Since 2016, enrollment of students for optometry & ophthalmology specialty of five-year program has expanded in China, and China Medical university has become the pioneer to recruit students to this major in Northeast China. With reference to our national situation, this paper focuses on how to help students form good professional ethics, gain professional knowledge, professional skills and scientific research ability, so as to enable them not only grasp basic theories and skills of clinical medicine, but also be skilled at optometry & ophthalmology; the construction of systematic curriculum of optometry & ophthalmology should be actively explored with the aim of comprehensive medical education as the foundation, systematic education of optometry & ophthalmology as its unique feature and education of humanistic medicine as the concept". Therefore, we innovatively put forward a teaching model of "basic-core of clinical medicine-professional direction and characteristic development courses", thus to provide a reference for training applied and compound Optometrists and ophthalmologists who are urgently in need at present in China.

Objective:To develop Z-scores for the aortic arch in normal fetuses as a reference for fetuses with suspected coarctation of aorta(CoA).Methods:The aortic arch inner diameters of 610 normal fetuses and 59 CoA fetuses from May 2010 to March 2015 in the Second Xiangya Hospital of Central South University were measured at the long axis of the aortic arch view. Gestational age(GA), femur length(FL) as the independent variable, the aortic arch inner diameters as the dependent variable, Z-scores were created relating the aortic arch inner diameters to the GA and FL. Z-score=[ln(measured diameter)-ln(predicted diameter)]/root MSE. Z-scores of the CoA fetuses were calculated with the above regression, and compared with the Z-scores of the control group.Results:A simple linear regression model was the best description of the data in each case and correlations between FL and the aortic arch inner diameters were excellent ( P<0.001). There was no significant difference in Z-scores calculated with FL or GA as independent variables ( P>0.05). Z-scores of the control group was between -2 and + 2, Z-scores of the CoA group was significantly lower and below -2( P<0.001). Conclusions:Z-scores of fetal aortic arch are sensitive indicators of fetal coarctation, and are of clinical importance for the diagnosis and follow-up study of CoA.

Objective:To explore the variation of renal volume with gestational age(GA), biparietal diameter(BPD), abdominal circumference(AC), femur length (FL) and the Z value calculation formula.Methods:Five hundred and eighty singleton pregnancy women from 20th to 38th gestational weeks in Second Xiangya Hospital of Central South University were enrolled. Two dimensional ultrasound was performed to record fetal growth parameters and renal longitudinal, transverse, anteroposterior diameters. Renal volume was calculated using ellipsoid volume equation: Volume =6/π×length×width×thickness. Using GA, BPD, AC, FL as independent variables and renal volume as dependent variables, the regression analyses of the mean and the standard deviation(SD) for each parameter were calculated separately. The Z-scores were calculated by the formula: Z-scores=(actual measurements of renal volume-predictive value of renal volume)/SD of predictive value.Results:Five hundred and forty-three cases of normal singleton fetuses were involved.The left and right renal volume were increased along with GA, BPD, AC, FL. Quadratic polynomial regression equations were each fitted to the models( r=0.775, 0.771, 0.811, 0.738, P<0.001; r=0.747, 0.735, 0.754, 0.745, P<0.001, respectively). The SD increased with the increases of independent variables and could be modeled with a simple linear regression( r=0.146, 0.225, 0.071, 0.155, P<0.001; r=0.091, 0.157, 0.091, 0.123, P<0.001, respectively). Z-scores were calculated and proved normally distributed after Shapiro-Wilk test( P>0.05). Conclusions:The normal Z-score reference range of fetal renal volume is established to help assess the normal renal growth and identify fetal renal abnormalities.

Objective To investigate the clinicopathologic features of Chinese patients with early gastric cancer (EGC) according to the World Health Organization(WHO) diagnostic criteria,and to explore the risk factors of lymph node metastasis (LNM) in EGC.Methods From 2002 to 2017,at the Second Affiliated Hospital of Nantong University,and from 2014 to 2017,at the People's Hospital of Qidong City,the People's Hospital of Haimen City and the People's Hospital of Rugao City,315 EGC patients with complete clinicopathological data were enrolled.The clinicopathologic features were analyzed including gender,age,tumor location,tumor size,macroscopic type,histological type (WHO),differentiation degree,depth of tumor invasion,Lauren subtype,infiltration pattern,ulceration,lymphoid follicles,lymphovascular invasion and perineural invasion.Chi-square test and Fisher's exact test were performed for univariate analysis and the logistic regression was used for multivariate analysis.Results The ratio of EGC was 10.0％ (315/3 140) of patients with gastric cancer and received surgery during the same period.Among the 315 EGC,the ratio of well-differentiated tubular adenocarcinoma was 11.7％ (37/315),which was lower than 24.8％(2 752/11 104) in Japan and 19.9％(41/206) in South Korea,and the differences were statistically significant (x2 =28.208,P＜0.01;x2 =6.51 0,P =0.011),however there was no statistically significant difference when compared with Western countries (11.9 ％,8/67;x2 =0.002,P=0.964).Among the 276 patients who underwent radical gastrectomy,49 (17.8 ％) patients had with LNM.The results of univariate analysis showed that tumor size,macroscopic type,differentiation degree,depth of invasion,infiltration pattern,ulceration and lymphovascular invasion were related with LNM(x2=9.327,6.038,6.381,34.983,19.309,52.297 and 5.058;all P＜0.05).The results of multivariate analysis revealed that lymphovascular invasion and ulceration were the independent risk factors of LNM (odd ratio (OR)=7.028 and 2.566,both P＜0.05).Conclusions There is obvious difference in pathological diagnostic standard of well-differentiated tubular adenocarcinoma between China,Japan and South Korea,which may influence the therapeutic strategy of EGC.Lymphovascular invasion and ulceration are independent risk factors of LNM in EGC.

Objective To investigate the level and correlation between Thioredoxin (Trx) and Thioredoxin interacting protein (Txnip) in aqueous humor of cortical cataract patients with type 2 diabetes.Methods The Txnip and Trx levels were determined by Elisa in aqueous humor of 60 cataract patients with type 2 diabetes,which were divided into group A (control group,HbA1c ＜5.5％),group B (5.5％ ≤HbA1c ＜6.5％) and group C (HbA1c＞6.5％),and each group contains 20 patients.Results The level of Txnip in group B was higher than that in group A,while that in group C was the highest,there were statistical differences (all P ＜ 0.05).Compared with group A,the level of Trx in group B was increased,while that in group C was the lowest,there were statistical differences (all P ＜ 0.05).The level of Trx was positive correlated with Txnip in group A (r =0.810,P =0.000),but negative correlated with Txnip in group C (r =-0.809,P =0.000) and degree of cataract in group C (r =-0.727,P =0.001).Logistic regression analysis revealed that Txnip and HbAl c were risk factors of cortical cataract.Conclusion Trx and Txnip may play an important role in the development of diabetic cataract.

Objective To study the expression and clinical significance of Kif2a in breast carcinoma by the application of tissue microarray. Methods Tissue microarray and immunohistochemistry method (S-P) were used to examine the expression of Kif2a in 102 cases of breast carcinoma tissue and adjacent tissue. The prognosis of 62 cases followed up were studied by both univariate and multivariate analysis. Results The expression of Kif2a has significant difference between breast carcinoma tissue and adjacent tissue. Kif2a expression were associated with lymph nodal involvement and HER2 expression (P < 0.05). In the 62 cases with followed-up data, univariante analysis revealed that the expression of Kif2a, lymph nodal involvement and HER2 expression were correlated with the survival rate. Cox stepwise proportional hazards analysis showed that they were independently prognostic factors. Conclusions Kif2a expression in breast carcinoma were associated with lymph nodal involvement and HER2 expression (P<0.05). It is meaningful to examine Kif2a expression for prognosis of the breast carcinoma.

Objective To observe the expression of small ubiquitin?related modifiers(SUMO)protein in normal cultured human lens epithelial cells(SRA01/04)and discuss regulation effects of SUMO protein on oxidative stress induced by high glucose. Methods The expression and local?ization of SUMO 1,2/3,4 was detected in normal cultured SRA01/04 cells through immunocytochemistry. The mRNA expression levels of SUMO 1?4 were examined by RT?PCR after the SRA01/04 cells treated with high glucose media at different concentrations and time points. Samples were grouped by medium concentrations(glucoses 5.5 mmol/L,12.5 mmol/L,25 mmol/L,50 mmol/L respectively for 24 h)and by treatment time(0 h, 6 h,12 h and 24 h respectively). After highly efficient transfection of GFP?SUMO2 into SRA01/04 cells,the survival and apoptotic rates of transfect?ed and un?transfected cells treated with high glucose was detected by CCK8 method and AV/PI double staining flow cytometry. Results The immu?nocytochemistry results showed that SUMO1,2/3,4 proteins were mainly located in the nucleus of SRA01/04 cells and part of SUMO2/3 was in the cytoplasm. RT?PCR results showed that compared with the low?glucose group,the mRNA expression of SUMO1?4 was increased along the increas?ing glucose concentration in the high?glucose group(P<0.05). Compared with 0 h,the mRNA expression of SUMO1?4 was enhanced at 6 h,12 h and 24 h(P<0.05)in the high?glucose group treated at 50 mmol/L concentration. Compared with the un?transfected cells,the survival rate was in?creased and the apoptotic rate was decreased in GFP?SUMO2 transfected cells in oxidative stress induced by high glucose(P<0.05). Conclusion SUMO protein was positively expressed in SRA01/04 cells and the expression of SUMO mRNA was affected by oxidative stress induced by high glu?cose.

Objective To investigate the clinical outcome and prenatal diagnosis feasibility of fetal congenital cardiac diventiculum.Methods The data of 12 fetuses with congenital cardiac diventiculum were retrospectively reviewed.The prenatal and postnatal medical records,including the characteristics of diverticulum,presence of abnormalities,karyotype and the outcomes of each pregnancy were collected.Results The overall incidence of cardiac diventiculum was 0.03％ (12/40 564) and the rate of incidence between left and right ventricle was 2 ∶ 1.Mean size of diventiculum was (69.75 ± 28.73)mm2,mean diameter of the diventiculum neck was (3.58 ± 0.80) mm and mean thickness of diventiculum wall was (1.54± 0.29)mm.Seven cases (58.4％) as an isolated malformation,5 cases (41.6％) combined with cardiac defect and extracardiac abnormalities,2 cases (16.7 ％) with chromosomal abnormalities.Five cases underwent termination of pregnancy,1 case died in uterus and 6 cases were born live.The mean follow-up periods was (62.33±-36.52)month.Of the 6 follow-up cases,4 cases (66.7％) remained asymptomatic,one case underwent drug therapy because of arrhythmia and one case combined with VSD underwent operation.Conclusions Echocardiography could be an useful tool to demonstrate and monitor congenital cardiac diventiculum prenatally and postnatally.The outcome of cardiac diventiculum depends on the size,progression,and the combined abnormalities and complications.

Objective To explore the expression of microRNA in Eaf2 knockout mice and the effect of Eaf2 on the apoptosis of human lens epithe?lial cells and the expression of microRNA in lens. Methods pEGFP?C1?Eaf2 was transfected into SRA01/04 cells using Lipofectamine 2000 to over express Eaf2 gene,and then the flow cytometry was used to detect cell apoptosis rate. And real time q?PCR was used to measure the expression of microRNA both in human lens epithelial cells and Eaf2 knockout mice. Results Compared with controls,the apoptosis rate of cells transfected with pEGFP?C1?Eaf2 was reduced,the expression of miR?125b and let?7a was significantly increased and miR?204 was decreased in cells transfect?ed with pEGFP?C1?Eaf2. Compared with controls,the expression of miR?125b and let?7a was lower and miR?204 was higher in Eaf2 knockout mice. Each result was statistically significant(P<0.01). Conclusion Eaf2 might inhibit apoptosis of human lens epithelial cells via regulating the expression of microRNA. Eaf2 may have a protective effect for the lens in the genesis of cataract.

Objective To study the relationship between the inflammatory cytokine levels and the expression of hepatic alpha-7 nicotinic acetylcholine receptor (α7 nAChR) in hyperlipidemia rats and to investigate the intervention effect of Yirui Capsules ( mainly composed of Radix Salviae Miltiorrhizae, Fructus Crataegi, Rhizoma Alismatis, etc). Methods Fifty male SD rats were randomly divided into blank control group ( fed with conventional diet, N=10) and high-fat diet group (fed with high-fat diet, N=40). After feeding for 14 d, the forty rats in high-fat diet group were further randomly divided into model control group, and low-, middle-, and high-dose Yirui Capsules groups (140, 280, 560 mg/kg, respectively), 10 rats in each group and the treatment lasting 30 days. And then, the serum levels of lipids were detected, C-reactive protein (CRP) and tumor necrosis factor (TNF) -α in the serum were detected by enzyme-linked immunosorbent assay ( ELISA) , and the expression of hepatic α7 nAChR was analyzed by immunohistochemical staining and reverse transcription-polymerase chain reaction (RT-PCR) . Results Yirui Capsules in different dosages could improve serum lipid levels in hyperlipidemia rats to various degrees. The contents of serum inflammatory cytokines CRP and TNF-α and the mRNA expression of hepatic α7nAChR were increased in the model control group as compared with those in the blank control group ( P<0.01). The contents of inflammatory cytokines CRP, TNF-αand the mRNA expression of hepatic α7nAChR were decreased in the three Yirui Capsules groups as compared with those in the model control group ( P<0.01). The results of immunohistochemical staining for α7nAChR expression were consistent with RT-PCR results. Conclusion The expression of hepatic α7nAChR is increased in hyperlipidemia rats. Yirui capsules are effective on decreasing inflammatory cytokine levels, improving lipid metabolism, and down-regulating α7nAChR expression.