Retinopathy of Prematurity is a retinal vascular proliferative disease.With the improvement of the medical care in China, retinopathy of prematurity (ROP) has become one of the main causes of child hood blindness in recent years.Several factors such as short gestational age, low birth weight and oxygen supplementation are the three major risk factors for the disease, however, the pathogenesis is still not clear.This review here aims to expand the etiology and pathogenesis of ROP and provide a theoretical basis for the prevention and control of the disease.

Based on the theory of Donabedian quality theory,namely structure-process-outcome theory,the evaluation and maintenance of nursing environment is analyzed.Through related websites,retrieval of patient safety case and literature and combined with the relationship with three layers,the high quality nursing environment and patient safety is analyzed,to study its localization and reference,and to put forward the corresponding suggestions in order to help ensure the safety of patients.

Objective To investigate the pathological features and clinical characteristics of primary mitochondrial myopathy and encephalomyopathy. Methods 11 cases of mitochondrial myopathy and encephalomyopathy were analyzed on clinical features, histochemical changes and ultrastructure observations of muscles. Results RRFs were found in all 11 cases by muscle staining of MGT under light microscope. 7 cases were only afflicated with muscle weakness, 4 cases also having impairment of central nervous system. The proportion of RRFs was 6.4% to 10.3%. We observed these cases under electronic microscope. In 9 cases,the ultrastructural alterations included subsarcolemmal accumulation of mitochondria,increases of the number,abnormal shape,disarrangement of cristae and paracrystaline inclusion bodies. In 2 cases the increase of mitochondrial number is only the alteration. Conclusions Typical RRF is valuable for diagnoses of mitochondrial myopathy and encephalomyopathy under light microscope. The accumulation of abnormal mitochondrials beneath sarcolemal,especially the paracrystaline inclusion bodies are significant in making a definite diagnosis of this disease under electronic microscope.

Objective To evaluate clinical value of ultrasonography before and after stent implantation in the patients with obstructive jaundice.Methods Ultrasonic findings before and after stent implantation in 38 patients with obstructive jaundice were analyzed respectively,and location and pathological natures of the obstruction were compared with those of stent implantation.Results Stent implantation was successfully achieved in all the cases with hilum (15/15,100%) and common bile ducts obstruction(12/12,100%),ampulla of Vater (5/6,83%) ,and duodenal nipple(1/5,20%).A success rate of stent implantation was 100%(8/8) in benign lesions,and 83.3% (25/30) in malignant ones.The total success rate was 86.8%.The significant difference was found between the obstruction location and success rate of stent implantation ( P 0.05 ).Conclusions Ultrasonography not only contributes to diagnosis of location and pathological nature of the obstruction for successful stent implantation but also explores complications early.

Objective To investigate the renal protection of Chinese cobra venoms (CCV) and its mechanism in renal ischemia/reperfusion (I/R). Methods Thirty-two rats were divided into four groups. 0.1% CCV was separately infused into abdominal cavity at 0.5 h, 24 h before reperfusion in group Ⅰ and Ⅱ . Group Ⅲ suffered from kidney I/R was served as pathological control. Group Ⅳ was sham operation group. BUN and Scr were measured before ischemia and 24 h after reperfusion. Complement C3 was observed at 0, 0.5, 2, 24 h after reperfusion. The kidney samples were examined by HE stain under light microscopy. Apoptosis was detected by terminal deoxynucleotidyl transferase mediated dUTP-biotin in situ nick-end labeling(TUNEL). Results Significant histological damage, apoptosis of tubular cell and impaired renal function were found in group Ⅰ and Ⅲ.The above indexes decreased to a less extend in group Ⅱ (P

Objective To establish a comprehensive evaluation system for clinical pathway quality for evaluation and verification.Methods Literature retrieval, clustering mergers and experts consultation method were used to determine indicators for clinical pathway quality evaluation, while gray correlation method was employed to calculate indicators weight coefficient and to evaluate indicators scoring,and sum indicators weighted scoring, so as to establish a clinical pathway quality comprehensive evaluation model.Indicator data of Shanghai′s 18 tertiary hospitals were used for verification.Results A total of 12 evaluation indicators, such as entry rate, mutation rate, completion rate and average length of stay were selected.After the weight calculation and grade scoring, the mathematical model of clinical pathway quality comprehensive evaluation was constructed.Data of these hospitals were put into the evaluation system for assigning ratings calculation, harvesting the overall score and ranking of each hospital.These data can help find out key management and key hospital intervention indicators in the next stage.Conclusions Different hospitals will be put on the same platform for comparison in this clinical pathway evaluation system, and the results can be quantified.The authors suggest that the next stage of health administration focus on the management of the hospitals and the key management of the sectors, making possible the prospective management of clinical pathways.

Objective To analyze the correlation between the diagnosis and treatment and the postoperative death and complication of the elderly patients.Methods A total of 1 932 cases of surgical patients (over 70 years old) were collected from a three-level general hospital 2013-2015.Their medical information of the treatment methods were recorded,including incision category,surgical approach,surgical grade and patient outcome after surgery(death or postoperative complications).Then we analyzed the incidence of death or postoperative complications,as well as the effects of treatment and postoperative outcome on complications or mortality.Results The admission status and incision type were the risk factors of postoperative death in elderly patients.Admission status pollution type,surgical approach and surgical grade were the risk factors of postoperative complications.Conclusion In order to reduce the risk of postoperative death and complications in elderly patients,the effect of admission and incision on the postoperative risk of elderly patients should be evaluated.

Public Health ; methods ; Systems Analysis

Objective To estimate the application of ultrasound measurement of detrusor wall thickness (DWT) in the assessment of curative effect after operation. Methods Detrusor thickness was measured by linear ultrasound (7. 5 MHz) either at a filling volume of 50% of cystometric capacity or at 250 ml filling in 86 patients, who were diagnosed equivocal BOO, during a pressure-flow study. All patients accepted transurethral resection of the prostate. At 3 months post-surgery, the patients were divided into two groups according to curative effect after operation. The volume of the prostate, age and DWT were compared between the two groups. Results There was no difference in either age or volume of the prostate between the two groups. DWT was significantly higher (P＜0.01) in the more curative effect group (37 cases, DWT 2. 5±0.3 mm) compared to the less curative effect group (49 cases, 2.2±0. 3 mm). As a predictor of curative effect, DWT of 2. 8 mm or greater had a positive predictive value of 100%, a negative predictive value of 62%, specificity of 100% and sensitivity of 19%. Receiver operating characteristic analysis (ROC) revealed that DWT had a high predictive value for curative effect post-surgery with an AUC of 0. 84±0. 04. Conclusions In patients with equivocal BOO, ultrasonographically assessed detrusor thickness may have a predictive value for curative effect post-surgery. However, this cutoff value needs to be validated in a larger study population.

Objective To evaluate the efficacy and safety of a collagen dressing for healing of wounds induced by fractional CO2 laser in patients with atrophic facial acne scars.Methods Seventy patients with atrophic facial acne scars were recruited to this study,and randomly divided into a treatment group and a control group.Both the two groups were treated by two sessions of fractional CO2 laser with an interval of one month.After each session of laser therapy,the treatment group were topically treated with a collagen dressing for 20 minutes once a day for 10 consecutive days,while the control group did not apply any collagen dressing.All the patients were followed for 6 months.Efficacy was evaluated by the degree of acute inflammatory reaction,time needed for crust shedding and patient comfort level.The length of downtime as well as incidence of post-inflammatory hyperpigmentation and other adverse reactions were also assessed.Results Compared with the control group,the treatment group showed a decrease in the score for acute inflammatory response (W =312,P ＜ 0.01),time needed for crust shedding (t =2.08,P ＜ 0.05),incidence rate of post-inflammatory hyperpigmentation (x2 =6.06,P ＜ 0.05),length of downtime (t =3.14,P ＜ 0.05),but an increase in self-reported comfort level (W =172,P ＜ 0.01).No new scar formed in any of these patients.Conclusion The collagen dressing is effective in reducing incidence of adverse reactions and improving satisfaction degree of patients with atrophic facial acne scars after fractional CO2 laser therapy.