Objective:To understand the changing trend and influencing factors of lens power (LP) in children aged 3-12 in Jing'an District, Shanghai.Methods:A cross-sectional study was conducted.One hundred and thirty-one eyes of 131 patients with refractive errors were included in the Optometry Clinic of Shanghai Eye Hospital from October 2019 to January 2020.The 1% atropine sulfate was employed to dilate pupils for children aged 6 years or younger, and 0.5% topiramate for children older than 6 years.The axial length, mean keratometry (Km), anterior chamber depth (ACD), lens thickness (LT) and central corneal thickness (CCT) were measured using an IOL Master.The spherical equivalent (SE) and best corrected visual acuity (BCVA) were measured after cycloplegia using autorefractor and phoropter, and the LP was calculated using the Bennett formula.The patients were divided into different age groups, including 3-4 years group (16 eyes), 5-6 years group (20 eyes), 7-8 years group (25 eyes), 9-10 years group (33 eyes) and 11-12 years group (37 eyes). There were 57 eyes in the male group and 74 eyes in the female group.The patients were also divided into different refractive groups, including mild myopia group (38 eyes), moderate myopia group (12 eyes), high myopia group (25 eyes), emmetropia group (11 eyes), mild hyperopia group (9 eyes), moderate hyperopia group (13 eyes), and high hyperopia group (23 eyes). The differences in ocular biological parameter measurements between different age groups, different gender groups and different refractive groups were compared and the correlations between age, eye parameters and LP were analyzed using Pearson correlation analysis.The contribution of multiple influencing factors to LP was analyzed by multiple linear regression models.The study protocol followed the Declaration of Helsinki and was approved by an Ethics Committee of Shanghai General Hospital, Shanghai Jiao Tong University Hospital (No.2020KY018). Written informed consent was obtained from each guardian of the subject.Results:The average LP of children in the 3-4 years group, 5-6 years group, 7-8 years group, 9-10 years group and 11-12 years group were (27.35±1.88), (24.71±1.92), (22.92±1.87), (21.49±1.54) and (21.25±1.55) D, respectively.With the increase of age, the LP value was decreased gradually.There were significant differences between 3-4 years group and 5-6 years group, 5-6 years group and 7-8 years group, 7-8 years group and 9-10 years group (all at P<0.05). The average LP value of girls was obviously higher than that of boys ( t=-3.38, P<0.01). The LP value of the high myopia group was significantly lower than that of the emmetropia group, and the LP values of the moderate myopia and the low myopia group were significantly lower than that of the hyperopia group, and the LP values of the low hyperopia group and the moderate hyperopia group were significantly higher than that of the emmetropia group (all at P<0.05). The LP value was negatively correlated with age, AL, ACD and CCT ( r=-0.76, -0.79, -0.38, -0.18; all at P<0.05), and was positively correlated with SE and LT ( r=0.62, P<0.05; r=0.68, P<0.01). There was no obvious correlation between Km and LP ( r=0.07, P=0.45). The independent influencing factors of LP were analyzed through multiple linear regression equations, showing that LP=-0.430×AL+ 0.329×LT-0.267×age-0.108×gender-0.084×CCT (male=1, female=0). The standardized coefficients of each factor arranged in descending order were AL, LT, age, gender and CCT (all at P<0.05). Conclusions:The LP of children aged 3-12 in Jing'an District of Shanghai decreases with age and increases with SE.LP values of girls are higher than those of boys.

Objective To investigate the relationship between disrupted corticospinal tract (CST) and motor recovery after stroke by using diffusion tensor tracking (DTT). Methods From March, 2012 to June, 2013, 15 chronic stroke patients with left subcortical lesions and 15 age- and sex- matched healthy subjects were performed diffusion tensor imaging (DTI) examination. The CST was tracked by DTT technique, and the damaged values of the CST caused by the stroke lesions were quantified using a CST template generated from healthy controls. Furthermore, the correlations of the damaged values of the CST with Fugl-Meyer Assessment (FMA) were performed. Results The range of the damaged values of CST in stroke patients was 0.00% to 29.6%. There were very strong negative correlation between the damaged values of the CST and FMA scores (the wrist, r = -0.660; hand, r = -0.813; wrist plus hand, r = -0.795, respectively, P < 0.01). It also showed strong negative correlation between the damaged values of the CST and FMA scores (upper limb, r = -0.614; upper limb plus lower limb, r = -0.563, respectively, P < 0.05). Whereas, there was no correlation between the damaged values of the CST and FMA scores of lower limb (r = -0.270, P = 0.331). In addition, the lesion volumes of stroke and FMA scores were not significantly correlated (P > 0.05). Conclusion The severity of motor deficit after stroke was closely related to the overlap of lesions with CST. The damaged values of the CST based on DTT may be used as a potential biomarker to assess motor impairments of upper limbs, especially hand and wrist in stroke patients.

Objective To investigate the mRNA level of lymphoid enhancing factor-1 ( LEF-1) in bone marrow mononuclear cells after the initial diagnosis and chemotherapy of patients with multiple myeloma (MM) and its clinical significance. Methods The LEF-1 mRNA of target gene in 42 MM patient was detected by real-time fluorescence quantitative polymerase chain reaction (RTQ-PCR), and 20 patients without hematological disease were enrolled as the healthy controls. Results The LEF-1 mRNA median level in previously diagnosed MM patients was significantly higher than that in the healthy controls [0.01068 (0.00017 - 0.14100) vs. 0.00101 (0.00009 - 0.002326)], and the difference was statistically significant (U = 91.00, P< 0.001); The LEF-1 mRNA median level in MM patients after chemotherapy was declined compared with the patients before chemotherapy [0.00011 (0.00001 - 0.01548) vs. 0.01068 (0.00017 -0.14100)], and the difference was statistically significant (U = 343.0, P< 0.001). The LEF-1 mRNA median level of MM patients after chemotherapy in progression of disease (PD) group was higher than that in the non-PD groups [0.08386 (0.00288 - 0.14100) vs. 0.003454 (0.000156 - 0.05660)], and the difference was statistically significant (U = 343.0, P< 0.001). The overall survival (OS) rate in the high LEF-1 expression group was shorter than that in the low LEF-1 expression group for MM patients in the initial diagnosis (47.6%vs. 65.5 %, χ2 = 3.931, P= 0.0414). Conclusion LEF-1 may be involved in the occurrence and development of MM, which has a potential to become an indicator of evaluating the poor prognosis and PD of MM patients, and could be served as a novel therapy target for the treatment of MM.

Objective To quantitatively analyze the mRNA expression level of lymphoid enhance factor 1 (LEF-1) in bone marrow mononuclear cells of patients with acute myeloid leukemia (AML) at intermediate-risk after initial diagnosis and chemotherapy, and to analyze its clinical significance. Methods The real-time fluorescence quantitative polymerase chain reaction (RT-PCR) was used to measure the expression level of LEF-1 gene in AML patients at intermediate-risk after initial diagnosis and chemotherapy, and its relationship with effectiveness and survival were analyzed. Results The LEF-1 mRNA level in preliminarily diagnosed patients with AML was significantly higher than that in control arm [0.00519 (0.00015-0.09207) vs. 0.00101 (0.00009-0.00233)], and the difference was statistically significant (u=134.50, P<0.01). The LEF-1 mRNA level in patients after chemotherapy was significantly declines as compared to that in patients before chemotherapy [0.00107 (0.00008 - 0.00744) vs. 0.00519 (0.00015 - 0.09207)], and the difference was statistically significant (u= 317.00, P< 0.01) and LEF-1 mRNA expression level before chemotherapy in complete remission (CR) patients was significantly higher than that in non-CR patients [(0.01108 (0.00164 - 0.09207) vs. 0.00110 (0.00015 - 0.00916)], and the difference was statistically significant (u=19.00, P<0.01). High LEF-1 expression predicted a significantly better overall survival in AML patients with intermediate-risk cytogenetics (χ2= 4.549, P= 0.033). Conclusions LEF-1 may be involved in the development and progression of AML at intermediate-risk patients and is closely related to tumor burden and treatment efficacy. LEF-1 may be a good predictor of better prognosis and a novel target for therapeutic effect.

Objective To analyze the mRNA expression level of lymphoid enhance factor 1 (LEF-1), and to investigate its clinical significance in bone marrow mononuclear cells of patients with chronic myeloid leukemia chronic-phase (CML-CP) after initial diagnosis and chemotherapy, and to analyze its clinical significance. Methods The real-time fluorescence quantitative polymerase chain reaction was used to measure the expression level of LEF-1 gene in 38 CML-CP patients after initial diagnosis and chemotherapy and 20 persons without blood system diseases and neoplastic diseases as normal control. The difference of LEF-1 expression level between the patients and healthy control was compared, and the effect of imatinib on the main molecular response (MMR) was analyzed. Results The expression of LEF-1 mRNA in 38 newly diagnosed patients [0.00214 (0.00020 - 0.02120)] was significantly higher than that in normal controls [0.00101 (0.00009 - 0.00233)] (U= 163.0, P< 0.01). The expression of LEF-1 mRNA in MMR group [0.00107 (0.00010 - 0.00519)] was significantly lower than that in non-MMR group [0.01015 (0.00091 -0.03615)] (U= 25.0, P< 0.01). There was no significant difference in LEF-1 mRNA expression between the normal control group and the MMR group after imatinib treatment (U= 201.0, P> 0.05). The level of LEF-1 mRNA expression of non-MMR group was also higher than that of the normal control group (U= 14.0, P<0.01). The rate of acquiring MMR was significantly higher in high LEF-1 mRNA expression group [84.2 %(16/19)] than that in low expression group [47.4%(9/19)] (χ2=4.209, P<0.01). The time of acquiring MMR was significantly shorter in the high LEF-1 mRNA expression group [(10.0 ± 4.5) months] than that in the low expression group [(14.6 ± 3.8) months] (t= 2.705, P< 0.01). Conclusions LEF-1 may be involved in the occurrence and development of CML, and reflects the tumor burden. It may be one of the indicators to predict the efficacy of imatinib.

With the use of high pure HF and HNO3 reagents, and autoclaves made of high purity Rerfluoroalkoxy ( PFA ) material, a solution sample digestion technique effective for phosphate samples, subjected to high temperature fusion, was established. The whole procedure was concise, fast and of low blank value. Key factors such as the amount and ratios of the reagents, the digestion temperature and time, were systematically optimized, it was found that within 0. 5 h at 150 ℃, only 1. 7 mL of total reagent consumption could lead to a complete sample decomposition. Most importantly, the samples were not required to be ground to fine powder, which greatly reduced the risk of contamination. In addition, an effective liquid_liquid extraction procedure based on 5_nonylsalicylaldehyde oxime as the extractant was established for matrix separation and analyte preconcentration. Under the optimal extraction conditions of 5 mL of 15% extractant, 0. 5% HNO3 of extraction acidity and 20% HNO3 of back_extraction acidity, a matrix separation efficiency of over 99. 999% could be realized and a preconctration factor of 10 could be obtained, which resulted in complete elimination of the matrix_induced interference and great enhancement of the analytical sensitivity. After optimization of the operation parameters of ICP_MS, high signal to background detection of Cu in 20%HNO3 at 840 W of plasma power and low sample uptake rate were realized. The detection limits of 2. 5 ng/g, RSD of 3. 3% for six detections of parallel samples, and the recovery of 94. 3% for spike test were obtained, respectively. The method was finally applied to three real samples analysis, and the results agreed well with the data from laser adsorption loss experiment.

Objective To explore the clinical value of tumor marker squamous cell carcinoma antigen(SCCA) ,tissue polypeptide specific antigen(TPS) ,neuron‐specific enolase(NSE) ,cytokeratin fragment 19(CYFRA21‐1) detections in the patient with lung cancer .Methods 70 patient with newly diagnosed lung cancer(including 26 cases of squamous cell carcinoma ,23 cases of adenocar‐cinoma and 21 cases of small cell carcinoma) ,40 cases of lung benign diseases and contemporaneous 30 individuals undergoing the physical examination were randomly selected as the lung cancer group ,lung benign disease group and healthy control group respec‐tively .Serum tumor markers of SCCA ,TPS ,NSE and CYFERA21‐1 were detected in all cases .Then the detection results were per‐formed the statistical analysis .Results The levels of SCCA ,TPS ,NSE and CYFERA21‐1 in the lung cancer group were significant‐ly higher than those in the lung benign diseases group and healthy control group ,the differences were statistically significant (P<0 .05) .The expression levels of serum SCCA ,TPS ,NSE and CYFERA21‐1 were different in different histological types of lung cancer .SCCA and CYFERA21‐1 were highly expressed in squamous cell carcinoma ,which showed the statistical difference com‐pared with other two pathological types of lung cancer(P<0 .05);the expression level of NSE was highest in small cell lung cancer , which showed the statistical difference compared with other two pathological types of lung cancer(PP<0 .05);the TPS expression level had no statistical difference among different pathological types of lung cancer(P>0 .05) .The combination detection of SCCA , TPS ,NSE and CYFERA21‐1 greatly increased the sensitivity and accuracy for diagnosing lung cancer .Conclusion The combina‐tion detection of SCCA ,TPS ,NSE and CYFERA21‐1 has very high clinical value for the diagnosis ,pathological typing and assisted clinical therapy of lung cancer .

Objective To study the effect of traditional Chinese medicine ointment ironing in alleviating the local reaction caused by intravenous infusion of 20%and sum up nursing experience. Methods Fifty eight patients of acute lumbar disc patients with intravenous infusion of 20% mannitol were randomly divided into the observation group and the control group according to the simple random method with 29 cases in each group. In the course of intravenous infusion of 20%mannitol, local hot dressing was done in the observation group using traditional Chinese medicine ointment ironing properly along the direction of the blood vessel from the 2 cm puncture needle until 30 min after intravenous infusion of mannitol was finished. The control group use the concentration of 330 g/L (33%) magnesium for hot and wet dressing until 30 min after intravenous infusion of mannitol was finished. The two groups were compared in terms of pain degree and the level of phlebitis. Result The pain degree and phlebitis level in the observation group were significantly lower than those in the control group (all P<0.01). Conclusion The traditional Chinese medicine ointment ironing can effectively alleviate local pain and reduce the severity of phlebitis caused by intravenous infusion of 20%mannitol , with curative effect better than that of magnesium sulfate.

Objective To quantitatively analyze the mRNA and protein expression level of a proliferation-inducing ligand (APRIL) and investigate its clinical significance in peripheral blood mononuclear cells and plasma from newly diagnosed patients with B-cell chronic lymphocytic leukemia (B-CLL).Methods The mRNA of the target gene in 32 B-CLL patients and 15 health controls was quantified with real-time fluorescence quantitative polymerase chain reaction (RFQ-PCR) and protein by enzyme-linked immunosorbent assay (ELISA).Results APRIL mRNA was assayed with RFQ-PCR,the intra-and inter-batch reproducibility showed the coefficient of variation (CV) were 1.69 ％-6.98 ％ and 6.49 ％-10.27 ％,respectively.The expressions of APRIL mRNA and protein in patients with B-CLL were significantly higher than those in control (P ＜ 0.05),and significant difference was noted among the comparable stages in the arms (P ＜ 0.05).The expression of APRIL mRNA and protein in TDI (treatment-demand-indicator) arm was significantly higher than those in non-TDI arm (P ＜ 0.05).Conclusions APRIL may be involved in the formation and development of B-CLL and be an influence factor for disease staging.Thus,APRIL may be a prognostic indicator as well as the therapy target for the disease.

Objective To study the effect of GTD time management on the efficiency of postnatal home visits, and discuss the effective methods to improve the efficiency of community healthcare works . Methods Home visits were implemented among puerperas in a certain community of Dongguan in 2012 , and GTD time management was introduced since July 2012.The time of postnatal home visit and puerperas ’ satisfaction were compared before and after intervention .Results After the introduction of GTD time management , the time of postnatal home visits was shortened .The time of home visit for puerperas after caesarean section declined from (35.15 ±11.74) min to (31.67 ±10.35) min, with statistically significant difference (t=2.688,P<0.01).Puerperas’ satisfaction improved from 93.63%to 98.14%, with statistically significant difference (χ2 =12.771,P <0.01).Conclusions GTD time management can assist community nurses in grasping focuses , simplifying processes , arranging working hours reasonably and improving the work efficiency of home visits and the satisfaction of puerperas .