With the development of medical theory and technology, the traditional teaching patterns have fallen behind the requirements for the training of medical students. Recently, virtual reality techniques have been proved to be effective in the practice of medical education. Through sum-marizing the experience of building simulation systems of eye anatomy, clinical features of eye and simulation practice, the author has elaborated the role of virtual reality technology in ophthalmology teaching theory and practice, which is of profound significance to improve the overall level of ophthal-mology teaching.

Objective To investigate the relationship between the expression of tumor apoptosis inhibitory protein(survivin) and the apoptosis induced by arsenic trioxide(As2O3) in transcatheter arterial chemoembolization therapy.Methods Sixteen Japanese big-ear white rabbits with implanted hepatic VX2 tumor at both right and left hepatic lobes were randomly and equally divided into two groups.Three weeks after the tumor was inoculated,1 ml lipiodol(UFLP) and 2 mg As2O3 were injected via hepatic arterial cannulation into the rabbits of study group,while only 1 ml UFLP was used for the rabbits in control group.Three weeks later,all the rabbits were sacrificed,and the tumor tissue,the tumor-neighboring tissue and the normal liver were separately collected and sent for TUNEL staining and examinations,which included the observation of apoptosis of tumor cells and the assessment of the expression of survivin protein.Results In study group,a large number of yellow apoptosis cells was seen in the tumor tissue but no apoptosis cell was found in the tumor-neighboring tissue or in the normal liver tissue.In the control group,no yellow apoptosis cell was observed in the tumor tissue,tumor-neighboring tissue or normal liver tissue.The survivin protein expression rate of the tumor tissue was 100%(16 / 16) in the control group,including strongly-positive in 12 and weakly-positive in 4 rabbits.In contrast,the survivin protein expression rate of both the tumor-neighboring tissue and the normal tissue was 0%.In study group,the survivin protein expression rate of the tumor tissue was 37.5%(6 / 16),including strongly-positive in 2 and weakly-positive in 4 cases,and the survivin protein expression rate of both the tumor-neighboring tissue and the normal tissue was 0%.Significant difference in survivin protein expression rate of the tumor tissue existed between two groups(P

Objective To study the influence of hydrocortisone sodium succinct by intravenous infusion or continuous intravenous micro pumping on the vital signs,shock duration,blood glucose and mortality in the patients with severe sepsis secondary shock.Methods Ninety patients with septic shock treated in our hospital from June 2014 to September 2016 were selected and divided into the control group and observasion group by using the random number table method,45 cases in each group.The control group was given hydrocortisone sodium succinct 200mg/d by slow intravenous drip for 2h,while the observasion group was given hydrocortisone sodium succinct 8.33mg/h by continuous intravenous micro pumping.The two groups were treated for continuous 5 d.The blood glucose,hemodynamics and prognosis were compared between the two groups.Results In the observasion group,the blood glucose indicators such as the time window of high blood glucose,LAGE,MBG and CV levels were lower than those in the control group,the difference had statistical significance (P<0.05).The hemodynamic indicators such as HR,CVP and MAP between the two groups before treatment and at 6,24 h and 5 d after treatment had no statistical difference between the two groups (P>0.05).The shock duration,ICU stay length,total hospital stay and 28 d mortality in the observasion group were lower than those in the control group,but the difference between the two groups had no statistical significance (P>0.05).Conclusion Continuous intravenous micro pumping of hydrocortisone sodium succinct can stabilize blood glucose fluctuation range in the patients with septic shock,but the hemodynamic indexes and prognosis have no obvious improvement.

Objective To explore clinical features of severe preeclampsia patients with adverse outcome, and the risk factors of adverse outcomes. Methods From Jan. 2008 to Dec. 2009 149 severepreeclampsia impatients who occurred adverse outcome enrolled as case,and 278 severe preeclampsia impatientswithout adverse outcome at the same period enrolled as control. The clinical features between the two groups were compared and the risk factors were investigated. Results No significant differences were found between the two groups in maternal age,times of previous prenancies. The gestation ages at the onset of preeclampsia and at delivery in the cases were less than controls(P ＜ 0. 05). There was significant difference in irregular antenatal checks between the two groups(x2 = 8. 515, P ＜ 0. 05). Proterinuria and the level of oedema in cases were higher than controls( P ＜ 0. 05). Fetal growth restriction (FGR) occurred more frequently in the cases (P ＜0. 05). Indirect bilirubin, total bilirubin, glutamic oxalacetic transaminase, glutamic pyruvic transaminase, uric acid, creatinine, white blood cell, thrombin time, D-dimeride of cases were higher than those of controls(Ps ＜0. 05). Albumin, platelet and profibrin of cases were lower than those of controls(Ps ＜ 0. 05 ＝. Multivariate logistic analysis showed that the gestation ages at the onset of preeclampsia, regular antenatal checks were significantly associated with adverse outcome(OR = 0. 899, P ＜ 0. 001; OR = 0. 600, P = 0. 022, respectively ＝Indirect bilirubin and D-dimeride were significantly associated with preeclampsia complications(OR = 1. 533,P =0. 010; OR = 1.001, P = 0. 003, respectively). Mean arterial pressure and creatinine were significantly associated with eyeground changes(respectively OR = 1. 030,P = 0. 048; OR = 1. 025, P = 0. 022, respectively).Regular antenatal checks was associated with dead fetus(OR = 0. 317, P = 0. 046). No significant differenceswere found between the two group in uterine-incision delivery(P ＞ 0. 05). Incidence rate of low birth weight infants and postpartum hemorrhage of cases were higher than controls and Apgar score was lower in cases than controls( all P ＜0. 05＝. Conclusion The gestation ages at the onset of preeclampsia,regular antenatal checks,fetal distress were risk factors for preeclampsia adverse outcome. Patients with.high indirect bilirubin and Ddimeride are more likely to suffer adverse pregnancy outcomes.

Diabetic macular edema(DME)and age-related macular degeneration(ARMD)are the leading causes of visual impairment and blindness worldwide, and their common pathological features are increased vascular permeability and abnormal neovascularization, in which cytokines such as vascular endothelial growth factor(VEGF)and angiopoietin-2(Ang-2)play an important role. Intravitreal injection of anti-VEGF agents significantly changed the clinical management of DME and ARMD, but limitations such as the non-responsive cases, the treatment burden and risks caused by frequent injections need to be overcome. Faricimab, a novel bispecific monoclonal antibody that simultaneously targets VEGF-A and Ang-2, can effectively reduce vascular permeability, decrease the number of neovascularization and alleviate retinal edema. Registered clinical studies have shown that Faricimab is effective in improving vision and reducing retinal edema, which is non-inferior to Aflibercept and Ranibizumab, maintains a long dosing interval, and has a high safety profile. This article reviews the latest advances in the treatment of DME and ARMD with Faricimab.

Objective To estimate the value of neck circumference in diagnosis of metabolic syndrome. Methods We analyzed the neck circumference of 523 volunteers and the occurrence of metabolic syndrome among them. Then we updated and revalued their data after follow-up for 1.5 years, meanwhile, we evaulated the value of Body Mass Index (BMI) and neck circumference in predicting metabolic syndrome. Results The increase of neck circumference was closely related to the occurrence of metabolic syndrome , and this tendency continued in the follow-up. Compared with BMI , neck circumference was sensitive in identifying the patients of metabolic syndrome. Conclusion Neck circumference has great value in diagnosis and treatment of metabolic syndrome.

Objective To evaluate the effects of Achilles tendon lengthening on talipes equinus in children with spastic cerebral palsy. Methods From December, 2013 to June, 2014, seventeen spastic cerebral palsy children with talipes equinus (34 feet) received Achilles ten-don lengthening. Ankle dorsiflexion range of motion (ROM) and surface electromyography from tibialis anterior and medial head of gastroc-nemius were measured before and 8 to 12 months after operation, respectively. ROM of passive and active dorsiflexion, root mean square (RMS) of tibia muscle group and co-contraction ratio (CR) when standing were compared. Results The ROM of ankle passive and active dorsiflexion increased (Z>4.867, P<0.001), while the RMS of gastrocnemius muscle decreased when ankle passively dorsiflex (t=4.31, P<0.001). RMS of tibialis anterior and gastrocnemius muscle changed little when standing (Z<1.291, P>0.05), while CR reduced (t=2.38, P<0.05). Conclusion Achilles tendon lengthening can improve the coordination of tibia muscle group to increase the ROM of ankle for chil-dren with talipes equinus after spastic cerebral palsy.

Accidents, Occupational ; Acute Disease ; Adolescent ; Adult ; Arsenic Poisoning ; Chemical Industry ; China ; Female ; Humans ; Male ; Middle Aged ; Young Adult ; Zinc

Objective To investigate the characteristics of etiology,efficacy of endoscopic management for recurrent idiopathic pancreatitis (RIP).MethodsThe clinical data of 58 cases of RIP diagnosed in our hospital from April 2005 to April 2011 were retrospectively analyzed.All the patients underwent endoscopic retrograde cholangiopancreatography (ERCP),and patients with suspected sphincter of Oddi dysfunction received manometry.According to the clinical and ERCP manifestations,the etiologies of RIP were determined and individualized endoscopic treatment was applied.The patients were followed-up postoperatively about the improvement of abdominal pain and recurrence of RIP.ResuItsFifty-eight patients (29 males,29 females) were suffered from acute pancreatitis from 3 to more than 10 times.The etiologies were as follows:29 cases of biliary microlithiasis,19 case of sphincter of Oddi dysfunction ( 16 cases of pancreatic type,3 cases of mixed type),4 cases of anomalous arrangement of the pancreaticobiliary duct,and 6 cases of normal manifestations at ERCP.Biliary sphincterotomy alone was performed in 33 patients,while both biliary and pancreatic sphincterotomy was performed in 8 patients,and pancreatic sphincterotomy alone was performed in 17 patients,after sphincterotomy,pancreatic stent insertion was performed in 24 patients.The follow-up data was obtained from 41 out of 58 patients,the follow-up period ranged from 3 ～ 67 months ( average 33 months).During this period,9(22.0％ ) patients suffered from RIP,and the treatment efficiency was 78％.ConclusionsBiliary microlithiasis and sphincter of Oddi dysfunction are the main causes of RIP.Drink could induce RIP.ERCP has definite treatment efficacy for RIP.