Polypoidal choroidal vasculopathy (PCV) is a fundus disease characterized by choroidal anomalous branch vascular network and terminal polypoidal dilatation.According to its fundus feature,lesion location,imaging feature and disease progression,PCV can be divided into different types or stages.It can be divided into hemorrhage and exudation PCV according to the fundus features,into macular,peripapillary,periphery and mixed types according to the lesion locations.It can also be divided into type 1 and 2 according to the ICGA (indocyanine green angiography) manifestations,and can be classified as early stage and late stage according to disease progression.There were different correlations between different types of PCV and some risk genetic loci,such as ARMS2 (age-related macular degeneration factor 2)/HTRA1 (high temperature essential protein A1),C2,complement factor B,complement factor H,and elastin genes.The response to therapy and prognosis are also different between different types.It is important to further study the clinical classification of PCV,to explore the genetic characteristics,influencing factors and treatment or prognosis features of different types of PCV.The results will improve the differential diagnosis of PCV,and the effectiveness of individualized treatment.

Objective To systematically review the efficacy and safety of photodynamic therapy (PDT) and intravitreal vascular endothelial growth factor (VEGF) inhibitors in the treatment of polypoidal choroidal vasculopathy (PCV),and to investigate the primary treatment tentatively.Methods A systematic search of Pubmed,Embase,the Cochrane Library and the Wanfang Data was performed to identify all comparative studies that compared the outcomes of PDT alone,intravitreal VEGF inhibitors alone and combined intravitreal VEGF inhibitors and photodynamic therapy.Outcomes of interest included the regression and recurrence rate of polypoidal lesions,best corrected visual acuity (BCVA),central retinal thickness (CRT),therapeutic times,and the occurrence rate of adverse events.2 randomized controlled trials (RCT) and 19 non-RTCs were identified.According to treatment methods,the data extracted was classified to 3 groups,analyzed with odds ratio (OR),weighted mean difference (WMD) and 95％confidence interval (95％CI).Results Meta-analysis suggests that the regression rate of polypoidal lesions (OR=0.34,0.07;95％CI=0.13-0.88,0.02-0.36) and BCVA (WMD=0.25,0.11;95％CI=0.14-0.36,0.01-0.21) in combined therapy group were significantly better than those in PDT group and intravitreal VEGF inhibitors group (P＜0.05).The recurrence rate of polypoidal lesions in PDT group was significantly lower than intravitreal VEGF inhibitors group (OR=0.35,95％CI=0.16-0.74,P=0.006).BCVA (P=0.025) and the occurrence rate of adverse events (OR=60.36,95％CI=6.04-603.50,P=0.000 5) in intravitreal VEGF inhibitors group were significant better than PDT group.Conclusions Combined treatment appeared to be superior to PDT alone or intravitreal VEGF inhibitors alone.Combined treatment takes priority over all others in the primary treatment of PCV.

Objective To evaluate the efficacy and safety of half-dose verteporfin photodynamic therapy (PDT) for chronic central serous chorioretinopathy (CSC).Methods 35 eyes (35 patients) with chronic (or recurrent) CSC treated with half-dose verteporfin PDT.Best-corrected visual acuity(BCVA),central macular thickness (CMT) were measured before and after treatment (1,3 and 6 months).The mean BCVA was 0.28± 0.22,mean CMT was(384.5 ± 85.0) μm.The situation of subretinal fluids (SRF) absorption was observed.Results In 35 eyes,SRF of 29 eyes (82.9％) completely absorbed and 6 eyes (17.1％) not completely absorbed after one month of treatment.SRF of all eyes (100.0％) completely absorbed after three months of treatment.After 6 months of treatment,SRF of 3 eyes (8.6％) were recurrence,which might be completely absorbed when a half-dose maintenance therapy PDT was used again.The mean BCVA significantly improved to 0.14±0.13 at 1 months,0.05±0.11 at 3 months and 0.05± 0.12 at 6 months after PDT (t=5.410,7.830,7.758; P＜0.05).The mean CMT decreased to (224.3± 61.4) μm at 1 months,(199.6±32.7) μm at 3 months and (205.3±39.6) μm at 6 months after PDT (t=11.856,11.781,11.900; P＜0.05).The mean CMT of controlled 32 eyes after treatment was (198.5± 33.9) μm,much lower than the fellow eyes(232.3 ± 17.5) μm (t =-3.988,P＜0.05).Conclusions Half-dose verteporfin PDT was safe and effective in treating chronic CSC,but may cause thinning of CMT.

Nowadays,the disconnection between pre-clinical medicine and clinical medicine exists in the medical postgraduate education.Application of the concept of translational medicine to the postgraduate education will play an important role in the training of medical personnel.This article gives a discussion on the means of training postgraduates by building a platform for translational medicine,reforming the curriculum,improving the research evaluation system and building cooperation among universities,hospitals and enterprises.

Objective To summarize the experience of early management in elderly patients with serious burning in order to raise cure rate. Methods Elderly patients (63 cases) with serious burning (burned area exceeding 30% or Ⅲ? area exceeding 10% ) admitted from 1990 to 2002 were retrospectively studied. Patients were divided into two groups according to the admission date, before and after January 1, 1996 since new management was extensively applied after 1996. These measures consisted of rapid and adequate fluid resuscitation, early enteral feeding and autograft after eschar excision. Results The incidence of sepsis and MODS was 38.7% and 19.4% respectively after 1996. It was evidently lower than the group before 1996(65.6% vs 43.8%, P

Objective To understand the status of field feces in Jingzhou City, so as to provide the evidence for improving the control measures to interrupt the transmission routes of schistosomiasis. Methods The distribution of field feces was investigated in 27 schistosomiasis endemic villages in Gong’an,Jianli,Jiangling,Honghu and Shishou counties(cities)from 2010 to 2012. The schistosome positive status of the field feces was surveyed with the hatching method. Results There were 1 366 field feces and the average density was 0.089 2 feces per 100 square meters in this survey. The cattle feces,human feces,dog feces and elk feces respectively accounted for 99.71%,0.07%,0.15% and 0.07% in the survey. The infection rates of the field feces were 1.46%and 2.42%in the channels and bottomlands,respectively(P>0.05). The average rate of infected field feces was 3.21%in 2010,0.36%in 2011,and 1.60%in 2012,and the difference between 2010 and 2012 was not statistically significant(P>0.05). Conclusions The main field feces come from cattle,and the main distribution of infected field feces is in channels and bottom-lands. Therefore,the management of cattle and treatment of field feces should be strengthened.

Objective To explore the observation and nursing on complications of artificial vessel arteriovenous fistula in hemodialysis patients. Methods The targeted treatment and nursing care were implemented according to different complications in 40 hemodialysis patients with artificial vessel arteriovenous fistula. Results A total of 25 complications happened in 13 patients. All the patients were cured without dysfunctions after targeted treatment and nursing care. Conclusion Detecting and dealing with the symptoms of complications of artificial vessel arteriovenous fistula in time is important to prolong the using time of artificial vessel arteriovenous fistula.

Objective To investigate the effect of pre - washing without heparin on adequacy of hemodialysis. Methods Using self-control method, fifty hemodialysis patients received pre-washing with heparin in normal saline and normal saline. Then we tested Kt/v by online clearance monitoring and observed clotting condition of dialyzer and hemodialysis tubes. Results There were no difference of Kt/v between two methods. After hemodialysis, no clotting phenomenon was found in dialyzer. There was a little pot of coagulation in artery and vein pot, but no significant difference between two methods. Conclusions Pre-washing with normal saline alone can not only ensure the adequacy of hemodialysis, but also reduce the risk of cross infection and reduce the amount of heparin, simplify operational procedures, so it should be promoted.

Objective To understand the key risk factors of schistosomiasis transmission in Jingzhou City,so as to provide the evidence for improving the treatment of these risk factors. Methods Each village of six counties was investigated and 3 envi-ronments were surveyed each village for the distribution of Oncomelania snails and animal stools in the field. The results were ana-lyzed and the risk factors of schistosomiasis transmission were assessed. Results The density of living snails was 0.43 snails per 0.1 m2,the frequency of the frames with snails was 9.12%,and no schistosome infected snails were found. All of the animal stools collected from the field were from bovines. The schistosome positive rate of animal stools was 37.50%(3/8)among the environ-ments,and the schistosome infection rate of stools was 8.11%(3/37). The schistosome infection rate of animal stools was 0 near the residence living sites,and the positive rates were 12.50%and 8.33%in the ditches and slopes,respectively(χ2=0.07,P>0.05). Conclusions Bovine is still the main infectious source of schistosomiasis,i.e. the main risk factor of the disease transmis-sion. Therefore,the strategy of controlling bovine should be strengthened.

Objective To investigate the clinical value of different double-J tube indwelling time in the treatment of ureteral stone-street complications after flexible ureteroscope lithotripsy. Methods Clinical data of 64 kidney calculi patients with ureteral stone-street complications after flexible ureteroscope holmium laser lithotripsy were retrospectively analyzed. The patients were divided into observation group (extubating the double-J tube 2 weeks after the surgery) and control group (retaining the double-J tube) with 32 cases in each group. The calculi clearance results and complication were compared between 2 groups. Results The success rate of stone removal in observation group was significantly higher than that in control group: 100.0% (32/32) vs. 65.6%(21/32), the calculi elimination time was significantly shorter than that in control group:(26.4 ± 6.6) d vs. (45.3 ± 10.9) d, the treatment cost was significantly lower than that in control group:(768.4 ± 152.6) yuan vs. (1 262.3 ± 156.8) yuan, the incidences of irritation symptoms of bladder and macroscopic hematuria were significantly lower than those in control group: 15.6% (5/32) vs. 90.6%(29/32) and 15.6% (5/32) vs. 100.0% (32/32), and there were statistical differences (P<0.05). There was no statistical difference in incidence of renal colic between 2 groups (P>0.05). Conclusions Removing the double-J tube 2 weeks after flexible ureteroscope lithotripsy results in higher stone clearance rate and less complications compared with retaining the double-J tube. It can reduce the occurrence of irritation symptoms of bladder, macroscopic hematuria and treatment cost.