Acute retinal necrosis syndrome (ARNS) is a group of eye syndrome.Acute uveitis, retinal artery occlusive vasculitis, fused necrotic retinitis and late stage of retinal detachment is the main clinical manifestation.A part of patients may be associated with increased intraocular pressure.The etiology and pathogenesis is still not clear completely and most people think that may be related to the virus infection, which mainly to reflected to be herpes simplex virus (HSV), varicella zoster virus (VZV), EB virus and giant cell virus (CMV) infection.Its diagnosis mainly depends on clinical manifestation, examination and etiological examination.Acute retinal necrosis syndrome is urgent and develops quickly, and it is lack of specific clinical symptoms in early times.By the way, it enjoys high misdiagnosis rate and poor prognosis.It is hard to cure, therefore, it is an important reason for the blindness.Once diagnosed, treatment should be adopted by carrying local and systemic antiviral, preventive laser photocoagulation in time.At the same time, it is essential that vitreous body resection combine with silicone oil tamponade treatment when necessary.The study shows that the effective measures of early treatment will be able to prevent disease progression and improve visual acuity.Therefore, early diagnosis and treatment of acute retinal necrosis syndrome is very important.In this paper, combination of the literature on the diagnosis and treatment of acute retinal necrosis syndrome were reviewed.

To understand the present situation of sport participation in community residents of Shanghai，study infecting factors to the regular sport participation rate and evaluate recognition degree of the relationship of sport and chronic disease，we carried out questionnaire survey indoors among the permanent residents,aged 35～74,in East Nanjing Road community, including survey on chronic disease and sport participation situation. The material was statistically analyzed and the related factors were proved by x2 test. The results showed that in 1457 permanent residents,470 regularly participat in sport, and were classified as sport population. The prevalence was 32.3%.The gender, age, education level, occupation and chronic disease had statistical significance (P<0.05) and they were probably infecting factors of the regular sport participation rate. Currently,the regular sport participation rate in community is relatively high and the purpose of sport participation was evident, however, the age structure of sport population was imbalance. The sport participation in residents was individualized and without proper scientific instruction.

BACKGROUND: Cervical spondylosis is a common disease in middleaged and elderly people. There are many methods of rehabilitative treatment such as traction, massage, medical gymnastics, acupuncture and local blocking, etc.OBJECTIVE: To observe the effects of rehabilitative exercise on patients with cervical spondylosis by way of quantitative generalized boxing exercise combined with local cervical medical exercise.DESIGN: Self-control study on patients with cervical spondylosis in the community for 3 monthsSETTING: Department of Rehabilitation Medicine, Huashan Hospital Affiliated to Fudan University PARTICIPANTS: The indoor questionnaire investigation about chronic diseases in community was carried out on 1 457 inhabitants with the age from 35 to 74 in a community of South Nanjing district, Shanghai in order to check out the patients with cervical spondylosis who had been diagnosed confirmatively by hospital and exclude the patients with the disease of spinal cord type. There were total 114 patients volunteering to participate in the 3-month rehabilitative treatment with an informed content, including of 12 with cervical type of the disease, 39 with nerve root type, 23 with vertebroarterial type, 5 with sympathetic nerve type, 35 with mixed type and none with spinal cord type.METHODS: 3-month rehabilitative exercise was carried out for the 114 patients with cervical spondylosis.① One or several kinds of generalized boxing exercise such as shadow boxing, eighteen-gesture training practice and joint exercise were chosen by the patients according to their own in terest and physical energy. It was required that patient exercise was done for 3 months with one time a day, and each time for no less than 30 minutes, with the intensity after each exercise arriving to the target heart rate level of 170 subtracting their age. ② Aiming to exercise the cervicalshoulder part and to relax its related functions, the local cervical medical exercise has 12 procedures including turning left and right, moving neck around, shrinking head and relaxing shoulders, stretching neck and extending back, turning head and watching the moon, waving arms, putting up arms, lifting chest and squaring elbows, and trying hard to stretch neck.It was required that each procedure be repeated 5 to 10 times at the beginning and later more times increasing gradually, and the whole set of exercise be practiced for 3 months with lor 2 times each day and each time lasted at least 10 minutes.③No other treatment was performed by the patients except for the above exercise intervention. The effects were evaluated after 3 months.MAIN OUTCOME MEASURES: ①The evaluated results of the curative effect in all patients with 3-month rehabilitative exercise.② Relationship between types of cervical spondylosis and curative effect ③ Relationship between course of disease and curative effect RESULTS: According to the intention-to-treat analysis, all the 114 patients persisting in the 3-month exercise intervention entered the result analysis. The curative effect evaluation: among the 114 patients, 44 were with the general curative effect, 40 with marked improvement, 25 with improvement, 5 with inefficacy. The percentage of the general curative and marked improved is 73.7%, and that of total improvement is 95.6% The clinical manifestations of all patients with cervical spondylosis including cervicoscapulargia, radioactive numb and pain in unilateral or bilateral upper arms, dizziness, tinnitus, headache, etc.were distinctively improved ② Relationship between the types of cervical spondylosis and curative effect: after 3-month treatment of rehabilitative exercise, the percentage of the general curative effect and marked improvement in patients with cervical type and nerve root type was higher than that in patients with verteboarterial type, sympathetic nerve type and mixed type (91.7%,97.4%, 47.8% ,20.0% ,65.7% respectively and p value below 0.01). ③ Relationship between the course of cervical spondylosis and curative effects: the percentage of the general curative effect and marked improvement in patients with the course of less than one year is 90.9% and that in patients with the course of 1 to 5 years is 88.6%, which were all higher than that in patients with a course of 5 more years (p value below 0.01).CONCLUSION: Quantitative generalized boxing exercise combined with local cervical medical exercise is helpful to improve the radiculopathy symptoms, but only combined with other treatments could patients with vertebroarterial type receive the best curative effect. In addition, there is a certain relation between the course of disease and curative effect, and patients with cervical spondylosis should be treated with rehabilitative exercise as early as possible, which suggestes that it is worthy of popularization that patients with cervical spondylosis are organized to practice quantitative boxing exercise combined with cervical medical exercise in the community.

Thyroid neoplasm is one of the most common endocrinal tumors. In general, thyroid cancer patients are usually presented with asymptomatic neck nodules. A differential diagnosis between malignant and benign thyroid neoplasm is very important for these patients. This review article primarily discusses biological markers used to aid the differential diagnosis of thyroid neoplasia, which may lead to a more rational approach to the treatment. It mainly describes the recent development of molecular biological markers VEGF-C, Cytokeratin-19, HBME-1, Pax8-PPAR and Galectin-3 for the differential diagnosis of thyroid neoplasms.

Objective To improve the diagnosis and treatment of hepatic angiomyolipoma. Methods Retrospective analysis was made on 8 cases of hepatic angiomyolipoma in terms of clinical findings,image,pathologic examination and surgical treatment.Results Correct preoperative disgnosis was made in only 1 case, 4 were misdiagnosed as malignancy. All 8 cases underwent hepatectomy with an uneventful recovery and without recurrence at follow up.Conclusions Hepatic angiomyolipoma is characteristic of clinical as well as image features, although it is often difficult to make correct diagnosis before operation owing to low incidence and variable imaging appearances.

Background and purpose:The traditional 3 incision surgery is an important means of esophageal cancer treatment, however, accompanied by more postoperative complications and higher mortality. Minimally invasive esophagectomy is a prospective technology with advantages, such as little trauma and quick recovery. This study retrospectively analyzed the perioperative effect of the esophagus cancer patients who accepted thoracoscopic-laparoscopic esophagectomy (TLE), open-laparoscopic esophagectomy (OLE) and open esophagectomy (OE) from Jan. 2013 to Jan. 2015. Methods:In this study, 72 patients received TLE, 76 patients received OLE and 115 patients received OE, respectively. One-way ANOVA, Kruskal Wallis test and Chi-square test were used to compare the differences of general clinical data, perioperative recover index, the number of lymphadenectomy and the postoperative complication among TLE, OLE and OE. Results:There were differences in the area of operative blood loss, duration of ICU stay and first standing time among the 3 groups. Pairwise comparison demonstrated that TLE group was signiifcantly better than OE group (P<0.012 5). The total number of lymphadenectomy among the 3 groups had no differences. However, the number of lymph node of the upper esophagus in the TLE groups was more than those in OLE group and OE group (P<0.001). The laryngeal recurrent nerve injury incidence in TLE group was signiifcantly higher than those in OLE group and OE group (P=0.012, 0.003). The total surgical complication had no differences among 3 groups. In areas of the cardiorespiratory system severe complication, 3 groups had statistical differences. Pairwise comparison showed TLE group was significantly less than OLE and OE group (P<0.0125). The first day and third day incidences of SIRS rate in TLE group were less than those in OLE group and OE group (P<0.0125). Conclusion:Comparing to OE group, with the same safety and feasibility, TLE had more advantages such as trauma, quick recovery, less complications. With the same effect of total lymphadenectomy to OE, TLE had the more advantage in upper mediastinal and recurrent laryngeal nerve lymph node cleaning.

BACKGROUND:Thoracolumbar fracture becomes more in the clinic. The fixation manner of thoracolumbar fracture is controversial. Injured vertebra pedicle screw fixation or traditional cross-segment pedicle screw fixation are controversial and lack the support of evidence-based medicine. OBJECTIVE: To evaluate the outcomes of injured vertebra pedicle screw and cross-segment pedicle screw fixation for thoracolumbar fractures. METHODS: According to Cochrane system evaluation, the folowing databases were retrieved: National Library of Medicine database, China National Knowledge Infrastructure, Wanfang database and VIP database. Conference proceedings were searched by hand. The retrieval time ranged from 2005 to March 2015. Randomized controled trials were colected. Meta-analysis was performed by using Cochrane Colaboration Revman 4.2. RESULTS AND CONCLUSION: By screening, a total of 14 clinical controled trials were selected, including 956 patients. Meta-analysis results showed that postoperative Cobb angle was improved significantly in the vertebral pedicle screw group than in the cross-segment pedicle screw fixation group (OR=-2.72, 95%CI:-3.08--2.35,P < 0.01). Correction rate of the vertebral height was higher in the vertebral pedicle screw group than in the cross-segment pedicle screw fixation group (OR=7.45, 95%CI:6.94-7.97,P < 0.01). The failure rate was lower in the vertebral pedicle screw group than in the cross-segment pedicle screw fixation group (OR=0.12, 95%CI: 0.05- 0.27,P < 0.01). Results verify that postoperative Cobb angle improved significantly after the injured vertebrae pedicle screw and cross-segment pedicle screw fixation for thoracolumbar fractures. The height was obviously corrected and fewer complications were caused such as implant failure. The fixation effect was good.

Objective To observe the clinical efficacy and safety of close-loop muscle relaxant injcction system (CLMRIS) combined with auditory evoked potentials index for monitoring in elderly patients during general anesthesia.Methods A total of 100 patients undergong abdominal operation with ASA Ⅰ-Ⅱ anesthesia in our hospital from February 2012 to October 2012 were selected.Patients were randomly divided into 2 groups:the traditional group (n=50) and the CLMRIS group (n=50).The traditional group was anaesthetized according to clinical experience,and the CLMRIS group was used with the muscle relaxant guided by the close-loop muscle relaxant injection system.The auditory evoked potential (AEP) index and the life index were observed,and the dose of muscle relaxant,the time of consciousness recovery,dynamic response rate during operation and the adverse reaction were recorded at the time points at entering the operating room,induction of anesthesia,tracheal intubation,incision,into the abdominal,exploration,closing abdomen,skin suture,consciousness recovery,tracheal extubation,out of room (T0-T10).Results The vital signs in all patients were stable.The dynamic response rate during operation was lower in the CLMRIS group than in the traditional group at each time points of T8-T10 (all P＜0.05).There was no increase in mean artery pressure (MAP) and heart rate in groups at the time points of T0-T1,T8-T10 (all P＞0.05).The time of tracheal intubation,tracheal extubation and consciousness recovery were shorter in the CLMRIS group than in the traditional group [(268±30.4) min vs.(172±23.7) min,(14±6.4) min us.(18±7.9) min,(8.8±2.9) min vs.(12.2±4.6) min,respectively,t=3.277,6.341,3.346,all P＜0.05].There were no significant differences in AEP index between groups at the time of T0 (P＞0.05),but at the time of T1,the AEP index was lower in CLMRIS group than in the traditional group (P＜0.05).Conclusions The application of close loop muscle relaxant injection system can improve the safety of general anesthesia in the elderly and reduce the incidence of postoperative residual paralysis.The CLMRIS combined with the auditory evoked potential for monitoring depth of anesthesia can prevent and reduce the incidence of intraoperative awareness,has a strong controllability in general anesthesia with smooth induction,and can reduce the dose of anesthetic drugs to achieve the best anesthetic effect.

Objective To assess the blocking effects of a new-type closure device for the puncture point of femoral artery in vitro.Methods An embolic colloidal substance with stable swelling value was embedded in an extracorporeal model which was used as an imitator of femoral artery blood flow velocity.Results The embolization colloid was not displaced by the imitated blood flow lash,the embolic colloid was firmly attached to the puncture point and no fluid extravasation occurred.Conclusion This new-type closure device for the puncture point of femoral artery is simple in structure and easy to manipulate with satisfactory blocking results.

Objective To investigate clinical characteristics of moderate and severe ovarian hyperstimulation syndrome (OHSS) in assisted reproductive technique .Methods The clinical data of 179 cases with moderate and severe OHSS receiving in vitro fertili‐zation‐embryo transfer (including ICSI) in the hospital from June 2012 to April 2013 were analyzed retrospectively .According to the clinical characteristic ,the OHSS was classified as as the moderate type and severe type ,and the late type and early type . Results It was no statistics difference between moderate type and severe type in the patients age ,number of retrieved oocytes ,ad‐mission transaminase ,proportion of fibrinogen normal numbers(P> 0 .05) .But it was a statistics difference between moderate type and severe type in the occurring time days of hospitalization ,hematocrit on admission ,albumin value ,transaminase maximum ,albu‐min dosage used ,proportion of paracentesis number ,pregnancy rate(P < 0 .05) .It was no statistics difference between early type and late type in the patients age ,admission transaminase ,proportion of fibrinogen normal numbers(P> 0 .05) .But it was a statistics difference between early type and late type in the number of retrieved oocytes ,the proportion of moderate OHSS patients ,days of hospitalization ,hematocrit on admission ,albumin value ,transaminase maximum ,albumin dosage used ,proportion of paracentesis number ,pregnancy rate(P< 0 .05) .Conclusion Synthesizing OHSS patients′ blood indexes ,we can evaluated patients′ pathogenet‐ic condition ,the treatment of disease ,and took appropriate preventive measures as soon as possible .Patients with late type may be have more severe pathogenetic condition than patients with early type .