Objective To investigate the effect of combined prism lenses for the treatment of juvenile myopes. Methods 622 cases of juvenile myopes ranging from - 1. 0D to - 5. 0D, aging from 6 - 18ages, were divided randomly into two groups. The control group(320 cases) wear general glass and the research group(302 cases) wear combined prism lenses. The juvenile myopes of both groups were checked their vision every 6 months and data were collected at the end of the fourth 6 months and analyzed by SPSS software. Results Ther eyes of increasing diopter in research group were 38(6.3%of all eyes) ,33 eyes were less than 1. 0D and 5 eyes were more than 1. 0D among them;but 294(46.0% of all eyes) in the control,201 eyes were less than 1.0D and 93 eyes were more than 1.0D among them. There were significant differences between two groups(P＜0.01). Conclusion Combined prism lenses for juvenile myopes (lower and middle) .compared with the common glass, had good clinical effect and it was a reliable and practicable method,to wear combined prism lenses for the treatment of juvenile myopes.

Objective To study the association of peptidylarginine deiminase 4 (PADI4) (padi4_94 and padi4_104) genetic single nucleotide polymorphism (SNP) and rheumatoid arthritis (RA) susceptibility in Han population of Hebei province. Methods This hospital-based case-control study included 115 RA patients and 106 healthy controls. All the individuals were recruited from Han Hebei residents and were randomly selected. The genotype and allele frequencies of PADI4 gene polymorphisms (padi4_94 and padi4_104) were analyzed by PCR-DNA sequencing method. Results The distribution of padi4_94 and padi4_104 genotypes between the two groups was not significantly deviated from that expected by Hardy-Weinberg equilibrium (P>0.05). The combined effect of padi4_94 and padi4_104 SNPs was analyzed and three haplotypos (AA, AG and GG) were found but without GA haplotype. The genotype and allele distribution of padi4_94 and padi4_104 in the patients with RA was not significantly different from that in healthy controls,and the analysis of haplotypes revealed that no haplotypes were risk factors for RA. Conclusion In Han population of Hebei province, the SNPs of PADI4 (padi4_94 or/and padi4_104) is no associated with RA susceptibility. Therefore, it should not be regarded as a genetic risk factor for RA.

BACKGROUND:Although thoracoscopy with pleurodesis is regarded as a positive and effective way for the treatment of malignant pleural effusion, the merit and demerit of sclerosants are directly related to postoperative recovery and the success of pleurodesis. OBJECTIVE:To evaluate the therapeutic effect of talc pleurodesisvia thoracoscopy in the treatment of refractory malignant pleural effusions METHODS:There were 14 male and 15 female patients in this study, age ranging from 38 to 79 years. Al patients with refractory malignant pleural effusion underwent talc pleurodesis under thoracoscopy. The postoperative adverse reactions, chest CT scan 1 month after operation and the fluid drainage were observed. RESULTS AND CONCLUSION:Twenty-nine patients with chest pain were observed in this study. Eighteen patients could relieve the pain itself without medications, eight patients required oral Tramadol and three patients took Demerol or morphine oraly to ease the pain. Fever occurred in three cases at 3 days after operation. Neither pneumonedema, acute respiratory failure, nor death ocurred postoperatively. One month later, complete successful pleurodesis was achieved in 24 cases, and partial successful in 3 cases, and unsuccessful in 2 cases. The results indicate that thoracoscopy with talc pleurodesis can be regarded as a positive and effective way for the treatment of malignant pleural effusion.

Objective To evaluate the value and feasibility of Microsim medical simulation training system in medical students' clinical thinking training. Method 96 students of 5-year program of medicine of Grade 2009 and Grade 2010 were the research object. These students were randomly divided into two groups (group A:After 3 weeks' clinical practice in respiratory medicine, taking 1 week Microsim training. group B: Taking 4 weeks clinical practice in respiratory medicine. Each group has 48 students.). The examination and teaching satisfaction of the two groups were observed after the end of the internship. SPSS 17.0 statistical software was used to analyze the collected data (measurement data matching t test, counting data by chi-square test). Results The Microsim system score: group A was (89.37±7.18), group B was (61.95±15.34). The difference between groups was statistically signifi-cant. The following scores suggested the assessment of students' ability of clinical thinking: ability to analyze problems [group A (89.95±4.02) vs. group B (75.51±6.34)], the ability to deal with the prob-lem [group A (78.81±8.09) vs. group B (59.67±9.33)], treatment scheme [group A (86.74±6.59) vs. group B (70.39±7.05)] and the treatment effect [group A (88.61±8.16) vs. group B (63.54±11.48)]. In these aspects, the two groups had statistically significant difference, but communication [group A (82.47 ±5.23) vs. group B (84.09 ±3.72)] had no statistically significant difference between the two groups. 89.6% (43) of the participants believed that the Microsim medical simulation training system could significantly improve the clinical thinking ability, but only 58.3% (28) of the students believed that the basic theory of knowledge could be consolidated. Conclusion Microsim medical simulation training system can improve the students' ability of clinical thinking and clinical comprehensive treat-ment ability. It can be used as an effective complement to clinical practice teaching.

Objective To investigate the effect of hypertension and hyperuricemia (HUA) on renal function.Method Total 1 209 subjects undergoing health check up from December 2000 to December 2002 and 45 patients with renal disorders were enrolled in the study.The blood pressure,height,weight,renal function and liver function were measured; and the glomerular filtration rate (GFR) was calculated.The GFR in patients with hypertension,HUA and hypertension with HUA was compared.Results The incidence of hypertension in HUA group and non-HUA was 23.9％ (58/243) and 13.9％ (134/966),respectively (x2 =14.52,P =0.000).GFR in HUA with hypertension,HUA and hypertension groups were (69.1 ± 30.5),(82.8 ± 25.3) and (90.1 ± 21.7) ml · min-1 · (1.73 m2)-1,respectively (P ＜ 0.01).Logistic regression analysis showed that the risk factors for GFR were UA,systolic pressure and age.After 5 years of follow up,GFR in hypertension group was significantly decreased from (90.7 ± 18.1) to (85.6 ± 17.6)ml·min-1 · (1.73 m2)-1m,in HUA group from (86.3±10.9) to(62.1 ±8.2) and inHUAwith hypertension group from (77.9 ± 18.9) to (49.3 ±9.8) ml · min-1 · (1.73 m2)-1,UA and age were the long-term factors that affect GFR (P ＜ 0.05).Conclusions Both hyperuricemia and hypertension can impair the kidney function,if hypertension is complicated with hyperurecemia the effect is more marked.

BACKGROUND:Some scholars believe that for primary spontaneous pneumothorax thoracoscopic surgery and intraoperative pleurodesis can effectively reduce the recurrence rate. ＜br> OBJECTIVE:To study the reliability and validity of video-assisted thoracoscopic entoiodine pleurodesis for treatment of primary spontaneous pneumothorax. ＜br> METHODS:Videothoracoscopy procedures were performed on 64 patients with primary spontaneous pneumothorax, including 46 males and 18 females, with an age ranging from 15 to 30 years. According to the use of pleurodesis, the patients were randomly divided into two groups:experimental group and control group. In the control group, no entoiodine was used;while in the experimental group, entoiodine dipped gauze was used on the visceral pleura. The operation time, intraoperative bleeding, postoperative drainage, postoperative leakage time, postoperative extubation time, postoperative complications and the recurrence rate of pneumothorax within 1 year after operation were compared between two groups. ＜br> RESULTS AND CONCLUSION:No significance was found in the operation time, intraoperative bleeding, postoperative leakage time, postoperative extubation time and postoperative complications between the two groups (P>0.05). Although the experimental group had significantly more postoperative drainage volume than the control group (P＜0.05), there were no consequences of medical intervention. Video-assisted thoracoscopic entoiodine pleurodesis could significantly reduce the recurrence rate of pneumothorax in 1 year after operation (P＜0.05). The results show that video-assisted thoracoscopic operation with entoiodine is a reliable and effective method to reduce the recurrence of pneumothorax after operation in patients with primary spontaneous pneumothorax.

Objective To explore the clinical effect of combination of vascularized fibular head epiphysis and peroneal neurovascular reverse flap repair defects of bone and skin in lateral malleolus in children.Methods Eight children with defects of bone and skin in lateral malleolus were recruited from May,2009 to September,2014.The age of children was ranging from 4 to 12 years old.Four children were injured by wheel twist,2 children were injured by traffic accident,1 was injured by machinery,and 1 was crashed with heavy object.The size of soft-tissue defect was ranging from 3 cm × 5 cm to 7 cm × 9 cm.The flap and bone healing along with ankle joint function scoring were evaluated.Patients were reviewed every 4 to 6 weeks during one year after their surgery,and they were reviewed every 6 months one year later.Results Secondary repair were conducted in all children.The curative effect got well after follow up for 6 months to 2 years(mean,12 months).The flap and fibular head epiphysis were well developed.The ossification of fibular head epiphysis did not found.According to American Orthopaedic Foot and Ankle Society (AOFAS) ankle function evaluation criteria,the results were excellent in 5 cases,good in 2 cases and poor in 1 at 10 months after operation.The shape and function of ankle joint were good,with one exception.The average motion degree of ankle joint was (68±5.12)°.Conclusion Combination of vascularized fibular head epiphysis and peroneal neurovascular reverse flap repair defects of bone and skin in lateral malleolus in children is effective.

Filtering is very important in acquiring EC G signals.With the characteristics of ECG signals analyzed,this paper designs and achieves a filtering circuit.The result of the experiment is also given.

Objective To study the gene polymorphism at position padi4_94 in Chinese Han people of Hebei Province and the characters of distribution.Methods 106 healthy individuals and 115 rheumatoid arthritis patients in Hebei Province were randomly selected. Padi4_94 gene was screened by sequencing of the promotor. The correlations between the SNP site and anti-cyclic citrullinated peptide antibody (anti-CCP) was discussed.Results There were three genotypes: AA, AG and GG in Chinese Han people of Hebei Province. No significant differences of gene frequency and allele gene frequency were found between healthy individuals and RA patients, and no correlation between SNP and the production of anti-CCP.Conclusions Hebei Province The gene polymorphisms at position padi4_94 existed in Chinese Han people of Hebei Province,but possibly would not affect RA susceptibility and the production of anti-CCP.

Objective To investigate the clinical value of PET-CT in aiding CT guided percutaneous puncture biopsy for lung mas-ses.Methods The retrospective data were analyzed including 5 7 patients with lung masses who underwent CT guided percutaneous puncture biopsy combined with PET-CT (regarded as a research group)and other 75 similar patients with single CT-guided biopsy (control group).In two groups,it was divided with malignant,suspicious malignant,can not be diagnosed,inflammatory,benign by pathological findings,and was contrasted with the surgical pathology or final clinical results.To calculate sensitivity,specificity and accuracy of diagnosis for cancer through two puncture method.Recorded complication for pneumothorax and bleeding in two groups .Be compared analysis using the 2 test.Results In study group,it was higher for the diagnosis of malignancy sensitivity, specificity,accuracy.There were 96.3% (52/54),100.0%(3/3)and 96.5%(55/57)in research group,while those were 88.4%(61/69),83.3% (5/6)and 88.0% (66/75)in the control group,respectively.And no statistically significant.Between research and the control group,there was a significantly statistical difference in the rate of twice punctures in one mass (χ2= 10.122,P=0.001).Between the two groups,there was no statistically significant difference in the pneumothorax rate and the hemorrhage rate. Conclusion PET-CT in aiding CT-guided lung biopsy improves the sensitivity,specificity and accuracy of diagnosis.