AIM:To study the efficacy and safety of intravitreal injection ranibizumab (IVR) assisted 25G+ minimally invasive vitreoretinal surgery (VRS) in the treatment of severe proliferative diabetic retinopathy (PDR).METHODS: Totally 61 patients and 74 eyes were selected with severe PDR from March 2015 to June 2016 in our hospital.According to the principle of voluntary,37 eyes of 31 cases in the VRS before the IVR treatment was set to the joint group,37 eyes of 30 cases line pure VRS was set to the VRS group.We compared the vitreous volume,logMAR,mean IOP,macular central retinal thickness and complications between the 2 groups.RESULTS: The blood rate of glass in the combination group was 8% after 1wk of postoperative which was significantly lower than that of the VRS group 27% (x2=4.573,P=0.032).The glass volume blood rate of the combined group was 0 after 1mo of postoperative while the VRS was 16%(P=0.033).The blood rate of glass in the combination group was 0 at 3mo of postoperative,and 8% in the VRS group(P=0.238).The LogMAR in the combined group was significantly lower than that in the VRS group(t=2.320,P=0.023).There was no significant difference in the mean IOP between the two groups (t=0.516,P=0.608).The mean macular retinal thickness of the combined group was 298.8±78.3μm which significantly lower than the VRS group 357.1±86.2μm(t=3.045,P=0.003).The combined high ntraocular pressure rate of the combined group was 14% which was significantly lower than 32% of the control group(x2=10.385,P=0.001).The rate of anterior membrane of the retina of the combined group,the rate of recurrent traction and the rate of retinal detachment of the newborn were lower than that of the VRS group,but the difference was not statistically significant (P>0.05).CONCLUSION: IVR assisted VRS,although there is a certain controversy,but in the appropriate dose,frequency and time to achieve significant efficacy,safety is also high.

OBJECTIVE: To evaluate the influence of endoscopic sinus surgery on olfactory disorder caused by chronic sinusitis and nasal polyps, by testing the olfactory function of seventy-four patients before and after endoscopic sinus surgery,and evaluate the outcomes of olfactory dysfunction after endoscopic sinus surgery in patients with choinc rhinosinusitis and the related factors. METHOD: The olfactory function of the seventy-four patients with chronic sinusitis and nasal polyps were tested by the T&T olfactory testing method at pre-operation and four weeks,twelve weeks, twenty-four weeks of post-operation. Patients were divided into two groups, according to whether combined with allergic rhinitis. Data were achieved by the scores of endoscopic appearances of Kennedy, and CT staging system of Lund-Mackey. Parallel processing standard endoscopic operation and processing specification during peri operation period. Analysing the degree of olfactory rehabilitation in chronic sinusitis and nasal polyps with allergic rhinitis. RESULT: (1) Compared with the level of olfactory function, significant improvement was found at first month;however, the olfactory function level 4 weeks after operations was significantly statistically different with that 12 weeks and 24 weeks after operations; (2) Lund-Mackey sinus CT higher score is related to the worse degree of postoperative nasal olfactory rehabilitation (P < 0.05). (3) The higher scores of endoscopic appearances of Kennedy is related to the worse degree of postoperative nasal olfactory rehabilitation (P < 0.05). (4) Allergic rhinitis is one of the factors of olfactory rehabilitation in chronic rhinosinusitis with olfactory dysfunction olfactory rehabilitation, the olfactory rehabilitation of patients with allergic rhinitis is worse than that in the patients with no allergic rhinitis. (5) Course of disease is one of the factors of chronic rhinosinusitis with olfactory dysfunction olfactory rehabilitation. Longer the course of disease, worse the olfactory rehabilitation. (6) E osinophil count was related to olfactory rehabilitation in chronic rhinosinusitis with olfactory dysfunction olfactory rehabilitation. Higher Eosinophil count, worse the olfactory rehabilitation. CONCLUSION FESS plays a positive role in the improvement of olfactory impairment in patients with CRS. It is important to protect the olfactory mucous during surgical removal of sinonasal lesions. The standard intraoperative procedure, treatment on allergic rhinitis and regular follow-up after operation are also very important.
Chronic Disease ; Endoscopy ; Humans ; Nasal Polyps ; complications ; surgery ; Nasal Surgical Procedures ; Olfaction Disorders ; rehabilitation ; Paranasal Sinuses ; surgery ; Postoperative Period ; Rhinitis, Allergic ; complications ; Sinusitis ; complications ; surgery ; Smell

Objective To explore the methods and effects of the general resident nurse on duty system,and thereby to play an effective role of skilled nurses to ensure the quality and safety of nursing.Methods Using the management experience of general resident doctors for reference,a general resident nurse on duty system was established.The general resident nurses were strictly selected,trained and examined.At the same time,the management regulations were formulated.Results This practice cultivated a general resident nurse team with well-prepared nursing knowledge,skilled techniques,good capacity to cope with emergency,which could play important roles in the guidance and quality control of clinical nursing.Conclusion The implementation of general resident nurse on duty system can help train the backbone of specialized care,reserve the force of handling emergency and improve the quality of nursing.

Objective To evaluate the efficacy of 3+x mode for the reduction of unplanned extubation in the patients with stomach cancer. Methods 107 patients with the indwelling gastric tube of gastric cancer perioperative from June 2014 to September 2014 were collected as the observation group, and 101 patients with the indwelling gastric tube of gastric cancer perioperative from June 2013 to September 2013 were collected as the control group. Once preoperative education on stomach tube was performed in the control group, and 3+x education mode was used in the observation group, so as to compare unplanned extubation rate of two groups. Results The tube unscheduled decannulation rate in postoperative patients with gastric cancer in the control group was significantly higher than that in the observation group [4.95 %(5/101) vs 0 (0/107)], and there was significant difference (χ2= 5.168, P= 0.029). Conclusion 3+x mode education can significantly reduce unplanned extubation rate in operation patients with gastric cancer.

Objective: To develop the ultra performance liquid chromatography tandem mass spectrometry ( UPLC-MS/MS ) for the determination of perfluorocarboxylic acids ( PFCAs ) in fish. Methods: The fish samples were extracted with tert-butyl methyl ether and purified by WAX columns. The WAX cartridges were rinsed with methanol and 25 mmol/L ammonium acetate, and the target compound residues were eluted with 0.5% ammonia methanol and then redissolved with 50% methanol aqueous solution after nitrogen blowing to nearly dry. Nine kinds of PFCAs were simultaneously quantified by UPLC-MS/MS with 1 mmol/L ammonium acetate-methanol solution as the mobile phase. Results: The extraction was separated well in UPLC BEH C18 column. There were good linear correlations of nine kinds of PFCAs in the range of 1.0-200.0 ng/mL, with the coefficients all more than 0.99. The limits of detection and quantification were 0.06-0.19 μg/kg and 0.19-0.62 μg/kg, respectively. The recovery rates were 70.08%-117.24% at different spiked levels ( 5.0, 25.0, 50.0 μg/kg ), and the relative standard deviations were 2.31%-19.68%. Conclusion Through optimizing the pretreatment conditions, the mobile phase of liquid chromatography and the detection conditions of mass spectrometry, the UPLC-MS/MS could meet the monitoring requirements of PFCAs in fish.

Animals ; Antineoplastic Agents ; therapeutic use ; Gene Silencing ; Genetic Therapy ; methods ; Humans ; MicroRNAs ; antagonists & inhibitors ; therapeutic use ; Neoplasms ; genetics ; therapy ; RNA Interference ; physiology ; RNA, Small Interfering ; antagonists & inhibitors ; therapeutic use ; RNA-Induced Silencing Complex ; metabolism

Objective:To compare the effects of different polishing techniques on the surface roughness of ceramic surfaces,provi-ding reference to restoration polishing in clinic.Methods:70 disc-shaped ceramic specimens were randomly divided into 7 groups(n=10).The glazing treated samples were served as the controls(group 1),the rest samples were treated by white aluminum oxide stone only(group 2)or followed by the polishing head of Ceramiste(group 3),Ceramiste and Ceramaster(group 4),Komer porcelain (group 5),Komer zirconium oxide(group 6)and EVE zirconium oxide,respectively.Roughness of the ceramic samples(including Ra,Rz and Rp)was measured with surface profilometry after different process and the data were analyzed by one way ANOVA.The surface characteristics of the specimens were observed by scanning electron microscopy.Results:The Ra and Rp of group 2 and 3 was higher than those of group 1(P <0.05).The Rz of group 2,3,4 and 5 was higher than that of group 1(P <0.05).Conclusion:Polishers interspersed with diamond grit may achieve a finish equal in smoothness to the glazed surface.

ObjectiveTo investigate the clinical features of patients with painless acute pancreatitis ( AP),and to improve the diagnosis accuracy of painless AP.MethodsThe clinical data of 12 patients with painless AP were retrospectively collected from January 2007 to January 2011.Results The mean age of patients with painless AP was 52 years old.Seven (58.3％) patients complained of abdominal distension and discomfort,4 (33.3％) patients complained of nausea and vomiting,abdominal tenderness occurred in 7(58.3％ ) patients.Serum levels of lipase and amylase was increased in 11 (91.7％) and 8 (66.7％)patients,respectively.The diagnostic accuracy of abdominal ultrasound and CT for AP was 58.3％ and 91.7％,respectively.Five (41.7％) patients were diagnosed to have AP upon admission,and 4 patients were misdiagnosed to have non-digestive diseases.There were 7 severe AP patients among the 12 painless AP patients,and the percentage was significantly higher than that in AP patients with pain (65/327,x2 =7.30,P ＜ 0.05).Painless AP patients needed longer hospital stay when compared with that of AP patients with pain [ ( 20.4 ± 9.1 ) d vs.( 12.9 ± 6.2) d,t =2.296,P ＜ 0.05 ) ].ConclusionsThe misdiagnosis rate of painless AP is high and patients with painless AP are in critical situation,and early measurement of serum levels of lipase and amylase,as well as CT scan is important for correct diagnosis.

As the necessary depletion material in hospitals,sterile packing material shows category diversification when being selected.This paper briefly analyzes the functions and values of domestic common sterile packing material such as pure cotton wrap cloth,hard quality packing container,paper/ plastics packing bag and the crease wrapping paper.Reasonable suggestions are also put forward.

Kennedy disease,a motor neuron disease,is an adult onset form of spinal and bulbar amyotrophy characterized by the damage of low motor neuron and uncompleted androgen insensitivity syndrome.So far,there is no effective treatment.This article is intended to provide neurologist with information about Kennedy disease in epidemiology,etiology,pathogenesis,clinical feature,treatment and so on.