AIM: To dynamically observe the feeling change of the photorecrptor layer in the eyes with acute central serous chorioretinopathy ( CSCR ) krypton laser treatment by fourier - domain optical coherence tomography ( FD - OCT), and to study their correlation with the chang of vision.
METHODS: This is a retrospective case series study. The clinical diagnosis of 52 patients with monocular initial onset of central serous chorioretinopathy, krypton laser photocoagulation before treatment, after 1, 2, 4, 6, 8wk, 6mo, FD - OCT were performed to observe the morphological changes characteristic of photoreceptor layer and changes in vision.
RESULTS: After 1wk treatment, all cases were improved; 2wk, 6 cases were cured; 4wk, 38 cases were cured; 6wk, 41 cases were cured; 8wk, 45 cases were cured, the OCT showed macular retinal neuroepithelial layer ( RNL ) from fully absorbed; 6mo with the same 8wk. Before and after treatment in patients with best corrected visual acuity and from the height difference between the macular region of RNL was statistically significant (P<0. 05), there was a correlation between the changes of visual acuity after treatment and the macular detachment of RNL height (P<0. 05), Photoreceptor layer of complete and incomplete best corrected visual acuity difference was statistically significant (P<0. 01).
CONCLUSION: FD-OCT can dynamicaly observed acute central serous chorioretinopathy krypton laser treatment of photoreceptor ultrastruture changes. Photoreceptor layer of complete and incomplete best corrected visual acuity difference was statistically significant (P<0. 01).

Objective: To explore the relationship between prevalence of atrial fibrillation (AF), iskhemia stoke and CHA2DS2-VASc score in patients≥65 years in order to provide prevention and treatment basis in clinical practice. Methods: A total of 5016 patients admitted in our hospital from 2013-10 to 2015-10 were enrolled. The patients were divided into 2 groups: AF group, n=437 and Non-AF patients, n=4579; according to age, the patients were further assigned into 4 subgroups as <65 years subgroup, (65-74) years subgroup, (75-84) years subgroup and ≥85 years subgroup. The risk factors for AF occurrence were retrospectively studied. Results: Compared with the Non-AF group, the patients in AF group had the elder age and more male gender, both P<0.001; more patients combining with hypertension, coronary artery disease (CAD), diabetes, sick sinus syndrome and rheumatic heart disease, all P<0.001. Age, male gender, CAD, sick sinus syndrome and rheumatic heart disease were the independent risk factors for AF occurrence. Compared with Non-AF group, AF group showed the higher prevalence rate of ischemic stroke and the elder onset age, both P<0.01. For non-valvular AF, the ratio of patients with CHA2DS2-VASc score≥2 was higher than those with CHA2DS2-VASc score<2 and the rate of anticoagulant therapy was decreasing by age increasing, all P<0.001. Conclusion: Age, male gender, CAD, sick sinus syndrome and rheumatic heart disease were independently related to AF occurrence. Non-valvular AF patients had the higher risk for ischemic stroke than non-AF patients, anticoagulation therapy should be conducted at the early stage.

Objective: To explore the relationship between lower extremity atherosclerosis disease (LEAD) and cardiovascular risk factors in elder people.
Methods: A total of 700 consecutive patients receive lower extremity Color Doppler ultrasound in our hospital from 2013-05 to 2014-11 were investigated. The patients were divided into 3 age groups: Young and middle group, n=83, Elder group, n=377 and Senile group, n=240. Based on ultrasound scoring system, the patients were divided into 4 groups: Normal group, n=112, Mild atherosclerosis (Mild) group, n=81, Moderate group, n=466 and Severe group, n=41. The cardiovascular risk factors among different groups were compared.
Results: Multivariate unconditional logistic regression analysis showed that age, smoking, history of diabetes, uric acid (UA), ankle-brachial index (ABI) were the independent risk factors for LEAD (B=0.144, 1.496, 0.963, 0.004, -2.510; 95% CI: 1.120-1.190, 2.257-8.824, 1.456-4.716, 1.001-1.007, 0.012-0.534;P=0.000, 0.000, 0.001, 0.006, 0.009 respectively. Ordinal logistic regression analysis indicated that age, male gender, smoking, ABI, UA, history of hypertension were related to the severity of atherosclerosis (B=0.130, 0.737, 0.592, -3.365, 0.003, 0.735; 95% CI: 0.097-0.162, 0.222-1.252, 0.052-1.132, -4.674 to -2.055, 0.001-0.005, 0.313-1.157;P=0.000, 0.005, 0.032, 0.000, 0.005, 0.001 respectively. Compared with Young and Middle groups, Elder and Senile groups had increased rates of moderate and severe arteriosclerotic lesions; compared with Elder group, Senile group presented the higher incidence of moderate and severe lesions, allP<0.01. With elevated age, the severity score of LEAD increased accordingly,P<0.01.
Conclusion: Lower extremity atherosclerosis lesions were more severe in elder patient, and it was particularly severe in senile patients.

China ; epidemiology ; Humans ; Neoplasms ; epidemiology ; prevention & control ; Registries

Objective To investigate the current status of healthcare-associated infection(HAI)and antimicrobial usage,so as to provide a scientific basis for improving the management of HAI. Methods A cross-sectional survey was conducted by combination of bedside visiting and medical records reviewing,HAI were investigated among all hospitalized patients between 0:00 and 24:00 on August 21 ,2014.Results A total of 2 216 patients were investiga-ted,the prevalence rate of HAI was 4.83% ,the case infection rate was 5.14% ;the main infection site was lower respiratory tract(63.16% ),antimicrobial usage rate was 39.71% ,the proportion of prophylactic and therapeutic use of antimicrobial agents was 32.27% and 61 .71% respectively.596 patients received therapeutic antimicrobial use,specimen detection rate was 56.21% (n= 335),the detection rate of pathogens was 15.52% (n= 52). The ma-jor detected bacteria were Pseudomonasaeruginosa,Klebsiellapneumoniae,Acinetobacterbaumannii,Escherichia coli,and Stenotrophomonasmaltophilia.Conclusion HAI prevalence survey is helpful for realizing the occurrence of HAI,respiratory tract is the main infection site,gram-negative bacteria is the major pathogen,management of prophylactic use of antimicrobial agents is the focus of HAI management.

Objective To observe the changes of islet cell apoptosis and oxidation-antioxidation before the transplantation, and to explore the pathways of islet protection. Methods Fifteen human pancreases were perfused with the Hanks solution containing collagenase, then digested and isolated. During the procedure, islet cell apoptosis was detected by TUNEL, SOD and MDA in the pancreas were measured by colorimetric method, and the morphologic changes were observed by H-E staining and dithizone staining. Results In the procedure of human islet isolation, especially in the stage of digestion, the apoptosis of human islet cells occurred. In the stages of perfusion and digestion, the MDA contents reached the high levels (6. 18 ± 2. 38 and 9. 21 ± 2. 75 umol/mg protein respectively),and the structures of the islets and tissues around the islets were damaged. Conclusion In the stages of perfusion and digestion, apoptosis of islet cells can be caused by oxidation. It suggests that antioxidation is a pathway for protection of islets before transplantation.

Objective: To assess the autonomic nervous impairm ent in chronic renal failure and its related factors. Methods: F orty adults were randomly selected including in-patients in the nephrology ward and healthy subjects for routine medical examination. The subjects were classifi ed into 4 groups: normal subjects(NS)，normal renal function，nitremia， uremic patients. The time domain measurements of heart rate variability(HRV) and ambula tory blood pressure were analyzed simultaneously . Results: (1) There were significant differences as compared with normal subjects in the time domain measurements of HRV in uremic group. It decreased significantly when the patient was defined as end stage chronic renal failure. There were no significan t differences between NS，normal renal function group and nitremic group. (2) Ti me domain measurements of HRV was significantly lower(P<0.05) in uremia with renal hypertension than in uremia with normal blood pressure. Conclusio n: (1) Patients with chronic renal failure(HRV) have their cardiac auton omic nervous system impaired conspicuously in the course of uremia. (2) There is a positive correlation between cardiac autonomic nervous system impairment in p atients with CRF and renal function levels. Uremia itself is an independent fact or for the impairment of cardiac autonomic nervous system. (3) Renal hypertensio n with uremia may intensify the impairment of cardiac autonomic nervous system of the patients.

Objective To investigate the change of serum ghrelin and sex hormones levels in girls with precocious puberty . Methods 87 girls with precocious puberty were divided into the simple premature thelarche (SPT ) and central precocious puberty (CPP) groups according to the results of gonadotropin releasing hormone(GnRH) stimulation test ,size of ovary and uterus ,and de-velopmental status of the secondary sex characteristics ,with 34 age-matched healthy girls as control group .The serum ghrelin level was quantitatively measured by enzyme-linked immunosorbent assay (ELISA) ,luteinizing hormone(LH) ,follicle stimulating hor-mone(FSH) ,estradiol(E2) ,progesterone(PRGE) ,prolactin (PRL) ,testosterone (TSTO) and LH and FSH stimulated by GnRH after 30 ,60 ,90 min were measured by chemoluminescence technique .Results The ghrelin level in the CPP group was significantly higher than that in the control group(P<0 .05);there was no statistically significant difference between the SPT group and the control group and between the CPP group and the SPT group (P>0 .05) .The 5 indexes of sex hormone (LH ,FSH ,E2 ,PRL , PRGE) in the CPP group were significantly higher than those in the SPT group and the control group (P<0 .05) ,but no statisti-cally significant difference existed between the SPT group and the control group (P>0 .05);the TSTO level had no statistically sig-nificant difference among 3 groups(P>0 .05) .Conclusion The serum levels of ghrelin and 5 indexes of sex hormone (LH ,FSH , E2 ,PRL ,PRGE) in girls with CPP are significantly increased .

Objective To assess the clinical value of serum uric acid levels in patients with acute ST-elevation myocardial infarction(STEMI).Methods A total of 502 consecutive patients with STEMI were enrolled from January 2005 to December 2010 for retrospective study.The level of serum lipid,echocardiographic data and in-hospital major adverse cardiovascular events(MACE)in patients with hyperuricemia(n =119)were compared with those in patients without hyperuricemia(n =383).The relationship between the level of serum uric acid and the degree of diseased coronary artery was analyzed.All data were analyzed with SPSS version 17.0 software to make t test and x2 test and Pearson correlation analysis.Results Serum uric acid level was positively correlated with serum triglyceride level.Compared with non-hyperuricemia patients,hyperlipidemia was more commonly found among hyperuricemia patients (43.7％ vs.33.7％,P =0.047),and serum triglyceride level was significantly higher in hyperuricemia patients[(2.11 ± 1.24)mmol/L vs.(1.78 ± 1.38)mmol/L,P =0.014].But a significant association between serum uric acid level and one or more diseased vessels was not observed(P ≥ 0.05).Leftventricular end-diastolic diameter(LVEDd)was found to be larger in hyperuricemia patients than non-hyperuricemia patients[(53.52 ±6.19)mm vs.(52.18 ±4.89)mm,P =0.041].Higher incidence in left systolic dysfunction and diastolic dysfunction was discovered in hyperuricemia patients(36.4％ vs.15.1％,P ＜0.01; 68.2％ vs.55.8％,P =0.023).Also,hyp-eruricemia patients had more in-hospital MACE(P ＜ 0.05).Conclusions Serum uric acid level is positively correlated with serum triglyceride level,but not with the severity of coronary artery disease.Hyperuricemia patients after STEMI tended to have higher incidence in left systolic dysfunction and diastolic dysfunction,and have more in-hospital MACE.

Objective To explore the differences in the strength of the nodes in the brain white matter weighted networks between the male patients with paranoid schizophrenia and male healthy controls, and to analysis the integrity of the white matter fiber tracts that connected to the different brain regions and its relationship with the course of disease. Methods Diffusion tensor imaging (DTI) data were obtained from 25 male patients with paranoid schizophrenia and 26 male healthy controls. The whole brain was parcellated into 90 regions by using the anatomical label map. Tractography was performed in the whole brain of each subject to reconstruct white matter tracts using the FACT algorithm. The brain white matter weighted networks were then constructed using the complex network theory. Results The strength of the nodes in the networks of schizophrenia significantly decreased in the right thalamus (P=0.03, corrected) and the right hes?chl gyrus (P=0.04, corrected). Negative correlation was found between the strength of the right thalamus and the course of disease (r=-0.45, P=0.03). Conclusion The integrity of the white matter fiber tracts connected to the thalamus and tem?poral lobes in the male paranoid schizophrenia is impaired. The lesion of fiber tracts connected to the thalamus is related with the course of disease.