Prevention and management of glaucoma is a priority task in the second phase of WHO " Vision 2020" project. In order to popularize the knowledge of glaucoma guideline, the author compiles the protocol of glaucoma guideline summary after referring to those deriving from American Academy of Ophthalmology, European Glaucoma Society, and South East Asia Glaucoma Interest Group. The guideline summary is easy to master and verify, and highlight the crucial points. The ISNT rule of neuroretinal rim is used to differentiate diagnosis between the physiological cup and glaucomatous rim lost. Foster's classification for primary angle-closure glaucoma (PACG) is used to select the treatment for PACG. It is emphasized that taking target pressure in the initial diagnosis, monitoring the optic discs and visual field loss in follow-up, and glaucoma screening by non-mydriatic digital fundus camera in the high risk population with screening diabetic retinopathy.

The primary eye care service is still absent in most of primary medical organizations in present China.Since imaging examinations provide main contribution to the diagnosis of eye diseases,ophthalmology and blindness prevention have technical predominance and requiring market in the field of telemedicine or e-healthy.We have explored different paradigms of blindness prevention according to variable levels of the region economy and medical conditions.In the urban community,the paradigm for preventable blindness has been adopted,and however,in the rural areas,the paradigm for curable blindness has been taken.It should be advocated to combine the primary eye care with the primary healthy care.It is in favor of sharing information,enhancing efficiency,improving quality, as well as entire orientation management to carry out digitalized ophthalmology regional cooperative medical service.Moreover,governmental leading function and policy sustaining are needed to complete the reform.

[Objective]To explore the rabbits' lipid peroxidation and cytokine level change caused by endotoxemia,use EPO for intervention.[Method]Bleed rabbits femoral for shock,after coming to,make injection of endotoxin,two beatings make dysfunctional multi-organs model;randomly divide 24 healthy rabbits into control group(1),2-beating group(2),EPO group(3),8 in each;take blood for testing indexes of TNF?,IL6,IL10 and MDA.[Result]Group 2 was higher than other groups on MDA level,group 3 less than group 2;group 2 was much higher than other 2 groups on TNF?,IL6 and IL10,group 3 less than group 2.[Conclusion]The cytokines and lipid peroxidation participating in the course of multi-organ injury caused by blood loss shock and endotoxemia can be reduced by EPO.

Objective To observethe effect of continuous veno-venous hemofiltration (CVVH) on serum level of antibrain-antibody (ABAb) in patients with severe traumatic brain injury.Methods Thirtysix patients with severe traumatic brain injury were randomly divided into control group (19 patients) and CVVH group (17 patients).The control group accepted conventional treatment,the CVVH group accepted CVVH treatment additionally for 7 d.ELISA was used to measure serum level of ABAb at 1,3,5,7,14 d after treatment.The change of ABAb in serum of each group was observed.The scores of Glasgow coma scale (GCS) was assessed everyday.Results The level of ABAb in CVVH group was significantly lower than that in control group from the third day after treatment[the third day:(1.28 ± 0.25) kU/L vs.(1.33 ± 0.30) kU/L;the fifth day:(1.37 ±0.17) kU/L vs.(1.42 ±0.22) kU/L;the seventh day:(1.45 ±0.37) kU/L vs.(1.52 ± 0.35) kU/L;the fourteenth day:(1.49 ± 0.41) kU/L vs.(1.67 ± 0.39) kU/L,P ＜ 0.05 or ＜ 0.01].The scores of GCS in CVVH group was significantly higher than that in control group from the seventh day after treatment [the seventh day:(6.95 ± 1.24) scores vs.(5.74 ± 1.51) scores;the fourteenth day:(9.29 ± 1.76) scores vs.(7.22 ± 1.24) scores] (P ＜ 0.01).Conclusion CVVH can decrease the level of ABAb and improve the prognosis.

Multidrug-resistant organisms are growing worldwide public health problem and few therapeutic options remain available.The traditional antimicrobials (glycopeptides) for multidrug-resistant Grampositive infections are declining in efficacy.New antimicrobials that are presently available are linezolid,daptomicin and tigecycline,which have well-defined indications for severe multidrug-resistant organisms infections.Unfortunately,the therapies available for multidrug-resistant Gram-negatives including carbapenem-resistant Pseudomonas aeruginosa,Acinetobacter baumannii and Enterobacteriaceae are limited to colistin and tigecycline only.Distribution of multidrug-resistant organisms are changing in recent years.Strains of multidrug-resistant organisms were dominated by Gram-negative bacteria in most hospital particularly in intensive care unit.Multidrug-resistant/pandrug-resistant Pseudomonas aeruginosa,Acinetobacter baumannii are increasing rapidly in trend.Strategy that includes surveillance,infection control procedures,isolation and antimicrobial principle should be emphasized and implemented to reduce multidrug-resistant organism diffusion.

Objective To investigate the variations of serum levels of visfatin in pregnant women with different types of glucose intolerance and the associations with insulin resistance.metabolic parameters and newborn birth weight.Methods Totally,120 pregnant women in late trimester were divided into 3 groups according to the results of 50 g glucose challenge test(GCT)and 75 g oral glucose tolerance test:GDM group(n=45),GCT(+)group(n=20),and NGT group(n=55).Fasting levels of visfatin,insulin,total cholestrol and triglyceride were measured and the newborn birth weight was recorded.Results The serum visfatin level was significantly elevated in GDM group compared with the NGT group[(374.9±23.1)ng/ml vs(308.9±16.8)ng/ml,P＜0.05],but no significant difference was shown when compared with the GET(+)group[(346.5±23.1)ng/ml].Furthermore,serum visfatin levels had no relationship with insulin resistance,metabolic parameter and newbom birth weight.Conclusions Visfatin is elevated in GDM women and closely related with GDM,but not with insulin resistance,metabolic parameters and newborn birth weight.

Multidisciplinary team(MDT)diagnosis and treatment of colorectal cancer has been adopted by plenty of hospitals as a kind of effective comprehensive therapy.Compared with the traditional diagnosis and treatment methods,MDT diagnosis and treatment achieve standardization of diagnosis and treatment and technical promotion through specialization of the team to ensure better treatment and prognosis of patients.However,MDT diagnosis and treatment of colorectal cancer is not perfect,which can be limited by two aspects of hospitals and patients and can realize maximum utility with knowledge of its characteristics.This article will try to explore the distribution and usage of the resource in MDT diagnosis and treatment of colorectal cancer,the advantages over the traditional cure methods and the limits.

Objective To investigate the effect of Zhubei Dingchuan pill on clinical symptoms and inflammatory mediators in serum and induced sputum of patients with chronic bronchitis. Methods 80 cases of patients with chronic bronchitis treated in the Department of Respiration in our hospital from January 2016 to January 2017 were selected and were randomly divided into the control group and the observation group, with 40 cases in each group. The control group was given symptomatic support treatment and the observation group was additionally given Zhubei Dingchuan pills on the basis of the control group. The changes of inflammatory mediators levels in serum and induced sputum were measured before and after treatment between the two groups, and the clinical efficacy was observed in the two groups. Results After treatment, the levels of interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α) and high-sensitivity C reactive protein (hs-CRP) in serum or induced sputum in the observation group were significantly lower than those in the control group (P<0.05). The effective rate of treatment in the observation group was significantly higher than that in the control group (95.0％ vs. 82.5％) (P<0.05). Conclusion Zhubei Dingchuan pill can effectively relieve the clinical symptoms in patients with chronic bronchitis, and its pharmacological mechanism is related to the decrease of levels serum and airway inflammatory mediators.

OBJECTIVE To identify the risk factors,distribution and kinds of pathogens and control measures for the patients with autoimmune disease(AD) complicated with fungal infections.METHODS Statistical analysis was carried out on the clinical data of 38 patients with AD complicated with fungal infaction.RESULTS The fungal infection in AD mainly occurred in the respiratory tract,urinary tract,digestive tract and on the skin.The main factors of these patients more likely were disturbed immunity,and unreasonable usage of corticosteroids,immunosuppressive agents and antibiotics.CONCLUSIONS It should as early as possible onset the clinical antifungal therapy,reasonable using of corticosteroids,immunosuppressive agents and antibiotics for fungal infaction,and supportive treatment according to the result of antifungal susceptibility test.

Three basic functions of the working principle of Caritational Ultrasonic Surgical is introduced:ultrasonic emulsification, ultrasonic incise homeostasis and ultrasonic sterilization and debridement. As a new-style surgical equipment, it is widely used in clinical operations, upgrading interrelated medicine technology. The basic structure, working principle, main characteristics and clinical applications are introduced, thus redounding to broadening the knowledge of doctors and nurses in the safe operation of the machine.