Objective To evaluate the predictive value of cord blood bilirubin levels for subsequent neonatal hyperbilirubinemia in term infants with ABO hemolytic disease.Methods A total of 292 term newborns with ABO hemolytic disease admitted from August 1,2011 to July 31,2012 were enrolled.Cord blood bilirubin levels were analyzed and the clinical characteristics of the neonatal hyperbilirubinemia group (n=34) and non-hyperbilirubinemia group (n=258) were compared.A receiver operating characteristic (ROC) curve analysis was performed to identify the predictive value of the occurrence and cut-off point of hyperbilirubinemia in term infants with ABO hemolytic disease.Paired-t-test,Chi-square test and Spearman correlation were used for statistical analysis.Results Of the 292 term infants with ABO hemolytic disease,34 cases had hyperbilirubinemia,with an incidence of 11.6％.Cord blood bilirubin levels were significantly associated with the presence of hyperbilirubinemia.The mean cord blood bilirubin level in infants who developed hyperbilirubinemia was (52.4± 13.2) μ mol/L,and was (35.0±8.0) μ mol/L for those who did not develop hyperbilirubinemia (t=7.540,P=-0.001).When cord blood bilirubin concentration increased,the incidence of hyperbilirubinemia gradually increased (x2=113.715,P＜0.001; rs=7.19,P＜0.001).The ROC area under the curve of 0.882 (standard error 0.005,95％CI:0.873-0.891,P＜0.001) was significant in predicting neonatal hyperbilirubinemia by cord blood bilirubin,and the occurrence of hyperbilirubinemia increased with increasing cord blood bilirubin level.Neonatal cord blood total bilirubin ≥ 50 μ mol/L predicted hyperbilirubinemia,and the positive predictive value was 0.683,negative predictive value was 0.959,sensitivity was 0.690 and specificity was 0.958.Conclusions Cord blood bilirubin level is useful in predicting subsequent neonatal hyperbilirubinemia in term infants with ABO hemolytic disease.

According to the anatomic classification,refractive surgery is divided into keratorefractive surgery,phakic refractive surgery and scleral refractive surgery.Most procedures for the correction of ametropia are performed on the cornea,with laser-assisted in situ keratomileusis(LASIK) being the most common one.LASIK has shown its limitations,however.For the correction of higher myopic and hyperopic refractive error,the procedure has considerable undesired effects,such as loss of contrast,glare,and iatrogenic keratectasia.Therefore,a variety of intraocular lens,known as phakic refractive surgery,have been designed to achieve full correction of high myopia and hyperopia without loss of accommodation.Phakic refractive surgery is different from kerato-or scleral refractive surgery in that it involves phakic intraocular lens,non-phakic intraocular lens and clear lens extraction +introcular lens.The author will outline recent progress in phakic intraocular lens and provide unifying concepts that are accepted by ophthalmologists.

OBJECTIVE:To explore the observation and nursing points of hemorrhage in intravenous thrombolysis after using alteplase. METHODS:128 patients underwent alteplase intravenous thrombolysis were selected as the research object. The occur-rence of hemorrhage in each part were observed within 48 hours after medication and nursed timely. RESULTS:128 patients re-ceived intravenous thrombolysis. 48 h later,26 patients suffered from hemorrhage complications (20.3%). Among them,there were 6 cases of nose bleeding (4.7%),8 cases of subcutaneous congestion (6.3%),6 cases of gingival bleeding (4.7%) and 6 cases of gastrointestinal bleeding(4.7%). There was no significant difference in the incidence of complications among those groups (P>0.05). The time of nose bleeding was (3.2 ± 1.3) h,the time of subcutaneous congestion (3.5 ± 1.2)h,the time of gingival bleeding(1.5±0.7)h,and the time of gastrointestinal bleeding(4.1±1.8)h. The time of gingival bleeding was earlier than that of other groups,with statistically significant difference(P<0.05). There was no statistically significant difference among other groups (P>0.05). CONCLUSIONS:In alteplase intravenous thrombolysis,nurses should closely monitor hemorrhage and complications, especially the complication of gingival bleeding. Find out the complications timely and nurse it as early as possible.

Objective To evaluate the clinical value of cervical conization in diagnosis and management of cervical carcinoma in situ.Methods The clinic-pathological data of the 65 patients with cervical carcinoma in situ from Jan 2004 to Feb 2007 were analyzed retrospectively.Results(1)Of the 65 patients,59 cases had received the colposcopical multiple biopsies before the cervical conization and there was a correlation in pathology between cervical conization and colposcopical multiple biopsies in 46 cases(78.0%),but there was not much correspondence between cervical conization and colposcopical multiple biopsy in 13 cases(22.0%).(2)30 patients were received hysterectomy or cervical conization again.Patients with positive margins were significantiy more likely to have residual disease than those with negative margins(P

Objectives:To evaluate the effectiveness of small fly spot scan excimer laser in situ keratomileusis for treatment of myopia accompanied with moderate astigmatism. Methods:Ninety six cases and 145 eyes were divided into three groups according to the preoperative refractive diopters. GroupⅠ: myopia 0～-6 D, astigmatism -2～-4 DC, groupⅡ:myopia -6.25～-10.0 D, astigmatism -2～-4 DC, and group Ⅲ:myopia≥10.25 D, astigmatism -2～-4 DC. The postoperative follow up was more than six months. Results:One month after the operation, uncorrected visual acuity equal to or better than 0.6 were 5.3% in groupⅠ, 15.8% in groupⅡ, and 66.7% in group Ⅲ. Six months after the operation, uncorrected visual acuity equal to or better than 0.6 were 4% in group Ⅰ,14% in groupⅡ,and 75% in group Ⅲ.Uncorrected visual acuity equal to or better than 1.0 were 96% in group Ⅰ, 86% in groupⅡ, and 25% in group Ⅲ.Postoperative refractive error within ?1.00 D were 8% in groupⅠ,14% in groupⅡ, and 41.7% in group Ⅲ. Postoperative refractive error within ?0.50 D were 92% in groupⅠ, 86% in groupⅡ, and 58.3% in group Ⅲ. Postoperative refractive clinder within ?1.00 DC were 8% in groupⅠ,10.5%in groupⅡ, and 50% in group Ⅲ. Postoperative refractive clinder within ?0.50 DC were 92% in group Ⅰ,89.5% in groupⅡ, and 50% in group Ⅲ. The average exciter zone diameter was (8.02?0.069)mm. Conclusions:Small fly spot scan exciter laser in situ keratomileusis is an effective and safe method to treat mild and moderate myopia accompanied with moderate astigmatism.

Objective:Contrast sensitivity(CS) is a new technique which measures the discrimination capacity of the human eye to an object under low contrast conditions.It is more acute and more complete in reflecting visual function than the Snellen chart which is used to test the discrimination under high contrast conditions.Our purpose is to compare the effect of an aspheric intraocular lens(IOL) with those of conventional monofocal silicone and acrylic IOL and multifocal IOL on functional visual performance. Methods:To 90 eyes after phaco emulsification with IOL implantation,30 eyes of age-matched patients were selected as control,all patients were 50-80 years old,with no disorders,other than cataract,known to affect CS.Corrected visions were all over 0.8.The CS was measured 30 days after surgery.Results:After surgery the patients' CS returned to the normal level,but which was lower than that of the control's.The aspheric IOL provided statistically significant better contrast sensitivity at 6,12 and 18 cycles per degree. Conclusion:The use of a modified prolate IOL in cataract surgery has the potential to improve CS,which is designed to partially compensate the average spherical aberration of the cornea.

Objective:To study analyze sthe contrast sensitivity of high myopia.Methods:The contrast sensitivity function(CSF) in 60 eyes of 30 patients with high myopia was studied with normal subjects as control.Those with other ocular disease or systemic disease were excluded to avoid any possible affection.The patients were aged from 12 to 62 years.Corrected vision were all over 0.8 in high myopia,and the control was more than 1.0.The contrast sensitivity function was measured with CSV-1000E Vision Testing Instrument(provided by VECTOR VISION company).Results:The results revealed that the CSF of high myopia in each space-frequency range was decreased.The difference between high myopia group and control group was significant(P

Objective:To determine whether laser in situ keratomileusis(LASIK) affects the central 30-degree visual field.Methods:This clinical trial comprised 31 patients(61 eyes)scheduled to have LASIK for myopia or myopic astigmatism.Automated static perimetry was performed before and 1 week,6 months after the surgery using the Octopus 1-2-3 perimetry.The main outcome measures were the meao sensitivity(MS) change in the central 15-degree visual field and the MS change in the 15-to 30-degree visual field.The preoperative and postoperative MS values were calculated,and the difference between them(delta MS) was determined.Statistical analysis were performed by SPSS12.0 using the randomized complete block design ANOVA(two factors analysis of variance).Differences among variables were evaluated by q-test. Results:One week after the operation,all uncorrected visual acuity equal to or better than 4.7.Six months after operation,visual acuity distributed between 4.9 and 5.2. There was no significant change in the central 15-degree visual field MS,neither 1 week nor 1 month after the operation;between 15 and 30 degrees,there was a statistically significant decrease.One week after the operation,the delta MS value was(-0.91?1.42)dB(mean?standard deviation);6 month after the operation,the delta MS value was(-0.87?1.38)dB. Conclusion:Automatic static perimetry can detect decreased sensitivity in the 15-to 30-degree visual field after myopic LASIK.It may be a useful quantitative subjective test for measuring the vision quality after refractive surgery in future.

Objective To explore the clinical value of laparoscopic-assisted vaginal hysterectomy(LAVH)in large uterus.Methods Retrospective analysis was conducted on clinical data of 94 patients(whose uterus were as big as 10-18 gestational weeks)who received hysterectomy from January 2005 to March 2007,in which 56 cases were performed laparoscopic-assisted vaginal hysterectomy(LAVH group)and 38 cases vaginal hysterectomy(VH group).The operation time,blood loss,postoperative hospital stay,and the incidence of postoperative complications were compared between the two groups.Results Compared with VH group,there were a lower chance of abdominal hysterectomy(0/56 vs 5/38,?2=5.389,P=0.020),a shorter operation time [(149?11)min vs(179?14)min,t=-11.610,P=0.000] and a shorter postoperative hospital stay [(5.8?1.4)d vs(7.3?3.6)d,t=-2.825,P=0.006] in the LAVH group.There were no significant differences in blood loss,morbidity and time to first flatus between the two groups.Conclusions The LAVH extends the indications of VH,ensuring the safety of VH for the uterus bigger than 10 gestational weeks,therefore it is an operative procedure to be recommended.

Objective: To evaluate the curative effect of the amblyopia therapeutic instrument and to search for a best treatment of amblyopia for pre-school children.Methods: One hundred and seven children with amblyopia were treated by the amblyopia therapeutic instrument and followed up, and the curative effects were analyzed.Results: The curative effects were significantty different between the group treeted with the instrument and those treated otherwise.Conclusion: The amblyopia therapeutic instrument is a satisfactorily effective option for the treatment of amblyopia in pre-school children.