Abstract?AIM: To evaluate the clinical application of IOL Master by comparing with traditional ultrasound biometry on the accuracy and characteristics of intraocular lens calculation.?METHODS:Data was analyzed from 164 patients ( 206 eyes ) with age - related cataracts who underwent phacoemulsification and intraocular lens ( IOL ) implantation in our hospital from June 2014 to June 2015. Before surgery, axial length and corneal curvature were measured with IOL Master and combined application of ultrasonic or manual keratometry, respectively. Phacoemulsification and foldable lens implantation were done in the patients. IOL power calculation was carried out using the SRK-Ⅱformula with the basis of IOL Master data. The visual acuity and refractive outcome were followed-up for 3mo postoperatively.?RESULTS:There was a significant difference between the two methods on axial length measurement which was 23. 86 ± 1. 05mm by IOL Master and 23. 50 ± 0. 83mm by ultrasound ( P = 0. 025 ). There was also a significant difference between the two methods on corneal curvature measurement which was 44. 18 ± 1. 35D by IOL Master and 43. 70 ± 1. 41D by keratometry ( P = 0. 01 ). The mean absolute error(MAE), at 3mo after operation, was 0. 41± 0. 30D and 0. 93 ± 1. 10D by the IOL Master and ultrasound groups, respectively, there was a significant difference between the two methods(P=0. 027).?CONCLUSION:The IOL Master is a non-contact, safe,easy-to-do and patient-friendly methods for axial length and corneal curvature measurement with high accuracy, thus it can calculate the IOL power more accurate and improve the predictive value for postoperative refraction.

Aim To determine the role of Wnt/β-catenin/TCF7L2 pathway in diabetic cardiomyopathy.Methods A model of type 1 diabetes mellitus was established by intraperitoneal injection of streptozotocin(STZ)into 7 or 8-week old C57BL/6 mice.After four weeks, the diabetic animals were divided into three groups with seven to eight in each:diabetes mellitus(DM), diabetes injected with β-catenin inhibitor iCRT14(2.5, 5 mg·kg-1).After continuous intrap-eritoneal administration for 8 weeks, heart samples were stained with HE and examined under light microscopy.Expressions and distributions of β-catenin and TCF7L2 in myocardium were detected by immunohistochemistry.Protein levels of β-catenin, Tcf7l2 were detected by Western blot.mRNA levels of β-catenin, Tcf7l2, Nppa and c-Myc were detected by qPCR.Results The myocardial cells in DM were relatively disordered and the size of the nucleus was irregular.Western blot and immunohistochemistry data showed that the expressions of β-catenin and TCF7L2 in heart with DM increased, while those in nucleus of the cardiomyocytes significantly increased.qPCR showed that the mRNA expression of β-catenin downstream target c-Myc and cardiac hypertrophy marker Nppa were up-regulated.After injection of eight weeks with different iCRT14 doses, the cardiomyocytes were relatively regular; the protein levels of β-catenin and TCF7L2 decreased, and their expressions in nucleus decreased as well; the mRNA levels of Nppa and c-Myc markedly decreased.Conclusions Activation of canonical Wnt/β-catenin/TCF7L2 signaling pathway plays a pivotal role in diabetic cardiomyopathy; iCRT14 significantly improves the phenotype of cardiomyopathy in type 1 diabetic mice.

0.05).However,neither CpG-ODN nor hTNF-? failed in improving the expression rates of CD1a.Conclusions CpG-ODN,like hTNF-?,has remarkable im- munostimulatory effect on the differentiation and maturation of monocyte-derived DC from patients with chronic hepatitis B.

Objective To investigate the potential clinical factors associated with the prognosis and relapse of adult onset Still's disease(AOSD).Methods The factors possibly influencing the prognosis and relapse of AOSD were analyzed by logistic regression and COX regression in the cohort study.Ninety-six con- secutive inpatients of AOSD diagnosed based on Yamaguchi criteria in the hospital from March 1996 to September 2004 were included in the study.Results Nine cases(9.4%)were lost during the follow-up. Eleven patients(12.6%)were diagnosed as other diseases(5 with other rheumatic diseases,4 with tumor and 2 with infections)in the 87 follow-up cases.In 76 cases,3 patients(3.9%)died and 33 patients(43.4%) got remission over one year after treatment.Splenomegaly(OR=3.14,95%CI=1.01～9.74)and treated with methotrexate(OR=0.22,95%CI=0.07～0.67)were associated with the prognosis from the logistic regression analysis of the 76 cases.The serum ferritin(RR=I.05,95%CI=1.01～1.08)and treated with methotrexate (RR=0.13,95%CI=0.02～0.76)were associated with relapse from the COX regression analysis of the 61 remis- sion cases.Conclusion We need to be very cautious in the follow-up of AOSD patients because some of them may change to other diseases.Methotrexate may be an importent therapy of AOSD not only in improve- ment the prognosis but also in reduction of relapse.

Objective　To study the significance of alteration of concentration of endothelins(ET) and calcitonin gene related protein(CGRP) in bile in patients with acute choiangitis of severe type(ACST). Methods　The concentration of ET and CGRP were detected by radioimmunoassay in 55 cases of ACST at openation time, and 7th, 14th day after operation. Results　Compared with the control group, the concentration of ET in bile in patients with ACST was significantly higher at operation time(P<0.01～0.001). The concentration of ET in bile also showed significant difference at operation time between the 2 groups with different ACST severity(P<0.05). The concentration of ET in bile gradually reduced after operations. Compared with the control group, the concentration of CGRP in bile was signficantly lower at operation time(P<0.01). CGRP in bile gradually rose after operation. Conclusions　The ET in bile has some effect on the ACST pathologic alterations. The content of ET in bile is related to the severity of ACST. The disturbance of the balance between bile ET and CGRP may contribute to the pathologic process of liver and bile duct injury in ACST.

OBJECTIVETo observe the intervention of Shenkangling Decoction (SD) on the renal injury of primary nephrotic syndrome (PNS) children patients of Shen deficiency blood stasis syndrome (SDBSS) and to explore its mechanism.

METHODSTotally 65 PNS children patients were randomly assigned to the combined group (33 cases, treated by SD +Western medicine) and the Western medicine group (32 cases, treated by Western medicine). Meanwhile, 30 healthy children were recruited as the healthy control group from the medical examination center. Those in the Western medicine group were treated with prednisone (5 mg per tablet) at the daily dose of 1.5 -2.0 mg/kg till two weeks after their urine protein turned to negative. Then the dosage was reduced once daily per every other day. The therapeutic course lasted for more than 1 year. For those with no effect of prednisone or partial effect, cyclophosphamide intravenous pulse therapy was additionally applied for 2 successive days per week, a total of 6 times, or they took cyclosporine A. Patients in the combined group additionally took SD while starting treatment of prednisone. SD was decocted in water for oral dose, once daily, taken in two portions until 2 months after prednisone was discontinued. Efficacy was evaluated based on serum levels of chemotactic factor CXCL16, disintegrin metalloproteinase 10 ( ADAM10 ), disintegrin metalloproteinase 17 (ADAM17), albumin (ALB), total cholesterol (TC), and 24-h urine protein excretion (UPE) detected by ELISA before and after treatment.

RESULTSCompared with before treatment in the same group, levels of CXCL16, ADAM10, ADAM17, TC, and 24-h UPE were significantly lower in the two treatment groups (P <0. 01). Compared with the control group, levels of CXCL16, ADAM10, ADAM17, TC, and 24-h UPE significantly increased, and the serum ALB level decreased in the two treatment groups (P <0.01). Compared with the Western medicine group at the same time point, levels of CXCL16, ADAM10, ADAM17, TC, and 24-h UPE significantly decreased in the combined group. The 1 -year recurrence rate and the recurrence times decreased in the combined group (P <0.01). The complete remission rate increased in the combined group (P <0.01).

CONCLUSIONSD could effectively improve the clinical prognosis of PNS children patients possibly by reducing the release of inflammatory mediators such as CXCL16, ADAM10, and ADAM17, decreasing UPE and the TC level, and elevating the serum ALB level.

Background Normal adult optic disc rim width follows inferior ≥ superior ≥ nasal ≥ temporal (ISNT) rule.Analysis of the optic disc structural parameters with Heidelberg retina tomograph (HRT) can understand whether ISNT principle is suitable to other optic disc structure parameters.Objective This study was to investigate the characteristics of optic nerve head structure parameters in normal Chinese adults.Methods The parents of twins who participated Guangzhou Twin Eye Study were enrolled in Zhongshan Ophthalmic Center from 2006 June to 2011 August.All subjects received the routine eye examinations,including visual acuity,slit lamp microscope,direct ophthalmoscope examination,auto-refraction examination and HRT Ⅲ examination.All data from the right eyes were collected and analyzed.HRT values from different quadrants of optical nerve head were compared with one-way analysis of variance,and the multiple comparison between quadrants was carried out by Bonferroni test.The differences of optical nerve head parameters in different gender were analyzed using independent sample t test and Bland-Altman test.Results In this study,1672 eyes of 1672 subjects were included,with the 759 male and 913 female persons and average age of (41.8±5.3)years.No significant differences were seen in the disc area (DA)between the superior and inferior,as well as the nasal and temporal quadrants among the subjects (P＞0.05).In addition,there were not significantly different in the rim area (RA) between the superior and nasal disc as well as the rim volume (RV) among the inferior,superior and nasal disc (P＞O.05).However,significant differences were found in the cup area (CA),cup/disk area ratio (C/DAR),cup volume (CV),mean cupdepth (MCD),maximum cup depth (MxCD),height variation contour (HVC),cup shape measure (CSM),mean retinal nerve fiber layer thickness (mRNFLT) and retinal nerve fiber layer cross section area (RNFLcsa) among the different quadrants (P＜0.001).The local differences from only DA and RA complied with an ordination of the ISNT rule.The values of DA,CA,C/DAR,CV,MCD,MxCD from male individuals were higher,but those of the RV,HVC,mRNFLT RNFLcsa were lower in comparison with female individuals.Nevertheless,all the differences were ＜ 0.1 with a maximal mean difference in DA and CA (both 0.07 mm2).Conclusions The optical nerve head configurations measured by HRT have different distributing characteristics in four quadrants in normal adults.Most parameters show the higher values in the inferior and superior than those in nasal and temporal of disc,but DA and RA meet ISNT rule.The differences of most parameters between male and female subjects can be ignored.

Background Heidelberg Retinal Tomograph (HRT) has been widely used in clinical diagnosis of glaucomatous optic neuropathy,importantly,the measurement results of HRT may be affected by myopia.Therefore,studying the effect of different refractive status and axial length on structural parameters of the optic disc is important.Objective This study was to evaluate the influence of refractive error and axial length to optic nerve head parameter measured by HRT.Methods The parents who participate in Guangzhou Twin Study were enrolled in this investigation from July 2006 to August 2011.The regular eye examinations,including visual acuity,slit lamp,fundus,auto-refraction,HRT-Ⅲ and intraocular lens (IOL) Master,were performed on all the subjects.Thc data from right eyes of subjects were collected and analyzed.The linear correlation analysis and multiple linear regression analysis were applied to analyze the correlation between HRT optic papilla configuration parameter and equivalent sphere and ocular axis length.Results A pilot prospective series cases observational study was designed.1748subjects were enrolled in this study.The disc area (DA) (P=0.021),rim area (RA) (P＜0.001),rim volume (RV) (P＜0.001),mean retinal nerve fiber layer thickness (mRNFLt) (P＜0.001) and retinal nerve fiber layer cross section area (RNFLcsa) in the high myopia were greater than those of the emmetropic group,with significant difference between the two groups (P＜0.001).However,the cup area (CA),cup/disk area ratio (C/DAR) and cup volume (CV) were less in the high myopic group than those of the emmetropic group (P=0.004,P＜0.001 and P＜O.001),respectively.In the mild-moderatc myopic group,the RV,mRNFLt and RNFLcsa were greater than those of the emmetropic group (all of the P value less than 0.001),but the numbers of DA,CA,C/DAR,and CV were less than those of the emmetropic group,the differences were significant and their P valuables were 0.038,＜ 0.001,＜0.001 and 0.001 respectively.The differences of structure parameters between the hyperopia group and the emmetropic group were not statistically significant (P＞0.05).The DA,CA,RA,C/DAR,CV,RV,mean cup depth (MCD),maximum cup depth (MxCD),cup shape measure (CSM),mRNFLt and RNTLcsa were (2.04±0.43) mm2,(0.49±0.34) mm2,(1.55 ± 0.34) mm2,0.23-0.13,(0.11 ± 0.12) mm3,(0.45 ± 0.19) mm3,(0.21 ± 0.09) mm,(0.60±0.21) mm,-0.21 ± 0.07,(0.29 ± 0.07) mm and (1.46 ± 0.36)mm2,respectively,in the 1748 eyes of 1748 subjects.No significant correlation was found between the DA value with SE (r=-0.032,P =0.186).However,weaker positive correlations were seen between the CA,C/DAR,CV,MCD,MxCD with SE (r=0.139,0.163,0.130,0.004,0.054,P＜ 0.05) and negative correlation between RA,RV,mRNFLt and RNFLcsa with SE (r =-0.178,-0.331,0.241,-0.239,P＜0.001).With the increase of the ocular axial length,the DA,RA,RV,mRNFLt and RNFLcsa values were enlarged,and the CV value was smaller.With the increase of CA,the RA,C/DAR,CV,RV,MCD,MxCD,CSM and RNFLcsa values elevated,but mRNFLt value was decreased.Conclusions Refractive error is not associated with DA,but the measuring results are different among various refractive groups.Refractive error,ocular axial length and DA affect the measuring result of HRT.

Objective To study morphological changes of rabbit artery endothelial cell injury and atherosclerosis caused by high fluoride and the role of selenium. Methods Twenty healthy male New Zealand white rabbits, body weight (2.0 ± 0.5)kg, were randomly divided into control group(drinking deionized water, fed basic diet), fluoride group(drinking fluoride 100 mg/L deionized water, fed basic diet), selenium group(drinking selenium 1 mg/L deionized water, fed basic diet), fluoride plus selenium group(drinking fluoride 100 mg/L deionized water, selenium 1 mg/L of deionized water, fed basic diet). The experimental period was 6 months. At 0, 3, 6 months of the experiment, serum fluorine and selenium levels were determined. At the end of the experiment,thoracic aorta was collected to observe its pathology and ultrastructural changes. Results Serum fluoride was significantly higher at the 3rd and the 6th month of experiment(all P ＜ 0.01 ) in fluoride group[ (0.589 ± 0.146),(0.772 ± 0.175)mg/L] and fluoride plus selenium group[ (0.502 ± 0.094), (0.693 ± 0.158)mg/L] than in control group[ (0.174 ± 0.002), (0.208 ± 0.031 )mg/L] and serum fluoride was significantly higher at 6 months than at 3 months(P ＜ 0.05 ) in fluoride group. Serum selenium was significantly higher at the 3rd and the 6th month of experiment (all P ＜ 0.01 ) in selenium group[ (0.252 ± 0.022), (0.319 ± 0.052)mg/L] and fluoride plus selenium group[ (0.239 ±0.016), (0.294 ± 0.018)mg/L] than in control group[(0.135 ± 0.014), (0.167 ± 0.019)mg/L], and serum selenium was significantly higher at the 6th month than at 3rd month of experiment in selenium group(P ＜ 0.05). Endothelial cell apoptosis indices were (4.92 ± 1.32)%, (30.30 ± 6.80)%, (6.57 ± 2.14)% and (14.29 ± 2.99)%, respectively in control group, fluoride group, selenium group and fluoride plus selenium group. Their main effect of fluorine and selenium was statistically significant (F = 106.833,20.082, all P ＜ 0.01 ). There were antagonistic effect between fluoride and selenium(F = 30.402, P ＜ 0.01 ). Pathological changes of rabbit aortic endothelial cells in fluoride group included endothelial with attached fibrin and red blood cells, and structural of the cells changed, with serious vascular injury; in fluoride plus selenium group apoptosis of endothelial cells decreased, with reduced number of attached red blood cells and fibrin, endothelial cell structure normal, the extent and scope of vascular damage significantly reduced. Conclusions Appropriate amount of selenium inhibits the apoptosis of endothelial cells induced by high fluoride, reduces aortic structural damage caused by high fluoride, and maintains the integrity of endothelial cells, thereby antagonizes the vascular damage and atherosclerosis induced by high fluoride.

Objective: To explore the incidence and risk factors of infection related to totally implantable access port (TIAP) in upper arm in cancer patients. Methods: A total of 1 961 patients who received TIAP for deliverance of chemotherapy at Renji Hospital, Shanghai Jiao Tong University School of Medicine during the period from February 2014 to December 2018. The general clinical data, catheterization status, bacteriological data and incidence of TIAP-related infections were retrospectively analyzed. The univariate analysis and multivariate Logistic regression analysis were used to determine the risk factors TIAP-related infections. Results: A total of 43 patients developed TIAP-related infections, with an incidence of 2.2% (43/1 961). The mean time interval from the implantation of upper arm TIAP to the diagnosis of infection was (116.88±95.39) d (7-377 d). In univariate analysis, gender (P=0.001), catheter diameter (P=0.000), upper extremity venous thrombosis (UEVT) (P=0.000) and outpatient (P=0.005) were significantly associated with the risk of infection related to upper arm TIAP. Multivariate binary Logistic regression analysis showed that gender (OR=0.35, P=0.012), UEVT (OR=31.59, P=0.000) and catheter diameter (OR=2.81, P=0.005) were three significant independent predictors of infection related to upper arm TIAP. Conclusion: Gender, UEVT and catheter diameter are independent risk factors for upper arm TIAP-related infection.