Objective To observe the effect of micro-pulse laser in the treatment of acute central serous chorioretinopathy (CSC).Methods 105 cases (114 eyes) with clinically diagnosed acute CSC were included in the study,including 78 males (86 eyes) and 27 females (28 eyes) with an average age of (40.40±7.80) years,and mean duration of 26 days.All patients were examined for best corrected visual acuity (BCVA),slit lamp microscope and pre-lens,direct ophthalmoscopy,color fundus photography,fluorescein angiography combined with indocyanine green angiography (ICGA),and micro-perimetry.Patients were randomly divided into micro-pulse laser treatment group (treatment group,61 eyes) and control group (51 eyes).The age (Z ＝-0.374),gender ratio (x2=0.010),disease duration (Z=-0.525),BCVA (t=1.885),foveal thickness (CFT) (t=-1.754) and macular light sensitivity (t=1.255) were similar between the two groups.The micro-pluse laser treatment was performed with an 810 nm infrared diode laser at the active leakage site on retinal pigment epithelium guided by ICGA.The exposure time was 0.2 s,effective working time was 15％,the laser spot diameter was 100 μm,and the distance between 2 spots was 100 μm.The control group received pseudo-treatment using the same laser parameters.After 2 weeks,1month,3 months and 6 months of treatment,all patients were examined with BCVA,ocular fundus,optical coherence tomography and micro-perimetry.These parameters were compared between the 2 groups.Results The subretinal fluid of 39 eyes in the micro-pulse laser group and that of 3 eyes in the control group were absorbed completely.The cure rates in the micro-pulse laser group (61.9％) was higher than that in the control group (x2 =38.015,P＜0.01).In the micro-pulse laser group,the mean BCVA was 67.81±11.70 at baseline,which increased significantly to 75±9.91,76.78± 9.43,78.56 ± 8.57 and 78.52 ± 8.60 at 2 weeks,1 month,3 months and 6 months after treatment respectively.In the control group,that was 63.86±10.35,64.20±11.43,63.90±10.88,64.55±11.04,64.10±11.12 at baseline,2 weeks,1 month,3 months,6 months post-treatment respectively.The mean post treatment BCVA at each time point were significantly higher in the micro-pulse laser group than that in the control group (P＜ 0.01).The mean CFT was (380.94 ± 50.73) μm at baseline,which reduced to (268.44±44.20),(242.78±41.31),(235.46±38.44),(235.56±38.71) μm at 2 weeks,1 month,3 months and 6 months post-treatment respectively in the nmicro-pulse laser group.In the control group,that was (397.98±52.61),(334.55±59.15),(316.16±55.25),(314.47±53.27),(321.51±55.74) μm at baseline,2 weeks,1 month,3 months,6 months post-treatment respectively.The mean post-treatment CFT at each time point in the micro-pulse laser group were decreased significantly compared to that in the control group (P＜0.01).The mean central retinal sensitivity was (15.03 ± 2.00) dB at baseline,which enhanced to (17.06 ± 1.71),(17.37 ± 1.61),(17.56 ± 1.58),(17.48 ± 1.53) dB at 2 weeks,1 month,3 months and 6 months post-treatment respectively in the micro-pulse laser group.In the control group,that was (14.54±2.22),(14.80±2.16),(14.88±2.09),(14.82±2.07),(14.69±2.11) dB at baseline,2 weeks,1 month,3 months and 6 months post-treatment respectively.The mean central retinal sensitivity at each time point of post-treatment in the micro-pulse laser group were enhanced significantly compared to that in the controlled group(P＜0.01).Conclusion In the treatment of acute CSC,micro-pulse laser can improve BCVA,reduce the mean CFT and improve the mean central retinal sensitivity.It is an effective and safe method to treat acute CSC.

Background Hypoxia is an important cause resulting in many retinal diseases,such as retinal edema,diabetic retinopathy,proliferative retinopathy and so on.ObjectiveThis study is to investigate the effects of hypoxia on the expression of AQP-4 in Müller cells in vitro.MethodsMüller cells were isolated from New Zealand white rabbits and primarily cultured in DMEM containing 20% fetal bovine serum by the explant culture method.The cells were identified by immunostaining for the glial fibrillary acidic protein(GFAP).Generation 2 of cells was cultivated with the chemical hypoxia inducer,CoCl_2,for 24 hours in the hypoxic group and only with DMEM in the control group.The expression of the AQP-4 protein in Müller cells was detected by immunocytochemistry.The expression of AQP-4 mRNA was determined by semi-quantitative reverse transcription-polymerase chain reaction (RT-PCR).ResultsAbout 90% of Müller cells(generation 2) presented a positive immunoreactivity for GFAP,showing a brown staining in the cytoplasm.Cultured cells displayed the presence of intermediate filaments,microvillus and various cellular organs.The Integralabsorbance of the AQP-4 protein in Müller cells was markedly increased 24 hours after incubation with CoCl_2 in comparison with the control group (t=6.74,P＜0.05).The expression level of AQP-4 mRNA in Müller cells was significantly enhanced 24 hours after incubation with CoCl_2 in comparison with the control group (t=21.79,P＜0.05). ConclusionHypoxia enchances the expression of AQP-4 in Müller cells and further increases fluid accumulation in the retina.These results suggest that Müller cells play an important role in the formation of retinal edema in diabetic retinopathy or proliferative retinopathy.

Objective To evaluate the efficacy of intravitreal injections of conbercept in choroidal neovascularization (CNV) secondary to pathologic myopia (PM).Methods A retrospective case series of 37 eyes of 37 patients affected with CNV secondary to PM treated by intravitreal injections of Conbercept.All the patients were examined with best-corrected visual acuity (BCVA) of Early Treatment Diabetic Retinopathy Study (ETDRS) chart,central macular thickness (CMT) of optical coherence tomography (OCT) at baseline.The initial average letters of ETDRS BCVA was 49.86±8.87,CMT was (306.38±31.01) μm.All eyes were treated with intravitreal Conbercept 0.05 ml (10 mg/ml).Follow up visits were performed monthly after injection.The mean follow-up time was 16.8 months.Injections were repeated according to the situation of BCVA,CMT,subretinal fluid and CNV leakage in follow-up.All eyes received an average of 4.8 injections.BCVA,CMT and ophthalmoscope examination were assessed monthly.The relationship of BCVA improvement and CMT reduction with the data at baseline and number of treatments were analyzed by Spearman Rho correlation respectively.Results During the 1,3,6 and 12 months after treatment,the mean BCVA were all improved with statistically significant difference (t=17.629,P＜0.01).At 12 months,15 eyes (45.9％) had improvement of 15 letters or more,32 eyes (86.5％) had improvement of 5 letters or more,and 1 eye (2.7％) had decreased more than 5 letters.During the 1,3,6 and 12 months after treatment,the mean CMT were all decreased with statistically significant difference (F=43.726,P＜0.01).At 12 months,the retinal fluid of 34 eyes (91.9％) were absorbed completely;33 eyes (89.2％) had angiographic closure at that time.There was no significant relevance between BCVA improvement and sex,age and course of the disease (P＞0.05),but a significant negative correlation was found between the BCVA improvement and BCVA at baseline,injection times (P＜0.05).There was no significant relevance between CMT reduction and sex,age,course of the disease and injection times (P＞0.05),but a significant positive correlation was found between CMT reduction and CMT at baseline (P＜0.05).There were no systemic or ocular serious side effects during the follow up.Conclusions Intravitreal injections of Conbercept showed BCVA improvement and CMT reduction.It appeared to be effective and safe for choroidal neovascularization secondary to pathologic myopia.Intravitreal Conbercept for CNV secondary to PM showed BCVA improvement,CMT reduction and safety.

Objective:To confirm the least practice times to eliminate the practice effect in the Working Memory Test Method: Four volunteers from college students practiced the Working Memory Test many times in two consecutive days Their scores were analyzed Result:Comparing their results before and after practice, there were significant practice effects with two types, three levels In order to eliminate these effects, the practice times before formal test was no less than 18 Conclusion:Practice effect is one of the factors affecting the results of the Working Memory Test, which can be eliminate after at least 18 times practice

Noise is a common occupational hazardous factor in the workplace. In addition to the specific damage to the auditory ， system of workers it can also harm the cardiovascular system and cause a serious disease burden. The mechanism of ， occupational noise on the cardiovascular system of workers is mainly oxidative stress inflammation and vascular endothelial ， - - - damage. As a stressor noise mainly leads to the changes of sympathoadrenal medullary system and hypothalamic pituitary ， ， ， - ， adrenal axis. The substances that play an important role include catecholamines cortisol angiotensin Ⅱ endothelin 1 - endothelial nitric oxide synthase and interleukin 6. The population epidemiological studies have shown that occupational noise ， exposure can lead to elevated blood pressure abnormal electrocardiogram and elevated blood lipids in workers. The influencing （ ， ， ） factors include noise characteristics intensity cumulative noise exposure and frequency and noise combined with other （ ， ， ， - ， occupational hazards such as high temperature welding fumes organic solvents hand transmitted vibration and work ） ， ， ， shifts . However due to the influence of research conditions experimental design and other factors some research conclusions still have limitations. More prospective and comprehensive studies are needed to verify the relevant conclusions in the future.

ObjectiveTo explore the molecular epidemiological characteristics of group A rotavirus diarrhea in children in Shanghai and to provide the background data for the implementation of rotavirus vaccination.MethodsA total of 910 stool samples were collected from the outpatient children with acute diarrhea from August 2008 to July 2009.Group A rotavirus was detected by usingcommercial colloidal gold device.Rotavirus strains were characterized for G and P genotypes using the nested reverse transcription polymerase chain reaction (RT-PCR).ResultsGroup A rotavirus was detected in 268(29.4％) out of 910 stool samples.Rotavirus infection was found year-round and the peak season was from October 2008 to January 2009,with the detection rates ranging from 38.3 ％ to 70.5％.Ninety-one percent of children (244 cases) with rotavirus-associated diarrhea occurred in children ＜3 years of age.The detection rate of rotavirus was highest (36.6％) in children aged 12-23 months.Among the 268 group A rotavirus-positive strains,G1 was the most common G genotype (65 strains),accounting for 24.3％,followed by G3 (40 strains,14.9％),G mixed genotypes (37strains,13.8 ％),G2 (27 strains,10.1％),G9 (14 strains,5.2％),G4(5 strains,1.9％),other G types (5 strains,1.9％),and unclassified G type (75 strains,28.0％).P[8] and P[4] were the most common P genotypes,accounting for 54.9％ (147 strains) and 11.9％ (32 strains),respectively,followed by P mixed genotypes (6 strains,2.2％) and other P genotypes (4 strains,1.5％),unclassified P type (79 strains,29.5％).The G/P genotype combinations were found as follows:G1P [8] (13.4％),G3P[8] (13.4％),GmixP[8] (10.1％),G1P[4] (8.2％),G9P[8] (2.2％),G2P [4] (1.9％),G1Pmix (1.9％).ConclusionsGroup A rotavirus is a major causative agent of diarrhea in infants and young children in Shanghai.The peak season of rotavirus infection appears in fall and winter.The currently licensed rotavirus vaccines cover the majority of genotypes of rotavirus strains prevailing in Shanghai.

Objective To explore the clinical characteristics,relationship between treatment and prognosis of sarcoidosis and relationship of relapse to prednisone.Methods The clinical data of 165 patients with sarcoidosis were collected.The clinical characteristics,treatment process and prognosis,relationship of relapse with prednisone maintenance dose and course of treatment were retrospective analyzed.Results Among them,the most common involved systems were lung and lymph nodes.The involvement rates of lung,extra-thorax lymph nodes,cutaneous,ocular,salivary glands,liver & spleen,kidney and nervous system was 87.3％,51.5％,6.7％,6.1％,6.1％,4.2％,1.2％ and 1.2％ respectively.Unilateral tonsil,breast,ovary and bone involvement was seen in only 1 patient respectively with an involvement rate of 0.6％.A retrospective analysis was made for 114 cases with complete follow-up data.The mean follow-up period was (11.7 ± 5.7) (5-32) years.And 46 cases had no symptom on routine medical examinations.The most common consulted departments were respiratory,dermatological and general surgery departments.Among 74 patients on prednisone,48 patients (64.9％) were cured while 13 patients (17.6％) relapsed.Whereas in the observation group,25/38 patients (65.8％) remitted spontaneously and only 1 patient (2.6％) had recurrence.Relapse occurred more often in prednisone therapy group than in observation group (P ＜ 0.05).Longer prednisone 10-15 mg daily maintenance and a longer total course of treatment were associated with fewer recurrence(P ＜ 0.05).Conclusions The clinical manifestations of sarcoidosis vary and many patients have a self-limiting course.The most common involved systems are lung and lymph nodes.Stage Ⅰ / Ⅱ disease should be observed before prednisone therapy.Prednisone 10-15 mg daily for at least 6 months and a total course of treatment over 18 months may prevent relapse.

BACKGROUND: Effects of Pericarpium aurantiin water extract on sleeping and spontaneous activity in Kunming mice has been investigated in three experiments, that is, the experiments of sleeping time due to supraliminal and subliminal dosage of sodium pentobarbital, and shaking cage for energy transducer, respectively.OBJECTIVE: To observe the influence of Pericarpium aurantiin water extract on sleeping and spontaneous activity of Kunming mice.DESIGN:Randomized controlled trial.SETTING: The Staff Rooms of Pathology, Physiology and Pharmacology in Gannan Medical College.MATERIALS: The experiment was conducted in the Central Laboratory of Science Research, Gannan Medical College from January through February 2005. Ninety adult Kunming mice, grade of clearness, were enrolled and randomly divided into three groups with 30 mice for each experiment:10 in control group, 10 in large-dosage group and 10 in small-dosage group.METHODS: ① In energy transforming trial, spontaneous activity of mice was recorded, small wave with wave amplitude ＜ 5 mm was considered as the waveform of gentle activity in mice, such as fur licking and tickling; middle wave with wave amplitude of 5-10 mm as the waveform of moderate activity, such as walking, standing, climbing up and down;large wave with wave amplitude ＞ 10 mm as the waveform of intensive activity, such as running, jumping up and down. Mice in the small-dosage group, large-dosage group and control group were respectively given intraperitoneal injection of 5 mg/g, 10 mg/g Pericarpium aurantiin water extract and equal volume of normal saline, and placed into the cage after 15 minutes. Then, 3 minutes later, waveforms of mice within 15 s was recorded. ② In the experiments on duration of sleep in mice due to supraliminal or subliminal dosage sodium pentobarbital, 0.02 mL/g or 0.01 mL/g sodium pentobarbital (2.5 g/L) were administrated intraperitoneally into mice in the small-dosage, large-dosage and control group 15 minutes after intraperitoneal injection of 5 mg/g, 10 mg/g Pericarpium aurantiin water extract and equal volume of normal saline were given to the three groups, respectively. Subsequently, comparisons of the number of sleeping mice, time to falling asleep, and sleeping time were carried out among the three groups.MAIN OUTCOME MEASURFS: ① Times of spontaneous activity, ②Sleeping time due to supraliminal dosage of sodium pentobarbital, ③ Duration of sleep due to subliminal dosage of sodium pentobarbital.RESULTS: All the mice were involved in the result analysis without loss.① There were fewer middle and large waves in the small-dosage and largedosage groups as compared with that in the control group (90.5±14.7,58.3±12.5, 45.6±10.1, t=2.341-3.215; P ＜0.05 or P ＜0.01), indicating that Pericarpium aurantiin water extract can evidently inhibit spontaneous activities in mice. ② In comparison with the control group, the time to falling asleep and the duration of sleep due to supraliminal dosage of sodium pentobarbital were shortened and prolonged significantly, respectively,in the small-dosage and large-dosage groups. ③ In comparison with the control group, the time to falling asleep and duration of sleep due to subliminal dosage of sodium pentobarbital were shortened and prolonged significantly, respectively, in the small-dosage and large-dosage groups.CONCLUSION: Pericarpium aurantiin water extract can prolong the duration of sleep and inhibit the spontaneous activities of Kunming mice,which is in cooperation with sodium pentobarbital in central inhibition.

Objective To investigate the effect of chest physiotherapy (CPT) on patients undergoing mechanical ventilation (MV).Methods A prospective randomized controlled trial (RCT) was conducted. Sixty-eight adult patients undergoing invasive MV over 48 hours admitted to intensive care unit (ICU) of Affiliated Hospital of Zunyi Medical College from December 2014 to October 2016 were enrolled, and they were divided into CPT group (n = 37) and control group (n = 31) by random number table. The patients in control group received routine physical therapy; while those in the CPT group received comprehensive CPT including manual lung inflation, vibration expectoration and early functional exercise etc. on the basis of the treatment in control group. Acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score and oxygenation index (PaO2/FiO2) before and after the treatment in both two groups were observed as well as the respiratory function and vital signs before and after CPT. The laboratory indicators after treatment, incidence of complications, duration of MV and the length of ICU stay in the two groups were recorded.Results The incidence of ventilator associated pneumonia (VAP) in the CPT group was significantly lower than that of control group (5.4% vs. 25.8%,P < 0.05), the patients in control group also had atelectasis, deep vein thrombosis and other complications, while no such complications were found in the CPT group. The duration of MV (hours: 77.4±41.0 vs. 133.9±117.2) and the length of ICU stay (hours: 134.4±71.4 vs. 207.4±177.7) in CPT group were significantly shorter than those of the control group (bothP < 0.05). There was no significant difference in APACHE Ⅱ score and PaO2/FiO2 before treatment between the two groups. After treatment for 2 days, the APACHE Ⅱ score in both groups was gradually decreased, and that in CPT group was more significantly, it was significantly lower than that of control group after treatment for 4 days (8.6±3.9 vs. 12.5±5.3,P < 0.05). The PaO2/FiO2 in the two groups was gradually increased after treatment. PaO2/FiO2 in CPT group was significantly increased at 3 days after treatment as compared with that before treatment [mmHg (1 mmHg = 0.133 kPa): 278.1±79.0 vs. 224.2±98.9], while PaO2/FiO2 in the control group did not appear significantly increased until after 4-day treatment (mmHg: 302.3±93.1 vs. 232.3±116.7, both P < 0.05). There was no significant difference in vital signs andrespiratory function parameters including tidal volume (VT), respiratory rate (RR), peak airway pressure (Ppeak) and mean airway pressure (Pmean) before and after treatment in CPT group excepting pulse oxygen saturation (SpO2) was significantly higher than that before treatment (0.985±0.016 vs. 0.978±0.018,P < 0.05), indicating that CPT treatment did not cause fluctuations in respiratory function and vital signs. Blood lactate in CPT group was significantly lower than that of control group (mmol/L: 1.10±0.79 vs. 1.32±1.09, P < 0.05), indicating that CPT treatment, especially early functional exercise, could improve the oxygen supply and limb circulation.Conclusion CPT treatment has some effect on prevention of VAP and other complications in patients undergoing MV, which could shorten the duration of MV and the length of ICU stay, and promote the recovery of patients.

Objective To analyze the correlation of visual acuity and metamorphopsia with foveal morphology before and after vitrectomy with internal limiting membrane peeling (ILMP) in idiopathic macular epiretinal membrane (IMEM) eyes.Methods This is a retrospective case series of 47 IMEM patients (49 eyes).All the patients underwent 25G pars plana vitrectomy with IMEM removal and ILMP.The best corrected visual acuity (BCVA) was measured using the international standard visual acuity chart,and the results were converted to the logarithm of the minimum angle of resolution (logMAR) visual acuity.The severity of metamorphopsia was measured using M-charts.The central macular thickness (CMT),inner nuclear layer thickness (INT),inner retinal layer thickness (IRT),outer retinal layer thickness (ORT),the status of ellipsoid zone (EZ) were assessed with spectral-domain optical coherence tomography at baseline and each month postoperatively.The differences in BCVA,CMT,INT,IRT,ORT and status of EZ before and after surgery were analyzed,so did the correlations between these indexes at the same time.Results Compared with baseline,the postoperative BCVA was significantly increased (F=6.133,P＜0.001),but the M value,CMT,INT,IRT,ORT were significantly decreased (F=12.481,10.565,15.739,6.046,10.569;P＜0.001);the integrity of EZ was improved significantly (x2=12.309,P＜0.001).Preoperative BCVA was positively related to the CMT (r=0.720) and ORT (r=0.720,0.887;P＜0.05),while negatively related to preoperative integrity of EZ (r=-0.295,P＜0.05).The postoperative BCVA was positively related to the preoperative BCVA and postoperative CMT,ORT (r=0.774,0.754,0.842;P＜0.05),while negatively related to postoperative integrity of EZ (r=-0.676,P＜0.05).The preoperative M value was positively related to the preoperative CMT,INT,IRT,and ORT (r=0.931,0.668,0.840,0.637;P＜ 0.05).The postoperative M value was positively related to the preoperative M value and postoperative CMT,INT,IRT,and ORT (r=0.723,0.722,0.767,0.825,0.387;P＜0.05).Conclusions Vitrectomy with ILMP for IMEM can improve the visual acuity,metamorphopsia and foveal morphology.Both visual acuity and metamorphopsia correlate with foveal morphology.