Diabetic macular edema (DME) is the leading cause of visual impairment in diabetic patients.With developments in laser systems,laser photocoagulation continues to be the necessary treatment for DME.The power development of laser treatment is optimizing efficacy and minimizing complications.This article reviews the laser treatment progress for diabetic macular edema.

Objective To observe the clinical effect of procedure for prolaps and hemofrhoids (PPH) in treatment of mixed hemorrhoids combined with non-functional obstructed defecation syndromes (ODS).Methods The clinical data of 50 patients with mixed hemorrhoids combined with non-functional ODS treated by PPH were retrospectively analysed.All these patients were followed up for 12 months,the treatment outcome was observed.Results Eleven cases were basic cured,apparently effective in 12 cases,and effective in 12 cases,invalid in 15 cases,the total effective rate was 70％ (35/50),inefficacy patients were mainly combined with rectocele.None patients had serious complications such as death,anastomotic infection and pelvic sepsis.Conclusion PPH convenient operation,small trauma,for the treatment of mixed hemorrhoids combined with internal rectal prolapse is safe and effective,but the effective is poorer in treatment of mixed hemorrhoids combined with rectocele.

Objective To compare the safety and effectiveness of power peripherally inserted central catheters (Power PICC) and double cavity central venous catheter (CVC) application in intensive care unit (ICU). Methods 458 cases were reviewed during January to September in 2014 and divided into two groups: Power PICC group (245 cases) and CVC group (213 cases) , and average retention time, successful rate of inserting catheter and the incidence of complications were compared. Results The average retention time of Power PICC group was (21.6±5.8) days which was longer than (13.1±3.4) days of CVC group (t=2.234, P <0.05). No statistics difference of successful rate between two groups (P>0.05). No significant difference for the total incidence of complications between two groups as 14.69% (36/245) and 19.72%(42/213)(P>0.05). No significant difference for the total incidence of complications in the operation time between two groups as 5.31% (13/245) and 4.23% (9/213)(P>0.05). But rate of catheter malposition for Power PICC group [ 2.86% (7/245) ] was higher than CVC group 0 (X2=4.428, P <0.05). Rate of the total incidence of complications in the retention time Power PICC group [ 9.39%(23/245) ] was lower than CVC group [ 15.96%(33/213)(P<0.05). And rate of catheter related blood stream infection of CVC group [3.29%(7/213)] was much more higher than Power PICC group (0)(X2=6.139,P<0.05). Conclusions Power PICC and CVC are both applicable for ICU, and Power PICC has more advantage regarding safety and effectiveness than CVC and can be one replacement for CVC.

Objective To observe the effect of acupuncture at the muscle region of meridians plus tuina on facial nerve function in peripheral facial paralysis. Method Sixty patients with peripheral facial paralysis (recovery stage) were randomized into a treatment group (intervened by acupuncture at the muscle region of meridians plus tuina) and a control group (intervened by conventional acupuncture), 30 cases in each group. Result The facial nerve electromyography (EMG) showed that the action potential latency and amplitude were changed significantly after the treatment in both groups (P<0.05), indicating that the two methods were both effective in recovering facial nerve function, while acupuncture at the muscle region of meridians plus tuina produced a more significant treatment effect compared to conventional acupuncture. In the treatment group, same treatment with different intervention times produced significantly different effects on the Toronto facial grading system (TFGS) (P<0.05), indicating that the earlier the intervention, the more significant the therapeutic efficacy. Conclusion Acupuncture at the muscle region of meridians plus tuina can produce a more significant effect in recovering facial nerve function in peripheral facial paralysis compared to conventional acupuncture.

Objective To investigate a periosteal autograft method to repair major defects of joint cartilage in rabbits of different ages. Methods Major cartilage defects of 52 rabbits aged 4 to 52 weeks were repaired with free periosteal grafts and the results were compared in the study. The regenerated cartilage by the cambium of periosteum growing up to the cavity of joint and that growing down to the cancellus of femur were also compared. Results The macroscopical and histological observations at different intervals showed that in young and adult rabbits the grafts could develop into cartilages to repair the major cartilage defects. In adult rabbits the newly formed cartilage was the same as the normal cartilage in thickness and histology. There was no difference between the cambium growing up to the cavity and that growing down to the cancellus. Conclusions Periosteum possesses chondrogenic potential and can be used to repair the cartilage defects. Different directions of chondrogenesis leads to no significantly different outcomes. In adult rabbits the newly formed cartilage can develop into a normal one.

OBJECTIVE To explore the interventions for ventilator-associated pneumonia(VAP) caused by Acinetobacter baumannii by making investigation to the ICU patients on ventilators.METHODS Bacteria culture of bronchial discharge of patients on ventilators was conducted and followed by causation analysis of VAP caused by A.baumannii.RESULTS The prevalence of VAP caused by A.baumannii was 8.7%.The main reasons for VAP caused by A.baumannii were inappropriate use of antibiotics,long duration of mechanical assisted ventilation,contaminated ventilator and its accessories,unable to perform proper aseptic technique,and severity of the underlying illness.CONCLUSIONS For patients on ventilator,effective nursing interventions and sterilization and isolation techniques can reduce the infection and promote the treatment effects.

OBJECTIVE To understand the bacterial spectrum distribution of sputum among the lung infection patients in our hospital and their resistance mechanisms for the reasonable clinical application of antibiotics to effectively prevent the occurrence of nosocomial infections. METHODS The pathogens isolated from the sputum of patients were identified with pathogen micro-biochemical identification code and the commonly used antibiotics were detected by drug sensitivity tests. RESULTS From 415 samples of the sputum,537 strains were detected out,from them Gram-positive cocci accounted for 70.8%,Gram-negative bacteria accounted for 28.1%,and Candida albicans accounted for 1.1%;MRSA was in 18 strains and ESBLs 6 strains. CONCLUSIONS It is important to sputum culturing for lung infection patients and determining the pathogen species and in their drug susceptibility results,the in order to rationally use the antibiotics and enhance the effectiveness of treatment.

Objective To investigate the changes of hepatocyte growth factor (HGF) and vascular endothelial growth factor(VEGF) after partial hepatectomy in patients with liver cirrhosis and their relationship with liver regeneration. Methods Thirty-five patients with partial hepatectomy between June 2007 and August 2009 were enrolled,according to whether cirrhosis were divided into cirrhosis group (16 cases) and non-cirrhosis group (19 cases). Liver size were measured with angiographic computed tomography at 7,30,90 d after operation. Regeneration rate of remnant liver were calculated. The serum concentrations of HGF and VEGF were meaaured. Postoperative hepatic function and complications incidence rate were comparatively analyzed. Results Compared with non-cirrhosis group, the postoperative hepatic function of cirrhosis group suffered serious damage. In non-cirrhosis group, the remnant liver regeneration rate reached (63.6± 15.9)%, (79.4 ± 17.2)%, (97.2 ± 18.3)% at 7,30,90 d after operation,in cirrhosis group,it reached (41.7 ± 10.7)%, (55.7 ± 13.2)%, (76.6 ± 12.5)%, liver in non-cirrhosis group regenerated rapidly (P <0.05). After hepatectomy,the HGF levels in cirrhosis group increased significantly at 1,3,7 d than those in non-cirrhosis group(P ＜ 0.05), but the VEGF levels were lower. Conclusions Liver in the patients with cirrhosis regenerate slowly and it may be due to in part through a decrease in VEGF. Whether it may,when given therapeutically represent a strategy to optimize liver regeneration in problematic patients needs to be clarified.

OBJECTIVETo analyze the influence of prelaboratory and intralaboratory factors on the turnaround time of the reports in order to develop a reference database for continuous quality improvement, a retrospective study of the timeliness was reported.

METHODSUsing cluster sampling of a total of 5,979 pathology reports selected by sampling a single month's reports from each quarter of the year 2000, of which there were 5,250 cases from routine biopsy and 729 cases from operative specimen. The timeliness and the factors that influence the turnaround time of the two types of surgical pathology reports were analyzed.

RESULTS4,872 pathology reports of 5,250 routine biopsy cases were completed in 3 working days, and 613 of 729 cases of the operative specimens were completed in 4 working days. The percentage was 92.8% and 84.1% respectively. Factors that significantly contributed to the increase in turnover time of biopsy reports included request of immunohistochemical staining, delayed arrival of the operative specimen at the laboratory after frozen section, additional recutting, intradepartment consultation and decalcification etc. As for the operative cases, several factors were associated with delayed report: second day arrival of the operative specimen at the laboratory after frozen section, lack of the adequate clinical history, request for immunohistochemical staining etc.

CONCLUSIONSThe majority of surgical pathology reports in the department can be completed timely and the timeliness meets the general standard. Only about 10 percent of the reports were delayed because of some prelaboratory and intralaboratory factors, for which there were 33.5% and 66.5% respectively for routine biopsy, and 50.9% and 49.1% respectively for operative specimen.