Background Idiopathic macular epiretinal membrane (IMEM) shows a high incidence and affects visual function of patients.The primary management of IMEM is vitrectomy,but the study on prediction of visual acuity after operation by optical coherence tomography (OCT) is seldom.Objective This study was to evaluate the predicting ability of OCT for preoperative visual outcome for IMEM patients who received vitrectomy.Methods The clinical data of IMEM patients with vitrectomy from March 2009 to May 2013 were retrospectively analyzed in People's Hospital Peking University.Forty-nine eyes of 48 cases were divided into continuous group (19 eyes of 18 cases) and discontinuous group (31 eyes of 31 cases) based on whether the extraretinal layers were intact on OCT,including retinal pigment epithelium (RPE),inner and outer segment of photoreceptors (IS/OS) and external limiting membrane (ELM).Central foveal thickness (CFT) by high-resolution spectral-domain OCT and best corrected visual acuity (BCVA) (LogMAR) before surgery and 12 weeks after surgery were recorded and compared between the two groups,and the correlations of shift of CFT with the shift of LogMAR vision was analyzed by unitary linear regression to evaluate the value of OCT in predicting postoperative vision.Writen informed consent was obtained from each patient prior to any medical operation.Written informed consent was obtained from each patient before surgery.Results In 12 weeks after operation,reflective strips of RPE layer,IS/OS and ELM layer were intact in 18 eyes of the continuous group after vitrectomy.The number of eyes with discontinuous strip in RPE layer decreased to 1 eye after operation from 6 eyes before operation,and the number of eyes with IS/OS reflective strip discontinue decreased to 19 eyes after operation from 29 eyes before operation,and that with ELM layer discontinue decreased to 15 eyes after operation from before operation in the discontinuous group.The improvement of LogMAR BCVA was increased with the decline of CFT values with a negative correlation between them (R2 =0.298,B =0.001,P =0.000),and postoperative LogMAR visual acuity improved 1 line whenever CFT reduced by 100 μm.LogMAR BCVA was 0.4±0.19 before surgery and 0.36±0.21after surgery in the continuous group,showing a insignificant difference between them (t =0.876,P=0.393).In the discontinuous group,the postoperative IogMAR BCVA was significantly higher after operation (0.46±0.26) than 0.82 ±0.41 after operation (t =6.206,P =0.000).The increase value of LogMAR after vitrectomy was 0.3 in the discontinuous group,which was superior to 0.0 of the continuous group.Conclusions The continuity of extraretinal layers and CFT by OCT are closely associated with the improvement of vision after vitrectomy in the eyes with IMEM.Postoperative vision is better in IMEM eye with continuous retinal reflective strips before operation,and majority of IMEM eyes can improve vision after operation.Preoperative OCT seems to be an important diagnostic tool for the selection of patients who benefit or not from surgery to certain extent.

Objective To reveal the fibrillar network in vitreous and the effect of plasmin on this network. Methods 20 vitreous gels of freshly slaughtered pigs were divided into 2 groups, the gels in first group were digested by 3 U plasmin (3 U/ml) at 37℃ for 24 hours respectively, the second group received the same PBS as control. After digestion, gels were fixed in neutral buffered formalin solution. Samples from vitreous base, cortex and the central region were observed by the technique of freeze etching electron microscopy. Results In vitreous collagen fibril network was in a three-dimensional array, collagen fibril density showed marked differences, central vitreous had the sparse fibril density, the cortex denser and the basal vitreous densest. After digestion by plasmin, the collagen fibrillar network was destructed. Conclusion Collagen fibrils in vitreous present spatial arrangement regularly, plasmin can lead to destruction of the fibrillar network.

Objective Nerve growth factor (NGF) is thought to be one of regulating factors of cellular function during the visual plasticity period. Levodopa is a neurotransmitter in central nerve system. Its mechanism of improving the visual function in amblyopia is unclear. Present study was to observe the role of levodopa in treating monocular deprived amblyopia and explore the effects of levodopa on the expression of NGF in visual cortex. Methods The animal models of monocular form deprived amblyopia were established in the right eyes of 12 4-week-old domestic cats by suturing the eyelid for 2 weeks and then the left eyes were reverse sutured. The 6 cats from models received 20 mg/kg of levodopa by oral administration. Other 6 normal cats were as normal controls. Pattern VEP (P-VEP) was recorded to check the visual acuity of the cats. The cell number density of NGF expression in visual cortex area 17 was detected and calculated by immunochemistry and expressed as positive number/field. Results The amplitude of P_(100) of P-VEP was significantly declined in monocular deprived eyes compared with fellow eyes and normal eyes in 2 weeks after monocular deprivation (P ＜0. 01) . However, after administration of levodopa, the amplitude of P_(100) recovered to normal 2 weeks later, presenting a insignificant difference between levodopa treating group and normal group (P＞ 0. 05). The latency of P_(100) was followed the same pattern between two groups. The NGF positive cells were decreased in monocular deprived group compared with normal group and levodopa group (80. 23 ± 9. 54 vs 111. 83 ± 7. 49, 80. 23 ± 9. 54 vs 118. 06 ± 12. 37, P ＜ 0. 01), but no significant difference in NGF positive cells was found between normal group and levodopa group (111.83 ±7. 49 vs 118. 06 ± 12. 37, P = 0. 94). Conclusion Levodopa is supposed to accelerate the recovery of visual function in amblyopic cat by enhancing the NGF expression in visual cortex area 17 during the critical period of visual development.

The nutritional survey was made in 184 anorexia children aged 3-7, 123 of them were treated with various measures for three months. The results indicated that the children with anorexia had low intake and deficiency in energy, protein, minerals and vitamins. Most of them had zinc deficiency, but they simultaneously had two to three nutrients deficiency.The zinc treatment could improve most patient's syndrome and nutritional status. The effect of zinc treatment with vitamines and iron preparations was better than zinc treatment only. The effect of treatment with Chinese medicine also was able to cure the children with anorexia to certain extent.

Background Branch retinal vein occlusion (BRVO)often leads to macular edema as the result of elevating intravitreal VEGF level,and avastin,a anti-VEGF drug,show a good effectiveness on macular edema secondary to BRVO.ObjectiveThis study attempts to evaluate the clinical efficacy of avastin on macular edema induced by BRVO.MethodsThis is a retrospective case-observation study.The clinical data of 39 eyes from 39 patients with macular edema induced by BRVO were included in this analysis.All of the patients received intravitreal injection of 1.25mg (0.05mL)avastin without other any therapy prior to the injection of avastin.This procedure followed the Declaration of Helsinki,and written informed consent was obtained from all the patients before and initial of any management.Clinical indexes included best-corrected visual acuity(BCVA),slit-lamp examination,intraocular pressure and stereoscopic biomicroscopy examination before injection and 3,6 and 12 weeks after initial injection.Optical coherence tomography (OCT),fundus photography,fluorescein fundus angiography(FFA)were performed prior to injection and 6,12 weeks after initial injection.The follow-up period was 3-20 months.ResultsThe mean BCVA was significantly improved at 3,6,12 weeks after injection in comparison with before injection (t=-6.039,-6.182,-4.189,all P=0.000).The mean CMT showed a statistically significantly decline at 6,12 weeks after injection in comparison with before injection(t=8.684,5.019,all P=0.000).No ocular or systemic adverse events were found after intravitreal injection of avastin during the follow-up duration.The numbers of visual acuity-improved eyes were significantly increased in the patients with disease course ≤1 month duration in comparison to ones with the course ≥1 month (P<0.05)in 3 weeks after injection.CMT was obviously decreased in 12 weeks after injection in comparison to before injection between with and without macular perfusion eyes (P<0.05).ConclusionIntravitreal injection of avastin is safe and effective for macular edema induced by BRVO,especially the patients with shorter course of disease.

The nutritional status, serum lipids, protein, Ca, and Zn of 85 toxemic and 42 normal pregnant women were estimated longitudinally from the first trimester to delivery. The results of dietary survey revealed that correlative and regressive relationship closely existed between serum TC, LDL-C, LDL-C/HDL-C, AI, and percentage of animal fat. In the toxemic cases, there were significant increases of serum LDL-C/HDL-C, AI, and decrease of HDL-C, HDL-C/TC and Ca in the 1st trimester as compared with those of the normal. In the 3rd trimester, there were significant increases of serum TG, TC, LDL-C, LDL-C/HDL-C, AI and MUFA, and decrease of serum HDL-C, HDL-C/TC, Ca, Zn, total protein and albumin in the toxemic cases. The regressive relationship was found between GI (ges-tosis index) and serum Ca in the 1st trimester or GI and serum P/S, A/G, LDL-C/HDL-C, AI in 3rd trimester. The problem of nutritional factors on development of toxemic cases was discussed and some nutritional suggestions were made.

A comprehensive evaluation of zinc and iron nutritional status was conducted in 203 children aged 2-7 years with anorexia. 147 of them took 3-7 mg of zinc sulfate?kg-1?d-1 for 60 days. The purpose of the study were to explore the relationship between zinc supplementation and the nutritional status of iron.Nutritional survey by 3-day-record method pre-and post zinc treatment showed that the average intakes of energy, protein, zinc, iron before treatment were 994kcal/d, 30.8g/d, 4.9mg/d, 7.6mg/d and were only 71%, 68%, 49%, 76% of RDA respectively. After treatment they reached 91%, 89%, 70%, 113% of RDA.There were significant positive correlations between zinc contents in serum or hair and hemoglobin (HB) or serum ferritin (SF) of the children with anorexia. After administration of zinc , the iron status of the children improved in some and fell in others. There were significant differences in some indices between the two groups before treatment. By stepwise discriminant analysis, a discriminant equation was obtained;Y = 3.591 - 0.175X1- 0.0152X2- 0.144X3+ 0.706X4(X1 = age, X2 = hair zinc,X3 = Hb, X4 = growth)If Y0, iron status may improve.

The basic mechanical properties of a Radial Shock Wave Therapy Equipment (RSWTE) were experimentally studied in this paper. The output energy of the RSWTE working on the operation frequency of 10 Hz was measured by dynamic pressure transducer under the conditions of different operation pressure. The results showed that both operation pressure and operation frequency have effects on the output energy of the equipment. The output energy increases with the increase of operation pressure, and the magnitude of increased energy decreases with higher operation of frequency. With the increase of operation frequency, the output energy rises up in condition of lower operation pressure and drops off in condition of higher operation pressure. The accurate medical treatment should be selected with the optimized energy and condition according to the treatment requirement to different illness in clinical medical applications.
Equipment Design ; High-Energy Shock Waves ; Physical Therapy Modalities ; instrumentation ; Pressure

Objective To investigate the level of readiness for hospital discharge in elderly patients with chronic obstructive pulmonary disease (COPD) and its correlation with patients'self-efficacy. Methods A questionnaire survey was administered to 240 elderly COPD patients admitted to the people's hospital of Wuhan University in Hubei Province from November 2017 to March 2018, using the Readiness for Hospital Discharge Scale and the Self-Efficacy for Managing Chronic Disease 6-Item Scale. Pearson correlations were used for analysis. Results Total scores for hospital discharge readiness were (6.13±0.89) and for self-efficacy were (3.42±1.46) in elderly COPD patients. Pearson correlation analyses indicated that there were significant positive correlations between the total scores and all dimensions of readiness for hospital discharge and self-efficacy in elderly patients with COPD (r=0.256-0.651, P<0.01). Conclusion The readiness for hospital discharge in elderly patients with COPD is still at a medium level, and the level of self-efficacy is low. Readiness for hospital discharge and self-efficacy are positively correlated in elderly patients with COPD. Health care workers should pay active attention to the readiness for hospital discharge in elderly patients with COPD so as to help them improve their self-efficacy, and promote disease recovery.

Objective: To explore the prevalence of health risk behaviors and the association between locus of control and health risk behaviors among college students, and to provide reference for the formulation of health risk behavior intervention for college students. Methods: A multi stage cluster random sampling method was used to select 2 provinces from the east, central and west regions of China, respectively. Two universities were then randomly selected from each selected province. A total of 3 951 college students from 12 universities completed the electronic and anonymous questionnaires, which included demographic characteristics, Multidimensional Health Locus of Control Questionnaire (MHLC) and Health Risk Behaviors Questionnaire. Chi square test and binary Logistic regression were applied to analyze data. Results: Totally 2 287(57.88%) students reported having three or more kinds of health risk behaviors. The prevalence of excessive screen time, insufficient physical exercise, poor eating behaviors, drinking and smoking were 97.34%(3 846), 74.72%(2 952), 72.21%(2 853), 13.62%(538) and 5.57%(220). Internal locus of control was associated with lower risk of three or more kinds of health risk behavior ( OR =0.98) and inadequate physical activity ( OR =0.93) and associated with higher risk of smoking ( OR =1.07). The powerful others was associated with lower risk of three or more kinds of health risk behavior ( OR =0.98), drinking ( OR =0.95) and unhealthy eating behavior ( OR =0.97). And the chance was associated with higher risk of three or more kinds of health risk behavior ( OR = 1.04 ), drinking ( OR =1.04) and inadequate physical activity ( OR =1.03)( P <0.01). Conclusion College students have serious health risk behavior problems, the locus of control is associated with health risk behaviors among college students. Which might be helpful to prevent the occurrence of health risk behaviors, and improve overall health of college students.