Background The pre-chop technique can decrease the use of ultrasound power,and thus reducing the loss of corneal endothelial cells (CECs) and injuries of other intraocular structures.Many currently developed manual pre-chop techniques restrict the wide application of the pre-chop technique because of their intrinsic disadvantages.The present study describes a manual pre-chop technique for pre-slicing the lens nucleus by using a novel reverse chopper,which has not been reported yet.Objective This study was to compare the efficacy and safety of pre-chop technique using a reverse chopper and stop-and-chop phacoemulsification technique on Ⅳ degree hard nucleus cataract.Methods A prospective clinical-controlled interventional study was performed.Thirty-two eyes of 32 cataract patients with Ⅳ degree of nucles were enrolled in People's Hospital of Hetian District from March 2015 to January 2016.The patients were randomized into the prechop group and matched stop-and-chop group according to random number table.The self-made reverse chopper-assisted pre-chop phacoemulsification surgery and stop-and-chop phaco surgery were performed on the eyes of corresponding groups,respectively.The ultrasound power,effective phaco duration,corneal endothelium loss rate,the eye number of different grade of cornea edema after operation and vision outcome were compared between the two groups.Written informed consent was obtained prior to relevant examination and surgery.Results The mean effective Phaco durations were 42.56 (39.31,45.81) seconds and 78.63 (73.85,83.40) seconds in the prechop group and stop-and-chop group,with a significant difference between them (Z =-4.937,P =0.000).The eye number with different degree of best corrected visual acuity (BCVA) was significantly different between the two groups,at postoperative day 1 and day 3 (P =0.013,0.033).The number of corneal endothelial cells (CECs) 1 month after surgery was (2 026.05 ± 154.03)/mm2 in the prechop group,and the number was (1 866.50-± 117.16)/mm2 in the stop-and-chop group,with a significant difference between them (t =3.298,P=0.003).The CECs loss rate was (13.36±2.85) ％ in the prechop group,which was lower than (25.77±3.81) ％ in the stop-and-chop group (t=-6.996,P=0.000).The eye number with different degree of corneal edema was significantly decreased in the prechop group compared with the stop-and-chop group at postoperative day 1 and day 3 (P =0.001,0.002).Conclusions Compared with the stop-and-chop phaco technique,a reverse chopper-assisted pre-chopping technique can decrease the intraoperative complication,lighten the postoperative damage of CECs and accelerate visual rehabilitation in hard nucleus cataract eyes.

Objective To assess the clinical effects of supracapsular implantation with optic capture of the posterior chamber intraocular lens in pediatric cataract.Design Retrospective case series.Participants 15 cases(17 eyes)with pediatric cataract.Methods Phacoemulsification,posterior continuous curvilinear capsulorhexis,about 4 mm in diameter,supracapsular implantation with optic capture of the posterior chamber intraocular lens in pediatric cataract were performed.Main Outcome Measures Preoperative and postoperative visual acuity,intraocular pressure,position of IOL,intraoperative and postoperative complications.Results Implantation of optic capture of the posterior chamber intraocular lens was successfully performed in 17 eyes.Positions of IOL were changed in 5 eyes after operation 6 months,from post-capsule to supra-capsule.Among these 5 eyes,opaque optic axis were found in 4 eyes.No optic axis opaque was found in 13 eyes with optic capture.The major complications of optic capture were lenticular precipitates:grade 1 in 3 eyes(18%);grade 2 in 7 eyes(41%).Anterior synechia of iris occurred in 1 eye(6%);posterior synechia of iris in 4 eyes(24%).Pupil deformity occurred in 5 eyes(29%).Conclusions Posterior continuous curvilinear capsulorhexis and supracapsular implantation with optic capture of the posterior chamber intraocular lens are safe and effective in the treatment of pediatric cataract,especially in the prevention of secondary opacification from the visual axis.

Background The innovation of pre-chop technique lies in shortening surgery duration,reducing ultrasound power,and deseasing the loss of corneal endothelial cells (CECs).Objective This study was to compare the efficacy and safety of pre-chop technique using a reverse-chopper and phaco-and-chop phaco technique to super high myopia associated with hard nucleus cataract.Methods A prospective randomized-controlled-clinical interventional study was performed.Fourty eyes of 40 high myopia associated with cataract patients with Ⅲ-ⅣV degree of nucleus were enrolled in Beijing Tongren Hospital from March to September 2016.The patients were randomized into the pre-chop group and matched phaco-and-chop group according to random number table,and the self-made reverse chopper-assisted pre-chop phacoemulsification (phaco) surgery and phaco-and-chop phaco surgery were performed on the eyes of different groups,respectively.The phaco power,effective phaco duration and best corrected visual acuity (BCVA) were recorded and compared between the two groups to evaluate the efficacy,and the loss rate of corneal endothelial cells and eyes in different grades of cornea edema after operation were compared between the two groups to assess the safety of surgery procedure.Written informed consent from each patient was obtained prior to relevant examination and surgery.Results The surgery was finished smoothly in the eyes.The mean effective phaco duration was (47.30±11.29) seconds and (57.70± 14.51) seconds in the pre-chop group and phaco-andchop group,respectively,with a significant difference between them (t =-2.530,P =0.016).The BCVA was better at the seventh day after surgery in the pre-ehop group than that in the phaco-and-chop group (4.75t0.11 vs.4.67± 0.14),showing a significant difference between the two groups (t=2.147,P=0.038).In 1 month after surgery,the CECs loss rate was (10.82±3.77)％ in the pre-chop group,which was lower than (16.11±6.47)％ in the phacoand-chop group (t=-3.758,P=0.001).The number of the eyes with grade 2-3 of corneal edema in the pre-chop group was significantly decreased in comparison with the phaco-and-chop group 7 days after surgery (Z =11.822,P=0.008).Conclusions Compared with the conventional phaco-and-chop technique,reverse-chopper prechop technique appears to have a better efficacy and safety in phaco surgery for high-myopia associated with hard nuclear cataractous eyes.

Objective:To study the effects of the secondary metabolites of Rhizotonia leguminicola on cyclophosphamide-induced immunoregulation in immunosuppressed mice.Methods:The immunosuppressed mouse model was established by cyclophosphamide(80 mg/kg) injected into abdominal cavity.The diluent of secondary metabolites of Rhizotonia leguminicola(SW) at the dosage of 8,16 and 32 mg/(kg?d) was intragastrically administered for 11 days respectively.Meanwhile,the normal control group and CTX model control group were established.Blood,thymus and spleen of the mice were collected respectively at 24 h after the last intragastric administration,and the immunological detection was also carried out.Results:CTX was injected constantly into the abdominal cavity at 80 mg/kg for 3 d,which leaded to immunosuppression of the mice.The groups which took SW at 8 and 16 mg/(kg?d) could increase the number of WBC of the mice.Cyclophosphamide induced a decrease of phagocytic activity of the peritoneal macrophages in the mice and a boost of hemolysin level of the peripheral blood,lymphocyte transformation of the spleens and the activity of NK cells,which were especially obvious in the group of SW at 16 mg/(kg?d).Conclusion:The secondary metabolites of Rhizotonia leguminicola have effects of recovery and reinforcement in cyclophosphamide-induced immunoregulation of immunosuppressed mice.

Using Xanthine-Xanthine Oxidase system to generate superoxide ani-on, using H2O2 -Fe2 + system to generate hydroxyl radical, the role of scavenging oxygen free radical by Miltiorrhiza was studied by electron paramagnetic resonance and spin trapping. The result suggested that the scavenging rate of hydroxyl radical by Salvia Miltiorrhiza injection is 65%, and that of superoxide anion is 100%. This result suggests that scavenging cytotoxic oxygen free radicals may be one of important pharmacological mechanism of Salvia Miltiorrhiza.

Objective To investigate the mechanism of cytokines in brain pathologic changes caused by lipopolysaccharide(LPS).Methods A rat model of LPS was established by injection with a dose of 5mg/kg LPS into thigh vein.60 SD rats were randomly divided into three groups:control group,LPS group,naloxone+LPS group,each group included 20 rats and was subdivided into 4 subgroups(1h,2h,4h,6h respectively).In each subgroup,cerebral pathological changes and concentrations of TNF-α,IL-1β,IL-6 in brain homogenate were investigated.Results Brain homogenate concentration of TNF-α in subgroup LPS 2h was higher than control group[(9 30±0.57) ng/g vs(8.00±0 79)ng/g,P＜0.01],other subgroups have no significant difference from control group. Naloxone group had lower TNF-α level than LPS group.Brain homogenare concentration of IL-1β in subgroup LPS 1h increased apparently[(0.56±0.08)ng/g,P＜0.01],subgroup LPS 2h had no significant change;other subgroups have no significant difference from control group.Natoxone group had lower IL-1β level than LPS group(P＜0.01).but no difference from control group.Brain homogenate concentration of IL-6 in subgroup LPS 2h and 4h were respectively(459.68±79.15)ng/g,(816.07±111.31)ng/g,significantly higher than control group[(377.22±63.73)ng/g,(369.98±34.35)ng/g,respectively].Control group had no significant cerebral pathologic changes,while LPS group showed apparent changes:edema,interstitial substance and mening vessels expanding and hyperaemia,neurosome minification,Nissl's body lost,karyopycnosm,and nucleoli abolition.Naloxone group had lighter neurocyre injuries and brain edema,especially at 2h and 4h.Conclusions After LPS injection,the level of cytokines changed as time goes by,and this fits the brain pathologic changes.Naloxone has protecnve effect on brain tissue in LPS treated rats.Inflammatory cytokines play an important role in the mechanism of cerebral damage in LPS rats.

OBJECTIVE:To determine whether bacterial endotoxins test(BET) can replace the pyrogen test for the sodium bicarbonate injection.METHODS:The comparative experiment of tachypleus amebocyte lysate(TAL) and rabbits were studied to determine the sensitivity.RESULTS:The sensitivity of TAL test was 0.125 EU.ml－1, 12 times higher than that of using rabbits.CONCLUSIONS:BET may replace pyrogen test.

In this study we implanted magnetically labeled neural stem cells (NSCs) in PD rats and then monitored their survival and migration in the host brain by magnetic resonance imaging (MRI). The mesencephalic NSCs were obtained from the brain of SD rats. Superparamagnetic iron oxide (SPIO) was transferred to NSCs by Lipofectamine transfection. Eighteen PD lesioned rats were selected for transplantation by evaluation of their rotational behavior in response to amphetamine and randomly assigned to 3 groups, i.e., sham group, PBS group and NSCs transplanted group, with 6 rats in each group. MR scanning was performed at 1, 2, 4, 6, 8 and 10 week(s) following transplantation. At the meantime, rotational behavior was assessed in each group. Our results showed that SPIO particles were clearly visible with Prissian blue staining in neurospheres and cells derived from NSCs. The rotational behavior of the NSCs transplanted group was remarkably improved compared with that of sham group and PBS group (P < 0.05). In vivo MR tracking of NSCs showed that SPIO labeling led to a strong susceptibility change of signal 1 week after transplantation on T2 weighted images. And a large circular hypointense signal appeared in the transplanted area on T2* gradient echo images. Ten weeks following transplantation, the hypointense signal on T2 weighted and T2* gradient echo images was still displayed. It is concluded that SPIO particles could label NSCs effectively, and MRI detection of SPIO labeled cells is a promising method and novel approach to analyzing the NSCs following transplantation in the treatment of PD.

Traditional medical education focus on expository teaching,rote learning,and apprenticeship training for clinical skill.Although these teaching approaches can be beneficial for imparting knowledge and clinical skill,they appear to be insufficient for team cooperation,knowledge integration,and standard training.Biomedical simulation teaching is a new method for imparting knowledge,and has achieved good results in current medical education.This paper aims to introduce the definition and characteristic of biomedical simulation,and the application and significance of biomedical simulation in ultrasound teaching are also outlined and discussed.

Background Obstructive meibomian gland dysfunction (OMGD) is due to the meibomian gland duct obstruction and/or meibum abnormal secretion.Meibomian gland morphological change is important to clinical observation.Objective This study aimed to image the meibomian gland structures and the morphological changes in eyes with OMGD using a non-contact infrared meibography system (Keratograph 5M).Methods A case-control study was performed in Tianjin Medical University Eye Hospital from January to June in 2015.Sixty OMGD patients and 60 age-matched healthy controls were recruited.Ocular Surface Disease Index (OSDI) questionnaire was employed for the assess of ocular surface symptoms,and slit-lamp examination was performed for the observation of lid margin and meibomian gland orifices.Meibomian gland secretion scores and Keratograph 5M examination the morphological changes of the meibomian glands.According to OSDI questionnaire,the patients of OMGD were classified into mild group (12.0 ＜ OSDI ≤ 22.0) (23 eyes),moderate group (22.0 ＜ OSDI ≤ 32.0) (21 eyes) and severe group (32.0 ＜ OSDI ≤ 100.0) (16 eyes).Partial or complete loss of the meibomian glands (meibomian dropout) was scored from grade 0 (no loss) through out grade 3 (lost area was ＞2/3 of the total meibomian gland area).Written informed consent was obtained from all subjects before the examination.Results The OSDI,meibomian gland orifices,meibomian gland secretion scores and meibomian gland dropout scores were significantly higher,and BUT was dramatically shorter in the OMGD group than those in the normal group,showing significant differences between the two groups (Z =-9.425,-8.954,-7.781,all at P＜0.05).The BUT was (6.10± 1.91) s and (10.67-±2.11)s,and meibomian gland dropout scores were 1.35±0.90 and 0.88±0.64 in the OMGD group and normal control group,showing significant differences between the two groups (t=3.276,-12.418,both at P＜0.05).OSDI,meibomian gland secretion scores and meibomian gland dropout scores were significantly in three intergroups (H=52.121,13.642,37.180,all at P＜0.05).BUT,meibomian gland orifices were significantly different among the mild,moderate and severe OMGD (F=58.191,8.474,both at P＜0.05).OSDI showed a significantly high positive correlation with meibomian gland orifices,meibomian gland secretion scores and meibomian gland dropout scores (r =0.708,P =0.000;r =0.759,P =0.000;r =0.270,P =0.003).BUT showed negative correlation with meibomian parameters (r=-0.692,P=0.000;r=-0.691,P=0.000;r=-0.192,P=0.036).Conclusions Keratograph 5M provides an effective noninvasive method in assessing the image of the meibomian gland structures and meibomian gland dropout.There are differences in the ocular surface and meibomian glands between the OMGD patients and normal persons.