AIM:To explore the changes of intraocular pressure measured by noncontact tonometer (IOPNCT) with high myopia and analyze the relative fators after small incision lenticule extraction(SMILE).METHODS:A retrospective study.Totally 108 cases (216 eyes) with high myopia received SMILE during March 2015 to October 2016 were involved.The IOPNCT, corneal central thickness (CCT) and corneal curvature for 3mo were recorded and analyzed by ANOVA, LSD t test.The Pearson correlation analysis and multiple linear regression model analysis were used to evaluate the relationship between IOPNCT and its influence factors.RESULTS:(1) There was significant statistical difference in IOPNCT after SMILE at 1d, 1wk, 1 and 3mo compare with preoperative (t=17.785, P=0.019;t=17.981, P=0.016;t=18.841, P=0.012;t=19.364, P=0.001);the IOPNCT after SMILE decreased.The IOPNCT values at every time after SMILE was no statistical difference (t=1.871, P=0.818;t=3.062, P=0.328;t=1.143, P=0.373).(2) The IOPNCT in high myopia were positive correlated with CCT and corneal curvature after SMILE (r=0.4356, 0.295;P<0.05), respectively.(3) The multiple linear regression model analysis revealed that Y=-14.601+0.348X1+0.03X2 (Y was IOPNCT, X1 was corneal curvature, X2 was CCT,P<0.001);Y=3.679+0.28X1+0.012X2 (Y was△IOPNCT,X1 was variation of corneal curvature,X2 was△CCT, P<0.001).CONCLUSION:The IOPNCT decreased after SMILE in high myipia, and it showed that there was no significant influence to use glucocorticoid eye drops in short terms.There was positive correlation among IOPNCT, CCT and corneal curvature after SMILE.

?The small incision lenticule extraction ( SMILE ) with femtosecond laser is a new mode of corneal refractive surgeryrecently. The safety, efficacy, stability and predictability of SMILE lead the corneal refractive surgery to a new world that only use femtosecond laser to correct myopia.With the development and popularity of SMILE, the clinical effect has aroused much concern.But there remain exited disputes in refractive stability, visual quality and corneal biomechanical property, contrast sensitivity and glare symptoms, corneal sensitivity and dye eye, corneal endothelial cells and intraocular pressure.These will be summarized in this review.

Objective To explore the association of activated blood platelet and large vacular disease in type 2 diabetes mellitus.Methods A total of 98 cases of type 2 diabetes mellitus patients were divided into two groups(50 cases with large vascular disease and 48 cases,as DM group)and 50 cases healthy subjects served as a control group.From 2002-05 to 2004-11,the doctors of the Department of Endocrinology,Subei Hospital to determined the expression of platelet activation PAC-1、CD62P in large vascular disease by technique of flow cytometry(FCM),and glycosylated hemoglobin(HbA_1c)、C-reactive protein(CRP)、fasting plasama glucose(FBG)、C-peptide(C-P)and blood lipids were measured and analysed for the correlation.Results Activated blood platelet was significantly increased in DM group as compared with that in control group(P

Objective To establish the reference interval of serum urea nitrogen (BUN) ,creatinine(Cr) ,uric acid(UA) for the healthy adults of Hengshui City .Methods 16 403 cases of healthy adults of different areas in the city were enrolled in the study .By using automatic biochemical analyzer ,3 kidney function indicators(BUN ,Cr ,UA) were determined .According to different sex and age groups ,statistical analysis was performed .Results The reference intervals of 3 kidney function indicators for healthy people in Hengshui City were as follows ,BUN :2 .75-7 .05 mmol/L for male and 2 .24-6 .58 mmol/L for female;Cr:49 .69-87 .96 μmol/L for male and 35 .82-72 .22 μmol/L for female;UA :209 .51 -500 .06 μmol/L for male and 146 .25 -389 .69 μmol/L for female . Conclusion The reference intervals established could basically reflect the concentrations of 3 kidney function indicators for the healthy adults in Hengshui City ,which could provide a reference .

Objective To assess the function of motor nerve fiber in patients with diabetic peripheral neuropathy (DPN) by single-fiber conduction studies.Methods According to the diagnostic standard of DPN issued in Toronto meeting in 2009,on the basis of the result of peroneal nerve conventional conduction study,a total of 65 patients with DPN in the Department of Endocrinology and the Department of Neurology of Tianjin Third Central Hospital from October 2012 to October 2013 were enrolled into the study,from whom 33 had abnormal sensory conduction (sensory-diabetic peripheral neuropathy group,S-DPN group),32 had abnormal sensory motor conduction (sensory motor-diabetic peripheral neuropathy group,SM-DPN group).Single-fiber conduction velocity (SF-CV) and single-fiber distal motor latency (SF-DML)were detected in all subjects.The obtained results were compared with the data from 34 healthy volunteers (control group).The relationship of SF-CV,SF-DML and the duration of diabetes mellitus,fasting glucose,HbA1 c was also studied in DPN patients.Results The SF-CV ((43.1 ± 3.6) m/s) was decreased in S-DPN group compared with control group ((47.5 ± 3.3) m/s,t =5.077,P ＜ 0.01).There were no significant differences in SF-DML ((3.6 ± 0.7) ms),motor nerve conduction velocity (MCV (49.5 ± 2.6)m/s) and DML ((3.4 ± 0.6) ms) in S-DPN group compared with that of control group ((3.4 ± 0.5) ms,(50.9 ± 3.5) m/s,(3.2 ± 0.5) ms,respectively).SM-DPN group had lower SF-CV ((35.2 ± 3.6)m/s,t =9.119,14.219),MCV ((40.9 ± 3.2) m/s,t =11.131,13.025) and increased SF-DML ((4.5±0.7) ms,t=5.692,7.231),DML ((4.2 ±0.7) ms,t=5.561,6.975) compared with the other two groups (P ＜0.01).SF-CV in DPN patients was negatively related to the diabetic duration (r =-0.340,P =0.006),while SF-DML had no correlation with duration of DM,fasting blood glucose and HbAlc.Conclusions Detection of SF-CV is easy to find early motor nerve dysfunction in DPN patients.SF-CV is decreased with the increasing duration of diabetes.

Objective To establish the reference intervals of total cholesterol (TC),triglyceride (TG),high density lipoprotein (HDL-C)and low density lipoprotein (LDL-C)in the healthy population in Hengshui region.Methods 16 403 healthy individuals were collected from the various counties and cities in this region and detected the above 4 blood lipid indexes (TC,TG,HDL-C, LDL-C)by adopting the automatic biochemical analyzer.The subjects were grouped according to different genders and ages and the detection results were performed the statistical analysis.Results TC 3.17-7.20 mmol/L;TG 0.08-3.16 mmol/L;HDL-C 0.94-2.30 mmol/L;LDL-C 1 .14 -4.59 mmol/L.Conclusion The differences of blood lipid detection results exist in males and fe-males in Hengshui region,the results are different among different age groups,it is suggested that different genders and different age groups should establish their own normal reference intervals in order to provide the diagnostic basis for clinic.

Objective To improve the current standard method of measuring urinary iodine by As (Ⅲ)-Ce4+catalytic spectrophotometry, reducing the amount of arsenic toxic reagent used to decrease environmental pollution,and make the modified method with good precision and accuracy. Methods For improving the current standard method of measuring urinary iodine, amount of arsenious acid solution was reduced from 0.100 mol/L H3AsO3(which contains NaCl 25 g/L) 2.5 ml to 0.025 mol/L H3AsO3(which contains NaCl 40 g/L) 2.5 ml;amount of ceric ammonium sulfate solution was reduced from 0.076 mol/L 0.30 ml to 0.025 mol/L 0.30 ml;photometric wavelength was changed from 420 nm to 400 nm. The new modified method was evaluated by standard curve linearity and linear range, sample detection limit, precision, accuracy, and urinary iodine values, and the rates of absorbance change in the test process were compared with the current standard method. Results The calibration relation of C= a + blgA (C: iodine concentration, A : measuring absorbance) in the new modified method existed when As3+-Ce4+ catalytic reaction was kept at a certain stable temperature range between 20 - 35 ℃ and in certain stable reacting time. The linear range of the calibration curve was 0 - 300 μg/L and the linear correlative coefficient was - 0.9998. The detection limit for iodine was 4 μg/L(0.25 ml of urine was tested). The test coefficient of variations(CV) were 1.7%(1.1/66.0), 1.8%(1.4/76.0), 2.0%(3.0/147.5), 1.6%(4.2/265.5) when measuring urine samples with iodine concentration of 66.0, 76.0, 147.5, 265.5 μg/L, respectively. The average recovery was 100.6% with a range of 95.0% (57.0/60.0) - 103.7% (62.2/60.0) when measuring 4 urine samples containing different iodine concentration, and average recovery was 101.0% (40.4/40.0), 100.4% (100.4/I00.0), 100.5% (60.3/60.0),100.4% (100.4/100.0), respectively. The test results of two national standard urinary iodine were all within the given value range and the relative deviation(RD) was < 5.0% and < 2.0% in 20, 25, 30, 35 ℃ test temperature,respectively. No significant difference was found between the results of the 48 urine samples determined by the new modified method and the current standard method(t = 0.634, P > 0.05). The table of suitable combination of As3+-Ce4+ reaction temperature and time for this method was obtained(such as 20 ℃ and 53 min, 25 ℃ and 40 min, 30 ℃and 30 min, etc. ). Compared with the standard method, the rates of absorbanee change of As ( Ⅲ )-Ce4+ reaction in the new modified method were more slowly, which further reducing the determination deviation caused by the temperature fluctuations or measuring time deviation in measurement process. Conclusions This new modified method greatly reduces the amount of arsenic in waste, reduces pollution, saving reagents, and this method is easier to operate with better precision and accuracy, which is suitable for application of measuring iodine in urine.

Objective To evaluate the effects of ischemic time factors on reduction of myocardial ischemia-reperfusion injury by sulfentanil postconditioning in rats .Methods Healthy adult male Sprague-Dawley rats ,weighing 230-250 g ,were heparinized and anesthetized with intraperitoneal 5% chloral hydrate 8 ml/kg .The hearts were excised and perfused in a Langendorff apparatus with K-H solution .After 30 min of stabilization ,48 isolated rat hearts were randomly assigned into 6 groups (n=8 each) using a random number table .In I/R1-3 groups ,the hearts were subjected to 30 ,45 ,and 60 min of myocardial ischemia ,respectively ,followed by 90 min of reperfusion . In SP1-3 groups , the hearts were subjected to 30 , 45 , and 60 min of myocardial ischemia , respectively ,followed by 90 min of reperfusion ,and sulfentanil 100 nmol/L was added to K-H solution at 15 min of reperfusion for postconditioning . Left ventricular end-diastolic pressure (LVEDP ) , left ventricular developed pressure (LVDP) ,+dp/dtmax ,-dp/dtmax ,HR and coronary flow (CF) were measured at the end of equilibration and 15 ,30 ,60 and 90 min of reperfusion .Creatine kinase (CK) and lactate dehydrogenase (LDH) activities in coronary effluent were measured at 5 min of reperfusion .Myocardial infarct size was determined in 5 hearts chosen randomly at 90 min of reperfusion .Results LVEDP was significantly higher ,and LVDP , ± dp/dtmax and CF were lower at each time point of reperfusion than at the end of equilibration in I/R1-3 groups ( P<0.05) .Compared with I/R1 and I/R2 groups ,LVEDP was significantly increased ,and LVDP and ± dp/dtmax were decreased at 30 ,60 and 90 min of reperfusion ,HR and CF were decreased ,and CK and LDH activities in coronary effluent and infarct size were increased at 15 and 30 min of reperfusion in group I/R3 ,and LVEDP was significantly decreased ,LVDP , ± dp/dtmax and CF were increased ,CK and LDH activities in coronary effluent and infarct size were decreased at 30 , 60 and 90 min of reperfusion in groups SP1 and SP2 ( P< 0.05 ) . Compared with group I/R3 , LVDP was significantly decreased at 30 ,60 and 90 min of reperfusion ( P<0.05) ,and no significant change was found in CK and LDH activities in coronary effluent and infarct size in group SP3 ( P>0.05 ) .Conclusion Sulfentanil postconditioning can attenuate myocardial ischemia-reperfusion injury when the rats are subjected to 30 or 45 min of ischemia ,however ,it provides no myocardial protection when the rats are subjected to 60 min of ischemia .

Objective To investigate motor nerve function status in rats with diabetes mellitus by motor unit number estimation (MUNE), and discuss it′s early diagnostic value in diabetic peripheral neuropathy (DPN). Methods Diabetic rat model (DM group) was induced by streptozotocin. The MUNE of gastrocnemius muscle and motor nerve conduction (MCV, CMAP) of the sciatic nerve were measured at the 4th, 8th and 12th week after onset of hyperglycemia in the DM group and the control group (normal SD rats). The ultrastructure of sciatic nerve was observed by electron microscope. Results At the 4th week, MUNE of gastrocnemius muscle was significantly decreased in DM group compared to that of the control group (275.88 ± 87.87 vs 369.71 ± 75.64,P<0.05). There were no significant differences in MCV and CMAP of sciatic nerve be?tween two groups. The electron microscopy observation showed that most nerve fibers were normal;a small amount of axonal atrophy, and myelin lamellar structure was separated in DM group. At the 8th week, compared with the control group, MUNE were reduced in gastrocnemius muscle in DM group (357.49±72.68 vs 221.26±92.41, P<0.01). There were no significant dif?ferences in MCV and CMAP of the sciatic nerve between DM group and control group. The electron microscope observation showed that part of nerve fibers were normal, the myelin focal plate layer was loose and separated, axonal atrophy, the axonal membrane and myelin sheath inner layer was separated with big gap. At the 12th week, MUNE of gastrocnemius muscle (127.87±19.80 vs 366.85±51.25), sciatic nerve MCV [(35.06±4.43) m/s vs (50.47±6.07) m/s] and CMAP [(2.91±1.37) mV vs (5.98±2.14) mV] were significantly decreased in DM group than those of control group (P<0.01). The electron microscopy observation showed severely damaged myelin flex and axonal squeeze. Conclusion MUNE is much earlier in detecting ear?ly motor nerve dysfunction in DM than conventional motor nerve conduction test.