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.

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

Objective To investigate the applied value of computed radiography(CR) system in intravenous pyelography in children.Methods Intravenous pyelography were carried out by CR and traditional intensifying screen/film in 45 children respectively.The diagnostic specificity between CR and traditional intensifying screen/film was compared.Results Urinary system in children could be displayed well by CR,the quality of CR films was ensured.The diagnostic corresponding rate was 86.7% and 59.1% by CR and traditional intensifying screen/film respectively.Conclusion CR is of significance value in diagnosis of urologic diseases in children.

Objective To summarize the clinical experience of liver transplantation in the treatment of hepatocellular carcinoma(HCC).Methods From June 2004 to March 2007,70 consecutive HCC patients underwent liver transplantation in our hospital,including classic orthotopic liver transplantation in 41 cases,and piggyback liver transplantation in 29 cases.All data of patients were retrospectively analyzed.Results All liver transplantation were successfully conducted.The average warm ischemia duration was 4.5 minutes,and cold ischemia duration was 8 hours.There were 3 cases of postoperative deaths.Surgical complications were intra-abdominal hemorrhage in 2 cases,and biliary anastomotic stricture in 4 cases.Sixty-seven cases were followed up for 12-33(average 21) months,10 cases had recurrence of liver cancer after transplatation and 1 dead.Conclusions Liver transplatation can used on selected patients with HCC.Successful liver transplantation relies on good quality of liver graft,and idealized technique of vascular and bile duct reconstruction are key factors of liver transplantation.Proper postoperative management can effectively reduce the complications of operation.