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.

Objective To evaluate the approaches and surgical technique for resection of the lesions occupying different parts of the caudate lobe of the liver. Methods The clinical data of cases undergoing resection of lesions originating in the caudate lobe were retrospectively analysed. The operative procedures were chosen according to lesion location. Results A total of 32 patients were operated on. The surgical technique included left, right and anterior transhepatic approach. The mean operative time was (198?73)min (range 60～345 min) and the mean intraoperative blood loss (917?914)ml (range 100～4?500 ml). There was no operative death, with complications occurring in 4 patients (12%). The patients with benign hepatic tumor are all alive after operation and the 1, 2, 3 and 4 year survival rates for the patients with malignant hepatic tumor were 87%, 59%, 43% and 43%, respectively. Conclusion Resection of the caudate lobe lesions different both in sizes and locations varies greatly in operative complexity, with combined hepatectomy being most difficult. Bilateral surgical approaches are suitable for almost all caudate lobectomies.

AIM: To confirm the effects of capillary endothelium injury in the lung with ischemia reperfusion. METHODS: The rabbits pulmonary models of ischemia reperfusion (I-R)injury were established. Plasma nitric oxide and endothelin levels, arterial oxygen tension and wet/dry weight ratios were determined in different periods in control and I-R groups, and the pulmonary ultrastructure abnormities were analyzed under electromicroscope. RESULTS: The plasma levels of NO and ET-1 in I-R animals increased significantly ,compared with those in sham treated control groups. The level of ET-1 had significantly negative correlation with PaO 2 and positive correlation with the value of the wet/dry weight ratios. The swelling and karyopyknosis of capillary endothelium in the lung with I-R groups were observed in ischemia periods. The injuries of endotheliums and typeⅠandⅡ alveolar cells in 0 5 h of reperfusion were more severe than those in ischemia time, and the injuries began to repair in 2 h of reperfusion time. CONCLUSION: In the I-R group, pulmonary capillary endothelium have been injuried, which may play a prominent role in I-R injury and dysfunction of the lung.

Objective:To observe and compare the therapeutic effect of metoprolol by routine increasing dose method and rapid titration method on acute myocardial infarction (AMI).Methods:A total of 60 inpatients,who were di-agnosed with AMI within 24h and without contraindications for metoprolol,were randomly divided into two groups:routine therapy group (received metoprolol using routine methods,the dose was added in seven days)and rapid ti-tration group (metoprolol was added in three days using titration).The dosage maintained with 190 mg/d after both groups reaching the target dose of 190mg/d;then therapeutic effects were observed in both groups.Results: ①There were no re-myocardial infarction,rehospitalization caused by heart failure and sudden death etc.in both groups;② Patients received echocardiography in outpatients after three months.Compared with routine increasing dose group,there was significant reduction in left ventricular end-diastolic diameter [LVEDd,(55.00±7.56)mm vs.(50.00± 5.81)mm]and significant rise in left ventricular ejection fraction [LVEF,(49.13 ± 10.18)% vs. (57.84±10.34)%]in rapid titration group,P <0.01 both.Conclusion:Rapid titration method could make the pa-tients rapidly reach the targeted dose of metoprolol and inhibit renin release earlier,block the renin-angiotensin sys-tem,and improve myocardial remodeling and cardiac function.

Objective To observe the impact of Aspergillus fumigatus conidia on the early apoptosis of alveolar epithelial cells.Methods A549 cells was first stimulated with tumor necrosis factor-α(TNF-α)or staurosporine (STS)to induce cell apoptosis,and then co-cultured with Aspergillus fumigatus conidia of three different concentrations (5 × 10 5 ,5 × 10 6 ,5 × 10 7 )simultaneously.The changes of the apoptosis rate of A549 cells were detected by flow cytometry.Results The early apoptosis of A549 cells was increased markedly after stimulated with TNF-α ([14.94 ± 0.82 ]% vs [3.26 ± 0.74]%,χ2 =9.18,P <0.05)and STS ([18.10±1 .00]% vs [3.26±0.74]%,χ2 =12.32,P <0.05). When Aspergillus fumigatus conidia of different concentrations were added,the apoptosis rate was decreased (χ2 =31 .23,P <0.05 ).The early apoptosis of A549 cells was negatively correlated with the concentration of Aspergillus fumigatus conidia (rTNF = - 0.92,r STS = - 0.94,both P < 0.05 ). Conclusion Aspergillus fumigatus conidia inhibits the early apoptosis of A549 cells induced by TNF-αor STS and the inhibit effect increases with the concentration of Aspergillus fumigatus conidia.

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.