Heritable changes in gene expression are regarded as epigenetics,which do not involve coding sequence modifications.The study of ophthalmology epigenetics is a rapidly growing area in biomedical research.Epigenetic mechanisms principally include DNA methylation,histone modification,chromatin remodeling and noncoding RNA.Aberrant DNA methylation and histone modification are linked to a number of age-related disorders,such as cancer,autoimmune and others.In recent years,the modulations of epigenetic changes on the pathogenesis of eye disorders and their roles in therapeutic interventions are drawing more and more attention,and these studies deepen the understanding of relevant diseases.Since the epigenetic alterations are reversible,modifying epigenetic marks contributing to eye diseases provide a new approach to the development of disease prevention,diagnosis and therapies.Herein we discuss the roles of epigenetic changes in eye disease development,hoping that ophthalmologists and researchers pay attention to these researching cues in pathogenesis of eye disorders caused by genetic expression alterations in response to environmental changes,importantly,to the implication for relevant eye disease therapy and prevention.

Objective To study the clinical and pathological features of periodic paralysis.Methods The clinical and pathological data of 9 patients with periodic paralysis were analyzed.Results The clinical manifestation of 9 patients were consistent with the general manifestation of periodic paralysis.The typical tubular aggregates in many fibers were observed in 4 cases of 7 patients with skeletal muscle biopsy.A few degenerating fibers were observed,while necrotic fibers and regenerating fibers were not found.Electromicroscope showed Honeycomb appearance in tubular aggregates of cross section,which was filled with glycogen granule.Conclusions According to the clinical manifestation and the laboratory examination,periodic paralysis can be clinical diagnosis.The tubular aggregates in many fibers are important pathological characteristic of periodic paralysis.In electromicroscope analysis,tubular aggregates may be compose of transverse tubular system or sarcoplasmic reticulum expansion.

Objective To investigate whether TNF-α can promote, but TGF-β can reduce Gli2 expression in primary leukemia cells. Methods (1)Western blot was used to detect Gli2 protein expression in leukemic cells. (2)Primary leukemia cells were treated with TGF-β1 or TNF-α,and expressions of Gli2 and TGF-βR were detected. (3)Primary leukemia cells were treated with TGF-β1,TNF-α or/and SIS3, and Gli2 protein expression was detected. Results (1)The primary leukemia cells could express Gli2 protein. (2)Significant reduction of Gli2 mRNA was observed in 1 ~ 10 ng/mL TGF-β1-treated primary leukemia cells for 12 ~ 24 h, No significant differences of Gli2 mRNA was found between the control group and TNF-α group. (3)Protein expresson of TGF-βRⅠand TGF-βRⅡ in 5 ng/mL TNF-α-treated primary leukemia cells for 24 h was higher than that of the control group. (4)Gli2 portein expression was lower in TGF-β1 with or without TNF-α-treated primary leukemia cells for 24 h than that in the control group, and Gli2 portein expression in the TGF-β1 plus TNF-α group was lower than that in TGF-β1 group. Conclusion Combinations of TGF-β and TNF-α can efficiently inhibit Gli2 expression than TGF-β alone in primary leukemia cells.

Objective To make hiatal hernia(HH) children grow and develop well by making correct early diagnosis and reducing misdiagnosis.Methods Reviewing clinical data of 12 patients with HH,including clinical character,X-ray diagnosis,correct examination,treatment and prognosis.Results Of 12 patients,9 cases were left HH,and 3 cases were right HH.All of them had internal expectant treatment;4 of them had operation.All of them had a good prognosis.Conclusions X-ray radiograph is a chief method of diagnosis of hiatal hernia.It is important to choose a specific position properly during radiograph examination.

Objective To study the long-term results of using an autologous vascularized pedicled flap of gastric tissues in the repair of traumatic bile duct strictures.Methods From 2002 to 2016,38 patients with traumatic bile duct strictures underwent repair using an autologous vascularized pedicled flap of stomach tissues.The postoperative morbidity,mortality,long-term clinical results,liver function and the rate of biliary stricture recurrence were studied.Results The overall complication rate was 18.4％ (7/38).A delay in healing of the incision wound occurred in 4 patients,biliary fistula in 2,and ascites in 1.Two patients died of malignant tumor.The median follow-up was 92 (61 ～ 107) months and the follow-up rate was 100％.Excellent results were obtained in 97.2％ (35/36) of patients.Abnormal liver function was detected in 1 patient which improved with treatment using choleretic drugs.The remaining 35 patients had normal liver functions with absence of abdominal pain.Conclusions To repair traumatic bile duct strictures using an autologous vascularized pedicled flap of stomach tissues was safe and reliable,and good long-term outcomes are available.

Objective To analyze the factors related to glare occurred after the phakic intraocular lens (P-IOL) implantation,and to raise the standard for the P-IOL selection.Design Retrospective case series.Participants 104 patients with high myopia underwent P-IOL implantation in Beijing Tongren Hospital.Methods In 104 cases,22 cases (22 eyes) were implanted angle supported Phakic6 designed accord with corneal symmetry,54 cases (54 eyes) were implanted iris fixed Verisyse,and 28 cases (28 eyes) were implanted posterior chamber PRL.Selection of the diameter of P-IOL optics depended on P-IOL diopters.The pupil diameter,the P-IOL optic center position,the pupil and corneal center position were measured with anterior segment optical coherence tomography (OCT).The contrast sensitivity (CS) under different condition (day,day and glare,night,night and glare) and in different space frequency (1.5,3,6, 12,18c/d)were examined with Optec6500 system.Main Outcome Measures Glare incidence,CS,and the influence of pupil diameter and P-IOL location to glare.Results None of the 104 P-IOL eyes occurred glare in day time.59 eyes (56.73%) complained of glare in dime condition.The glare incidence was 63.18% (14/22) in Phakic6 eyes,55.56% (30/54) in Verisyse eyes,and 53.27% (15/28) in PRL eyes (P=0.691).CS of all surgical eyes were improved in day time with or without glare luminous environment (P=0.000).And the CS of halo-complaining eyes was lower than of no halo eyes in night time with or without glare luminous environment (P=0.000).Glare oc- curred more frequently in eyes with the pupil diameter larger than P-IOL diameter in clime condition after surgery (10 in Phakic6 eyes, 20 in Verisyse eyes,12 in PRL eyes,all P

Objective To investigate the effect of electroacupuncture (EA) on the cognitive function of rats with chronic cerebral hypoperfusion (CCH) and its possible mechanism.Methods Forty male Sprague-Dawley rats were randomly divided into a sham operation group of 10 and an operation group of 30.Permanent bilateral common carotid artery occlusion (BCCAO) was conducted to introduce a model of CCH in the operation group,which was further divided into a model group,an EA 4 w group and an EA 1 w group,each of 10.The EA 4 w group was given 2/100 Hz dilatational wave EA for 4 weeks,and the EA 1 w group was provided with the same EA for one week.A Morris water maze was used to assess the rats' cognitive functioning,and a reverse transcription polymerase chain reaction (RT-PCR) was employed to detect the expression of JAK2/STAT3 mRNA in all the rats' brains.Results Compared with the sham operation group,the rCBF in the operation group had decreased significantly after BCCAO,and it was significantly lower than before the operation.Compared with the model group,the escape latency improved significantly from the 3rd day in the EA 4 w group,and from the 5th day in the EA 1 w group.The targeted quadrant residence time of the EA 4 w group was prolonged significantly.JAK2/STAT3 mRNA expression decreased significantly only in the EA 4 w group.Compared with the EA 1 w group,the escape latency of the EA 4 w group had decreased significantly by the 5th day,with the target quadrant residence time significantly prolonged,and JAK2 mRNA had decreased significantly as well.Conclusion EA can improve cognition in CCH,at least in rats,and especially with early intervention.This may be achieved through inhibiting excessive activation of the JAK2/STAT3 pathway,reducing brain injury.

Objective To assess the image findings of femoroacetabular impingement (FAI).Methods Image findings of 9 patients with surgically proved femoroacetabular impingement were retrospectively reviewed for characteristic image findings of FAL All 9 patients underwent X-ray examinations and MRI of affected hip, and 1 patient underwent MR arthrography (MRA) additionally. Results X-ray examinations of all 9 patients showed bump at femoral head-neck junction or overcoverage of the acetabula.MRI showed various degrees of injury of anterosuperior labrum in all 9 patients. The injuries were stage Ⅰ A in2 cases, stage Ⅰ B in3, stage ⅡA in2, and stage ⅡB in 2. MRA of the case showed tears of anterosuperior labrum, with contrast media entering into the teared labrum. There were sclerosis and cystic degeneration of subchondral bone of femoral head in 2 cases, and these findings were confirmed as cartilage delamination by surgery. Conclusions MRI can display the injures of labrum and articular cartilage, which is helpful to the early diagnosis of FAI.

AIM: To evaluate the clinical efficacy of surgery for spontaneous subconjunctival orbital fat prolapse via bulbar conjunctiva under topical anesthesia.
●METHODS: A total of 22 eyes of 11 patients received surgery for spontaneous subconjunctival orbital fat prolapse via bulbar conjunctiva under topical anesthesia were included. Objective and subjective duration of the operation, degree of cooperation during surgery, postoperative recovery, recurrence and complications were observed.
●RESULTS: In the process of surgery, patients without pain and being-cooperated were recorded in 17 eyes. The patients who occasionally felt slight pain, but within endurance after adding topical anesthesia once and the operation was completed successfully were recorded in 5 eyes ( the second eye surgery ) . The operation was successfully completed in all the patients. Compared the coordination degree during surgery of Gradel with GradeⅡ, the difference was statistically significant ( t=-3. 123, P<0. 01). All eyes were healed well after operation.
● CONCLUSION: The surgery for spontaneous subconjunctival orbital fat prolapse via bulbar conjunctiva under topical anesthesia can ensure satisfactory anesthetic effect and get better quality of operation. It′s a simple, safe and effective anesthesia method for spontaneous subconjunctival orbital fat prolapse.

Objective To detect the micrometastasis status and necessity of dissection of lymph nodes of hepatodudenal ligament in advanced gastric antral cancer. Methods Eighty-six lymph node samples of hepatodudenal ligament which were negative in routine pathological examinations were collected from 45 gastric antral cancer patients with radical dissection.The expressions of CK20 mRNA were detected for the existence of micrometastasis by RT-PCR. Results Micrometastasis was found in 46 out of 86 lymph nodes(53.49%) and 23 out of 45 patients(51.11%),significantly different from the routine pathological examinations(both P