AIM: To study whether there was a correlation between central foveal thickness (CFT) assessed with optical coherence tomography (OCT) and visual acuity of patient with high myopia after phacoemulsification and intraocular lens implantation.METHODS: Totally 67 patients with high myopia underwent phacoemulsification and intraocular lens implantation were enrolled in the study.Best corrected visual acuity (BCVA) was recorded and CFT was measured using OCT at 1wk,1 and 3mo after oerations.BCVA and CFT were compared before and after the operation.All patents were divided into two groups by the BCVA at 3mo after operation,BCVA>0.5 in Group A and BCVA≤0.5 in Group B.ANOVA,Spearman correlation analysis and independent t test were used for statistical analysis.RESULTS: There was a statistically significant difference between preoperative BCVA and postoperative BCVA (F=115.04,P<0.01).Preoperative CFT was different compared with that 1wk and 1mo after operation (P=0.04,0.02) and was not different with that 3mo after operation(P=0.52).There was a statistically significant difference in CFT of postoperative 3-month compared with that of postoperative 1-week(P<0.01) or that of postoperative 1-month (P<0.01).BCVA showed significant positive correlation with CFT without foveal lesion on postoperative 3mo (r=0.28,P=0.03).CFT of Group A and Group B was significantly different at 3mo after the operation (t=-2.24,P=0.03).There was no significant difference in age and intraocular lens of two groups.CONCLUSION: Optical coherence tomography allow for objective assessment of retinal construction changes in eyes with high myopia are correlated to visual acuity.

BACKGROUND: Interleukin-1 receptor antagonist can relieve damage of neuron and protect nerve. Aminoglutaric acid can induce exitotoxicity through activating some kinds of aminoglutaric acid receptor, at the same time, can protect nerve through some receptors. But the relationship between them was unclear during the process of cerebral ischemia reperfusion.OBJECTIVE: To investigate the effect of neuroprotective actions of interleukin-1 receptor antagonist on hippocampal neurons, and the relationship between interleukin-1 receptor antagonist and metabotropic glutamate receptor 5 within the process of cerebral ischemic reperfusion injury.DESIGN: Completed randomized controlled study.SETTING: State Key Laboratory of Magnetic Resonance and Atomic and Molecular Physics, Wuhan Institute of Physics and Mathematics, Chinese Academy of Sciences; School of Medicine & Life, Jianghan University.MATERIALS: The experiment was performed at State Key Laboratory of Magnetic Resonance and Atomic and Molecular Physics, Wuhan Institute of Physics and Mathematics, Chinese Academy of Science from May 2004 to January 2005. Totally 32 well-being pure breed male Wistar rats were selected.METHODS: Totally 32 rats were divided into four groups by method of the simple random sampling: normal group (n=8) received no surgical treatment, sham operated group (n=8) subjected to only dorsal and ventral neck midline incisions and gently dissection of the bilateral common carotid arteries free of surrounding nerve fibers without occlusion of the both vertebral arteries and common carotid arteries, saline group (n=8) suffered from the permanently occlusion of the both vertebral arteries by electrocauterization and transient (20 minutes) occlusion of bilateral common carotid arteries respectively, and received the treatment of a 2 μL normal saline injection into right lateral ventricle at the rate of 0.4 μL/minute following a needle withdrawal within 5 minutes, and experiment group (n=8) offered the same procedure of the saline group but for that the equivalent amount of rhIL-1ra took the place of normal saline into the lateral ventricle. Hematein-eosin staining was applied to observe pathological changes and immunohistochemistry (ABC) was used to survey the IR of mGluR5 varieties of the hippocampal neurons.MAIN OUTCOME MEASURES: ① Basic pathological changes of hip pocampus and cerebral cortex; ② mGluR5 immunoreactivity (IR) of hippocampus, the sensitive area to cerebral ischemia.RESULTS: Two rats were excluded from the experiment on account of their convulsion during reperfusion (one of the experiment group, another of the saline group), data of 30 rats was entered final analysis. ①Basic pathological changes of hippocampus and cerebral cortex: The Hemateineosin (H.E) staining showed that there is little pathological discrepancy between the normal group and the sham operated group, apparent neuronal degeneration such as peripheral edema around neurons, pyknosis, karyorrhexis and so onin the hippocampus and cortex of the rats of the saline group compared with those of the previous groups, and also the pronounced lower degree of neuronal degenerationin the rats of the experiment group.② mGluR5 immunoreactivity (IR) of hippocampus, the sensitive area to cerebral ischemia (absorbency): The immunohistochemistry presented that the mGluR5 immunoreactivity (IR) of CA1, CA3 areas of the normal group and sham group rats was strong positive (CA1: 0.54±0.12, 0.54±0.05; CA3:0.57±0.02, 0.58±0.08;P ＞ 0.05) Compared with of the normal group and sham group, the mGluR5 IR of the saline and the experiment groups reduced apparently (CA1: 0.30±0.03, 0.40±0.04; CA3: 0.30±0.04, 0.42±0.06;P ＜ 0.01), but the mGluR5 IR of the experiment group was quite stronger than that of the saline one (P ＜ 0.05).CONCLUSION: IL-1ra, one member of the Interleukin-1 family (system)of the cytokines, and mGluR5, one subtype of the metabotropic glutamate receptors were both involved in the pathophysiological process of the global cerebral ischemia reperfusion injury of the rat. Also, as the antagonist of the proimflammatory medium intetleukin-1 receptor, IL-1ra may show neuroprotection by affecting the mGluR5 expression of the CA1 and CA3 areas of the rat hippocampus within the process of cerebral ischemic reperfusion injury. Furthermore, here it demonstrated that besides IL-1ra, other factors might regulate the expression of mGluR5.

BACKGROUND: The development of hip joint in children with developmental dislocation of the hip (DDH) has been evaluated by X-ray plain film, which mainly presents Shen Tong's line continuity and epiphyseal nucleus position. There is still a lack of quantitative and objective evaluation methods. OBJECTIVE: To evaluate the rotation center and dislocation degree in DDH children by using three-dimensional (3D) computed tomography (CT).METHODS: Preoperative 3D CT was performed for 16 unilateral DDH from December 2010 to December 2014 in Tongji Hospital of Huazhong University of Science and Technology, with 4 males and 12 females, at the mean age of (4.42±2.59) years. There were 10 cases on the left side and 6 cases on the right side. 3D digital models were constructed by analysis. The 3D coordinate system was established with reverse engineering software. In 3D coordinatesystem, using inverse solution method of sphere fitting engineering, the rotation center of the acetabulum, the rotationalcenter of the femoral head, and the radius of ossification were constructed. Ossific radius ratio and dislocation lengthwere calculated. RESULTS AND CONCLUSION: (1) The acetabulum has the same point as the rotation center with the head of femur,and no significant difference in X, Y, and Z coordinates was detected (Px > 0.05, Py > 0.05, Pz > 0.05). However, it is notthe same condition in ipsilateral acetabular rotation center and femoral head rotation center, showing significant differences (Px=0.052, Py < 0.05, Pz < 0.05). (2) There were no significant differences in ossific radius between the healthy and affected sides (P > 0.05). The ossific radius was (21.37±4.42) mm and (20.14±3.14) mm on the healthy and affected sides of the femoral head (P < 0.05). (3) There was no significant difference in ossific radius ratio between healthy and affected sides (0.544±0.069 and 0.522±0.088; P > 0.05). (4) The dislocation length was 8.64-35.28 mm, mean (19.47±7.84) mm. (5) These findings suggest that 3D CT reconstruction can construct 3D digital models of DDHchildren. Thus, the accurate rotation center of the hip can be identified so as to precisely measure the dislocation length.

Objective Adult isolated ACTH deficiency ( IAD) is an uncommon and underestimated disorder with high rate of misdiagnosis.This paper aimed to analyze and summarize the clinical features of 6 patients with IAD to have deeper understanding of the disease. Methods Retrospective analysis was made on the data of 6 IAD cases enrolled in Nanjing Hospital of Nanjing Medical University from 2007 to 2015.Statistical analysis was made on the clinical manifestations, therapeutic schemes, laboratory and imaging results, along with outpatient follow-up(ranging from 0.5-10 years), in order to analyze clinical efficacy and prognosis result. Results Of 6 IAD patients, 4 patients showed main symptoms of long-term fatigue, anorexia, weight loss;5 patients were with differ-ent degrees of hypoglycemia (fasting blood glucose2.70 [1.2-3.0]mmol/L), among which 3 had hypoglycemic coma (fasting blood glucose <1.8mmol/L), 1 had chronic hypoglycemia and 1 had asymptomatic hypoglycemia( asymptomatic hypoglycemia by continu-ous glucose monitor system).4 of them had refractory hyponatremia (Serum Na+117 [110-120]mmol/L).ACTH values of all the patients were less than 0.01ng/L.After glucocorticoid replacement therapy, all the patients were followed up for six months after treat-ment and cortisol rhythm, plasma cortisol, urine cortisol, fasting blood glucose, serum sodium of the patients were in normal range, but still at a low level of ACTH. Conclusion The clinical manifestation of IAD is characterized as hypoglycemia, hyponatremia, low ACTH with other normal pituitary hormones.Long-term glucocor-ticosteroid therapy has favorable prognosis for patients with adult isola-ted ACTH deficiency.

Objective To evaluate the effect of beat to beat alterations in the cardiac cycle length on systolic flow velocity patterns of the pulmonary vein in patients with atrial fibrillation(AF).Methods Pulmonary vein flow was recorded in 20 control subjects and 74 patients with AF (16 with nonvalvular AF,22 with mild to middle mitral stenosis,and 36 with severe mitral stenosis) by transesophageal echocardiography.The peak velocities of the early systolic reversal wave (PVR) and the systolic forward wave (PVS) were measured.The relationships between the preceding R-R intervals and PVR,PVS were analyzed.Results The early systolic reversal wave was detected in all patients with AF.PVR was significantly lower in patients with severe mitral stenosis than that in patients with nonvalvular AF and mild to middle mitral stenosis.The preceding R-R interval had a significant negative correlation with PVR.PVS was significantly lower in patients with AF than that in controls.The preceding R-R interval had a significant positive correlation with PVS.Conclusions PVR and the systolic forward wave vary with disease conditions and preceding R-R intervals in atrial fibrillation.The evaluation of systolic pulmonary venous flow velocity patterns provides important information about left atrial hemodynamic abnormalities.

OBJECTIVE:To try to establish a combined serum-pharmacology and electrophysiology method for the study of mechanism of chuanxiong extract in dilatating coronary artery.METHODS:Chuanxiong extract was intragastrically given to rats and mice,then the serum contents of tetramethylpyrazine(TMP)were determined by HPLC,which provided data for electrophysiological study.The action of chuanxiong extract on Ca 2+ -activated K channel(Kca)of smooth muscle of coronary artery in pigs was studied by patch clamp technique.RESULTS:The calibration curve of TMP was linear in the range of0.216～54?g/ml(r=0.9999).The recovery was100.7%～102.4%.The serum concentrations of TMP in rats and mice were(3.56?3.01)and(8.19?6.57)?g/ml respectively.The chuanxiong extract could not markedly activate the Kca of smooth muscle of coronary artery in patch clamp study.CONCLUSION:The established method for TMP determination is feasible and relieable.In order to improve the combined electrophysiology and serum pharmacology technique,high quality medical materials should be adopted and the bioavailability improved.

Objective To explore the effect of triperygium wilfordii polyglucoside(TWP) on the podocytes of rats with diabetes nephropathy(DN). Methods One hundred SD rats were randomly divided into normal control group (Group A),DN group (Group B),TWP group(Group C).TWP group was divided into 3 subgroups(Ca,Cb,Cc)according to the different doses 4,8,16mg·kg-1·d-1,respectively.Rats in DN group and TWp group were given streptozocin(STZ)by intraperitoneal injection to establish animal model of diabetes.After 12 weeks,24 h urinary protein excretion rate(UAER),BUN,Scr,white blood cell(WBC),blood glucose(Glu),and kidney weight (KW)/body weight(BW)were determined.The renal pathological changes were evaluated by HE staining.The structural change of podocytes was observed by transmission electron microscope.The expressions of nephrin and podocin were evaluated by immunofluorescence staining. Results (1)Compared to group A,Scr,BUN,Glu,KW/BW,and UAER were significantly higher(P＜0.05)in group B and group C.Whereas the elevated liver enzymes and the decreased WBC were presented in group Cc (3/20). Compared to group A, the protein expressions of nephrin and podocin in nephridial tissue were lower, and the significant differences of pathomorphology in glomerulus,tubules and podocytes were observed in group B and group C. (2) Compared to group B, KW/BW and UAER were lower in group C (P＜0.01); the protein expressions of nephrin and podocin were higher in nephridial tissue; the pathomorphological improvements were exhibited in glomerulus,tubules and podocytes in group C, paralleled with the increase of TWP dose (P＜0.05 or P＜0.01).Conclusions TWP may exert the protective effect on podocytes in diabetic nephropathy rats,dependent on the dose of TWP. The mechanism may be associated with the up-regulatied expressions of nephrin and podocin.

Objective To characterize the features of breast mucinous carcinoma on T2WI, dynamic contrast-enhanced MR imaging (DCE-MRI) and diffusion weighted imaging (DWI) and correlate the MR features with histopathology. Methods MR imaging in 8 women (aged 33--65 years old) with mncinous carcinoma of the breast verified histopathologically was performed on 1.5 T scanner with T1WI, FS T2 WI, 3D DCE-MRI using volume imaging for breast assessment(VIBRANT) sequence, DWI with b value of 500 and 1000 s/mm2 by single-shot EPI sequence. According to the lexicon of BI-RADS-MRI designed by ACR, the MR findings were retrospectively studied, including morphology, signal intensity on T1WI and FS T2WI, mass enhancement, the patterns of dynamic enhancement curve, and the mean ADC on DWI. The pathologic diagnosis was made according to the standard criteria by the World Health Organization Classification of Tumors. Results Five patients were pure mucinous carcinoma and 3 patients were the mixed. The amount of mucus ranged from 60% to 90%. All 8 tumors presented as a mass on MRI with low signal intensity on T1WI, high or strongly high signal intensity on FS T2WI and high signal on DWI. The tumor size ranged from 1.3 to 3. 2 cm in diameter. Five tumors showed rim enhancement in early phase and the central part was gradually enhanced in delayed phase. One tumor presented slightly heterogeneous enhancement. Two tumors showed progressively heterogeneous enhancement. The mean ADC values of tumor were (2.41±0.28) ×10-3 mm2/s with b value of 500 s/mm2 and (2.06 ±0. 14) × 10-3 mm2/s with b value of 1000 s/mm2, and higher than that of the normal breast tissue [ ( 1.71 ±0. 32) × 10-3 and ( 1.43 ± 0. 24) × 10-3 mm2/s]. Conclusions The MR features of breast mucinous carcinoma on T1WI, DCE-MRI, and DWI are different from that of invasive ductal carcinomas and may reflect its distinct histological type. The combination of these MR sequences may lead to a pre-operative diagnosis of this tumor.

Objective To study the outcomes of two intervention strategies on the language development of young children with hearing loss greater than moderate degree by universal newborn hearing screening (UNHS) system.Methods Infants and young children,born from Jan 2002 to Dec 2007 in Shanghai and failed UNHS,were included in this study.They received audiometric evaluations at the Shanghai Children's Hearing and Speech Center.Among those diagnosed with hearing loss greater than moderate degrees,65 were intervened at 6 months and followed up subsequently.According to hearing loss degree and intervention strategies,20 of 65 were included in the hearing aid group(M_(HA)),19 was in the severe hearing aid group(S_(HA)),9 in the profound hearing aid group(P_(HA)),and 17 in the profound cochlear implamation group(P_(CI)).Other 36 were not intervened at 6 months old but followed up also.The control group was 36 normal hearing young children.The hearing losse and speech development were analyzed for statistical study.Results Between the group without intervention and the control group,between the group intervened and without intervention,statistically significant differences were noted (P＜0.05) in the average hearing threshold and the developmental scores.Between the control group and anyone group among M_(HA),S_(HA) and P_(CI),no statistically significant differences (P＞0.05) were noted in the developmental scores.For the same hearing level between the group P_(HA) and P_(CI),statistically significant differences (P＜0.05) were noted in the developmental scores.The developmental scores of P_(HA) was lower than that of P_(CI).Conclusion Early intervention is effective for infants and young children with hearing loss greater than moderate degree.Their speech development is noticeably faster than that of those without any intervention.According to hearing loss degree,it was very important for acquiring the best speech development that selected the most proper intervention mode.

To detect the expression of p16 protein and Ki-67 antigen in gastric mucosa-associated lymphoid tissue lymphoma(MALTL)and normal gastric mucosa and to investigate the clinical significance of their expression in the occurrence and development of gastric MALTL.Methods 47 samples of gastric MALTL diagnosed pathologically in the department of pathology of the PLA General Hospital from March 1993 to June 2005 were collected.By using immunohistochemial methods,the expression of p16 protein and Ki-67 antigen was detected in 20 samples of normal gastric tissue and the 47 samples of gastric MALTL.Results The positive rate of p16 protein Was 21.3%(10/47)and 90.0% in gastric MALTL and normal gastric tissue respectively.The positive rate of p16 protein in gastric MALTL was lower than that in normal gastric tissue(P<0.05).The expression of p16 was related to the degree of lymph node metastasis.The positive rate of Ki-67 labelling index(LI)in gnstric MALTL was hiigher than that in normal gastric tissue.A negative correlation was found between the expression of p16 protein and Ki-67 LI(P<0.05). Conclusions Detection p16 and Ki-67 may help to predict the possibility of lymph node metastasis and prognosis in gastric MALTL.