Objective: To explore the therapeutic effect of dexamethasone on proliferative retinopathy in different stages and its interaction with the vascular endothelial growth factor(VEGF).Methods: Models of oxygen-induced retinopathy(OIR) were established.Twenty C57BL/6J mice pups(7 days after birth) were randomized into 4 groups: normal control,pure OIR,early-treatment and late-treatment.Dexamethasone was administered at the dose of 0.5 mg/kg?d-1by subcutaneous injection to the early-treatment group from postnatal day 7 and to the late-treatment group from day 12,both for 5 days.Common pathological sections were made from both eyeballs of the C57BL/6J mice and detected by immunohistochemistry to count the nuclei of proliferative retinal vessel cells and investigate the expression of VEGF in the retina.Results: The nuclei of proliferative retinal vessel cells and the expressions of VEGF significantly increased in the pure OIR group as compared with the normal control(P

Background Postoperative ametropia, especially large astigmatism after deep anterior lamellar keratoplasty (DALK) for keratoconus often results in poor visual acuity.Though postoperative ametropia can be corrected by wearing glasses or performing corneal refractive surgery, the visual quality of patients is still poor, and the operations are difficult to implement because of insufficient corneal thickness.Toric intraocular collamer lens (TICL) implantation appears to have good corrective efficacy on severe astigmatism,but the research on the eyes after DALK is still less.Objective This study was to evaluate the efficacy and safety of TICL implantation for the ametropic eyes following DALK for keratoconus.Methods This study protocol was approved by Ethic Commission of Nanjing Drum Tower Hospital,and written informed consent was obtained from each patient prior to any medical procedure.A self-controlled serial observational research was carried out.Eight ametropic eyes of 8 patients who received the DALK for keratoconus before 18 months were enrolled in Nanjing Drum Tower Hospital from August 201 1 to March 2012, with the spherical diopter range from 0 D to-7.5 D and cylindrical diopter range from-2.5 D to-6.0 D.TICL implantation was performed on the eyes.The eye examinations were carried out before surgery and 1 week,3 months,6 months, 1 year and 2 years after surgery,including uncorrected visual acuity (UCVA) ,best corrected visual acuity (BCVA) ,comprehensive optometry, corneal astigmatism degree, the central corneal thickness and anterior chamber depth (ACD), corneal endothelial cell counts (ECD) ,intraocular pressure.The examination outcomes were compared before and after surgery.The intraoperative and postoperative complications were observed to evaluate the safety of TICL implantation for the ametropic eyes following DALK for keratoconus.Results The UCVA and BCVA were obviously improved at 6 months after TICL implantation in comparison with before surgery and maintained stable during the follow-up duration.The mean spherical diopter was from-0.5 D to-1.0 D and the mean cylindrical diopter was from-0.5 D to-2.0 D after surgery.The corneal endothelial cell counts were (2 520.2 ± 307.2) , (2 496.2 ± 306.2) , (2 469.6±304.5) , (2 432.0 ± 305.4), (2 383.4 ± 309.4)/mm2, and the intraoeular pressures were (14.57 ± 3.75), (16.62±4.21), (16.57±3.56), (15.66±3.37), (15.13±3.48) mmHg, showing insignificant differences among different time points (F =0.375,P =0.825;F =9.871, P =0.394).No significant differences were found in mean ACD and intraocular pressure between before and after surgery (t =1.56 ,P =0.16).The axial deviation of TICL was less than 10° in all the operated eyes 6 months after surgery.No intraoperative and postoperative complications were found during the follow-up duration.Conclusions TICL implantation is a safe and effective alternative and viable approach to myopic and astigmatism patients following DALK for keratoconus.

Objective To explore the effect of relaxation response on mental health in physically heath subjects.Methods The literatures on relaxation response published in recent 20 years were searched.Those using Symptom Checklist 90(SCL-90)and meeting inclusive criteria were analyzed with meta analysis.Results Nine literatures including 975 subjects were enrolled.The mean weight change(WMD)of SCL-90 Was 0.10 to 0.24.In overall effect test, Z value was 3.64 to 9.64(all P＜0.05).Conclusion Relaxation response may help to improve mental health of Chinese population.

Objective:To investigate whether topical hypothermia circumstance has the protective effects to the blood-ocular barriers during intraocular operations.Methods:Twenty New Zealand albino rabbits accepted vitrectomy in both eyes,useing hypothermal(4-10℃) intraocular irrigating solution in left eye(hypothermal intraocular irrigating solution group),and useing room temperature(25℃) intraocular irrigating solution in right eye(room temperature intraocular irrigating solution group)during the vitrectomy.Twenty-four hours after the operation,the retina of both eyes were checked;each eye accepted cavum vitreum perforation,and 0.5 ml of intraocular fluid were aspirsted for biochemical detection as well;as well as the retinas cut off for transmission electron microscopical(TEM) observations. Results:Inflammatory reaction of anterior ocular and the uvea in left eyes were generally slighter than the right eyes;dioptric media clarity of left eyes were also better than that in left eyes;average total protein concentration of the intraocular fluid was obviously lower than that in left eye(P

Objective: To develop the mental health knowledge questionnaire in order to know about the awareness of mental health knowledge in non-psychiatric clinicians. Methods: A sample of the 641 non-psychiatric clinicians from 2 tertiary general hospitals, 2 second-class general hospitals, and 1 community hospital were used for item analysis and internal consistency test; 38 cases were selected for the re-test interval of 2 weeks to test the test-retest reliability. And totally 99 psychiatrists finished the survey as controls. The awareness rates between the non-psychiatric and psychliatric clinicians were compared. Results: The questionnaire included 46 items and consis-ted of 6 subscales, involving anxiety, schizophrenia, depression, dyssomnia and psychological counseling, or-ganic brain disorder, and recognition for mental health service situation in general hospital The results of confirma-tory factor analysis showed that the ratio of chi-square and degree of freedom was below 3. The fitting indexes except GFI and AGFI were more than 0.90. The Cronbach's alpha coefficients ranged from 0.73 to 0.89, and test-retest Pearson correlation coefficient of reliabifity ranged from 0.59 to 0.78. Awareness rate was 47.6% in general hospital and 90.9% in psychiatric hospitals. Conclusion: The mental health knowledge questionnaire has good psychometric properties and may be applied in clinical studies.

Objective To explore cognitive change in schizophrenic patients with concomitant metabolism syndrome,and to provide theory basis for early intervention and treatment.Methods According to inclusion standard,56 schizophrenic inpatients with metabolism syndrome and 56 schizophrenic inpatients without metabolism syndrome were included.The matrics consensus cognitive battery(MCCB),stroop test,digit span,UPSA-B were used to assess the cognitive function.Results There were significant differences for test scores of symbol coding subtest,verbal memory subtest,digit sequence subtest,Maze subtest,continue performance among MCCB between schizophrenic patients with and without metabolism syndrome(27.07±10.46 vs 32.18±12.12,16.04±5.07 vs18.71±6.02,13.39±5.18 vs 15.79±5.48,1.38±0.66 vs 1.7±0.68,all P＜0.05),as well as stroop test and digit span test(31.14±11.68 vs 36.57±13.32,13.77±3.64 vs 15.82±4.38,P＜0.05 for both).Conclusion The schizophrenic patients with metabolism syndrome have severer cognitive impairment than those without metabolism syndrome.

Objective To investigate the intellectual characteristics and related factors for patients with mental retardation. Methods 118 patients with mental retardation and 118 normal subjects were assessed with Wechsler Adult Intelligence Scale-fourth edition of Chinese (WAIS-Ⅳ). Results The full intelligence quotient (FIQ), index and scores of subtests were significantly lower in the patients than in the controls (P<0.01), especially for those of working memory and processing speed index. The difference in percentage of significance between verbal comprehension and working memory was higher (P<0.05). The FIQ and some index of patients positively correlated with age, education level and their parents' education level (P<0.01). Conclusion The patients with mental retardation present an overall decline in intelligence,especially in the working memory and processing speed. The mental development is unbalanced in some patients, that the verbal comprehension is relatively better than working memory. The intelligence of patients with mental retardation may be related with their age, education level and their parents' education level.

Objective To establish a conventional intraocular lens (IOL) calculation formula which is applicable to eyeballs with abnormal data and laser in situ keratomileusis (LASIK) postoperative eyes.Methods A case-series study was adopted.According to the classical optical theory,a normal IOL implanted eye has the following characteristics:when light is refracted by cornea and arrives on the IOL plane,the value of refractive power (F1) + IOL refractive power (F2) =the value of refractive power which is suitable for vitreous body depth (F3).Thereafter,a mathematical model was built on the basis of theory,experience,and regression analysis data after IOL implantation surgeries.Furthermore,based on the new LASIK postoperative cornea curvature modified formula,the two kinds of IOL calculation programs of conventional and LASIK postoperative eyes were established.The test data was collected from 644 patients who had undergone the cataract extractions and IOL implantation surgeries (600 physiological cornea eyes,7 radial keratotomy [RK] eyes and 37 LASIK postoperative eyes) at the Affiliated Drum Tower Hospital of Nanjing University Medical School.Through the analysis of these data,the new formulas were examined.Results With IOL refractive power of 607 eyes (including 7 RK postoperative eyes),the average error of XLQ formula (the tentative name of the established formula in this study)was 0.1 D,and the 95％ limits of agreement range was-1.1 to + 1.2 D.The error range of IOL refractive power predicted by XLQ,SRK-T and Haigis formulas was-2.21 to +2.25 D,-5.10 to +5.63 D and-3.00 to +3.18 D,respectively,the absolute average error of IOL refractive power predicted by the three formulas was (0.43 ± 0.28),(0.74 ± 0.53) and (0.79 ± 0.49) D,respectively.Compared with SRK-T and Haigis formulas,the average error of IOL refractive power predicted by XLQ formula was Lower,with significant differences between them (both at P =0.000).The error value of IOL refractive power predicted by XLQ formula had no statistical correlations with axial length (AL),keratometry (K) and A constant respectively (all at P＞0.05),while the error value predicted by SRK-T and Haigis formulas had statistical correlations with AL,K and A constant,respectively (all at P＜0.05).Thirty-seven patients who had conducted LASIK for myopia (and whose IOL refractive power value were predicted by XLQ formula) had been undergone the postoperative examination.Comparing the predicted and actual value,the error range of IOL refractive power was-0.52 to +1.18 D,and the absolute average error was (0.49±0.26)D.Conclusions The conventional mode of the XLQ formula established in this study can be used in the cases with broad values of axial length,corneal curvature and A constant,as well as various types of physiological cornea and RK postoperative eyes;the dedicated mode is suitable for LASIK postoperative eyes of myopia.

Objective:To compare the one-year postoperative visual quality after trifocal intraocular lens (IOL) implantation and monofocal IOL implantation.Methods:A cohort study was conducted.Forty-one eyes from 41 age-related cataract patients who underwent phacoemulsification extraction combined with IOL implantation in Nanjing Drum Tower Hospital from May 2017 to June 2018 were enrolled.The patients were divided into trifocal IOL group (20 eyes) receiving ZEISS AT LISA tri 839MP trifocal IOL implantation and monofocal IOL group (21 eyes) receiving ZEISS 603P monofocal IOL implantation according to their willingness.One year after surgery, uncorrected distant visual acuity (UCDVA), uncorrected intermediate visual acuity (UCIVA), uncorrected near visual acuity (UCNVA), best corrected distance visual acuity (BCDVA), distance corrected intermediate visual acuity (DCIVA) and distance corrected near visual acuity (DCNVA) were detected in both groups.The patient point spread function (PSF), modulation transfer function (MTF) cutoff frequency, Strehl ratio (SR), OQAS Ⅱ values at 100%, 20%, and 9% contrast (OV 100%, OV 20%, OV 9%) and objective scattering index (OSI) were measured by OQAS Ⅱ.Wavefront aberrations including total aberration (TA), total high order aberrations (tHOAs), spherical aberration, coma, trefoil aberration, total low order aberrations (tLOAs), defocus, and astigmatism were evaluated with the iTrace visual function analyzer.All aberrations were represented by root mean square.The visual acuity of operative eyes was measured with a phoropter, and defocus curves were drawn with visual acuity better than 0.5 LogMAR.The incidence of posterior capsular opacification (PCO) in the IOL region was quantitatively analyzed by Sellman method.Visual function was scored by visual function index (VF-14). This study adhered to the Declaration of Helsinki.The study protocol was approved by an Ethics Committee of Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School (No.2018-219-01). Written informed consent was obtained from each subject prior to any medical examination.Results:One year after the operation, UCIVA, UCNVA, DCIVA, and DCNVA of trifocal IOL group were significantly better than those of monofocal IOL group, and the differences were statistically significant (all at P<0.001). OQAS Ⅱ visual quality indicators showed that the MTF cutoff frequency, SR, OV 100%, and OSI values of trifocal IOL group were significantly higher than those of monofocal IOL group, showing statistically significant differences (all at P<0.001). No significant difference in wavefront aberrations was found between the two groups (all at P>0.05). Defocus curve showed that the LogMAR visual acuity of patients at -1.0 D, -1.5 D, -2.0 D, -2.5 D, -3.0 D, and -3.5 D (namely, 1 m, 66 cm, 50 cm, 40 cm, 33 cm, and 29 cm) in monofocal IOL group were significantly better than those in trifocal IOL group (all at P<0.05). There was a higher incidence of PCO in trifocal IOL group than monofocal IOL group, with a statistically significant difference ( χ 2=41.0, P<0.001). The VF-14 score of trifocal IOL group was 87.99±1.09, which was significantly higher than 81.49±1.67 of monofocal IOL group ( t=10.301, P<0.001). Conclusions:One year after trifocal IOL implantation, the full range of vision, subjective and objective visual quality of eyes are better than eyes implanted with monofocal IOL.