Objective To analyze the operative methods,intraocular lens (IOL) implantation and postoperative complications in children with congenital cataract,and give the references for treating of congenital cataract.Methods From January 2008 to January 2016,children under the age of 13 years with congenital cataract were enrolled.Preoperative and posterior slit lamp microscope,fundus,intraocular pressure were examined.Children under 2 years old were treated with phacoemulsification (PHACO),posterior continuous curvilinear capsulorrhexis (PCCC),anterior-vitrectomy (AV),and ＞ 2-4 years old with PHACO + PCCC + AV + IOL implantation,＞ 4-7 years old children with PHACO + PCCC + IOL implantation,children ＞ 7 years with PHACO + IOL implantation.Results A total of 476 patients (740 eyes) were enrolled in the study,the average age were (33.59 ± 37.14) months,of which 0 ～ 6 months were 166 cases (282 eyes,38.11％).260 eyes were implanted with IOL,aged (5.59 ±2.43) years,480eyes were implanted in the second surgery,aged (4.06 ± 2.12) years.Refaction diopter (equivalent spherical) after IOL implantation in children aged ＞ 2-4 years old was (3.53 ± 0.56) D,＞ 4-6 years old was (2.36 ± 0.32) D,＞ 6-8 years old was (1.65 ±0.52)D,＞8-13 years old was (-0.25 ±0.32) D.The postoperative complications occurred in 326 eyes,of which 115 eyes (35.28％) with iridotic adhesions,97 eyes (29.75％) with posterior cataract on the visual axis,and 54 eyes (16.56％) with glaucoma.At the last follow-up,the best corrected visual acuity were (0.56 ± 0.41) LogMAR for monocular cataract surgery and (0.42 ± 0.27) LogMAR for binocular cataract surgery,the difference was statistically significant (P =0.04).Conclusion One-third of children with congenital cataract are treated with surgical treatment under 6 months old,about half of the children undergo IOL implantation at 2 ～ 3 years of age.The postoperative visual acuity in children with binocular cataract is better than children with monocular cataract.The complications in children are more complicated than adults,which should be paid more attention.

Objective To select the risk factors and focus on the pathogenesis of anterior ischemic optic neuropathy (AION) after cataract surgery.Methods A retrospective review of all patients with phacoemulsification surgery referred to the Ophthalmology Divisions,the First Affiliated Hospital,Zhengzhou University,from September 1,2010 to September 1,2016 was performed.Eligible patients were 11 206 cases(13 320 eyes),30 cases (30 eyes) were complicated with AION after cataract surgery (AION group),and 90 cases (90 eyes) were selected as control group according to the ratio of 1 ∶ 3 by random sequence.Factors of small cup disc ratios,previous surgery history,cardiac disease,diabetes,hypertension,hyperlipemia,smoking,carotid disease and intraocular pressure (IOP) were collected,x2 test,Logistic regression and t test were performed to analyze risk factors for AION.Results Small cup-disc ratios,diabetes,hypertension,hyperlipemia,carotid disease were influencing factors of AION after cataract surgery.Hyperlipemia and carotid disease were risk factors of AION after cataract surgery.There was no significant difference in preoperative intraocular pressure between two groups(all P ＞ 0.05).The intraocular pressure at postoperative 1 day and 7 days in AION group were higher than those in control group (all P ＜ 0.05).Conclusion Hyperlipemia and carotid artery disease are risk factors for AION after cataract surgery,and high intraocular pressure may be the inductive factor of AION.

Objective To analyze the accuracy,sensitivity and safety of multidetector CT angiography(MDCTA) and DSA;furthermore to explore the clinical value of MDCTA in studying the delayed cerebral vasospasm(DCVS) .Methods Delayed cerebral vasospasm was induced in 17 rabbits by injection of autologuous blood into the cisterna magna and followed by a second injection 24 hours later.MDCTA and DSA were carried out at the 7th day before and after the procedure in order to obtain the data of vascular diameter changes for comparative study.Results The basilar artery diameters detected by MDCTA were shown preoperatively as(1.55 ? 0.14) mm and postoperatively as(0.95 ? 0.20) mm;and detected by DSA as(1.61 ? 0.19) mm and(1.00 ? 0.17) mm postoperatively;showing statistically equivalence between the two methods.Conclusions MDCTA is recommended as a reliable,rapid,and minimally invasive diagnostic method,providing a new technique for the delayed cerebral vasospasm research.

Objective:To investigate the roles of S100B protein and anti-brain antibody (ABAb) in the pathophysiology of Alzheimer's disease (AD) by analyzing the changes of the serum levels of S100B and ABAb and the relationships of the measures with cognition deficits in patients with AD.Methods:In this study,32 patients with AD(AD group) and 40 age-matched volunteers without cognitive impairment(control group) were enrolled.The diagnosis was made according to the Diagnostic and Statistical Manual of Mental Disorders,Fourth Edition (DSM-Ⅳ).The mental and social functional conditions were assessed with the Mini-Mental State Examination (MMSE) and Activity of Daily Living Scale(ADL),the cognitive function of patients was evaluated with the Alzheimer's Disease Assessment Scale-cognitive subscale(ADAS-Cog).The serum S100B proteinand ABAb levels were examined by enzyme-linked immuno sorbent assay(ELISA).Results:The serum S100B protein[(0.66 ± 0.17) μg/L vs.(0.30 ± 0.04)μg/L] and ABAb [(1.93 ± 0.95) U/L vs.(1.31 ± 0.25) U/L] levels were higher in AD patients than in the controls (Ps ＜ 0.01).In AD patients,the serum S 100B protein markedly negatively correlated with the scores of the MMSE(r =-0.66),while positively correlated with ADL and ADAS-Cog(r =0.57,r =0.53)(Ps ＜ 0.005).ABAb levels negatively correlated with the scores of the MMSE(r =-0.57),while positively correlated with ADL and ADAS-Cog(r =0.52,r =0.34)(Ps ＜0.05).The serum S100B protein levels were positively related to ABAb levels in AD group(r =0.51.P ＜0.005),but not in control group(r =0.076,P =0.654).Conclusions:It suggests that the serum levels of S100B protein and ABAb are related with cognitive function in patients with Alzheimer's disease,and S100B protein and ABAb might play key roles in mechanism of Alzheimer's disease.

Objective To evaluate the potential activity ofSaccharomyces boulardii as an adjuvant to triple therapy for Helicobacter pylori infection,so as to forecast the probable effectiveness of Saccharomyces boulardii in the eradication of Helicobacter pylori and the adverse reaction.Methods A total of 120 patients who received gastroscopy and tested positive for Helicobacter pylori infection were divided into standard triple therapy group and Saccharomyces boulardii group with 60 cases each by random digits table method.Patients were randomized to receive one week standard triple therapy,supplemented with Saccharomyces boulardii in Saccharomyces boulardii group.Saccharomyces boulardii was taken 500 mg per day for one week.All adverse reactions were recorded during the treatment period.13C or 14C urea breath test was performed at four weeks after the end of triple therapy to evaluate the situation of Helicobacter pylori eradication.Results Helicobacter pylori eradication rate in Saccharomyces boulardii group was higher than that in standard triple therapy group [80.00％ (48/60) vs.73.33％ (44/60)],but there was no significant difference (P =0.542).Five adverse reactions including epigastric discomfort,nausea,diarrhea,taste disorder and liver injury were recorded during the treatment period.The incidence of adverse reactions such as epigastric discomfort and diarrhea in Saccharomyces boulardii group was significantly lower than that in standard triple therapy group [13.33％ (8/60)vs.43.33％(26/60),3.33％(2/60) vs.26.67％(16/60)],and there was significant difference (P ＜ 0.05).Conclusion Saccharomyces boulardii as an adjuvant to triple therapy can not improve Helicobacter pylori eradication rate,but can decrease the incidence of adverse reactions during the treatment period and improve the complicance of Helicobacter pylori eradication treatment.

Objective To study the intervention effect of montelukast on thymus and activation-regulated chemokine(TARC) in the children with asthma.Methods 100 children with asthma were randomly divided into montelukast (LTRA) group ( n = 50) and budesonide (BUD) group ( n = 50), the LTRA group was treated with montelukast, the BUD group was treated with budesonide,50 children without asthma as control group were inhaled NS.Before and after 7 days treatment,the asthma symptoms, FEV1,concentration of TARC were measured.Results Before treatment,the concentration of TARC in asthma group was significantly higher than control group (P < 0.05 ).After treatment, the concentration of TARC in BUD group and LTRA group was significandy decreased( P < 0.05 ), but the difference between these two groups was not significantl( P > 0.05 ), the concentration of TARC in control group was not significantly decreased(P > 0.05 ) ;the symptoms were better after treatment in BUD group and LTRA group,(P <0,05) ,and the pulmonary function was significantly improved after treatment in BUD group and LTRA group ( P < 0.05 ).Conclusion TARC was the important factor in children asthma.Montelukast could block the production of TARC ,and was more convenient and safe for children asthma.

Objective To detect the mutations of COL7A1 gene in three cases of dystrophic epidermolysis bullosa pruriginosa (DEBP). Methods Clinical data were collected from 3 patients with DEBP. Skin lesions were obtained from these patients and subjected to transmission electron microscopy. DNA was extracted from the peripheral blood of the 3 patients, their 16 relatives, and 150 unrelated normal human controls, and PCR was performed to amplify all the exons and flanking sequences of COL7A1 gene followed by sequencing.Results The patient 1 and 2 had family history, whereas the case 3 was sporadic. Transmission electron microscopy showed tissue cleavage beneath lamina densa in case 1 and slightly decreased anchoring fibrils in some areas of the lesions in case 1 and 3. Three heterozygous mutations of COL7A1 gene, i.e., c. G6734T, c.G6859A and c. G5318T, which leaded to three amino acid mutations, i.e., p. G2245V, p. G1773V and p. G2287R, were found in patient 1, 2 and 3 respectively. Of them, p. G2245V and p. G1773V were novel mutations. The mutations strictly cosegregated with the phenotype in the patients of family 1 and 2. No mutation was detected in the unaffected parents of patient 3 or the 150 unrelated healthy controls. Conclusions The p. G2245V, p. G2287Rand p. G1773V mutations of COL7A1 gene may be responsible for the phenotype of DEBP in the three cases,and of them, p. G2245V and p. G1773V have never been reported.

Objective To study cutaneous ultrastructural changes and FERMT1 gene mutations in a patient with Kindler syndrome. Methods Clinical data were collected, and tissue samples obtained from the lesions of poikiloderma were observed by using transmission electron microscopy. Fifteen coding exons and their flanking sequences of the FERMT1 gene were amplified by PCR and DNA sequencing was followed.Results Reduplication of lamina densa was seen between the dermal-epidermal junctions of the lesional skin. The patient was found to be homozygous for a novel splice-site mutation (IVS9 + 1G ＞ A) in FERMT1 gene, and his parents were heterozygous for it. The mutation was undetected in fifty normal control individuals.Conclusions Transmission electron microscopy may serve as an ancillary examination for the diagnosis of Kindler syndrome. The IVS9+1G＞A mutation of FERMT1 gene may contribute to the clinical phenotype of Kindler syndrome in this patient.

Objective　To ascertain the natural infection rate of hemorrhagic fever with renal syndrome virus (HFRSV) among its hosts and the type of the natural foci for providing some baseline data for the immigrant health and epidemic prevention of the Three-Gorge region. Methods　Epidemiological survey on the field was performed including epidemiological data collection, ecology of rodents and pathogen detection. HFRS virus antigen of hosts were detected by the direct immunofluorescent assay (DIFA) technique and determination of HFRSV-RNA by ISH were carried out from HFRSV-Ag-positive animals. Results　HFRSV-Ag-positive animals were found in 5 migration areas ie Baitao Town of Fuling Section, Wansheng Village of Fengjie County and Dachang Town of Wushan County. The positive hosts were as follows, Rattus Norvegicus, Apodemus agrarius, Anourusurex squamipes, Mus musculus and Rattus flavipectus. The positive rate of HFRSV in the mice of 5 migration areas were 19.4%, 17.0%, 14.0%, 13.7%, and 8.5% respectively. The results showed that the lung tissues of some hosts in all five migration areas were HFRSV-RNA-positive. Baitao Town and Peishi Town were attributed to mixture type epidemic areas while. Kangle Town, Wansheng Village and Dachang Town were domestic rats type epidemic areas. Conclusion　This study shows that the five migration areas are natural epidemic foci of HFRS. It is predicted that maximum risk of HFRS breakout or epidemic may take place after the completion of the San Xia Reservoir(the Three-Gorges Reservoir), which results from rodent moving toward higher land. Therefore, deratization and preventive measures for rat are important in migration areas.