AIM:To investigate the clinical value of wide angle digital imaging system ( RetCam Ⅱ) for the screening of retinopathy of premature infants ( ROP) .
●METHODS: A total of 200 cases ( 400 eyes ) in preterm children were selected Jan. 2012 to Dec. 2015 in line with obstetric screening criteria using RetCamⅡROP screening children for binocular indirect ophthalmoscopy results as the gold standard, RetCamⅡ for screening value of ROP in premature children.
●RESULTS:The screening of 200 cases ( 400 eyes ) in premature infants, binocular indirect ophthalmoscopy were detected 63 eyes with ROP (15. 8%), 337 normal eyes, 42 eyes with ROP phase l, 14 eyes with phase ll, 7 eyes with phase lll, no one with ROP phase lV and ROP phaseⅤ. A total of a 64 eyes with ROP were screened by RetCam ll, which the misdiagnosis in 5 eyes, diagnostic level decreased in 6 eyes. The consistency of RetCam ll detection results with binocular indirect ocular fundus examination results was 0. 814, P<0. 05. RetCamⅡfor screening children preterm children ROP lesion sensitivity of 93. 7% and a specificity of 98. 5%, missed diagnosis rate was 6. 4%, misdiagnosis rate was 1. 5%, 92. 2%positive predictive value, negative predictive value of 98. 8%.
● CONCLUSION: RetCam Ⅱ in preterm children ROP screening has high clinical value.

Objective To explore a brief regimen to treat and manage asthmatic patients.Methods 122 asthmatic patients(including 12 inpatients) treated and managed at respiratory clinic were followed up for 1～10 years.The data of these patients were collected and analysed Results On the base of asthma education patients were received inhaled glucocorticoid combined with ? 2 agonist and/or theophylline for two to five years Of 122 patients,20(16 4%) patients remised and remained good control without any medication,90(73 8%) patients relapsed within 1 to 2 years after drug withdrawal Conclusions Asthmatic patients must be treated and managed regularly according to GINA It was especially emphasized that inhaled glucocorticoid is the mainstay of ling term threapy Most patients can remise for quite a long time with agreeable quality of life while a few patients can be cured

Based on the analysis on the present status and importance of medical humanity education for inter-national medical students during the clinical internship, this paper discussed the importance of strengthening medi-cal students′humanistic education during the clinical internship and proposed ways to promote the humanity educa-tion:optimizing the setting of humanity education curriculum and adhering to the humanity education throughout the whole process of clinical internship;improving the clinical supervisors′humanity quality and ensuring the quality of humanity education;holding the orientation of evaluation and adding the humanity quality as one of the evaluation indicators; establishing hospital atmosphere with humanity spirit and highlighting environmental education effect;building theuniversity-intern hospital two-grade platform of humanity education and standardizing the relevant systems.

Objective To investigate the effects of zinc gluconate combined with Danshen injection on the plasma lipid level following exposure to noise in rats. Methods Fifty female SD rats were randomly divided into a control group, a noise exposure group (model group), a zinc gluconate + noise exposure group (zinc gluconate group), a Danshen injection+noise exposure group (Danshen injection group) and a zinc gluconate+Danshen injection+noise exposure group (combination group), 10 rats in each group. The zinc gluconate group received intragastric administration of zinc gluconate 8-10 mg/(kg?d), the Danshen injection group received intraperitoneal injection of Danshen injection 6 mg/(kg?d), the combination group received intragastric administration of zinc gluconate 8-10 mg/(kg?d) and intraperitoneal injection of Danshen injection 6 mg/(kg?d). On the day 10, except in the control group, the rats in the rest of the groups were continuously exposed to high frequency steady noise for 7 days (4 000 Hz, 95 dB, 3 h/d). The serum levels of total cholesterol (TC), triglycerides (TG), high density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C) were detected. Results The serum levels of TC (1.88 ± 0.17 mmol/L vs. 1.55 ±0.09 mmol/L), TG (1.45 ± 0.38 mmol/L vs. 1.01 ± 0.27 mmol/L), LDL-C (0.29 ± 0.04 mmol/L vs. 0.23 ± 0.03 mmol/L) in the model group were significantly lower than those in the control group (P<0.01 or P<0.05), while the serum HDL-C level in the model group were significantly lower than that in the control group (0.55 ± 0.08 mmol/L vs. 0.62 ±0.06 mmol/L;P<0.01). The serum TC level in the zinc gluconate group was significantly lower than that in the model group (1.71 ± 0.11 mmol/L vs.1.88 ± 0.17 mmol/L;P<0.05). The serum levels of TC (1.73 ± 0.21 mmol/L vs. 1.88 ± 0.17 mmol/L) and LDL-C (0.25 ± 0.03 mmol/L vs. 0.29 ± 0.04 mmol/L) in the Danshen injection group were significantly lower than those in the model group(all P<0.05). The serum levels of TC (1.57 ± 0.21 mmol/L vs. 1.88 ± 0.17 mmol/L), TG (0.84 ±0.40 mmol/L vs. 1.45 ± 0.38 mmol/L) and LDL-C (0.24 ± 0.05 mmol/L vs. 0.29 ± 0.04 mmol/L) in the combination group were significantly lower than those in the model group (P<0.01 or P<0.05), and the serum HDL-C level (0.61 ± 0.07 mmol/L vs. 0.55 ± 0.08 mmol/L) in the combination group was significantly higher than that in the model group (P<0.05). Conclusions Noise exposure may induce dyslipidemias in rats. Zinc gluconate and Danshen injection can regulate the plasma lipid level following exposure to noise in rats, and combination of zinc gluconate and Danshen injection may be superior to zinc gluconate or Danshen injection alone.

Objective To explore the differences of Th17 population and serum transforming growth factor (TGF)-β1 levels between early-and late-stage primary biliary cirrhosis (PBC) and their roles in pathogenesis.Methods Peripheral Th17 counts were analyzed by flow cytometry.The expression of IL-17A in peripheral blood mononuclear cells and TGF-β1 were measured by real-time quantitative polymerase chain reaction.Serum concentration of TGF-β1 was measured by enzyme-linked immunosorbent assay.Liver biopsies were stained with hematoxylin-eosin to determine the pathological stage.Results were evaluated using KrustalWallis test followed by Mann-Whitney U tests for comparisons of Th17 population between patients with early and late PBC,patients with chronic hepatitis B (CHB) and health controls (HCs).ANOVA followed by LSD t-tests were used for comparing IL-17 mRNA,TGF-β1 mRNA and TGF-β1 serum concentration between groups.The correlations between Mayo risk score and peripheral Th17 of PBC patients,Mayo risk score and serum concentration of TGF-β1 was analyzed by Pearson correlation analysis separately.Results The peripheral Th17 population increased in patients with early PBC (1.03±0.33)％,compared to those with late PBC [(0.48± 0.13％,U=14.0,P＜0.01],CHB [(0.56±0.35)％,U=104.5,P＜0.01],and HCs [(0.36±0.17)％,U=8.0,P＜0.01],while TGF-β1 changed in the opposite direction.Serum concentration of TGF-β1 elevated in late PBC (43.0± 18.7) ng/ml compared with early PBC (29.5±12.2) ng/ml,t=2.85,P=0.006.Conclusion The opposite changes of Th17 population and TGF-β1 level in early and late PBC indicated their different roles in different stages.Th17 may contribute to the autoimmune response in early PBC,participate in the occurrence of autoimmune inflammation,while TGF-β1 to fibrogenesis in late stage.In addition,the possible regulation mechanisms of differentiation of Th17 by TGF-β1 cannot be ignored.

Objective To observe the clinical efficacy of Yu’s meridian detection and treatment plus acupuncture in treating facial paralysis.Method Sixty patients with facial paralysis in acute stage were randomized into a treatment group and a control group, 30 cases in each group. The treatment group was intervened by Yu’s meridian detection and treatment plus acupuncture, while the control group was by ordinary acupuncture. The House-Brackmann (H-B) scale and symptom-sign scores were observed before and after the treatment.Result The H-B scale scores were changed significantly in the two groups after the treatment (P<0.05). After the treatment, the H-B score of the treatment group was significantly different from that of the control group (P<0.05). The symptom-sign scores were significantly changed in both groups after the treatment (P<0.01). The symptom-sign score of the treatment group was significantly different from that of the control group after the treatment (P<0.05).Conclusion Yu’s meridian detection and treatment plus acupuncture is an effective method in treating facial paralysis.

Objective To investigate the incidence and risk factors of adverse drug reactions in hematological system induced by linezolid.Methods In this retrospective study, 124 inpatients treated with linezolid (n=62) or vancomycin (n=62) for anti-infective therapy between January 2012 and December 2015 in clinical departments of the Second Affiliated Hospital of Anhui Medical University were included.The incidence hematological adverse drug reactions were observed, and the single factor and the multiple factor Logistic regression methods were used to analyze the risk factors of developing thrombocytopenia and decline of hemoglobin.Results Among the 62 inpatients treated with linezolid, thrombocytopenia occurred in 21 patients(33.87%), and decline of hemoglobin occurred in 17 patients (27.42%).No patient discontinued the use of linezolid for the reason of thrombocytopenia or decline of hemoglobin.In multiple stepwise regression analysis, linezolid use[OR=7.699,95%CI (1.408,42.090),P=0.019], treatment duration>14 d[OR=7.639,95%CI(1.162,50.226),P=0.034], baseline eGFR<80 mL·min-1[OR=6.150,95%CI(1.604,23.577),P=0.008], baseline ALB<25 g·L-1[OR=4.078,95%CI(1.017,16.351),P=0.047] and baseline platelet count<200×109·L-1[OR=6.148,95%CI(1.705,22.172),P=0.006] were independent risk factors for thrombocytopenia;linezolid use [OR=4.335,95%CI(1.308,14.365),P=0.016] and baseline ALB<25 g·L-1[OR=5.424,95%CI(1.824,16.129),P=0.002] were independent risk factors for the decline of hemoglobin.Conclusion The incidences of thrombocytopenia and anemia induced by linezolid are not rare, and most of them can be returned to normal.The risk factors of thrombocytopenia and anemia should be concerned and the routine blood test should be monitored during use.

Objective To research the serum urea nitrogen (BUN),creatinine (Cr),urinary inhibition C (CysC) and retinol binding protein (RBP) four biochemical indicators of joint detection on the early diagnostic value of lupus nephritis (LN).Methods According to the American Rheumatology Association (ACR) 2012 revision of the diagnostic criteria,collected 177 LN patients with kidney disease from January 2011 to April 2016 in Shaanxi Provincial People's Hospital,at the same time,choose 167 cases of healthy physical examination as normal control group.With Hitachi 7170A a fully automated analy zer on two groups of serum BUN,Cr,CysC and concentration of RBP for testing,the data obtained by SPSS17.0 statistical software for statistical analysis.Results LN patient group compared with healthy controls,the serum BUN (6.67 ± 1.43 mmol/L vs 6.57±1.16 mmol/L),Cr (96.9±10.1 μmol/L vs 92.6±13.2 μmol/L),CysC (1.7±0.5 mg/L vs 0.75±0.15 mg/L),RBP (180.5±8.28 mg/L vs 42.6±9.6 mg/L) concentrations were higher,and serum CysC,RBP higher level com pared with healthy control group difference was statistically significant (t=8.145,21.594,all P＜0.05).Single parameter detected abnormal rate in terms of LN patients serum BUN,Cr,CysC and RBP abnormal rates were 28.3％,29.4％,68.4 ％,65.0 ％,four indicators combined detection of abnormal rate was 85.3 ％,significantly higher than the single parameter test (x2 =35.973～168.742,all P＜0.01).Conclusion Conbined detection of BUN,Cr,CysC and RBP four early diagnosis of renal damage in patients with lupus nephritis had important clinical value.

Objective To clarify the diagnostic value of salivary gland ultrasonography in Sj(o)gren's syndrome (SS),and its correlation with the disease activity index and important organs involvement were analyzed.Methods A total of 116 patients with SS were involved,including 71 cases of primary SS and 45cases of secondary SS.Ultrasonography examination of major salivary glands was conducted for these patients,at the same time the clinical data including inflammatory parameters,the immunological parameter and the involved systems were collected.Ultrasonography examination was conducted in 49 cases as the control group.Use t test,x2test and analysis of variance for statistical analysis.Results The positive rate of salivary gland uhrasonography in SS (56/116,48.3％) was significantly higher than that of the normal control groups (1/49,2.0％),(The chi-square value was 32.57,P＜0.05),the sensitivity of salivary gland ultrasonography in primary SS (62.0％) was obviously higher than secondary SS (27％),(The Chi-square value was 13.75,P＜0.01).The specificity of salivary gland ultrasonography was 98％.The scores of salivary gland ultrasonography had shown positive correlation with the erythrocyte sedimentation rate,the levels of Immunoglobulin (Ig)G,and RF(r=0.234,0.353,0.176;P=0.002,0.000,0.013),and negative correlation with the white blood cell count (r=-0.292,P=0.000).Conclusion Salivary gland ultra-sonography provides additional evidence for the diagnosis of SS,particularly in primary SS groups.The scores of ultrasonography are correlated with inflammatory biomarkers,indicating that salivary gland ultrasonography is related to disease activity.

Objective To study the changes and significance of Bid gene expression in hypoxic-ischemic brain damage (HIBD) in neonatal rats.Methods The animal models of HIBD were made. Total RNA from ipsilateral cerebral hemisph ere was extracted.RT-PCR was used to evaluate the levels of Bid gene expression at different time points after hypoxic-ischemic. Results The levels of Bid mRNA were higher in HIBD rats than those in normal rats.The ex pression of Bid mRNA in ipsilateral hemiphere following cerebral hypoxic-ischem ic began to increase at 6 h, increased to the highest level at 24 h, and then gr adually returned.Conclusion The upregulation of Bid mRNA can play a role in the induction of apoptosis fol lowing cerebral hypoxic-ischemic. J Appl Clin Pediatr,2005,20(2):121-122