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 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 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 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.

0.1%EDTA≈5% HP ? CD≈1%lecithin. Conclusion: The three methods have good correlation.

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.

Objective To investigate the situation of admission nursing evaluation on elderly patients of geriatrics departments in several Shanghai comprehensive hospitals, and the results will be the base for designing elderly patient′s comprehensive admission nursing evaluation form. Methods 41 nurse managers of geriatrics department in Shanghai comprehensive hospitals were selected as research object. Self-designed questionnaire included general data, elderly patient admission nursing evaluation content and the importance of each item. Results The effective recovery rate was 97.56%(40/41). 98%(39/40) hospitals considered that elderly patients need to have a comprehensive assessment according to the elderly characteristics, only 18%(7/40) hospitals used the special nursing evaluation form for elderly patients. The score of importance of five dimensions were as follows: geriatric syndromes or problems scored (4.64 ± 0.38), physical function assessment scored (4.60 ± 0.46), physiological function assessment scored (4.53 ± 0.45), mental and psychological assessment scored (4.10 ± 0.57) and social assessment scored (4.07±0.52). The score of importance of 29 items were as follows:fall assessment scored (4.90±0.30), pressure ulcer assessment scored (4.85 ± 0.36), activities of daily living scored (4.75 ± 0.44), urinary incontinence assessment scored (4.70 ± 0.52), pain assessment scored (4.70 ± 0.46). Conclusions It is of great significance to carry on the comprehensive admission nursing evaluation for the elderly patients, which needs to be valued and strengthened.

New registry classifications of chemical drugs redefined the concepts of new drugs and generic drugs. New drugs emphasize the international innovation including innovate new drugs and modified new drugs. Modified new drugs are improvement of drugs already on the market to achieve superior efficacy. With the advantages of high success rate,high return,low risk and long life cycle,modified new drugs have become the mainstream of new drugs research and development in the world. Modified new drugs R&D in China should be based on clinical demand and focused on the differentiation research in order to obtain new preparations with signif-icant clinical advantages to better serve the clinical practise. This paper states the concept and characteristics of modified new drugs in China,makes case analysis and shares the development history of blockbuster modified new drugs in the world,clarifies the opportuni-ties and challenges and provides ideas for the future development of modified new drugs in China.

Objective To investigate the possible protective effect of Shenqingyin Decoction on the kidney of experimental diabetic rats and its possible mechanism. Methods Totally 40 rats with diabetes induced by streptozocin were divided into 4 groups: diabetes model group, Shenqingyin group, Benopril group and Shenqingyin-Benopril combination group. After 8 weeks' treatment, blood glucose, renal function and 24h urine protein were measured, and malondialdehyde (MDA) in renal tissues and urine, superoxide diamutase (SOD) activity and serum transformed growth factor-β_1(TGF-β_1) were tested; renal pathological changes were observed with light microscope as well. Results The serum BUN, Scre of all medicine groups were significantly improved, which did not significantly differ from that in control group (P>0.05). However, it had no obvious improving effect on blood sugar. The content of 24h urine protein in all medicine groups was significantly lower than that in model group (P<0.05 or P<0.01), and Shenqingyin-Benopril combination group had the significantly lower level than the other two medicine groups (P<0.01). MDA in renal tissues and urine, SOD activity and serum TGF-β1 in all medicine groups significantly differed from those in the model group (P<0.05 or P<0.01), and Shenqingyin-Benopril combination group had obvious difference with the other two medicine groups (P<0.01). Light microscopy showed amelioration of different degree in renal pathological changes, but with no significant differences in all medicine groups. Conclusion Shenqingyin Decoction has a protective effect on the kidney of experimental diabetic rats, and it has some synergetic effect when combined with Benopril. The mechanism may be related to inhibiting oxidative stress, improving the body's antioxidant ability and decreasing the expression of inflammatory factor TGF-β_1.