Objective: To improve the understanding of the clinical feature and early diagnosis of relapsing polychondritis(RP). Method: Eleven patients with RP were analyzed retrospectively and the reported literatures were reviewed. Result: Nine cases had initial involvement of auricular cartilage while two polyarthritis. The treatment of 2RP patients with respiralory tract involvement was invalid and 1 patient died. Nine cases were initially misdiagnosed, with a misdiagnosis rate of 81.82%. Conclusion: RP involves cartilage and connective tissue. The prognosis with respiralory tract involvement is poor. RP is a sort of paroxysmal and progressive inflammation involving cartilages all over the body with a variety of clinical manifestations. Early diagnosis of RP is based on full understanding of its clinical features.

AIM:To explore the clinical value of combined detection of C-reactive protein ( CRP ) , erythrocyte sedimentation rate ( ESR) and white blood cell ( WBC) count in patients with ocular syphilis.
METHODS:Dates of CRP, ESR, WBC, TPPA and RPR of 51 ophthalmopathy patients caused by syphilis and 50 normal control from Jan. 2012 to Dec. 2015 in eye hospital were recruited and analyzed statistically.
RESULTS:The positive rates of CRP, ESR and WBC of oculopathy patients were 16%, 18% and 39%, respectively, which were higher than those in the control group. In patients group, the positive rate of ESR was higher than CRP and WBC. There were no obvious relationships between RPR titers and positive ratios of CRP, WBC and ESR.
CONCLUSION: The blood level of CRP, WBC and ESR may have certain help in estimating and monitoring condition of patients with ocular syphilis.

Objective To compare the differences between state-owned hospitals and private-funded hospitals in Shanghai on the introduction and application of hospital marketing conception. Methods Questionnaire and interviews were conducted to reflect understandings in marketing conception,advertisements,hospital brand,customers' sense of satisfaction,etc. Results State-owned hospitals were less concerned in marketing conception compared with their private counterparts,even less sufficient in marketing input or management. Conclusion The state-owned hospitals should update their conception and enhance their ability of marketing management.While the private hospitals need to maintain the moderation of marketing and deal with the relationship among marketing,profit and development properly.

Objective To explore the values of diffusion-weighted imaging(DWI)and apparent diffusion coefficient(ADC)measurements in various lesions of multiple sclerosis(MS).Methods Sixty patients with clinically diagnosed remitting-relapsing MS(RRMS)were included to undergo conventional brain MRI and DWI scans.the lesions were included when the diameter was more than 5 mm.mean ADC values were measured for various lesions of MS.The statistical analyses were performed to determine the differences of mean ADC values among various lesions of MS.and to compare the correlation between ADC values of lesions and Expanded Disability Status Scale(EDSS)scores.Results (1)The ADC value of hypointense lesions was significantly higher than that of isointense lesions(F=55.90,P<0.05),the ADC values were(127.5 ±9.3)×10-5mm2/s and(95.7 ±6.3)×10-5mm/s respectively.The nodular enhancing lesions had a significantly lower ADC value than the ring-enhancing lesions(F=64.18,P<0.01).the ADC values were(114.7 ±12.3)×10-5mm2/s and(140.7 ±11.0)×10-5mm2/s respectively.The ADC value of confluent lesions was substantially higher that of discrete lesions(t=9.04,P<0.01).the ADC values were(141.4±6.5)×10-5mm2/s and(105.4±13.9)×10-5mm2/s respectively.(2)No correlation between ADC of lesions and EDSS scores was found(r=0.35,P>0.05).Conclusion DWI and quantitative ADC are useful to explain the pathological changes in different lesions and to monitor the disease duration of MS.

Objective To investigate the brain magnetic resonance imaging(MRI)findings in 33 patients with neuromyelitis optica(NMO).Methods Patients who fulfilled the latest diagnostic criteria of NMO and whose brain MRI did not satisfied with diagnostic criteria of multiple sclerosis(MS)were enrolled.All the patients underwent brain MRI and spinal cord scannings and subsequent images analysis.Results Thirty-three patients with NMO were included to study.Five out of 33(15.2%)patients did not have brain parenchymal abnormalities,28 out of 33 patients(84.8%)were detected to have brain abnormal findings.Brain parenchymal lesions were well-defined in 22 patients(66.7%),no non-specific or atypical brain parenchymal lesions were found in the supratentorium or infratentorium in the other 6 cases(18.2%).However,brain MRI disclosed macroscopic,symmetrical diffuse FLAIR and T2-visible hyperintensity in deep white matter.Fifteen cases had more than one lesion(≥2 lesions),and the other 7 cases had single lesion.Supratentorial lesions were mostly punctate or small dots in nonspecific hyperintensity in juxtacortical,subcortical and deep white matter regions,a few were atypical patches.In the infratentorium,brainstem was an easily involved region(14/33,42.4%),especially in medulla(7/33,21.2%).Conclusions Brain MRI abnormalities are common in Chinese NMO,and brain lesions do not exclude the diagnosis of NMO.The observations of brain lesions are helpful to improve and revise diagnostic criteria of NMO.

Objective To investigate quantitatively the thermal sensation characteristics of the patients with facial palsy and the value of quantitative thermal test (QTT) in prognostication.Methods The QTT threshold of the fore ear and cheek of 30 patients with peripheral facial palsy was tested,their facial nerve conduction velocity was measured,and House-Brackmann facial nerve grading system was used to estimate facial nerve function at 2～3 weeks,a month,two months and half a year post onset.Results It was found that 12 out of 30 patients had abnor- mal QTT threshold value;the majority of them suffered from herpes virus and diabetes.In those with abnormal QTT, 8 were with diabetes mellitus (account for 66.7%),3 with partial shingles (account for 25%),and 1 with positive serum virus infection (account for 8.3%).Those with normal QTT were significantly different from those with abnor- mal QTT,with regard to the House-Brackmann rating scores after 2 and 6 months post onset (P

OBJECTIVETo evaluate the therapeutic effect on pain in the dressing change after perianal abscess surgery treated with warm suspending moxibustion at Changqiang (GV 1).

METHODSOne hundred and sixty patients were randomized into a moxibustion group and a far-infrared therapy group, 80 cases in each one. In the moxibustion group, the warm suspending moxibustion at Changqiang (GV 1) was applied. In the far-infrared therapy group, the infrared ray was radiated at Changqiang (GV 1). The treatment started in 10 min after dressing change in the two groups. Totally, 8 treatments were required. The time requirement being equal to or less than 2 score in the assessment face scale (AFS), the case number of pain relief in 10 min after treatment and the intention of the two therapies after everyday dressing change were observed in the patients of the two groups.

RESULTSIn the moxibustion group, the time of pain relief was shorter than that of the far-infrared therapy group [(11.5 +/- 3.9) min vs (17.8 +/- 3.8) min on the 1st day; (9.4 +/- 3.6) min vs (15.2 +/- 4.3) min on the 2nd day; (7.8 +/- 2.7) min vs (14.3 +/- 3.2) min on the 3rd day; (6.4 +/- 3.3) min vs (10.5 +/- 2.9) min on the 4th day; (5.9 +/- 2.9) min vs (11.2 +/- 1.9) min on the 5th day; (5.3 +/- 2.2) min vs (8.8 +/- 2.3) min on the 6th day; (5.4 +/- 1.8) min vs (9.2 +/- 2.1) min on the 7th day; (5.1 +/- 1.4) min vs (9.5 +/- 2.6) min on the 8th day, all P < 0.05]. The case numbers of pain relief in 10 min after treatment were 74 cases, 75 cases, 77 cases and 78 cases from the 1st to the 4th day separately in the moxibustion group, which were much more than 63 cases, 65 cases, 68 cases and 69 cases in the far-infrared therapy group (all P < 0.05). The treatment intention scores in the moxibustion group were better than those in the far-infrared therapy group (all P < 0.05).

CONCLUSIONThe warm suspending moxibustion at Changqiang (GV 1) relieves pain rapidly in the dressing change of much more patients after perianal abscess surgery in much shorter time as compared with the far-infrared therapy. Moreover, the patients have more expectation to be treated with moxibustion therapy.

Abscess ; surgery ; Adolescent ; Adult ; Aged ; Anus Diseases ; surgery ; Female ; Humans ; Male ; Middle Aged ; Moxibustion ; Pain, Postoperative ; therapy ; Young Adult

OBJECTIVETo explore the effect of Bushen Huoxue Compound (BHC) on lactate dehydrogenase (LDH) leakage, expressions of vascular endothelial growth factor (VEGF) and VEGF mRNA in retinal Muller cells under high glucose condition or advanced glycosylation end products (AGEs) condition by using serum pharmacological method.

METHODSThe retinal Müller cells of 5-7 days post-natal Sprague Dawley (SD) rats were cultured with modified enzyme-digestion method. Purified retinal Muller cells were cultured in normal conditions, high glucose condition (50 mmol/L) or AGEs (50 mg/L and 100 mg/L) conditions, and BHC-containing serum was added to culture medium. The LDH leakage and VEGF expressions were measured by enzyme-linked immunosorbent assay (ELISA). In addition, the relative expression of VEGF mRNA was tested by reverse transcription polymerase chain reaction (RT-PCR).

RESULTSCompared with the normal control group, expressions of VEGF and VEGF mRNA were significantly increased in the high glucose group, the low dose AGEs group and the high dose AGEs group (all P < 0.01). The LDH leakage was obviously increased in the high dose AGEs group, when compared with the normal control group and the high glucose group (P < 0.01). The LDH leakage, expressions of VEGF and VEGF mRNA were obviously decreased by BHC-containing serum both in high glucose and AGEs conditions (P < 0.05, P < 0.01). BHC-containing serum had no significant effect on the LDH leakage and expressions of VEGF and VEGF mRNA in normal conditions (P > 0.05).

CONCLUSIONSAGEs intervention could obviously lower the stability of Müller cell membrane. Up-regulated expressions of VEGF and VEGF mRNA in cultured Müller cells could be induced by AGEs or high glucose. BHC-containing serum could stabilize the stability of Müller cell membrane, inhibit the transcription of VEGF mRNA and decrease the protein expression of VEGF, which might be one of important mechanisms for preventing and treating diabetic retinopathy.

Animals ; Cells, Cultured ; Diabetic Retinopathy ; Drugs, Chinese Herbal ; pharmacology ; therapeutic use ; Ependymoglial Cells ; Glucose ; L-Lactate Dehydrogenase ; RNA, Messenger ; Rats ; Rats, Sprague-Dawley ; Vascular Endothelial Growth Factor A

Background Recently,whether the epithelial flaps should be removed or preserved during the Epi-LASIK and its affection on clinical results are concerned.Objecfive This system analysis was to evaluate and compare the clinical effectiveness between on-flap Epi-LASIK and off-flap epi-LASIK for myopia. Methods A systematic literature retfieval was conducted in the MEDLINE,EMBase,Coehrane Library,CBM disc,CNKI from 2003 through 2009.The possible differences in reepithelization time,pain sensation,and haze after surgery were compared between on-flap and off-flap Epi-LASIK for myopia.The statistical analysis was performed using a RevMan 4.2 software.The data was extracted,and the methodological quality was evaluated by two reviewers independently with weighted mean difierence(WMD)for the effectiveness analysis and odds ratio(OR)for counting variable.The quality of included literature was scored according to the Jadad Scale. Results A total of 8 studies involving 251 patients(502 eyes)were included in the meta-analysis.Of these eight studies.five studies were randomized clinical trials and the other three studies were retrospective cohort studies.Compared with on-flap Epi-LASIK group,off-flap Epi-LASIK group had a better postoperative outcome in the mean reepithelization time(WMD=1.32,95％CI-1.82to-0.82,P<0.01)and pain scores at 3,5 day(WMD=-O.99,95％CI-1.71 to-0.28,P(0.01)(WMD=-0.94.95％CI-1.35 to-0.54,P<0.01)after surgery.No significant difierenees were found in the eye numbers of haze at 1 month(OR=0.62,95％C1 0.34 to 1.12,P=0.11),3 months(OR=0.70,95％C1 0.31 to 1.55,P=0.38)and 6 months(OR=1.14,95％C1 0.58 to 2.26,P=0.71)between these two types of operation.The pain scores at the first day after surgery was not significantly different between these two groups(WMD=-0.17,95％CI -0.55 to 0.20,P=0.37). Conclusion The effectiveness of off-flap Epi-LASIK is superior to on-flap Epi-LASIK for myopia.Some high-quality randomlizd and control studies are needed for the further clinical evaluation.

Background Biometry of the anterior ocular segment parameter is very important for the diagnosis and treatment of glaucoma and ocular injury as well as measurement of intraocular lens(IOL).Objective This study was to compare the differences in the anterior chamber depth(ACD) and the central corneal thickness (CCT) between Sirius and Pentacam and evaluate the agreement of these two measurement methods.Methods The ACD and the CCT of 38 right eyes from 38 health volunteers aged 23- 32 years were measured with both Pentacam and Sirius.Three times of measurement were pedormed on each eye for each method to obtain the average values.The repeatability and agreement from each method were assessed as intraclass correlation coefficient( ICC ) and coefficient of variation(CV) and the agreement between these two methods were evaluated using Bland-Altman mode.ResultsThe mean ACD value was( 3.18±0.21 ) mm from Pentacam with the ICC 0.995 and CV 0.066.The mean ACD value from Sirius was (3.22 ±0.21 )mm with the ICC 0.996 and CV 0.065.The difference value in ACD between two methods was 0.04 mm,showing a significant difference( t =-6.225,P＜0.05 ) and a positive correlation (r=0.977) between two methods.The 95％ limit of agreement was( -0.04-0.13)mm within 1 standard difference (SD) of the mean value( ±0.21mm),which was acceptable for clinical measurement.The CCT was( 535±33 )μm from Pentacam with the ICC 0.994 and CV 0.062.The CCT was(537±36)pm from Sirius with the ICC 0.999 and CV 0.067.The difference value in the CCT between two methods was about 2 μm,presenting a in significant difference ( t =1.771,P＞0.05 ) and positive correlation ( r =0.985 ).The 95 ％ limit of agreement was ( - 11.64-15.65 ) μm within 1 SD of the mean value( ±34.27 pm),which was acceptable for clinical measurement.ConclusionsSirius and Pentacam show good agreement in the measurement of ACD and CCT.The two methods offer an alternative choice for the biological measurement of the anterior ocular segment.