Leber hereditary optic neuropathy is an optic neuropathy associated with mitochondrial DNA. The disease affects young men mainly, which is considered to be due to denaturation of the retinal nerve ganglion cell and axonal loss of optic nerve, leading to optic atrophy. Nowadays, there are some development in studying Leber hereditary optic neuropathy by optical coherence tomography (OCT) and optical coherence tomography angiography (OCTA). It is great help to know the disease, forecast the progression of disease, and take action on intervention. In addition, there is a lack of in-depth study on OCT and OCTA characteristics among different mutation sites of LHON, different genders of the same site, different families of the same site or even different branches of the same family. It is expected to be improved in the future work.

Objective To observe the characteristics of multifocal eletrotetinogram (mfERG) in nonarteritic anterior ischemic optic neuropathy (NAION) and its relationship with visual acuity and macular central retinal thickness (CRT).Methods By means of patients self-contrast analysis.40 patients (40 eyes) with NAION were collected underwent the examinations of best corrected visual acuity, fundus color photography, fundus fluorescein angiography and field of vision.All the disease and normal eyes had underwent the examination of frequency-domain optical coherence tomography (fdOCT) and mfERG.The CRT and retinal thickness about perifovea, parafovea were documented with fdOCT.All patients underwent the retinal macular function exam with mfERG.Centered by macular fovea, the reaction zone were divided into 5 rings from inside to outside by circles, ring 1 0.00°, ring 2 5.44°, ring 3 10.31°, ring 4 16.31°, ring 5 23.42°.Treated ring 1 hexagon as macular center the amplitude densities of P1 wave, the amplitude of P1 and N1 wave, and the latencies of P1and N1 wave at cvcry ring were observed.The relationship between mfERG characteristics and visual acuity or CRT were analyzed by Spearman correlation analysis.Results fdOCT revealed that there was significantly statistical difference in the retinal thickness about perifovea between disease eyes and contralateral eyes (P＜＜0.05).The increase of CRT and retinal thickness about parafovea had no significantly statistical difference between diseases eyes and contralateral eyes (P＞0.05).mfERG revealed that the decrease of amplitude densities about P1 wave at ring 1 to 2 had significantly statistical difference between two groups (P＜0.05);there were no significantly statistical difference in the amplitude densities of P1 wave at ring 3 to 5;the decrease of amplitude about P1 and N1 wave at ring 1 had significantly statistical difference between two groups (P ＜ 0.05).There was no significantly statistical difference in the amplitude of P1 and N1wave at ring 2 to 5, the latencies of P1 and N1 wave at ring 1 to 5 (P＞0.05).The correlation analysis revealed that the amplitude densities and amplitude of P1 wave at ring 1, amplitude of N1 wave at ring 1 had no effect on visual acuity (r=0.087,0.195,-0.134;P＞0.05) and CRT(r=-0.154,0.365, 0.412;P＞0.05).Conclusions Compared with contralateral eyes,the disease eyes were significantly decrease in amplitude densities of P1 wave at ring 1 to 2, amplitude of P1 and N1 wave at ring 1.There are no correlated between the amplitude densities of P1 wave at ring 1,amplitude of P1 and N1 wave at ring 1 and visual acuity or CRT.

Objective To observe the efficacy and safety of tirofiban combined with lowmolecular-weight heparin in treatment of acute coronary syndrome.Methods 138 patients with acute coronary syndrome were divided into two groups(observation group and control group).In observation group,80 cases were treated with tirofiban combined with low-molecular-weight heparin on the basis of conventional therapy.In control group,58 cases were treated with low-molecularweight heparin on the basis of conventional therapy.The efficacy and safety were compared between the two groups.Results The total efficacy was higher in observation group than in control group (x2=8.589,P＜ 0.01).The improvement of 24 h anginal attacks,decrease in values of ECG ST segment and cardiac troponin T value were better in observation group than in control group(all P＜ 0.05).The blood platelet count and adverse reactions were not different between the two groups(t=0.294,x2 =0.747,both P ＞ 0.05).Conclusions Tirofiban combined with low-molecular-weight heparin is effective and safe in the treatment of acute coronary syndrome.It can increase the clinical effect,improve clinical symptoms and signs in the patients,and is worthy of clinical application.

Objective To summarize MSCT manifestations of normal small bowel with oral water and colon water enema double-filling. Methods Small bowel parameters of 44 healthy volunteers were measured with oral water and colon water enema double-filling. The parameters included bowel wall thickness, diameter of filling bowel, bowel wall delamination, bowel wall CT attenuation, the number of the plica, the attenuation of mesenteric fat, mesenteric vessels, the appearance rate of lymph node in mesentery, retroperitoneum, and so on. Results The average bowel thickness was (1.72±0.20) mm; the average diameter of filling bowel was (21.24±3.05) mm; the average CT attenuation of plain scan, artery phase and portal phase was (28.13±0.38) HU, (55.42±0.88) HU and (67.86±0.94) HU. Jejunum plica of normal small intestine was 2.29/cm; the number of the mesenteric artery bowel was 2.59/cm; the average attenuation of mesenteric fat was-98.57 HU; the single layer of bowel changed mostly. Conclusion Proper knowledge of normal manifestations of small bowel on MSCT is helpful for the diagnosis of small bowel diseases.

By using SWOT method, we analyze the strengthen, weakness, existing opportunity and challenging of applying Mini-CEX which is named Mini Clinical Evaluation Exercise in theOrgan-system-based curriculum modelclinical nursing teaching, and propose related development strategy of Mini-CEX.

Objective To understand perinatal health care and demand status, and explore the influence factors of perinatal health in Jinzhou area. Methods Randomly investigate 996 mothers from three hospital in Jinzhou. Results Seeking pregnancy health service demand rate: general hospital of obstetrics and gynecology accounted for 52.2%(520/996), maternity hospitals accounted for 39.5%(393/996), family planning services accounted for 8.3% (83/996). Good crowd in pregnancy cognition, > 30 65.3% (297/455), 30 years old or less accounted for 34.7% (158/455). Medical personnel in maternal knowledge acquirement accounted for 33.2% (331/996), pregnant women school training accounted for 23.9% (238/996), network way accounted for 16.2% (161/996), the relatives and friends accounted for 10.7% (107/996), books accounted for 10.8% (108/996), the other way accounted for 5.1% (51/996).The related factors of postpartum depression are marital status, antenatal education, the way of breastfeeding. Conclusions The family planning service has not fully played its efficiency. Women under t he age of 30 need to enhance conciousness about health care before pregnancy. The network platform still has space to play education function. It′s necessary that puerperal nursing routine should add postnatal depression questionnaire in the future.

Objectives:To understand the current situation of premenstrual syndrome (PMS) and type D personality in female college students,and to explore the relationship between them.Methods:Totally 856 female college students were assessed with the Premenstrual Syndrome Scale (PMSS,those with total score of 6 or higher as having PMS) and Type D Personality Scale 14 (DS-14,those negative emotion and social inhibition factor with total score of 10 or higher as having type D personality).Result:A total of 280 students were detected with PMS,and the rote was 32.7％.Totally 272 students were detected with the type D personality,and the rote was 31.8％.The total score of DS-14 and the score of 2 factors were higher in PMS group than in non-PMS group (Ps ＜0.001).The rate of PMS was lower in type D personality group than in non-type D personality group (11.76％ vs.25.34％,P ＜ 0.001).Conclusions:The occurrence of premenstrual syndrome may be related to the type D personality.The evaluation of personality characteristics should be taken into consideration when formulating the intervention program.

Objective To study the effect of the combination of pathidine hydrochloride and anisodamine on the intraoperative effiacy of transhepatic biliary drainage and stent implantation done on the patient with advanced malignant obstructive jaundice.Methods 100 cases of percutaneous transhepatic catheterizde drainage (PTCD) and percutaneous transhepatic biliary stenting (PTBS) done for advanced malignant obstructive jaundice were divided into control group and experimental group,50 cases in each group.In experimental group,100 mg pethidine hydrochloride and 10 mg anisodamine were injected intramuscularly 30 min before operation,while in control group,no analgesic or antispasmodic were used before and during operation.The blood pressure and heart rate were observed,the incidence rate of biliary-cardiac reflex and operating time were recorded,while the scale of pain felt by patient was evaluated with visual analogue scale.Results Compared to the control group,the patients in experimental group have more stable vital signs,feel more comfortable,suffering shorter operative time,less incidence rate of biliary cardiac reflex and less pain by using pethidine hydrochloride and anisodamine.Conclusion Application of pathidine hydrochloride and anisodamine during the transhepatic biliary drainage and stent implantation done on the patient with advanced malignant obstructive jaundice may release pain,reduce operating time.It is safe,at lower cost and can be used as routine medicine before PTCD or PTBS.

Objective To study the efficacy of tirofiban coronary injection combined with atorvastatin in the treatment of patients with acute coronary syndrome (ACS) and arrhythmia. Methods Ninety-two patients with ACS and arrhythmia admitted to Yiwu Central Hospital from January 2017 to May 2018 were enrolled, and they were divided into a control group and a study group by reference to random number table method, with 46 cases in each group. The patients in the control group received routine treatment; the patients in the study group were treated with tirofiban coronary injection combined with atorvastatin on the basis of the treatment in the control group. The changes of myocardial injury markers, blood lipid levels, inflammatory factors, apoptosis indicators and incidence of adverse reactions were observed before and after treatment in the two groups. Results After treatment the levels of serum cardiac troponin T (cTnT), creatine kinase (CK), CK isoenzyme (CK-MB), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), interleukin-6 (IL-6), hypersensitive C-reactive protein (hs-CRP) and C-myc were significantly lower than those before treatment in the two groups, and all the levels in the study group were lower than those in the control group [cTnT (mg/L):1.5±0.5 vs. 3.2±1.0, CK (U/L): 158.6±17.2 vs. 224.1±20.3, CK-MB (U/L): 30.5±11.4 vs. 44.3±9.7, TC (mmol/L):5.0±0.8 vs. 5.6±0.5, LDL-C (mmol/L): 2.0±1.0 vs. 2.7±1.3, IL-6 (mg/L): 86.5±15.2 vs. 131.4±16.3, hs-CRP (mg/L): 4.7±3.3 vs. 7.3±3.6, C-myc: (18.2±8.1)% vs. (23.4±10.3)%], and all the above differences were statistically significant (all P < 0.05). After treatment, the levels of Bcl-2 in the two groups were significantly higher than those before treatment, and the level in the study group was obviously higher than that of the control group [(78.4±12.2)% vs. (69.3±9.7)%, P < 0.05]. The adverse reactions were found in 6 patients in each group, and the incidence of adverse reactions was the same in the two groups [13.0% (6/46) vs. 13.0% (6/46), P > 0.05]. Conclusions Tirofiban coronary injection combined with atorvastatin is markedly effective in the treatment of patients with ACS and arrhythmia, as it can reduce myocardial cell damage, regulate blood lipid levels, inhibit inflammatory response and antagonize cardiomyocyte apoptosis.

Objective To prepare the multi-functional ultrasound contrast agents,which were investigated for ultrasound(US)/MR dual-mode imaging and high-intensity focused ultrasound(HIFU)synergism in vitro.Methods Double emulsion method was used to prepare the superparamagnetic iron oxide(SPIO)-loaded PLGA microcapsules(s-PLGA),and its morphology,size,Fe3O4 loading capacity were assessed.Then,the prepared s-PLGA microcapsules with different concentrations were applied to perform ultrasound and MR imaging in vitro.In addition,the degassed bovine liver in vitro was directly injected into 200 μl s-PLGA in saline(0.5 mg Fe/ml)just before HIFU ablation,the saline(200 μl)and pure PLGA (200 μl)were employed for control.After HIFU ablation,the volume of coagulated tissue irradiated by HIFU was calculated.Results The s-PLGA microcapsules were observed with regular spherical morphology and its average size was(885.6 ± 133.2)nm.In vitro,the s-PLGA showed hyperechogenicity in US imaging and MR negatively enhanced effeet in T2WI,the volume of coagulated tissue irradiated by HIFU after local injection of s-PLGA was larger than that of saline and pure PLGA(P＜0.05).Conclusions The prepared s-PLGA microcapsules are successfully acted as dual-mode biological imaging contrast agents for ultrasound and MR imaging and HIFU synergism in vitro.