The characteristics of non-arteritic anterior ischemic optic neuropathy (NAION) include sudden decline of visual acuity, sector-shaped visual field defect connected with the physiological blind spot or hemi-visual field defect, and optic disc edema. Early angiographic abnormalities of optic disc and peripapillary choroidal circulation are important cues for the diagnosis. Angiography combined with visual field test can make the diagnosis more accurate. The pathological mechanism and process of NAION and ischemic cardiovascular/cerebrovascular disease are essentially the same. There are several critical issues in this field we need focus on, including strengthening the cooperation with relevant professional disciplines; improving the ocular ischemia through drugs, intervention and other means; preventing more serious cardiovascular events and intervening in a number of high-risk populations to reduce the incidence of AION.

Objective To investigate the clinical efficacy of Zhuang medical sinew therapy forcervical spondylotic radiculopathy and provide reliable experimental data and scientific evidence for the establishment of clinical technical operation standardization.Method Eighty patients with cervical spondylotic radiculopathy were randomly allocated to treatment and control groups, 40 cases each.The control group took Jingfukang granules with hot water and the treatment group received Zhuang medical sinew therapy.The therapeutic effects were compared after one course of treatment.The 20-point scale score and the VAS score were recorded in the patients before and after treatment.Result Thirty-eight patients in the treatment group and 36 patients in the control group completed the required treatments. The total efficacy rate was 92.1% in the treatment group and 72.2% in the control group;there was a statistically significant difference between the twogroups(P<0.05).There were statistically significant post-treatment differences in the Japanese 20-point scale score and the VAS score between the two groups (P<0.05).Theresults showed that the Japanese 20-point scale score and the VAS score improved more in thetreatment group.Conclusion Zhuang medical sinewtherapy has a marked effect oncervical spondylotic radiculopathy.

Automatic Data Processing ; Computer-Aided Design ; Cone-Beam Computed Tomography ; Expert Systems ; Humans ; Imaging, Three-Dimensional ; Orthodontics, Corrective ; Robotics ; Surgery, Computer-Assisted

AIM:To analyse the risk factors of age, sex, course, best corrected visual acuity(BCVA),diopter and fundus features of high myopes with progressive high myopia. METHODS: A total of 167 patients with high myopes were categorized into four groups: group 1,age of 29 years or younger; group 2,between the age of 30 to 49 years; group 3,between the age of 50 to 69 years and group 4,age of 70 years or older. The refractive errors of all patients were measured without cycloplegia with an autorefractometer. Data of the spherical equivalent(SE) of the refractive errors in diopters (D)and fundus examed by direct ophthalmoscope were used in statistical analyses.RESULTS: The number of female was statistically larger than that of male(P＜0.01),also the disease course was correlated to the age. The visual acuity of high myopes significantly decreased as they grew older including the higher incidence of lacquer cracker, submacular hemorrhage, Fuchs spots, chorioretinal atrophy . CONCLUSION: Female maybe a risk factor of high myopia, advanced age is an important factor of visual acuity decrease. High myopes ought to be treated early to delay the progress of myopia and development of macular degeneration.

Objective To investigate the application of laparoscope,duodenoscope and choledochoscope in the treatment of intra-and extrahepatic bile duct stone.Methods The clinical data of 3 16 patients with intraand extrahepatic bile duct stone who were admitted to the Bethune First Hospital from April 2007 to August 2010were retrospectively analyzed.There were 269 patients with cholecystolithiasis and choledocholithiasis,10 patients with cholesystolithiasis,choledocholithiasis and hepatolithiagis,and 37 patients with choledocholithiasis.Laparoscopic cholecystectomy(LC)+laparoscopic common bile duct exploration(LCBDE)+choledochoscopy was applied to patients with hepatolithiasis or with the diameter of common bile duct≥10 mm;endoscopic sphincterotomy (EST)+LC or LC+EST was applied to patients with the diameter of common bile duct between 10 mm and 5 mm and the diameter of cystic duct<5 mm;LC+laparoscopic transcystic common bile duct exploration(TC-CBDE)+choledochoscopy wag applied to patients with the diameter of common bile duct≤5 mm and the diameter of cystic duct≥5 mm.Results The success rate of operation was 96.8%(306/316).A total of 163 patients received LC +LCBDE+T-tube drainage+choledochoscopy,and the mean operation time,expense,duration of hospital stay were 93.6 minutes,2.8×104 yuan and 9.8 days,respectively,and 5 patients had complications postoperatively.Fifty-four patients received EST+LC,and the mean operation time,expense,duration of hospital stay were 45.0minutes,6.6 days,2.3×104yuan,respectively,and 1 patient had complication postoperatively.Sixty-seven patients received LC+EST,and the mean operation time,expense and duration of hospital stay were 40.0minutes,6.1 days,2.4×104 yuan,respectively,and 2 patients had complication postoperatively.Thirty-two patients received one-stage repair of common bile duct and LC+TC-CBDE+choledochoscopy,and the mean operation time,expense and duration of hospital stay were 97.3 minutes,7.3 days and 2.5×104yuan,respectively,and 1 patient had complication postoperatively.A total of 272 patients were followed up for 12 months,except for 6 patients with recurrence of common bile duct stone,no residual stone or biliary stricture was etected.Conclusion Combined application of laparoscope,duodenoscope and choledochoscope has advantages of less trauma,quick ecovery and fewer complications in the treatment of intra-and extrahepatic bile duct stone.

Objective To explore and establish a kind of dissertation evaluation system which can fully reflects the characteristics of academic medical doctoral training.Methods 41 medical doctoral dissertation evaluation systems and related literatures were collected,to get the current situation of this dissertation evaluation system in our country and find the key points of various evaluation systems.A questionnaire survey was conducted among 350 doctoral supervisors coming from 6 universities so as to define the framework and connotation of evaluation indicators.Using the Delphi expert consultation method,the connotation of evaluation indicators and composition as well as the weight of various indicators was improved.Results The doctoral supervisors who participated in the research considered that building the dissertation evaluation system should follow the principle of science,innovation and fairness,and the evaluation frame-work should have secondary index and evaluation elements.The evaluation contents concluded choosing topic,literature review,basic theory and professional knowledge,paper writing,innovation,research ability and academic morals and so on.And on the basis of this,the paper explored and developed a more scientific and comparative dissertation quality evaluation system with medical specialty.Conclusion The cultivation units should take the educational goal of evaluation target and the requirements of awarding degree into consideration,seeking opinions fully to the first-line supervisors and combing quantitative and qualitative evaluation effectively with scientific and operable principles when specifying evaluation system.

Objective To evaluate the causes of postoperative complications in severe liver rupture and explore the prevention experienees.Methods The clinical data of 66 liver rupture patients who underwent surgical treatment in our hospital from January 2005 to July 2012 were retrospectively analyzed.The commou complications after surgery and the treatment measures of the complications were sludied.Results There were 9 deaths of severe liver rupture after surgery and related complications were found in 22 cases,including bile leakage (5 cases),intrahepatic abscess (3 eases),subphrenic infection (3 cases),pleural effusion (8 cases),intra-abdominal hemorrhage (2 cases),stress ulcer bleeding (2 cases).Conclusions Using damage control theory could improve the cure rate.Precise liver transection and postoperative excellent management was able to reduce the incidence of postoperative complications in severe liver rupture.

BACKGROUND:Anterior cruciate ligament is the important anatomic structure to maintain the knee joint stability. The tendon bone healing and clinical functional recovery after anterior cruciate ligament have attracted more attention. OBJECTIVE:To observe the healing of graft tendon and surrounding bone with histological method through the same diameter grafts matching with the bone tunnel of different sizes in the anterior cruciate ligament reconstruction surgery, and to detect the functional recovery with biomechanics. METHODS:Middle 1/3 of canine autologous tendon was selected as the anterior cruciate ligament graft, and then trimmed into the same diameter of 4 mm. Sixteen adult mongrel canine were randomly divided into four groups. The anterior cruciate ligament was resected completely, and the tibial and femoral tunnels were prepared on the end sites of tibia and femur with the diameters of 5, 4.5, 4 and 3.5 mm, then implanted into the tendon in prepared and linked into the bone tunnel. At 6 weeks after reconstruction, the experimental canine were sacrificed under general anesthesia to col ect the tissue and organs in the surgical area. Then the hematoxylin-eosin staining, biomechanical testing and statistical analysis were performed. RESULTS AND CONCLUSION:At 6 weeks after anterior cruciate ligament reconstruction, anatomical observation showed that there were no significant differences in growth of grafts and bone tunnels between groups;hematoxylin-eosin staining showed sharpey-like fibronectin could be seen in the tendon bone healing surface, and the col agen fibers in the 3.5 mm bone tunnel group were more compact and regular than those in the other groups;the biomechanical testing results in the 3.5 mm bone tunnel group were better than those in the other groups. The results indicate that during anterior cruciate ligament reconstruction, decreasing the diameter of bone tunnel that matched with grafts in order to make the tendon and the bone tunnel closely matched can provide a more stable cel biological and mechanical environment, accelerate the formation and transformation of tendon-bone healing interface, and can improve the quality of tendon-bone healing.

Objective To discuss the best bacterial combination for the diagnosis of Bacterial vaginosis (BV).Methods This is a retrospective study,230 BV-positive patients and 360 healthy women were enrolled based on the Amsel criteria and Nugent score.5 BV-associated bacteria,including Gardnerella vaginalis,Atopobium vaginae and Leptotrichia/Sneathia species,et al.were amplified by specific-PCR assay,the detection rate were compared between two groups.ROC curve and Kappa test were used to select the best combination.Results The detection rate of Gardnerella vaginalis,Atopobium vaginae,Leptotrichia/Sneathia species,Megasphaera species and Mobiluncus mulieris in BV group (91.3％,83.5％,39.1％,42.6％ and 36.5％ respectively) were markedly higher than that in healthy women (37.2％,14.4％,11.7％,8.9％ and 5.6％ respectively),x2 value were 168.848,275.776,60.949,92.886 and 92.68,all P ＜ 0.05.The area under ROC curve of A.vag,G.Vag + A.vag,G.Vag + A.vag + Lepto,G.Vag + A.vag +Mega and G.Vag + A.vag + M.mul were 0.845,0.862,0.865,0.869 and 0.867,and the sensitivity and specifity were higher than 80％,the value of Kappa were larger than 0.75 (P ＜ 0.05).Thus,these five methods were coincident.Conclusion Detection of Atopobium vaginae may be a better way for the diagnosis of BV.

Objective To study knowledge,ability and related behavior of reproductive health among unmarried women migrants in Qingdao area,Shandong and evaluate effectiveness of basic intervention,including provision of free condom and health education and enhanced intervention,including healthy sex,contraception and health-care seeking behavior.Methods A community intervention trial was conducted among 1800 unmarried women migrants aged 18 -29 years in 10 workplaces of Qingdao.Basic intervention included health knowledge publicity and distribution of free condoms,and enhanced intervention included distribution of very important person (VIP) service cards,hotline telephone service,broadcasting digital versatile disc (DVD) of reproductive health knowledge,health lectures,peer education,and so on,in addition to health knowledge publicity and distribution of free condoms.Effectiveness was evaluated using questionnaire before and six months after intervention.Results After intervention,awareness of reproductive health and attitude to reproductive health improved significantly among the women migrants,as compared to those before intervention,particularly in knowledge of contraception and sexual health with enhanced intervention (with more than 20％ of them aware) ( P ＜ 0.01 ).About effectiveness on health-care seeking behavior,59.2％ (482/814) and 80.8％ (651/806) of the women migrants with reproductive tract infections would visit physicians after basic and enhanced intervention,as compared to those of 32.0％ (286/895) and 31.9％ (275/862) before them,respectively (P＜0.01).About effectiveness on contraceptive behavior,persistent and proper use of effective contraception methods improved significantly after intervention,as compared to that before it ( P ＜ 0.05 ),but with no significant difference between the two group with basic and enhanced intervention.Conclusions Both basic and enhanced intervention is effective and feasible in women migrants,more effective for enhanced one.