Central serous chorioretinopathy (CSC) is characterized by serous detachment of the sensory retina as a consequence of the focal leakage of fluid from the choriocapillaries to subretinal space through a defect of the retinal pigment epithelium(RPE). The exact cause of CSC is not well unknown. Psychological stress is thought to contribute to CSC, but the physiologic mechanisms are unclear. It is hypothesized that psychological stress can induce CSC through the mechanism of the hypothalamic-pituitary-adrenal (HPA) system. Psychological stress can adversely affect HPA axis and causes glucocorticoid levels to elevate. Increased glucocorticoids constrict choroid vessels, which leads to ischemia of choroids and damage vascular endothelial cells, thus causing vasopermeability to increase. RPE dysfunction will occur as a result of abnormalities in the choroidal circulation. The large molecules including protein may enter the subretinal space through the damaged vessels and RPE.

AIM: To investigate the clinical efficacy and safety of intravitreal injection of triamcinolone combined macular grid photocoagulation treatment for macular edema.
METHODS: Totally 150 cases (150 eyes) with macular edema in our hospital from July 2009 to November 2013 were selected, which were randomly divided into study group (75 cases, 75 eyes) and control group (75 cases, 75 eyes) . The cases in control group were treated with macular grid photocoagulation treatment, those in the study group used triamcinolone acetonide combined macular grid photocoagulation treatment. Best corrected visual acuity ( BCVA ) , parallel optical coherence tomography ( OCT) and fundus fluorescein angiography (FFA) were detected before treatment, after treatment 7d, 1, 3, and 9mo.
RESULTS:After the treatment, patients' vision were significantly improved in two groups (P<0. 05). In the study group 7d, 1, 3, and 9mo after operation, the visual acuity was better than the control group and preoperative (P<0. 05); fovea macular neurosensory layer thickness decreased significantly (P<0. 05). In the control group, the point omentum macular neurosensory retinal thickness was not statistically significant at 7d, 1, 3, and 9mo after operation compared with before treatment (P>0. 05). Fovea macular neurosensory retinal thickness in the study group was significantly lower than that in control group (P<0. 05). Intraocular pressure of 7 cases in the study group increased slightly, and were normal after treatment.
CONCLUSION: Triamcinolone acetonide combined macular grid photocoagulation treatment is accurate, can effectively improve the visual acuity, reduce macular edema, it is safe and reliable, and suitable for clinical application.

The internship is the transition period of a medico becoming a doctor,the cultivation of clinical work ability of interns is a comprehensive ability cultivation which includes the foundation theories' consolidation and use,the practical operative train- ing,the cultivation of clinical thought ability and communication between doctors and patients,etc.To educate pediatrics intern has its characteristics.

Behcet Syndrome ; complications ; Humans ; Male ; Middle Aged ; Myocardial Infarction ; complications

Antibiotics, Antineoplastic ; pharmacology ; Apoptosis ; drug effects ; Breast Neoplasms ; metabolism ; pathology ; Cell Line, Tumor ; Cell Proliferation ; drug effects ; Down-Regulation ; Doxorubicin ; pharmacology ; Female ; Humans ; Oligonucleotides, Antisense ; pharmacology ; Phosphoproteins ; metabolism ; RNA-Binding Proteins ; metabolism ; Random Allocation

Disaster Planning ; Humans ; Physicians

Objective To describe the pathogenic and serological test results of the plague in China from 2001 to 2009, and human and animal plague distribution. Methods Through access to information of the plague surveillance report in China from 2002 to 2010, national plague pathogenic and serological test results and the epidemic situation were analyzed from 2001 to 2009. Results From 2001 to 2009, 2966 strains of Yersinia pestis were isolated in the seven provinces which were Guizhou, Guangxi, Yunnan, Qinghai, Tibet, Gansu and Inner Mongolia. Of these, 1 138 000 animals were detected by bacteriological method, 1998 strains of Yersinia pestis were isolated;379 227 groups of intermediary animals were detected, 927 strains of Yersinia pestis were isolated;41 strains of Yersinia pestis were isolated from human body. Animal serums of 1 169 702 were detected by indirect hemagglutination assay(IHA), of these 3177 animal serums were positive, 168 human serums were positive;53 323 animal samples were detected by reverse indirect hemagglutination assay(RIHA), of these 500 were positive. There were outbreak or epidemic of plague in 9 types of plague foci, 2925 strains of Yersinia pestis were isolated. Two animals and 6 fleas were judged as new reservoir and new vector. There were 23 counties of 6 provinces were judged as plague new natural foci counties. Conclusions The plague epidemic in China is still serious between 2001 and 2009. There are nine types of foci in the active state.

Abstract?AIM: To observe the clinical efficacy of intravitreal Lucentis injection combined with panretinal photocoagulation ( PPR ) and compound trabeculectomy for neovascular glaucoma ( NVG) .?METHODS:A total of 14 cases (14 eyes) with NVG were collected from January to November 2015.All cases were treated with intravitreal lucentis injection, PPR and compound trabeculectomy by turns.Intraocular pressure ( IOP) , visual acuity and the complications at pre-or post-surgery were recorded, respectively.?RESULTS: Followed up for 3-6mo, the average IOP preoperatively was significantly decreased than that detected at post-operation ( 18.00 ±6.70 vs 41.65 ± 4.07mmHg, t=11.288, P<0.05).IOP less than 21mmHg with or without the usage of anti-intraocular pressure drugs was defined as the sign of successful or effective surgery, respectively.At the ultimate follow-up, 11 cases were successful, 2 cases were effective, and the success rate was 79%, effective rate was 14%.Only 1 case was applied cyclocryotherapy due to the uncontrolled IOP. Moreover, the results of visual acuity detection demonstrated that 6 eyes got a better visual acuity, 7 eyes remained the same condition and 1 case got no light perception. Meanwhile, 13 cases showed none iris neovascularization during the follow-up; 1 case got a reappearance of iris neovascularization on the third month, which was then dissolved subjected to the intravitreal lucentis injection in combination with PPR. One case developed post -operative hyphema and absorbed after 1wk. No shallow anterior chamber and eyeball atrophy happened.?CONCLUSION:Intravitreal lucentis injection combined with PPR and compound trabeculectomy is an effective and safe therapeutic strategy for the treatment of NVG.

Purpose To retrospectively analyze and summarize the image features of rare ovarian clear cell carcinoma (OCCC), and to provide basis for clinical diagnosis. Materials and Methods CT and MRI features of 30 cases of OCCC confirmed by pathology were retrospectively analyzed. Sixteen of all the patients underwent pre- and post-contrast CT scan. And 14 patients underwent pre- and post-contrast MRI scans. Results ① CT features: unilateral mass was revealed in 15 cases and bilateral mass was in 1 case. The maximum diameter of the mass ranged from 8 to 23.7 cm, mean (12.86±3.96) cm. One mass was irregular, 4 masses revealed incomplete capsule, and 4 masses had septa in the mass. CT value of cystic part of the mass was 20-30 HU, and which of solid part was 28-53 HU. On post-contrast CT images, the septa and solid component of the mass showed marked enhancement and delay enhancement, while the cystic component showed no enhancement. ② MRI features: Unilateral mass was revealed in 13 cases and bilateral mass was in 1 case. The maximum diameter of the mass ranged from 9.2 to 30.0 cm, mean (14.03±4.72) cm. One mass was irregular, 2 masses revealed incomplete capsule, and 2 masses had septa in the mass. The cystic component showed heterogenous signal intensity on T1WI, and high signal intensity on T2WI. There was no enhancement on post-contrast images. The solid component showed iso-intensity on T1WI, high signal intensity on T2WI, and diffused restricted on diffusion-weighted images. There was markedly enhancement on post-contrast images. ③ Blood supply of the tumor: In 8 cases, the branch of enlarged ipsilateral ovarian artery fed the tumors. In other 16 cases, the masses were surrounded by enlarged ipsilateral ovarian vein. Conclusion The characteristic CT and MRI features of OCCC include: a cystic solid mass with complete capsule; the solid component projects into the cavity, which could be hypervascular and marked enhanced.

OBJECTIVETo explore the effects of warm needling combined with Zhangmo decoction (see text) on endometrial receptivity in patients with clomiphene (CC)-induced ovulation.

METHODSOne hundred and sixty cases were randomly divided into a CC group (group A), a CC+ progynova group (group B), a CC+ Zhangmo decoction group (group C) and a CC+ Zhangmo decoction + warm needling group (group D), 40 cases in each one. In the Group A, CC alone was applied. In the group B, progynova was jointly used on the 8th day of menstrual cycle. In the Group C, Zhangmo decoction was jointly used on the 5th day of menstrual cycle. In the group D, based on treatment of the Zhangmo decoction, warm needling was applied at Guanyuan (CV 4), Zhongji (CV 3) and Zigong (EX-CA 1) etc. The endometrial thickness and type, pulsatility index (PI), resistance index (RI), ratio of S/D on day of human chorionic gonadotropin (HCG) and pregnancy rate were observed in fou groups.

RESULTSThe PI, RI and S/D in the group C and D were obviously lower than those in group A and B (all P < 0.01). The endometrial thickness was (7.7 +/- 1.49) mm in group B, (8.2 +/- 1.54) mm in group C and (8.9 +/- 1.51) mm in group D, which were significantly different from (6.4 5 +/- 1.26) mm in the group A (all P < 0.01) also there was a significant difference between group C and D (P < 0.05). The rate of endometrial type A was 65.0% in the group D, which was significantly higer than 27.5% in the group A, 32.5% in the group B and 35.0% in the group C (all P < 0.01). The pregnancy rate was 30.0% in the group D, which was obviously higher than 12.5% in the group A, 15.0% in the group B and 17.5% in the group C (P < 0.05). The endometrial thickness and rate of endometrial type A in the pregnant were obviously higher than those in the non-pregnant (both P < 0.01) while PI, RI and S/D was lower than those in the non-pregnant (P < 0.01, P < 0.05).

CONCLUSIONWarm needing combined with Zhangmo decoction could improve endometrial thickness, morphology and uterine spiral artery to improve pregnancy rate, which has superior effect to clomiphene, clomiphene combined with progynova and clomiphene combined with Zhangmo decoction.

Chorionic Gonadotropin ; metabolism ; Clomiphene ; administration & dosage ; Combined Modality Therapy ; Drugs, Chinese Herbal ; administration & dosage ; Embryo Transfer ; Female ; Fertilization in Vitro ; Humans ; Infertility, Female ; drug therapy ; metabolism ; physiopathology ; therapy ; Ovulation Induction ; Pregnancy