In the past, the ways to amblyopia neural mechanism research are given priority to visual electrophysiology and so on, which express the result use two -dimensional form, these ways mainly research the functions of the state before the lateral geniculate body. For the study of optic center, animal models are used to research it. But these kinds of methods are unable to accurately detect amblyopia neural mechanisms of human beings. Vulnerable to a variety of factors, it is difficult to finish the amblyopia treatment effect evaluation. Functional magnetic resonance imaging ( fMRI ) can reflect the three-dimensional visual cortex neuron activity noninvasively and accurately, and give rise to amblyopia neural mechanism and therapeutic effect evaluation. Therefore, in this paper, the amblyopia neural mechanisms and visual center after treatment effect evaluation of fMRI research progress are summarized.

AIM:To explore the clinical effect of capsule membrane phacoemulsification and capsular bag in phacoemulsification in treatment of hard nuclear cataract with high myopia.
METHODS:A total of 297 patients(322 eyes) with hard nucleus cataract(Ⅳ-Ⅴ grade nucleus) and high myopia were selected from Mar. 2014 to Mar. 2016 in our hospital. They were randomly divided into the observation group with 149 cases(162 eyes) and the control group with 148 cases(160 eyes). The observation group received capsule membrane phacoemulsification and the control group received capsular bag in phacoemulsification. The therapeutic effect and safety of patients in two groups were compared. The comparison of phacoemulsification time, energy parameters and corneal endothelial cell density used t-test, post-operative visual acuity and the occurrence of complications were tested by Chi-square test.
RESULTS: The harder the nucleus was, the longer the phacoemulsification time and higher the average phacoemulsification energy was, and the differences were statistically significant(P<0. 05). The phacoemulsification time and energy parameters of the observation group were significantly lower than that of the control group( P<0. 05 ). One month after operation, the postoperative visual acuity in two groups was significantly higher than the visual acuity at 1d after operation(P<0. 05). But there was no statistical significance on the visual acuity at 1mo after operation between two groups ( P> 0. 05 ). After operation, the density of corneal endothelial cell in two groups was significantly lower than the density before operation ( P < 0. 05 ). But there was no statistical significance on the density of corneal endothelial cell after operation between two groups ( P > 0. 05 ). The intraoperative complication rate of observation group was significantly lower than that of the control group ( P<0.05 ) , but there was no statistical significance on postoperative complication rate between two groups ( P>0. 05). CONCLUSION: For the treatment of hard nuclear cataract with high myopia, capsule membrane phacoemulsification and capsular bag in phacoemulsification have similar effect, but capsule membrane phacoemulsification has better safety.

AIM:To explore the changes of intraocular pressure measured by noncontact tonometer (IOPNCT) with high myopia and analyze the relative fators after small incision lenticule extraction(SMILE).METHODS:A retrospective study.Totally 108 cases (216 eyes) with high myopia received SMILE during March 2015 to October 2016 were involved.The IOPNCT, corneal central thickness (CCT) and corneal curvature for 3mo were recorded and analyzed by ANOVA, LSD t test.The Pearson correlation analysis and multiple linear regression model analysis were used to evaluate the relationship between IOPNCT and its influence factors.RESULTS:(1) There was significant statistical difference in IOPNCT after SMILE at 1d, 1wk, 1 and 3mo compare with preoperative (t=17.785, P=0.019;t=17.981, P=0.016;t=18.841, P=0.012;t=19.364, P=0.001);the IOPNCT after SMILE decreased.The IOPNCT values at every time after SMILE was no statistical difference (t=1.871, P=0.818;t=3.062, P=0.328;t=1.143, P=0.373).(2) The IOPNCT in high myopia were positive correlated with CCT and corneal curvature after SMILE (r=0.4356, 0.295;P<0.05), respectively.(3) The multiple linear regression model analysis revealed that Y=-14.601+0.348X1+0.03X2 (Y was IOPNCT, X1 was corneal curvature, X2 was CCT,P<0.001);Y=3.679+0.28X1+0.012X2 (Y was△IOPNCT,X1 was variation of corneal curvature,X2 was△CCT, P<0.001).CONCLUSION:The IOPNCT decreased after SMILE in high myipia, and it showed that there was no significant influence to use glucocorticoid eye drops in short terms.There was positive correlation among IOPNCT, CCT and corneal curvature after SMILE.

AIM: To assess the prevalence of refractive errors in middle school students in Lanzhou city and explore the risk factors for myopia.METHODS: A cross-sectional survey was conducted. A questionnaire assessed the students' socioeconomic background and visual tasks followed by visual acuity assessment and a full eye examination including slit lamp examination, fundus evaluation, retinoscopy, and subjective refraction.RESULTS: Among 2 256 enumerated students aged 15-19 years, 2 037 (90.3%) students had significant refractive errors. Myopia was the leading refractive error (1 951/2 256,86.5%), astigmatism was the second most common refractive error (921/2 256, 40.8%), but amblyopia (10/2 256, 0.4%),strabismus (5/2 256, 0.2%), hyperopia (4/2 256, 0.2%) and other treatable eye disorders were uncommon. Almost 95.3% of students with significant refractive errors wore spectacles before the survey. Age, sex, visual tasks, and a parental history of myopia were risk factors for myopia.CONCLUSION: The prevalence of refractive errors and the risk factors for myopia in schoolchildren in Lanzhou city are similar to those reported in other regions of China.Interventions of myopia progression should be performed to protect the visual acuity of school-aged students.

AIM:To analyze the recovery of visual cortex activation range of color vision in anisometropia amblyopia children after treatment by using blood oxygen level dependence-functional magnetic resonance imaging ( BOLD- fMRI ) and SPM8 software.
METHODS:Self-control study. This fMRI study directly compared activity in visual cortex produced by color monocular stimulation in 13 monocular anisometropia amblyopia children. The project of study was blocked design. The data of functions and anatomical MRI was stimulated by three-primary colors and was preprocessed and analyzed by SPM8 that based on MATLAB software. According to the data, we compared the change of the central area of color vision when first visit and 1, 2 ,4wk after treatment.
RESULTS: The BA17, BA18, BA19 and BA37 of amblyopia children were different activated after they accepted the three-primary colors stimulation (P<0. 01). After 4wk treatment, amblyopia children accepted red stimulation, the visual cortex activation range without expanding; after accepting green stimulus, on the left side of the visual cortex BA37, BA19, BA20, the average t value were 3. 5210, 3. 2716, 3. 1534 ( P< 0. 01 ); after accepting blue stimulation, the scope of the right side of visual cortex at BA19, BA18 were expanded to different extent, the average t value were 3. 7345, 3. 2701 (P<0. 01).
CONCLUSION: After 4wk treatment, visual cortex activation of color vision of anisometropia amblyopic children is expanded, but with low extent, after the short-term treatment of amblyopia, visual cortex activation of color vision has a certain degree of recovery but not obvious.

?The small incision lenticule extraction ( SMILE ) with femtosecond laser is a new mode of corneal refractive surgeryrecently. The safety, efficacy, stability and predictability of SMILE lead the corneal refractive surgery to a new world that only use femtosecond laser to correct myopia.With the development and popularity of SMILE, the clinical effect has aroused much concern.But there remain exited disputes in refractive stability, visual quality and corneal biomechanical property, contrast sensitivity and glare symptoms, corneal sensitivity and dye eye, corneal endothelial cells and intraocular pressure.These will be summarized in this review.

AIM:To evaluate the efficacy and stability by comparing acuity and diopter of small incision lenticule extraction ( SMILE) , femtosecond laser in situ keratomileusis ( FS-LASIK ) and laser in situ keratomileusis ( LASIK ) in treating myopia with a follow-up of 6mo.
METHODS: A retrospective study, 42 cases ( 84 eyes ) received SMILE, 37 cases ( 74 eyes ) received FS-LASIK and 31cases (62 eyes) undergone LASIK in our hospital during Apr. 2014 to Jun. 2014 were involved. The follow-up data of 6mo was analyzed. The preoperative spherical equivalent was -5. 91±1. 83D, -5. 89±1. 96D, -5. 88±1. 68D in SMILE, FS-LASIK and LASIK group, respectively. The differences of preoperative best corrected visual acuity ( BCVA ) , pupil diameter ( PD ) and central corneal thickness ( CCT ) had no statistically significant between three groups. The postoperative uncorrected visual acuity ( UCVA) , BCVA and diopter were comparative analyzed at 1wk, 1, 3 and 6m after surgery.
RESULTS:1) No patients lost to follow-up of 1wk and 1mo. A total of 10 eyes (5 cases), 10 eyes (5 cases) and 8 eyes (4 cases) lost to follow-up of 3m in SMILE、FS-LASIK and LASIK group, respectively, and raised to 18 eyes (9 cases), 12 eyes (6 cases) and 14 eyes (7 cases) in follow-up of 6m. 2) At 1wk follow-up, the differences of UCVA between SMILE group, FS- LASIK group vs LASIK group was statistically significant respectively ( t=4. 098, P=0. 000;t=2. 493, P=0. 004). 3) In LASIK group, the differences of UCVA between 1wk vs 3, 6m follow-up was statistically significant respectively (t=3. 410, P=0. 001;t=3. 771, P=0. 000), the differences of UCVA between 1m and 6m follow-up was statistically significant (t=2. 283, P=0. 026). 4) The differences of diopter were not statistically significant among three groups at 1wk, 1, 3 and 6mo follow-up respectively (χ2=0. 119, P=0. 942;χ2=1. 504, P=0. 471;χ2=0. 949, P=0. 622; χ2=0. 277, P=0. 871). 5) the differences of eyes with UCVA≥5. 0 was statistically significant between SMILE group vs FS-LASIK group, LASIK group at 1wk follow-up (χ2=9. 249, P=0. 002<0. 05/3;χ2=12. 906, P=0. 000<0. 05/3), there was no significant statistical difference between FS-LASIK group and LASIK group (χ2=0. 500, P=0. 604). 6) there was no significant statistical difference of eyes with SE (±0. 50D) at any time post operation among three groups (χ2=0. 809, P=0. 697;χ2=1. 176, P=0. 634;χ2=0. 871, P=0. 736;χ2=0. 683, P=0. 770).CONCLUSION: All of SMILE, FS-LASIK and LASIK are effective and stable on treating myopia according to follow-up of 6mo. However, in this study, SMILE group shows more effective than FS-LASIK and LASIK at 1wk, which could enhance postoperative UCVA more rapidly.

AIM: To observe the efficacy of Medpor porous polyethylene implants in treatment of enophthalmos combined with orbital fracture.
METHODS: Seventeen cases ( 17 eyes ) with enophthalmos caused by orbital fracture underwent surgical treatment with Medpor porous polyethylene implants. All accepted a 6-mo follow-up and the data of enophthalmos, eyeball movement and diplopia were collected.
RESULTS: The average difference of exophthalmos between damaged eyes and undamaged eyes was (3. 4±1. 5 ) mm preoperatively, two cases had residual 1mm enophthalmos 6mo after surgery, while other 15 cases were completely corrected. Seventeen cases suffered from eyeball movement restriction and diplopia preoperatively, 16 cases had normal eyeball movement without diplopia 6mo after surgery, 1 case with limitation of abduction and horizontal diplopia. There was no extrusion, rejection, infection or other complications occurred during follow-up.
CONCLUSION: Medpor porous polyethylene implants can effectively improve the orbit volume to repair enophthalmos caused by orbital fracture.

AIM: To evaluate the effects of glycemic control on refraction in diabetic patients. METHODS: Twenty newly diagnosed diabetic patients were included in this study. The random blood glucose, HbA1c levels, fasting C-peptide and postprandial 2h C-peptide were measured before treatment. The patients with random blood glucose higher than 12.0mmol/L and HbA1c level higher than 10.0% were selected. Refraction, intraocular pressure, radius of the anterior corneal curvature, depth of the anterior chamber, lens thickness, vitreous length, and axial length were measured on admission and at the end of week 1, 2, 3 and 4 during glycemic control.RESULTS: A transient hyperopic change occurred in all the patients receiving glycemic control. The maximum hyperopic change was 1.60D (range 0.50±3.20D). Recovery of the previous refraction occurred between two and four weeks after insulin treatment. There was a positive correlation between the maximum hyperopic changes and the HbA1c levels on admission (r=0.84, P<0.05). There was a positive correlation between the maximum hyperopic changes and the daily rate of blood glucose reduction over the first 7 days of the treatment (r=0.53, P<0.05). During transient hyperopia, no significant changes were observed in the intraocular pressure, radius of the anterior corneal curvature, depth of the anterior chamber, lens thickness, vitreous length and axial length.CONCLUSION: Transient hyperopic changes occur after glycemic control in diabetic patients with severe hyperglycemia. The degrees of transient hyperopia are highly dependent on HbA1c levels before treatment and the rate of reduction of the blood glucose level.

This study aimed to investigate the immune adjuvant effect and mechanism induced by chitosan nanoparticles carrying pJME/GM-CSF. In this study, plasmid DNA (pJME/GM-CSF) was encapsulated in chitosan to prepare chitosan-pJME/GM-CSF nanoparticles using a complex coacervation process. Immunohistochemistry was used to detect the type of infiltrating cells at the site of intramuscular injection. The phenotype and functional changes of splenic DCs were measured by flow cytometry after different immunogens were injected intramuscularly. The killing activity of CTLs was assessed using the lactate dehydrogenase (LDH) release assay. The preparation of chitosan-pJME/GM-CSF nanoparticles matched the expected theoretical results. Our results also found that, after pJME/GM-CSF injection, the incoming cells were a mixture of macrophages, neutrophils, and immature DCs. Meanwhile, pJME/GM-CSF increased the expression of MHC class II molecules on splenic DCs, and enhanced their Ag capture and presentation functions. Cell-mediated immunity was induced by the vaccine. Furthermore, chitosan-pJME/GM-CSF nanoparticles outperformed the administration of standard pJME/GM-CSF in terms of DC recruitment, antigen processing and presentation, and vaccine enhancement. These findings reveal that chitosan could be used as delivery vector for DNA vaccine intramuscular immunizations, and enhance pJME/GM-CSF-induced cellular immune responses.
Adjuvants, Immunologic ; administration & dosage ; Animals ; Chitosan ; administration & dosage ; immunology ; Dendritic Cells ; immunology ; virology ; Encephalitis Virus, Japanese ; genetics ; immunology ; Encephalitis, Japanese ; immunology ; prevention & control ; virology ; Female ; Granulocyte-Macrophage Colony-Stimulating Factor ; administration & dosage ; genetics ; immunology ; Humans ; Immunity, Cellular ; Japanese Encephalitis Vaccines ; administration & dosage ; genetics ; immunology ; Mice ; Mice, Inbred BALB C ; Nanoparticles ; administration & dosage ; Spleen ; immunology ; T-Lymphocytes, Cytotoxic ; immunology ; virology ; Vaccines, DNA ; administration & dosage ; genetics ; immunology