Vitrectomy combined with internal limiting membrane (ILM) peeling and vitreous tamponade is a conventional method for treating macular hole (MH),but the visual acuity and MH closure rate remains to be further improved.After removal of posterior vitreous cortex,the ILM is grasped with an ILM forceps and peeled off in a circular fashion for approximately 1 disc diameters around the MH.During the circumferential peeling,the ILM is not removed completely from the retina but is left attached to the edges of the MH.The ILM was then massaged gently over the MH from all sides until the ILM became inverted and then peel all other ILM within vascular arcades.Inverted ILM flap technique is one of the important improvement methods in MH vitrectomy,especially for MH with large diameter and unhealed MH after ILM peeling.Compared with conventional vitrectomy combined with ILM peeling,inverted ILM flap technique can enhance MH closure and improve visual acuity.Due to lack of large sample observation in clinical trials of inverted ILM flap technique,we still need more cases and longer follow-up of this technology to more accurately evaluate the effectiveness and safety of this technique.

Objective To study the clinical effect of treating mild and moderate hypertension in the elderly with flavored liuwei dihuang decoction.Methods From January 2016 to January 2017,120 cases of elderly patients of mild and moderate hypertension with the diagnosis and treatment in our hospital are divided into two groups, the control group was treated with nifedipine zyban, and the observation group was treated with flavored liuwei dihuang decoction;Record two groups of patients with various experiment data, make an analysis of the relevant data obtained and discuss the clinical effect of flavored liuwei dihuang decoction to treat the mild and moderate elderly hypertension.Results The clinical results of the treatment of observation group were better than that of the control group.The patients had fewer adverse reactions, and the differences between two groups were statistically significant (P< 0.05).Conclusion The treatment which using the flavored liuwei dihuang decoction in the mild and moderate elderly hypertension receives significant improvement in the clinical symptoms and little adverse reactions.It is worth using widely in clinical practice.

Objective To investigate the efficacy of intracytoplasmic sperm injection (ICSI) combined with percutaneous testicular sperm aspiration (PTSA)in the treatment of severe male infertility. Methods From October 1998 to December 2000, 162 couples were enrolled, and ICSI and PTSA were adopted. Ovarian stimulation was achieved by the short protocol. All metaphase Ⅱ (MⅡ) oocytes were selected for ICSI. Results 1 517 MⅡ oocytes were injected in 185 cycles, 990 fertilized (65.3%), and 152 embryo implanted. 54 couples achieved clinical pregnancy (35.5%). Conclusion PTSA combined with ICSI is a rapid, convenient, painless and effective approach for the treatment of severe male infertility.

To evaluate the clinical effect of therapeutic soft corneal contact lens in combination with fresh amniotic membrane transplantation in the treatment of pterygium and its clinical value.
●METHODS: This study was a retrospective analysis of 200 pterygium excision patients (200 cases, 220 eyes) in hospital from January 2010-June 2011. The patients were divided into two groups. Group 1 (100 cases, 110 eyes) were patients treated with fresh amniotic membrane transplantation and therapeutic soft corneal contact lens while group 2 ( control group, 100 cases, 110 eyes) did not use corneal contact lens. The clinical outcomes in these two groups were compared in a 6 - 18mo postoperative follow-up observation.
●RESULTS: ln control group using corneal contact lens the epithelium repair time ranged from 2 - 7d with an average time of 3. 8d; in group 1 the epithelial repair time ranged from 1 - 5d with an average time of 2. 5d. The patients were followed up for 6 - 18mo, 9 recurrent eyes were found in control group, the recurrence rate was 8. 2%; 5 recurrent eyes were found in experimental group the recurreat rate was 4. 5%. There were significant differences in the 2 groups comparing treatment outcomes (P< 0. 05). Early stimulative symptoms after surgery can be reduced by wearing contact lenses.
●CONCLUSlON:The therapeutic effect of fresh amniotic membrane transplantation after pterygium excision is enhanced by the therapeutic application of corneal contact lens. The epithelial repair time is shortened, the recurrence rate is reduced after pterygium excision and stimulative symptoms including photophobia, tearing, foreign body sensation and ophthalmodynia caused by corneal epithelial defect can be relieved.

Objective To evaluate the effect of noninvasive diagnosis methods direct rectal examination (DRE) ,transrectal ultra-sonography(TRUS) and multiparametric magnetic resonance imaging(MP-MRI) for prostate cancer detection .Methods The clini-cal data of 113 patients suspected prostatic cancer were analyzed retrospectively .Every patient was examined by TRUS ,DRE and MP-MRI before pathology or operation .The sensitivity rate and the specificity rate of DRE ,TRUS and MP-MRI were calculated and compared among the three methods .Results The sensitivity rate and the specificity rate of prostate cancer were 33 .3% and 88 .7% for DRE ,62 .7% and 67 .7% for TRUS ,86 .3% and 83 .9% for MP-MRI respectively ,two comparison between the three group had statisfically difference(P<0 .05) .But ,of prostate cancer with prostate specific antigen (PSA) 4 .0~10 .0 ng/mL in gray zone ,the sensitivity rate and the specificity rate were 27 .8% and 86 .5% for DRE ,44 .4% and 59 .5% for TRUS ,77 .8% and 81 .1% for MP-MRI ,two comparison between the three group had statisfically difference(P<0 .05) .Conclusion MP-MRI has bet-ter detection efficiency .It could obviously reduce the missed diagnosis rate on PCA with PSA in gray zone .

Objective To investigation the rule of TCM syndrome differentiation on vascular dementia,and to guide clinic therapy.Methods The vascular dementia TCM syndrome differentiation scale (SDSVD) was used for TCM syndrome differentiation of 60 cases of vascular dementia.Results The Vascular dementia has such TCM syndromes:deficiency of kidney-essence accounting for 28.3％,turbid phlegm blocking the clear orifices accounting for 23.3％,obstruction of collaterals by blood stasis accounting for 21.7％,liver Yang adverse rising accounting for 10.0％,fire-heat prosperous accounting for 8.3％,metabolic waste in viscera accounting for 8.3％.QI and blood paucity accounting for 3.3％.Conclusion The Vascular dementia has a clear TCM syndrome regularity,the syndromes of deficiency of kidney-essence accounting,turbid phlegm blocking the clear orifices,and obstruction of collaterals by blood stasis are the top three syndromes.

Objective To investigate the effect oflevecamitine on nutrition,microinflammation status in ma-intenance hemodialysis (MHD) patients. Methods Forty two MHD patients were selected, who had undergone he-modialysis for at least two months before the study. One gram of levoeamitine was injecfed to the patients at the end of each dialysis treatment for six months. The parameters of inflammation stress were studied. Results After treatment with levocarnitine for six months, the average levels of dry body weight decreased markedly. ( P<0.05 ), The aver-age serum levels of C2reaetive protein (CRP),interleuldn26 (IL26) ,tumor necrosis factor2α(TNF2α), (P<0.01 ). Difference was not significant between serum lipid parameters before and after the treatment. Conclusion Intravenous supplement with levocamitine in MHD patients, appears to be associated with an improvement of nutrition and mieroinflammation status.

Objective To explore the influence from I Ching perception of febrile disease theory to the syndrome differentiation and treatment of Viral myocarditis.Methods Documentary study.Results The febrile disease theory gained certain reference from simple ontology and motion concept in ancient Chinese philosophy.VMC was caused by disorder of five evolutive phases and six climatic factors,transition from Kan diagram to Li diagram,together with the mixture of pathogenic qi.Treatment should mainly focus on eliminating pathogen and nourishing yin to coordinate water and fire,conforming to universe rules,and smoothing Qi to reduce blockage.Conclusion The cognitive perception,pathogenesis and treatment of febrile disease theory are all deeply influenced by I Ching.Therefore,the combination of I Ching and febrile disease theory in diagnosis and treatment of VCM will improve clinical effects,as well as featuring the cultural nature of Traditional Chinese Medicine.

Objective To study the effects of activation and inhibition agents of protein kinase C on the function and expression of P glycoprotein in drug resistant gastric cancer cells. Methods Immunohistochemical staining and FACS were used to determine the expression of P glycoprotein on drug resistant gastric cancer cells SGC7901/VCR and its parent cells SGC7901, which were treated or not treated by activation or inhibition agents of protein kinase C(PMA or H 7). Double labeled immunoflurescent and laser scan confocal microscopy were used to detect the coexpression of protein kinase C ? and P glycoprotein on drug resistant gastric cancer cells. Rohdamin 123 was used as fluorescent probe to observe the effects of PMA and H 7 on the function of P glycoprotein and drug accumulation in SGC7901/VCR. Results P glycoprotein had positive staining on SGC7901 cells and much stronger staining on SGC7901/VCR cells. Protein kinase C ? and P glycoprotein exhibited coexpression on SGC7901 cells and much higher coexpression level on SGC7901/VCR cells. When treated by PMA, SGC7901/VCR cells showed time dependent decreasing of drug accumulation, enhancing function and decreasing expression of P glycoprotein. When treated by H 7, SGC7901/VCR cells showed time dependent increasing of drug accumulation, weakening function and increasing expression of P glycoprotein.Conclusion Protein kinase C may play a role in multidrug resistance of gastric cancer cells via modulating the expression and function of P glycoprotein.