Glaucoma is the first leading cause of irreversible blindness globally. China is one of the major developing countries and has the biggest burden of primary angle closure glaucoma (PACG) in the world. As the aged population grows in China, the amount of patients of PACG and"oecludable angle"will be increased consequently. China is facing a number of barriers in the prevention of glaucomatous blindness such as unbalanced alloeation of heahhcare resources, laek of evidence-based guidelines of glaucoma in accor- dance with Chinese situation, and sequential severe over-treatment. In this article, we reviewed the current mode of the prevention of glaucomatous blindness in China from the point of view of evidenee-based medicine and health economics, and provided several sugges- tions in further researehes and clinical works.

AIM: To analyze the reasons of low vision and blindness in elderly patients and the application of optical aids in rehabilitation.METHODS: Totally 87 elderly patients which had 74 cases of low vision,13 cases of blind,including 53 males and 34 females.Routine internal and external eye examinations should be performed,and special removal examinations should be performed if necessary.Both refractive correction,and try with far and near optical aids,check after wearing a typoscope distant and near vision,distant vision ≥0.05 out the blindness,distant vision ≥0.3 out the disability.Near vision ≥ 0.5 was valid,<0.5 was invalid.RESULTS: Among 87 elderly patients with low vision,high myopia was the leading cause of blindness,followed by macular degeneration,cataracts,glaucoma and diabetic retinopathy.The visual acuity after refractive correction increased ≥ 2 lines in 62 cases (71%),visual acuity was not correct or corrected for ≤ 1 of 25 cases (29%).With aids,far visual was ≥0.3 of the 70 cases (80%),≥0.05 in 10 cases (11%),<0.05 in 7 cases (8%),residue removal rate of 92%.With reading glasses near and near visual acuity was >0.5 effective in 60 cases (69%),<0.5 ineffective in 27 cases (31%).Typoscope was often used in 58 cases,not often used 18 cases,11 cases rarely used or give up.CONCLUSION: High myopia is the leading cause of low vision and blindness in the elderly,followed by macular degeneration.The application of visual aids is still reliable and economical and effective treatment method,patients should be encouraged to use visual aids to improve the utilization rate of aids,so as to improve the quality of life of patients.

Adolescent ; Child ; Child, Preschool ; Female ; Herpesvirus 4, Human ; Humans ; Infant ; Infectious Mononucleosis ; diagnosis ; pathology ; virology ; Liver ; pathology ; Male

Objective: To investigate the relationship between HLA-DR4/1 subtypes and T cell responses to type Ⅱ collagen or anti-CⅡ263-272 antibodies. Methods: Peripheral blood mononuclear cells and sera were obtained from 70 rheumatoid arthritis (RA) patients. T cell proliferative responses to CⅡ263-272 were evaluated by 3H thymidine incorporation assay. Antibodies specific to CⅡ263-272 were determined by ELISA. HLA-DR4/1 subtypes were analyzed by PCR-SSP. Results: In HLA-DR4/1 positive group, T cell proliferative responses to CⅡ263-272 were observed in 55.6% RA patients and anti- CⅡ263-272 antibodies were present in 66.7% RA patients. In HLA-DR4/1 negative group, T cell proliferative responses to CⅡ263-272 were observed in 30.3% RA patients and anti-CⅡ263-272 antibodies were present in 34.8% RA patients. The number of positive antibodies to CⅡ263-272 or T cell proliferative responses to CⅡ263-272 in HLA-DR4/1 positive group were higher than in negative group. Conclusion: There is a relationship between HLA-DR4/1 subtypes and T cell responses to CⅡ263-272 or anti-CⅡ263-272 antibodies.

BACKGROUND:Electromagnetic fields can cause changes of the body,especially the nervous system.Effect of pulsed electromagnetic fields(PEMFs)on neural stem cells has been detected.OBJECTIVE:To investigate the effect of prenatal pulsed electromagnetic fields(PPEMFs)on neural stem cell proliferation and nestin protein expression in the hippocampus of rat offspdng.METHODS:Sprague Dawley female rats weighing 240-260 g were included and randomly divided into two groups:control and PPEMFs.Rats from the control group were given no interventions.Rats from the PPEMFs group were given PEMFs stress at gestational days 14-20.Each stress was given three times daily for 10 minutes.The male and female offspring rats were sacrificed at 1 month of age and their brains were sectioned to determine the expression of nestin protein and Brdu-positive cells in the hippocampus by immunohistochemistry.RESULTS:The expression of nestin-and Brdu-positive cells in the hippocampus of female and male PEMFS offspring were significantly higher compared with the control group(P<0.001),and there was a significant difference between female and male offspring(P<0.001).The nestin-and Brdu-positive cells in female offspring outnumbered those in male offspring(P<0.001);however,there was no significant difference between female and male offspring in the control group(P>0.05).CONCLUSION:PPEMFs can increase the number and proliferative capability of the neural stem cells in offspring.It may be a pdmary stage of the cascade reaction of the body to the brain damage caused by PPEMFs stress.

Objective To study the anatomical basis and clinical causes of splenic infarction with an attempt to improve on the diagnosis and treatment of splenic infarction.Methods This study was conducted on 11 patients with splenic infarction seen in our hospital from December 2003 to September 2012,131 patients with a clinical diagnosis and treatment reported in the literature since 1999,and 25 adult cadavers showing the anatomy of the splenic arteries with an aim to find out the causes of splenic infarction.Results The clinical data showed that splenic infarction occurred more commonly in patients 60 years of age or older (73％ vs 27％,P＜0.05),and in males more than in females (62％ vs 38％,P＜0.05).The diagnosis was first made significantly more often by physicians than by surgeons 88/32 (79％ vs 21％,P＜0.05).The anatomical data showed that the majority of the splenic arteries in the 25 adult cadavers was curved.Conclusions The clinical manifestations of splenic infarction easily led to a misdiagnosis.Improvement in the diagnosis and treatment of splenic infarction would depend on the clinical awareness of this condition,the prothrombotic state detection and the implementation of timely and standardized treatment.

Objective To compare the computed orthopantomography(COPT)with Sh?ller radiography(SR),film orthopantomography(FOPT)and other traditional radiographic techniques in the radiography of temporomandibular joint(TMJ).Methods Ninty-eight cases were randomly divided into 3 groups,and the open and close positions of TMJs of both sides were examined with SR,FOPT,and COPT, respectively.The satisfactory rates of the X-ray pictures were statistically analyzed with Pearson chi-square in SPSS10.0,and the satisfactory rates were analyzed with q test between the groups.Results One hundred and forty-four of the open and close positions of 144 TMJ pictures of the COPT group,128 of 128 of the FOPT group,and 6 of 120 of the SR group were satisfactory in the mandible ramus of the TMJ,with satisfactory rate being 100%,100%,and 5%,respectively(P0.01),respectively between FOPT and COPT groups.The difference was not statistically significant.The exposure was as follows:COPT,99—113 mAs;FOPT,210—225 mAs;and SR,48—75 mAs.Therefore,COPT and FOPT were superior to SR in the pictures of the mandible ramus,coronoid process,and incisure,but inferior in the joint space pictures.The satisfactory rates of the condylar process and articular tubercle were same in the 3 groups.The exposure of the FOPT group was greater than that of the COPT and SR groups.Conclusion COPT is superior to SR and FOPT in TMJ radiography,and should be applied widely in the clinic.

A female patient aged 61 years was diag-nosed with metastatic liver cancer from colorectal cancer. Com-puted tomography (CT) scanning showed that the mass was located at the confluence of 3 hepatic venous trunks and had a diameter of 7 cm. The patient's standard liver volume was 1087 ml, and the volume in the right lobe was 634 mL and the right posterior lobe was 279 ml. We attempted to resect the left and caudate lobes with the middle hepatic vein (MHV) and to reconstruct tributaries of the MHV from segment V using a cryo-preserved autologous iliac artery. The operation time was 280 minutes and blood loss was 300 mL, and no postoperative com-plications were observed. The length of hospital stay was six days. Two weeks after the operation, imaging examinations by ultrasound and CT indicated that the graft vessel was patent. Three months after the operation, ultrasound examination demonstrated that the bypass was blocked, while no atrophy in hepatic segment V was detected, which indicated that communi-cating branches between the hepatic veins of segment V and the right hepatic veins had formed. Hepatectomy combined with hepatic venous reconstruction is safe and feasible for hepatoma at the confluence of three hepatic venous trunks.

Objective To analyze the surgical treatment options and its results for thoracic and thoracolumbar disc herniation.Methods From June 2004 to December 2009,thirty-one patients of thoracic and thoracolumbar disc herniation with or without ossification of ligament flavum were surgically treated,including 22 males and 9 females,with a mean age of 54 years(range,24 to 71 years).According to Anand and Regan clinical classification,there was type 2 for 1 case,grade 3a for 2,grade 3b for 3,grade 4 for 6,and grade 5 for 19.The neurological status was Frankel B for 2 cases,C for 6,D for 11,and E for 12.Anterior surgeries were performed for 18 patients without ossification of ligament flavum.Anterior decompression was performed through the resection of posterior part of vertebral body,or subtotal resection of vertebral body,followed by strut graft and internal fixation.Posterior surgeries were performed for 13 patients with disc herniation and ossification of ligament flavum.The resection of hemi-articular process and total laminectomy was performed.Results The complications of 18 patients with anterior surgery included laceration of dura mater in 1 case,nerve root sleeve injury in 1 case,intercostal neuralgia in 3 cases,atelectasis in 1 case,and femoroiliac numbness in 2 cases.The complications of 13 patients with posterior surgery included intra-canal hematoma in 1 cases,leakage of cerebrospinal fluid in 2 cases,infection of incision in 1 cases,and pneumonia in 1 case.The patients were followed for 18 months(range,6 to 48 months).At final follow-up,the neurological status and local symptom improved in all patients,with Frankel C for 3 cases,D for 7,and E for 21;and Anand and Regan type 1 for 2 cases,2 for 1,3a for 1,4 for 2,5 for 10 and no symptom for 15.Conclusion For thoracic and thoracolumbar disc herniation,anterior surgery is suitable for patients mainly suffered anterior cord compression.Resection of posterior part of vertebral body or subtotal resection of vertebral body is often needed for sufficient decompression.Posterior surgery is suitable for patients with anterior and posterior cord compression due to ossification of ligament flavum,and the decompression can be obtained by resection of hemi-articular process and total laminectomy.

Adult ; Arsenic Poisoning ; etiology ; Female ; Humans ; Male ; Middle Aged ; Organotin Compounds ; poisoning ; Water Pollution ; Young Adult