AIM:To investigate the clinical value of wide angle digital imaging system ( RetCam Ⅱ) for the screening of retinopathy of premature infants ( ROP) .
●METHODS: A total of 200 cases ( 400 eyes ) in preterm children were selected Jan. 2012 to Dec. 2015 in line with obstetric screening criteria using RetCamⅡROP screening children for binocular indirect ophthalmoscopy results as the gold standard, RetCamⅡ for screening value of ROP in premature children.
●RESULTS:The screening of 200 cases ( 400 eyes ) in premature infants, binocular indirect ophthalmoscopy were detected 63 eyes with ROP (15. 8%), 337 normal eyes, 42 eyes with ROP phase l, 14 eyes with phase ll, 7 eyes with phase lll, no one with ROP phase lV and ROP phaseⅤ. A total of a 64 eyes with ROP were screened by RetCam ll, which the misdiagnosis in 5 eyes, diagnostic level decreased in 6 eyes. The consistency of RetCam ll detection results with binocular indirect ocular fundus examination results was 0. 814, P<0. 05. RetCamⅡfor screening children preterm children ROP lesion sensitivity of 93. 7% and a specificity of 98. 5%, missed diagnosis rate was 6. 4%, misdiagnosis rate was 1. 5%, 92. 2%positive predictive value, negative predictive value of 98. 8%.
● CONCLUSION: RetCam Ⅱ in preterm children ROP screening has high clinical value.

Alzheimer's disease( AD) , a neurodegenerative disease, can result in memory loss, cognitive and behavioral deficits. The pathological hallmarkes are β amyloid plaques and neurofibrillary tangles which lead loss of neurons in brain. As the extension of the central nervous system, retina has a similar tissue anatomy with central nervous system. The β amyloid plaques have also been detected in retina of AD. Furthermore, according to eye examinations of AD patients, we have found the loss of retinal ganglion cells, the attenuation of retinal nerve fiber layer thickness, the smaller changes of macula lutea, the decline of vascular density and so on. And then, there occurs the visual field loss and the decline of contrast sensitivity and so on in AD patients. Thus, the retina has occurred nerve degenerative changes in AD. Meanwhile, there has been proved that the retina nerve degeneration is even earlier than senile plaques formation in brain. In addition, curcumin, a natural and safe fluorescent dye, can be used to label β amyloid plaques in retina. The above suggests that retina can be a window for the early diagnosis of AD.

BACKGROUND: Cone-beam CT (CBCT) and orthopantography are two imaging methods mostly used in the preoperative evaluation of dental implantation. CBCT has high cost and low penetration rate, but orthopantography can result in a larger error in the measurement of bone quantity.OBJECTIVE: To compare the accuracy of bone quantity measurement using CBCT and orthopantography, and to evaluate the clinical effect of simulation in posterior implant region. METHODS: 115 implants from 72 patients undergoing implantation of posterior teeth in the Eye & ENT Hospital of Fudan University were selected. The horizontal heights from the top of the alveolar bone to the important anatomic structures (mandibular nerve or maxillary sinus floor) were measured using CBCT and orthopantography and then analyzed statistically. The implantation simulations were performed using Planmeca Romexis3.8 (for CBCT) and Cliniview9.3 (for orthopantography) to compare the differences in stimulated and postoperative horizontal heights.RESULTS AND CONCLUSION: There were significant differences in the measured data between CBCT and orthopantography (P < 0.05), especially in the maxilla (P < 0.01). There were significant differences between the simulated and postoperative results of the two methods (P < 0.05). The average error and standard deviation in orthopantography were larger than those in CBCT. The average error of implantation simulation using CBCT in the maxilla was smaller than that using orthopantography, whereas the error was similar in mandibular simulations. To conclude, CBCT is more accurate for assessing the quantity of bone in posterior implant region, especially in the maxilla. The accuracy of CBCT and orthopantography in implantation simulation needs to be improved.

Ezrin protein plays an important role in morphogenesis,motility,adhesion.Moreover,Ezrin protein participates in multiple steps of the process of tumor invasion and metastasis.In the progress of tumor metastasis,Ezrin protein is related to several signaling pathways such as Rho mediated signaling pathways,hepatocyte growth factor (HGF) pathways,Fas mediated cell apoptosis signaling pathways,phosphatidyl inositol 3-kinase (PI3K)-Akt pathways,and in which it plays different regulatory role.

Objective To study the effects of Baihu Rensen decoction combined with Fufang Xiebai capsules for treatment of patients with severe pneumonia accompanied by heat-phlegm and sthenic-fu syndrome.Methods A prospective study was conducted; 266 severe pneumonia cases with heat-phlegm and sthenic-fu syndrome admitted into the Department of Respiratory Diseases in Kunshan Hospital Affiliated to Jiangsu University from January 2012 to December 2013 were selected. The patients were randomly divided into a integrated traditional Chinese and western medicine group (136 cases) and a western medicine treatment group (130 cases). Both groups were given basic conventional western medicine according to the disease situation. The integrated traditional Chinese medicine (TCM) was additionally given Baihu Rensen decoction combined with 350 mg of Fufang Xiebai capsules, 3 times a day, 4 grain each time, 7 days constituting a course of treatment. The rate of body temperature descent, the degree of improvement in clinical TCM symptoms, peripheral white blood cell (WBC) count, neutrophil percentage and the situation of endogenous pyrogen production in the two groups were compared.Results After treatment, the body temperature, TCM symptom scores, WBC count and neutrophil percentage were lower than those before treatment, 3 days after treatment these data reached their valley values, and the decrease in level was more significant in the combination group [body temperature (℃): 36.5±0.0 vs. 37.0±0.0, TCM symptom scores: 1.7±0.2 vs. 6.1±0.7, WBC (×109/L): 7.1±0.3 vs. 8.3±0.5, neutrophil percentage: 0.64±0.02 vs. 0.76±0.23, allP < 0.05]. Interleukin-1β (IL-1β), tumor necrosis factor-α (TNF-α), interferon (IFN-α, IFN-γ), and interleukin-6 (IL-6) level in western medicine (WM) group was respectively marked 1, the levels of IL-1β, TNF-α, IFN-α, IFN-γ, and IL-6 in combination group after treatment for 6 hours were significantly lower than those of WM group, and reached the valley at 12 hours (the relative expression value of each of the above indexes in combination group to each of those in WM group was 0.37, 0.16, 0.21, 0.27 and 0.15 respectively), and had a mild rebound at 24 hours.Conclusion By the addition of Baihu Rensen decoction combined with Fufang Xiebai capsules on conventional basic medicine for treatment of severe pneumonia patients with heat-phlegm and sthenic-fu syndrome, the therapeutic effect is much better.

BACKGROUND: Several studies have demonstrated that the range,thickness and morphology of oral prosthesis directly influence patient's phonetic function,and titanium base and polymethyl methacrylate(PMMA)resin base yield different influences on phonetic function due to different thicknesses of materials.OBJECTIVE: To analyze the phonetic parameters in one complete denture patient who wear titanium base and PMMA resin base simultaneously and investigate the influences of maxillary complete denture base on phonetic function.METHODS: Through the use of computer-based voice analysis software PRAAT4.4.34,frequency value of the first concentrated frequency area when speaking consonant sounds/x,sh,r,zh,ch,j,q/and voice onset time when speaking consonant sounds/g,k,zh,ch,j,q/were statistically analyzed in the same patient who separately wear titanium complete denture base and PPMA resin complete denture base,and spectrogram of velar stops between complete denture bases was compared.RESULTS AND CONCLUSION: MMPA resin complete denture base was to some extent poor in promoting the recovery of phonetic function owing to great base thickness.Titanium complete denture base with less thickness in the tongue or palate region would help recovery of phonetic function.Extraction and analysis of phonological parameters,such as frequency value of first concentrated frequency area and voice onset time,using CSL computer*based voice analysis system,would provide objective evidence for lamprophony analysis after wearing complete denture.Maxillary denture with thinner base in tongue and palate regions better promotes the recovery of patient's phonetic function.

Objective To investigate the clinical application and therapeutic effect of reservation cortical expand resection and reconstruction for extremities bone tumor. Method Twelve cases with extremities invasion bone tumor were reviewed,including 6 male and 6 female.The average age was 37.1 years old.According to the MRI,TypeⅠtumor located in metaphysic and growth eccentricity,and was treated with outside tumor osteotomy with reservation of one side as integumentale,the cut line was shape of "匚".Type Ⅱ tumor was with invasion part articular surface,and was operated with part joint osteotomy with reservation of one side as integumentale,the cut line was shape of"L".Type Ⅲ was with invasion total joint surface and as integmentale,all tumor segment including joint could be cut,but the shape of cut close to the diaphysis was echelonment. Result The operation time was 1~3 h,the operative bleeding quantity were 150~400 ml,all incisions were obtained primary healing.Twelve cases were followed up from 6 months to 8 years.The average extremity functional score according to the system of ISOLS(International Society of Limb Salvage):upper extremity was 22.3 and the lower was 25.3 The average bone healing time of returned deactivation bone graft and bone allograft healing with the osteotomy plane was 3 months,original tumor recurrence in local was 1,the recurrence rate was 7.69%,no malignant change and metabasis was found. Conclusion The reservation cortical expand resection and reconstruction could increase the treatment effect of extremities bone tumor,it is key to decrease the recurrence with strict indication,non-neoplasma and aseptic technique.Tumor shell and osteotomy plane should be deactivated thoroughly.

[Objective]To investigate the restoration of the axial alignment of the lower extremity during operation for fracture of tibia plateau and to assess the curative effect.[Method]A retrospective analysis of 45 cases of fracture of tibial plateau were conducted from May 2000 to June 2005,25 male cases and 20 female,mean age were 45.3.The type of fracture:3 cases were Schatzker I,10 were type Ⅰ,19 were type Ⅲ,6 were type Ⅳ,5 were type Ⅴ,2 were type Ⅵ.All cases were treated with open reduction,bone graft and internal-fixation with plate and screw under arthroscopy-assisted,and the normal axial alignment of the lower extremity was restored.The restoration standard was in accordance with the uninjured side limb.The way of measurement:the axial line from anterior superior iliac to interdigit of the first and second toe was done,then,the perpendicular distance from the center of patella to this line was calculated,and compared the data with uninjured side limb's.[Result]Forty cases were followed up,from 6 months to 24 months,average 15 months,according to the Rasmussen knee score standard,24 were excellent,11 were good,3 were fair and 2 were poor.The satisfactory rate was 87.5%,the restoration of knee function were close correlated with whether the line normal or not,there were abnormal lines recurrence in some cases,the main causes were:(1)Meniscus to be cut excessive to the loading redistribution in joint;(2)The reduced articular surface collapsed,again due to the affected limb weight loading too early;(3)Fractures were too complicated to be compress fixed with common buttress plate,resulted in displace fracture.[Conclusion]It is very important that the axial alignment of the lower extremity to be corrected during operation to the injured knee function restoration after operation,and the causes result in the axial line abnormal above-mentioned should be considered thoroughly,at the same time,the corresponding measures should be taken.

Objective To study the characteristics of clinical and laboratory findings in patients with adrenocorticotropic hormone(ACTH)independent macronodular adrenocortical hyperplasia(AIMAH).Methods The clinical and laboratory findings of 7 cases of AIMAH admitted between 1997 and 2005 were reviewed retrospectively.Results 5 of the 7 patients showed typical clinical features of Cushing's syndrome,including moon face,central obesity,hypertension,etc.A part of patients had hypokalemia(43%)and secondary diabetes mellitus(71%).There was lowering of plasma ACTH levels,and an increased cortisol secretion or disturbance in or circadian rhythm.In 6 patients,a low dose or high dose of dexamethasone suppression tests failed to suppress cortisol secretion.CT scan showed bilateral macronodular adrenal hyperplasia.Pituitary MR imaging for pituitary was negative in 6 patients.Unilateral total adrenalectomy was performed in 2 cases.4 cases were treated by bilateral adrenalectomy.One patient died of stroke before operation.5 cases received glucocorticoid replacement therapy after operation.Pathologic examination showed diffuse yellow or brown nodules measuring 0.3 cm～7.0 cm in diameter in all the specimems of 6 patients who undement operation.There was no recurrence in all the patients ofter surgery during the follow-up period.No Nelson syndrome occurred in these 6 patients postoperatively.Conclusion AIMAH is a rare cause of Cushing's syndrome with unique clinical,CT image and pathological findings.Bilateral adrenalectomy in one stage or in stages,or unlateral adremectomy is indicated on the basis of clinical and CT findings.

In order to explore the available sero-diagnotic method for surveillance in basically controlled and controlled areas of schistosomiasis japonica, a 3 years longitudinal investigation of children 6~14 years old with COPT in 5 endemic areas was carried out after being basically controlled for 8~16 years. The results showed that the examination of children with COPT is one of the available serodiagnostic methods of schistosomiasis for surveillance. In all five areas the positive rate of children in this age group was less than 3%, and the circumoval precipitin rate among the positive cases was less than 5%. Therefore, it is indicated that the above mentioned two indexes can be used for sero-surveillance of schistosomiasis japonica.