· AlM: To analyze the clinical data of 54 cases misdiagnosed as optic neuritis and to explore measures to reduce misdiagnosis
· METHODS: This retrospective study comprised 54 patients that had been misdiagnosed as optic neuritis from September 2000 to June 2013. The misdiagnosis features were summarized.
· RESULTS:Many diseases can easily be misdiagnosed as optic neuritis, including ischemic optic neuropathy, intracranial tumors, optic nerve vasculitis, myelinated nerve fibers, and so on.
· CONCLUSlON: The measures to reduce misdiagnosis consisted of detailed history collection, perfect physical examination and comprehensive expertise of fundus disease.

Objective To investigate the cognition of falling from doctors,nurses and patients in eight Chongqing local hospitals,and develop targeted health education to prevent the occurrence of falling events.Methods Based on data analysis of 368 falling cases from eight Chongqing local hospitals,a selfdesigned questionnaire was developed and used to investigate doctors,nurses and patients from these eight hospitals.1 393 questionnaires were returned,with a recovery rate of 97.69％.The method of t test,analysis of variance and Chi Square （x2) test were used for analysis.Results Nurses had highest recognition for falling features,doctor followed,patients with the lowest,the differences had statistical significance; Nurses' cognitive degree from Third-Grade A-Level hospital was above that of nurses from Second-Grade A-Level hospital,the differences had statistical significance; Doctors' cognition of hospitalization days when falling and susceptible population of falling was lower than that of nurses.Nurses thought falling tended to occur from nightfall to midnight.Conclusions Survey found that,the cognitions of falling from doctors,nurses and patients were different from actual results.Cognition were also different among three sides of them,according to the survey results,health education for different objects should be provided,raise everyone's awareness,thus using targeted falling prevention measures to reduce the incidence of falling.

OBJECTIVE To explore the cognition of hand hygiene knowledge and related factors of hand hygiene compliance among undergraduate nursing students.METHODS Totally,67 undergraduate nursing students completed a questionnaire regarding the hand hygiene knowledge and related factors of hand hygiene compliance.RESULTS The undergraduate nursing students achieved(19.01?2.16) points in hand hygiene knowledge.As for the factors affecting their compliance with hand hygiene,98.51% agreed that detergents or disinfectants could stimulate the skin and cause dryness;62.69% believed they failed to keep their hands clean due to busy work;62.69% noted that the hospital didn′t keep the medical professions under strict surveillance,and so on.CONCLUSIONS The undergraduate nursing students have a good cognition about hand hygiene,but there are many factors affecting their compliance.Measures should be taken to keep the availability of necessary articles needed for hand hygiene,and the surveillance of hand hygiene should be strengthen.

BACKGROUND:An amyloid-beta (Aβ) aggregation in the brain can induce nerve cel apoptosis, loss of synapses and functional damage. However, there is stil no effective intervention. Improving the synaptic plasticity provides an important direction for the treatment of early Alzheimer’s disease. OBJECTIVE: To screen the best model of Alzheimer’s disease and to explore the expression of synapse-associated proteins in Aβ25-35-injured PC12 neurons. METHODS:PC12 cels were induced by 50 μg/L nerve growth factor to differentiate into neuronal-like cels. Then, these cels were treated with Aβ25-35 at different concentrations. Consequently, cel survival rate was detected using cel counting kit-8; neurogranin and neuregulin immunofluorescence stainings were used to observe morphological changes of model cels; western blot used to detect the expression level of neurogranin, calmodulin kinase II, postsynaptic density-95 proteins. RESULTS AND CONCLUSION:Over time, the survival rate of PC12 neurons induced by Aβ25-35 was decreased in a dose-dependent manner. Shortened synaptic length, neuronal atrophy and sparsely interconnected neurons were visible. Expression levels of neurogranin, calmodulin kinase II and postsynaptic density-95 proteins were al down-regulated. These findings indicate that to screen the cel model of Alzheimer’s disease, the optimal concentration and interventional time of Aβ25-35are 10 μmol/L and 48 hours, respectively.

ObjectiveTo investigate the clinical and MRI features of multiple sclerosis in children,including the clinically isolated syndrome (CIS) and relapse.MethodsIn total,16 cases of pediatric multiple sclerosis were included in this study.Of them,11 patients were female and 5 were male,with the mean onset age of 10.1 years.They were followed up for 4 months to 7 years and found to have 1-5 relapses.The clinical manifestations of CIS and relapse were analyzed by a pediatric neurologist.An experienced neuroradiologist reviewed the MRI images of CIS and relapse.Information on the location,size,and pattern of the lesions was gathered.The location of lesions included subcortical,central,and periventricular white matter,cortex,deep gray matter,brain stem,and cerebellum.ResultsCIS episode presented acute onsets in 13/16 cases,with symptoms of cortice in 10 cases and visual impairment in 6 cases.Relapse occurred in 14/16 cases within one year.The incidence of symptoms of cortice was less frequent and severe in the second episode of MS,whereas the visual impairment had a high incidence.All patients had full recovery after the last episode.MRI of CIS showed confluent subcortical white matter lesions in 13/16 cases,abutting on central white matter lesions.The most frequently involved brain part was the frontal lobe,followed by the parietal lobe.Cortical involvement was observed in 9/16 cases.In 6 cases,periventricular white matter lesions were detected.Bilateral deep gray matter was abnormal in 4 cases.Other abnormalities included brain stem lesions in 5 cases,cerebellum lesions in 3 cases,optic nerve involvement in 3 cases,and pyramidal tract lesions in 2 cases.MRI of relapse revealed more small lesions in the subcortial and periventricular white matter in the patients.In the second episode,only 2 cases presented cortical involvement.Lesions were found in the brain stem in 4 cases and in the cerebellum in 5 cases.Pyramidal tract involvement was identified in 6 cases,serving as “railway track sign”.ConclusionsCIS in children is characterized by large confluent lesions in subcortical white matter coalescing with central white matter.MRI of relapse showed distinctive “railway track sign”.It is important to integrate MRI and clinical features in the diagnosis of pediatric multiple sclerosis.

AIM: To evaluate the therapeutic efficacy and safety of heavy silicone oil (HSO), Densiron 68, was used as internal tamponade to treat complex vitreoretinopathy.METHODS: A retrospective study of 30 patients (30 eyes) who underwent vitrectomy and HSO tamponade for complex retinal detachment between January 2015 and January 2016.The best corrected visual acuity (BCVA), intraocular pressure (IOP), retinal reattachment and complications after surgery were observed.RESULTS: There were statistical significances in both the BCVA difference between pre-operation and HSO tamponade, and the BCVA difference between pre-operation and the removal of HSO for 3mo (z=-2.198, P=0.028;z=-2.682, P=0.007).The average intraocular pressure of HSO tamponade group was 20.233±8.007mmHg, and the average intraocular pressure of pre-operation group was 16.067±4.025mmHg, showing significant difference(t=-2.913, P=0.005).Between the pre-operation group and the HSO removed group 14.933±3.423mmHg, there was no significant statistical difference in the analysis of IOP (t=2.635, P=0.430).Anatomical success was achieved in 90% of cases after the removal of HSO.Most common complications were cataract formation and oil emulsification.CONCLUSION: Densiron-68 is a safe and effective tamponade material for the treatment of complex vitreoretinopathy.However, most common complications are cataract formation and oil emulsification.So clinicians should strictly handle indications and usage during the clinical applications.

Objective To investigate the effect of Problem- based Learning (PBL) applied in the course of Activities of Daily Living (ADL) Skills and Environmental Adaptations. Methods PBL (PBL class) and traditional teaching (traditional class) were applied in different classes. Their scores of the final examination were compared, and the students were investigated with the questionnaire. Results The scores of final examination were higher in the PBL class than that in the traditional class (P<0.05). Most of the students accepted the PBL in the course. Conclusion PBL can improve the quality of teaching of occupational therapy.

Objective To obtain the incidence of “clopidogrel low response”( CLR ) of acute coronary syndrome ( ACS ) patients after percutaneous coronary intervention ( PCI ) by Thrombelastography ( TEG) and Light transmission aggregometry( LTA) ,and explore the correlation of CLR with clinical related factors and major adverse cardiac events.Methods This study is a cohort study.214 ACS patients in the Department of Cardiology of Peking University People′s Hospital,who were ready to treat with PCI between May 2014 and November 2014 were enrolled.Among them, 168 cases(78.5%) were male with an average age of (61.32 ±10.79) years;46 cases(21.5%) were female with an average age of (68.72 ±8.38) years.The clinical data were recorded, such as history of present illness, the past medical history, clinical medication, and the results of coronary angiography.After taken clopidogrel 75 mg per day at least for 4 days,all patients were detected the contribution from ADP-stimulated platelets to maximal clot strength by TEG( TEG-ADP-Inhib), and detected ADP induced maximal platelet aggregation ratio by LTA ( LTA-ADPMAX ) .The occurrence rate of CLR was calculated, and the correlation between results of the two assays were anylysed.Patients were divided into two groups according to CLR.Univariate analysis was used to compare the difference of clinical data between CLR group and non-CLR group, then Logistic regression analysis was conducted to find out the related risk factors that may influence the occurrence rate of CLR.Compare the correlation between CLR and MACE according to 6-month followed-up.Results There was negative correlations between LAT and TEG in the adenosine diphosphate induced platelet reactivity ( r=-0.282,P=0.000).CLR was found in 115 (53.7%) patients by LTA and in 74(34.6%) patients by TEG and the difference between the two CLR ratio was significant (χ2 =10.486, P =0.001 ) .There were significant differences in age,smoking history and prior PCI/CABG history between CLR group and non-CLR group according to LTA grouping(t=2.829,P=0.005;χ2 =11.058,P=0.001;χ2 =4.252,P=0.039), and there was significant differences in history of cerebrovascular accident between CLR group and non-CLR group according to TEG grouping (χ2 =4.584, P=0.032 ).Logistic regression analysis showed smoking history was the protective factor for CLR ( OR=0.390,P=0.001) , while history of cerebrovascular accident was the independent risk factor (OR=2.499,P=0.037) for CLR.According to 6-month followed-up, the incidence of clinical ischemic events and bleeding events in CLRLTA group was 5.2%and 0 respectively, in N-CLRLTA group was 10.1% and 3% respectively;the occurrence rate of clinical ischemic events and bleeding events was no significant difference between two groups(χ2 =1.834,P=0.176;χ2 =1.682,P=0.195).The incidence of clinical ischemic events and bleeding events in CLRTEG group was 8.1% and 0 respectively, in N-CLRTEG group was 7.1%and 2.1%respectively;the occurrence rate of clinical ischemic events and bleeding events was no significant difference between two groups(χ2 =0.065,P=0.798;χ2 =0.432,P=0.511 ).Conclusions The correlation between the testing results of TEG and LTA in ACS patients treated with clopidogrel was poor, CLR ratios detected by two assays were significantly different.Smoking history was the protective factor for CLR , while history of cerebrovascular accident was the independent risk factor for CLR.CLR was not the risk factor for MACE in ACS patients.

Objective To observe the influence of Suifukang (SFK) on hemorheological change of rats induced spinal cord injury. Method Through half-transection spinal cord injury, the effects of SFK on hemorheological changes of 50 SD rats were observed. Results After injury, the hemorheological property was changed from lower coagulability to higher coagulability. After administrated with SFK, the hemorheological property was changed from higher coagulability to lower coagulability. Conclusion SFK could effectively reverse the abnormal hemorheological status into normal one.

OBJECTIVE To prevent the nosocomial infection event in the clinical laboratory. METHODS To enhance the conception of self-protection,amplify necessary rules and regulation,fine technique training,establish the health-record of the department staff,purchase the facilities of protection,and disinfect the instrument and environment of laboratory even the test report sheet. RESULTS By means of above mentioned measures and management,it could control in most degree of nosocomial infection in clinical laboratory,and ensure the safety and health of the department staff. CONCLUSIONS The nosocomial infection event of clinical laboratory can be prevented by amplification of necessary rules and regulation as well as enhancement of the management.