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 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 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 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.

Objective:To explore the risk factors of neurological complications after interventional treatment of ruptured intracranial aneurysms(RIAS), and to establish a predictive model of nomogram.Methods:The clinical data of 89 patients with RIAS who underwent endovascular treatment in Nanyang Second General Hospital Affiliated to Xingxiang Medical University from January 2016 to January 2019 were retrospectively studied.The clinical imaging data were collected and followed up for 6 months.The patients were divided into two groups: no neurological complications group (61 cases) and neurological complications group (28 cases). To analyze the clinical indicators and the possible related factors of neurological complications after RIAS interventional therapy.A nomogram was established to score the influencing factors, and a scoring prediction model was constructed; the clinical calibration of the model was evaluated by consistency index (C-index) and calibration curve, and the clinical differentiation of the model was evaluated by nomogram relying on ROC curve.Results:Multivariate logistic regression analysis showed that Hunt-Hess classification ( OR=4.927, 95% CI: 1.189-20.426, P=0.028), Fisher classification ( OR=4.633, 95% CI: 1.012-21.208, P=0.048 ), aneurysm cyst xiaofu ( OR=5.918, 95% CI: 1.104-24.948, P=0.015), wide carotid aneurysm ( OR=4.381, 95% CI: 1.029-18.645, P=0.046) and treatment Strategy ( OR=4.887, 95% CI: 1.235-19.329, P=0.024) is an independent risk factor for nerve-related complications after RIAs interventional therapy.The predictive model of nomogram showed that Hunt-Hess classification (grade IV, V) was 100, aneurysm bleb (with) 98, treatment strategy (stent implantation) 95, wide-necked aneurysm (yes) 92 and Fisher grade (grade III, IV) 81; the C-index of the predictive model was 0.871; the nomogram relied on ROC curve AUC 0.871, and the treatment strategy (stent implantation) was 95; the Fisher grade (grade III, IV) was 81; the C-index of the predictive model was 0.871.The sensitivity and specificity were 85.71%(24/28) and 77.05%(47/61) respectively. Conclusion:Hunt Hess classification, Fisher classification, aneurysmal sac caruncle, wide necked aneurysms and treatment strategies will affect the occurrence of neurological complications after RIAS interventional therapy.The nomogram established by this method can provide intuitive and reliable reference for clinical practice.

Objective To evaluate the assistant diagnostic value of low dose CT in patients with pulmonary embolism (PE) based on ventilation/perfusion (V/Q) SPECT imaging.Methods One hundred and two patients with clinical suspected PE had been enrolled for this retrospective study.The final diagnosis of PE was made according to the 2008 guidelines of European Society of Cardiology (ESC).All patients underwent V/Q SPECT/CT (Hawkeye 4,GE).The imaging findings from low dose CT lung window were used for differential diagnoses of abnormal regions in SPECT imaging.The diagnostic efficiency of V/Q SPECT alone was compared with that of V/Q SPECT combined with low dose CT scan.Crosstabsx2 test was performed using SPSS 13.0 software.Results Twenty-nine patients (28.43％,29/102) were finally diagnosed as PE.V/Q SPECT alone had a sensitivity of 93.10％ (27/29),a specificity of 90.41％ (66/73),and an accuracy of 91.18％ (93/102).With additional diagnostic information from low dose CT,the diagnostic specificity increased to 95.89％ (70/73,X2 =1.72,P ＞ 0.05 ),and the accuracy increased to 95.10％ (97/102,x2 =1.23,P ＞ 0.05) though the sensitivity remained the same.Conclusion Imaginginformation from low dose CT in hybrid SPECT/CT may enhance V/Q diagnostic accuracy for PE.

Objective To study the changes and clinical significance of serum kalium,natrium,chlorine,calcium and glucose in children with febrile convulsion(FC).Methods Serum kalium,natrium,chlorine,calcium and glucose concentrations were measured in 41 children with FC(FC group),30 children with fever and without convulsion(fever group) and 30 normal children(normal group) by automatic biochemical detector.Results Serum kalium and calcium concentrations had no significant difference between FC group and fever group,but they were significantly lower than those of normal group(F=5.965,3.048 P0.05).Conclusions There are hyponatremia,hyperglycemia and lowered blood kalium and calcium in patients with FC.Hence,while treating the patient with FC,the disturbance of blood electrolytes and glucose need be corrected to avoid the recurrence of FC and the progressive injury of important organs such as brain.