Objective To compare the differences of optic disc parameters and the thickness of circumpapillary retinal nerve fiber layer (CP-RNFL) in acute uveitis Vogt-Koyanagi-Harada (VKH) syndrome with different degrees of optic disc edema. Methods This is a retrospective study including 40 eyes of 23 VKH patients. The eyes were divided into 2 groups according to the results of fluorescein fundus angiography (FFA). The discs with hyperfluorescence but no leakage were in mild optic disc edema group (group A, 13 patients and 25 eyes), and the discs with hyperfluorescence and leakage were in severe optic disc edema group (group B, 10 patients and 15 eyes). The patients were significantly older in group B than in group A (t=-2.17, P<0.05). The differences of gender, diseased time (t=-1.67) and corrected visual acuity (t=-0.76) between 2 groups were not significant (P>0.05). Eighty eyes of 46 normal healthy subjects, matching group A and group B with age and gender, were divided into group C (26 subjects and 50 eyes) and group D (20 subjects and 30 eyes) respectively.All subjects underwent three dimensional optical coherence tomography examinations. The parameters included average thickness of entire circumpapillary retinal nerve fiber layer (CP-RNFL), thickness of nasal, superior, temporal and inferior quadrant of CP-RNFL, disc area, disc cup area, rim area, cup/disc (C/D) area ratio, C/D horizontal diameter ratio and C/D vertical diameter ratio. Results The disc area, disc cup area and rim area were bigger, the thickness of mean CP-RNFL and the nasal and temporal quadrants of CP-RNFL were thicker in group A than those in group C (P<0.05). The disc area and rim area were bigger, the thickness of mean CP-RNFL and the nasal, superior, temporal and inferior quadrant of CP-RNFL were thicker, C/D area ratio and C/D diameter ratio were smaller in group B than those in group D (P<0.05). The disc area was bigger, disc cup area, C/D area ratio and C/D diameter ratio were smaller, the thickness of mean CP-RNFL and the nasal , superior and inferior quadrants of CP-RNFL were thicker in group B than those in group A (P<0.05). Conclusions Acute VKH uveitis with mild optic disc edema has thicker CP-RNFL in the nasal and temporal quadrants; with severe optic disc edema has thicker CP-RNFL in all 4 quadrants. Acute VKH uveitis also has smaller C/D area ratio and C/D diameter ratio.

Objective To observe the efficacy and safety of apatinib combined with docetaxel in the third line and above treatment of advanced serum alpha-fetoprotein-positive gastric cancer(AFPGC). Methods A total of 41 patients with AFPGC from February 2015 to April 2018 in Suining Central Hospital of Sichuan Province were retrospectively analyzed. The patients were divided into experimental group and control group according to different treatment methods,15 patients in the experimental group received with apatinib combined with docetaxel,and 26 patients in the control group received chemotherapy alone or optimal nutritional support. The short-term efficacy,long-term efficacy and adverse reactions were evaluated by Response Evaluation Criteria in Solid Tumours(RECIST)version 1. 1,progression-free survival(PFS),overall survival(OS)and National Cancer Institute Common Terminology Criteria for Adverse Events(NCI CTCAE)version 4. 0. Results After 2 cycles of treatment,no complete remission( CR)was achieved in either group,4 partial remission (PR),7 stable disease(SD),4 progressive disease(PD)in the experimental group,and 2 PR,7 SD,17 PD in the control group. The objective response rate(ORR)was 26. 67％(4 / 15)and 7. 69％(2 / 26)respective-ly in the experimental group and the control group,with no significant difference(χ2 = 1. 433,P = 0. 231). The disease control rate(DCR)was 73. 33％(11 / 15)and 34. 62％(9 / 26)respectively in the two groups, with significant difference(χ2 = 5. 707,P = 0. 017). The median PFS of the experimental group and the control group were both 3. 0 months,and there was no significant difference between the two groups(χ2 = 4. 425,P =0. 350). The median OS were 6. 0 months and 4. 0 months respectively,and the difference was statistically sig-nificant(χ2 = 5. 727,P = 0. 017). The occurrence rates of leukopenia of the experimental group and the control group were 73. 33％(11 / 15)and 30. 77％(8 / 26),the occurrence rates of hypertension were 40. 00％(6 /15)and 0(0 / 26),the occurrence rates of proteinuria were 26. 67％(4 / 15)and 0(0 / 26),the occurrence rates of poor appetite were 80. 00％(12 / 15)and 38. 46％(10 / 26),and the occurrence rates of hemorrhage were 33. 33％(5 / 15)and 3. 85％(1 / 26). The occurrence rates of the above adverse reactions in the experi-mental group were significantly higher than those in the control group(χ2 = 6. 930,P = 0. 008;χ2 = 9. 191, P = 0. 002;χ2 = 4. 953,P = 0. 026;χ2 = 6. 600,P = 0. 010;χ2 = 4. 471,P = 0. 034),and the differences were statistically significant. There was no significant difference in the incidence of thrombocytopenia,anemia, nausea and vomiting,diarrhea,fatigue and hand-foot syndrome between the two groups( all P > 0. 05). Conclusion The DCR of apatinib combined with docetaxel in the third-line and above treatment of advanced AFPGC patients is higher. This scheme can prolong survival period,and the adverse reactions are more serious,but they are basically tolerable.