Objective To make a survey of the binocular visual acuity, residual visual acuity and the pathogenic factors causing the deficient of the vision handicap student in Blindness-Deaf-Mute school in Guiyang to provide the data for low vision rehabilitation. Methods Through routine examination, we examined the 58 students with vision impairment and further advised them wear the optics visual aids. Results 6 cases of low vision, accounting for 10.3%; 52 cases of blindness, accounting for 89.7%. One case was rectified its visual acuity by means of subjective refraction and rectification of eyesight. Causes of the disease: 35 cases suffered from the deficient due to genetic factors, accounting for 60.3%; among them, the congenital glaucoma was the first (12/35). 23 cases suffered from the deficient due to acquired factors, accounting for 39.7%, among them, the keratomalacia was the first (19/23). Visual aids wearing :visual acuity≥0.3, 3 cases; visual acuity≥0.05, 6 cases. Conclusions Prevention can prevent the genesis of blindness. The students of residual visual acuity should wear visual aids.

Objective To analyze the clinical characteristics,therapy and follow-up of the patients with ulcerative colitis (UC).Methods Collect the date of 77 inpatients with UC at the Second Affiliated Hospital of Chongqing Medical University be-tween November,2009 and october,2014,and assigned the patients randomly.Results 69.9% of the patients who were in the ac-tivity stage were moderate severity.E2 (46.6%,34/73)and E3 (50.7%,37/73)were the common lesions range.The main clinical manifestations were abdominal pain,diarrhea,mucopurulent bloody stool and bloody stool.The enteroscopy mostly showed that in-testinal mucosa hyperemia,eddma,erosion,and small ulcers had the common features of UC.The common biopsy results were chro-nic inflammation and/or erosion.The average value of serum ALB decreases while the severity of UC patients increases.Drug thera-py was the main treatment of UC.The maintenance therapy was aminosalicylic acid,the effective ratio of treatment is 89.0%(55/73).Conclusion UC treatment plan basically follow the consensus and we should enhance the follow-up of UC patients.

Objective To study the effects of psychological rehabilitation in the treatment of paraplegic patients with spinal cord injury (SCI).Methods A hundred paraplegic spinal fracture survivors were divided into a research group and a control group with 50 cases in each.Systematic rehabilitation was given to the patients in the control group,while this was combined with individualized psychological rehabilitation protocols for the patients in the research group.The daily treatment lasted 10 weeks,6 days a week.All of the patients were assessed with the Barthel index (BI),a functional independence measure (FIM),the Hamilton depression scale (HAMD) and the Hamilton anxiety scale (HAMA) pre-treatment and post-treatment.Results Before the intervention there was no significant difference between the 2 groups in any of the assessments.After ten weeks the average BI,FIM,HAMD and HAMA results in the research group were significantly better than those pre-treatment and also significantly better than those in the control group.Conclusions Psychological rehabilitation can distinctly improve the functioning and psychological state of paraplegic patients after SCI.

Objective To investigate awareness about tuberculosis (TB) prevention and treatment and influence of professional training on TB detection among health-care workers (HCWs) in general hospitals.Methods In total,750 HCWs were trained for TB-related knowledge for eight class-hours in a two-day course in three general hospitals,and 20 HCWs from each of the three hospitals classified as grade 3A and grade 2A in urban Beijing and grade B at suburban Beijing,respectively,were interviewed with questionnaire designed to understand their awareness about TB prevention policy,epidemiology,diagnosis and treatment,and to evaluate effectiveness of the training,respectively.All the trainees responded before and after the training,with a hundred percent of response rate.TB diagnosis and reporting one year before training in the three hospitals were compared to those one year after it.Results Scores of knowledge about TB diagnosis and treatment averaged 64-80 for HCWs before training,with statistically significant difference among three hospital (F = 5.984,P ＜ 0.01).Scores increased after training,but without significant difference from those before it (P ＞ 0.05).Awareness of TB prevention policy,regulations and epidemiology was insufficient in most HCWs of those hospitals,with lowest and highest average scores of 38.3 and 71.7 before training,respectively,but scores increased significantly after training (P ＜ 0.01).Proportion of TB diagnosis with chest roentgenograph at grades 3A and 2A hospitals was significantly higher one month,three months and six months after training,as compared to that at suburban hospitals (P ＜0.01).There was significant decrease (P ＜ 0.01) in proportion of chest roentgenograph at respiratory departments in hospitals grade 3A and grade 2A after training.There was no significant difference in reporting of pulmonary TB and positive sputum smear (P ＞ 0.05) before and after training.Conclusions HCWs in general hospitals had experience and capacity in diagnosis and treatment of pulmonary TB,but their knowledge of TB prevention policy and epidemiology was insufficient.Their ability in finding and reporting TB can not been improved with short-term training.

Objective To study the effect of different psychological rehabilitation time on patients with spinal cord injury (SCI). Methods 80 patients with SCI caused by spinal fracture were divided into early psychological rehabilitation group (n=40) and late psychological rehabilitation group (n=40). The routine treatment was administered to both groups, and psychological rehabilitative therapy was also administered immediately and 3 weeks after admission respectively. Their function, psychological state and quality of life were evaluated. Results The scores of modified Barthel index (MBI), Functional Independence Measure (FIM), and psychology, independence, social relations and the total score in World Health Organizations Quality of Life (WHOQOL-100) were higher, and the scores of Hamilton Self-rating Scale for Depression (HAMD) and Hamilton Self-rating Scale for Anxiety (HAMA) were lower in the early psychological rehabilitation group than in the late psychological rehabilitation group (P<0.05). Conclusion Early psychological rehabilitation is beneficial for functional and psychological state recovery in patients with SCI.

Objective To explore the relationship between serum 25 (OH)D level and cognitive function in patients with Alzheimer's disease (AD).Methods Totally 113 AD impatients were enrolled in this study.Their serum 25 (OH) D2,25 (OH) D3,and total 25 (OH) D levels were determined by liquid chromatography-tandem mass spectrometry (LC-MS/MS).Patients were divided into Vitamin D severe deficiency group [25 (OH)D level≤25 nmol/L],deficiency group [25 (OH)D levels:25-50 nmol/L],insufficiency group [25 (OH) D level:50-75 nmol/L],and sufficiency group [25 (OH) D level ≥ 75 nmol/L] according to the criteria proposed by US Institute of Medicine.The cognitive function was assessed by MMSE score.The association between serum 25 (OH) D level and cognitive function was systematically analyzed.Results The serum levels of 25 (OH) D,25 (OH) D2,and 25 (OH) D3 were (27.08 ± 15.33) nmol/L,(1.23 ± 0.93) nmol/L and (24.50 ± 13.04) nmol/L in AD patients.The proportions of severe deficiency,deficiency,insufficiency,and sufficiency were 60.18％ (68/113),30.97％ (35/113),7.97％ (9/113),and 0.88％ (1/113),respectively,among these AD patients.A positive correlation was found between serum 25 (OH) D concentration and MMSE score in AD patients.Conclusions Impatients with AD often have severe vitamin D deficiency and need vitamin D supplementation.Serum 25 (OH) D concentration is associated with cognitive function,and therefore vitamin D supplementation may improve cognitive function.

Recurrent laryngeal nerve injury is one of the serious complications after thyroidectomy.Unilateral injury causes hoarseness,while bilateral injury causes difficulty in breathing or even life-threatening glottis obstruction.Analyzing the root cause of the thyroid injury,firstly it is the anatomical factors of recurrent laryngeal nerve,namely the close and complex relationship between the recurrent laryngeal nerve and the inferior thyroid artery,the existence of branches of recurrent laryngeal nerve and its variation,and the presence of non recurrent laryngeal nerve and Zuckerkandl nodules.Those are all made the recurrent laryngeal nerve easy to be damaged.Secondly it is because of the vulnerability of the recurrent laryngeal nerve itself.Last improper using of energy operation instrument will cause heat injury on nerves.Below counter measures can be implemented to prevent recurrent laryngeal nerve injury.Dissect to show recurrent laryngeal nerve or make it ‘ visualization’ during thyroidectomy.Elaborately anatomize recurrent laryngeal nerve to appropriate degree.Be familiar with the property of energy operation instrument and thus safely use them to reduce the heat injury of recurrent laryngeal nerve.Reasonably use the intraoperative nerve monitoring in the surgery,which assist to reduce the risk of injury of recurrent laryngeal nerve.

Objective To investigate the heat effects of the high-frequency electric knife on the recurrent laryngeal nerve ( RLN) in pigs and the safety margin in which electric knife can be used .Methods Totally 12 pigs for experiment were randomly divided into 3 groups by the distance between the head of the electric knife and the nerve(2 mm, 1 mm, 0 mm).The application time of the electric knife touching RLN was set to be 3 s and the application energy of the electric knife was 90 W.The data of electromyogram were measured by means of nerve detector before and after operation .Statistical analysis was made based on those data .The nerve tissues were taken to make paraffin sections so that the histological change can be observed and compared before and after damage.Results The data from electromyogram by nerve detector indicated that the difference of the amplitude of group 2(1 mm)and group 3(0 mm)had statistical significance(P<0.05)within group.There were significant difference of the amplitude between the 3 groups.Histological study showed that the tissues of group 3(0 mm)had obvious injury .Conclusions In thyroid surgery , the safety range of high frequency electrical knife used around RLN is:the distance from electrical knife head to nerve should be no less than 2 mm.

Objective To investigate the variability in biochemistry in cerebral palsy children who accepted rehabilitation exercise. Methods From March to November, 2015, 24 children with cerebral palsy were measured the levels of hemoglobin, creatine kinase and blood urea before treatment. They all accepted routine rehabilitation exercise, and were measured hemoglobin, creatine kinase and blood urea again one week after treatment as the load increased, and six weeks after treatment at the end of exercise. They were assessed with Gross Motor Function Measure (GMFM-88) before and six weeks after treatment. Results The scores of GMFM-88 improved after treat-ment (t>7.12, P<0.001). Hemoglobin decreased (P<0.01), while creatine kinase and blood urea increased one week after treatment (P<0.01). Hemoglobin and blood urea came back to the levels before treatment six weeks after treatment (P?0.05), while creatine kinase reduced (P<0.01), but was still more than that before treatment (P<0.01). Conclusion Hemoglobin, creatine kinase and blood urea may respond the train-ing situation of cycle and the stage of exercise, and indicate the effects of load in the cerebral palsy children accepted rehabilitation exercise.

_ Objective_ To evaluate the efficacy of unilateral subtotal adrenalectomy in the treatment of bilateral adrenal solitary neoplasma causing Cushing's syndrome and to elaborate the therapeutic principle. Methods From 2007 to 2013, a total of ten patients were diagnosed with Cushing's syndrome caused by bilateral solitary adrenal neoplasma. We compared patients'clinical symptoms, hormone profiles, biochemical and metabolic parameters, and imaging data before and after the surgery. Five of them chose the optimal neoplasma based on the lateralization ratio of adrenal venous sampling result and the other 5 patients chose the optimal neoplasma based on the diameter of the mass reflected by the computed tomography result and were then operated. Results After the unilateral subtotal adrenalectomy,the24-hour urinary free cortisol decreased significantly(P<0.05)and the midnight serum cortisol level also significantly reduced(P<0. 01). Plasma adrenocorticotropic hormone level increased significantly(P<0. 01). Nine patients of them did not need contralateral adrenalectomy and one patient received contralateral adrelectomy because of the remnant of Cushingnoid symptoms. Conclusion Unilateral subtotal adrenalectomy is an effective and safe way to treat Cushing's syndrome caused by bilateral solitary neoplasma.