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.

Adult ; Crown Lengthening ; Dental Restoration, Permanent ; Esthetics, Dental ; Female ; Humans ; Incisor ; Malocclusion ; therapy

Objective:To investigate the clinical efficacy of every 3-week regimen of oxaliplatin (OXA) plus 5-fluorouracil (5-FU)/leucovorin(CF)as postoperative adjuvant chemotherapy for colorectal cancer.Methods:Ninety eight patients with stage Ⅱ to stage Ⅲ colorectal cancer received every 3-week OXA plus 5-FU/CF adjuvant chemotherapy for six cycles after resection surgery. All the patients received a complete reexamination every 3 months after the end of adjuvant chemotherapy. The disease-free survival period and 1- and 2-year disease-free survival rates were observed.Results:The total 2-year disease-free survival rate was 74.5%. It was 87.0% for stageⅡpatients and 63.5% for stage Ⅲ patients. The main adverse reaction included peripheral neurotoxicity, neutropenia and diarrhea at grades Ⅰ to Ⅱ. Grades Ⅲ to Ⅳ adverse reactions occurred rarely.Conclusion:The every 3-week OXA combined with 5-FU/CF adjuvant chemotherapy regimen had definite efficacy and good tolerance, which was a rational choice of postoperative adjuvant chemotherapy for colorectal cancer.

Objective To observe the analgesia effects of nitrous oxide inhalation in childbearing. Method Respectively estimate the labor time,delivery type,degrees of labor pain, fetal distress and postpartum hemorrhage condition between analgesia group of 86 cases and control group of 45 cases. Result Compared to control group, the painful extent of delivery process in analgesia group was obvious lightened and childbearing time was decreased. Conclusion BZ Analgesia effects of nitrous oxide inhalation is positive in childbearing and has great value of clinical applying in obstetrics.

Objective: To evaluate the impact of the number of negative lymph nodes on disease free survival (DFS) of patients with locally advanced gastric cancer. Methods: A total of 485 patients who underwent surgery for gastric cancer were enrolled in this study. We analyzed the data of these patients including complete information of follow-up and definite postoperative pathological results. The disease free survival of all patients was more than 6 months and was analyzed according to the pathological stage respectively. COX regression analysis was performed to screen the independent prognostic factors. Kaplan-Meier method was used to draw the disease free survival curve and the disease free survival rate was compared among subgroups. Results: Cox regression analysis showed that the disease free survival rate of gastric cancer patients with pathological stage T_3N_(0～2)M_0 was significantly associated with age, degree of tumor differentiation, tumor location as well as the number of negative lymph nodes. In the T_3N_0M_0 subgroup, when the number of negative lymph nodes was 1 to 4 and 5 or more, the 2-year disease free survival rate was 8.3% and 55.6%, respectively, and the 3-year disease free survival rate was 0 and 24.9%, respectively (P=0.025).In the T_3N_1M_0 subgroup, when the number of negative lymph nodes was 3 or less, 4 to 9, and 10 or more, the 2-year disease free survival rate was 17.3%, 39.1%, and 52.6%, respectively, and the 3-year disease free survival rate was 4.2%, 6.0%, and 17.1%, respectively (P<0.001). In the T_3N_1M_0 subgroup, when the number of negative lymph nodes was 7 or less and 8 or more, the 2-year disease free survival rate was 11.5% and 35%, respectively, and the 3-year disease free survival rate was 0.8% and 5%, respectively (P=0.015).Conclusion: For gastric cancer patients with pathological stage T_3N_(0～2)M_0, the number of negative nodes could reflect the level of regional lymph node dissection. The number of negative nodes can be an index for evaluation of the accuracy of pathological staging and is considered as an independent prognostic factor for disease free survival of gastric cancer patients.

[Objective]To improve the diagnosis and treatment of acute fatal pulmonary thromboembolism(PTE)in orthopedic perioperation.[Method]Clinical manifestations,radiological features,laboratory examination data,treatment and prognosis of 12 patients diagnosed as acute fatal PTE in orthopedic perioperation from February,2002 to July,2005 were retrospectively analyzed.[Result]Nine patients received emergent thrombolytic and anticoagulant therapy,7 were alleviated and 2 died;3 patients with sudden cardiac arrest died after failed cardiopulmonary resuscitation.[Conclusion]Acute fatal PTE is a severe disease of orthopaedics.The realization and alert of the existence of acute fatal PTE must be increased.Early diagnosis and efficient treatment is the key to preventing from death.

Objective To explore the clinical curative effect of hollow screw internal fixation for the treatment of distal epiphyseal teenagers tibial fracture.Methods Thirty -nine cases of epiphyseal fractures of the distal tibia were treated in Shanghai Children′s Hospital between February 2005 and September 201 4.This study included 24 boys and 1 5 girls with the average age of 1 3.1 years (ranged 1 0.5 to 1 6.2 years old).Preoperative diagnosis was confirmed by the X -ray films or CT examination.All the cases were closed fractures and manipulative reduction all failed.Surgi-cal reduction was performed when plain radiographs showed the fracture gap of epiphysis board and articular surface were greater than 2 mm or after closed reduction.Under C -arm X -ray machine,ankle axial traction was performed initially.Anatomical reduction underwent according to the bone fracture type.The fractures were fixed with cannulated screws by percutaneous or open approach.Postoperative X -ray or CT confirmed anatomical reduction at articular sur-face and growth plate.All patients had been immobilized with short -leg cast for 4 -6 weeks.The ankle joint function and growth were evaluated by means of American Orthopaedic Foot and Ankle Society(AOFAS)Ankle Hindfoot Scale. Results All patients were followed up for 5 to 91 months with an average duration of 35 months.X -ray films showed that all fractures were bone healing.No uneven articular surface was found and there was no extremity rotation and shorte-ning deformity.Results were evaluated by AOFAS scoring system:excellent in 27 cases,good in 10 cases,and general in 2 cases.All patients were able to participate in the normal physical activities.Conclusions CT with multiplanar recon-struction is a premise to make an accurate diagnosis and to choose a reasonable approach.For failed closed reduction for adolescent distal tibial epiphyseal fractures,the cannulated screws are simple and may have a satisfactory effect.

By means of literature review,the paper made a comparative study of key development projects of healthcare information in China over the last decade,in terms of their project characteristics,economic environment,development entity,investment and compensation practice,development strategy,coverage,experience and promotional values.Setbacks identified include the following:discrepancy in regional development stages of healthcare information; successful pilots are limited to scientific research samples; lack of regional models; systems separation; poor continuity and coordination; waste and insufficiency of resources in the investment and construction among others.The authors recommend a better exchange of experiences in building the regional healthcare information service platforms,greater investment,better compensation mechanism,better top-tier design,and maximized coverage within reach of supervision and technology.

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.