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.

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.

Objective To evaluate the clinical results of transjugular intrahepatic portosystemic shunt(TIPS)creation with 8 mm diameter covered stent-graft. Methods Ninteen concecutive patients with portal hypertension underwent TIPS creation with 8 mm diameter covered stent-graft for variceal bleeding and/or refractory ascites. Evaluation of the results through observing the improvement of clinical symptom and periodic follow up was carried out. Results Technical success achieved in all patients reaching 100% without related complications. Median follow-up was 13.5 months(ranged, 2.7 - 28 months). One case(1/19,5.3%)showed aggravation of hepatoencephalopathy and 2 others(2/19, 10.5%)revealed rebleeding. The primary patency rate was 100%(16/16)after 6 months, and 87.5%(7/8)after 12 months. Improvement or resolved rate of ascites was 66.7% (12/18). Conclusion TIPS creation with 8 mm diameter covered stent-graft can degrade the incidence of hepatic encephalopathy, improve the rate of TIPS patency and keeping the effective shunt flow.

Male mice of Kunmlng strain were infected with 10 000 tachyzoites intraperitoneally. 2 hours after infection the mice were divided into 2 groups and administered 5 % of amylurn and 200 mg/kg of artemether by gavage for 8 consecutive days. The ultrastructural enzyme cytochemical studles on cytidine monophosphatase (CMP ase) and glucose-6-phosphatase (G-6-P-ase) of the parasites were carried out. CMP-ase was found scattered in the lysosomes of the parasites as well as in the macrophages. No differences were observed in the localization and intensity of CMP-ase activity between the nontreated and treated with drug parasites. G6-P-ase was found surrounding the parasite membrane and scattered in the parasitophorous vacuole in the nontreated parasites. After treatment with artemether, the intensity of G-6-P-ase activity was decreased compared with nontreated control parasites. It is suggested that artemether may exert some action on the G-6-Patase of T. gondii and thus influence the energy metabolism of the parasite.

AlM:To observe the clinical effect of slack skin excision combined with orbicularis oculi muscle shortening and orbicularis muscle shortening in the treatment of elderly patients with lower eyelid entropion, and provide the reference for the clinical treatment.METHODS: Eighty-two ( 126 eyes ) clinical diagnosis’s elderly patients with lower eyelid entropion were collected from our department, then randomly divided into excised relaxing skin and orbicularis oculi muscle shortening treatment group and the orbicularis muscle shortening treatment group. The general data of the two groups, long term curative effect and short-term curative effect were compared.RESULTS:The age, sex, proportion of patients with the first time operation, course of disease were no statistical significance between the observation group and the control group (P>0. 05). The short-term effective rate of the observation group was 95. 2%, while the short-term effective rate of the control group was 77. 8%, the short-term efficiency differences between the two groups was statistical significance (χ2=4. 100, P=0. 043). The long-term cure rate of the observation group was 82. 5% ( 34 cases, 52 eyes), recurrence rate was 17. 5% (7 cases, 11 eyes), while the cure rate of the control group was 60. 3%(25 cases, 38 eyes), recurrence rate was 39. 7% (16 cases, 25 eyes) , the difference of long term cure rate was statistical significance between the two groups (P<0. 05).CONCLUSlON: The clinical curative effect of slack skin excision combined with orbicularis oculi muscle shortening in the treatment of senile inferior entropion is better than orbicularis muscle shortening operation, recommending application in the clinical.

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 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.