In this article,authers reported a method of keeping hetero-sclera as intra-sclera fillings and external Pad pressure. Based on the analysis and discussion of 153 eye cases, it is shown that there is no obvious relationship between the success of operations and the range of retinal detachment and the size of holes. The success,however.has a close bearing on the membrane formation. Among the 153 eye cases, 126 were cured which accounted for 82.4％ while 27 cases failed, making up 17.6％. In the process of using foreing sclera, no complications,such as infection, sclera′s falling off or getting into the vitreous body,were found.

Objective To compare the clinical characteristics and prognosis of bacterial liver abscess in patients with or without type 2 diabetes mellitus, in order to guide clinical diagnosis and treatment.Methods The clinical data of 110 patients with bacterial liver abscess at the First Affiliated Hospital of Anhui Medical University were retrospectively analyzed.Among them, 45 cases with type 2 diabetes mellitus and 65 cases without type 2 diabetes mellitus were included in the study.The demographic data, clinical signs and symptoms, laboratory findings, pathogenic results, imaging findings, treatment and prognosis were compared between the two groups.Differences among the quantitative data with normal distribution were compared using t test, while count data were compared with χ2 test or Fisher exact test.Multivariate Logistic regression was used to determine the prognostic risk factors of two groups.Results Fever as initial symptom in diabetic group and non-diabetic group were 37 cases and 40 cases, respectively, while abdominal pain presented in 7 cases and 22 cases of the two groups, respectively, both with statistically significant difference (χ2=5.417 and 4.582, respectively, both P<0.05).As for laboratory examination, neutrophil counts in the two groups were (12.87±8.83)×109/L and (10.24±4.86)×109/L, respectively, the percentages of neutrophils were 0.841±0.077 and 0.799±0.103, respectively, albumin levels were (28.36±4.65) g/L and (30.67±6.16) g/L, respectively, with statistically significant difference (t=2.010, 2.317 and-2.265, respectively, all P<0.05).Patients with elevated blood urea nitrogen in the two groups were 13 cases and 8 cases, respectively, patients with elevated creatinine were 9 cases and 4 cases, respectively, with statistically significant difference (χ2=4.733 and 4.892, respectively, both P<0.05).In diabetic group, pus culture was positive in 13 out of 19 cases, and blood culture was positive in 7 out of 21 cases.In non-diabetic group, pus culture was positive in 9 out of 13 cases, and blood culture was positive in 6 out of 25 cases.The positive rates of Klebsiella pneumoniae in the two groups were 37.5% (15/40) and 15.8% (6/38) , respectively, with statistically significant difference (χ2=4.669, P=0.031).The effective rates of the two groups with glycemic control were 84.4% (38/45) and 84.6% (55/65), respectively, and the mortality rates of the two groups were 2.2% (1/45) and 1.5% (1/65), respectively.Multivariate Logistic regression showed that multiple abscess (OR=34.61, 95% CI: 1.601-748.457, P=0.024) was prognostic risk factor and invasive intervention (OR=0.028, 95%CI: 0.001-0.984, P=0.049) was protective factor in the diabetes mellitus group.Hypoalbuminemia (OR=14.793, 95% CI: 1.605-136.322, P=0.017) and the history of abdominal surgery within two years (OR=7.624, 95% CI: 1.294-44.913, P=0.025) were prognostic risk factors in the non-diabetic group.Conclusions Patients with bacterial liver abscess showing symptoms of severe infection in diabetic group are more frequently than patients in non-diabetic group.Klebsiella pneumoniae infection rate is also higher in diabetic group.Patients with bacterial liver abscess and diabetes mellitus should receive antibiotic treatment combined with invasive therapy in time.

Objective:To assess the quality of life (QOL) and cognition function in patients with severe obstructive sleep apnea (OSAHS), and to study the relationship between the QOL and severity of OSAHS, excessive daytime sleepiness (EDS),cognition disorders. Methods:Sixty-two patients with OSAHS and 32 non-OSAHS patients (control group) which all diagnosed by polysomnography (PSG) were chosen from The First Hospital of Lanzhou University, and they were assessed by QOL using the Short-Form 36 Health Survey questionnaire (SF-36), by EDS using the Epworth sleepiness scale (ESS), and for cognition disorders by mini-mental state examination (MMSE).The associations between the total score on the SF-36 and the baseline characteristics, PSG parameters, such as ESS score, and MMSE score were examined by simple regression analysis and stepwise multiple regression analysis.Results:The scores of SF-36 and MMSE in OSAHS group were significantly lower than the control group (63.9?14.7/78.8?4.5, 24.6?2.0/27.1?1.3,P

3:00~4:00 time slot.The older the patients are,the more severe the OSAHS is,the more significant this correlation is.

[Objective]We summarized Professor Zhang Weihua’s clinical experience in treating constipation and diarrhea alternating bowel dysfunction by Chinese medicine. [Method] This paper revealed the professor Zhang Weihua ’s experience of curing constipation and diarrhea alternating bowel dysfunc-tion by analyzing the etiology and pathology ,therapeutic principles and relevant cases .[Results] The etiology and pathology of constipation and diarrhea alternating bowel dysfunction is root deficiency and tip excess ,and cold-heat complex ,the disorders of E. conduction,and the treatment should focus on using warming and heat-clearing simultaneously, tonifying spleen and kidney. [Conclusions] The experience of Professor Zhang Weihua in treating con-stipation and diarrhea alternating bowel dysfunction is effective and thought-provoking in treatment.

Objective To summarize the clinical data and laboratory features of vera polycythemia incorporated with hemolysis in one case. Methods The treatment and diagnosis of series of laboratory detection with conventional cytogenetics,mutation detection in JAK2V617F,BCR/ABL fusion gene were investigated with literature. Results JAK2V617F point mutation was detected positively,BCR/ABL fusion gene was negative and trisomic chromosome 8. The case was mend and discharged after successively treated with conventional treatment of dexamethasone,antiinfective,hepatoprotective and follow-up treatment of bloodletting,hydroxyurea and interferon.Conclusions The onset of vera polycythemia is latent which is difficult to find in the early phase.Allele-specific PCR (AS-PCR) of JAK2V617F mutation will be helpful to the diagnosis.

Objective To study the changes of serum high-sensitivity C-reactive protein (ha-CRP) and depression in patients with obstructive sleep apnea-hypopnea syndrome (OSAHS),and investigate the relationship between them.Methods Thirty healthy volunteers (control group) and 54 OSAHS patients (OSAHS group) were recruited for the study.The level of serum hs-CRP was determined by scatter rate nephelometry,and the state of depression was assessed by self-rating depression scale (SDS).Results The level of serum hs-CRP and SDS score were higher in OSAHS group than those in control group [(48.8 ± 12.7) scores vs.(36.3 ± 6.3) scores,(3.3 ±0.7) mg/L vs.(1.4 ± 0.4) mg/L](P＜0.01).SDS score and the level of serum hs-CRPwere positively correlated to apnea-hypopnea index(AHI) (r = 0.636,0.628 ;P<0.01) and negatively related to the MSaO2 (r =-0.509,-0.614;P <0.01) and LSaO2 (r =-0.607,-0.512;P <0.01).The level of serum hs-CRP was positive correlation to SDS score (r = 0.536,P<0.01).SDS score was related to the AHI,the level of serum hs-CRP and LSaO2 in multiple linear regression(F= 33.31,P = 0.002).Conclusion Depression is correlated to AHI and the level of serum hs-CRP in patients with OSAHS.

Objective To evaluate the effect and safety of tiotropium plus sustained-release theophylline in treating stable moderate chronic obstructive pulmonary diseases (COPD) . Methods A randomized clinical trail was conducted in 80 patients with stable moderate COPD, who were admitted to our hospital from March 2008 to December 2009. All patients were divided into two groups randomly and accepted tiotropium (groupⅠ ,n =40) or tiotropium plus sustained-release theophylline (group Ⅱ ,n =40) treatment for 12 weeks. Results Seventy patients completed the study,in which 36 cases had tiotropium alone and 34 cases had combination therapy. At the end of treatment, no statistically significant difference was found between the two groups in the comparisons of FEV1, FEV1%, FVC, FEV1/FVC, activity score and impacts score of the St George's Respiratory Questionnaire (SGRQ) (Ps > 0. 05). While the symptoms score (53.08 ± 12.25 vs.59.39±9.74,t=2.39,P<0.05) and total score (23. 91 ±2. 57 vs. 25. 27 ±2.14, t =2.40, P <0.05) of SGRQ were significantly lower in group Ⅱ compared to group Ⅰ. Six adverse events,including dry mouth (n =4), palpitation (re = 1) , constipation (n = 1), were observed in tiotropium alone group during the treatment period. Eleven adverse events were observed in combination treatment group, including dry mouth (re = 3) ,stomach discomfort or nausea (n = 3), diarrhea (re = 2) , palpitation (n = 2), constipation (n = 1) . The incidences of adverse reactions of two groups had no significant difference (P > 0. 05). Conclusion Compared with the single application of tiotropium, tiotropium plus sustained-release theophylline therapy can alleviate symptoms and improve life quality in patients with stable moderate COPD,without significantly increasing adverse reactions.

Objective To summarize the MSCT signs and the key points of differential diagnosis of sclerosing mesenteritises (SM) which were misdiagnosed by clinical and CT,to reduce the misdiagnosis rate.Methods Clinical and MSCT data of 23 misdiagnosed SM patients were analyzed retrospectively.The misdiagnosed diseases,misdiagnosed causes,and differential diagnosis were analyzed.Results SM were mainly misdiagnosed as tumor and infective inflammation.The main causes of misdiagnosis and differential diagnostic features were listed as follows.(1)SM didn't have specific clinical manifestations.(2)The density of the adipose tissue in mesentery increasedmisty mesentery.A clear demarcation between the lesion and the surrounding normal fatty tissue could be differentiated from infective inflammation.(3)The mass-like false capsule had space-occupying effect of displacement of the surrounding structures.However, the blood vessels were encapsulated by the mass-like false capsule with fat ring around, which could be differentiated from fat-containing tumors.(4)The soft mass was formed at the root of the mesentery.The fat halo sign and mild enhancement of the mass can be differentiated from lymphoma and carcinoid.Conclusion SM is easily misdiagnosed both in clinical practice and medical imaging.Recognition of differential diagnostic features of MSCT can reduce the misdiagnosis rate.

Objective To observe the level of autophagy induced by TRAIL in TT cell line and identify the role of autophagy in TRAIL-inducing apoptosis of TT cell line.Methods The growth inhibition of TT cells was measured by MTT assay.MDC staining was used to identify the happening of autophagy.Annexin V/PI double staining was used to analyze the apoptosis rate of TT cells by flowcytometry.The protein expression of caspase-8 and Beclin1 was detected by Western blot.Results ① The growth inhibition ratio of TT cells induced by TRAIL at the concentration of 250,500,1000 and 2000 ng/ml was (3.02 ± 1.82)％,(4.87 ± 1.45)％,(7.51 ± 1.57) ％,(12.76 ± 3.23) ％ respectively,which suggested significant resistance of TT cells to TRAIL.② MDC-labeled green light vesicles was significantly increased after the treatment of TRAIL for 48 h.③ The apoptosis rate of TT cells induced by TRAIL at the concentration of 500 ng/ml and 1000 ng/ml after the pretreat ment of 3-MA for 4 h was(17.83 ± 1.54) ％ and(27.81 ± 1.79) ％ respectively,which was significantly higher than the apoptosis rate induced by TRAIL(3.70 ± 0.34) ％,(6.55 ± 0.59) ％ alone and that induced by 3-MA(7.71 ± 0.64) ％ (t =3.282,P ＜ 0.05 ; t =7.830,P ＜ 0.01).④ The combination treatment of TRAIL and 3-MA increased the cleavage of caspase-8 and down-regulated the expression of Beclin 1.Conclusion Autophagy induced by TRAIL may contributes to the resistance of TT cells to TRAIL,which can be reversed by the inhibition of autophagy.