (PIH) Methods Twenty women with PIH (6 mild, and 14 moderate or severe PIH ) and 20 women with normal pregnancy were recruited as study group and control group, respectively The two groups were matched in maternal age, parity and gestational age Flow cytometer was used for counting the number of peripheral blood circulating endothelial cells (CEC), while enzyme linked immunoadsordent assay (ELISA) was used to measure the concentration of serum HGF Results In the study group, the concentration of HGF was (1395?512) ng/L, and the number of CEC was (109 360?24 070) /L In the control group, the concentration of HGF was (1565 ?399) ng/L, and the number of CEC was (21 800?4420)/L The differences both in the concentration of HGF and the number of CEC between the two groups were statistically significant ( P

Objective:To prepare fenofibrate PEG2000-DSPE micelles in order to improve the solubility of fenofibrate, and study the oral pharmacokinetics of the micelles in SD rats. Methods:Fenofibrate PEG2000-DSPE micelles were prepared and characterized. The rats were administrated with fenofibrate PEG2000-DSPE micelles and fenofibrate suspension, respectively. The blood samples were collected from eye socket and determined by HPLC. The compartmental pharmacokinetics was analyzed by DAS software. Results:Fenofibrate PEG2000-DSPE micelles were prepared successfully. The mean particle size was (23. 40 ± 3. 62) nm, the drug loading and the entrapment efficiency was (97. 65 ± 3. 32) % and (1. 33 ± 0. 32) %, respectively. The mean plasma concentration-time curves of fenofibric acid were both in accordance with two-compartment mode after oral administration of fenofibrate PEG2000-DSPE micelles and fenofibrate suspension in rats. After the oral administration, AUC(0-24) and Cmax of fenofibrate PEG2000-DSPE micelles was respectively 7-fold and 14-fold higher than that of fenofibrate suspension [(61. 41 ± 5. 71)μg·h·ml-1 vs (8. 49 ± 0. 66)μg·h·ml-1, and (9.67±1.65) μg·ml-1 vs (0.71 ±0.09) μg·ml-1]. The relative bioavailability of fenofibrate PEG2000-DSPE micelles was 723. 3%. Conclusion:The bioavailability and absorption rate of fenofibrate are both increased by the micelles remarkably when com-pared with those of fenofibrate suspension after oral administration. The PEG2000-DSPE micelles served as drug carrier for oral delivery present promising application perspectives.

OBJECTIVE:To study in vitro anticancer activity of conjugated linoleic acid-gemcitabine conjugate (CLA-GEM). METHODS:IC50 of different tumor cells (breast cancer MCF-7 cell,breast cancer MDA-MB-231 cell,lung cancer A549 cell, small cell lung cancer NCI-H446 cell,glioma C6 cell)were investigated after treated with different concentrations(0.001-100μmol/L)of CLA-GEM and gemcitabine(GEM)for 72 h;survival rates of MCF-7 cell were investigated after treated with above so-lution for 24,48 and 72 h. The dependence of 0.001-100 μmol/L CLA-GEM and GEM to nucleoside transporter was investigated (by IC50)through MCF-7 cells and MDA-MB-231 cells treated with nucleoside transporter inhibitors(NBMPR,100 μmol/L)and di-pyridamole(4 μg/ml). The change of MCF-7 cell cycle was investigated after treated with 1 μmol/L CLA-GEM and GEM for 24 h. RESULTS:Compared with GEM,IC50 of MCF-7,MDA-MB-231 and NCI-H446 cells became lower after treated with CLA- GEM (P<0.01),there were no statistical significances in IC50 between A549 and C6 cells(P>0.05). Survival rate of MCF-7 cells de-creased significantly after treated with GEM for 48 h and CLA-GEM for 24 h. Survival rate of MCF-7 cells was the lowest,being 21% after treated with GEM for 72 h,while tumor cells were sacrificed by CLA-GEM completely. Compared with GEM or CLA-GEM,IC50 of MCF-7 and MDA-MB-231 cells increased significantly after treated with NBMPR,dipyridamole combined with GEM (P<0.01);there were no statistical significance in IC50 after treated with NBMPR,dipyridamole combined with CLA-GEM (P>0.05). Compared with GEM,CLA-GEM could prolong 6% of S stage of MCF-7 cells (P<0.01). CONCLU-SIONS:Compared with GEM,CLA-GEM exhibits significant antitumor activity and rapid action,and it isn’t influenced by nucle-ic acid transportation.

Purpose To study the clinicopathologic feature, classification, benign or malignant histological features and differential diagnosis of extra-adrenal paraganglioma.Methods We performed a retrospective analysis of 21 cases of extra-adrenal (sympathetic and parasympathetic) paraganglioma. Histological, immunohistochemical findings, and follow-up data were reported with review of the relative literatures.Results There were 10 male and 11 female patients aged from 9 to 81 years (mean 46.5 years).Ten tumors occurred in the retroperitoneum, seven in the neck, and one case in the mediastinum, urinary bladder, spermatic cord and kidney, respectively.There were 3 cases of functional and 18 cases of non-functional paragangliomas.Histologically, the tumor was composed of chief cells and sustentacular cells. The chief cells were arranged in nests, alveolAR~-like and stereo-like structures.They were surrounded by sustentacular cells partly or completely.There was one malignant case, in which tumor cells had significant cell atypia and nuclear mitosis, and focal or diffuse necrosis, regional lymph node metastasis and blood vessel involvement were also observed.Immunohistochemical investigations revealed chief cells were intensely positive for neuroendocrine markers such as NSE, CgA, Syn and NF, but negative for CK, EMA and SMA.Sustentacular cells were positive for S-100 protein.The malignant cells were only positive for NSE and weakly positive for CgA.Eighteen cases were followed up.One patient developed to multi-organ metastasis and died.One patient was diagnosed as benign extra-adrenal paraganglioma that recurred and involved adjacent organs after 3 years.Conclusions It is generally considered that malignant potential, local invasiveness and distant metastasis are not correlated with the histological appearances of the extra-adrenal paraganglioma.So,further follow-up will be needed. It is necessary to emphasize the differential diagnoses of extra-adrenal paraganglioma from other pleiomorphic tumors.

Objective To explore the effect on job competency by reforming Fundamental Nursing courses among undergraduate nursing students.Methods 86 nursing undergraduates in Grade 2011 were recruited as the control group receiving conventional teaching method,while 119 students in Grade 2012 were recruited as the experimental group receiving reform of fundamental nursing courses.The teaching outcomes were evaluated by using Job Competence of Nursing Students Evaluation Form and Medical education environment measurement table.Results The reform of fundamental nursing courses had significantly elevated all the aspects of professional competency among nursing undergraduates (P＜0.01),including personal traits,clinical ability,communication,critical thinking,specialty construction[(35.71 ± 3.82) vs.(33.41 ± 4.77),(55.29 ± 8.29) vs.(43.93 ± 8.68),(22.19 ± 2.71) vs.(19.88 ± 2.96),(16.83 ± 2.85) vs.(14.37 ± 2.71),(37.78 ± 6.31) vs.(32.42 ± 5.72)].Meanwhile,three dimensions of medical education environment for nursing students were also improved,including the student's perception of the teacher,self academic perception,self social perception [(35.23 ±5.72) vs.(31.28 6..22),(21.42 ±4.19) vs.(23.42 ±3.53),(19.44 ± 3.86) vs.(18.19 ± 3.47),t=-4.523、-3.503、-2.308,P＜0.01 or 0.05)].However,there was no significant differences in the aspects of learning perception,environment perception,and the total score of medical education environment (t=-1.866、0.725、-1.705,P＞0.05).Conclusions The professional competence and parts of the teaching environment around the nursing students have been elevated through the reform of Fundamental Nursing course.The reform also laid a solid foundation for the employment of nursing students.

ObjectiveTo study the efficacy and safety of heated humidified high flow nasal cannula ( HHHFNC) and nasal continuous positive airway pressure( NCPAP) ventilation for prevention of extubation failure in extremely low birth weight(ELBW)infants in our NICU.MethodsFrom Jan.2011 to Dec. 2014, 129 ELBW infants admitted to our hospital were randomly assigned into HHHFNC group and NCPAP group. The inclusion criteria were gestational age ( GA ) <34 w, birth weight ( BW )<1000 g, admission within 7 d after birth and transition to noninvasive respiratory support after a period of mechanical ventilation with an endotracheal tube. The primary outcome included:the incidence of extubation failure, nasal injury, air leak, abdominal distention and bronchopulmonary dysplasia ( BPD). Results Statistically significant difference sexisted between the two groups on oxygen the rapyduration, the time required reaching total enteral feedings and the incidences of nasal injury, air leak, abdominal & nbsp;distention and necrotizing enterocolitis ( P<0. 05). The incidence of extubation failure within 7 days was 25. 8℅ in HHHFNC group and 47. 6℅ in NCPAP group ( P <0. 05 ) . No differences between the 2 groups on total ventilation duration, non-invasive ventilation duration, re-intubation rate at 3d after extubation, BPD, retinopathy of prematurity ( ROP ) , intracerebral hemorrhage ( ICH ) , periventricular leukomalacia(PVL)and patent ductus arteriosus(PDA).Conclusions HHHFNC is an effective and safe method for prevention of extubation failure in ELBW infants.