Proliferative diabetic retinopathy (PDR) is one of the serious ocular complications of patients with diabetes mellitus and also the leading cause of blindness.Pars plana vitrectomy (PPV) is an effective treatment for severe vitreous hemorrhage and PDR.The intraocular concentration of vascular endothelial growth factor (VEGF) of patients with PDR usually increase abnormally,which promote growth of neovessels and make it early to leak and bleed.Numerous neovessels in vitreous cavity and retinal surface can lead to intraoperative bleeding and may affect the definition and precision of operation and prolong surgical time.If we conduct gas/fluid exchange regardless of severe active bleeding,proliferate membrane may reoccur at a high rate postoperatively due to the residual platelet and impair the success rate of surgery seriously.In addition,with the high activity of neovessels,anterior chamber,vitreous and retinal hemorrhage may appear as well as other postoperative complications like postoperative high intraocular pressure caused by inflammation or hemorrhage and traction retinal detachment because of reoccurrence of fibro membrane,which directly affect the postoperative visual function recovery and long-term prognosis.As wide clinical application of anti-VEGF agents in recent years,studies found that preoperative intravitreal injection of anti-VEGF drugs assisted PPV can limit the activity of neovessels and significantly reduce the incidence of intraoperative and postoperative bleeding,facilitate operation,shorten surgical time and improve the success rate of surgery.In this paper,the mechanism,effectiveness,clinical utility and safety of anti-VEGF therapy assisted vitrectomy for the treatment of PDR are reviewed.

Objective To investigate the efficacy of rabeprazole combined with mosapride in the treatment of reflux esophagitis. Methods A total of 92 patients with reflux esophagitis admitted from April 2016 to April 2017 in our hospital were divided into study group and routine group (n = 46). The routine group was treated with omeprazole and Mosapride,the study group was treated with rabeprazole and mosapride. The clinical efficacy and adverse reactions in the two groups were observed and compared. Results The total effective rate was 91.30％ in the study group and 76.09％ in the conventional group, the difference was statistically significant (P<0.05). The total effective rate of reflux symptoms, esophageal irritation and esophageal irritation was significantly higher in the study group than in the conventional group (P<0.05)The adverse reaction rate was 4.35％ in the study group and 6.52％ in the conventional group, the difference was not statistically significant (P<0.05). Conclusion In the course of clinical treatment of reflux esophagitis, attention should be paid to the two aspects of acid suppression and gastric motility. In the inhibition of acid, the effect of Bella is obviously higher than that of omeprazole. In gastric motility, mosapride in clinical effect is better. Reflux esophagitis by rabeprazole combined with mosapride treatment, clinical efficacy is significant, and adverse reaction rate is low, safe and reliable, worthy of clinical application.

With artificial intelligence,the authors designed an Expert System for the Differential Diagnosis and Treatment of Lumbago.ESSDTL shows that it not only helps doctors to diagnose the illness of lumbago but also helps young doctors and medical students to gain experience by running practical cases and explaining their procedures for diagnosing and treting the diseases through ESDDTLexplanation facilities.

Objective:To observe the changes of structure and function of pharyngeal muscle in SD rats with altitude hypoxia induced obstructive sleep apnea syndrome(OSAS),in an attempt to investigate the remodeling of pharyngeal space and the possible biomechanical mechanism of OSAS.Methods:Twenty-four SD rats(12 male and 12 female) were randomly assigned to 4 groups with 6 rats in each group.Rats in group A and B were male and those in group C and D were female.Rats in group A and C were placed in altitude chamber and treated with altitude hypoxia 6 h per day for 22 days.The pressure in the chamber was 53.9 kPa with an oxygen concentration of 10.0%-11.2%.Rats in group B and D,serving as controls,received no treatment.All rats were sacrificed on the 23~(rd)day.The open-angle and the inside diameter of rats′ pharyngeal-ring and the pathology of pharyngeal tissues were examined in all rats.Results: The open-angles of rats′ pharyngeal-ring of group A, B,C and D were(55?24)?,(15?8)?,(38?20)?,and(35?15)?,respectively;and the inside diameters of the pharyngeal-ring(cm) were(0.4?0.2,) 0.2?0.1,0.3?0.1,and 0.3?0.1,respectively.The open-angle and the inside diameter of rats′ pharyngeal-ring in group A were significantly higher(P

The breast cancer stem cells are a subpopulatiom of breast tumor cells that selectively possess tumor initiation and self-renewal capacity. Recent findings suggest that it may correlate with the failure treatment and relapse of breast cancer. The isolation of phenotypically distinct tumorigenic of breast cancers will find a way to elucidation of the pathways that account for their tumorigenic potential to cure the disease.

Acetyltransferases ; genetics ; Breast Neoplasms ; genetics ; Female ; GPI-Linked Proteins ; Gene Expression Regulation, Neoplastic ; genetics ; Humans ; Membrane Glycoproteins ; genetics ; Neoplasm Metastasis ; genetics ; physiopathology ; S100 Proteins ; genetics ; Transcription Factors ; genetics

Foreign Bodies ; surgery ; Head ; Humans ; Imaging, Three-Dimensional ; Jaw Fractures ; surgery ; Maxillofacial Injuries ; diagnostic imaging ; surgery ; Radiography, Dental, Digital ; Surgery, Computer-Assisted ; Tomography, X-Ray Computed

Objective Identifying the factors of psychological pressure from medical disputes on clinical doctors and possible solutions. Methods Self-rating Anxiety Scale (SAS) and the Occupational Stress Indicator (OSI) were called into play, to study 52 clinical doctors in a tertiary hospital in a city, who had encountered medical disputes in recent two years. In parallel, 63 clinical doctors without such disputes and 50 non-clinical workers were randomly selected as the control group for questionnaires. Results Clinical doctors with such an experience were commonly found to be anxious, and their SAS score (58. 27±11.38)averaged higher than those in the control group. Doctor-patient relationship, legal liabilities and clinical positions were found to be positively correlated to psychological pressure of clinical doctors. Conclusions Medical disputes tend to add to psychological pressure of the doctors. Clinical doctors deserve psychological counseling and training and improvement of their working conditions.

Objective　To analyse the sensitivity of fineneedle aspiration cytology (FNAC) of breast masses.Methods　A series of 1035 FNAC of breast masses was reviewed.502 cases acccepted operation for histopathologic diagnosis.Results　The sensitivity of FNAC for breast malignant tumor was 98.9% and the specificity was 85.7%.Conclusions　The FNAC of breast masses has high accuracy.

Objective To evaluate the effectiveness and advantage of the TruviewTM EVO2(R) optical laryngoscope in comparison with the commonly used laryngoscope for the endotracheal intubation in patients in the emergency setting. Method Thirty-six patients in need for emergency endotracheal intubation in our hospital from February to May 2009 were randomly assigned to give intubation by using a TruviewTM EVO2(R) optical laryngoscope (T group) or a commonly used laryngoscope(R group). Cormack and Lehane laryngoscope grade (the degree of exposure of glottis by using laryngoscope), IDS (Intubation Difficulty Scale) score, the time taken for successful intubation, lowest SpO2 and the complication during intubation were essential factors for comparison between two groups. Results Our data showed that there was no difference in duration of the successful endotracheal intubation attempts between these two groups (respectively 22.73 ± 7.66 s and 19.91 ± 8.03 s, P ＞ 0. 05). However, the glottis exposure condition was significantly improved with TruviewTM EVO2(R) optical laryngoscope (P ＜ 0.01). The average IDS score for patients in T group was 0.33 ± 0.49, which is much lower than those in the R group (4.11± 0.90, P ＜ 0.01). In addition, the average SpO2 value measured in T group during the intubation operation was significantly higher than that in R group (98.87±0.74% and 91.45 ±4.86% respectively, P ＜0.01) and there was less complication observed in patients of T group. Conclusions Using TruviewTM EVO2(R) optical laryngoscope for emergency endotracheal intubation could help to expose the glottis in an ideal view, predominately lower the C/L grade and thus decrease the difficulty in intubation for clinicians. Its specially designed oxygen supplier allows the SpO2 to be maintained at a high level during the operation as well as reduce the incidence of complication. It is therefore extremely useful for emergency tracheal intubation, particularly a difficulty intubation situation.