Objective: To study the clinical manifestations of the head and neck angiosarcoma and the re-lationship of the staging with clinical treatment and prognosis. Methods: The clinical data of 21 patients with head and neck angiosarcoma treated in our hospital between January 1993 and January 2008 were retro-spectively analyzed. By studying the medical records of all patients and reviewing the related literatures, we discussed the clinical manifestations of these patients and the relationship of staging with clinical treatment and prognosis of head and neck angiosarcoma based on soft tissue sarcoma staging of AJCC2002' 6th. SPSS 17.0 software was used for statistical analysis. We calculated the survival rate using Kaplan-Meier method and compared the survival curves using log rank test. Results: Among these 21 cases, 10 were treat-ed with non-combined treatment, and the other 11 cases were treated with combined treatment. There were 6 stage Ⅰ cases, 3 stage Ⅱ cases, 1 stage Ⅲ case, and 11 stage Ⅳ cases. The 1-, 3-, 5- and 10-year total sur-vival rates were 72.2%, 41.3%, 27.5% and 13.8%, respectively. The average time of recurrence or metastasis was 4 months. Twelve cases had local recurrence (accounting for 57.1%), and 11 cases had distant metasta-sis (accounting for 52.4%). The metastatic sites included lymph node in 5 cases, lung in 4 cases, liver in 1 case, and bone in 1 case. Different treatment modalities (χ~2=8.31, P=0.004) and tumor staging (χ~2=9.74, P=0.002) were prognostic factors. Conclusion: There are no unified treatment strategies for angiosarcoma of the head and the neck. The overall prognosis is still not ideal. Biological treatment has been applied to clinical practice. Preoperative combined treatment has positive results. Tumor staging is an important factor affecting the prognosis. Surgery-based combined treatment can improve patient survival.

Objective To investigate the clinical effect of compound Qianglizhenxian pill on epilepsy. Methods 94 patients with epilepsy were treated with compound Qianglizhenxian pill, and every course lasted three months. After treatment, checking patients' electroencephalogram again, evaluating the clinical effect according to degrees and numbers of attack. Results After 12 months of treatment, 90.43% of patients got an obvious improvement, while 6.38% for better, 3.19% for validity and no invalid. Conclusions There is a great improvement for patients with epilepsy after taking the medicine. The effective control rate is 92.62% with no toxication on blood system, liver and kidney.

Objective To investigate clinical value of levels of CA125 and LPA as a panel for early diagnosis of ovarian cancer.Methods The levels of two tumor markers(CA125 and LPA)in serum were determined in 76 patients with ovarian cancer,35 patients with benign tumor and 29 healthy control.Results The results showed that the levels of two tumor markera in ovarian cancer patients were significantly higher than those in benign tumor patients and controls(P＜0.05).Butuo siguificant difforences was loud betwcen benigutumor patient and coatrols.Conclusion Combined detection of the two markers represent a potential biomarker for diagnosis of epithelial ovarian cancer because of its diagnostic accuracy in ovarian cancer case.

Objective To study the diagnosis, treatment and prognosis of mixed thyroid malignant tumors. Methods Clinical data of 7 cases with merged different histological types of thyroid malignant tumor treated from January 1977 to December 2006 were retrospectively analyzed. Results Merged different histologic types of thyroid malignant tumor accounted for 0. 14% of all thyroid malignant tumors treated during this period. Preoperative imaging and laboratory data had no specific value in the diagnosis of this merged different histologic types of thyroid malignant tumors. Radical resection in combination of hormonal therapy and 131I radiotherapy achieved a satisfactory result, though thyroid malignant tumor combined with thyroid cancer usually predict a poor prognosis. Conclusions Merged different histologic types of thyroid malignant tumor is a rare clinical entity, with the pathogenesis being obscure and no consensus of opinion on its nomenclature. The prognosis depends on the highest ～ade among an individual group of malignant tumors.

Objective To evaluate the effectiveness of repeated intravitreal conbercept injection in patients with macular edema (ME) of retinal vein occlusion (RVO),guided by optic coherence tomography (OCT).Methods It is a retrospective case study.Forty patients (40 eyes) diagnosed as ME secondary to RVO were enrolled in this study.There were 19 males (19 eyes) and 21 females (21 eyes),with the mean age of (53.58 ± 13.19) years and the mean course of 1.5 months.The best corrected visual acuity (BCVA),indirect ophthalmoscopy,fundus fluorescein angiography (FFA) and OCT were performed.The mean baseline of BCVA,central macular thickness (CMT) were 0.25 ± 0.18 and (509.48 ± 170.13) μm respectively.All the patients were treated with 10.00 mg/ml conbercept 0.05 ml (including conbercept 0.5 mg).Follow-up of these patients was 1 to 6 months after treatments,the BCVA,fundus manifestations,OCT were retrospectively observed by every month,the FFA was retrospectively observed by every 3 months.When there was retinal edema or CMT ≥ 50 μm by OCT during follow-up,those patients were retreated with intravitreal conbercept injection.The changes of the BCVA,CMT were evaluated before and after treatment.Meanwhile,complications in eyes related to medicine and treatment methods were evaluated too.Results At the 6 months,the BCVA was improved (increase≥2 lines) in 25 eyes (62.50％),stabilized (± 1 line) in 13 eyes (32.50％) and decreased 2 lines in 2 eyes (5.00％).Retinal hemorrhage and exudates were absorbed in most patients.FFA showed no fluorescein leakage in 1 1 eyes (27.50％),minor fluorescein leakage in 26 eyes (65.00％),and retinal capillary non-perfusion in 3 eyes (7.50％).OCT showed absorption of the subretinal fluid.The mean CMT were (235.20± 100.44) μm at 6 months.Intravitreal injection of conbercept was applied for 4 times in 8 eyes (20.00％),3 times for 18 eyes (45.00％),and 2 times for 14 eyes (35.00％).The mean number of intravitreal injection was 2.85 times.There were no ocular or systemic adverse events observed in all patients.Conclusion Intravitreal conbercept injection is an efficacy and safe treatment for the patients with ME of RVO guided by OCT.It can stabilize and improve the visual acuity.

Child ; Evidence-Based Medicine ; Humans ; Nephritis ; diagnosis ; etiology ; therapy ; Practice Guidelines as Topic ; Purpura ; complications ; diagnosis ; therapy

Educational Measurement ; Humans ; Inservice Training ; Pneumoconiosis ; diagnosis ; Reference Standards

Objective To evaluate the safety and effectiveness of vitrectomy combined with internal limiting membrane (ILM) tamping on macular hole and retinal detachment (MHRD) in highly myopic eyes.Methods 23 patients (23 eyes) were retrospectively reviewed,who were diagnosed as MHRD through examination of the ocular ftmdus,optic coherence tomography (OCT) and B-mode ultrasonography.There were 5 males (5 eyes) and 18 females (18 eyes).The mean age was (62.35 ± 8.28) years.The mean course of disease was 1.1 months.The logarithm of the minimum angle of resolution (logMAR) best-corrected visual acuity (BCVA) was 2.31 ± 0.72.The mean axial length was (28.66 ± 1.99) mm.All patients underwent 23G microincision vitrectomy.After vitreous gel and cortex were gently resected,the ILM around the edges of the macular hole was stained with indocyanine green,and was folded and pushed to fill the macular hole gently.Then silicone oil or C3F8 gas tamponade was applied in 18 eyes and 5 eyes,respectively.The silicone oil was removed after 3 months.The follow-up was 6 months.The BCVA,macular hole closure,retinal anatomical reattachment were retrospectively observed,and were used to evaluate the safety and effectiveness of the surgery.Results At the 6 months after surgery,the logMAR BCVA was improved to 1.13 ± 0.38,the difference was significant (t=l 5.33,P=0.00).The postoperative macular hole closure rate and retinal anatomical reattachment rate were 100％.There were no ocular or systemic adverse events observed in all patients.Conclusion Vitrectomy combined with ILM tamping is an effective and safe treatment for the high myopic eyes with MHRD.

Objective:To investigate the correlation between hyperreflective dots (HRD) and lipid levels and systemic inflammatory factors in patients with branch retinal vein occlusion (BRVO) or central retinal vein occlusion (CRVO).Methods:A cross-sectional clinical study. From December 2016 to June 2020, 118 eyes of 118 patients with retinal vein occlusion diagnosed in the Department of Ophthalmology, Central Theater Command Hospital of People's Liberation Army were included in the study. Among them, 67 cases of BRVO and 51 cases of CRVO were divided into CRVO group and BRVO group accordingly. Peripheral venous blood was drawn from the patients within 3 days after the eye examination to detect the percentage of neutrophils, monocytes, hypersensitive C-reactive protein (CRP), total cholesterol, triglyceride, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, and lipoprotein(a). The ratio of monocytes to high-density lipoprotein (MHR) was also calculated. The 3D OCT-2000 instrument from Topcon (Japan) was used to measure the central retinal thickness (CRT) and the numbers of HRD. According to the different distribution position, HRD is divided into inner retina HRD, outer retina HRD, and total retina HRD.The independent sample t test was used to compare the continuous variables of the two groups, and the χ2 test was used to compare the rates. The correlation between HRD counts and blood lipid levels and peripheral blood inflammation indicators in patients with different types of RVO was analyzed by Spearman correlation analysis. Results:The average age of patients in the BRVO group and CRVO group were 60.1±9.5 and 53.6±15.7 years, respectively; the prevalence of hypertension was 53.7% (36/67) and 24.5% (12/51), respectively. Comparison of age ( t=2.634) and prevalence of hypertension ( χ2=11.298) between the two groups showed statistically significant differences ( P<0.05). Gender ( χ2=2.000), course of disease ( t=-1.101), prevalence of diabetes ( χ2=1.315), eye category ( χ2=1.742), baseline visual acuity ( t=1.792), intraocular pressure ( t=0.708), CRT ( t=1.318), and peripheral blood include the percentage of neutrophils, the absolute number of monocytes, CRP, total cholesterol, triglycerides, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, lipoprotein(a), MHR ( t=-0.559, 1.126, 0.579, 1.299, -0.134, 0.556, 1.230, -0.267, 0.483), the difference was not statistically significant. Correlation analysis showed that the HRD counts in the outer retina of BRVO patients were positively correlated with total cholesterol ( r=0.289, P=0.036); the HRD in the inner retina and total HRD counts of CRVO patients were positively correlated with CRP ( r=0.406, 0.343; P=0.004, 0.014). There was no correlation between HRD counts and percentage of neutrophils, absolute number of monocytes, triglycerides, high-density lipoprotein, low-density lipoprotein, lipoprotein(a), and MHR ( P>0.05). Conclusion:The number of HRD is related to the blood lipid level in BRVO patients and CRP (an inflammatory index) in CRVO patients.

Objective To analyze levofloxacin resistance in Helicobacter pylori (Hp) and the sequence difference of gyrA gene in levofloxacin resistance and sensitive Hp strains. To explore the function of gyrA gene mutation in the development of levofloxacin resistance Hp strain.Methods From July 2007 to December 2008 in Department of Gastroenterology, Jinhua People hospital of Zhejiang Province, the gastric mucosa from gastroscopy biopsy of chronic gastritis and peptic ulcer patients were cultured in Hp selective medium under microaerobic condition at 37 degrees for three to five days. The Hp strains were isolated and identified by oxidase test, catalase test,urease test and UreA gene detecting. The levofloxacin susceptibility was determined by E-test and then resistance and sensitive strains were screened. The genomic DNA of Hp strains was isolated. The gyrA gene was amplified by PCR and the sequences were analyzed. Results 38 clinical isolated Hp strains were passed the levofloxacin susceptibility E-test, among those the minimum inhibitory concentration (MIC) of 12 strains was over 1.0 μg/ml, the percentage of resistant strain was 31.58%, while the sensitive stains was 68.42%. The gyrA gene sequence result indicated 10 resistant strain with 261, 271 and 272 10 site mutation, 2 strains with C261A mutation, one strain with C261G mutation, two strains with G271A mutation, 2 strains with A272G mutation, 2 strains with C261A,G271T andA272G mutation, 1 strain with C261G and A272G mutation. However, no mutation sites were found in 26 sensitive strains. Conclusion The rate of levofloxacir-resistance in isolated clinical Hp strain was high. The drug-resistance was associated with 261,271 and 272. site mutation of gyrA gene.