AIM: To investigate whether carnosine can inhibit cataract formation and protect Na+-K+ATPase against inactivation induced by a glucocorticoid.METHODS: Two hundred and twenty clear lenses cultured in vitro were randomly divided into five groups: control group (DMEM), steroid group (DMEM+Dexamethason 10μmol/L),lower concentration carnosine-treated group (DMEM+Dexamethason 10μ mol/L+Carnosine 2mmol/L), higher concentration carnosine-treated group (DMEM+Dexamethason 10μmol /L+Carnosine 5mmol/L) and carnosine group (DMEM + Carnosine 5mmol/L). Progression of cataract formation was evaluated daily using a dissecting microscope. On 1, 3, 5 and 7d, 10lenses of every group were homogenized and the activity of Na+-K+ATPase was measured by using spectrophotometer.RESULTS: During the incubation, mistlike opacity was observed in the lenses of the control group and carnosine group,but in the steroid group appeared dense nuclear opacity, while both two carnosine-treated groups came out visible demarcation between nuclear and cortical regions on 7d. A decrease in the activity of Na+-K+ATPase was found in the lens of the steroid group. On 3, 5, 7d, Na+-K+ATPase activity decreased 22.34% (P=0.002),47.98% (P＜0.001),75.37% (P＜0.001) compared with that at 1d, respectively. In the carnosine group,the activity of Na+-K+ATPase remained at the level of the control throughout the 7-d incubation, indicating that carnosine itself did not interfere with the original lens enzyme activity. In the lower concentration carnosine-treated group, on 3, 5, 7d,the activity of Na+-K+ATPase increased 10.8% (P＜0.05),44.6% (P＜0.01), 57.4% (P＜0.01) of control activity, respectively. In the higher concentration carnosine-treated group, on 3, 5, 7d, the activity of Na+-K+ATPase increased 11.3% (P＜0.05), 45.7% (P＜0.01), 57.6% (P＜0.01) of control activity,respectively. The activity of Na+-K+ATPase in both two carnosine-treated groups were only 6.7% and 6.5% lower than that of the control group after 7-d incubation. After the 7-d incubation, the Na+-K+ATPase activity of the lenses in the steroid group decreased significantly compared with carnosine-treated groups (P＜0.01).CONCLUSION: Carnosine prevents the cataract formation induced by a glucocorticoid, and significantly inhibits the inactivation of Na+-K+ATPase induced by a glucocorticoid.

Objective To investigate polymorphism of CD40 gene and its relation with autoimmune thyroid disorders(AITD) in China's Northwest region.Methods The study recruited 372 subjects: 165 Graves' disease(GD) and 113 Hashimoto's thyroiditis(HT) and 93 healthy subjects as controls.① Using PCR-restriction fragment length polymorphism(PCR-RFLP) to analyze the C/T polymorphism in the 5′UTR and the-58038T point mutation in exon3.② Using amplification refractory mutation system-PCR(ARMS-PCR) to analyze the C64610G point mutation in exon9.Results ① There were significant differences in allele frequencies of C and genotype CC between GD group and control group in 5′UTR C(-1)T(P

AIM: To assess the prevalence of refractive errors in middle school students in Lanzhou city and explore the risk factors for myopia.METHODS: A cross-sectional survey was conducted. A questionnaire assessed the students' socioeconomic background and visual tasks followed by visual acuity assessment and a full eye examination including slit lamp examination, fundus evaluation, retinoscopy, and subjective refraction.RESULTS: Among 2 256 enumerated students aged 15-19 years, 2 037 (90.3%) students had significant refractive errors. Myopia was the leading refractive error (1 951/2 256,86.5%), astigmatism was the second most common refractive error (921/2 256, 40.8%), but amblyopia (10/2 256, 0.4%),strabismus (5/2 256, 0.2%), hyperopia (4/2 256, 0.2%) and other treatable eye disorders were uncommon. Almost 95.3% of students with significant refractive errors wore spectacles before the survey. Age, sex, visual tasks, and a parental history of myopia were risk factors for myopia.CONCLUSION: The prevalence of refractive errors and the risk factors for myopia in schoolchildren in Lanzhou city are similar to those reported in other regions of China.Interventions of myopia progression should be performed to protect the visual acuity of school-aged students.

AIM: To observe the efficacy of Medpor porous polyethylene implants in treatment of enophthalmos combined with orbital fracture.
METHODS: Seventeen cases ( 17 eyes ) with enophthalmos caused by orbital fracture underwent surgical treatment with Medpor porous polyethylene implants. All accepted a 6-mo follow-up and the data of enophthalmos, eyeball movement and diplopia were collected.
RESULTS: The average difference of exophthalmos between damaged eyes and undamaged eyes was (3. 4±1. 5 ) mm preoperatively, two cases had residual 1mm enophthalmos 6mo after surgery, while other 15 cases were completely corrected. Seventeen cases suffered from eyeball movement restriction and diplopia preoperatively, 16 cases had normal eyeball movement without diplopia 6mo after surgery, 1 case with limitation of abduction and horizontal diplopia. There was no extrusion, rejection, infection or other complications occurred during follow-up.
CONCLUSION: Medpor porous polyethylene implants can effectively improve the orbit volume to repair enophthalmos caused by orbital fracture.

AIM:To evaluate the efficacy and stability by comparing acuity and diopter of small incision lenticule extraction ( SMILE) , femtosecond laser in situ keratomileusis ( FS-LASIK ) and laser in situ keratomileusis ( LASIK ) in treating myopia with a follow-up of 6mo.
METHODS: A retrospective study, 42 cases ( 84 eyes ) received SMILE, 37 cases ( 74 eyes ) received FS-LASIK and 31cases (62 eyes) undergone LASIK in our hospital during Apr. 2014 to Jun. 2014 were involved. The follow-up data of 6mo was analyzed. The preoperative spherical equivalent was -5. 91±1. 83D, -5. 89±1. 96D, -5. 88±1. 68D in SMILE, FS-LASIK and LASIK group, respectively. The differences of preoperative best corrected visual acuity ( BCVA ) , pupil diameter ( PD ) and central corneal thickness ( CCT ) had no statistically significant between three groups. The postoperative uncorrected visual acuity ( UCVA) , BCVA and diopter were comparative analyzed at 1wk, 1, 3 and 6m after surgery.
RESULTS:1) No patients lost to follow-up of 1wk and 1mo. A total of 10 eyes (5 cases), 10 eyes (5 cases) and 8 eyes (4 cases) lost to follow-up of 3m in SMILE、FS-LASIK and LASIK group, respectively, and raised to 18 eyes (9 cases), 12 eyes (6 cases) and 14 eyes (7 cases) in follow-up of 6m. 2) At 1wk follow-up, the differences of UCVA between SMILE group, FS- LASIK group vs LASIK group was statistically significant respectively ( t=4. 098, P=0. 000;t=2. 493, P=0. 004). 3) In LASIK group, the differences of UCVA between 1wk vs 3, 6m follow-up was statistically significant respectively (t=3. 410, P=0. 001;t=3. 771, P=0. 000), the differences of UCVA between 1m and 6m follow-up was statistically significant (t=2. 283, P=0. 026). 4) The differences of diopter were not statistically significant among three groups at 1wk, 1, 3 and 6mo follow-up respectively (χ2=0. 119, P=0. 942;χ2=1. 504, P=0. 471;χ2=0. 949, P=0. 622; χ2=0. 277, P=0. 871). 5) the differences of eyes with UCVA≥5. 0 was statistically significant between SMILE group vs FS-LASIK group, LASIK group at 1wk follow-up (χ2=9. 249, P=0. 002<0. 05/3;χ2=12. 906, P=0. 000<0. 05/3), there was no significant statistical difference between FS-LASIK group and LASIK group (χ2=0. 500, P=0. 604). 6) there was no significant statistical difference of eyes with SE (±0. 50D) at any time post operation among three groups (χ2=0. 809, P=0. 697;χ2=1. 176, P=0. 634;χ2=0. 871, P=0. 736;χ2=0. 683, P=0. 770).CONCLUSION: All of SMILE, FS-LASIK and LASIK are effective and stable on treating myopia according to follow-up of 6mo. However, in this study, SMILE group shows more effective than FS-LASIK and LASIK at 1wk, which could enhance postoperative UCVA more rapidly.

· AIM: To investigate the complications of intravitreal triamsinolone acetonide (TA) injection in vitrectomy for proliferative diabetic retinopathy (PDR).· METHODS: From February 2005 to January 2007, 18patients (18 eyes) with PDR who were injected with TA in vitrectomy were observed retrospectively after surgery.· RESULTS: During a postoperative follow-up period of 3 to 6 months (mean 4.6 months), some complications including deposit of TA granules on the macular region and surface of the retina (3 eyes), postoperative vitreous hemorrhage (3eyes), elevated intraocular pressure (2 eyes) and pseudohypopyon (1 eye)were observed.· CONCLUSION: The complications after surgery such as deposit of TA granules on the macular region and surface of the retina and pseudohypopyon could be cured without any special treatment. All eyes with elevated intraocular pressure after surgery were controlled by drug. Re-operation may be an effective method for patients with unabsorbable vitreous hemorrhage after vitrectomy.

Objective To observe the effects of high fat diet and 6?week voluntary wheel running on the structure of hypothalamus, pituitary and testis and sex hormone levels in pubertal male rats. Methods Forty 3?week?old male Spra?gue?Dawley rats were randomly divided into following groups: the control group fed with normal diet (C), training group fed with normal diet ( CE) , control group fed with high fat diet ( D) , and training group fed with high fat diet ( DE) , 10 rats in each group. The groups C and D were bred for 8 weeks freely, and the groups CE and DE were assigned to have vol?untary wheel running twice/d, 1 h/time, 5 d/w, for 6 weeks after a 2?week adaptive feeding. Eight weeks later, blood sample was collected to detect the serum T, E2 , FSH and LH, and the E2 and T of testis were also detected. The histology of hypothalamic, pituitary, and testis tissues was observed by light microscopy. Results ( l) Compared with the group C, the group D had significantly decreased levels of serum T and E2 and testicular T (P<0?05), and significantly increased serum E2, FSH and LH levels (P<0?05). In the group D, vacuolar lipid droplets were increased in the hypothalamus, e?osinophils and basophils were reduced in the pituitary, and the area of seminiferous tubules, percentage of sperm cells, and quantity of Leygid cells were significantly decreased in the testis. (2) Compared with the group D, the serum T and testic?ular T concentrations were increased, but the serum E2, FSH and LH were decreased significantly (P<0?05) in the group DE, and vacuolar lipid drops were increased in the hypothalamus, eosinophil cells were increased in the pituitary gland, and the area of seminiferous tubules was increased but not significantly in the testis. Conclusions 6?week voluntary wheel exercise can improve the high fat diet?induced abnormal secretion of sex hormones, but not effectively improve the histologi?cal changes in hypothalamus, pituitary gland and testis.

Objective To study the relationship between the medial artery calcification and expression of core-binding factor alpha 1 (Cbf α-1) and collagen Ⅱ (Col Ⅱ) in chronic kidney disease (CKD) stage 5 patients.Methods Pieces of radial arteries were taken from 40 patients with CKD stage 5 during internal arteriovenous fistula operation.Ten patients with subtotal gastrectomy and normal renal function were chosen as control.The vessels were examined for calcification by von Kossa stain and for the presence of Cbfα-1 and Col Ⅱ by immunohistochemistry.According to von Kossa stain,CKD stage 5 patients were divided into no calcification group,mild-moderate calcification group and severe calcification group.Other related factors including serum calcium,phosphate,intact parathyroid hormone (iPTH),C-reactive protein (CRP),triglyceride(TG),cholesterol(TC) and lowdensity lipoproteins(LDL) were also detected.Results Seventeen (42.5％) of CKD Stage 5 patients showed vascular calcification,while calcification was not found in controls.Most calcification occurred in medial layer.Positive immunohistochemical staining of core-binding factor and Col Ⅱ was found in the smooth muscular cell plasma of medial layer in the vessels with calcification.However,above positive staining was also observed in 78.3％ of no calcification group.But there was little staining in control group.Positive staining score of Cbfα-1 and Col Ⅱ in severe calcification group was significantly higher than that in no calcification group.Same findings were obtained in mild-moderate calcification group,but the difference between them was not statistically significant.CRP and Ca × P were positively correlated with staining score of Cbfα-1 and Col Ⅱ.Serum phosphate was positively correlated with Cbfα-1 (r=0.786,P＜0.01) and Col Ⅱ (r=0.785,P＜0.01) respectively.Conclusions 42.5％ of CKD stage 5 patients in our group shows vascular calcification,which occurrs mainly in medial layer.High expression of Cbfα-1 and Col Ⅱ can be observed in vascular calcification of radial arteries,which is earlier than vascular histological changes.Cbfα-1 and Col Ⅱ may be involved in the development of vascular calcification.

This study aims to compare the urate-lowering response rate of febuxostat and allopurinol in gout patient using a model-based meta-analysis. The literature search identified 22 clinical trials of gout with a total of 43 unique treatment arms that met our inclusion criteria, and a total of 6 365 gout patients were included in the study. The response rates of allopuriol and febuxostat were characterized by Tmax model and Emax model respectively, and the effect of baseline serum uric acid (sUA) and patient type on the drug effect was tested. The results showed that allopurinol can reach an average maximum response rate of 50.8% while febuxostat can reach a 100% response rate within a very short time, and the ED50 was 34.3 mg. Covariate analysis revealed that baseline sUA has a negative effect on response rate of allopurinol, and a positive effect on the predicted ED50 of febuxostat. For patients who had shown inadequate response to prior allopurinol treatment, the average response rate was about half that of the allopurinol responder patients.
Allopurinol ; therapeutic use ; Febuxostat ; Gout ; blood ; drug therapy ; Gout Suppressants ; therapeutic use ; Humans ; Thiazoles ; therapeutic use ; Uric Acid ; blood

Diagnostic Errors ; Humans ; Myoclonus ; diagnosis ; Tics ; diagnosis