0.05). Conclusions The distribution of the RMSh was widely ranged among hyperopic children,and some children expressed higher value of RMSh. As the pupil diameter got larger,the RMS value of HOA significantly increased. Vertical coma was more frequent dominating type of HOA among hyperopic children. (Ophthalmol CHN ,2006,15: 187-190)

Objective To explore the clinical value of cardiac magnetic resonance imaging (CMRI) in assessment of right ventricular function in patients with pulmonary arterial hypertension (PAH).Methods The PubMed/MEDLINE,Wanfang data,CNKI (from January 2001 to April 2015) were searched.The search terms were pulmonary arterial hypertension,right ventricular function,and cardiac magnetic resonance imaging.An inclusion criterion was the patients suffering from PAH,and the healthy volunteers were served as controls.The study was designed as randomized controlled trial.All the subjects investigated had received CMRI.The end of the trial included right ventricular end diastolic volume (RVEDV),right ventricular end systolic volume (RVESV) and right ventricular ejection fraction (RVEF).Meta analysis was conducted by RevMan 5.0 software provided by Cochrane Collaboration,and the publication bias was analyzed by the funnel plot analysis.Results Five papers involving 381 patients met the criteria.It was showed by Meta-analysis that compared with healthy control group,RVEDV was increase in PAH group [weighted mean difference (WMD) =33.96,95％ confidence interval (95％CI) =20.80-47.12,P ＜ 0.000 01],RVESV was increased (WMD =41.91,95％ CI =29.63-54.19,P ＜ 0.0O0 01),and RVEF was decrease (WMD =-20.09,95％CI =-22.65 to-17.52,P ＜ 0.000 01).Conclusion CMRI can be used to evaluate the right ventricular function of patients with PAH,and it has important significance in the evaluation of right ventricular function in patients with PAH.

Objective To explore the relationship between serum tumor markers and cervical cancer by using Logistic regression, and to further establish the diagnosis model of squamous cell carcinoma antigen (SCC) in cervical cancer by using chi-squared automatic interaction detector (CHAID) analysis of decision tree.Methods Total of 581 cases of cervical cancer,342 cases of cervical benign diseases and 341 cases of healthy controls who detected tumor markers in Taizhou Hospital of Zhejiang during 2010-2013, were retrospectively studied.The test results of carbohydrate antigen 199 (CA199), carbohydrate antigen 125 (CA125), carcinoembryonic antigen (CEA), SCC, and alpha fetoprotein (AFP) were reviewed.The Logistic regression were firstly used in screening the related tumor markers of cervical cancer, and then the CHAID method of decision tree was used in determining the values of the related tumor markers on the diagnosis of cervical cancer.The SCC elevated cases of uterine disease from January 2014 to December 2014 were collected to verify the diagnostic value of SCC in cervical cancer patients.Results Logistic regression analysis showed that among the 5 tumor markers which might be associated with cervical cancer, SCC was the only one which had statistical significance between cervical cancer and cervical benign diseases (Wald x2 =22.120,P =0.000), the OR and its 95％ CI was 1.900 (1.454-2.483).With the SCC numerical increases, the proportion of patients with cervical cancer also gradually increased, when SCC ＞ 2.20 μg/L, the positive predictive value was 94.7％.In 284 cases of SCC higher than 2.20 μg/L who considered as uterus related diseases, there were 270 cases (95.1％) who were eventually confirmed as cervical cancer.Conclusion There was a good diagnostic value of SCC for cervical cancer patients.

Objective To evaluate the multi-detector CT (MDCT) on pulmonary changes in post-operative adult receptor of liver transplantation complicated with acute respiratory distress syndrome (ARDS).Methods Nineteen adult patients admitted into Tianjin First Center Hospital from January to December 2016 to perform the first time liver transplantation were enrolled in this study. Before operation, the CT showed no significant abnormality in the patients' lungs, after operation MDCT was applied to observe the pulmonary changes of ARDS post-operative complication in the adult receiver of liver transplantation, and the pulmonary changes in different gender of patients were analyzed and compared.Results MDCT showed that after liver transplantation all the 19 patients (100%) had lung pathological changes, of whom 18 cases (94.7%) manifested 2 or more than 2 kinds of pulmonary changes, including consolidation shadows (12 cases, 63.2%), patchy shadows (2 cases, 10.5%), ground glass opacity (6 cases, 31.5%) and pleural effusion (18 cases, 94.7%). In the comparisons between male and female patients with post-operative ARDS after liver transplantation, there were no significant differences in the lung pathological changes shown in MDCT (allP > 0.05) statistically.Conclusion The application of MDCT has great potential value in the evaluation of the disease situation after liver transplantation, that might providehelp to the postoperative treatment.

Objective To study the drug resistance mechanism and homologous relationship of four clinical strains of carbapen-em-resistant Klebsiella pneumoniae isolated from different sites of the same one patient.Methods Four carbapenem-resistant K .pneumoniae strains were isolated from blood,urine,sputum and pelvic drainage of a patient after cystectomy in clinical mi-crobiology lab of Xinhua Hospital in March 2012.① Modified Hodge test was used to detect the expression of carbapenemase.② PCR amplification assay and DNA sequencing were used to detect resistance-related genes.③ SDS-PAGE analysis was per-formed to analyze outer membrane porin components of the four carbapenem-resistant K .pneumoniae isolates.ERIC-PCR as-say was used to analyze the homology of these carbapenem-resistant isolates.Results Modified Hodge test demonstrated that all the four carbapenem-resistant K.pneumoniae expressed carbapenemase.KPC-2 gene was identified in all the four isolates by PCR test and DNA sequencing.SDS-PAGE analysis indicated an outer membrane porin alteration common to all the four iso-lates which is distinct from that of the strain sensitive to antibiotics.The identical DNA fingerprinting of the four strains was confirmed by ERIC-PCR analysis.Conclusions The antibiotic resistance mechanism of the four carbapenem resistant K.pneu-moniae associated with this case includes the expression of KPC-2 and altered outer membrane permeability induced by abnormal expression of outer membrane porin.These four strains belong to one common clonal group.

Objective:To investigate the relationship between serum homocysteine (HCY), folate (FOL) and methylenetetrahydrofolate reductase (MTHFR) C677T, A1298C gene polymorphism in patients with type 2 diabetic nephropathy (DN).Methods:A total of 161 patients with type 2 diabetes diagnosed in Jiangsu Shengze Hospital between January 2017 and December 2018, including 81 DN (41 males, 40 females; age: (61.5±14.2) years), 80 diabetic mellitus without nephropathy (DM; 42 males, 38 females, age: (57.7±10.8) years), and 77 normal controls (NC; 39 males, 38 females, age: (58.2±16.3) years) were retrospectively analyzed. The serum levels of HCY and FOL were detected by enzyme circulation and electrochemiluminescence respectively. TaqMan genotyping technique was used to detect MTHFR 677T&A1298 gene polymorphism. The serum levels of HCY and FOL were compared with one-way analysis of variance (the least significant difference t test), and the distribution differences of MTHFR gene were analyzed by χ2 test. Results:The difference of HCY level among DN, DM and NC groups was significantly different ((19.76±7.81), (15.62±5.01) and (8.09±3.74) μmol/L; F=81.738, P<0.001). The FOL level among the 3 groups was also significantly different ((12.18±3.01), (13.50±2.71) and (15.43±2.95) μg/L; F=26.978, P<0.001). The frequencies of 677T allele (51.2%, 83/162), 677TT/1298AA genotype (25.9%, 21/81) in DN group were significantly higher than those in DM (33.1%, 53/160; 11.2%, 9/80) and NC (33.8%, 52/154; 10.4%, 8/77) groups ( χ2 values: 10.821, 9.099, both P<0.05), but the 1298C allele frequency was not significantly different among the 3 groups (21.6%(35/162, DN) vs 16.9%(27/160, DM) vs 18.2%(28/154, NC); χ2=1.269, P>0.05). The levels of HCY and FOL in individuals with 677TT/1298AA genotype were significantly higher than those in individuals with other genotypes ( F values: 12.955, 15.504, all P<0.05). Conclusion:The abnormal metabolism of HCY and FOL caused by MTHFR C677T&A1298C gene polymorphism may be the genetic risk factor of DN.

Objective To observe the pronunciation characteristics of vowels' tone in prelingual hearing-impaired children accepted cochlear implant (CI). Methods 8 prelingual hearing-impaired children accepted CI aged 3~4 years (group CI) and 8 normal-hearing children (group NH) with the same age were asked to pronounce the vowels of /a/, /o/, /e/, /i/, /u/, and /ü/ in four tones with the direction of speech training teacher. The sounds were recorded and analyzed with Praat software extract Formants (F1, F2) and duration of the sounds. Results The error of vowels in four tones was more in group CI than in group NH, but difficult level was almost the same between groups. There was significant difference in the F1 of /e/, F2 of /i/ and /u/ in tone 2, F2 of /e/ and duration of /o/, /e/, and /ü/ in tone 3 between groups (P<0.05). Conclusion Pronouncing the four tones of vowels is more difficult for the hearing-impaired children. For vowels articulation training,it is important to focus on the mouth and breath training.

AIM:To explore the involvement of oxidative stress and apoptosis in the pathogenesis of diabetic cataract induced by Streptozotocin ( STZ) and the interventions of puerarin in order to supply references for clinical treatment.
METHODS:Male SD rats were divided into four groups randomly, control group, diabetic group, apocynin group and puerarin group. The diabetic group were replicated by single injection of STZ (65mg/kg, ip). The expression of p22, p47, p67, Bax/Bcl2, Caspase 3 and P53 proteins were detected by Western Blotting.
RESULTS:The diabetic rats were replicated successfully and the expression of Bcl2 was downregulated while the expression of p22, p47, p67, Bax, Caspase 3 and P53 were upregulated in diabetic group with a significant statistical differences when compared with control group (P<0. 05). Apocynin and prerarin can reverse the abnormal expression of the aforementioned proteins dramatically (P<0. 05).
CONCLUSION: NADPH oxidase mediated oxidative stress and P53, Bax/Bcl2 mediated apoptosis are involved in the pathogenesis of diabetic cataract and puerarin can alleviate cataract greatly by inhibiting the aforementioned signal pathway.

Objective To evaluate the effect of endoplasmic reticulum stress in trophocytes,in patients with intrahepatic cholestasis of pregnancy (ICP).Methods Sixty-one pregnant women who were hospitalized in Women's Hospital,School of Medicine,Zhejiang University from January to December 2015 were recruited.Thirty-one women who were diagnosed as ICP were defined as the ICP group and 30 healthy pregnant women were defined as the control group.The localization and expression intensity of glucose regulated protein 78 (GRP-78) in placental tissues were detected by immunohistochemistry technique.Electronic microscope was used to observe ultra-microstructure change of the endoplasmic reticulum in trophocytes and cell line Swan71.Reverse transcription (RT)-PCR and western blot were used to investigate the expression of GRP-78 mRNA and protein in Swan 71 cell.Results (1) GRP-78 protein was mainly expressed in the cytoplasm of cytotrophoblasts and syncytiotrophoblasts.The protein expression of GRP-78 in placentas of the ICP group (13.2±2.4) was significantly higher than that in the control group (7.8±1.3,P＜0.01).(2) The volume of endoplasmie reticulum did not increase and the microvilli developed well,with no swelling and no expansion of endoplasmic reticulum in the control group.In the ICP group,microvilli injury,endoplasmic reticulum edema were found;the volume of endoplasmic reticulum increased,with dilation,vacuolation and significant degranulation.After treated with 100 μmol/L cholyglycine for 24 hours,universal dilatation of the endoplasmic reticulum were seen in the Swan71 cells.(3) In Swan71 cells,cholylglycine displayed a concentration-dependent up-regulation on the expression of GRP-78.The expressions of GRP-78 mRNA in 0,25,50,100 μmol/L cholylglycine experimental group were 1.01±0.17,2.17±0.16,5.47±0.36,5.65 ± 0.82,respectively.The expression of GRP-78 protein in 0,25,50,100 μmol/L cholylglycine experimental group were 1.01±0.04,1.17±0.15,1.33±0.13,1.73±0.13,respectively.The expression of GRP-78 mRNA and protein in 100 and 50 μ mol/L cholylglycine experimental group were significantly higher than 0 μmol/L (all P＜0.01).Conclusion The obvious expansion of endoplasmic reticulum and the increased expression of GRP-78 in trophocytes indicated that endoplasmic reticulum stress of trophocytes may be involved in the pathogenesis of ICP.

Objective To investigate the schistosomiasis japonica infection and preventive knowledge of immigration popula-tion in Jinshan District,Shanghai so as to provide the evidence for improving the control work. Methods The immigration popula-tion from schistosomiasis endemic provinces and local people were screened by serum IHA screening for schistosome infection, and the positives were further examined by Kato-Katz technique and the miracidium hatching method. The schistosomiasis preven-tive knowledge and behaviors were investigated by questionnaires. Results A total of 579 were investigated with 348 immigration people and 231 local people,and among them,the male accounted for 72.0%and female accounted for 28.0%. In the immigration population,the main age group was 20-29(56.0%),and 56.6%of the immigration had an education level at senior middle school or higher. The most proportion of immigration was from Anhui Province(36.2%). There were 4 IHA positive persons(1.15%)in the immigration,and 1 was positive in the stool test,and the schistosome infection rate was 0.29%. There were no positives in the local people. The schistosomiasis preventive knowledge of the immigration was generally poor,and some people’s behaviors of see doctor and medication were incorrect. Conclusion There are schistosome infected persons among the immigration population from schistosomiasis endemic provinces,and their schistosomiasis prevention knowledge was poor,thus there is a schistosomiasistransmission risk.