Objective To investigate corneal shape changes following three different surgical procedures of retinal and vitreous surgery. Methods A total of 41 eyes of 41 patients were divided into 3 groups based on the type of surgical procedure: encircling with vitrectomy, encircling with additional segmental buckling, and local buckling. The corneal shapes of these eyes were examined by corneal topographic machine before operation and one week, one month, and three months after operation. Results Corneal astigmatism and surface asymmetry index(SAI) significantly increased one week after operation compared with before operation (P

Objectives To study ho to make an accurate diagnosis of ectopic pregnancy in the early stage through different ultrasonic checking ways, so as to decrease the misdiagnosis and missed diagnosis rates. Methods 195 cases of ectopic pregnancy patients, which were diagnosed by abdominal ultra-sound (TAS) or by vagina ultra-sound (TVS), were collected, then compared with the operational pathological results and anzlyzed the reasons of the misdiagnosis and missed diagnosis, so as to find out the best ultrasonic way. Results 195 cases of ectopic pregnancy patients were diagnosed by ultrasound, the positive coincidence rate was 95.4% (186/195), misdiagnosis rate was 4.1% (8/195) and missed diagnosis rate was 0.5% (only 1 case). Among 186 cases of ectopic pregnancy, which totally conformed to the operational pathological results, 82 cases were pelvic adhesion, 51 cases (62.2%) were diagnosed ectopic pregnancy by TAS. 104 cases were not pelvic adhesion, in which 48(46.2%) cases were diagnosed ectopic pregnancy by TAS, then the significant differences were being shown. Conclusions When in pelvic adhesion, the ultrasonic checking way is mutually related to the positions of the oviduct and ovary in the pelvic cavity. When the oviduct and ovary are pressed close to the anterior abdominal wall, TAS is the best way while they are pressed close to posterior pelvic wall, TVS is the best way. The ultrasonic checking way for ectopic pregnancy is varied upon different patients.It is the main reason of misdiagnosis and missed diagnosis, that the clinical material and dynamic observation were not taken into consideration

To investigate the mechanism of aldosterone in the induction of hypertensive myocardial fibrosis, we compared the changes of the incorporation rate of 3H proline, the contents of cardiac tissue collagen, and the activities of the cardiac mitogen activated protein kinase (MAPK) in the spontaneous hypertensive rats (SHRs) untreated and treated with a competitive antagonist of the aldosterone receptorspironolactone (spiron), and also in normotensive rats. The results showed that the incorporation of 3H proline incubating with the myocardial tissue slices significantly increased at three time points (at 4,6,8 h), that the tissue collagen contents and the activities of tissue MAPK also increased in SHRs than in SHRs treated with spiron and in normotensive rats. It suggests that aldosterone stimulates the cardiac MAPK through specific recepter, thus increases the absorption of proline and synthesis of collagen in the cardiac fibroblasts, and in turn, is responsible for the myocardial fibrosis.

Objective To study the etiology and antibiotic resistance of bloodstream infections in low birth weight preterm infants .Methods A total of 95 cases of bloodstream infections in low birth weight preterm infants were treated in our hospital from January 2011 to April 2014 .The clinical data of these patients were analyzed retrospectively .Results A total of 96 pathogens were isolated ,including 57 strains of gram‐negative bacilli ,38 strains of gram‐positive cocci ,and 1 strains of Trichosporon asahii .The most frequently isolated pathogens were Klebsiella pneumoniae (40 strains)and coagulase‐negative Staphylococcus(31 strains).All gram‐negative bacilli were sensitive to carbapenems such as imipenem and panipenem . Streptococcus isolates were sensitive to most antibiotics .Most Staphylococcus isolates were methicillin‐resistant ,which were highly resistant to common antibiotics but all sensitive to linezolid , vancomycin and teicoplanin . Conclusions The most important pathogens responsible for bloodstream infections in low birth weight preterm infants in our hospital are K lebsiella pneumoniae and coagulase‐negative Staphylococcus . Early identification of responsible pathogen and rational antimicrobial therapy are critical for good prognosis of bloodstream infections in low birth weight preterm infants .

Objective To determine the clinical value of laparoscopic right hepatectomy (LRH) carried out following a standardized technique.Methods The medical records of 15 patients who underwent LRH at the First Affiliated Hospital of Soochow University were retrospectively reviewed.The perioperative indicators which included the operation duration,blood loss,tumor diameter,hospitalization duration and postoperative complications were analyzed.Results There was no conversion to open surgery.The operation duration was (251.1 ± 73.3) min.The resected tumor diameter was (8.5 ± 4.2) cm,the blood loss was (550.8 ± 343.6) ml,and the hospitalization duration was (10.2 ± 3.7) days.There was one patient who developed postoperative bile leakage.There was no other complication and there was no perioperative death.Conclusions The standardized technique of LRH was easy and effective.This technique shortened the operation duration and improved patient safety.

We described clinical process of two cases of intraocular lymphoma in aspects of early diagnosis by fine needle aspiration (FNA) and biopsy and treatment by intravitreal methotrexate (MTX). Two patients were suspected to have primary intraocular lymphoma (PIOL) with geographic yellow-white infiltrates and vitreous opacity. FNA confirmed malignant intraocular lymphoma in one patient and failed in the other patient due to complication of vitreous hemorrhage. Subsequent vitreous biopsy confirmed malignant intraocular lymphoma in the other patient. Both patients were treated by intravitreal methotrexate. In case 1 the tumor had complete remission and follow-up of 12 months had not found any signs of recurrence. In case 2 the patient died of brain metastasis 22 months after the ocular biopsy. Our findings demonstrate that although cytological examination of vitrectomy specimens remains the gold standard in diagnosis of PIOL, examination of FNA and biopsy increases the reliability of early diagnosing or excluding a PIOL. Individualized intravitreal methotrexate can be used to effectively treat PIOL. More effective integrated program treating primary central nervous system lymphoma/PIOL is worthy of looking forward to.

Objective To explore the effects of empowerment education on rehabilitation in patients with celebral hemorrhage . Methods Select 200 cases of patients with celebral hemorrhage cured rehabilitation medical center ,the patients were randomly and single-blindly divided into 2 groups (n=100 each) .Both the treatment group and the control group were given rehabilitation guid-ance on the day of discharge and 1st ,2nd ,4th ,7th ,9th ,12th weeks after discharge .Patients in control group were given compliance education philosophy ,and patients in treatment group were given empowerment education philosophy .Patients of both groups were used Barthel index (BI) to assess the activities of daily living (ADL)and motor assessment scale (MAS) to motor function in the day of discharge and 25th weeks after discharge from hospital .Results The BI [(44 .12 ± 8 .56) vs .(62 .16 ± 8 .77)]and MAS [(18 .70 ± 9 .47) vs .(28 .53 ± 8 .75)]of treatment group were apparently higher than those of the control group (P<0 .01) .The to-tal effective rate of the treatment group was higher than that of the control group(70% vs .85% ) Conclusion Empowerment educa-tion can obviously improve the ADL function and promote the recovery of motor function in patients with cerebral hemorrhage and improve the effect of family rehabilitation .

Objective To investigate the expression and significance of programmed death-1 (PD-1) in cellular immune response of patients with tuberculosis (TB) infection .Methods Twenty drug-sensitive (DS) and fifteen drug-resistant (DR ) subjects with TB infection who were hospitalized in Jiangmen Central Hospital affiliated Sun Yat-Sen University and Jiangmen tuberculosis dispensary from July 2011 to July 2012 were included in this study . Twenty-six healthy subjects were included as control . The expressions of PD-1 on CD4 + and CD8 + T lymphocytes were measured using flow cytometry and plasma interferon-γ (IFN-γ) ,levels were analyzed before and after TB treatment for 3 months .Kruskal-Wallis H test was used for analysis of multiple independent samples and Wilcoxon signed-rank test was used for analysis of paired samples . Pearson test was used for correlation analysis . Results After anti-TB chemotherapy ,the expressions of PD-1 on CD4 + and CD8 + T cells in both TB groups were significantly decreased (DS group :15 .99% vs 21 .59% and 11 .86% vs 18 .52% ;DR group :26 .64% vs 35 .47% and 29 .64% vs 34 .56% ) (both P < 0 .05) .Plasma IFN-γ level in DS group increased significantly after treatment(50 .65 ng/L vs 32 .31 ng/L , P < 0 .01) ,while that in DR group did not increase significantly (22 .26 ng/L vs 20 .03 ng/L ,P> 0 .05) .In DS group ,the expression of PD-1 on CD4 + T lymphocytes was negative correlated with plasma IFN-γ level both before and after anti-TB chemotherapy (pre-treatment : r = - 0 .510 , P < 0 .05 ; post-treatment : r = - 0 .520 , P< 0 .05 ) . Conclusions PD-1 modulates T cell function of immune response against TB infection in DS-TB subjects and plays a key regulatory role in CD4 + T lymphocyte mediated immunity during TB infection . However , the immunomodulatory mechanism of cell immunity in DR-TB subjects may be more complex .

To determine the diagnostic value as well as the evaluation value in therapy, the specific IgM and IgG anti-bodies of the infected and treated rabbits were detected using soluble egg antigen(SEA) and adult worm antigen(AWA) by ELISA. By using SEA to detect the IgM antibodies, the serum antibody level rapidly dropped 7 weeks after infection even without treatment, and those of IgM in sera detected by AWA rose early than IgG detected by SEA. After 5 month treatment, IgM detected by AWA and IgG detected by SEA were still positive. From these observations, it is evident that SEA is a better antigen to detect specific IgG in the diagnosis of schistosomiasis, AWA is a better one for early diagnosis. The use of AWA as antigen to detect IgM showed high diagnostic value both in acute and chronic schistosomiasis. However, detection of the IgM/ IgG in ELISA using SEA and AWA could not evaluate the therapeutic effect well.

Objective To investigate the diagnosis and treatment of post-transplant lymphoproliferative disease (PTLD) after hematopoietic stem cell transplantation (HSCT).Methods Clinical data of one case of PTLD,including clinical manifestations,diagnosis and treatment,were retrospectively analyzed.And the related literatures were reviewed.Results From January 2007 to November 2012,one case developed PTLD among 196 patients who were followed up after HSCT in the First Affiliated Hospital of Chongqing Medical University.The incidence of PTLD was 0.5％.Clinical manifestations of the patient were not typical,including frequent fever,multiple lymphadenopathy and multiple pulmonary nodules.The patient was diagnosed as diffuse large B-cell lymphoma (B-DLCL) by pathological examination of the swollen lymph node.After withdrawal of immunosuppressants,the temperature returned to normal,and lymphadenopathy and pulmonary nodules disappeared completely.Conclusion PTLD is a severe complication of HSCT with distinctive morphologic and clinical characteristics.The origin of this disease may be associated with Epstein-Barr virus infection and imrnunosuppressive therapy.It needs the pathologic detection to make a definite diagnosis.Several different treatment strategies have been employed,and reduction of immunosuppressive therapy may lead to regression of PTLD.