Utility of real-time 3D visualization system in the early stage of phacoemulsification training.

AIM: To determine the teaching effects of a real-time three dimensional (3D) visualization system in the operating room for early-stage phacoemulsification training. METHODS: A total of 10 ophthalmology residents of the first-year postgraduate were included. All the residents were novices to cataract surgery. Real-time cataract surgical observations were performed using a custom-built 3D visualization system. The training lasted 4wk (32h) in all. A modified International Council of Ophthalmology's Ophthalmology Surgical Competency Assessment Rubric (ICO-OSCAR) containing 4 specific steps of cataract surgery was applied. The self-assessment (self) and expert-assessment (expert) were performed through the microsurgical attempts in the wet lab for each participant. RESULTS: Compared with pre-training assessments (self 3.2±0.8, expert 2.5±0.6), the overall mean scores of post-training (self 5.2±0.4, expert 4.7±0.6) were significantly improved after real-time observation training of 3D visualization system (P<0.05). Scores of 4 surgical items were significantly improved both self and expert assessment after training (P<0.05). CONCLUSION: The 3D observation training provides novice ophthalmic residents with a better understanding of intraocular microsurgical techniques. It is a useful tool to improve teaching efficiency of surgical education.

Aggregation-caused dual-signal response of gold nanoclusters for ratiometric optical detection of cysteine.

Designing ratiometric sensors for cysteine (Cys) monitoring with high accuracy is of great significance for disease diagnosis and biomedical studies. The current ratiometric methods mainly rely on multiplex probes, which not only complicates the operation but also increases the cost, making it difficult for quantitative Cys detection in resource-limited areas. Herein, one-pot prepared gold nanoclusters (Au NCs) that glow red fluorescent were synthesized by employing glutathione as the stabilizer and reducing agent. When Fe3+ is present with Au NCs, the fluorescence is quenched and the scattering is strong because of the aggregation of Au NCs. With introduction of Cys, Cys can efficiently compete with glutathione-modified Au NCs for Fe3+, which leads to increase of fluorescence and decrease of scattering. The ratiometric determination of Cys can be thereby realized by collecting the fluorescence and SRS spectrum simultaneously. The linear range for Cys was 5-30 µM with a detection limit of 1.5 µM. In addition, the sensing system exhibits good selectivity for Cys and shows potential application in biological samples.

[Application status and thinking of acupuncture and moxibustion therapy for assisted reproductive field in the United States].

The application status of acupuncture and moxibustion therapy for assisted reproductive field in the United States was analyzed, and the existing problems and future development directions were discussed. According to the survey on the 456 websites of assisted reproductive clinic in the United States mentioned in the report of U.S. Centers for Disease Control and Prevention (CDC), 111 clinics among 456 assisted reproductive clinics recommend and used acupuncture and moxibustion therapy, accounting for 24.3%. Acupuncture and moxibustion therapy had obvious effect, good safety and low cost, and the assisted reproductive institutions in the United States had a high degree of application and recognition to acupuncture and moxibustion therapy. However, some problems, such as immature treatment scheme, unclear mechanism and imperfect insurance policies, still existed. In the future, the advantages of Chinese traditional acupuncture and moxibustion should combine with international modern assisted reproductive technology, and multi-center and large-sample clinical randomized controlled trials and basic experimental research on the mechanism of acupuncture and moxibustion for assisted reproduction should be carried out.

[Application of Tiaojing Cuyun acupuncture in treatment of diseases with ovarian function decline].

Taking regulating the thoroughfare vessel and the conception vessel, tonifying liver and kidney, calming mind as the treatment principle, Tiaojing Cuyun acupuncture (acupuncture for regulating menstruation and promoting pregnancy) is commonly used in clinical treatment of diseases with ovarian function decline, and recommends full cycle acupuncture treatment. Clinical research shows that Tiaojing Cuyun acupuncture can improve menstruation and ovulation, increase the reserve function and response of ovary as well as endometrial receptivity, so as to improve the pregnancy outcome. It can also improve the related symptoms caused by negative emotions and low estrogen, and comprehensively enhance the health related quality of life in patients. The mechanism of Tiaojing Cuyun acupuncture mainly involves 2 aspects, i.e. overall regulation on hypothalamus-pituitary-ovary (HPO) axis and the local regulation on FSH/cAMP signal transduction in ovarian granulosa cells.

Novel glutamic acid derivatives from the bulbs of Fritillaria verticillate Willd and their antitumor activities.

Four previously undescribed glutamic acid derivatives, verticillamines A-D (1-4), together with six known compounds (5-10) were isolated from the bulbs of Fritillaria verticillate Willd. The structures of (1-10) were established on the basis of UV, IR, MS, 1D and 2D NMR, and the absolute configurations of compounds (1-4) were determined by calculated ECD methods. Among them, compounds (1-3) were rare 2-methyl-γ-lactam alkaloid derivatives. Moreover, both γ-lactam alkaloids (1-5) and pyrrolidine alkaloids (6-7) were discovered in Fritillaria for the first time. Compound 8 exhibited moderate cytotoxic activities against A2780 and HepG 2 cells, with IC50 values of 11.7 ± 5.2 µM and 25.6 ± 2.8 µM.

The acts of opening and closing the eyes are of importance for congenital blindness: Evidence from resting-state fMRI.

Volitional eye closure is observed only in conscious and awake humans, and is rare in animals. It is believed that eye closure can focus one's attention inward and facilitate activities such as meditation and mental imagery. Congenital blind individuals are also required to close their eyes for these activities. Resting-state functional magnetic resonance imaging (RS-fMRI) studies have found robust differences between the eyes-closed (EC) and eyes-open (EO) conditions in some brain regions in the sighted. This study analyzed data from 21 congenital blind individuals and 21 sighted controls by using amplitude of low-frequency fluctuation (ALFF) of RS-fMRI. The blind group and the sighted group shared similar pattern of differences between the EC and EO condition: ALFF was higher in the EC condition than the EO condition in the bilateral primary sensorimotor cortex, bilateral supplementary motor area, and inferior occipital cortex, while ALFF was lower in the EC condition than the EO condition in the medial prefrontal cortex, highlighting the "nature" effect on the difference between the EC and EO conditions. The results of other matrices such as fractional ALFF (fALFF) and regional homogeneity (ReHo) showed similar patterns to that of ALFF. Moreover, no significant difference was observed between the EC-EO pattern of the two subgroups of congenital blind (i.e., with and without light perception), suggesting that the EC-EO difference is irrespective of residual light perception which reinforced the "nature" effect. We also found between-group differences, i.e., more probably "nurture effect", in the posterior insula and fusiform. Our results suggest that the acts of closing and opening the eyes are of importance for the congenital blind, and that these actions and their differences might be inherent in the nature of humans.

Xanthones and anthraquinones from the soil fungus Penicillium sp. DWS10-P-6.

Two new xanthones, oxisterigmatocystins J and K (1-2), and two new anthraquinones, versicolorins D and E (3-4), were isolated from solid cultures of the fungus Penicillium sp. DWS10-P-6, together with twelve known compounds (5-16). Their structures, including their absolute configurations, were characterized on the basis of extensive 1D NMR, 2D NMR, MS and CD spectral data. The cytotoxic activities of compounds 1-12 against HL-60, MDA-MB-231 and PC-3 cells were also evaluated. Compounds 4 and 5 showed significant cytotoxic activity against the HL-60 cell line with IC50 values of 1.65 µM and 1.05 µM, respectively.

[Status of acupuncture service quality control].

In order to guarantee and improve the quality of acupuncture service, the developments of the control of acupuncture service quality in the World Health Organization (WHO) and various countries were summarized. A number of normative documents that could improve acupuncture service security and effectiveness have been developed in WHO and many countries, in which, acupuncture training, safety manipulation and the guidelines for clinical practice of disease have been included. There are great differences in the qualification authentication and management of acupuncture practitioners among different countries. In China and South Korea, the official government departments are in charge of the management, but, in most of the countries, the qualification attestation examination of acupuncture is conduced mainly by the national/local industry organizations authorized by the state and operated by the commissioned experts. The medical service quality evaluation system is complicated. Because of the specific characteristics of acupuncture discipline itself, it is necessary to develop the service quality assessment system and the standard which is especially adaptable in acupuncture discipline.

Inter-hemispheric Intrinsic Connectivity as a Neuromarker for the Diagnosis of Boys with Tourette Syndrome.

Tourette syndrome (TS) is associated with gross morphological changes in the corpus callosum, suggesting deficits in inter-hemispheric coordination. The present study sought to identify changes in inter-hemispheric functional and anatomical connectivity in boys with "pure" TS as well as their potential value for clinical diagnosis. TS boys without comorbidity (pure TS, n = 24) were selected from a large dataset and compared to age- and education-matched controls (n = 32). Intrinsic functional connectivity (iFC) between bilateral homotopic voxels was computed and compared between groups. Abnormal iFC was found in the bilateral prefronto-striatum-midbrain networks as well as bilateral sensorimotor and temporal cortices. The iFC between the bilateral anterior cingulate cortex (ACC) was negatively correlated with symptom severity. Anatomical connectivity strengths between functionally abnormal regions were estimated by diffusion probabilistic tractography, but no significant between-group difference was found. To test the clinical applicability of these neuroimaging findings, multivariate pattern analysis was used to develop a classification model in half of the total sample. The classification model exhibited excellent classification power for discriminating TS patients from controls in the other half samples. In summary, our findings emphasize the role of inter-hemispheric communication deficits in the pathophysiology of TS and suggest that iFC is a potential quantitative neuromarker for clinical diagnosis.

Globus Pallidus Interna in Tourette Syndrome: Decreased Local Activity and Disrupted Functional Connectivity.

Globus pallidus interna (GPi) is an effective deep brain stimulation site for the treatment of Tourette syndrome (TS), and plays a crucial role in the pathophysiology of TS. To investigate the functional network feature of GPi in TS patients, we retrospectively studied 24 boys with 'pure' TS and 32 age-/education-matched healthy boys by resting state functional magnetic resonance images. Amplitude of low-frequency fluctuation (ALFF) and functional connectivity were used to estimate the local activity in GPi and its functional coordinate with the whole brain regions, respectively. We found decreased ALFF in patients' bilateral GPi, which was also negatively correlated with clinical symptoms. Functional connectivity analysis indicated abnormal regions within motor and motor-control networks in patients (inferior part of sensorimotor area, cerebellum, prefrontal cortex, cingulate gyrus, caudate nucleus, and brain stem). Transcranial magnetic stimulation sites defined by previous studies ("hand knob" area, premotor area, and supplementary motor area) did not show significantly different functional connectivity with GPi between groups. In summary, this study characterized the disrupted functional network of GPi and provided potential regions-of-interest for further basic and clinical studies on TS.