The definition of visual impairment, the current status of visual impairment in the elderly, influencing factors related with visual impairment and management control modes are reviewed.There are three international standards of visual impairment including the WHO standard in 1972, the United States standard, and the WHO standard in 2003. The domestic standard is consistent with the WHO standard in 1972. Currently, with the global aging, the international and the Chinese situations of visual impairment are severe,and it is urgent to reduce the incidence of visual impairment. The visual impairment of the elderly is affected by various factors. A variety of management and control modes of visual impairment for the elderly have begun to bear fruit. The aim of the review is to provide the basis to screen for high-risk groups of visual impairment and provide timely intervention to reduce the prevalence of visual impairment in the older population.

Through surveying the hospital′s operation situation and management process of the simple clinic , and outpatient quantity in January to March 2016, we discussed and analyzed the problem of the simple clinic when working , then promoted service process reengineering , so as to the hospital′s simple clinic come into being scientific , reasonable , system management model .

Objective To study effects of classical intrafascial supracervical hysterectomy(CISH) on immune functions.Methods A total of 60 women with benign gynecopathy requiring a hysterectomy were randomly divided into two groups with 30 patients in each group,receiving either CISH or abdominal hysterectomy(AH).The white blood cell(WBC) count and neutrophil granulocyte percentage before and 1 day after the surgery,and peripheral T-lymphocyte subgroup(CD_3,CD_4,and CD_8),(interleukin-2)(IL-2),and interleukin-10(IL-10) 1 day before and 1 and 4 days after the surgery were measured,respectively. Results Postoperative levels of CD_3 and CD_4 in both groups decreased significantly at 1 day after operation(CISH Group: q_(CD3)=6.033,(q_CD4=4.763);AH Group: q_(CD3)=11.043,q_(CD4)=9.202;P0.05),and were significantly higher(q_(CD3)=6.531,q_(CD4)=5.269,P0.05) in the CISH Group.The IL-2 levels were significantly lower at 1 and 4 days after operation than before the operation in the AH Group((q_(1-2)=11.187),q_(1-3)=5.404,P

Objective To discuss the clinical significance of serum pyridinoline cross-linked carboxy-terminal telopeptide of typeⅠcollagen in patients with rheumatoid arthritis (RA). Methods Serum ⅠCTP was measured by ELISA and RF, CRP by immunonephelometry assay in 55 patients with active and 25 with stable RA as well as 52 age and sex-matched normal controls. Results SerumⅠCTP was positively correlated with RF and CRP (rs=0.407, 0.534, P0.05). The sensitivity, specificity and accuracy of serumⅠCTP test were 67.3%, 84.6%, 75.7% in serum of the patients with active RA respectively. The mean serumⅠCTP in normal controls was (3.5?2.0) ?g/L. The serumⅠCTP was more sensitive than CRP in the patients with active RA. Conclusion SerumⅠCTP in patients of RA is a reliable assistant marker for early diagnosis, monitoring of the course and the effectiveness of treatment.

Based on the hospital information systems and the hospital network,a software for patients with peripherally inserted central catheter (PICC) was developed and applied in clinical practice,which achieved the share of PICC information within the hospital,saved nursing time effectively,made the clinical data more standardized,systematical and objective.

Objective To investigate the efficacy and mechanism of hyperbaric oxygen combining conventional therapy on persistent vegetative state ( PVS).Methods Sixty-two cases of PVS patients were treated with hyperbaric oxygen ( HBO ) combinting with conventional therapy.( 1 ) Hyperbaric oxygen therapy:hyperbaric oxygen chamber was adopted and the air pressure was 0,18 -0.20 MPa.The patients breathed pure oxygen for 30 min,2 times per day with a 10 min interval,and continued for 10 days as a course with an average of 4 to 6 courses.(2)Conventional therapy:All patients received drug treatment in hyperbaric oxygen therapy at the same time,including hemostasis,dehydration,anti-infection,nerve cell nutrition agents,wake promoting agents and supportive therapy.All patients were divided to three groups according to the course of disease:26 - 59 days in A group,60-119 days in B group,120 -268 days in C group,and the relationship between disease course and HBO treatment efficacy was analyzed.Results Afer HBO combining conventional therapy,27 cases (43.5％) were recovered,18 cases(29.0％ ) had obvious effect,8 cases( 12.9％ ) had effect,9 cases( 14.5％ )were inefficacy.The efficiency related to the course of disease.The total efficiency rate was 85.5％.The efficacy of HBO treatment had significant difference in A,B and C group ( 96.2％,62.5％ and 41.7％ in A,B and C group respectively,x2 =24.83,P ＜ 0.01 ).The shorter course indicated the better efficacy.Conclusion Hyperbaric oxygen combining conven.

Objective To observe the clinical effects of hyperbaric oxygen combined large dose ganglioside on delayed encephalopathy after acute carbon monoxide poisoning(DEACMP).Methods A totol of 72 patients of DEACMP were randomly divided into the observation group(37)and the control group(35).The patients of control group were given the routine treatment with hyperbaric oxygen.In the treatment group patients were given large doses of gangliosides 100 mg,1 times a day,for a period of 20 to 30 days additionally to the routine treatment of hyperbaric oxygen.All patients were examined before and after treatment in EEG examination (EEG),mini-mental state examination(MMSE).Results The abnormal rate of EEG was 37.83％(14/37) in the control group,which was significantly lower than that of 65.71％(23/35) in the treatment group((x2 =5.60,P ＜ 0.05).In the treatment group,the MMSE was(15.45±2.93) and(23.70±2.13) before and after treatment,respectively; in the control group,the MMSE was(14.88±2.84) and(20.33±2.09) before and after treatment.The MMSE was significantly impoved after treatment in both group(t =3.18 and 2.91,Ps ＜0.05).Furthermore,the MMSE impoved more significantly in the treatment group compared to the control group (t =6.28,P ＜ 0.05).The effective rate of treatment group was 86.48％(32/37),which was significantly higher than that of 51.43％(20/35) in the control group(x2 =7.72,P ＜ 0.01).Conclusion Application of large dose ganglioside treatment had significant clinical effects in delayed encephalopathy after acute car-bon monoxide poisoning,which is better than the effect of routine hyperbaric oxygen treatment.

New registry classifications of chemical drugs redefined the concepts of new drugs and generic drugs. New drugs emphasize the international innovation including innovate new drugs and modified new drugs. Modified new drugs are improvement of drugs already on the market to achieve superior efficacy. With the advantages of high success rate,high return,low risk and long life cycle,modified new drugs have become the mainstream of new drugs research and development in the world. Modified new drugs R&D in China should be based on clinical demand and focused on the differentiation research in order to obtain new preparations with signif-icant clinical advantages to better serve the clinical practise. This paper states the concept and characteristics of modified new drugs in China,makes case analysis and shares the development history of blockbuster modified new drugs in the world,clarifies the opportuni-ties and challenges and provides ideas for the future development of modified new drugs in China.

Objective To investigate the possible protective effect of Shenqingyin Decoction on the kidney of experimental diabetic rats and its possible mechanism. Methods Totally 40 rats with diabetes induced by streptozocin were divided into 4 groups: diabetes model group, Shenqingyin group, Benopril group and Shenqingyin-Benopril combination group. After 8 weeks' treatment, blood glucose, renal function and 24h urine protein were measured, and malondialdehyde (MDA) in renal tissues and urine, superoxide diamutase (SOD) activity and serum transformed growth factor-β_1(TGF-β_1) were tested; renal pathological changes were observed with light microscope as well. Results The serum BUN, Scre of all medicine groups were significantly improved, which did not significantly differ from that in control group (P>0.05). However, it had no obvious improving effect on blood sugar. The content of 24h urine protein in all medicine groups was significantly lower than that in model group (P<0.05 or P<0.01), and Shenqingyin-Benopril combination group had the significantly lower level than the other two medicine groups (P<0.01). MDA in renal tissues and urine, SOD activity and serum TGF-β1 in all medicine groups significantly differed from those in the model group (P<0.05 or P<0.01), and Shenqingyin-Benopril combination group had obvious difference with the other two medicine groups (P<0.01). Light microscopy showed amelioration of different degree in renal pathological changes, but with no significant differences in all medicine groups. Conclusion Shenqingyin Decoction has a protective effect on the kidney of experimental diabetic rats, and it has some synergetic effect when combined with Benopril. The mechanism may be related to inhibiting oxidative stress, improving the body's antioxidant ability and decreasing the expression of inflammatory factor TGF-β_1.

Objective To compare the difference of ultrasound-guided anterior sciatic nerve block by multiple injection and single injection.Methods Among 90 patients undergoing lower limb operation,aged 18-68 years old,47 patients were males and 43 patients were females,all falling into ASA Ⅰ-Ⅲ.The patients were randomized to ultrasound-guided anterior sciatic nerve block by multiple injection (group M,n=45) single injection (group S,n=45).Local anesthetic of 0.5% ropivacaine hydrochloride 20 ml was used.The width,thickness and depth of sciatic nerve and blocking performance time were recorded.Sensory and motor blockade on the operated limb were evaluated every 10 minutes after injection of local anesthetic for 30 minutes and complications were observed in two groups.Results The width,thinkness and depth of sciatic nerve on the ultrasound screen were not statistically significant in the two groups.The performance time of group M was longer than that of group S (P<0.05).The proportion of patients with sensory blockade of each nerve significantly differed between the two groups: for superficial peroneal nerve at 10,20,and 30 minutes,for the sural nerve at 20,30 minutes,for the tibial nerve at 30 minutes,that of group M was higher than that of group S (P<0.05).A significantly greater rate of motor blockade was observed for the dorsal flexion of foot and toes extension in group M than that of group S at 30 minutes (P<0.05).The complications of nausea,vomitting and tinnitus were not different in two groups.Conclusion Multiple injection needs more operation time compared with single injection,but its onset time of sensory and motor blockade is quicker,the complications were not different.