Total 1049 new cases of blindness were detected by visual acuity survey in a population aged 68 or above in Changning District of Shanghai from 2003 to 2008. Among all eases 21.5% were age-related macular degeneration (AMD) blindness, with a trend of ascending from 17.7% in 2003 to 29. 9% in 2008. Most of the cases were classified as grade 3 (56. 9% ) or grade 4 (41.3%) of blindness. AMD has become one of the leading causes of blindness at present and should be the key eye disease for prevention of blindness.

Objective To quantitatively evaluate relative contribution of medical history,physical examination and laboratory investigation to diagnoses for medical outpatients.Methods In total,145 medical visitors to the outpatient department of Peking Union Medical College Hospital (PUMCH) during October 10 to 16,2008 were recruited and followed-up for 12 months.Results Nineteen of 145 visitors (13.1%) were lost during the period of follow-up and diagnoses were established for 86 of them (68.3%)finally with medical history and for 20 (15.9%) with physical examination or laboratory investigation,respectively.Confidence index of internists in their correct diagnosis increased to 7.3 with medical history and to 7.9 and 8.7 with physical examination and laboratory investigation in average,respectively.Conclusions Most visitors to internal medicine department could be diagnosed correctly with medical history only.On the basis of physical diagnosis,selection of adequate laboratory investigation for them is critical to improvement of clinical diagnosis.

Clinical data of 21 pregnant women with scrub typhus were analyzed retrospectively.They all had fever,13 of them with lymph nodes enlargement,12 with skin rashes,11 with eschar or ulcer,and 20 positive with Weil-Felix reaction.Oxytetracycline was given in 17 of them and other four were treated by azithromycin,with all cured.Seven of them gave natural childbirth at the 37th week of gestation,nine were aborted inductively,three aborted spontaneously and two delivered premature births.Scrub typhus was harmful to both pregnant women and their fetuses,early diagnosis and treatment are necessary for patients with it for avoiding exacerbation and reducing fatality.

Sixty-fourth patients with vascular dementia were recruited in the study and randomly assigned in rehabilitation (medication plus rehabilitation)and control group (medication alone).The treatment period lasted for 12 weeks,the scorings of mini mental statement examination(MMSE) and activity of daily living scale (ADL) were compared before and 4,8,12 weeks after treatment in both group.The scorings of MMSE and ADL in rehabilitation group and control group were both improved after treatment(P ＜0.05),but the scorings in rehabilitation group were better than those in control group(P＜0.05).

A cross-sectional study was conducted on 1619 youngsters aged 13-15.They were divided into two groups:one with family history of diabetes (FHD~+) and another without a family history of diabetes (FHD~-).Measurements included height,weight,waist circumference (WC) and hip.FHD~+ group had significantly higher WC measurement,waist-to-hip ratio (WHR) and waist-to-height ratio (WHtR) when compared with FHD~-group (P ＜0.01).The abdominal obesity rate defined by WC measurement in FHD+ group was higher than that in FHD~-group (P＜0.01).The rate of overweight and obesity defined by body mass index (BMI) were no significant difference between two groups.After adjusting the gender and age,logistic regression analysis showed that the odds ratios of WC alone and BMI+WC for FHD~+ were 2.029 and 1.364 (95% CI:1.211-3.400,1.043-1.784,P＜0.05) respectively.Our data suggest that teenage with a family history of type 2 diabetes has a tendency of overweight characterized by the abdominal obesity.

369 patients with hypertension living in Xietu community were randomized into 2 groups:intervention group receiving the group-interference-management and control group receiving routine hypertension management services.We found that patients in the intervention group had better self-management behaviors,self-efficacy and health status in comparison with the control group (P＜0.05).The systolic and diastolic blood pressure in the intervention group decreased more remarkably than that in the control group (P＜0.05).Our result suggested that the community-based hypertension group-interference-management model is more effective to control hypertension than the routine hypertension management services.

The clinical data of 22 cases with gastrointestinal stromal tumors were retrospectively analized.The main clinical manifestations were gastrointestinal bleeding (14/22),abdominal discomfort (5/22) and abdominal lump (3/22),stomach was the most common site of the tumor (14/22).All 22 cases underwent surgical treatment and pathological examination confirmed that 12 cases were benign.Immunohistochemical results showed that 68% cases were negative in solubility acid protein-100 (S-100),and the positive rates of tyrosine-protein kinase acceptor 117 (CD117),hemopoietic stem cell antigen 34 (CD34) and negative rate of smooth muscle actin (SMA) were all 73%.Eighteen cases were followed up for 1-5 years after operation,among them 3 died.The survival was closely related to the size,the pathological characteristics and the recurrance of the tumor as demonstrated by multivariate Cox regression analysis.Since gastrointestinal stromal tumor has no specific clinical manifestations,preoperative diagnosis is difficulty,so surgical resection and subsequent pathological examination is used for confirmation of diagnosis,as well as treatment of the disease.

One hundred sixty-three cases with a mean age of 58 years (range 21 to 87) underwent nephron sparing surgery due to suspected renal tumors.Mean tumor size was 2.8 cm (range 1.0 to 4.0 cm).Frozen section analysis was routinely performed during surgery,positive tumor margins in frozen section analysis were found in 5 cases (3.1%),and immediate radical nephrectomy was followed.Among 158 cases,in which frozen section analysis showed negative margins,paraffin sections disclosed positive tumor margins in 6 cases (3.8%).Our results suggest that frozen section analysis during nephron sparing surgery has limited clinical significance and hence routine incorporation in urological practice should be reconsidered.

The aim of this study is to evaluate the application of untrasound-guided local anesthesia in alleviation of pain after percutaneous liver biopsy.The clinical results of 1417 cases of percutuneous liver biopsy were retrospectively analyzed.In 896 patients under ultrasound-guided local anesthesia 51 felt pain after liver biopsy,while in 521 patients whose local anesthesia without ultrasound guidance,143 felt pain (5.7% vs.27.4%,X~2=118.63,P＜0.01).The results indicate ultrasound-guided local anesthesia can effectively alleviate pain after percutaneous liver biopsy.

Since the attenuated live vaccine against measles was developed,the epidemic of measles has been controlled effectively,however,there is a trend of gradual increase of measles cases in recent years.The epidemiological and clinical features of 4430 measles patients in Shenzhen Municipality in last 10 years were reviewed.The data showed that the epidemic season was postponed with the peak of June to September;the prevalent age groups were infants and adults,the number of severe cases increased;and the positive rate of serological antibody in infants with measles was the lowest.