Keratoconus is a relatively common, bilateral, non-inflammatory corneal ectasia characterized by thinning and scarring of the central portion of the cornea,seriously destroyed the vision. The aetiology of this condition is probably multiple factors,such as collagen themry,genetic themry,epithelia themry,etc.Now,recent investigations devote to gene,and think it one of the major aetiological factors. Laboratory studies suggest a role for degradative enzymes and proteinase inhibitors and a possible role for the interleukin-1 system in its pathogenesis, but these roles need to be more clearly defined. It has well-described clinical signs, but early forms of the disease may go undetected unless the anterior corneal topography is studied. Contact lenses are the most common treatment modality. When contact lenses fail, corneal transplant is the best and most successful surgical option.

With the development of modern vitrectomy,some new ideas have been proposed concerning the treatment of Terson syndrome.Developed neurosurgery has offered more chances of survival to patients with subarachnoid hemorrhage(SAH).Terson syndrome,as the initial presentation,has gained more and more attention from ophthalmologists,though strict guidelines for its treatment have not yet been established.The paper reviews the progress in the clinical researches of Terson syndrome.

Objective　To investigate the changes of free calcium distribution in hepatocytes after administration of phenylephedrine. Methods The changes of fluorescence intensity were observed by confocal laser scanning microscopy after administration of phenylephedrine alone or pretreated with phentolamine before phenylephedrine administration. Results　The fluorescence intensity increased rapidly after administration of phenylephedrine to hepatocytes. When liver cells were pretreated by phentolamine before phenylephedrine administration, the changes of fluorescence intensity not obvious. Meanwhile, the inconformity of the fluorescence intensity in hepatocytes suggested the existence of the second subarea of free calcium distribution. Conclusion　Ca2+ signal can be arisen by phenylephedrine via the α-receptor in hepatocytes in vitro. The distribution and dynamic changes of free calcium in hepatocytes display some characteristics.

Background Fungal keratitis is one of primary infectious ocular diseases in China.Conventional diagnostic method is fungal cultivation.In vivo laser confocal microscope is a noninvasive examination of ocular surface.However,the study on features of in vivo laser confocal microscope images of frequent fungal keratitis is still not thorough.Objective This study was to analyze laser confocal microscope imaging features of four typical fungal keratitis.Methods The clinical data of 65 eyes from 65 patients with fungal keratitis were retrospectively analyzed.The patients were initially diagnosed in Nanjing General Hospital of Nanjing Military Command PLA from January 2007 to November 2011, and laser confocal microscope examination of ocular surface and fungal cultivation were performed.The characteristics of laser confocal microscope images were investigated,including shape and type of hypha,distribution of spores and the relationship of hypha with lesion.The differentiation between fungal hypha and other corneal tissues was summarized.Results Fungal cultivation showed that among the 65 patients,Fusarium,Aspergillus,Candida and Alternaria were common pathogenic fungus with the infected proportion 63.0％ , 16.9％,3.0％ and 4.6％ ,respectively, and 12.5％ patients were infected by other fungus.In the images of laser confocal microscope,hyphae of Fusarium presented the branch-like high reflective structure in the corneal superficial stromal layer and thinning line shape in the deep stromal layer.Few inflammatory cells were found.The peudohyphae and spores from Candida were seen in corneal superficial and mid stroma layers, with few inflammatory cells and many proliferating stromal fibers in the lesions.The hyphae of Aspergillus presented worm-like, showing the thinner and shorter shapes in comparison with those of Candida.The hyphae of Alternaria were long,straight and thick in shape,and spherical chlamydospores were found on the hyphal tip.The hyphae, subepithelial plexus, dendritic cells, fibrosis of the cornea all showed high reflection under the laser confocal microscope, but evidently differences appeared in shape,distribution and course in corneas.Conclusions Hyphae are the main basis to diagnose fungal keratitis and differentiate fungi.As a non-invasive examination method,laser confocal microscope can provide useful information for the early diagnosis and treatment of fungal keratitis in vivo.

Objective: Epi-LASIK appeared to be effective and safe in the treatment of high myopia,but some patients complain about visual symptoms postoperation.The purpose of this study was to evaluate the high order aberrations(HOAs) of the vision-decreased eyes treated by Epi-LASIK,and to analyze the causes of postoperative glare,scieropia and monocular diplopia.Methods: We evaluated 76 eyes of 49 patients treated by Epi-LASIK with a questionnaire three months after surgery,and from them selected 34 eyes of 27 patients who scored less than 80 points and complained of postoperative visual symptoms,including glare(25 eyes in 20 patients),scieropia(7 eyes in 5 patients)and monocular diplopia(2 eyes in 2 patients).Another 42 symptom-free eyes of 22 patients treated by Epi-LASIK were included in the control group.The root mean square(RMS) of total HOAs,coma and SA were determined with the iTrace Visual Function Analyzer from the central 6.0 mm zone,and the modulation transfer function(MTF) was simulated with the iTrace 3.1 software.Results: Significant differences were found in the RMS of total HOAs,coma and SA between the eyes with visual symptoms and those without,and the values of ablation zone decentration were significantly higher in the former than in the latter(P

Objective　To establish the animal model of denervation of sympathetic nerve and to explore the effects of denervation of the sympathetic nerve on liver regeneration after partial resection. Methods　The animal model of denervation of sympathetic nerve was made with 6-OHDA. A total of thirty male Wistar rats were divided equally into experimental and control group. The left and middle lobe of liver were resected with improved Higgins and Anderson's method. Meanwhile, denervation was made in the experimental group. All the rats were killed by haemospasia on the 7 th day after operation. HMI, RLR and MI were measured. The rates of DNA synthesis were detected by 3H-TdR method. Results　The concentration of NE decreased extremely on day 3 to day 14 after administration of 6-ONDA. No death happened in all the rats 7 days after liver resection. HMI, RLR, MI and 3H-TdR incorporation significantly decreased in experimental group compared with that in control (P<0.01). Conclusion　The chemical denervation of sympathetic nerve can be aroused by administration of 6-OHDA. Regeneration of the liver is inhibited by the denervation of sympathetic nerves.

Objective To investigate the feasibility and safety of Bean Bag in lateral position placing during pulmonary operations,evaluate its effects by comparing with the routine placing of lateral position by sandbags and side shields, and to provide scientific evidences to solve the existing clinical problems in lateral position placing. Methods One hundred patients with pulmonary surgeries who needed lateral position placing were divided into Bean Bag group and routine method group randomly according to random digit table,50 patients in each group.Bean bag was used in lateral position placing in Bean Bag group,while sandbags and side shields were used in routine lateral position placing in routine method group. The required time for positioning and skin pressing condition, the activity of both upper limbs during postoperative follow-up were recorded.The satisfaction of operating surgeons on this position was acquired by self-designed questionnaire when operation was finished. Results The required time for positioning in Bean Bag group was(178.36±24.27)seconds,and that for positioning in routine method group was (282.06 ± 29.34) seconds, there was statistically significant difference between two groups (t=19.254,P<0.01).There were 14 patients who appeared skin injury and press red in Bean Bag group and 27 patients who appeared skin injury and press red in routine method group, and there was statistically significant difference between two groups(χ2=6.986,P=0.008).In Bean Bag group,the total score of seven items in satisfaction questionnaire of operating surgeons on patient's position was 38.34±1.36,while that in routine method group was 29.34±1.29,there was statistically significant difference between two groups(Z=33.924,all P<0.01). Conclusions Our study indicated that it was feasible and safe to use Bean Bag to place lateral position.The exposure of operating field was good and the stability of position was strong. Compared with routine position placing method, lateral position placing by using Bean Bag could save time, the operating procedures were more simple and convenient, and it could protect the physiological function of all aspects in patient's body more effectively, the satisfaction of surgeons for this method in lateral position placing was higher. It might deserve to popularize this method in the clinical practice in the future.

Objective:To evaluate the impact of three small compounds, namely sodium diethyldithiocarbamate (DTC), levamisole (LMS) and imiquimod (Imi), on the immunogenicity and protective efficacy of the candidate antigen PA0833 from Pseudomonas aeruginosa ( Pa) and analyze the underlying mechanisms. Methods:PA0833 was formulated with aluminum adjuvant and the above small compounds, respectively. BALB/c mice were immunized with these vaccines intramuscularly on days 0, 14 and 21. Serum samples were collected and the levels of PA0833-specific IgG were measured by ELISA. The protective efficacy of these vaccines was evaluated by assessment of survival rates, body weights, clinical scores, inflammatory factors, and histopathological changes after infecting the immunized mice with Pa PAO1 strains. Besides, the mice were injected with DTC intramuscularly for seven consecutive days to analyze the mechanism of DTC in enhancing immune response using transcriptome sequencing and flow cytometry. Results:All these small compounds were capable of effectively enhancing the immunogenicity of PA0833 formulated with aluminum adjuvant, reducing bacterial loads in lung tissues, inhibiting the secretion of TNF-α, IL-6 and IL-1β, and improving mouse survival rates upon Pa infection. DTC was more effective than the other two compounds. Transcriptome sequencing identified 121 up-regulated genes and 18 down-regulated genes in DTC-treated group as compared with PBS control group. These differentially expressed genes were significantly enriched in immune pathways, with a strong activation of the IL-17 pathway. Flow cytometry analysis demonstrated significant activation of dendritic cells and proliferation of Th17 cells in splenocytes in DTC-treated group as compared with PBS control group. Conclusions:All three small compounds are able of effectively enhance antigen immunogenicity with DTC being the most effective, indicating that DTC can be used as a novel adjuvant in vaccine development.

Adult ; Corneal Perforation ; surgery ; Humans ; Male

Background Neonicotinoid insecticides (NEOs) are emerging synthetic insecticides that have been used in various pest management regimens worldwide as alternatives to conventional insecticides. Recently, several studies have indicated that humans are widely exposed to NEOs, but limited is known about the levels and associated health risks of NEOs exposure among children. Objective To estimate exposure levels of four kinds of NEOs in urine samples among 5-year-old children from Laizhou Wan, Shandong Province, and to evaluate health risks of single and cumulative exposure to NEOs among children in this area. Methods A total of 205 children who participated in the 5-year-old follow-up in Laizhou Wan Birth Cohort (LWBC) were included. Urinary concentrations of four NEOs [imidacloprid (IMI), acetamiprid (ACE), clothianidin (CLO), and thiamethoxam (THM)] were measured by high-performance liquid chromatography coupled with triple quadrupole mass spectrometry. Based on the detected NEOs concentrations, estimated daily intake (EDI) was calculated, and the health risk of exposure to single NEO was assessed using hazard quotient (HQ, risk threshold=1). A relative potency factor (RPF) approach was used to standardize the concentrations of the four NEOs by IMI to calculate their cumulative concentrations. Then, the health risk of cumulative exposure to the four NEOs was further evaluated based on the HQ method. Results The detection rates of the four NEOs in the 5-year-old children were all above 90%, and their median creatinine-adjusted urinary concentrations were in the order from high to low as follows: CLO (1.373 μg·g⁻¹) > THM (0.628 μg·g⁻¹) > IMI (0.310 μg·g⁻¹) > ACE (0.073 μg·g⁻¹). Of the four NEOs, the median EDI of IMI was 0.035 µg·kg⁻¹·d⁻¹, higher than those of CLO (0.032 µg·kg⁻¹·d⁻¹), THM (0.012 µg·kg⁻¹·d⁻¹), and ACE (0.002 µg·kg⁻¹·d⁻¹). The maximum HQ values of IMI, CLO, THM, and ACE were 0.168, 0.152, 0.055, and 0.022, respectively, which were all far lower than the risk threshold of 1. The median concentration of cumulative exposure to the four NEOs standardized by IMI was 21.241 μg·g⁻¹, and its median EDI was 2.370 µg·kg⁻¹·d⁻¹. The maximum HQ of cumulative exposure to the four NEOs was only 0.694, which also did not exceed the risk threshold of 1. Conclusion NEOs exposure is common among the 5-year-old children in Laizhou Wan, Shandong. Although there is no obvious health risk associated with single and cumulative exposure to NEOs in the children in this area, their exposure levels of NEOs are higher than those in some foreign areas. The adverse health effects of long-term exposure to low dose of NEOs deserve our extensive attention.