AlM:To analyze and explore the clinical efficacy of strengthening lateral tarsal strip and advancing lower eyelid retractor for the treatment of degenerative entropion with eyelid relaxation
METHODS: Reviewed from January 2011 to January 2013, 21 cases (33 eyes) of degenerative entropion eyelid relaxation were treated with operation of strengthening lateral tarsal strip and advancing lower eyelid retractor ( fornix conjunctival incision ) , the follow-up was 12-24mo, curative effect was observed.
RESULTS: All the patients were cured completely, have no recurrence or overcorrection phenomenon. The cure rate of operation was 100%, there was no complication.
CONCLUSlON: Operation of strengthening lateral tarsal strip and advancing lower eyelid retractor is a safe, reliable, efficient operation to the treatment of degenerative entropion with mode of eyelid relaxation.

Objective To explore the effect of group psychotherapy on mental health of psychiatric nurses after violence.Methods Group psychosocial interventions were conducted on psychiatric nurses who were exposed to violence.The measures included observation and understanding,learning and self-understanding,self-acceptance,self-adjustment and behavioral improvement for 8 weeks,once a week,60-120 min each time.Before and after intervention,the mental health status of psychiatric nurses was evaluated by self-reporting inventory (SCL-90).Results The scores by SCL-90 in the psychiatric nurses before and after intervention were higher than those in the national norm with statistically significant difference (P ＜0.05).The scores by SCL-90 as well as all of dimensions after the intervention were all significantly higher than those before intervention (P＜0.05).Conclusion Group counseling intervention has a positive effect on improvement of mental health of psychiatric nurses after violent incidents.

BACKGROUND: Psychological behaviors play an important role in children accidental injury, and children with a tendency of accidental injury display specific psychological properties in characters and behaviors.OBJECTIVE: To investigate the difference of personality and behavioral characters between normal children and children with a tendency of accidental injury.DESIGN: Case controlled analysis based on suffered children and normal hildren.SETTING: Department of pediatric in a civic hospital.PARTICIPANTS: Totally 131 accidental injured children aged from 7 to 11 years were admitted at Tengzhou Civic center hospital between January and December 2001. Those with congenital intellectual disturbance and brain trauma were excluded and the rest 89 cases were asked to fill questionnaire, 8 were removed from the study due to unintegrated data and 81pieces of integral data were collected (reclaiming rate of 91.01%), including 50 males and 31 females with the mean age of (8.59±1.86) years, the intelligence quotient was(96±15) determined by Peabody picture vocabulary test(PPVT); and 81 children in control group matched in age and sex were selected from healthy children of school age without injury history and similar in some aspects, such as parents' culture degree, economic condition, educational state and the economic and culture state of inhabitancy with control group, including 45 males and 36 females with the mean age of (8.92±1.73) years, the intelligence quotient was(98±18) by PPVT. Two groups were matched in sex, age and IQ(P＞0.05).METHODS: Eysenck personality questionnaire and Achenback children behavioral rating scale(parents rating scale) were used.RESULTS: Data of two groups with 81 questionnaires in each entered into the final analysis without loss. ① Scores for psychoticisim, introverted and extroverted character and neurological quality in Esonk personality question naire were(50. 01±10.58, 55.19±12.1, 57.35±10.12) in injury group, higher than corresponding(45.63±13.81, 48.09±6.49, 50. 01±10.39)in control group( t = 2. 27-4.65, P＜0.05) . Scores for modified rating scale was(49.42±10.42) in control group, higher than(39.65±13.03)in injury group( P＜0.001); ② The median was found higher in hyperactivity, aggression, violation of discipline, bad communication, split anxiety,depression and physical complaint in boys of injury group; as well as in hyperactivity, cruelty, aggression, depression, physical complaint, social retreat, violation of law in girls of injury group, comparing to control group(P＜0.001); ③ Positive behavioral detecting rate of injury group was 32.09% (26/81), higher than 11.11% (9/81) of control group(P ＜0.001), OR was 3.78, and 95% CI was 1.66-8.59. Behavioral factors was proved of lower sensitivity(32. 1% ) with specificity of 88.9% and higher prognostic value of 74. 3%; ④ The mean score for Achenback children behavioral rating scale was(39. 84±10. 99) in boy which was obviously higher than(34.26 ± 10.43) in girls of injury group( P ＜0.05). The edian for violation of discipline and aggression in boys and depression in girls were significantly higher than the opposite sex group(P＜0.05 or 0.01) . The mean score for Achenback children behavioral rating scale was (37.62±11.03) in injury group, which were obviously higher than (17.77±12.12) of control group( P＜0.01) . ⑤Results of multiple factors Logistic analysis revealed that the risk factors for accidental injury included: aggression, hyperactivity and iolation of discipline in boys and aggression, violation of discipline and depression in girls.CONCLUSION: Children with a tendency of accidental injury has obvious ehavioral problems, behavioral factors were proved of lower sensitivity, but of igher specific positive prognostic value. Both boys and girls displayed speific characters in aggression and violation of discipline, and lack of pretendng capability comparing to normal children, thereby liable to response in on-rational manner.

AIM: To evaluate the clinical effect and the rotational stability of AcrySof Toric intraocular lens ( IOL ) implantation to correct preexisting corneal astigmatism in cataract surgery.
METHODS: Twenty-three patients ( 28 eyes ) were enrolled from the department of ophthalmology in the first Affiliated Hospital of Nanjing Medical University. All patients underwent similar phacoemulsification procedure combined with AcrySof Toric IOL implantation from June 2012 to December 2013. The uncorrected visual acuity ( UCVA ) , best corrected visual acuity ( BCVA ) , anticipated residual astigmatism, postoperative residual astigmatism, and Toric IOL axis were detected and measured.
RESULTS:Three months after operation, the UCVA of all eyes were 0. 75±0. 16 and the BCVA were 0. 84±0. 15, there was no significant difference between UCVA and BCVA ( t = 1. 036, P>0. 05 ). The anticipated residual astigmatism was ( 0. 28±0. 12 ) D. The actual residual astigmatism after 3mo of the operation was (0. 42±0. 17) D. There was no significant difference between anticipated and actual residual astigmatism (t=1. 259, P>0. 05). The mean axis rotation of Toric IOL was 3. 02o±1.56o (0o-7o) after 1d of operation and 3. 28o±1. 85o (0o-7o) after 3mo. Among all the eyes, 25 eyes ( 89%) rotated <5o, in 3 eyes (11%) rotated 5o-7o.
CONCLUSION: The AcrySof Toric IOL implantation shows good effectiveness, predictability and stability in correcting pre-existing astigmatism in cataract patients.

Neurofibromatosis type 2 (NF2) is a dominantly inherited genetic condition. Bilateral vestibular schwannoma, which are benign tumors, composed of neoplastic Schwann cells that arise from the eighth cranial nerve, are the hallmark of NF2. Standard approaches for treatment of growing vestibular schwannoma include observation, surgical removal and radiation therapy. Molecular targeted therapies also present great prosperity in recent years. In this review, we summarize the latest progresses on the treatment of NF2-associated vestibular schwannoma.
Humans ; Molecular Targeted Therapy ; Neurofibromatosis 2 ; radiotherapy ; surgery ; therapy ; Neuroma, Acoustic ; radiotherapy ; surgery ; therapy

Objective To explore the relation between rheumatoid arthritis (RA) and the meteorological factors.Methods All RA cases in the group were followed for 12 months,patients were follow-up for every two weeks.In each followed-up,all RA cases were evaluated by the disease activity score-28 (DAS28) and the improved Jamieson questionnaire,and the correlation of the DAS28 and the average values of meteorolo-gical factors (temperature,humidity,atmospheric pressure,relative humidity,wind speed) by Pearson correlation coefficient.The moderate-severe activity cases were evaluated by chi-square test of different seasons.Results One hundred and eighty-eight cases completed the observation,One hundred and sixty-four cases were in moderate disease activities (x2=9.42,P=0.022).Sixty-eight cases were distributed in winter,which was significantly higher than other three seasons.The average temperature and wind speed was negatively related to the DAS28 (r=-0.743,P＜0.01; r=-0.576,P=0.003).Conclusion The activity of RA has the characteristics of seasonal changes,and is easily being aggravated in winter.Many factors may influence RA,including temperature and wind speed.Creating an appropriate micro-climate environment is beneficial for RA patients to reduce the disease activity.

OBJECTIVE:To explore the cultivation method for community pharmaceutical care talents in higher vocational colleg-es. METHODS:According to the talent training aims to meet the demand of community pharmaceutical service positions in higher vo-cational colleges,the teaching reform was carried out for talent cultivation mode,course structure system,training base construction and teaching methods. RESULTS:In terms of talent cultivation mode,the work-integrated learning mode was built;in terms of course structure system,“Medicine,Pharmacy,Humanities and Expansion”course module was constructed to further optimize it;in terms of training base construction,the capital investment was increased to improve the school training base,meanwhile,cooperation between schools and enterprises was carried out to strengthen the construction of out-of-school training bases;in terms of teaching methods, PBL,case teaching model and situational teaching method were implemented. CONCLUSIONS:The quality of pharmaceutical talents has been significantly improved by implementing reform of the talent cultivation mode,the course structure system and teaching meth-ods,together with constructing training bases.

Objective To observe the level of circulating CD31 +/CD42b-endothelial microparticles in patients with ST-elevated myocardial infarction (STEMI),and discuss the correlation between CD31 +/CD42b-and traditional myocardial injury index.Methods A total of 22 healthy subjects and 44 patients with angiographically confirmed coronary atherosclerotic lesions collected from January 2010 to December 2010 were studied prospectively.The patients were divided into SAP (stable angina pectoris,Canadian Cardiovascular Society,CCS Ⅱ to Ⅲ ) group (n =22) and STEMI group (n =22).The level of circulating CD31 +/CD42b-endothelial microparticles was detected by flow cytometric device after admission; creatine kinase (CK) and its isoenzymes (CK-MB) were detected by using biochemical analyzer; C-reactive protein was determined by a highly sensitive latex-enhanced turbidimetric immunoassay with a low detection limit of 0.25 mg/dl (IMMAGE,Beckman Coulter; Reagent from Orion Diagn Co.Ltd.,Vantaa,Finland).Cardiac troponin I was measured by chemiluminescence immunoassay (ACCESS2 from Beckman Coulter).In 22 STEMI patients,blood sample was taken not only after admission but subsequently at 4-hour intervals during the first 48 hours.Peak levels of myocardial enzymes after injury ( creatine kinase,CK; creatine kinase MB isoenzyme,CK-MB; c troponins I,cTnI) and high sensitive C reactive protein (hs-CRP) values were determined.The correlation between circulating level of CD31 +/CD42b(-) and peak levels of myocardial biomarkers after injury were analyzed.Results The endothelial micro-particles were significantly higher in STEMI patients than those in either SAP group or normal group ( P ＜ 0.01 ),whereas there was no difference between the latter two groups.In STEMI patients studied in these cross sectional study,circulating CD31 +/CD42b-microparticles were positively correlated with peak level of myocardial biomarkers after injury.Moreover,the correlations between myocardial biomarkers after injury ( CK,CK-MB,cTnl and hs-CRP) and circulating CD31 +/CD42b-microparticles were r =0.489,P =0.021; r =0.501,P=0.018; r=0.491,P=0.02; r=0.612,P=0.002.Conclusions The level of circulating blood CD31 +/CD42b-endothelial micro-particle was expected to become a predictive marker in STEMI.

The clinicopathological data of 173 cases of inflammatory myofibroblastic tumor (IMT)were retrospectively analyzed.Among them 125 were males and 48 females with a mean age of 47.9 y (5-78 y).The lesions of 117 cases were located in lungs,41 cases in eyes,8 in ileocecum,2 in liver,2 in spleen,1 in abdominal wall,1 in maxillary sinus and 1 in face.The average diameter of lesions were 3.5 cm,ranging from 1.0 cm to 7.0 cm.The clinical manifestations were not specific,depending on the locations of tumor.The imaging examinations were helpful for diagnosis.The prcsence of slender-spindled myofibroblasts and proliferation of fibroblast cells,with infiltration of chronic inflammatory cells were the basic histopathological features of the disease.Combined with the histological characteristics and immunohistochemical staining IMT can be differentiated from other spindle cell tumors.Appropriate surgical resection is the main treatment for IMT.

BACKGROUND:The position of median and radial nerves corresponding to elbow is usual y estimated by macroscopical measurements, but there are big data errors when the elbow is bent. OBJECTIVE:To measure and analyze the impacts of elbows in different positions on median and radial nerves under X-ray. METHODS:Ten fresh frozen upper limb specimens were selected. The distance of median and radial nerves to the osseous marks inside the elbow was measured when the elbow was in extension, extension-half pronation, bent at flexion 90 degrees and bent at 90 degrees with the injection of normal saline into the joint capsule, respectively. RESULTS AND CONCLUSION:The positions of median and radial nerves were not influenced when the elbow was in extension or in extension-half pronation (P>0.05). The distance of median and radial nerves to the osseous mark of the elbow was significantly lengthened when the elbow was moved from from extension to was bent at 90 degrees (P<0.05). The intra-articular injection of normal saline when the elbow flexion 90 degrees significantly elongated the distance of median and radial nerves to the osseous mark of elbow (P<0.05). These results suggest that the elbow in different positions can induce the displacement of median and radial nerves. In addition, the distance between median, radial nerves and the osseous marks of the elbow is obviously lengthened when the elbow is in flexion with intra-articular injection of normal saline.