With the improvement of clinical and scientific research level of pediatric retinal diseases in China,teaching in pediatric retinal diseases for medical students and residents has become increasingly important.Because infants cannot cooperate in ophthalmic examinations,this part becomes a difficult point in clinical teaching and practice.By using the RetCam,a wide-field retinal imaging system,infant's retinal images can display in real time on screen and images and videos can be recorded and reviewed after examination finished.By setting up teaching target reasonably,arranging teaching contents scientifically,and using teaching method properly,we applied multimedia-assisted instruction in teaching pediatric retinal diseases based on RetCam and enhanced teaching effect.

Animals ; Dose-Response Relationship, Drug ; Female ; Humans ; Metals, Heavy ; analysis ; pharmacology ; Placenta ; chemistry ; drug effects ; physiology ; Pregnancy ; Rats

Adolescent ; Adult ; Disease-Free Survival ; Female ; Graft vs Host Disease ; etiology ; prevention & control ; Hematologic Neoplasms ; therapy ; Hematopoietic Stem Cell Transplantation ; adverse effects ; Humans ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive ; therapy ; Leukemia, Myeloid, Acute ; therapy ; Lymphocyte Transfusion ; Lymphoma, Non-Hodgkin ; therapy ; Male ; Middle Aged ; Recurrence ; Survival Rate ; Transplantation, Homologous ; Young Adult

Objective:To determine the valproate concentration in plasma of epilepsy patients by HPLC, and compare with the re-sults of chemiluminescence microparticle immunoassay ( CMIA) to evaluate the consistency of the two methods. Methods:HPLC and CMIA was respectively applied to determine the plasma concentration of valproate in 230 epileptic patients. The correlation of the two methods was studied by Passing-Bablok regression and Bland-Altman method. Results:The regression equation of the determination re-sults of HPLC (Y) and CMIA (X) was Y=1. 069 7X+2. 338 2 (R2 =0. 969, n=230), which showed promising correlation. Bland-Altman analysis showed that the consistency of the two methods was poor, and the values of HPLC were higher. Conclusion: HPLC and CMIA used for the determination of valproate plasma concentration show good correlation. However, the consistency is poor and there is system error. In the clinical treatment, adjustment and choice should be paid more attention.

Objective To investigate the effects of subretinal fluid drainage combined with intravitreal anti-vascular endothelial growth factor (VEGF) drugs in the treatment of severe exudative retinal detachment Coats disease.Methods Thirteen patients (13 eyes) with 3B Coats' disease diagnosed at the Eye Center of Tongren Hospital were included in the study.The participants were aged from 1 year to 11 years with a mean age of (4.15 ± 2.99) years.The visual acuity was no light perception in 1 case,from light perception to counting finger in 7 cases,from 0.01 to 0.1 in 2 cases,and could not be measured due to young in 3 cases.Patients underwent retinal fluid drainage combined with intravitreal ranibizumab (IVR,0.5 mg,0.05 mL) at the pars plana of ciliary body,and with retinal laser photocoagulation or cryotherapy according to the retinal peripheral vascular activity.During the follow-up,the visual acuity,intraocular pressure,slit lamp,indirect ophthalmoscope and color ophthalmoscope were examined and observed.The abnormal blood vessel change,absorption of subretinal fluid,retinal reattachment and complication were observed.Results Two subretinal fluid drainage were performed in 3 cases,one subretinal fluid drainage in 10 cases.Six cases were combined with two intravitreal injections,4 cases with three intravitral injection,3 cases with intravitreal injection for more than three times.Five cases were treated with simple photocoagulation,3 cases with simple retinal cryotherapy,and 5 cases with laser combined with cryotherapy.In 13 patients,the visual acuity was improved in 2 cases,unchanged in 8 cases,and could not be measured due to young in 3 cases.Eight cases had complete retinal reattachment.No significant postoperative complications occurred during follow-up,such as endophthalmitis,retinal hole and vitreous hemorrhage.Conclusion Subretinal fluid drainage combined with intravitreal injection is an effective method for severe 3B stage Coats disease.

Objective To analyze the clinical and radiographic features of short stature combined with skeletal deformity in children,and to diagnose exactly and cure promptly in children.Methods One hundred and twenty children were collected,included 69 males and 51 females.All of the children were collected detail medical history including history of birth,feeding,growth and development and family history and taken both physical and X ray examination that bone age could be evaluate by Gruelich-Pyle method.The children were taken a laboratory examination including calcium,phosphours,alkaline phosphatase,chromosome karyotype,and so on.Results Among 120 children,there were 36 cases(30.0%) of achondroplasia,20 cases(17.0%)of Turner syndrome,10 cases(8.0%)of multiple epiphyseal dysplasia,1 case(0.8%)of spondyloepiphseal dysplasia congenital,7 cases(5.8%) of spondyloepiphyseal dysplasia tarda,2 cases(1.6%) of osteogenesis imperfecta,1 case(0.8%) of cleidocranial dysplasia,5 cases(4.2%)of mucopolysaccharide Ⅳ,5 cases(4.2%) of pseudoachondroplasia,9 cases(7.5%)of hypophosphatemic ricket,24 cases(20%)of short limb dwarf.Among 120 cases,27 were regularity dwarfism(22.5%),93 cases were irregularity dwarfism(77.5%);Among 93 cases of irregularity dwarfism,80 cases were short limb dwarfism including 36 cases of short upper limb(short upper arm 35 cases,shortforearm 1 case),20 cases of short lower limb,24 cases of proportional short stature,13 cases of short trunk.X ray bone age lag 46 cases,ahead of schedule 15 cases(12.5%),normal 59 cases.Conclusions The main causes of short stature combined with skeletal deformity are genetic bone disease.To analyze the feature of clinical and radiographic is a valuble instrument for the children diagnosis of short stature combined with skeletal deformity.Part of them skeletal age were lagged.

ObjectiveTo discuss the effect of neonatal behavioral neurological assessment (NBNA) and developmental screening test (DST) on newborns with hypoxic ischemic encephalopathy (HIE). MethodsNBNA was performed for 60 newborns with HIE within 12-14 days and DST was also performed at 6th month after birth.ResultsMild and severe degree HIE newborns with low NBNA scores had unfavorable prognosis. Conclusions NBNA and DST can provide evidence for early interference for newborn's HIE.

Background Posterior capsule opacification (PCO) is a main cause for visual acuity decline after modern extracapsular cataract surgery.Objective The aim of this study was to investigate the effect of rapamycin on PCO formation following phacoemulsification combined with intraocular lens (IOL) implantation in rabbit eyes.Methods Thirty New Zealand albino rabbits were randomized into three groups according to the difference in the implanted IOLs:conventional IOL without modification,IOL coated by a polymer material and IOL with sustained released rapamycin.Phacoemulsification combined with intraocular lens implantation surgery was performed in the left eye.The anterior ocular segment and PCO formation in the rabbit eyes were examined by slit lamp biomicroscope 1-7 days after operation,and the flare and inflammatory response of the anterior chamber as well as the degree of PCO severity were graded based on the criteria of Yang.The differences in examination outcomes were compared by the Kruskal-Wallis H test.The animals were sacrificed 12 days after surgery and eye specimens were prepared for histopathological examination to evaluate the biological behavior of lens epithelial cells (LECs) on the posterior capsule.Results The coated area of the implanted lens was semi-transparent with a smooth surface.The number of eyes with aqueous flare at grades 3 and 4 insignificantly increased but those with an inflammatory response at grades 3 and 4 significantly increased in the conventional IOL group and the polymer modified IOL group,compared with the rapamycin modified IOL group on the first day after operation (H =4.038,P =0.133 ; H =8.604,P =0.014).On the seventh day,the number of eyes with aqueous flare at grades 3 and 4 and inflammatory response at grades 3 and 4 significantly increased in the conventional IOL group and the polymer modified IOL group,compared with the rapamycin modified IOL group (H =8.891,P =0.012 ; H =7.664,P =0.0220).The histopathological examination showed that marked proliferation of LECs appeared between the anterior and posterior capsule in the conventional IOL group and the polymer modified IOL group;however,less LECs and regenerative cortex were seen in the rapamycin modified IOL group.Conclusions IOL loaded with rapamycin can inhibit the inflammatory response and alleviate the severity of PCO after phacoemulsification combined with IOL implantation.The implantation of IOL loaded with rapamycin may be a new approach to the prevention and treatment of PCO.

Objective To investigate clinical characteristics of refractory systemic juvenile idiopathic arthritis(JIA)and the efficiency of glucocorticoid in therapy on this kind of disease.Methods Thirty-nine children with systemic JIA were divided into low dose group 0.5-1.0 mg/(kg?d)and high dose group 1.0-1.5 mg/(kg?d).And the efficiency was observed by change of active index after 10 and 20 days.Results The effective power was 58.8% and 72.7% after 10 days,respectively.After 20 days,the power was 76.5% and 90.9%,respectively.The power in high dose group was significantly higher than that in low dose group.It had no difference in statistical analysis for efficiency of 2 kind of glucocorticoid dosage to control fever,but it had obvious difference to control arthralgia,arthrocele,erythrocyte sedimentation rate(ESR),C-reactive protein(CRP).Conclusion Glucocorticoid therapy is very effective to control the activity of disease in patients with systemic JIA.

OBJECTIVETo observe the clinical efficacy difference in treatment of functional dyspepsia (FD) between syndrome differentiation based acupuncture and ordinary acupuncture.

METHODSSeventy FD patients were assigned to a syndrome differentiation based acupuncture group (Group A) and an ordinary acupuncture group (Group B) by Excel Software randomization. Zhongwan (RN12 ), Tianshu (ST25), and Zusanli (ST36) were needled as main points for patients in Group A. Meanwhile, different combined acupoints were needled according to syndrome differentiation. Only the same main points were needled for patients in Group B. All patients were needled once per day, 30 min each time, 6 days as one treatment cycle, 2 treatment cycles in total. Fasting serum levels of gastrin (GAS) and motilin (MTL) were determined before treatment and after 2 treatment cycles. 36-item Short-form Heath Survey (SF-36) and Nepean Dyspepsia Index [NDI, including Nepean Dyspepsia Symptom Index (NDSI) and Nepean Dyspepsia Life Quality Index (NDLQI)] were assessed before treatment, after 2 treatment cycles, and one month after treatment.

RESULTSCompared with before treatment in the same group, serum levels of GAS and MLT increased in the two groups after 2 treatment cycles (P <0. 05), but changes were more obvious in Group A (P <0. 05). Compared with before treatment in the same group, SF-36 and NDLQI score increased, and NDSI score decreased in the two groups after 2 treatment cycles and 1 month after treatment (all P <0. 05). Compared with Group B, SF-36 and NDLQI score increased in Group A after 2 treatment cycles and 1 month after treatment (P <0. 05, P <0. 01). But NDSI score at 1 month after treatment was lower in Group A than in Group B (P <0.01).

CONCLUSIONSyndrome differentiation based acupuncture could evidently improve dyspeptic symptoms of FD patients, and significantly improve their quality of life with remarkable curative effect.

Acupuncture Points ; Acupuncture Therapy ; Dyspepsia ; therapy ; Humans ; Motilin ; Needles ; Quality of Life ; Surveys and Questionnaires ; Syndrome