Many studies have shown that high myopia is strongly hnked with glaucoma.Besides,due to its own characteristics of longer axial length,deeper anterior chamber depth and wider chamber angle width,high myopia is often more likely to develop a complication of primary open-angle glaucoma.However,the early fundus changes induced by glaucoma might be concealed by the fundus changes induced by high degree myopia because the latter itself could also induce a series of fundus changes.As a consequence,a deep understanding of the clinical features and diagnosis of high myopia with primary open-angle glaucoma is particularly essential in making early diagnosis as well as reducing missed diagnosis and misdiagnosis.This article summarizes the clinical features of high myopia with primary open-angle glaucoma to enhance understanding of such diseases and provide a basis for the early diagnosis of the diseases.

Objective To analyze the risk factors of malignant glaucoma for primary angle-closure glaucoma(PACG) patients after surgery.Methods Clinical data of elderly patients with PACG who had received surgical treatment at our hospital between 2013 and 2016 were retrospectively analyzed.Patients were divided into two groups according to whether they suffered (Group A) or not (Group B) from malignant glaucoma after surgery.Results A total of 238 patients (315 eyes) were retrospectively analyzed: 17 cases (22 eyes) in Group A and 221 cases (293 eyes)in Group B.The index of axial length, chamber depth and crystal thickness was lower in Group A than in Group B,and the difference was statistically significant(P<0.05).Univariate analysis showed that age under 50, continuous high intraocular pressure, axial length below 22 mm, chamber depth below 2 mm, crystal thickness below 4.5 mm, completely closed anterior chamber angle and chronic angle-closure type were the possible risk factors for malignant glaucoma after surgery (P<0.05).The logistic regression analysis showed that age under 50 and axial length below 22 mm were independent risk factors for malignant glaucoma for PACG patients after surgery.Conclusion PACG patients,especially those who are young or with short axial length,are more vulnerable to malignant glaucoma.

Objective To explore the effective nursing and long-term safety training mode, early intervention on safety awareness of junior nurses, regulate the safety behavior, ensure patient safety. Methods The ideas and methods of HSE management system (health, safety and environment trinity management system) were introduced, from training needs research, safety courses design, safety behavior training, training process management,safety knowledge clinical application and training quality control implementation of systematic management.From 2013 to 2014 low seniority nurses safety training for 2 years, including new hospital nurse per year.Taking the self contrast before and after experimental design, safety knowledge to master the situation, the nurse's satisfaction and quality of care and safety management before and after training were compared. Results The actual class qualified rate and safety knowledge awareness and the excellent and good rate of safety skills assessment after training were 80.10%(157/196), 92.34%(181/196),96.43%(189/196), which were higher than those of 65.30%(128/196), 81.63%(160/196), 88.78%(174/196) before training, and the differences were statistically significant, χ2=10.81,9.94,7.07,P<0.01. The overall satisfaction of the nurses for safety training was 92.35%(181/196)after training, which was higher than that of 80.61%(158/196)before training, the difference was statistically significant, χ2=16.37, P < 0.01.The qualified rate of nursing quality for the critically ill patients after training was 90.13%(210/233), which was higher than that of 81.48%(176/216) before training, the difference was statistically significant, χ2= 6.94, P < 0.01. The patient safety and quality, the quality of nursing records were 95.81%(206/215), 95.29%(688/722) after training, respectively, which were higher than those of 89.60%(181/202), 85.10%(577/678) before training, the differences were significant, χ2=5.98,4.17, P<0.05. Conclusions Improved safety training is normative, practicability and maneuverability, safety behavior norms, improve the risk identification and emergency handling ability, reduce nursing risk, close to the clinical need for safety management, safety training for nurses to provide the basis for sustainable development.

Objective To observe the clinical features of retinal arterial occlusion (RAO) in youth.Methods This is a retrospective case review.Nine patients (9 eyes) with RAO were enrolled in this study.There were 6 males (6 eyes) and 3 females (3 eyes).The average age was (14.22± 3.93) years.The best-corrected visual acuity (BCVA),indirect ophthalmoscopy,fundus color photography and fundus fluorescein angiography were performed.All patients underwent systemic evaluation including blood routine,erythrocyte sedimentation rate,blood lipids,vasculitis screening,homocysteine level,antiphospholipid antibody,blood coagulation,neck vascular ultrasound,and cardiac color ultrasound and electrocardiogram examination.All patients received oxygen therapy,blood medications and symptomatic treatment.Meanwhile,the patients with autoimmune diseases were received systemic glucocorticoid therapy.The follow-up was ranged from 6 to 12 months.The visual acuity and fundus change before and after treatment were compared.Results among 9 patients,one patient had systemic lupus erythematosus,one patient had congenital heart disease,one patient had hypergammaglobulinemia,and carotid artery color ultrasonography showed that the internal carotid artery vessels faltered in 2 cases.The BCVA was 0.01-0.12.Among 9 eyes,there were 5 eyes (55.6％) with retinal branch artery occlusion (BRAO),2 eyes (22.2％) with central retinal artery occlusion (CRAO),2 eyes (22.2％) with ciliary retinal artery occlusion (CLAO).CRAO eyes showed positive RAPD (relative afferent pupillary defect),fine retinal artery and the corresponding vein,pale white retinal edema in posterior area and macular cherry-red spot.BRAO eyes manifested as inferior temporal artery occlusion and pale white retinal edema around them.CLAO eyes showed temporal ligulate grey-white retinal edema.At the last follow-up,BCVA improved and retinal vessels returned to normal in 7 eyes (77.8％);BCVA unchanged and no improvement in fundus in 2 eyes (22.2％).Conclusion Adolescent RAO is mostly partial occlusion,the prognosis is generally good after early active treatment.