AlM:To discuss the feasibility of microcoria optometry in screening for children ametropia. METHODS: Totally 217 school - age children were selected, included 94 first-grade students ( 6 ~ 8 years old) and 123 fourth-grade students ( 9 ~12 years old ) . Refractive diopter was measured with automatic refractor RM-8000 to evaluate the accuracy of micocoria optometry in screening ametropia.RESULTS: After cycloplegia, both the mean sphere diopter and cylinder diopter in grade one students changed significantly (P<0. 05), the mean sphere diopter in grade four students changed significantly (P<0. 05), while the mean cylinder diopter had no statistical difference ( P>0. 05 ) in grade four students. Different refractive type: before and after mydriasis spherical myopia, spherical equivalent difference was 0. 263 ± 0. 618 and 0.216±0.653D, with statistical significance (P<0.01);ln hyperopia group, spherical myopia, spherical equivalent difference was 0. 947±0. 946 and 1. 039±0. 984D, with statistical significance ( P = 0. 000 ). The lenticular difference between the two groups were not statistically different ( P > 0. 05 ). Choosing small pupil computer optometry for ≤- 1. 00D, ≥- 0. 50D child myopia or hyperopia could get more accurate value of diagnostic cutoffs, Youden index was 0. 672 and 0. 580. CONCLUSlON: Microcoria optometry can be as a effective method of screening of children with ametropia, but if for optometry, school-age children must accept mydriasis.

The trophoblast is fetal-derived and in direct contact with maternal tissues. The expression of the various types of MHC antigen in trophoblast cells is very important for successful pregnancy. Among nonclassical MHC class Ⅰ antigens, HLA-G is expressed specifically on cytotrophoblast cells and its expression protects the fetal from maternal immune attack. The expression of the distinct subtypes of classical MHC class Ⅰ antigen is different in different subtypes of trophoblast cells. The expression of MHC class Ⅱ antigen is inhibited in trophoblast during pregnancy. It is suggested that C Ⅱ TA plays an important role in regulation of MHC class Ⅱ gene expression.

Objective To investigate the protective mechanism of hyaluronic acid (HA) antagonistic to nitmprusside sodium (SNP) on the tissue engineering cartilage. Methods Alginate culture for two weeks was used to recover phenotype of dedifferentiated chondrocytes. Differentiation state of chondrecytes was analyzed by immunostaining. The growth of alginate-recovered chondrocytes on the chitosan-based scaffold was observed by scanning electron microscope. After cultured for 3 weeks, this tissue engineering cartilage was treated with SNP in the absence or presence of HA combined with specific β1 integrin blocking antibody collagen type Ⅱ and aggreean were detected by RT-PCR and Western blot. Results Collagen type Ⅱ expression in dedifferentiated chondrocytes was significantly enhanced by alginate bead culture. The chitosan-based scaffold supported cell adhesion, proliferation and migration. A dose-dependent inhibitory effect on the expression of collagen type Ⅱ and aggrecan was observed when tissue engineering cartilage was treated with SNP alone. HA significantly promoted collagen type Ⅱ, and aggrecan expression antagonistic to low concentrations of SNP (p<0.05). However, the specific β1,integrin blocking antibody abrogated the effects of HA. Conclusion Alginate culture recovers the phenotype of dedifferentiated chondrocytes. HA abrogats the inhibitory effect of SNP via β1 integrin signal pathway to protect tissue engineering cartilage.

Objective:To study the effects of phentolamine and dopamine combined with cardiopulmonary resuscitation on the patients with cardiac arrest.Methods:60 patients with cardiac arrest who were treated from February 2015 to April 2016 in our hospital were selected and divided into the control group and the observation group according to different treatment methods.The control group was treated with routine treatment.while the observation group was treated with phentolamine and dopamine based on the control group.The changes ofcTnI,CK,CK-MB levels,MDA,SOD concentration and hemodynamics were observed before and after treatment.Results:After treatment,the total mortality was 20％ in the observation group,which was significantly lower than that of the control group (33.33％,P＜0.05).The levels of cTnI in the observation group were significantly lower than those of the control group at 2 h and 24 h after the cardiopulmonary resuscitation(P＜0.05).After the cardiopulmonary resuscitation,the serum levels of CK and CK-MB in the observation group were significantly lower than those in the control group (P＜0.05).The concentration of MDA and SOD in the observation group were significantly higher compared with the control group [(1.86± 1.65) μg/L vs(3.81± 1.24) μg/L、(6.58± 0.95)μg/L vs(3.74± 0.56) μg/L](P＜0.05).After the cardiopulmonary resuscitation,the MAP value of observation group was significantly higher than that of the control group (P＜0.05).The CO value and CI value of observation group were significantly increased from the 6th day to the control group (P＜0.05),and the PCWP values of observation group were significantly lower than those of the control group (P＜0.05).Conclusion:Phentolamine combined with dopamine could effectively improve the cardiac hemodynamics and prognosis of patients with cardiac arrest,reduce the myocardial injury and enhance the survival with high safety.

The mucous barrier is a major physiological obstacle that the mucosal drug delivery system needs to deal with. In response to this physiological barrier, many achievements have been made in research of mucosal adhesion and mucus penetration. This review puts emphasis on the progress of the research on new mucosal adhesion strategies such as cationization, sulfhydrylization, maleimide functionalization, lectinization and catechol conjugation; polyethylene glycol (PEG), polyvinyl alcohol (PVA), poly (2-alkyl-2-oxazoline) (POZ), zwitterionic polymers and other mucus-inert materials, strategies to enhance mucus penetration ability such as enzyme functionalization, reducing agent pretreatment and so on. The problems of each strategy are also analyzed and discussed, which can provide some references for clinical transformation.

Objective To study the mechanism of serum thyroxin and insulin change after hemihepatectomy. Methods The hemihepatectomy was performed in rabbits, the fasting peripheral blood samples were drawn on the day prior to surgery, and 24 hour, 48 hour, the first week, one month after operation respectively for monitoring the serum thyroxin and insulin.Results The level of TT 3 was (1.93?0.47) nmol/L, TT 4 (53.56?8.4) nmol/L preoperatively. The levels of TT 3 and TT 4 significantly decreased at 24 hour postoperatively, and gradually rose at 48 hour and up to normal levels in the first month postoperatively. The level of insulin rapidly rose immediately after operation, and began to decrease in the first week, and returned to the preoperative level in one month after operation. Conclusions The syndrome of normal thyroid disease and the syndrome of non thyroid disease can occur after hemihepatectomy; and hyperinsulinemia also can occur after hemihepatectomy.

Clinical data of twenty-six patients with primary tumors involving hip ioint treated surgically in Renmin Hospital of Wuhan University between March 1999 and May 2005 were retrospectively analyzed.The diagnosis of all patients was confirmed by pathohistology.There were 3 cases of chondrosarcomas.6 osteosarcomas,1 synovial sarcoma,14 giant cell tumors and 2 aneurysmal bone cysts.Seventeen cases were treated with custom-made total hip replacement prosthesis,7 with custom-made dipolar femoral head prostheses and 2 with saddle prostheses.They were followed up for 18 months to 6 years with an average of 4 years and 3 monts.Local relapse rate and final limb salvage rate was 40%and 60% in 10 patients with malignant bone tumors:125%and 875%in 16 patients with low-grade malignant bone tumors.According to Enneking(MSTS)evaluation criteria.the average score was 19 with an excellent and good rate of 76.9%.Custom-made artificial hip prosthesis is a satisfactory method in limb salvage operations for patients with malignant or low-grade malignant bone tumors jn hip joint.

Objective:To investigate the ability of doctors in different regions and levels of hospitals in assessing the severity of severe trauma in China.Methods:A total of 38 trauma centers of China Trauma Rescue & Treatment Association (19 tertiary hospitals and 19 secondary hospitals, including 20 eastern and 18 western hospitals) were selected from November 2018 to May 2020. Two junior, two middle, and two senior emergency surgeons were selected in each center. Injury severity score (ISS) was performed on 10 patients with severe trauma, and the qualified rate was analyzed.Results:The qualified rates of junior, middle, and senior doctors were 56.05%, 56.18%, and 56.71%, respectively ( P>0.05). The qualified rates of tertiary and secondary hospitals were 63.07% and 49.56%, respectively ( P<0.01). The qualified rates of eastern and western hospitals were 67.00% and 44.44%, respectively ( P<0.01). Conclusions:The overall level of injury assessment of severe trauma patients by doctors in China is satisfactory, while there are still differences in hospital levels and regions. In the future, attention should be paid to the training and system construction in primary hospitals. We should actively support the construction and development of hospitals in the western regions and realize the standardization of trauma treatment in China as soon as possible.

The water-soluble polypeptide drug oxytocin was encapsulated in liposomes by reverse-phase evaporation vesicle method to obtain oxytocin loaded liposomes (OT@LPs) which was further modified with cationic cell penetrating peptide—arginine octamer (R8) to get R8 modified oxytocin loaded liposomes (OT@LPs-R8) which showed enhanced mucoadhesive. The brain targeting efficiency was evaluated preliminarily after nasal administration. OT@LPs-R8 showed a round shape with a particle size distribution of 110.2 ± 7.3 nm, a surface potential as high as +18 mV, a drug loading (62.17 ± 1.88) %, an encapsulation rate (5.85 ± 0.72) %, and stood stable in nasal mucus. After nasal administration, it could significantly prolong the retention and enhance the distribution in the brain with no irritation to the nasal mucosa. The animal experiment in line with the regulations of the Department of Laboratory Animal Science of Fudan University on the ethics of animal experiments had been carried out after passing the review of the Animal Ethics Committee of Fudan University. The results showed nasal administration of OT@LPs-R8 could promote oxytocin directly into the brain from the nose which expected to become a new carrier for delivery of oxytocin to the brain.

Objective To investigate the acute side effect of 3D printing individual non-coplanar template for 125I seed implantation in head and neck recurrent/ metastatic carcinoma.Methods Between January 2016 and December 2016,42 patients of local recurrent malignant tumor of head and neck received 3D printing guide plate assist radioactive seeds implantations,and included in the study.The tumor volume ranged from 2.4 to 102.8 cm3 (median 28.6 cm3).The prescribed dose is 110-160 Gy,and the seeds activity were 0.34 to 0.70 mCi (1 Ci =3.7 × 1010 Bq).All patients carried out preoperative planning design,individual guide plate production,seed implantation,postoperative dose assessment,and followup.The side effects of skin,mucous membrane,blood and spinal cord were statistically analyzed.Results All patients were operated successfully.The follow-up time was 4-14 months (median 8.5 months).There were no adverse reactions at grade three or above.Three patients had grade one skin reaction.One patient experienced grade one mucosal reaction,two experienced grade two mucosal reactions.The skin response was correlated with the dose of the skin (x2 =7.067,P =0.032).No hematologic toxicity or radiation myelopathy was observed and no seed displacement was found.Conclusions 3D-printing guide plate can provide good accuracy for positioning and direction.For local recurrent malignant tumor of head and neck,there were no obvious adverse reactions and the operation was simple and the dosage was accurate.