· AlM: To analyze the clinical data of 54 cases misdiagnosed as optic neuritis and to explore measures to reduce misdiagnosis
· METHODS: This retrospective study comprised 54 patients that had been misdiagnosed as optic neuritis from September 2000 to June 2013. The misdiagnosis features were summarized.
· RESULTS:Many diseases can easily be misdiagnosed as optic neuritis, including ischemic optic neuropathy, intracranial tumors, optic nerve vasculitis, myelinated nerve fibers, and so on.
· CONCLUSlON: The measures to reduce misdiagnosis consisted of detailed history collection, perfect physical examination and comprehensive expertise of fundus disease.

Hemangioma ; metabolism ; pathology ; Humans ; Immunohistochemistry

Spironolactone has been widely used in clinical treatment of PA,but its adverse effects are prominent when at large dose.So it is very important for clinicians to choose proper medications and doses for PA.With widespread use of selective aldosterone-receptor antagonists,non-aldosterone antagonists diuretic,calcium antagonists,angiotensin-converting enzyme inhibitors and angiotensin-receptor blocker in treatment of PA,clilicians now have more choice.This review introduces the progress in medications of PA in recent years.

The hospitalpice enterprise has developed vigorously in China ever since 1980s.However,influenced by the long history and traditional Chinese culture,there are some ethical dilemmas in the issues of choice of death and palliative treatment.Choice of death and palliative treatment for the dying patients have been restricted by the traditional Chinese philosophy of death,traditional principles of filial piety,and the absence of support from euthanasia legislation.It is suggested that during the introduction of hospitalpice into china,the traditional Chinese value be respected.Meanwhile,people's cognition of hospitalpice should also be shifted to decrease the constraint of traditional ideas.The whole social power should be united and professional regulation construction should also be strengthened.Besides,it is also important to improve training for related professionals,promote the process of hospitalpice legislation as well as go abide by the current laws in order to achieve a high-quality hospitalpice.

Objective To observe the cardioprotective effect of ginseng-monkshood extract injection on ischemia-reperfusion injury in rats'isolated working hearts.Methods The heart models of ischemia-reperfusion injury were built by Langendorff isolated heart perfusion technology.The different concentrations of nitrogen saturated Ginseng-monkshood extract injection were used for infusion,and the indexes of heart rate,coronary flow and myocardial enzymes were observed in reperfusion 20 min and 40 min.Results Infusion of ginseng-monkshood extract injection can improved heart rate and flux of coronary artery and inhibit the leak of lactic dehydrogenase and creatine kinase during ischemia reperfusion.Conclusions Ginseng-monkshood extract injection has obviously protective effect on myocardial ischemia reperfusion injury.

Objective To investigate the siRNA interference of S100A4 mRNA of human pancreatic cancer cell radiosensitivity.Method Cultured human pancreatic BxPC-3,AsPC-1 in vitro,logarithmic phase cells as the experimental object,were divided into three groups:normal control group (without any treatment),negative control group (transfected with negative control fragment),interference group (transfected S100A4 protein fragment siRNA),the chemical synthesis siRNAS100A4 fragment interference of S100A4 mRNA 0,1,2,3,5,7,10 Gy given 6MV X-ray irradiation,the use of clone formation assay,Giemsa stained colony formation rate is calculated and SF2,and the fitting cell survival curve.Results The siRNA interference S100A4 after BxPC-3 cells SF2 value are:the control group 0.68±0.02,negative control group 0.65±0.01.interference group,0.38±0.02,P＜0.05.AsPC-1 cells SF2 value:control group 0.48±The0.02,negative control group 0.47±0.02; interference group:0.37±0.04,P＜0.05.Conclusion siRNA interference S100A4 after increased radiosensitivity of human pancreatic cancer cell lines.

An analysis of the characteristics of the facial fractures in children was performed in this paper by investigating the cases of the facial fractures in children.In the study,86 cases of facial fractures in children under 12 years from January 2000 to June 2008 were reviewed,who were treated by the Fourth Military Medical University. The information included the age,gender,time distribution of jury,type of fracture, nerve injury, and associated systemic injuries. The youngest age was 13 months, the ratio of male to female was 2.19∶ 1. The majority of fractures were occurred in summer. The most cases were caused by the traffic accidents, and the mandible fractures were higher than others. The number of conservative treatment were higher than operation,78% cases of condyle fractures were treated conservative, the operation of maxilla and zygomatic arch fracture were less than 50%. The males were higher than the females according to the facial fracture in children.Traffic accident was the main risk factor of condylar fracture. The mandibular fractures were occurred frequently and treated normally by conservative method.

Objective To investigate the efficacy of preemptive analgesia with parecoxib sodium combined with local infiltration anesthesia with ropivacaine for postoperative pain after laparoscopic cholecystectomy.Methods One hundred and fifty ASA Ⅰ or Ⅱ patients,aged 41-63 yr,weighing 55-87 kg,scheduled for laparoscopic cholecystectomy under the general anesthesia,were randomly divided into 3 groups (n=50 each): parecoxib sodium+0.9％ normal saline (group A),parecoxib sodium + 0.5％ ropivacaine (group B) and parecoxib sodium + 0.75 ％ ropivacaine (group C).Parecoxib sodium 40 mg was injected intravenously 30 min before induction of anesthesia.Anesthesia was induced and maintained with remifentanil and propofol given by TCI.Immediately before skin closure,0.9％ normal saline 12 ml was given in group A,and 0.5％ and 0.75％ ropivacaine 12 ml were injected for local infiltration anesthesia in groups B and C,respectively.VAS scores were maintained ≤ 3after operation.When VAS scores ＞ 3,pethidine 75 mg was injected intramuscularly.Ramsay sedation scores were recorded at the end of operation and 2,4,8,12 and 24 h after operation.The side effects (nausea and vomiting,allergy,respiratory depression,etc.),requirement for pethidine,algesic sites (incisional pain,upper abdominal pain,referred pain in right shoulder),and condition of the wound healing were all recorded within 24 h after opcration.Results Compared with group A,Ramsay sedation scores,the incidence of nausea and vomiting,the requirement for pethidine and total amount of pethidine,and the incidence of incisional pain were significantly decreased in groups B and C (P ＜ 0.05 or 0.01).Compared with group B,the requirement for pethidine and total amount of pethidine,and the incidence of incisional pain were significantly decreased in group C (P ＜ 0.05 or 0.01).There was no significant difference in Ramsay sedation scores between groups B and C (P ＞ 0.05).There was no significant difference in the condition of the wound healing,upper abdominal pain and referred pain in right shoulder between groups A,B and C (P ＞ 0.05).Conclusion For the patients scheduled for laparoscopic cholecystectomy,local infiltration anesthesia with ropivacaine can improve the efficacy of preemptive analgesia with parecoxib sodium,and it provides better postoperative analgesia when 0.75 ％ ropivacaine is used.

[Objective]To analyze the clinical and radiographic outcome of surgical treatment for idiopathic scoliosis in patients treated at the age of 20 years or older.[Methods]In this study,62 adult patients with idiopathic scoliosis who underwent surgery using pedicle screw instrumentation were followed up for 2 to 5 years,and the results were analyzed clinically and radiographically.[Results]The prevalence of pain requiring specific treatment decreased from 16% to 4%,and the pain relieve was reliably obtained in the older patients.Radiographically,the mean correction rate of Cobb's angle was 56% for both the thoracic and lumbar curves,whereas it decreased with the age increasing,especially in relation to the thoracic curve.The sagittal plane correction was satisfactory.[Conclusion]This study clarified different specific characteristics and problems in the surgical treatment of adult idiopathic scoliosis in different age groups.Pain is the most important indication for surgery in patients older than 40 years,and it has been improved reliably by surgery in most of these patients.On the other hand,the correction rate of Cobb's angle would be decreased with the increased age,the sagittal plane correction rate is not related to age.