AIM: To observe the effect of ischemic preconditioning (IPC) on the subsequent permanent ischemic rat retina. METHODS: A model of two-vessel occlusion (2VO) was used to give an ischemic insult to rat retina. Bilateral carotid arteries were occluded directly in the simple ischemic groups. A procedure of double 2 min ischemia- 3 min reperfusion was applied to IPC groups before their carotid arteries were occluded. Experimental control groups received the same operation except that their exposed vessels were not occluded. Other 6 normal rats served as immunohistochemical controls. Eyeballs were taken out after being subjected to 1, 3 and 7 days of ischemia. The morphometry of retina was measured by stereologic methods. The apoptosis during the retinal ischemia was detected by TUNEL. Immunohistochemistry staining was used for the localization of bcl-2 in retina. RESULTS: In IPC groups, the thickness of retina was thinner than that in simple ischemic groups. The apoptosis was less when compared with the simple ischemic groups at the same ischemic time. The apoptotic cells show only in INL and the apoptosis of RGCs was not appeared until 7 days postischemia. There was no significant difference of the numerical density of RGCs at the different time after the operation. The bcl-2 immunoreactivity was weaker than that of the simple ischemic groups too. CONCLUSION: IPC reduced the injury caused by ischemia in retina, showing a protective effect.

AIM: To investigate the surgical methods of Helveston syndrome.
METHODS: Fifteen cases ( 30 eyes ) with Helveston syndrome were studied. Surgical method was selected according to the degree of superior oblique muscle overaction and dissociated vertical deviation (DVD).
RESULTS: Binocular superior oblique intrathecal tenectomy was performed in 8 patients (16 eyes). Follow-up period after surgery was 1-3a. Those 8 patients got A-sign correction, of which 3 patients (6 eyes) got DVD vanished and 5 patients (10 eyes) got DVD alleviation. None of the 8 cases needed another operation for DVD. Binocular superior rectus recession and binocular lateral rectus recession with vertical offsets was performed in 4 patients (8 eyes). Follow-up period after surgery was 1-3a. The 4 patients got A sign correction and with orthophoria, of which 1 patient ( 2 eyes ) got DVD vanished and 3 patients ( 6 eyes) got DVD alleviation. None of the 4 cases needed another operation for DVD. Binocular lateral rectus recession and vertical offsets was performed in 3 patients (6 eyes). Follow-up period after surgery was half a year, with orthophoria, no A sign, DVD weakened, and no second operation was needed. CONCLUSION: Surgical procedures for Helveston syndrome can be selected according to the degree of superior oblique muscle overaction and DVD.

Objective To investigate the feasibility and clinical application of prospective ECG-gated scan and adaptive cardio se-quence scan of dual-source CT coronary angiography.Methods 255 patients who underwent coronary CT angiography using a dual-source CT scanner were divided into two groups:group A underwent prospective scan,group B underwent retrospective scan.The two groups were further subdivided into low heart rate group and high heart rate group,recorded as A1(n=51),A2(n=89),B1(n=26), B2(n=89),respectively.Group A1 preceded with prospective ECG gated scan;group A2 performed with adaptive cardio sequence scan;group B1 and B2 underwent retrospective scan.All of them applied ATCM (automatic tube current modulation)technique. Effective dose was recorded.The image quality was assessed by two experienced radiologists with a four-point grading scale.Results The excellent or good image quality (score 1 and 2)of the four groups were above 95%,and no statistical differences in images scores was detected in A1 and B1 (P =0.726),A2 and B2 (P =0.079).Effective dose was significantly different in A1 and B1(P <0.001),A2 and B2 (P <0.001),and the former decreased 50% and 40% as compared with the latter.Conclusion Using prospective ECG gated scan and adaptive cardio sequence scan,assessable image quality of coronary artery can be acquired with dual source CT (heart rate<90 beast per minute),and radiation dose can be obviously reduced.

Objective To identify the differential serum proteins in patients with hepatic injury resulting from coal-burning type of arsenism. Methods Six serum samples were collected from patients with liver injury resulting from coal-burning type of arsenism and healthy subjects(control gruop) in endemic arsenism area. Twodimensional gel electrophoresis(2-DE) was performed to separate serum proteins, after silver staining, the differential expression of proteins were analyzed and then identified by matrix-assisted laser desorption/ionization time of flight mass spectrometry(MALDI-TOF-MS). Results The 2-DE map of serum protein patterns of patients and normal control were established successfully. The results showed that there were an average of (824 ± 31 ) spots and (782 ± 42) spots on 2-DE matching of the patients and control groups and the matching rate was 94.9%(782/824). From these two groups 49 differential protein spots were identified, of which over 3 times the difference in the expression of 30 protein spots were singled out and MALDI-TOF-MS analysis was carried out. Ten proteins were identified. Upregulated expression was observed in alpha-2-macroglobulin, B-cell receptor-associated protein, keratin 1,apolipoprotein A-I, and down-regulated expression was observed in haptoglobin, α2-heremans-schimid-glycoprotein,mitogen-activated protein kinase 4, zinc finger protein 323, ZAP-70 and SP40 in the patient group. Conclusions The well-resolved and reproducible 2-DE serum patterns of patients are established and some differentially expressed proteins are characterized. Whether these proteins of differential expression are serum markers for liver injury resulting from coal-burning type of arsenism need to be further verified.

Objective To study the morphological characteristics of femurs of adult human and 11 kinds of adult animals fromcattle, horses, pigs, goats, sheep, dogs, cats, rabbits, geese, ducks, chickens, and to establish an effective species identification method among various species. Methods The 4 cmmid-dia-physeal segment of the femur fromadult human (older than 20 years old) at autopsy w as obtained. Addi-tionally, the 4 cmones from11 kinds of adult animals w ere obtained. After decalcification, all femurs w ere made into slices, and then w ere observed by optical microscope. The 25 indexes w ere selected and analyzed by step discriminant analysis according to differences betw een human and mammal, human and poultry, and human and 11 kinds of animals. Results The histological structure of bone mineral density of middle part of femur had obvious characteristics among the species. And the morphology and number of osteon show ed the trend of obvious biological evolution. There w ere 11 indexes w ith significant differ-ences betw een human and 11 kinds of animals to establish some mathematical models to discriminate all species. The correct discrimination rate w as 96.3% betw een human and mammal. The correct discrimina-tion rate w as up to 100% betw een human and poultry, and w as 89.4% among human, mammal and poultry. Conclusion The mathematical models have good correct discrimination rate among human and the other animals, w hich could be applied in the practical species identification cases.

Objective To study the clinical characteristics of chronic active Epstein-Barr virus (EBV) infection (CAEBV) in children and to provide a basis for the diagnosis and treatment of CAEBV.Methods Clinical data,laboratory serology,pathological examination,treatment and follow-up results of 10 cases with CAEBV infection who were treated in Xijing Hospital of the Fourth Military Medical University from January 2008 to January 2016 were analyzed retrospectively.Results CAEBV major manifestations were continuous or intermittent fever,hepatomegaly,splenomegaly and lymphadenopathy,and others,including general fatigue,cough,hematemesis,diarrhea,skin rash,jaundice,sore throat,muscle joint pain,and so on.And with liver dysfunction,hematologic abnormality,and so on.All patients in anti-EB virus capsid antigen IgG (EBVCA-IgG)antibodies and EBEA-IgG antibodies had positive,while all patients in EBVCA-IgM antibodies had negative.The median load of EBV-DNA detected by real-time polymerase chain reaction(PCR) in the peripheral blood was 7.15× 105 copies/ml.Six of 10 cases CAEBV patients presented a poor clinical course,1 case died from intracranial hemorrhage,2 cases from respiratory failure,1 case from gastrointestinal bleeding,1 case from liver failure,1 case from severe multiple pathogens infection,rest 3 cases showed an improvement and 1 cases had a recurrence.Conclusion CAEBV infection has varieties of clinical features,with poor prognosis and high mortality.If the patients had unexplained fever,hepatomegaly,splenomegaly and lymphadenectasis,we should be timely detect virology and histopathological to diagnosis as early as possible.

Objective To develop a nylon membrane chip for rapid and systematic detection of the diabetes-associated 45 mutant loci in mitochondrial DNA(mtDNA).Methods The mutant-and wild-type probes were designed for detection of 45 mutant loci in mtDNA with Primer Premier 5.0 and NCBI BLAST softwares and the 90 probes with 8 poly T were immobilized on the Hybond N~+ nylon membranes which were treated with 5?SSC Buffer by UV-crosslinking;Then asymmetric PCR was employed to obtain the target single strand DNA(ssDNA).The PCR products were labeled with biotin after purification.NBT/BCIP was used as substrate that yields a very intense purple signal followed by AP-avidin,and the signals were observed in 24 samples with known sequences to evaluate the chips,each sample was repeatedly measured three times.Results The specific target fragments of 45 loci can be amplified under the same condition with nine sets of primers.The annealing temperatures of the wild-type [(59.01?1.42)℃] and mutant-type [(59.34?1.29)℃ ] probes are so close(t=1.046,P =0.301)that hybridization can be performed at the same temperature.The spots on the membrane chip are distinct,regular and well-distributed.The results of positive-and negative-control are perfect.The signals of negative probes and the background are similar.The results of chip were nearly concordant with that of DNA sequences(?~2=113.132,Kappa value =0.888,P = 0.000)except for T16189C mutant.Conclusions We have successfully developed a nylon membrane chip for rapid and systematic detection of the diabetes-associated 44 mutant loci in mtDNA.It could be used for screening for diabetic patients and high-risk people.

Background Biometry of the anterior ocular segment parameter is very important for the diagnosis and treatment of glaucoma and ocular injury as well as measurement of intraocular lens(IOL).Objective This study was to compare the differences in the anterior chamber depth(ACD) and the central corneal thickness (CCT) between Sirius and Pentacam and evaluate the agreement of these two measurement methods.Methods The ACD and the CCT of 38 right eyes from 38 health volunteers aged 23- 32 years were measured with both Pentacam and Sirius.Three times of measurement were pedormed on each eye for each method to obtain the average values.The repeatability and agreement from each method were assessed as intraclass correlation coefficient( ICC ) and coefficient of variation(CV) and the agreement between these two methods were evaluated using Bland-Altman mode.ResultsThe mean ACD value was( 3.18±0.21 ) mm from Pentacam with the ICC 0.995 and CV 0.066.The mean ACD value from Sirius was (3.22 ±0.21 )mm with the ICC 0.996 and CV 0.065.The difference value in ACD between two methods was 0.04 mm,showing a significant difference( t =-6.225,P＜0.05 ) and a positive correlation (r=0.977) between two methods.The 95％ limit of agreement was( -0.04-0.13)mm within 1 standard difference (SD) of the mean value( ±0.21mm),which was acceptable for clinical measurement.The CCT was( 535±33 )μm from Pentacam with the ICC 0.994 and CV 0.062.The CCT was(537±36)pm from Sirius with the ICC 0.999 and CV 0.067.The difference value in the CCT between two methods was about 2 μm,presenting a in significant difference ( t =1.771,P＞0.05 ) and positive correlation ( r =0.985 ).The 95 ％ limit of agreement was ( - 11.64-15.65 ) μm within 1 SD of the mean value( ±34.27 pm),which was acceptable for clinical measurement.ConclusionsSirius and Pentacam show good agreement in the measurement of ACD and CCT.The two methods offer an alternative choice for the biological measurement of the anterior ocular segment.

Background Axial length and anterior chamber depth are important parameters for the calculation of diopter of intraocular lens ( IOL ). Objective This study was to investigate and compare the measuring outcomes of axial length and anterior chamber depth with IOLMaster,Axis- Ⅱ A-scan and ODM 1000A sonograph.Methods This a observational study.Axial length and anterior chamber depth were measured in 83 eyes of 48 patients with IOLMaster,Axis-Ⅱ A-scan and ODM 1000A sonograph by the same operator.The measuring results were compared among the three methods.Results The axial length were(25.79±0.85) mm,(25.72± 0.82 )mm and ( 26.00 ±0.83 )mm respectively with Axis- Ⅱ,ODM 1000A sonograph and IOLMaster.The difference between Axis-Ⅱ and DM 1000A sonograph was (0.07 ± 0.35 )mm without statistical difference between them (t=1.711,P =0.091 ).The difference of axial length between IOLMaster and DM 1000A sonograph was ( 0.27 ±0.29) mm with a statistical difference between them ( t =-8.570,P =0.000 ).The difference between IOLMaster and Axis- Ⅱ was (0.21 ±0.32 ) mm and showed a statistical difference ( t =- 5.931,P ＜ 0.01 ).The positive correlations were found in the axial length values by the each other comparison among the three instruments( r=0.916,0.938,0.928,P＜0.01 ).The anterior chamber depth values were ( 3.81 ±0.21 ) mm,( 3.84 ±0.25 ) mm and ( 3.83 ±0.18 )mm respectively with Axis-Ⅱ,0DM 1000A sonograph and IOLMaster.The difference of anterior chamber depth between Axis- Ⅱ and DM 1000A was (0.03 ±0.17 ) mm without statistical difference between them ( t =- 1.324,P =0.189 ).The difference in the anterior chamber depth between IOLMaster and DM 1000A was (0.01 ±0.15 ) mm and that between IOLMaster and Axis-Ⅱ was( 0.01 ±0.12)mm without any statistical differences among them (t =0.815,P=0.417 ;t=-0.900,P=0.371 ).The high correlation between anterior chamber depth measurements were found by the each other comparison in the three instruments ( r =0.735,0.813,0.823,P ＜ 0.01 ).Conclusions ODM 1000A sonograph can provide precise axial length and anterior chamber depth values.However,ODM 1000Asonograph can not substitute for IOLMaster in the measurement of the anterior chamber depth and axial length.

Background Clinical research showed that the corneal endothelial cell density value from different corneal specula microscopies exist diversity.The relevant literature of SP02,Tomey EM-3000 and SP3000P is still seldom up to now. Objective This research was to assess the repeatability of endothelial cell density measurements by SP02,Tomey EM-3000 and SP3000P respectively and the agreement among 3 kinds of endothelial microscopes.MethodsFifty-four healthy volunteers with the age 17-38 years old were included this research.The written informed consent was obtained from each subject before examination.The corneal endothelial cell densities in the right eyes were analyzed with SP02,Tomey EM-3000 and SP3000P respectively for 3 times under the automatic mode,and the analytical procedure of SP3000P measurement were divided into automatic mode SP3000P (A) and manual correction modes SP3000P( M).The repeatability of each specula microscopy was analyzed by calculating the intraclass correlation coefficients (ICC) and coefficient of variation ( CV ),and the 95％ confidence intervals and plotting Bland-Altman graphs were used to analyze the agreement among these methods.ResultsThe mean corneal endothelial cell densities in the population ＜24 years were significantly higher than the ones ≥ 24 years (t =3.692,P＜0.05 ),but no statistical difference was found between different gender ( t =0.335,P =0.739 ).The mean corneal endothelial cell densities were ( 3058 ± 260 ),( 2954 ± 229 ),( 2668 ± 258 ),( 2734 ± 268 ) cell/mm2 ; the ICCs were 0.957,0.940,0.972 and 0.972 and the CV were 0.063,0.061,0.056,0.058 for SP02,Tomey EM-3000,SP3000P (A) and SP3000P ( M ) respectively.The 95％ confidence intervals were ( - 100.8 - 306.8 ),( 162.6 - 617.4 ),( 109.9-494.1 ) and ( -0.6 - 132.6 ) cell/mm2 for between SP02 and Tomey EM-3000,SP3000P ( A ) and SP02,SP3000P(A) and Tomey EM-3000,SP3000P(A) and SP 3000P(M) respectively.ConclusionsSP02,Tomey EM-3000 and SP3000P(A) have good repeatability in the measurement of corneal endothelial cell density,however the outcome is different.Therefore,it is not interchangeable for the detection of corneal endothelial cell density.The differences of corneal endothelial cell density obtained from these instruments shall be paid high attention for their differences.SP3000P(A) and SP3000P(M) can be used interehangeably and SP3000P(A) is a preferable choice due to its convenience and quickness.