Objective To observe the clinical features and outcomes of vitrectomy for diabetic retinopathy (DR) with central retinal vein occlusion (CRVO) in type 2 diabetes mellitus (T2DM).Methods A total of 192 patients (241 eyes) with proliferative DR (PDR) who underwent vitrectomy were enrolled in this study.All the patients were diagnosed as vitreous hemorrhage (VH) because of suddenly decreased vision.There were 93 eyes with tractional retinal detachment (TRD) and six eyes with neovascularization of iris (NVI).The patients were divided into PDR with CRVO group (group A,41 eyes) and PDR group (group B,200 eyes) according to the results of fundus examination.All patients received vitrectomy with silicone oil and C3F8 gas tamponade.There were 138 eyes with silicone oil tamponade which including 30 eyes in group A and 108 eyes in group B.The difference of number in silicone oil-filled eyes in two groups was statistically significant (x2=5.110,P＜0.05).There were 38 eyes with C3F8 gas tamponade which including six eyes in group A and 32 eyes in group B.There was no difference in C3F8 gas-filled eyes numbers in two groups (x2 =0.048,P＞0.05).The follow-up ranged from one to 60 months,with the mean of (28.69± 17.28) months.The corrected vision,retinal reattachment,persisting macular edema (ME),neovascular glaucoma (NVG) and repeated VH after surgery were comparatively analyzed.Results Of 241 eyes,there were 41 eyes (17.0％) with CRVO.Before surgery,the differences of corrected vision (Z=-0.138),intraocular pressure (t=0.966),whether there was TRDor not (x2=0.412),whether underwent panretinal photocoagulation or not (x2 =1.416) were not statistically significant (P＞0.05),but the difference of whether NVI were present or not was statistically significant (x2=31.724,P＜0.05)between two groups.After surgery,the corrected vision improved in both two groups (Z=2.319,4.589;P＜0.05).There was no difference of corrected vision after surgery between two groups (Z=0.782,P＞0.05).Postoperative complications occurred in 94 eyes,including 26 eyes in group A and 68 eyes in group B.The differences of incidence of reoperation (x2 =0.498),retinal reattachment (x2 =0.818),persisting ME (x2 =2.722) between two groups after surgery were not statistically significant (P ＞ 0.05).The incidence of repeated VH (x2 =5.737) and NVG (x2 =6.604) in group A were higher than those in group B (P＜ 0.05).Conclusions CRVO is commonly found to coexist with DR in T2DM patients with VH.Combined with CRVO patients are more likely to suffer NVI.Vitrectomy can improve the visual function in PDR with CRVO patients.

Objectives: This prospective,randomized and controlled clinical trial was designed to investigate the effect of short course intensive insulin therapy(SCIIT) on stress-induced hyperglycemia and outcomes in critically ill patient. Methods:The diabetes or other illness which directly influenced blood glucose were excluded and the critically ill patients was maintained with normoglycemia((4.4-6.1) mmol/L) in the first seven days by intensive insulin therapy.After the first seven days,these patients was treated like conventional insulin treatment group.Conventional insulin treatment group was maintained with blood glucose at a level between 3.9-10 mmol/L.Results: Of 41 patients enrolled in the study,30 patients were eligible for analysis.After intervention stopped,blood glucose level in intensive insulin treatment group(5.92?1.24 mmol/L) was lower than in conventional insulin treatment group((9.22?)2.51 mmol/L).And in the same time,insulin consumptions in SCIIT group was lower than in conventional insulin treatment group.There was no significant difference in ICU mortality between two groups,although decreasing trend favored to treatment group. Conclusion: In critical ill patient,(SCIIT) can achieve similar blood glucose range when compared with the plan of IIT.The benefit of improving morbidity and mortality could be expected in large sample RCTs.

BackgroundThere are a lot of studies about the wound healing charateristics of cornea after SBK with femtosecond laser.In our study,mechanical microkeratome was preferred for corneal flap.We observed the proliferation of keratocytes by investigating the myofibroblast ( MF) activity.Objective The study was to compare the morphologic and histological changes in the cornea after sub-Bowmans keratomileusis ( SBK) with photorefractive keratectomy ( PRK) and laser in situ keratomileusis ( LASIK)by investigating the express of transforming growth factor-β( TGF-β)and α-smooth muscle actin( α-SMA)and to investigate the wound healing characteristiCs of cornea after SBK.MethodsTwenty-seven adult New Zealand white rabbits were randomly assigned into group A,B and C.SBK waa performed on the right eyes of each rabbit in group A,LASIK for group B and PRK for group C.All the left eyes were used as the normal control group.Histological examinations by light microscopy were performed on day 7,1 months,3 months after surgery.The expression of α-SMA and TGF-β and the number of activated MF were assessed by immunohistochemiatry.ResultsIn SBK group,corneal epithelium cells proliferation around the wound was seen and the numbers of active fibroblasts were increased after surgery.The expression of α-SMA or TGF-β around the corneal flap and the corneal 8troma started at day 7 postoperatively and peaked at 1 months and decreaaed around the corneal flap and the corneal 8troma started at day 7 postoperatively and peaked at 1 months and decreaaed t3mnh.TFβep( SBK:t=2.226,2.158,2.330,P＜0.05;PRK:t=4.745,6.524,6.293,P＜O.05).The numbersof activ( SBK:t=2.226,2.158,2.330,P＜O.05;PRK:t=4.745,6.524,6.293,P＜0.05).The numbersof activatedMFs were different fromLASIKstatisticallytoobetweenSBKgroupandPRKgroup ( SBK:t =4.439.5.692,4.175,P＜0.05 ; PRK:t=6.330,6.723,5.267,P＜0.05 ).Theα-SMAand TCF-βexpressionsin SBKgroupwerelessthan PRK group but more thanLASIKgroup( TCF-β:t =4.691,5.527,t =4.399,P＜0.05 ; α-SMA:t =9.637.10.282,8.197,P＜0.05).The numhers of MFs in SBK group was less than PRK group before 3 months and were same at 3 months ( t =5.188,4.529,P＜0.05 ).Conclusions ComparedwithconventionalLASIK,SBKcanup-regulatethe expression of α-SMA.TGF-β,activated MFs in the corneal flap.which enhance corneal biomechanics and promote healing.However,most of the disadvantages caused by wound healing in SBK still remain compared to PRK.

In this article,the authors introduced the functions of different catalogue of Traditional Chinese Medicine,together with the development of the past and present condition of catalogue.The authors also presented the opinion on how to work best with it.

OBJECTIVE To study the relationship between HLA-DRB1*03 genes and expression of cytokine IL-18 in chronic hepatitis B patients.METHODS A total of 153 chronic hepatitis B patients and 138 normal healthy people were detected.HLA-DRB1*03 alleles were conducted in all the patients with polymerase chain reaction-sequence specific primer(PCR-SSP),and IL-18 was detected by ELISA.RESULTS Thirty-four individuals with chronic hepatitis B patients were HLA-DRB1*03 genes positive,the frequency was 22.22%,which was higher than the frequency of HLA-DRB1*03 in heathy individuals.The average level of IL-18 in chronic hepatitis B patients with HLA-DRB1*03 negatives was significantly higher than in HLA-DRB1*03 positives.CONCLUSIONS HLA-DRB1*03 closely relates with susceptibility to chronic hepatitis B.In chronic hepatitis B patients,the average level of Th1 cytokines in HLA-DRB1*03 negatives is higher than that in HLA-DRB1*03 positives.

OBJECTIVEObserve and analyze the informations of western medicine and traditional Chinese medicine in patients with coronary heart disease (CHD), in order to provide reference for clinical treatment.

METHODSelect patients with CHD in diagnosis of the first place in 17 hospitals, drug informations of these patients were analyzed using frequency method and association rules.

RESULTIn 84 697 patients,there were 47 564 males and 32 882 females. The median age was 71 years old, 76 172 patients have medicine records, including 278 kinds of western medicine and 331 kinds of traditional Chinese medicine. Aspirin was the most common used western medicine (51 132 patients, 67.08%), followed by isosorbide dinitrate, clopidogrel etc. The most common used traditional Chinese medicine was danhong injection, followed by shuxuetong injection. After classified the drugs, at the forefront of western medicine were antiplatelet drugs, nitrates drugs, statins, beta blockers, calcium antagonists, ACEI; the most used in traditional Chinese medicine was injection of blood-activating and stasis-resolving, followed by oral preparations of blood-activating and stasis-resolving medicine, Fuzheng class oral medicine, purgation medicine etc. After association rules, combination therapy among western medicine was the most common, combination of western medicine with blood-activating and stasis-resolving was very commonly, especially antiplatelet drugs and nitrates drugs.

CONCLUSIONWestern medicine in the treatment of patients with CHD was in accordance with the guidelines recommend, but with the lower utilization rate. Traditional Chinese medicine has become an important method for the treatment of CHD, promoting blood circulation and removing blood stasis is an important part of traditional Chinese medicine treatment in patients with CHD.

Adrenergic beta-Antagonists ; therapeutic use ; Adult ; Aged ; Aged, 80 and over ; Animals ; Aspirin ; therapeutic use ; Combined Modality Therapy ; Coronary Disease ; drug therapy ; Drugs, Chinese Herbal ; therapeutic use ; Humans ; Hydroxymethylglutaryl-CoA Reductase Inhibitors ; therapeutic use ; Male ; Medicine, Chinese Traditional ; methods ; Middle Aged ; Nitrates ; therapeutic use ; Platelet Aggregation Inhibitors ; therapeutic use

Adolescent ; Adult ; Aged ; Case-Control Studies ; Central Nervous System Neoplasms ; cerebrospinal fluid ; diagnosis ; Child ; Female ; Humans ; Hyaluronan Receptors ; cerebrospinal fluid ; Leukemia ; cerebrospinal fluid ; Male ; Middle Aged ; Young Adult

Complement Factor H ; genetics ; Hemolytic-Uremic Syndrome ; genetics ; Humans

Objective:To explore the effect of fortified human milk feeding on growth and complica-tions of infants with extremely and very low birth weight (ELBW/VLBW)during hospital stay by a pro-spective,random and controlled study.Methods:In the study,1 22 ELBW/VLBW infants were enrolled and divided into two groups.The infants fed with human breast milk,combined with human milk fortifi-cation (HMF)during hospital stay were named HMF group (n=62),and those fed exclusively with pre-mature formula were named premature formula feeding group (PF group,n=60 ).The data of the in-fants’growth (the velocity of increase on the weight,length,head circumference and upper arm circum-ference),the time of rebounding to birth weight,the time of needing intravenous nutrition,the time of hospitalizing,the proportion of extrauterine growth retardation (EUGR)during hospital stay,the level of hemoglobin,bone metabolism and incidence of complications were compared between the two groups. Results:Among the 1 22 infants included,(1 )the length increment in HMF group was higher than PF group [(0.89 ±0.23)cm/week vs.(0.79 ±0.34)cm/week,P=0.04];there were no significant differences in the weight gain,head circumference increment and upper arm circumference increment (P>0.05);(2)the age of rebounding to birth weight [(1 0.1 3 ±4.03)d vs.(8.03 ±3.28)d,P=0.002]and the duration of intravenous nutrition [(1 6.77 ±6.63)d vs.(1 4.23 ±4.1 5)d,P=0.01 ] in HMF group were longer than that in PF group,there were no significant differences between the two groups in the hospital stay and age achieved feeding;(3 )there were no significant differences between the two groups in the incidence rate of EUGR during hospital stay (P>0.05);(4)the level of calcium at birth in HMF group was lower than that in PF group [(2.1 9 ±0.22)mmol/L vs.(2.32 ±0.27) mmol/L,P=0.005 ],and the level of alkaline phosphatase (AKP)in HMF group at discharge was higher than in PF group [(363.98 ±1 22.49)mmol/L vs.(299.73 ±1 1 7.39)mmol/L,P=0.004];(5)the incidence of the feeding intolerance (6.5% vs.1 8.3%,P=0.04)and sepsis (4.8% vs. 1 6.7%,P=0.03)in HMF group were less than in PF group,there were no significant differences be-tween the two groups on the morbidity of necrotizing enterocditis,retinopathy of prematurity (ROP),and bronchopulmonary dysplasia (BPD)(P>0.05).Conclusion:HMF for premature infants may ensure the same growth pattern as those fed by premature formula,promote the calcium absorption,decrease the inci-dence of sepsis and feeding intolerance,and does not increase the incidence of necrotizing enterocolitis.

This paper reports one case of overseas imported quartan malaria and the diagnosis and treatment process. By using dihydroartemisinin combined with piperaquine,the treatment results are satisfactory.