Pharmaceutical therapy,including anti-vascular endothelial growth factor treatment and intravitreal corticosteroids,is the most common treatment for branch retinal vein occlusion (BRVO) and its complications,however there are confusing ideas about the protocol,patient selection,timing and endpoint of this treatment.The disease is easy to relapse with these drugs therapy.Collateral vessel formation was found in patients receiving intravitreal injection of ranibizumab or triamcinolone for BRVO and secondary macular edema.The mechanism of collateral vessel formation has not been carefully investigated.In the past thrombolysis,arteriovenous fasciostomy and laser choroidal retinal vascular anastomosis were used to reconstruct the retinal circulation,but their rationality,effectiveness and safety need to be further were studied.In recent years,because of the key technology is still immature,the artificial vascular bypass surgery experiment is not yet practical,but provides us a new idea worth looking forward to for the treatment of BRVO.

Objective To study and analyze the effect of fluoride faction shouted tons melitracen sheet (Deanxit)on abdominal pain symptoms of functional gastrointestinal disorders (FGIDs).Methods 82 patients with abdominal pain FGIDs were randomly divided into A group(n =40)and B group(n =42).A group was given conven-tional treatment,group B was given deanxit treatment on the basis of A group.The treatment efficacy and the total inci-dence of adverse reactions were analyzed.Results The total effective rate of group B (90.24%)was significantly higher than that in group A (65.85%),the difference was statistically significant (χ2 =4.538,P <0.05).There were no serious adverse reactions observed during treatment in the two groups,the incidence rate of adverse reactions between the two groups had no statistically significant difference (P >0.05).Conclusion Deanxit in the treatment of FGIDs can achieve satisfactory therapeutic effect,the drug can significantly alleviate the symptoms,andit is safe and without serious side effects.

Objective To explore the anesthesia effect and influence of combined spinal epidural anesthesia (CSEA)with head -up of 10°on maternal hemodynamics during cesarean section.Methods 120 pregnant women undergoing cesarean section were selected,and were randomly divided into group A,B and C,40 cases in each group. Three groups were all given CSEA,yet pregnant women in group A were taken supine position,group B was taken head-up of 10°,and group C was taken head -up of 20°.Hemodynamic parameters of three groups of the following time points were compared,including before anesthesia(T0 ),5min after anesthesia(T1 ),skin incision(T2 ),fetal disen-gagement immediately(T3 ),and operation at the end(T4 ),also anesthesia effect was recorded,and usage of ephedrine and local anesthetic was noted,and adverse reactions were compared.Results Compared with T0 ,group A's hemody-namics in T1 decreased,including systolic blood pressure (SBP),diastolic blood pressure (DBP),and increased in T2 and T3 ,yet there were no statistical differences on hemodynamics in three groups in T4 .Compared with group B and C,there were statistical differences on hemodynamics in T1 ,T2 and T3 in group A(t =3.63 -7.25,P <0.05 or P <0.01),yet there were no statistical differences on hemodynamics in group B and C(t =0.00 -0.93,all P >0.05). Anesthesia block scores in group A,B and C were (2.0 ±0.3)points,(2.5 ±0.2)points,(2.6 ±0.2)points,and scores of B and C were higher than that in group A(t =3.92,4.01,all P <0.05).Cases and total usage of ephedrine in group A were higher than those of group B and C(χ2 =31.43,50.61,t =16.27,20.17,all P <0.01).Cases of adjusting surgical position,and addition of local anesthetic in group C were significantly higher than those of group B (χ2 =23.85,28.47,all P <0.01).Conclusion It has better anesthetic effect of taking CSEA by head -up of 10°, and maternal hemodynamics are more stable,can better meet operation's requirements,also with easier operation,so it is superior to supine position and head -up of 20°.

Objective To evaluate quantification of metamorphopsia in eyes with idiopathic macular hole (IMH) before and after surgical treatment, and investigate its relationship between postoperative visual acuity, the macular hole index (MHI), and the macular hole prognostic factor (HPF). Methods Thirty eyes of 30 patients, who underwent successful vitrectomy and internal limiting membrane (ILM) peeling for IMH and were followed up more than 6 months, were included in the study. The uncorrected visual acuity of the fellow eyes was better than 20/25 and there was no metamorphopsia in that eye. The macular hole closure was confirmed by optical coherence tomography (OCT) scans. Metamorphopsia was evaluated by metamorphopsia-charts (M-chart). OCT, best corrected visual acuity (BCVA) and metamorphopsia were obtained before and after surgery. Vertical (MV) and horizontal (MH) metamorphopsia, macular hole index (MHI, the ratio of the height to the diameter of the base) , and macular hole prognostic factor (HPF,the ratio of the height to the minimum diameter) were measured. The metamorphopsia score was the average value of MV and MH. SPSS 16. 0 statistical analysis software was used for data analysis. Results Preoperative MV and MH were (1.82±0.04)° and (1.81±0.04)°, respectively. Six months after surgery,the MV and MH were (0.17±0.03)° and (0.11±0.03)° respectively. There was significant difference between pre- and post-operative metamorphopsia results (Z=-0.788, P＜0.05). The metamorphopsia score at 6 months after surgery were positively correlated with the value of the postoperative BCVA (LogMAR) (r=0.540, P=0.004) and negatively correlated with the values of preoperative MHI and HPF (r=-0.676,-0.518; P＜0.05). Conclusions Successful vitrectomy and ILM peeling can improve metamorphopsia of IMH. Postoperative metamorphopsia was correlated with the postoperative BCVA and the preoperative macular hole contour.

Objective To evaluate metamorphopsia and vision-related quality of life (VRQoL) and its influencing factor after vitrectomy for idiopathic macular hole (IMH).Methods This is a prospective and nonrandomized clinical cohort study.Thirty eyes of 30 IMH patients who received vitrectomy and inner limited membrane (ILM) peeling were included.The best-corrected visual acuity (BCVA),medical refraction test and optical coherence tomography (OCT) were performed.BCVA was recorded as logarithm of the minimum angle of resolution (logMAR).The macular hole index (MHI) was measured using OCT.The average logMAR BCVA and MHI in suffering eyes at baseline were 1.02± 0.07 and 0.47 ± 0.02,respectively.The uncorrected visual acuity of the fellow eyes was less than 0.1.Follow-up period was longer than 6 months.At 6 months after surgery,the central retinal thickness (CRT) was measured by OCT;vertical and horizontal metamorphopsia were measured by metamorphopsia charts;VRQoL was evaluated by Chinese VRQoL-25.Spearman correlation analysis was performed to analyze the relationship of VRQoL and postoperative BCVA,metamorphopsia and preoperative MHI.Results At 6 months after surgery,macular hole closure was confirmed by OCT in all patients.The vertical and horizontal metamorphopsia were (0.17± 0.03)° and (0.11 ± 0.03)°,respectively.The VRQoL-25 composite score was 79.81 ± 1.29.The average BCVA was 0.59±0.05.The average CRT was (155.10± 6.27) μm.The postoperative VRQoL was positive correlated with preoperative MHI (r=0.491,P=0.002),and negative correlated with preoperative BCVA (r=-0.445,P=0.014),postoperative BCVA (r=-0.530,P=0.003) and postoperative metamorphopsia (r=-0.532,P=0.006),but not correlated with the postoperative CRT (r=0.231,P＞0.05).Conclusions IMH patients improved their visual acuity after surgery,but still have metamorphopsia.VRQoL was negative correlated with metamorphopsia,positive correlated with preoperative MHI.

Objective To observe the effect of gene therapy for Parkinson disease by triple transduction with dopamine-biosynthesizing enzyme genes. Methods We constructed high titer purified adeno-associated virus (AAV) vectors containing cDNAs encoding human tyrosine hydroxylase (TH), aromatic L-amino acid decarboxylase (AADC) and GTP cyclohydrolase I (GCH) respectively. AAV-TH, AAV-AADC and AAV-GCH were stereotaxically injected into the denervated striatum of Parkinsonian rat; the expression of TH, AADC or GCH was assayed by using immunohistochemical staining; the rotational behavior was assayed for 1 year.Results The immunohistochemical staining and behavioral testing showed that all of TH, AADC and GCH were expressed stably in the striatum, and the rats treated with AAV-TH, AAV-AADC and AAV-GCH showed more remarkable decrease in rotation rate persisted for at least 1 year, than those treated with AAV-TH and AAV-AADC(P

Objective To explore the selection of reasonable interventional treatment to portal hypertension under different conditions.Methods The data of 76 patients with portal hypertension and interventional treatment from 1997 to 2002 were retrospectively analyzed. 26 patients were treated with transjugular intrahepatic porto-systemic stent shunt (TIPSS). Of these 26 patients, 11 patients suffered from hemorrhage after surgery treatment by devascularization, 6 patients with hemorrhage after stomach mirror treatment, and 9 patients with ineffective medicine treatment. 50 patients were treated with percutaneous transhepatic variceal embolization (PTVE) combined with partial splenic embolization (PSE), and they all showed inefficacy by medicine treatment. Free portal pressure (FPP) in pre- and post-treatment was measured in all 76 cases. The hepatic volume was measured by spiral-CT before and one year after the treatment.Results In TIPSS group, FPP was reduced from (3.85?0.42) kPa to (3.09?0.44) kPa (( t= 3.682, P

Based on binocular disparity, three-dimensional (3D) display technology makes the right and left eyes see different images in a certain way, which generates a stereo image after the processing of the brain's visual cortex.Due to its high-definition stereoscopic surgical field of vision and accurate spatial positioning ability, 3D display technology has been widely used in surgery.Ophthalmic microsurgery is performed with the help of microscope because of the complex intraocular operation and small operating space, especially minimally invasive vitreoretinal surgery, which is the most difficult surgery with the longest learning curve in ophthalmology.The 3D display viewing system can improve surgical accuracy, reduce retinal phototoxicity, relieve the pressure on the neck and back of the surgeon as well as promote communication and cooperation between medical staff and so on.At present, the major 3D display systems applied in ophthalmology include the NGENUITY 3D Visualization System and TrueVision 3D Visualization System, both of which require wearing 3D glasses.The naked eye 3D display system is the main direction of future development.The combination of 3D display system and ophthalmic surgical robot system provides a new idea for the development of remote ophthalmic surgery.At the same time, broader application of 3D display system requires continuous improvement.In this article, the research and application of 3D display system in anterior segment surgery and vitreoretinal surgery were reviewed.

OBJECTIVE To investigate and analyze hand carrier state of medical staff in Tianjin and the antibiotic resistance of the pathogens.METHODS Bacteria or pathogens were isolated from the samples using a sterilized cotton swab on the whole hand before hand washing or hand disinfection,and drug sensitivity test was performed.RESULTS In 16.72% of all samples(50/299),there were 64 kinds of bacteria or pathogens isolated.A.baumannii,Staphylococcus aureus and A.lwoffii were the most common bacteria,40.6% resistant to more then 3 kinds of drugs.Four Meticillin-resistant S.aureus(MRSA) strains were detected out.CONCLUSIONS The high rate of hand carrying bacteria and resistance in Tianjin should pay attention to.

Background Bevacizumab and triamcinolone acetonide (TA) has been widely used in the treatment of diabetic macular edema (DME) clinically,but the effectiveness of both treatment has disadvantage.Therefore,some researchers try to combine bevacizumab with TA for the management of DME,but its efficacy is controversial.Objective This study was to evaluate the efficacy and safety of intraovitreal injection of bevacizumab combined with TA versus bevacizumab for DME.Methods The randomized controlled trials (RCTs) of bevacizumab combined with TA versus bevacizumab via intraovitreal injection for DME were searched from Pubmed,EMbase,Cochrane Library,CNKI.The methodological quality of the literature was evaluated according to evidencebased medicine (EBM),and the quality of the RCTs was appraised based on the Cochrane Handbook for Systematic Reviews of Interventions Version 5.0.The outcome indicators including the change values of central macular thickness (CMT) and best-corrected visual acuity (BCVA) as well as the safety indicators including topical and system adverse response of RCTs were analyzed with Cochrane Collaboration' s software RevMan 5.0.Results Nine RCTs were included with 665 eyes.The decrease value of CMT was more remarkable in the bevacizumab combined with TA group than that of the only bevacizumab group 12 weeks and 18 weeks after intravitreal injection (WMD =-44.69,95％ CI:25.27-64.11,P ＜ 0.000 001 ; WMD =-66.86,95％ CI:40.67-93.05,P ＜ 0.000 001).However,no significant differences were found in the change value of CMT in 6 weeks and 6 months after injection between the two groups (WMD =-15.40,95％ CI:-4.04-34.85,P =0.12 ; WMD =-2.57,95％ CI:-19.62-24.75,P =0.82).The improvement value of BCVA (LogMAR) in the bevacizumab combined with TA group was superior to that of the only bevacizumab group 6 weeks after injection (WMD =-0.04,95 ％ CI:-0.08--0.00,P =0.05),but there were no significant differences between the two groups at 12weeks,18 weeks and 6 months after treatment (WMD =-0.04,95％ CI:-0.12-0.05,P=0.36;WMD =-0.04,95％ CI:-0.11-0.03,P=0.28; WMD =0.03,95％ CI:-0.05-0.12,P=0.45).The incidence rate of transient anterior response after injection was not significantly different between the two groups (RR =0.89,95％ CI:0.49-1.60,P =0.70).Secondary ocular hypertension after injection occurred in 30 eyes in the bevacizumab combined with TA group,but no hypertension was seen in the only bevacizumab group.Conclusions Compared with only bevacizumab,intravitreal injection of bevacizumab combined with TA has a better efficacy in improving CMT but no obvious dominant in increasing BCVA for early DME.Intravitreal injection of bevacizumab combined with TA seemingly has a higher risk of inducing controllable ocular hypertension than administration of only bevacizumab.