With well understanding of the ethical problems in ophthalmic clinical treatment, strategies were developed to help establish a credible relationship with children and then to avoid causing psychological harm to them. The informed consent given prior to treatment can effectively minimize potential medical risks.

Objective To discuss the value of essential hypertension arteriosclerosis as a predictor of early renal damage.Methods 90 cases of essential hypertension with early renal damage were selected and statistical analysis to result of AASI,Scr,ACR and eGFR with SPSS17.0、Excel statistical analysis software were carried out.Group A was defined as AASI≥0.55 and group B was defined as AASI＜0.55.Compared the two groups with relevant analysis,and then built multivariate linear regression equation.Results ① The group A showed higher age(P＜0.01),24 h DBP(P＜0.05),ACR(P＜0.01),ACR(+) rate(P＜0.01)and lower eGFR (P＜ 0.01),compared with the group B.②AASI showed a positive correlation with age (r＝ 0.483,P＝ 0.000),24 h SBP (r＝ 0.350,P ＝0.001),ACR (r＝0.474,P＝ 0.000),and a negative correlation with eGFR (r＝-0.383,P＝ 0.000).Two multiple linear regressions showed that AASI was associate with eGFR (B ＝-0.001,P＝ 0.038) and ACR(B ＝ 0.025,P ＝ 0.000) independent of other factors.Conclusion ①Arteriosclerosis is closely related with age and blood pressure mutation rate day and night.②Arteriosclerosis has a closely relationship with essential hypertension early renal damage,and can predict early renal damage in hypertension patients.

Objective　In order to explore the prevalence of hypophosphatemia in postoperative patients of general surgery,as well as the time and dosage of phosphate replacement and its effects.Methods　To serum phosphate levels of 45 patients with phosphate replacement begun on the second postoperative day and 45 without replacement were monitored at the preoperative day,and the first,third,fifth and seventh postoperative day.Results　The incidence of hypophosphatemia was 91.1%(41/45) in cases without phosphate replacement.While it was 57.8%(26/45) in those with replacement.The serum phosphate concentrations in cases with phosphate replacement were higher than those without replacement on the third(P<0.001),fifth(P<0.05) and seventh(P<0.01) postoperative day.The Apache Ⅱ scores in cases with phosphate replacement decreased on the third postoperative days compared with those on the first day(P<0.001).Conclusion　The postoperative replacement of phosplates can avert the occurrence of hypophosphatemia and improve the Apache Ⅱ score.

Chronologicaol order of acupuncture,as one of the in uential factors of acupuncture therapeutic e ect,has been commonly ignored at present.This article is to explain the rationality and necessity of chronologicaol order of acupuncture through following aspects.One is based on TCM theory,such as the'branch'and the'root',gentleness and urgency,qi and blood,reinforcing de ciency and reducing excess.The other is ndings of modern clinical and experimental researches.

AIM: To investigate therapeutic effects of recombinant human growth hormone(rhGH) on rat sepsis and its possible mechanisms. METHODS: Mean arterial pressure (MAP), levels of plasma TNF?,IL-1? and endotoxin,leukocyte count and survival rate within 1 week were determined after E. coli injection among control group,sepsis group and sepsis+rhGH group. RESULTS: (1)rhGH diminished the decrease of MAP, reduced plasma endotoxin and TNF? levels and increased neutrophil ratio in total leukocytes in sepsis rat. rhGH increased survival rate within 1 week on sepsis rat. (2)No changes were found in IL-1? level among the three groups. CONCLUSION: rhGH showed desirable beneficial effects on rat sepsis, which may attribute to: improving circulatory function; maintaining intestinal mucosa barrier, attenuating bacteria/endotoxin translocation and inhibiting the production and release of TNF?.

ObjectiveTo value fluorescent quantified PCR (polymerase chain reaction) technique to detect the DNA of Mycobacterium tuberculosis from clinical patients.MethodsDetect the DNA of TB from the sputum of 80 active tuberculosis and hydrothorax of 40 tuberculous pleuritis.At equal pace,make a comparison to proceed microscopic examination and cultivation.ResultsWith fluorescent quantified PCR,56.2％ (45/80),27.5％ (11/40)positive detection from active tuberculosis and tuberculous pleuritis respectively.16.2％ ( 13/80 ),0.0％ positive specimen were detected with microscopic examination in two group of patients.Cultivation got 37.5％ (30/80),2.5％(1/40) positive detection respectively.ConclusionFluorescent quantified PCR was more sensitive and specific than traditional methods,and valuable in the microscopic examination and cultivation negative patients especially.

Objective To evaluate the diagnostic value of virtual touch tissue quantification (VTQ) for nonpalpable breast masses.Methods Two hundred and one nonpalpable breast masses in 176 women who had been scheduled for a sonographically guided core biopsy or operation were examined with the B-mode sonography and VTQ.The pathologic diagnosis was used as the golden standard.The diagnostic performances of the two methods were evaluated with receiver operating characteristic curve(ROC).Results The mean shear wave velocity (SWV) measurement values were (6.17 ± 1.95)m/s in malignant masses and (3.39± 1.82)m/s in benign masses(P ＜0.01),respectively.The area under the ROC curve was 0.789 for the VTQ and 0.840 for the BI-RADS-US,respectively.No statistically difference was found between them.The area under the ROC curve of the combination of the two methods was 0.934,the diagnostic performance of the combination was better than that of BLRADS-US(P ＜0.01)and VTQ alone (P ＜0.01).Conclusions VTQ is a good method for diagnosing nonpalpable breast lesions.The combination of BI-RADS-US and VTQ has better diagnostic perform ance for differentiation of nonpalpable breast lesions,which has important value in clinical application.

Objective To investigate the state of perceived stigma,self-efficacy and quality of life of patients with mental disorders,and analyze the relationship among these variables,and explore the mediating effect of self-efficacy between the perceived stigma and quality of life.Methods Totally 406 patients with mental disorders were assessed with the Perceived Devaluation-Discrimination Scale (PDDS),Self-efficacy Scale (SES) and Schizophrenia Quality of Life Scale (SQOLS).Results The average score of PDDS was (2.44±0.36).The average score of GSES was (25.75±7.31).The perceived stigma,self-efficacy and quality of life were significantly correlated with each other.The self-efficacy played a mediating role between perceived stigma and quality of life.Conclusions The self-efficacy is the intermediary variable of perceived stigma and QOL of patients with mental disorders.

OBJECTIVE:To study the therapeutic effect of naloxone early to administer on acute craniocerebral trauma ME_THODS:46 patients with acute craniocerebral trauma were randomly divided into two groups:Besides routine treatment,25 patients were treated with naloxone in a dose of 8mg q d ,21 patients did not treated with naloxone The GCS score,plasma ET levels,transcranial Doppler(TCD),and electroencephalogram(EEG) were measured 1 day,7 days after the administration The results were analyzed statistically RESULTS:In treatment group,GCS score was obviously improved,the level of ET in plasma was reduced;brain vasospasm incidence rate was lower and abnormal rate of EEG was lower in comparison with those in control group As a result,the detecting indices in treating group were superior to those in the control group(P

Objective To investigate the value of C-reactive protein (CRP),serum amyloid A (SAA) and CD64 in early diagnosis of sepsis in very low birth weight infants (VLBWI).Methods Fifty-four VLBWI suspected to sepsis and 20 VLBWI without infection in neonatal intensive care unit of the Second Hospital of Wenzhou Medical College from May 2010 to May 2012 were enrolled in this study.CRP,SAA and CD64 of sepsis group were measured at 0 and 24 hour after suspected bacterial infection; and those of control group were measured at corresponding age.CRP and SAA were detected by enzyme-linked immunosorbent assay,and CD64 was detected by flow cytometry.The difference between groups was compared by Mann-Whitney U test.Receiver operating characteristic curve was used to predict the sensitivity and specificity of the three biomarkers on sepsis.Results Fifty-four VLBWI were suspected with sepsis,and 37 patients were finally diagnosed.The levels of the three biomarkers in sepsis group were higher than those of control group not only at 0 h [CRP:13.3 mg/L(4.6-67.2 mg/L) vs 4.4 mg/L(1.6-11.2 mg/L),Z=-2.308; SAA:95.7 mg/L(4.5-265.9 mg/L) vs 7.3 mg/L(2.5-16.9 mg/L),Z=-2.425; CD64:7306 fluorescent antibody molecules/cell (2667-10 853 fluorescent antibody molecules/cell) vs 2502 fluorescent antibody molecules/cell (1839-3017 fluorescent antibody molecules/cell),Z=-3.704],but also at 24 h[CRP:35.4 mg/L (7.7 106.5 mg/L) vs 3.2 mg/L (1.1-7.8 mg/L),Z-5.501; SAA:359.3 mg/L (3.8-503.2 mg/L) vs 6.6 mg/L (3.0-12.7 mg/L),Z =-2.818; CD64:8304 fluorescent antibody molecules/cell (2819-11 758 fluorescent antibody molecules/cell) vs 2563 fluorescent antibody molecules/cell (1760-3154 fluorescent antibody molecules/cell),Z =-7.670],P＜0.05 respectively.The best cutoff value of CD64 was 2934 fluorescent antibody molecules/cell,with the sensitivity of 81.1％ at 0 h and 91.9％ at 24 h; and the specificity of 90.0％ at 0 h and 80.0％ at 24 h.Although SAA had similar sensitivity (0 h:83.8％; 24 h:86.5％) as CD64,its specificity was relatively low(0 h:65.0％; 24 h:55.0％).Both the sensitivity (0 h:62.2％; 24 h:70.3％) and specificity (0 h:70.0％; 24 h:70.0％) of CRP were low.Combination of the three infection biomarkers could increase the sensitivity (0 h:91.9％; 24 h:97.2％) and specificity (0 h:95.0 ％ ; 24 h:90.0％).Conclusions Combination of CRP,SAA and CD64 might improve the diagnostic accuracy of sepsis in VLBWI.