Objective To evaluate improvement of visual acuity for advanced proliferative diabetic retinopathy eyes with different complications after vitrectomy. Methods Four groups of advanced proliferative diabetic retinopathy (APDR) in 314 eyes with diabetes type Ⅱ and type Ⅰ were analyzed retrospectively: vitreous hemorrhage with limited traction retinal detachment (VH), extensive fibrovascular membranes with traction retinal detachment (TD), combined rhegmatogenous and traction retinal detachment (CRT) and cataract with vitreous hemorrhage or and traction retinal detachment (CHD). Results 0.1 or better postoperative visual acuity was achieved in 59.5% of type Ⅱ and 66.7% of type Ⅰ in the VH group; 39.4% of type Ⅱ and 52.6% of type Ⅰ in the extensive TD group; 31.6% of the CRT group; 62.5% of the CHD group. The major intraoperative complication is iatrogenic retinal breaks. The causes of postoperative visual loss in present study included neovascular glaucoma (2.8% of type Ⅰ and 0.4% of type Ⅱ in aphakia, 25% of type Ⅱ in aphakia and 4.2% in pseudophakia), retinal detachment and CRAO. Conclusion The majority of APDR eyes obtained better visual improvement after vitrectomy and photocoagulation.

Objective To evaluate the success rate and the risk of impairing vision for epimacular surgery. Methods A retrospective analysis of 57 eyes with epimacular membrane after surgery was made, and the changes in visual acuity and near visual acuity, in different etiology, improvement in distortion, as well as intraoperative and postoperative complications were compared. Results The eyes of 78 8% achieved a visual improvement of more than 2 lines. The visual improvement after surgery of epimacular membranes was the most in buckling group, then in macular hole with epimacular membrane and idiopathic eyes, the change was very limited in macular traction syndrome. The improvement of near visual acuity is usually better than distant visual acuity. The improvement rate of distortion is of 65 0%. The main intraoperative complication was reopen of the primary hole(4 eyes) and the formation of new hole(5 eyes). Conclusion Surgical peeling for epimacular membranes can improve the visual acuity and distorted vision,particularly in epimacular membrane after buckling surgeries, with macular hole and idiopathic eyes. possible risks might be present in surgical manipulation.

Objective To observe the characteristics of the images of optical coherence tomography (OCT) performed on the patients with vitreomacular traction syndrome and its clinical significance. Methods The clinical data of 25 patients with vitreomacular traction syndrome diagnosed by OCT, fundus fluorescein angiography, and B-scan ultrasonography and confirmed by surgical treatment were retrospectively analyzed. The features of images of OCT in vitreomacular traction syndrome were observed. Results Five types were found in the images of OCT in the patients with vetreomacular traction syndrome. The main characteristic of the images of OCT in the patients with vitreomacular traction was the highly reflective band of the vitreous posterior cortex inservion at fovea. In 25 patients, vitreomacular traction associated with macular edema was found in 10, macular hole in 3, macular epiretinal membrane in 6, retinoschisis in 1, and retinal detachment in 5. Conclusion OCT is a potential powerful toll for detecting and monitoring vitreomacular traction syndrome.

Objective To research paramagnetic contrast media(PCM)dose,injection speed and imaging time etc in low field MRI.Methods 406 patients with lesions spreading all over the body received Gadolinium-DTPA-enhanced scan by bolus injection with the dose of 0.1～0.15 mmol/kg within 60 seconds,and the effects of contrast-enhanced were observed.Results Among 406 patients lesions,337 cases(83%)were enhanced,9 undiscovered lesions displayed enhancement on the precontrast views,5 cases were discovered new lesions in delaying enhancement scan.Conclusion It is safe to apply the above mentioned dose and injection speed in clinic.The side-effects is small,and the development effect is good.It is especially important for lesions involving the structure of the blood brain barrier(BBB).

OBJECTIVE:To effectively prevent and treat antibiotic-associated diarrhea (AAD). METHODS: Take some clinical cases to analyse and summarize the result about multiple micro-ecological preparations such as probiotic yoghurt,lively bacterium preparation and prebiotics being used to prevent and treat AAD. RESULTS: It was showed by cases that probiotic yoghurt and lively bacterium preparations could effectively prevent AAD in patients with AAD risk factors,and the application of micro-ecological preparations exhibited a remarkable efficacy for the patients with AAD. CONCLUSION: Rational application of micro-ecological preparations is conducive to the prevention and treatment of AAD.

lusions WI parameters reflect both cardiac and vascular changes of hyperthyroid patients. Mid-systolic hemodynamic turbulence appears in a portion of hyperthyroid patients.

Abstract Myopia is a common refractive error in the process of development. With the high incidence and low age of myopia in children and adolescents, it has become a worldwide public health problem, seriously endangering physical and mental health. The prevention and control of myopia has a long way to go. Low concentration atropine, as an M type choline receptor inhibitor, has been proved by medical research to effectively delay the progress of myopia. This paper reviews the relevant studies at home and abroad in recent years. The optimal concentration of low concentration atropine, the best clinical regimen and possible potential side effects were discussed. From the point of view of school public health, this paper discusses the significance of low concentration atropine for the prevention and control of myopia among school age students, in order to provide a reliable basis and new ideas for the follow up clinical application of atropine and myopia prevention and control strategies for school students.

This study examined the wave intensity (WI) of the carotid artery in patients with hyperthyroid in order to assess the hemodynamic changes of hyperthyroid patients. A total of 86 hyperthyroid patients without cardiac morphological changes and arrhythmia, and 80 healthy control subjects were enrolled in the study. Right common carotid artery (RCCA) was selected for ultrasonic imaging to obtain WI indices, including amplitude of the peak during early systole (W1), amplitude of the peak during late systole (W2), area of the negative wave during mid-systole (NA), interval between R wave of electrocardiogram and W1 (R-1st), interval between W1 and W2 (1st-2nd). The levels of serum thyroid hormones, consisting of free triiodothyronine (FT3), free thyroxin (FT4) and thyroid stimulating hormone (TSH), were measured in hyperthyroid patients. Echocardiographic indices including left ventricular ejection fraction (LVEF) and left ventricular fraction shortening (LVFS) were determined in each subject. The results showed that the W1, W2, NA, and (1st-2nd×HR) in hyperthyroid patients were significantly higher than those in healthy controls. There was no significant difference in LVEF and LVFS between the two groups. FT3 was correlated with W1, W2, NA, (1st-2nd×HR), pulse pressure (PP) and heart rate (HR) in hyperthyroid patients. Several abnormal waves on WI curves were present in 19 hyperthyroid patients during mid-systole. It was concluded that WI technique may prove a real-time, noninvasive, sensitive and convenient tool for assessing the cardiac function and hemodynamic alterations in hyperthyroid patients.

Objective To explore the relationship between accessory renal artery(ARA)and essential hypertension,and the possible mechanism using CT angiography(CTA).Methods The patients who underwent CTA examination on renal artery were reviewed retrospectively in our hospital.A variety of CTA reconstruction techniques were used to observe the type and number of ARA,as well as the diameter of ARA and the main renal artery.Results A total of 126 ARA(66 left ARA and 60 right ARA)were found in 253 patients. 10% of the patients had more than two ARAs.In 164 patients with essential hypertension,ARA detection rate was 40.2%(66/164).In the non-hypertension patients,the proportion of ARA was 31.5%(28/89).There was higher proportion of young(P=0.002)and male (P=0.022)patients in ARA hypertension group compared with ARA non-hypertension group.There were no significant differences on the prevalence of type(P=0.826)and number of ARA(P=0.501)between these two groups.In all of the patients with single ARA,no significant differences were detected on the ratios of diameter of ARA and main renal artery between the two groups(P=0.32). However,in ARA hypertension group,the diameter of main renal artery on the ARA side was significantly smaller than that on the opposite side(P=0.01).In non-hypertension ARA group,no statistical difference was found between the diameter of bilateral main renal arteries(P=0.06).Conclusion ARA is more prevalent in essential hypertensive patients,especially in young male.The decrease of the diameter of main renal artery in the ARA side may be a possible mechanism for essential hypertension.

Objective To investigate the clinical efficacy of neoadjuvant chemoradiotherapy in the treatment of locally advanced low and middle rectal cancer,and evaluate the effect of related clinical factors upon the long-term survival. Methods Clinical data of 101 patients with locally advanced low and middle rectal cancer admitted to our hospital from January 1,2010 to December 31,2014 were collected. All patients completed the preoperative intensity-modulated radiation therapy DT45-50. 4 Gy,synchronized with oxaliplatin+capecitabine/5-fluorouracil or single drug capecitabine chemotherapy,and total mesorectal excision) was performed 4-13 weeks after the end of the neoadjuvant therapy. The short-term efficacy and long-term prognosis of these patients were evaluated. Kaplan-Meier method was used for survival analysis,and Cox’s regression model for multivariate analysis. Results The total sphincter preservation rate was 53. 5%.The decrease rates of T,N staging and TNM total staging were 73. 26%,67. 32% and 72. 3%,respectively. The pathological complete response ( pCR) rate was 16. 8%.The median follow-up time was 41 months. The 3-year overall survival (OS), desease-free survival (DFS),local recurrence and distant metastases rates were 82. 2%,80. 7%,7. 2% and 12. 1%,respectively. The single factor analysis demonstrated that ypT and ypN stages were the risk factors affecting the 3-year OS,DFS anddistant metastases ( all P＜0. 05).Multivariate analysis revealed that ypT stage was an independent factor affecting the 3-year OS,and ypT and ypN stages were the independent factors of the 3-year DFS ( all P＜ 0. 05 ). ConclusionsNeoadjuvant chemoradiotherapy combined with TME in the treatment of locally advanced middle and low rectal cancer can partially decrease the tumor staging,enhance the sphincter preservation rate and improve long-term clinical prognosis. Both ypT and ypN stages are correlated with the clinical prognosis of patients.