Objective To observe the imaging features of branching vascular network (BVN) in polypoidal choroidal vasculopathy (PCV).Methods Eighty PCV patients (90 eyes) were enrolled in this study.The patients included 58 males and 22 females.The age was ranged from 49 to 85 years,with a mean age of 61.4 years.All the patients were examined for fundus photography,fundus fluorescein angiography (FFA),indocyanine green angiography (ICGA) and optical coherence tomography (OCT).The fibrovascular retinal pigment epithelium detachment (PED) was defined as a well-demarcated subretinal heterogeneous plaque with increasing fluorescence on FFA.The late lichenoid hyperfluorescent plaque was defined as a well-demarcated lichenoid hyperfluorescent plaque on late phase ICGA.The double-layer sign on OCT was defined as a wide range of shallow PED from Bruch membrane.Results BVN were found on early ICGA in 76 eyes among the 90 eyes (84.4％).Among these 76 eyes,18 eyes (23.7％) demonstrated the subretinal reddish-orange branches corresponding to BVN.Fifty-six eyes (73.7％) demonstrated all or part of the BVN on early FFA.Three eyes (3.9％) demonstrated branching transmitted fluorescence corresponding to BVN throughout the FFA.Seventy-three eyes (96.1％) were manifested by occult choroidal vascularization on FFA,and 21 eyes (27.6％) of them were fibrovascular PED.Among the 76 eyes with BVN,all BVN appeared earlier than polypoidal lesions on ICGA.Polypoidal lesions located on the terminal of BVN in 62 eyes (81.6％).Sixty-nine eyes (90.8％) on ICGA demonstrated the late lichenoid hyperfluorescent plaque,whose area was equal to or greater than the area of BVN shown on early ICGA.Seventy-two eyes (94.7％) had the double layer sign.Among these 72 eyes,15 eyes (20.8％) had lumen like structure within the double-layer sign.Sixty-five eyes (90.3％) had punctate and linear hyperreflectance within the double-layer sign.Two eyes (2.8％) demonstrated a hyporeflective short segment and a gap of Bruch membrane on OCT corresponding to the origin of the BVN.Sixty-three eyes (87.5％) had an area of double-layer sign that matched the area of late lichenoid hyperfluorescent plaque on ICGA.Conclusions BVN in PCV can be noted as reddish-orange branches on fundus examination.Most of the BVN are shown as early branching transmitted fluorescence but collectively an occult choroidal vascularization on FFA,as lichenoid hyperfluorescent plaque on late ICGA,and as double-layer sign on OCT whose area matches late lichenoid hyperfluorescent plaque.

Objective To find out about the current situation of the for-profit hospitals in a Southern province and to compare them with the nonprofit hospitals there of the same size. Methods Using routine health statistics data of the year 2002,71 for-profit hospitals with authorized beds were compared with 132 nonprofit hospitals of the same size.Results The for-profit hospitals had a small number of staff and basically little burden posed by retired personnel;they provided a small volume of outpatient and emergency services but a volume of inpatient services equal to that provided by the nonprofit hospitals;their income and expenditure levels were less than half of those of the nonprofit hospitals,but they had a balanced budget;like the nonprofit hospitals,they faced the issue of patients defaulting on payment.Conclusion Now that the development of non-public economy is being encouraged in the country,for-profit hospitals will witness high growth.Thus possible adverse effects ought to be carefully taken into account in the formulation of policies and corresponding countermeasures ought to be taken.

Retinal hemorrhage can be divided into intravitreal, subhyaloid, subinner limiting membrane, superficial retinal, deep retinal, subretinal and subpigment epithelial hemorrhage. Each of these hemorrhages has a characteristic and recognizable appearance. Comprehending the classification and characteristic of retinal hemorrhage has important value in diagnosis, differential diagnosis and guideline for treatment.(Ophthalmol CHN, 2009, 18: 221-224)

Ocular fundus imaging technology has developed rapidly in the past decade. The exsiting imaging technology is constantly updated and new imaging technology emerges one after another. The related research and development investment, equipment usage and paper publication are all growing rapidly. At the same time, it is developing towards the direction of multi-technology combination, integration of artificial intelligence and big data, as well as small-size and automation use of equipment. However, there are many challenges behind the prosperity of ocular fundus imaging, such as professionally remodeling of fundus diseases knowledge system standardization, balance and independence of scholarly communication, misunderstanding of "multimodal images", validation of the effectiveness and applicability of emerging technologies, clinical imaging research innovation, original technology innovation and technology reserve, fundus imaging data integration and analysis system for the future.

China ; Metals, Heavy ; Research Support as Topic ; statistics & numerical data

Objective To find out about the development of nongovernmental medical services in China as well as the appraisals of such services by various quarters so as to provide basis for the formulation of policies for their management and development. Methods Cross-sectional studies were made in the provinces of Guangdong, Shanxi and Sichuan. By means of questionnaires and interviews, appraisals of nongovernmental medical services by residents, physicians, managers of medical institutions, investors of nongovernmental medical institutions and managers from the administrative departments of health were collected and differences in the appraisals made by people representing various interest groups were analyzed. Results Over 30% of the residents make use of nongovernmental medical services and appraisals of them surpass those of public medical services. Nongovernmental medical institutions have both advantages and disadvantages, with unfair social treatment being the major obstacle to their development. Conclusion Since nongovernmental medical services have already taken an important position in the setup of medical services of China, efforts should be made to coordinate relevant policies so as to bring their role into greater play.

Objective To explore the correlation between vitamin A (VA) level andMycoplasma pneumonia (MP). Methods Children aged 0-12 years hospitalized with acute infectious respiratory diseases during March 2015 to December 2015 were randomly selected. The level of serum VA was detected by high performance liquid chromatography (HPLC). MP-DNA on nasopharyngeal swab was detected by polymerase chain reaction (PCR). The serum MP-IgM was detected by enzyme linked immunosorbent assay (ELISA). The MP infection rate among subclinical VA deficiency (SVAD) group, suspicious subclinical VA deifciency (SSVAD) group and VA normal group were analyzed and compared.Results Among 600 children, there were 83 cases of SVAD (13.83%) and 193 cases of SSVAD (32.17%). There were statistical differences of the incidences between SVAD and SSVAD in children younger than 1-year-old, 1-3 years old, 3-6 years old and≥6 years old (P all<0.001), among which SVAD and SSVAD groups had the highest incidence rates in infants younger than 1 year old (26.36% and 49.10%respectively). Among 600 children, MP was positive in 201 children (33.5%), in whom 57 children (28.35%) were SVAD and 70 children (34.83%) were SSVAD. The incidence rate of SVAD in children with MP positive was higher than that in children with MP negative (P<0.001). In 201 children with MP positive, there were signiifcant differences in the distribution of SVAD, SSVAD and VA among different age groups (P=0.003), and the incidence rate of SVAD in infants younger than 1 year old was higher (48.39%).Conclusions SSVAD and SVAD are common in infants younger than 1 year old; SVAD may be associated with MP infection in children.

Objective:To evaluate the utilization of both parenteral nutrition and enteral nutrition drugs for the reference of clinical medication.Method:The statistics on nutrition drugs in a hospital from 2006 to 2008 were conducted by the defined daily dose method.Result:The cost ratio of the nutrition drugs to the total drug consumption increased annually.Glutamine was the leading nutrition drug according to the increase tendency of DDDs.The utilization ratio of enteral nutrition drugs to the whole nutrition drugs increased continuously,from 8.72%to 15.58%during 2006 to 2008.Conclusion:Nutritional support has attracted more and more clinical attention,and DDDs of the enteral nutrition increases rapidly.

Exhaled gaseous signal molecules such as nitric oxide(NO),carbon monoxide(CO) and hydrogen sulfide(H2S) can be measured with a non-invasive technique.The fraction of NO level in exhaled gaseous of patients with airway inflammatory illness(such as bronchial asthma) significantly increases.No in exhaled gaseous is one of the markers in the diagnosis of asthma,and it is also a marker of anti-inflammatory response for patients with asthma.The fraction of CO level in exhaled gaseous of patients with bronchial asthma is also si-gnificantly elevated.Both NO and CO in exhaled gaseous in other airway inflammatory illness,such as chronic obstructive pulmonary disease,chronic bronchitis and cystic fibrosis are also evidently changed.Measuring exhaled gaseous signal molecules can provide important basis for the diagnosis and treatment of airway inflammatory illness.

Objective To compare the postoperative effect of pars plana vitrectomy,phacoemulsification and intraoeular lens (IOL)implantation with silicon oil removed,phacoemulsification and IOL implantation.Design A retrospective case-control study.Par- ticipants 91 cases(104 eyes)of proliferative diabetic retinopathy with tractive retinal detachment or vitreous hemorrhage were per- formed cataract surgery with IOL implantation.Methods All patients were followed up average 6 months,in whom 52 eyes with pars plana vitrectomy,phacoemulsification and IOL implantation(combined group),and the other 52 eyes with silicon oil removed,pha- coemulsification and IOL implantation(sequential group).The differences of the postoperative visual acuity and inflammatory reactions of the anterior chamber between the two groups were analyzed.Main outcome measures Visual acuity and inflammatory reactions of the anterior chamber.Results There were 14/52 eyes with best corrected visual acuity more than 0.1 in combined group and 8/52 eyes in the sequential group after the surgeries(X~2=-6.87,P=0.07) .Corneal edema happened in 16/52 eyes in combined group and 6/52 eyes in sequential group 1 week after the surgeries(X~2=11.53,P=0.001).Keratic precipitate happened in 20/52 eyes in combined group and 9/52 eyes in sequential group after the surgeries(X~2=5.79,P=0.019) .Conclusions The incidence of postoperative anterior chamber in- flammation is higher in Phacoemulsification combined with pars plana vitrectomy group.