The definition of visual impairment, the current status of visual impairment in the elderly, influencing factors related with visual impairment and management control modes are reviewed.There are three international standards of visual impairment including the WHO standard in 1972, the United States standard, and the WHO standard in 2003. The domestic standard is consistent with the WHO standard in 1972. Currently, with the global aging, the international and the Chinese situations of visual impairment are severe,and it is urgent to reduce the incidence of visual impairment. The visual impairment of the elderly is affected by various factors. A variety of management and control modes of visual impairment for the elderly have begun to bear fruit. The aim of the review is to provide the basis to screen for high-risk groups of visual impairment and provide timely intervention to reduce the prevalence of visual impairment in the older population.

Through surveying the hospital′s operation situation and management process of the simple clinic , and outpatient quantity in January to March 2016, we discussed and analyzed the problem of the simple clinic when working , then promoted service process reengineering , so as to the hospital′s simple clinic come into being scientific , reasonable , system management model .

Objective To discuss the clinical significance of serum pyridinoline cross-linked carboxy-terminal telopeptide of typeⅠcollagen in patients with rheumatoid arthritis (RA). Methods Serum ⅠCTP was measured by ELISA and RF, CRP by immunonephelometry assay in 55 patients with active and 25 with stable RA as well as 52 age and sex-matched normal controls. Results SerumⅠCTP was positively correlated with RF and CRP (rs=0.407, 0.534, P0.05). The sensitivity, specificity and accuracy of serumⅠCTP test were 67.3%, 84.6%, 75.7% in serum of the patients with active RA respectively. The mean serumⅠCTP in normal controls was (3.5?2.0) ?g/L. The serumⅠCTP was more sensitive than CRP in the patients with active RA. Conclusion SerumⅠCTP in patients of RA is a reliable assistant marker for early diagnosis, monitoring of the course and the effectiveness of treatment.

Objective To study effects of classical intrafascial supracervical hysterectomy(CISH) on immune functions.Methods A total of 60 women with benign gynecopathy requiring a hysterectomy were randomly divided into two groups with 30 patients in each group,receiving either CISH or abdominal hysterectomy(AH).The white blood cell(WBC) count and neutrophil granulocyte percentage before and 1 day after the surgery,and peripheral T-lymphocyte subgroup(CD_3,CD_4,and CD_8),(interleukin-2)(IL-2),and interleukin-10(IL-10) 1 day before and 1 and 4 days after the surgery were measured,respectively. Results Postoperative levels of CD_3 and CD_4 in both groups decreased significantly at 1 day after operation(CISH Group: q_(CD3)=6.033,(q_CD4=4.763);AH Group: q_(CD3)=11.043,q_(CD4)=9.202;P0.05),and were significantly higher(q_(CD3)=6.531,q_(CD4)=5.269,P0.05) in the CISH Group.The IL-2 levels were significantly lower at 1 and 4 days after operation than before the operation in the AH Group((q_(1-2)=11.187),q_(1-3)=5.404,P

Objective To investigate the effect of acute exhausted exercise in high temperature environment on the expression of myocardial HSP70 and plasma ANP level of in rats. Methods Forty eight male Sprague-Dawley rats was randomly and equally assigned to the following six groups:control group(C),exercise group(E),one-hour heat exposure group (H), heat exposure and exercise group (HE), exercise and 24 hours after exercise group(E'),heat exposure and 24 hours after exercise(HE'). Each group consisted of 8 rats. Rats in E,HE,E' and HE' ran on a treadmill until exhaustion, while rats in H and H' were exposed in a high temperature environment (33℃ ,50%RH) for one hour. Rats in C,E,HE and H were killed immediately after exercise or heat exposure. Rats in HE' and E' were killed 24 hours after exercise. Samples from myocardium and serum were collected for determining HSP70,ANP and CK-MB. Results(1) HSP70 levels in groups E and E' are significantly higher than that in group C(P<0.05 and P<0.01,respectively),and the level in group HE' is significantly higher than that in groups H and E'(P<0.01 );The HSP70 level in group H is significantly higher than that in group C. (2) The ANP and CK-MB levels in group E are Significantly higher than that in group C.and in group HE is higher than in group H (P<0.05);The HSP70 levels in group E' and HE' significantly decrease comparing to that in groups E and HE (P<0.01). Conclusions(1)Both heat exposure and exercise can induce the increased expression of myocardial HSP70 in rats and the peak expression is seen 24 hours after exercise. The increased expression of HSP70 may have protective effects on the heat-induced myocardial injury. (2) The increased ANP levels in plasma immediately after exhausted exercise improves the blood circulation in myocardium and hints the potential possibility of myocardial damage. However,the high temperature environment does not strengthen the increase of plasma ANP level that caused by exhaustive exercise.

Objective To investigate the effect of antisense inhibitor of telomerase on growth of tumor cells.Methods:Phosphorothioate antisense oligonucleotides (PS-ASON) with sequence TAGGGTTAGACAA which can recognize the RNA template region of telomerase and PS-random primer with 13-nucleotides were incubated with RCZ cell line derived from renal cell carcinoma (RCC).The number of cells was counted from 1 to 43 days,doubling time was calculated and inhibiting rate was determined by MTT method.Results ASON group reduced the number of cells (P<0.01), lengthened doubling time (P<0.005),and elevated the inhibiting rate (P<0.01) compared with random primer control and empty control.The efficacy depended on the dose of ASON (P<0.05) and it was of sequence-selective specificity.Conclusion The ASON targeted to the RNA template has an inhibition effect on the growth of RCZ cell and may have potential significance in tumor therapy.

Objective To observe the clinical effects of hyperbaric oxygen combined large dose ganglioside on delayed encephalopathy after acute carbon monoxide poisoning(DEACMP).Methods A totol of 72 patients of DEACMP were randomly divided into the observation group(37)and the control group(35).The patients of control group were given the routine treatment with hyperbaric oxygen.In the treatment group patients were given large doses of gangliosides 100 mg,1 times a day,for a period of 20 to 30 days additionally to the routine treatment of hyperbaric oxygen.All patients were examined before and after treatment in EEG examination (EEG),mini-mental state examination(MMSE).Results The abnormal rate of EEG was 37.83％(14/37) in the control group,which was significantly lower than that of 65.71％(23/35) in the treatment group((x2 =5.60,P ＜ 0.05).In the treatment group,the MMSE was(15.45±2.93) and(23.70±2.13) before and after treatment,respectively; in the control group,the MMSE was(14.88±2.84) and(20.33±2.09) before and after treatment.The MMSE was significantly impoved after treatment in both group(t =3.18 and 2.91,Ps ＜0.05).Furthermore,the MMSE impoved more significantly in the treatment group compared to the control group (t =6.28,P ＜ 0.05).The effective rate of treatment group was 86.48％(32/37),which was significantly higher than that of 51.43％(20/35) in the control group(x2 =7.72,P ＜ 0.01).Conclusion Application of large dose ganglioside treatment had significant clinical effects in delayed encephalopathy after acute car-bon monoxide poisoning,which is better than the effect of routine hyperbaric oxygen treatment.

Objective To identify an suspected Vibrio cholerae isolated from Xiangyang Central Hospital and characterize the strain in terms of antibiotic resistance and relevant virulence genes.Methods Pathogen identification and susceptibility testing were completed with MicroScan WalkAway 40 Automated Microbiology System.Slide agglutination was used for serotyping. PCR and sequencing technology were employed for 16s RNA gene analysis.PCR technique was used to detect six major viru-lence genes.Results This suspectedVibrio cholerae isolate was confirmed as non-O1 and non-O139 Vibrio cholerae .Suscep-tibility testing results indicated that the strain was sensitive to ampicillin,chloramphenicol,trimethoprim-sulfamethoxazole, and tetracycline.16s RNA gene sequence analysis showed 100% homologous with the registered sequence in National Center for Biotechnology Information database.Virulence genes rtxC and toxR were identified.The other virulence genes such as tcpAET,ctxA,hlyA,and tcpACL were negative.Conclusions This suspected Vibrio cholerae isolate is confirmed as non-O1 and non-O139 Vibrio cholerae .The pathogenic factors may be related to the virulence genes rtxC and toxR.

Based on the hospital information systems and the hospital network,a software for patients with peripherally inserted central catheter (PICC) was developed and applied in clinical practice,which achieved the share of PICC information within the hospital,saved nursing time effectively,made the clinical data more standardized,systematical and objective.

Objective To compare the difference of ultrasound-guided anterior sciatic nerve block by multiple injection and single injection.Methods Among 90 patients undergoing lower limb operation,aged 18-68 years old,47 patients were males and 43 patients were females,all falling into ASA Ⅰ-Ⅲ.The patients were randomized to ultrasound-guided anterior sciatic nerve block by multiple injection (group M,n=45) single injection (group S,n=45).Local anesthetic of 0.5% ropivacaine hydrochloride 20 ml was used.The width,thickness and depth of sciatic nerve and blocking performance time were recorded.Sensory and motor blockade on the operated limb were evaluated every 10 minutes after injection of local anesthetic for 30 minutes and complications were observed in two groups.Results The width,thinkness and depth of sciatic nerve on the ultrasound screen were not statistically significant in the two groups.The performance time of group M was longer than that of group S (P<0.05).The proportion of patients with sensory blockade of each nerve significantly differed between the two groups: for superficial peroneal nerve at 10,20,and 30 minutes,for the sural nerve at 20,30 minutes,for the tibial nerve at 30 minutes,that of group M was higher than that of group S (P<0.05).A significantly greater rate of motor blockade was observed for the dorsal flexion of foot and toes extension in group M than that of group S at 30 minutes (P<0.05).The complications of nausea,vomitting and tinnitus were not different in two groups.Conclusion Multiple injection needs more operation time compared with single injection,but its onset time of sensory and motor blockade is quicker,the complications were not different.