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.

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.

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.

Objective To observe the change of serum anti-brain antibodies after cardiopulmonary resuscitation,and investigate the clinical significance.Methods A total of 27 cases of cardiopulmonary resuscitation after cardiac arrest patients with success and survival more than 12 weeks were divided into two groups according to Glasgow Coma Scale (GCS) score:mild and moderate group with GCS score ≥ 8 scores (12 cases) and severe group with GCS score≤7 scores (15 cases).The serum anti-brain antibody levels at 3,7 days and 2,3,4,12 weeks after recovered in the spontaneous circulation (ROSC) was compared between two groups,and compared with control group (15 cases of healthy persons).Results The serum anti-brain antibody levels at 3,7 days and 2,3,4,12 weeks after ROSC were significantly higher than those in control group [(1.34 ± 0.23),(1.30 ± 0.27) kU/L vs.(0.28 ± 0.05) kU/L,(1.38 ± 0.33),(1.44 ± 0.30) kU/L vs.(0.28 ±0.05) kU/L,(1.44 ±0.31),(1.51 ±0.33) kU/L vs.(0.28 ±0.05) kU/L,(1.53 ±0.27),(1.67 ±0.36) kU/L vs.(0.28 ±0.05) kU/L,(1.72 ±0.25),(1.93 ±0.44) kU/L vs.(0.28 ±0.05) kU/L,(1.98 ±0.45),(2.15 ±0.52) kU/L vs.(0.28 ±0.05) kU/L],and there were significant differences (P＜ 0.01).The serum anti-brain antibody levels in severe group were significantly higher than those in mild and moderate group,and there were significnat differences (P ＜ 0.05).Conclusions The serum anti-brain antibody levels after cardiopulmonary resuscitation rise significantly.Anti-brain antibody may be used as a biochemistry marker to judge degree and prognosis of brain injury with patients after cardiopulmonary resuscitation.

Objection]To study the clinical effect of self-prescribed jianpihuazhuoxiaoyu decoction in treating the patients with non-alcoholic liver of fat. [Methods]45 patients were treated with self-prescribed Jianpihuazhuoxiaoyu decoction in treatment group and other 45 patients with Polyene Phosphatidylcholine Capsules and Ursodeoxycholic Acid. Observe the patients'body mass index(BMI),radiological changes,liver function(AST/ALT) and lipids(TG/TC/HDL/LDL). [Results] The total effective rates were 91.3%,82.6% respectively, compared with the control group,the treatment group significantly improved liver function,lipid content decreased,obesity weight was effectively controlled and reduced,sonogram also showed improvement in the texture of the liver,compared with control group there were significant differences(P<0.05),difference was statistically significant.

The changes of the pulmonary ultrastructures of 15 dogs of respiratory distress syndrome (RDS)induced with intravenous injections of different doses of oleic acid under different methods of management (nontreated and treated with scopolamine) were observed after the animals were killed 6 hours and 24 hours after injection. The changes were similar on all the specimens except that those of the dogs killed at the earlier interval were less severe. The nontreated dogs and the dogs treated with scopolamine slso showed similar changes, which indicates that scopolamine is useless in treating the RDS produced by oleic acid.Correlating to the accumulation of neutrophils in the capillaries, the authors suggested that the injury induced by oleic acid to the capillary endothelium, besides the chemical toxic action of the drug, was also due to the complement and the toxic oxygen radicals produced by neutrophils.It was found that the hyaline membrane consisted of plasma protein granules in some cases and fibrin in others but no necrosis of the epithelial cells underneath the hyaline membrane was seen. Some authers suggested that the different constituents of the hyaline membrane were resulted from the precipitation of the edema-tous fluid protein on the surface of alveoli, but this suggestion could not be confirmed either by the electron microscopic study of othrs or by ours.There was a large amount of surfactant found in the intraalveolar space and vacuolation was seen, which indicates that no reduction of surfactant occurred in RDS but there was some alteration of its nature resulting in the loss of its activity.

Extracellular purine and pyrimidine nucleotides produce the biologic effects involved in activating P2 receptors.P2 receptors are divided P2X and P2Y receptor subtypes.There is molecular and functional evidence for widespread expression of P2X and P2Y receptor subtypes in osteoblasts,osteoclasts and cartilage cells of the skeletal system.Working through P2 receptors,ATP and other nucleotides released into the bone microenvironment regulate formation and activity of bone and cartilage,including development,growth,turnover and repair of biological functions.The release of nucleotides is increased under inflammatory conditions,and localized ATP release could stimulate formation and activation of osteoclasts.Abnormalities of bone remodelling can produce a variety of skeletal disorders.P2 receptors play an important role in the inflammatory disease of bone.

The current prevalence of myopia has been as high as 27.65%～53.80%among adolescents in Chinese schools.The major reasons are too much near-work activity and lack of outdoor activity for a long time.In order to reduce the prevalence of myopia in Chinese adolescents,we suggest that Chinese students should have 3.5 hours outdoor activity everyday,including 30 minutes travel between home and school,1 hour outdoor activity between classes,1 hour outdoor sport class at school,and 1 hour outdoor activity after school.