AIM: To comprehensively investigate the current status of cataract surgery in Leshan city, and find the existing problems according to the survey results as a guide to cataract prevention and treatment in future.
METHODS: We surveyed the status of cataract surgery containing equipments, surgeons and surgery conditions in 17 ophthalmology departments of general hospitals from Leshan including 6 counties, 1 county-level city and 4 districts during 2012. Cataract surgery methods, according to various surgery financial resources, surgical performances and surgical incision, were divided into phacoemulsification and intraocular lens implantation ( Phaco + IOL ) , extracapsular cataract extraction and intraocular lens implantation ( ECCE + IOL ) , and each method contained 2 groups. We analyzed the outcomes following preoperative examination, surgeons, surgical methods, surgical equipments, types of IOL, surgical quantity, surgical results, and intraoperative complication.
RESULTS: In whole city there were 16 operating microscopes, 43 slit lamp microscopes, 12 non-contact tonometers, 1 intraocular lens Master, 8 optical A/B type ultrasonic examination systems, 4 YAG lasers and 12 phacoemulsification instruments. There 15 doctors could complete cataract surgery independently, and 5 of them were phacoemulsification surgeons. The total number of completed cataract surgeries reached 6 211 eyes, containing 3 564 eyes for Phaco+IOL ( 57%) ( preoperative visual acuity ≥0. 3 in Phaco+IOL1 were 1 520 eyes, 24%) and 2 647 eyes for ECCE+IOL ( 43%) ( 1 533 eyes in ECCE+IOL1, 25%). In various groups, off-blindness rate was 94. 80%-100%, off-disability rate was 90. 41%-100%, and 94. 96% - 100% received intraocular lens implantation, intraoperative complication rate was 1. 00%-15. 10%.
CONCLUSION: The distribution of surgeons and equipments in the whole city is unbalanced, and the utilization rate of phaco equipment is low. The levels are different in various hospitals on surgical technique, surgical quantity and surgical results. Phacoemulsification and intraocular lens implantation is considered as the main therapy for cataract, and as a transition to dioptric and personalized cataract surgery. The surgical condition of the city is good, but the proportion of cataract surgery for prevention of blindness in Leshan city is low, and the surgical technique remains to be further improved.

Objective To explore the significance of day surgery mode on cataract patients for achieving win-win among patient, hospital and medical insurance.Methods 120 cataract patients (selected from December 2015 to June 2016, in the Ophthalmic Center of Leshan People′s hospital) were included in this retrospective study and day surgery group (n=60) was observation group and hospitalization surgery group was control one (n=60).All cases underwent cataract phacoemulsification and intraocular lens implantation.Treatment process, average day on the waiting list, average preoperative stay, average length of stay, medical cost and patient satisfaction were compared between the two groups.Results Days on the waiting list in day surgery group (1.2 d) reduced 8 days than in hospitalization surgery group (9.2 d).Preoperative stay in day surgery group reduced 1.5 days than in hospitalization surgery group.Length of stay ware reduced by 3 days as compared to the control group.The average medical cost in day surgery group was much less than the control group and the patient satisfaction was much higher.Conclusion The high efficiency of day surgery mode can shorten the length of hospital stay, lessen the cost of medical expense, realize the security management of medical service, so as to provide more convenience, more safety, better quality and cheaper medical service for patients.It achieves social and economic benefits and finally achieves win-win among patient, hospital and medical insurance.

Objectives:To evaluate the effect of different teeth arrangement methods on the masticatory efficiency of complete dentures.Methods: Three complete dentures for each of ten edentulous patients were made respectively by using maxillary teeth arrangement,mandibular teeth arrangement and comprehensive teeth arrangement methods.After three months of wearing,the masticatory efficiency of the three complete dentures was tested by light absorption method,and was compared to that of dentulous subjects.Results:The masticatory stroke and masticatory efficiency in denture wearing group were fewer and weaker than those in dentulous group in either bilateral mastication or unilateral mastication. Good masticatory efficiency was gained after three months of wearing the complete dentures made by the three different teeth arrangement methods.There were no significant difference in the masticatory stroke and masticatory efficiency of complete dentures made by mandibular teeth arrangement and comprehensive teeth arrangement methods,but they were both higher than those made by maxillary teeth arrangement method.Conclusions:The complete dentures made by mandibular teeth arrangement method and comprehensive teeth arrangement method are feasible for restoration of masticatory efficiency of endentulous patients.

OBJECTIVE: To explore the neuroprotective effect of electroacupuncture therapy on damaged cholinergic neurons in hippocampus in aged rats with Alzheimer's disease (AD). METHODS: Thirty six aged male rats were randomly divided into normal control group, sham-operated group, untreated group and electroacupuncture group. Animal model of AD was established with fimbria-fornix transection. The rats in the electroacupuncture group received electroacupuncture on Baihui (DU 20), Yongquan (KI 1), Taixi (KI 3) and Xuehai (SP10). The activity of choline acetyltransferase (ChAT) in septal area of brain was detected by radioimmunoassay, and the protein expressions of nerve growth factor (NGF) and c-fos in CA3 region of hippocampus were detected by immunohistochemical assay. RESULTS: The ChAT activity and the expression levels of NGF and c-fos proteins in the electroacupuncture group were significantly higher than those in the untreated group. CONCLUSION: Electroacupuncture therapy can protect cholinergic neurons in hippocampus in aged rats with AD by means of promoting synthesis of c-fos protein and increasing the expression level of NGF.

Objective To establish a rapid and precise continuous flow-injection chemiluminescence (CL) method for the determination of perphenazine. Methods In HNO_3 medium, perphenazine could be oxidated by ceriuim (IV) and CL was proportional to the perphenazine concentration without any sensitizers. Thus, a new flow-injection CL method was developed. Results Under the optimized conditions, the proposed method allowed the determination range within 1.0?10~ -7 -7.0?10~ -5 g/mL with the detection limit of 8.0?10~ -8 g/mL. Eleven parallel assays were conducted on perphenazine of 1.0?10~ -6 g/mL, with the relative standard deviation of 1.8%. Conclusion The method is simple, rapid, precise, and sensitive, and has broad linear range; therefore, it has been applied to the the determination of the perphenazine in tablets with satisfactory results.

Objective To extract characteristic parameters of ECG signals a new method of non-invasive diagnosis for coronary heart disease with artificial neural network. Methods ECG signals were digitized with A/D converter and filtered to eliminating the noise. Span of QRS interval, R-R interval,and voltage of S-T segment of filtered ECG were detected. These 3 characteristics were as the input parameters of the input layer. Samples were trained with an improved 3-layers back propagation(BP) artificial neural network, as trained samples. The non-trained samples were recognized with these BP neural networks. Results After 12 samples had been trained about 1500 times, the BP neural network could accurately distinguish samples of coronary heart disease from the trained samples and also recognize 20 non-trained samples, 19 to be correct except one. Conclusion It is showed that based on BP network and characteristic parameters of ECG, a new and promising method of non-invasive diagnosis for coronary heart disease has been found.

Objective Through the analysis of cases,to improve the cognition of clinicians on extracranial vas-cular embolism diseases(VED)in children.Methods The clinical information included incidence trend,thrombophi-lia,clinical features,treatment and prognosis of 29 children with VED,who were admitted from January 201 1 to Decem-ber 201 5 in Nanjing Children′s Hospital Affiliated to Nanjing Medical University,and retrospectively analyzed.Results The annual rate of VED increased from 0 to 1 .49 per 1 0 000 hospital admissions from January 201 1 to December 201 5.In 29 cases,there were 20 male and 9 female,with an average age of 6.03 years old (2 h -1 3.83 years old).In-fants accounted for >20%(6 /29 cases).The average age of the female,non infected group,rheumatic disease group and venous thrombosis group was higher than that of the male,the infection group,the non rheumatic disease group and the arterial embolization group,but there was no significant difference(all P >0.05).Thrombophilia were as follows:in-fection disease,heart disease,kidney disease syndrome,rheumatoid disease,tumor,and twins embolization syndrome. Risk factors included central venous line,immobility,dehydration,glucocorticoids use,etc.Heart disease was the leading cause of non thrombotic embolism,while other thrombophilic diseases resulted in thrombotic embolism.Pulmonary em-bolism was mainly seen in patients with severe pneumonia,especially mycoplasma pneumoniae pneumonia (MPP ).The older the age,the more typical clinical manifestations,and significantly elevated D dimer,fibrin/fibrinogen degradation products tips VED.Treatment depends on the degree of risk.Thirty -seven point five percent(3 /8 cases)of children with arterial embolism were less than 1 year old,and the mortality 25.00% (2 /8 cases)was significantly higher than that of venous thrombosis 1 7.65%(3 /1 7 cases)and 1 1 .76% (2 /1 7 cases).Conclusion Heart disease mainly cause arterial embolism and infection,while nephritic syndrome and rheumatic disease mainly cause venous embolism.Pulmona-ry embolism is mainly seen in children with severe pneumonia,especially MPP.The risk of arterial embolization is higher than that of venous embolism.

Objective To establish a rapid and precise continuous flow-injection chemiluminescence method for the determination of tetracycline and oxytetracycline. Methods In NaOH solution, tetracycline and oxytetracycline can sensitize obviously the chemiluminesence (CL) intensity of the reaction of luminol with KIO4, the sensitized CL intensity is proportional to the concentration of tetracycline and oxytetracycline. So, a new flow-injection CL method has been developed. The optimum chemical conditions for the CL reaction were investigated. Results Under the optimized conditions (KIO4 concentration: 1.0×10-5 mol/L; NaOH concentration: 0.1mol/L; luminol concentration: 1.0×10-4mol/L), tetracycline and oxytetracycline were determined. The linear range of the working curves was 1.0×10-7 -1.0×10-4g/mL, the detection limits was 1.0×10-8g/mL and 1.1×10-8g/mL, and the relative standard deviation was 2.6% (CS=1.0×10-6g/mL; n=11) and 2.0% (CS=1.0×10-6g/mL; n=11) respectively. Conclusion The method is simple, rapid, and sensitive, and it has been successfully applied to the the determination of tetracycline and oxytetracycline tablets, the mean recoveries being 99.7% and 98.8% respectively.

Objective: To investigate the associations of deficits in prepotent response inhibition with attention deficit and impulsive behavior in children with attention deficit hyperactivity disorder (ADHD), so as to provide insights into response inhibition training in ADHD to relieve clinical symptoms. Methods: From March to December 2022, 57 children with ADHD were selected from the clinical psychology department of a tertiary hospital in Hangzhou City as the ADHD group, and 55 normal children matched by age and gender were selected from a primary school as the control group. Prepotent response inhibition, attention deficit and impulsive behavior were assessed by inhibition conflict task, visual continuous performance test (CPT) and matching familiar figures test (MFFT), respectively. The associations of deficits in prepotent response inhibition with attention deficit and impulsive behavior were analyzed using multiple linear regression model, and the predictive value of deficits in prepotent response inhibition on ADHD was evaluated using receiver operating characteristic (ROC) curve. Results: The children included in the ADHD group had a mean age of (8.77±1.60) years and 44 males (77.19%), and the children included in the control group had a mean age of (9.20±1.77) years and 42 males (76.36%). The error rate of inhibition conflict task, missing report rate of visual CPT and the number of MFFT errors were higher in the ADHD group than in the control group [22.50% (12.50%) vs. 8.75% (7.00%), 24.00% (30.00%) vs. 7.50% (7.00%), 8.67±3.32 vs. 4.47±3.16; all P<0.05]. Multiple linear regression model showed that the error rate of inhibition conflict task was positively associated with the missing report rate of visual CPT (R2=0.135, β=0.091, P<0.001) and the number of MFFT errors (R2=0.092, β=0.009, P<0.001). The area under the ROC curve was 0.891, the sensitivity was 93.00%, the specificity was 80.00%, and the cut-off was 13.13%. Conclusions The deficits in prepotent response inhibition are positively associated with attention deficit and impulsive behavior.

OBJECTIVETo investigate the therapeutic effect of IL-6 mAb on experimental autoimmune myocarditis (EAM) in rats, and search the mechanism of the role of IL-6, helper T cells 17 (Th17) and regulative T cells (Treg) in EAM pathogenesis.

METHODSThirty-four Lewis rats were divided into three groups randomly, i.e. control group (n = 6), EAM group (n = 12), and IL-6 mAb intervention group (n = 16). Rats in EAM group and IL-6 mAb intervention group were injected intracutaneously with myosin to establish EAM model. Rats in IL-6 mAb intervention group were injected intraperitoneally with 1 mg IL-6 mAb on 1st, 7th to 20th day after cardiac myosin immune injection. Myocardial inflammation was examined by HE stain, Masson stain, and TdT assay (TUNEL reaction) on 21st and 84th day after IL-6 mAb therapy in order to assess the therapeutic role. Spleen cells were analyzed by flow cytometry to illustrate Th17 and Treg cells? number and function. The serum concentration of IL-6, IL-10, IL-17, and TGF-beta in each group was measured by ELISA, concentration of STAT3, RORgammat, and Foxp3 mRNA in each group was determined with RT-PCR. Spleen cells derived from EAM were stimulated by IL-6 mAb in vitro, and the concentration of IL-10, IL-17 and TGF-beta was measured by ELISA.

RESULTSInflammation score, fibrosis score, and apoptosis index in IL-6 mAb intervention group were significantly decreased as compared with those in EAM group (P < 0.01). The number of Th17 and Treg cells in EAM group on the 21st day (experimental acute peak stage) were increased, and those in intervention group on the 21st day were significantly inhibited (P < 0.01). The concentration of serum IL-6, IL-10, IL-17 and TGF-beta in intervention group on the 21st day was decreased dramatically in comparison with that in EAM group on the same day (P < 0.01). The levels of peripheral blood STAT3, RORgammat, Foxp3 mRNA in intervention group on the 21st day was decreased significantly as compared with that in EAM group (P < 0.01). The expression of IL-10, IL-17 and TGF-beta was increased significantly (P < 0.01) by stimulation of IL-6 mAb on spleen cells derived from EAM in vitro.

CONCLUSIONSIL-6 mAb could neutralize IL-6, and ameliorate myocarditis and reduce heart autoimmune responses. IL-6 mAb has significantly protective effects on EAM by suppressing Th17 and Treg cells.

Animals ; Antibodies, Monoclonal ; therapeutic use ; Autoimmune Diseases ; drug therapy ; immunology ; Disease Models, Animal ; Forkhead Transcription Factors ; metabolism ; Interleukin-10 ; metabolism ; Interleukin-17 ; metabolism ; Interleukin-6 ; immunology ; Male ; Myocarditis ; drug therapy ; immunology ; Nuclear Receptor Subfamily 1, Group F, Member 3 ; metabolism ; Rats ; Rats, Inbred Lew ; STAT3 Transcription Factor ; metabolism ; Th17 Cells ; immunology ; Transforming Growth Factor beta1 ; metabolism