AIM: To evaluate the clinical effect and the rotational stability of AcrySof Toric intraocular lens ( IOL ) implantation to correct preexisting corneal astigmatism in cataract surgery.
METHODS: Twenty-three patients ( 28 eyes ) were enrolled from the department of ophthalmology in the first Affiliated Hospital of Nanjing Medical University. All patients underwent similar phacoemulsification procedure combined with AcrySof Toric IOL implantation from June 2012 to December 2013. The uncorrected visual acuity ( UCVA ) , best corrected visual acuity ( BCVA ) , anticipated residual astigmatism, postoperative residual astigmatism, and Toric IOL axis were detected and measured.
RESULTS:Three months after operation, the UCVA of all eyes were 0. 75±0. 16 and the BCVA were 0. 84±0. 15, there was no significant difference between UCVA and BCVA ( t = 1. 036, P>0. 05 ). The anticipated residual astigmatism was ( 0. 28±0. 12 ) D. The actual residual astigmatism after 3mo of the operation was (0. 42±0. 17) D. There was no significant difference between anticipated and actual residual astigmatism (t=1. 259, P>0. 05). The mean axis rotation of Toric IOL was 3. 02o±1.56o (0o-7o) after 1d of operation and 3. 28o±1. 85o (0o-7o) after 3mo. Among all the eyes, 25 eyes ( 89%) rotated <5o, in 3 eyes (11%) rotated 5o-7o.
CONCLUSION: The AcrySof Toric IOL implantation shows good effectiveness, predictability and stability in correcting pre-existing astigmatism in cataract patients.

OBJECTIVETo investigate the expressions of sphingosine-1-phosphate receptors 1-3 (S1P1- 3) in the corpus cavernosum of castrated male rats and its relationship with the NOS/NO/cGMP and RhoA/Rho kinase signaling pathways.

METHODSWe equally randomized 18 eight-week-old healthy male SD rats into a sham-operation control, a castration, and a testosterone replacement (TR) group and harvested the bilateral testes and epididymides from the rats in the latter two groups, followed by 4 weeks of subcutaneous injection of testosterone propionate at 3 mg per kilogram of the body weight per day for those in the TR group and that of plant oil for those in the control and castration groups. At the age of 12 weeks, we measured the serum testosterone (T) level and maximum intracavernous pressure/mean arterial pressure (ICPmax/MAP) of the animals and determined the expressions of SlP1-3, eNOS, P-eNOS, ROCK1, and ROCK2 in the corpus cavernosum by Western blot and immunohistochemistry.

RESULTSThe serum T level was significantly decreased in the rats of the castration group as compared with those of the control and TR groups ([0.41 ± 0.04] vs [16.01 ± 1.02] and [15.84 ± 1.32] nmol/L, P < 0.01), with no statistically significant difference between the latter two groups. The ICPmax/MAP at 0 V, 3 V, and 5 V electric stimulation was remarkably lower in the rats of the castration group (0.088 ± 0.014, 0.323 ± 0.014, and 0.432 ± 0.012) than in those of the control group (0.155 ± 0.011, 0.711 ± 0. 010, and 0.819 ± 0.024) and TR group (0.153 ± 0.012, 0.696 ± 0.017, and 0.763 ± 0.027) (P < 0.01), with no significant difference between the latter two groups. With GAPDH as internal control, the animals of the castration group showed markedly reduced expressions of S1P1 ([49.99 ± 3.39]%), eNOS ([46.82 ± 3.81]%) , and P-eNOS ([45.42 ± 4.35]%) in comparison with those in the control group ([72.57 ± 3.06], [89.76 ± 3.98], and [82.53 ± 8.92] and TR group ([71.77 ± 4.43], [87.19 ± 4.23], and [79.82 ± 7.38]%) (P < 0.01) , while the expressions of S1P2, S1P3, ROCK1, and ROCK2 were significantly upregulated in the castration group ([82.35 ± 4.13], [61.03 ± 5.14], [74.50 ± 4.02], and [69.83 ± 5.75]%) as compared with those in the control group ([41.67 ± 1.68], [31.66 ± 2.67], [35.69 ± 5.56], and [39.85 ± 7.17]%) and TR group ([42.80 ± 3.87], [32.25 ± 4.22], 38.06 ± 5.21], and [42.36 ± 4.44]%) (P < 0.01).

CONCLUSIONAndrogen deficiency induces significant reduction of ICPmax/ MAP in male rats, which is possibly associated with the decline of S1P1 in the corpus cavernosum, inhibition of the eNOS/NO/cGMP signaling pathway, increased expressions of S1P2 and S1P3, and activation of the RhoA/Rho kinase signaling pathway.

Animals ; Male ; Nitric Oxide Synthase Type III ; metabolism ; Orchiectomy ; Penis ; metabolism ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Receptors, Lysosphingolipid ; metabolism ; Testosterone ; blood ; pharmacology ; rho-Associated Kinases ; metabolism

Objective:To explore the association of physical activities,sedentary behaviors with over-weight/obesity in Chinese children aged 9 -1 1 years,analyze the gender difference and heterogeneity of the association across different provinces,and provide evidence for prevention and control of overweight and obesity.Methods:Using the data of 40 692 children aged 9 -1 1 years from Chinese National Survey on Students’Constitution and Health in 201 0,the height and weight were measured and the time spent in physical activities,screen behaviors and homework were collected.We analyzed the associations among physical activities,sedentary behaviors and overweight/obesity in boys and girls separately,and assessed the heterogeneity of associations across different provinces with Meta-analysis.Results:The prevalence of overweight/obesity of the boys (27.1 %)was higher than that of the girls (1 2.9%),compared with the rural students (1 5.6%),the situation of overweight/obesity of the urban students (23.8%)was more serious,the prevalences of overweight/obesity were separately 22.6%,1 9.2% and 1 7.5% among developed,middle-developed and undeveloped social economic status subgroups.The boys with physical activities no more than 1 hour per day were more likely to be overweight/obese,with the OR of 1 .09 (95%CI:1 .02,1 .1 7).The girls with screen time more than 1 hour per day or homework time more than 2 hours per day were more likely to be overweight/obese,with the ORs of 1 .1 3 (95%CI:1 .02, 1 .26)and 1 .1 8 (95%CI:1 .03,1 .35)respectively.The high level of sedentary behaviors (more than 1 35min per day)was associated with overweight/obese in the girls,and the OR was 1 .1 9 (95%CI:1 .08,1 .33).There was no significant heterogeneity of effect values between physical activities and over-weight/obesity in the boys and between sedentary behaviors and overweight/obesity in the girls across the different provinces (P >0.05).Conclusion:The associations among physical activities,sedentary be-haviors and overweight/obesity existed in Chinese children aged 9 -1 1 years,which were different in boys and girls.There was no statistically significant heterogeneity across different provinces.The strate-gies to prevent and control overweight/obesity in primary school students should focus on gender-specific needs.

Objective To explore the dysfunction of dendritic cells (DC) related to TGFβ reversed after blocking the TGFβ signal pathway by recombinant adenovirus vector encoding for Smad7.Methods Smad7 by recombinant adenovirus vector was transfected into dendritic cells.Expression of immunologic phenotypes was detected by FCM,and CTL activity induced by DC was compared.Results The DC modified with Smad7 still expressed high adhesiveness factor related to maturation even if existing exogenous TGFβ1,which was significant statistically compared with DC transfected with control adenoviral vector (P ＜0.01).Even if existing exogenous TGFβ1,the DC modified with Smad7 pulsed with soluble antigen associated with Lewis pulmonary carcinoma could still induce potent CTL activity against Lewis pulmonary carcinoma,which showed significant difference with DC-Ad-c (P ＜0.01).Conclusion The inhibitory effects on function of DC of TGFβ may be reversed by blocking the Smad signal of TGFβ pathway.

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.

The veins on the dorsum of the foot have been dissected and observed on 200cases of the Chinese adult lower extremities.The great saphenous vein is the chief draining vessel of the hallux,the toes andthe skin of the dorsum of the foot.The position and the tributaries of this vessel areconstant.Its diameter ranges from 1.9 to 5.0mm,with an average of 3.2mm.The dorsal venous arch is usually single(93%),double arches are seen in 6%,and absent in 1%.According to the form of reflux,the dorsal venous arch may begrouped into five types.In the most common type,the arch is continuous withthe great saphenous vein and the anterior malleolar branch of the small saphenousvein(49.5%).The dorsal metatarsal veins usually drain directly into the dorsal venous arch.Some of the neighboring dorsal metatarsal veins may drain through a commontrunk.The perforating veins on the dorsum of the foot may be divided into threedifferent groups:the anterior malleolar,marginal and intermetatarsal group.Thelatter usually drains into the dorsal venous arch at the base of the first intermeta-tarsal space.The valves of the superficial veins on the dorsum of the foot were also observed.There is no valve in the lateral part of the dorsal venous arch,but there may beone or two valves in its most medial part(66.7%).It appears that the venousblood from the first metatarsal vein usually drains into the great saphenous vein.

To look for a more stable and convenient way of constructing short hairpin RNA expression vectors targeting the latent membrane protein-1(LMP-1) encoded by Epstein-Barr virus(pshLMP1), and to study the inhibition function of pshLMP1 expression vectors in HNE1 cells, we designed the pshLMP1 expression cassette and pshLMP1 expression vectors by both the annealing method and PCR method and then co-transfected with pEGFP-N1-1158 into HNE1 cells to observe the mRNA and protein levels of LMP-1 genes by green fluorescence analysis, RT-PCR and western blot. pshLMP1 expression vectors were successfully obtained by both methods but better cloning efficiency was achieved and fewer deletions and mutations of nucleotides were achieved with the PCR method. Furthermore, the mRNA and protein levels of LMP-1 genes were down-regulated by pshLMP1 expression vectors. According to our research, we found that the PCR method provides a more efficient way to construct pshLMP1 expression vectors which have the ability to inhibit the function of LMP-1 genes expressed in HNE1 cells, and also provides a novel application of RNA interference technology against-EBV.

Background Sirius system,a new Scheimpflug camera combined with Placido topography,improved the capability of imaging the anterior eye segment significantly.However,the study of assessing the repeatability and agreement between Sirius and Pentacam is still lack up to now.Objective This study was to evaluate the repeatability and agreement of the anterior ocular segment measuring parameters by Sirius and Pentacam in myopia received laser in situ keratomileusis (LASIK).Methods Thirty-five myopic eyes of 35 patients received LASIK were included in School of Optometry and Ophthalmology Eye Hospital from 2010 May through 2010 July.Corneal power flat keratometry (Kf),step keratometry (Ks),mean keratometry (Km),thinnest corneal thickness(TCT),the location of TCT,anterior chamber depth (ACD) and anterior chamber volume (ACV) were measured by Sirius and Pentacam in all the eyes,respectively.The repeatability of the measuring results were evaluated using intraclass correlation coefficients (ICC) and Cronbach's coefficient alpha (CoA),and the agreement of measuring parameters between Sirius and Pentacam was analyzed using Bland-Altman plot.Results Both Sirius and Pentacam demonstrated high intraobserver repeatability,with all ICC and CoA more than 0.90.No significant differences were found in Kf values and Ks values between the two methods (t =-1.533,-1.750,P＞0.05).Km value was (39.14 ± 1.95) D by Sirius measurement,which was sígnificantly higher than (39.05 ± 1.91) D by Pentacam measurement (t =3.572,P =0.001).The TCT was (457.6 ± 40.9) μm by Sirius method,showing a significant reduce in comparison with (465.4±37.5) μm of Pentacam method (t =-6.689,P＜0.001).A positive correlation was seen in the TCT between the two methods (r=0.988,P＜0.001).The Bland-Alrman plots showed the 95％ CI-21 μm to 6 pm in the TCT value between the two devices.Pairwise comparison of the location of TCT measurements showed significant differences between the two devices (t =-4.132,-5.696,P＜0.001),with a good correlation (r=0.751,0.775) and the 95％ CI (-0.36-0.17 mm,-0.35-0.12 mm).A very good agreement was seen in ACD between the two devices (-0.02-0.12 mm),but the agreement result was not very well in the ACV between the two devices with the 95％ CI (-27.70-6.20 mm3).Conclusions Sirius and Pentacam measurements for anterior ocular segment parameters have a very good repeatability in post-LASIK eyes.In addition,good agreement results are exhibited in corneal power,TCT and ACD between Sirius and Pentacam with an acceptable maximal different value between them.Sirius and Pentacam can be used interchangeably in clinical examination.However,the two devices can not interchangeably for ACV measurement and TCT location.

OBJECTIVETo study the effect of Shenfu Injection (SI) on the post-operative cognitive dysfunction in senile patients receiving the orthopedic surgeries after general anesthesia.

METHODS100 patients, 60-89 years old, waiting for selective surgery at the orthopedics department, were randomly assigned to two groups, the SI group (50 cases) and the control group (50 cases), who met the standard of the American Society of Anesthesiologists (ASA) II-III. After surgical incision, patients in the SI group were transfused with SI 200 mL (50 mL SI was added in 200 mL normal saline), while those in the control group were transfused with 200 mL normal saline at the same time. The mean arterial pressure (MAP), heart rate (HR), and oxygen saturation (SpO2) were compared between the two groups before anesthesia, after intubation, 30 min and 60 min after anesthesia, 5 min and 30 min after extubation. The time for surgery, the time of intra-operative hypotension, the volume of hemorrhage, the time for post-operative consciousness recovery, the liver function, the kidney function, and the fasting blood glucose of patients before surgery, 3 days and 7 days after operation were compared. The cognitive functions of patients were tested before surgery, 3 days and 7 days after operation. The incidence of post-operative cognitive dysfunction of patients was compared between the two groups.

RESULTSThere was insignificant difference in MAP, HR, and SpO2 between the two groups at each time point (P > 0.05). There was insignificant difference in the pre-operative cognitive function score, the time for surgery, the time of intra-operative hypotension, the volume of hemorrhage, the liver function, the kidney function, and the fasting blood glucose between the two groups ( P > 0.05). The time for post-operative consciousness recovery was obviously shorter in the SI group than in the control group, showing significant difference (P < 0.05). The post-operative 3-day and 7-day cognitive function scores were obviously better in the SI group than in the control group, showing significant difference (P < 0.05). The incidence of post-operative cognitive dysfunction of the SI group [3 days: 12% (6 cases); 7 days: 8% (4 cases) ] was significantly lower than that of the control group [3 days: 20% (10 cases); 7 days: 14% (7 cases) ] ( P < 0.05).

CONCLUSIONSI could improve the post-operative cognitive function of senile patients receiving the orthopedic surgeries after general anesthesia, lower the incidence of post-operative cognitive dysfunction rate, and shorten the time for post-operative consciousness recovery.

Aged ; Aged, 80 and over ; Anesthesia, General ; adverse effects ; Cognition ; Cognition Disorders ; etiology ; Drugs, Chinese Herbal ; pharmacology ; Humans ; Injections ; Middle Aged ; Orthopedic Procedures ; Postoperative Period