Objective To evaluate the clinical effects of surgical treatment for diabetic retinopathy(DR)with diffuse diabetic retinal edema(DDRE)and massive subretinal hard exudates(MSHE)by vitrectomy,endolaser retinal photocoagulation and long acting gas tamponade via analyzing the long term results.Methods Thirty eyes of twenty five patients with DR with DDRE and MSHE were recruited from October 2001 to December 2006.Among them,17 eyes belonged to 14 male patients and 13 eyes of 11 females.The patients' age was from 36 to 68 years(mean 54.6).The best corrected visual acuity(BCVA),color fundus photography,fundus fluorescein angiography(FFA)and optic coherence tomography(OCT)were performed preoperatively.Pars plana vitrectomy,posterior hyaloid removal,endolaser photocoagulation and long acting gas tamponade were used to treat the affected eyes.Results Preoperative BCVA was finger counting to 0.05 in all the 30 eyes.During 12-23 months of follow up period,2 eyes showed no change in BCVA,vision improvement was observed in 28 eyes(93.3%)with BCVA rising to 0.03-0.04 in 3 eyes,≥0.09 in 25 eyes,and among them the BCVA rose from 0.04 to 1.0 in one eye.The macular retina thickness thinned from preoperative ≥450?m to postoperative 160 220?m,intra-retinal and pre-retinal hemorrhage as well as MSHE was absorbed markedly or completely.Visual acuity decreased in 7 eyes(23.3%)during 24-42 months of follow up,anterior ischemic opticneuropathy occurred in 3 eyes(10%),macular edema recurred in 4 eyes(sub-macular hard exudates appeared in 2 eyes),and macular thickness measured 310-410?m.Scars in sub-fovea and peri-fovea sub-retina were noted in 5 eyes,in which the visual acuity was improved from finger counting to 0.04.Conclusion Vitrectomy,including posterior hyaloid removal,endolaser retinal photocoagulation and long acting gas tamponade may offer satisfactory effects in the treatment for DR complicated with DDME and MSHE.

BACKGROUND:Core training has been gradual y accepted worldwide.“Core”is only a generalized perception, and how to define the muscles, the difference among the muscles and the mode of the muscle recruitment consist of the important part of research work on core training.
OBJECTIVE:From the aspects of theoretical basis, the development of training methods and measurement of training effectiveness, to elaborate the method issues and new insights on core stability training.
METHODS:PubMed, ScienceDirect and CNKI databases were searched by the keywords of“core training, core exercise, core strength”in the titles and abstract to retrieve relevant articles published from 1979 to 2013.
RESULTS AND CONCLUSION:The neural subsystem was first reported by Panjabi to monitor the various signals from the transducers and direct the active subsystem to provide the needed stability. Neutral zone is regarded as an important clinical indicator relevant to spinal stability. Spinal injury and muscle weakening can result in spinal instability and even low back pain and peripheral pain. Core trainings include Swiss bal , plank exercise, sling exercise and so on. Up to now, research on core training is focusing on its mechanism. Core stability training is not only defined as torso stability training, but also refined to the stability training of each joint.

0\^05). Conclusion MMP\|2 and MMP\|9 may serve as indicators of invasion and malignant phenotype.Neither of them can represent the phenotype of metastasis,but both can represent that of matrix degradation.Moreover,MMP\|9 may play more important role in glioma invasion than does MMP\|2.

Objective To study the influence factor of recurrence in breast cancer.Methods The grouping treatment and tumor by stages,tumor transfer were observed in 105 cases with primary breast cancer.Results Among 105 patients,the inside of 2 years relapse was 47.6%(50/105);Tumor Ⅱ period recurrence rate was 40.0%(10/25),Ⅲ period recurrence rate was 28.0%(7/25);Among 105 cases,the distant place transfer to recurrence rate was 31.4%(33/105);Among 105 patients for surgical operation,its relapsing rate was 40.0%,but in 25 cases after operation putting radiation treatment,relapse rate was 16.0%;The part recurrence rate totally was 58.0%(61/105),among them the chest wall recurrence rate was 13.3%(14/105);The supraclavilar lymphonodes transfer was 20.9%(22/105),the axlla lymphnides transfer was 23.8%(25/105);The distant place transfer was 31.4%(33/105).Conclusion The recurrence rate of association treatment obviously is lower than that pure surgical operation,the relapsing of tumor with tumor by stages and transfer relevanted.

Objective To explore the effrciency of intra-arterial neoadjuvant chemotherapy before radical excision in patients with cervical cancer.Methods 50 cases with cervical cancer were enrolled into the study and were treated with a 2～3 course of intra-arterial neoadjuvant chemotherapy immediately after the pathological diagnosis.The regime included Then radical excision was performed in those who were good for the operation.Results Complete recovery(CR) was acquired in 12 patients and partial recovery(PR) in 26 patients.The total response rate was 76.0 %.The tumor size reduced significantly(P

Objective To evaluate the safety and efficacy of Perclose device after cerebral angiography or intervention procedures. Methods Two hundred and eighty-nine patients who underwent cerebral angiography or intervention procedure were divided into two groups: 143 patients accepted Perclose device for hemostasis (device group), 146 patients accepted manual method for hemostasis (handwork group). Time to achieve hemostasis and ambulation,complications associated with the procedure,the rates of successful hemostasis and patients' discomfort were compared. Results The rates of successful hemostasis were 96.5%( 138/143) in the device group and 97.9%( 143/146) in the handwork group (P> 0.05). Time to achieve hemostasis and ambulation in the device group were (3.13 ± 2.17) min and (1.99 ± 1.11) h ,they were shorter than those in the handwork group [(15.91 ± 3.27) min and (17.93 ± 7.82) h](P< 0.01). The occurrence rate of complication at the femoral access site and patients' discomfort rates from staying in bed in the device group were lower than those in the handwork group (P < 0.01). There were 7 cases of large hematoma and 1 case of pseudoaneurysm in the handwork group. Conclusions The use of Perclose device is a safe and effective method for hemostasis of the femoral access site after cerebral angiography and intervention. It could shorten the time of staying in bed and decrease vascular complications significantly.

Objective To probe into the effect of systematic nursing model on treatment compliance and clinical efficacy of elderly patients with diabetes. Methods 100 elderly patients with diabetes in our hospital were selected from January 2008 to December 2010.The patients were divided into the study group and the control group randomly,50 cases in each group.The patients in the control group were treated with conventional care model,while the patients in the study group were treated with systematic nursing model.The compliance,clinical treatment effect,and improvement of clinical indicators were compared and ana lyzed in two groups respectively. Results Compared with the control group,treatment compliance indexes such as self-monitoring,diet control,medication compliance,exercise therapy in the study group were significantly improved,the difference was statistically significant.Compared with the control group,the clinical efficacy of patients in the study group was significantly improved.Compared with the control group,the FBG,PBG and HbAlc were improved significantly,the difference was statistically significant. Conclusions Systematic nursing model plays a positive role in promoting treatment compliance and clinical effects of elderly patients with diabetes mellitus.The interventions need to be further enriched and perfected.

Objective Based the previous studies, the present study was performed to investigate the antagonistic effects of different doses of Astragaloside IV on the immune function of Treg mediated by HMGB1 in vitro and its potential mechanism.Methods CD4+CD25-T cells isolated from the spleens of male BABL/c mice by magnetic beads were seeded on 48-well cell culture plates and were randomly divided into four groups as follows(12 holes per group). Normal control group: CD4+CD25-T cells were cultured merely. Treg group: Tregs(100μl) and CD4+CD25-T cells were co-cultured in ratio of 1:10. HMGB1+Treg group: Tregs(100μl) stimulated by HMGB1(1μg/ml) for 72 h and CD4+CD25-T cells were co-cultured in ratio of 1∶10. HMGB1+AST IV+Treg group: Tregs(100μl) stimulated by HMGB1(1μg/ml) and AST IV(100μg/ml)for 72 h were co-cultured with CD4+CD25-T cells in ratio of 1:10. CD4+CD25-T cells and supernatants were again collected on post-culture 72 hour. The proliferation of CD4+CD25- T cells was analyzed by MTT test, the activity of NFAT and the contents of cytokines of IL-2 released into supernatants were also determined by means of ELISA. Results When CD4+CD25-T cells were co-cultured with Tregs, the cell proliferation(0.166±0.039) and the levels of NFAT(0.156±0.035) and IL-2(2.38±0.58) in supernatant were markedly decreased as compared with those in the control group(P<0.01). However, the contrary results were found when CD4+CD25-T cells were co-cultured with Treg stimulated by HMGB1. Compared with those in the(HMGB1+Treg) group, the contrary results were showed with a dose-dependent in the(HMGB1+ASTⅣ+Treg) group.Conclusion ASTⅣcan rivalry the effects of HMGB1 on immune function of Treg in vitro, this result indicate that ASTⅣhas the therapeutic action on inflammation promoted by HMGB1.

Objective To evaluate the therapeutic effect of small bone flap craniotomy decompression of posterior cranial fossa and duraplasty in the treatment of Chiari malformation type Ⅰ.Methods The clinical data of 45 Chiari malformation type Ⅰ patients who were treated with small bone flap craniotomy decompression of posterior cranial fossa and duraplasty were retrospectively analyzed,31 cases among them with syringomyelia.Results According to Tator etc.standard,1 month after surgery,the excellent in 30 cases,good in 15 cases.Follow up from 6 months to 6 years,the excellent in 37 cases,good in 8 cases.Among 31 patients with syringomyelia,26 cases were syringomyelia subsided,5 cases were not obvious change.Conclusion The small bone flap craniotomy decompression of posterior cranial fossa and duraplasty can make the craniocervical decompression,and has obvious effect of treating syringomyelia,is safe and effective in treatment of Chiari malformation type Ⅰ.

Objective To build position system based on a large ship ocean nursing needs.Methods Two rounds of expert consultation were carried out through the literature material method,field survey,comparative research method,and Delphi method to build nursing station system of the large ship.Results The expert authority coefficient was 0.81.Two rounds of expert coordination coefficients were 0.55,0.52.The nursing position system contained three parts:level Ⅰ position,level Ⅱ position and the post job responsibilities.Conclusions The system contains 21 stations,the expert opinions are concentrated with high credibility,it can provide certain theoretical support for the nursing personnel selection,training,and ship jobs management of large ship.