Diabetic retinopathy ( DR ) is one of the most serious microvascular complications of diabetes. It also is a world's major causes of blind eye diseases. Although the injection of anti - vascular endothelial growth factor intraocular drug is becoming a hotspot of current research. Pan retinal photocoagulation (PRP) remains the effective and economical treatment for DR. As a destructive treatment, PRP will inevitably cause some changes on the normal morphology and function of the retinal and cornea. Currently, with the development of the optical coherence tomography, confocal microscopy and other auxiliary examination, we have more accurate and objective research to better understand the laser-neural tissue interaction. This may help us to protect the patient's visual function more efficiently.

Objective To estimate the operational efficiency of 37 county level public general hospitals in Hubei province using the world popular method of Bootstrap-data envelopment analysis.The aim is to make up for the theory and methodology gaps on DEA research for hospitals in China,and to provide policy and management recommendations for their further improvement.Methods The input and output indicators of hospital efficiency evaluation were selected based on our previous research.R Software was used to describe the current input and output indicators,while FEAR package used to measure Bootstrap-DEA efficiency value of the sample hospitals with bias corrected,along with such applied analysis as efficiency benchmarking for the technical efficiency outcomes.Results There are great differences among the healthcare input and output of these hospitals.In particular,the difference in the number of actual beds was 4.67 times between the highest hospital and the lowest one.All of the bias corrected efficiency scores were lower than those before correction,and the average bias corrected score of the sample hospitals is 0.717 9.Moreover,only 20 hospitals(54.05%)have their efficiency scores above the median level.Conclusions The healthcare resources allocation of these hospitals needs to be further optimized.Hospitals still have big potential to improve their efficiency.Besides providing policy support,the government is advised to guide hospitals to innovate their management mechanisms,such as introducing and applying benchmarking,ranking,inter-hospital learning among others,so as to continuously improve their operational efficiency.

Objective To study the therapeutic effect of catgut net wrapping for preservation of the injured spleen.Methods Catgut net wrapping method was used to preserve the injured spleen,and the clinical material of those patients treated by the wrapping method was retrospectively evaluated.Results Ultimate spleen recovery was achieved in each case of 15 patients without postoperative bleeding observed,any abscess formation,or complications related to the use of catgut net wrapping.The patients were discharged after 10 to 14 hospital dayS.Two-week-fol-low-up results showed this therapeutic opinion is safe.Conclusion As a means of preserving the injured spleen,the catgut net wrapping method was simple,safe,and efficacious.

ObjectiveTo evaluate the diagnostic performance of bone SPECT and CT fusion imaging in bone metastases from pediatric neuroblastoma.MethodsTwenty-four pediatric patients with neuroblastoma were included in this retrospective study.All patients underwent planar imaging and SPECT integrated with CT.Lesion visibility,diagnostic certainty and diagnostic performance were evaluated with KolmogorovSmirnov test andx2 test.ResultsLesion visibility of SPECT alone,SPECT integrated with CT were significantly better than that of planar imaging ( both H =69.000,P ＜ 0.05 ).SPECT and CT fusion imaging,SPECT alone both detected five more bone lesions than planar bone imaging (77 vs 72).The diagnostic accuracy of SPECT imaging (62.34％,48/77 )was significantly higher than that of planar imaging (45.45％,35/77; x2 =4.416,P ＜ 0.05 ).The sensitivity,specificity and accuracy of SPECT and CT fusion imaging for diagnosing malignant bone lesions were significantly higher than those of planar imaging:82.35％ (42/51) vs 53.19％ ( 25/47),88.46％ ( 23/26 ) vs 40.00％ ( 10/25 ),84.42％ ( 65/77 ) vs 45.45％ (35/77 ; x2 =12.571,14.016,25.667,all P ＜ 0.01 ).The diagnostic specificity and accuracy of SPECT and CT fusion imaging were significantly higher than those of SPECT alone ( 53.85％,14/26 ;62.34％,48/77) (x2 =7.589,9.606,both P ＜0.01 ).However,there was no significant difference of sensitivity between the two methods (x2 =2.942,P ＞ 0.05 ).Diagnostic certainty by SPECT and CT fusion imaging was significantly higher than that by SPECT alone ( H =28.000,P ＜ 0.05 ) and by planar imaging (H =21.000,P ＜ 0.05).ConclusionSPECT and CT fusion imaging can detect more bone lesions in patients with pediatric neuroblastoma.It is helpful for diagnosing bone metastases from pediatric neuroblastoma.

Objective To evaluate the curative efficacy of endoscopic retrograde cholangiopancreatography (ERCP) on bile leaks after orthotopic liver transplantation (OLT). Methods Data of 12 cases, hospitalized in our hospital from March 2013 to February 2016, with bile leaks after OLT confirmed by magnetic resonance imaging of the pancreas (MRCP) or ERCP were retrospectively analyzed . The curative efficacy of ERCP was evaluated including clinical symptoms of bile leaks and complications, occurrence time and location, diagnosis and treatment process and efficacy. Results In this study, 12 cases were male patients, with the average age of 49.75 ± 8.55 (age from 35 to 62 years old). Among them 11 cases were successfully treated by endoscopic nasobiliary drainage (ENBD), and the success rate of endoscopical therapy was 91.7%, the curative rate of bile leaks was 91.7%(11/12). No ERCP related serious complications and death were found in patients. Nine cases combined with biliary strictures and/or biliary duct stone/bile plug were performed endoscopic sphinctrotomy (EST) during the first time of ERCP, and accepted further ERCP treatment after 2 weeks when the bile leaks were healed. All patients with ENBD were carried out well except one case. Conclusion ERCP is a safe and effective minimally invasive treatment method for different types of bile leaks after OLT.

It is difficult to measure the circular arc radius for central angle less than 30 degrees. The existing measuring methods are of low efficiency and big error. Through designing the machine vision system and studying the image detecting method for measurement, It is obtained good results by using the new measurement for tracheal intubation's circular arc radius, Realized a rapid and accurate measurement of the circular arc radius, and expanded the application in the field of machine vision.
Humans ; Imaging, Three-Dimensional ; instrumentation ; Intubation ; Trachea

Objective To investigate the effect of Curcumin on rats with severe acute pancreatitis associated renal injury and explore the possible mechanisms.Methods A total of 72 rats were randomLy divided into sham-operated group(S group, n =24), severe acute panceratitis with renal injury group(M group, n =24) ,Curcumin-treated group(Cur group,n=24).The S and M groups were given 1.5 ml saline through intragastric administration 3 hours before operation,while the Cur group was fed with same amount of Curcumin diluent(200 mg/kg).The pancreas and pancreatic tail-segment was dissociated and the head of pancreas was occlused in rats to form the model,blood vessel forceps was loosed after 3 hours.All the rats were sacrificed at 12 h,24 h, 36 h and 48 h after modeling.The level of ascites, serum amylase, creatinine, blood urea nitrogen were detected and the pathological chang of pancreas was observed under light microscope.Take the right kidney for Superoxide Dismutase (SOD) determination and the expression of hypoxia inducible factor-1αmRNA in the right kidney was detected with realtime polymerase chain reaction (RT-PCR).Results Compared with Cur group, the level of ascites, serum amylase, creatinine, blood urea nitrogen in M group were significantly increased, but the activity of SOD, the express of hypoxia inducible factor-1αmRNA had a significant decline (P＜0.05).The tissue damage of pancreas and the kidneys became more serious.But a better performance was to be found in the function of the Cur group's kidney and pancreas, and the the difference was statistical significance (P ＜0.05).Conclusion Curcumin has a good protective effect on severe acute pancreatitis associated renal injury.It may be through up-regulation expression of HIF-1α mRNA and increase the activity of superoxidase dismutase, then reduce the cell apoptosis and necrosis of the kidney, improve the ability of the kidney to tolerate hypoxia.

Objective: To present a modified option to surgical crown lengthening for repair of biologic width loss. Methods: The alternative to the traditional method involves reshaping the fractured root surface in combination with conservative removal of the supporting alveolar bone to rebuild the biological width. Although these teeth were considered as not suitable for the traditional methods, 7 teeth from 7 patients with fracture surface located lower than alveolar bone crest were treated by this modified method of surgical crown lengthening. Restoration was accomplished on these teeth two month later. Periodontal index such as tooth mobility, plaque index, probing depth and bleeding index were recorded and followed up. Results: The mean follow-up period was 17 months (ranged from 10 to 31 months). Result of surgery and restoration of these 7 teeth was satisfactory. The gingival tissue remained healthy and esthetic with good function. Conclusion: This modified surgical crown lengthening can be used as an alternative to the traditional method to save more fractured teeth.

Objective To investigate the value of the manipulative reduction monitored by ultrasound for the intussusception of children.Methods One hundred and three intussusception children were dynamically observed by ultrasound,and were pressed softly beginning with the head of the intussusceptum,and observed whether there was intestinal peristalsis, and whether the intussuseeptum shortened and disappeared finally.The results were analyzed based on the size of the masse, the length of the intussusceptum,and the patients' age,and compared with the X-ray high pressure air enema.Results Fifty (48.5 ％) intussusception children were recovered.The recoverability was related to the size of the mass, the length of the intussusceptum, and the age of the children (level of cooperation).Thirty-nine patients were recovered after reexamined one hour later.The recoverability of manipulative reduction monitored by ultrasound for the mass diameter less than 2.0 cm was obviously higher than that by X-ray high pressure air enema.Conclusions Manipulative reduction monitored by ultrasound could cure almost half of the intussusception children patients directly.It could decrease the number of patients who were treated with high-pressure air enema,it could relieve the pain of the children and reduce their medical expenses.It also could be acted as a screening way to other therapies like high pressure air enema.

Objective To investigate the effect of rhodiola on severe acute pancreatitis associated renal injury and explore the potential mechanisms.Methods A total of 90 rats were randomly divided into sham-operated group (S group,n =18),severe acute pancreatitis with renal injury group (M group,n =18),low rhodiola dose group (3 g/kg,T1 group,n =18),moderate dose rhodiola group (6 g/kg,T2 group,n=18),high rhodiola dose group (9 g/kg,T3 group,n =18).The S and M groups were given 6 g/kg saline through intraperitoneal injection before operation while the T1 group,T2 group and T3 group were given with 3 g/kg,6 g/kg,9 g/kg dose of rhodiola through intraperitoneal injection,respectively.The pancreas was dissected and the head of pancreas was occluded by blood vessel forceps for 3 hours to make rat model.All the rats were sacrificed at 12 h,24 h,36 h after modeling.The level of ascites amylase,serum amylase,creatinine,blood urea nitrogen,interleukin 1β(IL-1β) and interleukin 10 (IL-10) were detected and the pathological change of pancreas and the left kidney was observed under light microscope.The serum levels of IL-1β and IL-10 were detected by enzyme-linked immunosorbert assay (ELISA).Take the right kidney for superoxide dismutase (SOD) determination and the expression of hypoxia inducible factor-1α (HIF-1α)mRNA in the right kidney was detected by real-time polymerase chain reaction (RT-PCR).Results Compared with the S group,the level of serum amylase,creatinine,blood urea nitrogen and IL-1β in M group increased significantly,but the activity of SOD has a significant decline (P ＜ 0.05).Compared with M group,the level of serum amylase,creatinine,blood urea nitrogen and IL-1 β in T2 group has a significant decline,but the activity of SOD,the express of HIF-1α mRNA and IL-10 has a significant increase (P ＜ 0.05).With the dose of rhodiola increased,the renal and pancreatic function in T2 group had a better performance than T1 group,and the difference was statistical significant (P ＜ 0.05).But compared with T2 group,the renal and pancreatic function in T3 group did not increased significantly (P ＞ 0.05).Conclusions Moderate dose of rhodiola (6 g/kg) has a good protective effect on severe acute pancreatitis associated renal injury.It may be associated with the inhibitory expression of IL-1β,up-regulated expression of IL-10,HIF-1α mRNA,and the increased activity of SOD.So it can then reduce cell apoptosis and renal necrosis,and improve the ability of the kidney to tolerate hypoxia.