Purpose To investigate the relationship between the changes of the thickness of retina in macula and the abnormalities in multifocal electroretinograms (mERG) in diabetic retinopathy. Methods mERG and optical coherence tomography (OCT) examination were performed in 38 patients (60 eyes) with DR (phase Ⅲ～Ⅳ). The data were processed with software SPSS and line relation analysis was done. Results The response densities of N 1, P 1 and N 2 in central 5? area was significantly negative related to the thickness of neuroretina in macular fovea (correlation efficient -0.252～-0.266, P

Objective To investigate the clinical manifestation and inspection method about abnormal uter-ine bleeding due to cesarean section scar diverticulum.Methods retrospective analysis of 156 abnormal uterine bleeding cases due to cesarean section scar diverticulum.Analysis the relevance ratio,the starting time of clinical symptom,related influencing factors,the information of examine and misdiagnose.Results there are 12 cases cesare-an section scar diverticulum in 2010;30 cases in 2011;26 cases in 2012;37 cases in 2013;51 cases in 2014.The starting time of clinical symptom is 1 ~6 month pose menstrual in 48 cases;6 months to 2 years pose menstrual in 89 cases,2 years later pose menstrual in 19 cases.98 cases don′t have evidential abnormality even through many times ultrasonograph.43 patients subjected diagnosis curettage.The uterine bleeding time obviously longer comparing retro-position of uterus with anteposition and msposition of uterus.Conclusion the morbidity of abnormal uterine bleeding cases due to cesarean section scar diverticulum is low,but the rate of misdiagnosis and missed diagnosis is little high-er.We need to elevate the rate of diagnosis,and to research the preservation and magagement gradually.

Objective To retrospectively analyze whether the kyphosis exists after removal of the internal fixators for thoracolumabar vertebrae fractures. Methods A total of 18 patients (35-68 years old) with thoracolumabar vertebrae fractures (T11-L2 ) were fixed with short segment pedical screw. The fixators were removed one year postoperatively to observe the changes of the Cobb' s angle and trauma vertebra'height. Results All the patients were followed up for 6-24 months ( average 18.7 months),which showed no intraoperative or postoperative complication, breakage or loosening of the screws. Compared to the Cobb angle and the vertebra height before removal of the internal fixators, the average loss of the Cobb angle was 0.7° and that of the vertebra height was 0.8 mm six months after removal of the fixators, 1.9° and 1.1 mm respectively one year after removal of the fixators, and 2.4° and 1.3 mm respectively two years after removal of the fixators in 16 patients without osteoporosis (P ＞0. 05). Among two patients with osteoporosis, the average loss of the Cobb angle and the vertebra height was 6° and 8°respectively and 3 mm and 5 mm respectively six months after removal of the fixators; 13° and 17° respectively and 5 mm and 7 mm respectively one year after removal of the fixators; 15° and 19° respectively and 6 mm and 7.5 mm two years after removal of the fixators. Conclusions After the internal fixation for thoracolumbar vertebrae burst fractures, kyphosis develops mildly, with insignificant change of the vertebral height. While the kyphosis becomes worse after removal of the fixators for thoracolumbar vertebrae burst fractures in patients with osteoporosis.

Objective To investigate the subtype distribution and sequence characteristics of HIV-1 strains prevalent among sexual infectors in Beijing. Methods We collected the blood samples from 100HIV sexual infectors in Beijing during 2008 and separated plasma specimens. RNA was extracted from the plasma and the gag gene was amplified by RT-PCR and nest-PCR. The PCR products were sequenced directly and phylogenetic analyses of gag gene was performed using the MEGA4 software. Results Among 100 HIV-1 plasma samples,84 gag gene fragments were amplified and analyzed. Eight HIV subtypes including B(22 strains), B'(8 strains),C( 1 strain) ,CRF01_AE (38 strains) ,CRF02_AG (2 strains) ,CRF07_BC(9 strains) ,CRF08_BC(3 strains) and C/CRF01_AE recombinant like strain( 1 strain) were identified circulating in Beijing. Conclusion CRF01 _AE and subtype B were predominant in Beijing account for 45.2% and 26.2% and the surveillance of HIV gene variation should be paid more attention.

Objective To investigate the immunogenicity of group A plus group C meningococeal glycoconjugate vaccine,namely dosage,immune memory and compatibility. Methods The mice were injected with group A plus group C meningococcal glycoconjugate vaccine with different dosages. Blood samples were taken on the 14th day after the last injection for testing the antibodies against polysaccharide A and C. After the optimal immunization dosage had been decided,the mice were inoculated separately with the monovalent group A and the monovalent group C and the bivalent group A plus group C glycoconjugate vaccine with one,two or three injections for observation of the effectiveness of different injections and the compatibilities. Results The dosage of 1.25 μg of each polysaccharide of group A and group C in bivalent glycoconjugate vaccine appears to be immunologically optimal to vaccinate the mice. Immunological memory could be induced in mice inoculated with the glycoconjugate vaccine,and the antigenic immunogenicity of the group A component and group C component in the formulation of group A plus group C meningococcal glycoconjugate vaccine was not affected. Conclusion Group A plus group C meningococcal glycoconjugate vaccine have good immunogenicity,immune memory and compatibility.

Objective: To examine the vitamin A status of children and adolescents aged between 6-17 years old in Chongqing, and to analyze the influencing factors of vitamin A deficiency, providing a scientific basis for nutritional improvement measures. Methods: From 2016 to 2017, a multi-stage random sampling method was used to select approximately 1 508 children and adolescents aged between 6-17 years old from three rural and three urban locations in Chongqing. This study carried out a questionnaire survey and laboratory testing, and the statistical analysis was performed using SPSS version 25.0. Results: The mean vitamin A level was (1.45±0.42)μmol/L, while the prevalence of vitamin A deficiency and the subclinical deficiency rate were 0.46% and 13.46%, respectively. The binary Logistic regression analysis revealed that the following factors were associated with a lower risk of vitamin A deficiency:overweight and obese students(OR=0.51); students whose mothers had a high school education or above(OR=0.35, P=0.01); students from big cities; and higher quartile albumin levels (Q 3 and Q 4). Students who did not eat meat each day(OR=2.05), students aged 6-8 years old, and students with C-reactive protein in the third (OR=2.12) and fourth (OR=4.54) higher quartiles were at a higher risk of vitamin A deficiency. Conclusion The subclinical vitamin A deficiency rate was relatively high among children aged 6-17 years old in Chongqing. Measures including nutritional education, reasonable diets, and nutritionally fortified food or fortifiers should be used when necessary.

Objective: To understand the status of vitamin D deficiency and high blood pressure in primary and middle school students aged 7 to 17 years old in Chongqing, and to explore the correlation between vitamin D deficiency and high blood pressure in children and adolescents. Methods: From 2016 to 2017, a total of 1 360 primary and middle school students, aged 7 to 17 years old, were selected from three rural and three urban sites in Chongqing using multistage stratified random sampling. This study carried out a questionnaire survey, and participants underwent a physical examination which included blood pressure and serum vitamin D assessments. Results: The deficiency and insufficiency rates of vitamin D were 9.71%, and 62.57%, respectively. The high blood pressure rate was 25.88%. Multivariate Logistic regression analysis showed that after adjusting for age, economic status, waist circumference, BMI classification, and family history of hypertension, the risk of hypertension was 1.42 times that of the normal group (P<0.05), and the risk of high systolic blood pressure was 1.59 times that of the normal group (P<0.05). Conclusion The deficiency and insufficiency rate of vitamin D among children and adolescents aged 7 to 17 years old in Chongqing was high, and the phenomenon of high blood pressure was prominent. Students with vitamin D deficiency and insufficiency were more likely to have high blood pressure.

Objective: To investigate the influencing factors of smoking tendency of adolescents and to analyze the influence of e-cigarette on smoking tendency of teenagers and the possible interaction, to provide evidence for tobacco control measures. Methods: Stratified multistage cluster probability sampling method was used to select 6 178 students from junior middle school, high school and vocational high school students in Shanghai for questionnaire survey from September to October 2019. Students with smoking tendency were taken as case group, adolescents with same sex and similar age(within 1 year) were mathed in 1∶3 ratio. A total of 631 adolescents with smoking tendency and 1 870 non-smoking tendency were included in the study. Conditional Logistic regression was used to analyze the influencing factors and possible interactions. Results: After adjusting gender, age and other covariates, conditional Logistic analysis results showed that the smoking tendency of middle school students was associated with factors such as their friends smoking, trying cigarettes and trying e-cigarettes. The OR value and 95%CI were 3.26(2.47-4.29), 5.90(3.76-9.24), and 3.28(2.11-5.10), respectively. The interaction analysis results showed that the OR value and 95%CI of the multiplying interaction between friends smoking and trying e-cigarettes, trying smoking and trying e-cigarettes were 8.62(4.90-15.17) and 12.01(6.02-23.95), respectively. There was no additive interaction. Conclusion Tobacco control interventions, such as e-cigarette harm publicity and peer education, can help to change teenagers smoking tendency and further reduce their tobacco use rate.

Objective It constructs a new culture index system for high-quality development of public hospitals to provide scientific tool for evaluating the level of new culture construction of public hospitals and promoting high-quali-ty development.Methods A pool of indicators was established based on policy combing and literature research.Then,an indicator system was formed through Delphi expert consultation and demonstration,and weighting coefficients were assigned using the hierarchical analysis method.Results The indicator system of the new culture in public hospi-tals contains four primary indicators,eight secondary indicators and 23 specific entries.The four primary indicators are hospital culture system construction,strengthening the orientation of patients'needs,caring for medical staff and distinctive hospital culture.The effectiveness of implementation as an additional dimension contains two secondary indicators and eight specific entries.The weights of the primary indicators are balanced.Among the sec-ondary indicators,institutional planning(0.250),staff care(0.170),medical services(0.130),discipline branding(0.125)and professionalism(0.125)have higher weights.Conclusion The new culture index system for high-quality development of public hospitals is in line with Xi Jinping's cultural thought and the requirements of the new culture for high-quality development of public hospitals.It needs to pay attention to the planning of the cultural system,em-phasises the care of employees and the cultivation of professionalism,and focuses on the construction of medical services and disciplinary brands,so as to promote the construction of the new culture in public hospitals in line with the requirements of the national strategies.

Objective It constructs a new culture index system for high-quality development of public hospitals to provide scientific tool for evaluating the level of new culture construction of public hospitals and promoting high-quali-ty development.Methods A pool of indicators was established based on policy combing and literature research.Then,an indicator system was formed through Delphi expert consultation and demonstration,and weighting coefficients were assigned using the hierarchical analysis method.Results The indicator system of the new culture in public hospi-tals contains four primary indicators,eight secondary indicators and 23 specific entries.The four primary indicators are hospital culture system construction,strengthening the orientation of patients'needs,caring for medical staff and distinctive hospital culture.The effectiveness of implementation as an additional dimension contains two secondary indicators and eight specific entries.The weights of the primary indicators are balanced.Among the sec-ondary indicators,institutional planning(0.250),staff care(0.170),medical services(0.130),discipline branding(0.125)and professionalism(0.125)have higher weights.Conclusion The new culture index system for high-quality development of public hospitals is in line with Xi Jinping's cultural thought and the requirements of the new culture for high-quality development of public hospitals.It needs to pay attention to the planning of the cultural system,em-phasises the care of employees and the cultivation of professionalism,and focuses on the construction of medical services and disciplinary brands,so as to promote the construction of the new culture in public hospitals in line with the requirements of the national strategies.