Objective To evaluate the clinical features, diagnosis, and outcome of the treatment of cytomegalovirus (CMV) retinitis, and the relationship between CMV retinitis and acquired immunodeficiency syndrome (AIDS). Methods A total of 95 eyes of 56 patients with cytomegalovirus retinitis and AIDS were studied. The fundus feature, visual acuity and CD4 + T lymphocyte counts were analyzed and the follow up periods ranged from 2 weeks to 18 months. Results Before the definitive diagnosis of CMV retinitis, the courses of AIDS were 4 to 26 months in all patients. In the initial examination, the granular form of CMV retinal lesion was noted in 55 eyes (57%) in which retinal lesion of 46 eyes was peripheral. The fulminant form of CMV retinitis of 25 eyes (26%) was found in the posterior pole and consisted of densely opaque retinal lesions with blotchy hemorrhage and vasculitis. The overlap between these two presentations was noted in 15 eyes. Papillitis was observed in 7 eyes of CMV retinitis in this series of patients. The visual acuity ranged from finger counting to 0.5. The patients with extensive CMV retinitis or CMV retinitis in the posterior pole got poorer vision. The CD4 + T lymphocyte counts of 30 patients was 0 30 (mean, 15?9/?l), and the survival time ranged from 2 weeks to 18 months (mean, 6.4?3.3 months). The vision was improved and CD4 + T lymphocyte counts was significantly higher in the group treated with ganciclovir, and progression of CMV retinitis occured and the vision decreased in the non treated group. Conclusion CMV retinitis is the most common intraocular complication in patients with AIDS. Diagnosis of CMV retinitis is based on the characteristic of necrotizing retinitis which was typically associated with retinal hemorrhage and vasculitis. Ganciclovir is effective for the treatment of CMV retinitis.

Objective To explore the relationship between superior vena cava-jugular vein oxygen saturation-differential value (ScVO2-SjVO2) and injury severity and prognosis in patients suffered from severe traumatic brain injury,finding out the chnical value.Methods Forty-three patients with severe tranmatic brain injury were selected and divided into two groups according to Glasgow Coma Scale (GCS) score,19 cases were enrolled in GCS 3-5 scores group;24 cases in GCS 6-8 scores group;20 contemporaneous cases in control group had conscious and without traumatic brain injury.The changes of ScVO2-SjVO2 at 0,12,24,48 h after admission of ICU among the groups were observed.In addition according to the degree of change in ScVO2-SjVO2,12 cases were enrolled in ScVO2-SjVO2 ＜ 0.05 group;14 cases in ScVO2-SjVO2 0.05-0.15 group; 17 cases in ScVO2-SjVO2 ＞ 0.15 group.The GCS score and mortality rate in patients after brain injury 28 d among groups were observed.Results GCS 3-5 scores group compared with control group,ScVO2-SjVO2 reduced significantly at 0,12,24,48 h after admission of ICU (-0.071 ±0.032 vs.0.093 ±0.049,-0.097 ±0.052 vs.0.081 ±0.052,-0.035 ±0.031 vs.0.089 ± 0.059,0.036 ± 0.033 vs.0.081 ± 0.064),there were significant differences (P ＜ 0.01).GCS 6-8 scores group compared with control group,ScVO2-SjVO2 dramatically increased at 0,12,24 h after admission of ICU(0.173 ± 0.043,0.158 ± 0.067,0.123 ± 0.073),there were significant differences (P ＜ 0.01 or ＜ 0.05).ScVO2-SjVO2 ＜0.05 group and ScVO2-SjVO2 ＞0.15 group compared with ScVO2-SjVO2 0.05-0.15group,the mortality rate significantly increased,the mortality rate were 8/12,4/17,1/14,respectively,there were significant differences (P ＜0.01).ScVO2-SjVO2 ＜0.05 group and ScVO2-SjVO2 ＞0.15 group compared with ScVO2-SjVO2 0.05-0.15 group,GCS score decreased significantly[(4.17 ± 1.34),(5.88 ±1.35) scores vs.(6.86 ± 1.35) scores],and there was significant difference (P ＜0.01 or ＜0.05).Conclusions When ScVO2-SjVO2 ＜ 0.05,the difference is negatively related to the deg~e of brain injury.When ScVO2-SjVO2 ＞0.15,the difference is positively related to the degree of brain injury;ScVO2-SjVO2 can assess injury severity objectively in patients who suffered from severe traumatic brain injury,and it also expresses the rate of cerebral oxygen metabolism.It can provide a basis for treatment accurately and timely,and judgment prognosis.

Objective:To assess the periodontal diseases as a possible risk factor for preterm and low birth weight. Methods: A population-based, cross-sectional study was carried out in Hubei. The samples were chosen randomly by the rule of admittance. Socio-demographic information relating to health and maternal habits was collected through a questionnaire. The clinical parameters were debris index-simplified (DI-S), sulcus bleeding index (SBI), probing pocket depth (PD) and clinical attachment loss (CAJ). The birth time and weight were recorded. The result was analyzed with chi-square test and logistic regression analysis.Results: The incidence of preterm low birth weight was 12.3%. The gingivitis and periodontitis were diagnosed in 86.6% and 64.2% of preterm low birth weight cases. The odds ratio of having gingivitis and preterm low birth weight was 1.30(95%confidence interval: 0.53-3.22). The odds ratio of having periodontitis and preterm low birth weight was 2.69(95%confidence interval: 1.37-5.27). Conclusion: The periodontal diseases of pregnancy can be regarded as an important risk factor for preterm low birth weight.

Objective To develop a simple new-type photographic device for the field battle and peace time,because of the function of the trivet of X-Ray machine is limited.Methods Circular chrome-plating seamless steel tubes,whose diameter is 4 cm and 5 cm respectively,were connected so as to constitute the arm structure in C shape and foundation in T shape.Results The simple new-type photographic device could project for patients in each kind of body posture and the range of focus adjustment could meet normal requirements.It was operated nimbly and freely.The material was durable and the structure was reasonable and stable.Conclusion The simple new-type photographic device meets the practical requirements in field battle and peace time.

Objective To study the associations between neo-adjuvant chemotherapy (NACT)sensitivity and expression of relative proliferation and apoptosis genes in cervical cancer tissues. Furthermore,the potential roles of relative genes expression as monitor in the chemotherapy against cervical cancer tissues were studied. Methods Fifteen pathologically proved Ⅱ A stage cervical cancer patients with HPV 16 positive were divided into effective group and non-effective group according to the clinical response to NACT, the changes of HPV16-E6, p53 genes and proteins expressions were measured by real-time quantitative reverse transcription polymerase chain reaction (RT-PCR) and Western blot. At the same time, MTT assay was used to detected proliferative activity to paclitaxel liposome and carboplatin (paraplatin) in HeLa cells. Results In effective group, the overall response rate was 73.3 % (11/15) and the HPV16-E6 mRNA and protein level after NACT was significantly decreased than that before NACT (t=3.359, t=3.614, P＜0.05), while p53mRNA and protein level increased significantly (t =5.852, t=2.838, P ＜0.05). However, there have no significant different between pre-NACT and Post-NACT of the two genes in the non-effective group. After using chemotherapy HeLa cells growth decreased. Conclusion HPV16-E6 and p53 expreesion level are useful paraneters in evaluating NACT response in cervical cancer tissues. The detection of the two genes expression is a method for predicting efficacy in NACT.

Objective To investigate the changes in corneal astigmatism after trabeculectomy using removable suture and the duration of postoperative diopter stabilization.Methods From June 2014 to July 2016,70 primary glaucoma patients (70 eyes) were enrolled and divided into two groups,including experimental group 40 patients (40 eyes) with trabeculectomy using removable suture and control group 30 patients (30 eyes) with trabeculectomy alone.Then,several variables of corneal topography,corneal curvature,diopter and intraocular pressure were recorded and analyzed before operation and 1 week (before removal of the suture),1 month and 3 months after surgery.Results In the two groups,postoperative diopter and intraocular pressure at each time point approached significant difference (all P ＜ 0.01).There was significant difference in comparison of corneal astigmatism 1 week after surgery (3.80 ± 1.31) D and preoperative corneal astigmatism (1.48 ± 0.79) D in experimental group,and this was true of the control group for corneal astigmatism 1 week after surgery [(1.42 ± 0.32)] and preoperative data (1.12 ± 0.36) D (all P ＜ 0.05).Moreover,corneal astigmatism 1 month and 3 months after surgery in the experimental group was (1.50 ± 0.71) D and (1.36 ± 0.61) D,and this data in the control group was (1.24 ± 0.31) D and (1.09 ±0.34)D respectively,and their differences was not statistically significant compared with the control group (all P ＞ 0.05).There was significant difference in the corneal astigmatism 1 week after operation (P ＜ 0.01),while there was no significant difference in this variable 1 month and 3 months after operation between the two groups (all P ＞ 0.05).Although the corneal astigmatism 1 month after operation was enhanced compared with 3 months after operation,but the difference was not statistically significant (all P ＞ 0.05).In addition,the number of with-the-rule astigmatism in the experimental group and the control group were 33 eyes and 22 eyes respectively (P =0.36).Conclusion The corneal astigmatism caused by trabeculectomy using removable suture was significantly enhanced in the early period,but it decrease easily in 1 month after removing the suture,with keeping stable in 3 months and getting with-the-rule astigmatism 3 months after surgery.

Objective To investigate the effects of β-blockers on cardiac protection and hemodynamic in patients with septic shock. Methods A prospective randomized controlled trial was conducted. Forty-one patients with septic shock in accordance with early goal directed treatment and met the target within 6 hours,and admitted to intensive care unit (ICU)of Affiliated Huxi Hospital of Jining Medical College from January 2012 to January 2014 were enrolled. The patients were divided into treatment group (n=21)and control group (n=20)by random number table. The patients in both groups were given the standard treatment,esmolol was giving to patients in treatment group in order to control the heart rate (HR)below 100 bpm within 2 hours,and the patients in control group only received standard treatment. The changes in hemodynamic parameters〔mean arterial pressure(MAP),central venous pressure(CVP), HR,cardiac index(CI),stroke volume index(SVI),systemic vascular resistance(SVRI),global end diastolic volume index(GEDVI)〕,biochemistry metabolic of tissue〔central venous oxygen saturation(ScvO2),lactic acid(Lac)〕,and cardiac markers 〔troponin I (cTnI)〕before and 12,24,48,72 hours after the treatment were recorded. Results①Before treatment,the hemodynamic parameters,tissue metabolism index and cTnI had no significant differences in both groups (all P>0.05).②The hemodynamic parameters after treatment in the control group showed no significant difference compared with that before treatment. HR and CI in the treatment group were gradually declined after treatment,SVRI and GEDVI were gradually increased. There were significant differences in HR,CI,SVRI,and GEDVI between treatment group and control group from 12 hours on〔HR(bpm):93±4 vs. 118±13,CI (L·min-1·m-2):3.3 ±0.8 vs. 4.5 ±0.6,SVRI (kPa·s·L-1·m-2):159.2 ±27.4 vs. 130.5 ±24.2,GEDVI(mL/m2):668 ±148 vs. 588 ±103,P<0.05 or P<0.01〕. MAP,CVP and SVI in the treatment group showed no significant changes. ③Lac after treatment in both groups was decreased slowly,Lac (mmol/L)at 12 hours after treatment was significantly decreased compared with that before treatment (control group:8.8 ±3.2 vs. 9.8 ±3.4,treatment group:9.5±3.1 vs. 10.5±4.1,both P<0.05). The Lac of control group and treatment group were 2.5±1.2 and 2.7±1.1 at 72 hours after treatment,and there was no significant difference between two groups (all P>0.05). The ScvO2 was not decreased in both groups.④Compared with before treatment,cTnI in the control group was gradually increased,peaked at 72 hours,and that in the treatment group was gradually increased,peaked at 24 hours and then gradually declined. Compared with control group,the cTnI (μg/L)in the treatment group was decreased significantly at 24,48,72 hours (1.15 ±0.57 vs. 1.74 ±0.77,0.93 ±0.52 vs. 2.15 ±1.23,0.52 ±0.36 vs. 2.39 ±1.17,all P<0.01). Conclusionsβ-blockers (esmolol) can improve cardiac function and myocardial compliance,reduce the myocardial injury in patients with sepsis shock. Although β-blockers can decrease cardiac output,it has no influence on the circulation function and tissue perfusion.

Objective To improve microbial specimen detection rate before therapeutic antimicrobial use.Methods A system of selective targeted management by clinical department was established,before management was as control group (July-September 2013),after management was as intervention group(October-December 2013),microbial specimen detec-tion in patients before antimicrobial use was compared between before and after management.Results Of all hospitalized pa-tients,11 254 received therapeutic antimicrobial agents,3 426 were sent specimens for microbial detection,the specimen detection rate was 30.44%;specimen detection rate in control and intervention group was 28.80% and 31.89% respective-ly ,the difference was significant(χ2 =12.71,P <0.05).3 716 patients(46.61%)received restrained antimicrobial therapy, and 1 418 (79.20%)received special antimicrobial therapy,compared with control group,the difference were both signifi-cant(χ2 =32.86,19.31,respectively,both P <0.05).Conclusion Applying selective targeted management can improve microbial specimen detection rate before therapeutic use of antimicrobial agents.

Objective To assess the efficiency and methods of the interventional management in acute mesenteric venous thrombosis (AMVT). Methods Fifteen patients with AMVT who diagnosed by imageology were treated by interventional procedures. Eight patients were treated by transcatheter superior mesenteric artery thrombolysis with urokinase, 5 cases by percutaneous transhepatic treatment, 2 cases by transjugular intrahepatic portosystemic shunt approach. Results The technical success was achieved in all the 15 cases without complications. The majority of the thrombus was cleared by interventional procedures and flow restorated on the angiograms. All the patients with follow-up from 10 to 22 months showed no recurrence. Conclusion The minimally invasive interventional techniques are safe and effective in the treatment of mesenteric venous thrombosis without necrosis.

Objective To investigate the effect of thrombelastography ( TEG ) monitoring on anticoagulation therapy in deep vein thrombosis ( DVT ) in the perioperative period of arthroplasty replacement through dynamic detecting of TEG.Methods 60 patients under went total knee arthroplasty ( TKA) were selected as the patient group from 2011 to 2013, Including 22 men and, 38 women, aging from 50 to 74 years old.These patients were divided into low molecular weight heparin ( LMWH ) group and rivaroxaban group according to random number table.Each group had 30 cases.Patients in both were all given routine dose anticoagulant drugs to prevent DVT.Other treatment were the same as conventional therapy for both group patients.Meannhile, 42 health examination participants were selected as the control group, 24 men and 18 women, aging from 45 to 75 years old.The parameters of TEG were measured by TEG@5000 thromboelastograph hemostasis system ( American Haemoscope Corporation).DVT was diagnosed by LOGIQ 7 color Doppler ultrasonic diagnostic apparatus of American GE Corporation. Data were analyzed by SPSS17.0.The predictive value of TEG on DVT was evaluated by receiver operating characteristic cure (ROC),sensitivity,specificity,positive predictive value (PPV) and negative predictive value (NPV). Results Abnormal detection rates of Angle,MA,CI in rivaroxaban group(36.7%,46.7%,36.7%) were higher than LMWH group ( 10.0%, 20.0%, 13.3%) , and the differences between both groups all had statistical significance between both group(χ2 =5.963,P=0.015;χ2 =4.800,P=0.028;χ2 =4.356,P=0.037).CI , MA and Angle had better clinical diagnostic value on DVT.Their sensitivity was 75.0%, 75.0% and 62.5%, specificity respectively was 80.8%, 76.9%and 78.8%respectively.MA=68.35 mm
could be the best clinical diagnosis of critical point on DVT at anticoagulation treatment endpoint.Conclusion TEG can monitor coagulation state of TKA patients, TEG′R can evaluate the safety and effectiveness of anticoagulation therapy on DVT.(Chin J Lab Med, 2015, 38:333-336)