Prevention and management of glaucoma is a priority task in the second phase of WHO " Vision 2020" project. In order to popularize the knowledge of glaucoma guideline, the author compiles the protocol of glaucoma guideline summary after referring to those deriving from American Academy of Ophthalmology, European Glaucoma Society, and South East Asia Glaucoma Interest Group. The guideline summary is easy to master and verify, and highlight the crucial points. The ISNT rule of neuroretinal rim is used to differentiate diagnosis between the physiological cup and glaucomatous rim lost. Foster's classification for primary angle-closure glaucoma (PACG) is used to select the treatment for PACG. It is emphasized that taking target pressure in the initial diagnosis, monitoring the optic discs and visual field loss in follow-up, and glaucoma screening by non-mydriatic digital fundus camera in the high risk population with screening diabetic retinopathy.

The primary eye care service is still absent in most of primary medical organizations in present China.Since imaging examinations provide main contribution to the diagnosis of eye diseases,ophthalmology and blindness prevention have technical predominance and requiring market in the field of telemedicine or e-healthy.We have explored different paradigms of blindness prevention according to variable levels of the region economy and medical conditions.In the urban community,the paradigm for preventable blindness has been adopted,and however,in the rural areas,the paradigm for curable blindness has been taken.It should be advocated to combine the primary eye care with the primary healthy care.It is in favor of sharing information,enhancing efficiency,improving quality, as well as entire orientation management to carry out digitalized ophthalmology regional cooperative medical service.Moreover,governmental leading function and policy sustaining are needed to complete the reform.

[Objective]To explore the rabbits' lipid peroxidation and cytokine level change caused by endotoxemia,use EPO for intervention.[Method]Bleed rabbits femoral for shock,after coming to,make injection of endotoxin,two beatings make dysfunctional multi-organs model;randomly divide 24 healthy rabbits into control group(1),2-beating group(2),EPO group(3),8 in each;take blood for testing indexes of TNF?,IL6,IL10 and MDA.[Result]Group 2 was higher than other groups on MDA level,group 3 less than group 2;group 2 was much higher than other 2 groups on TNF?,IL6 and IL10,group 3 less than group 2.[Conclusion]The cytokines and lipid peroxidation participating in the course of multi-organ injury caused by blood loss shock and endotoxemia can be reduced by EPO.

Objective To investigate the variations of serum levels of visfatin in pregnant women with different types of glucose intolerance and the associations with insulin resistance.metabolic parameters and newborn birth weight.Methods Totally,120 pregnant women in late trimester were divided into 3 groups according to the results of 50 g glucose challenge test(GCT)and 75 g oral glucose tolerance test:GDM group(n=45),GCT(+)group(n=20),and NGT group(n=55).Fasting levels of visfatin,insulin,total cholestrol and triglyceride were measured and the newborn birth weight was recorded.Results The serum visfatin level was significantly elevated in GDM group compared with the NGT group[(374.9±23.1)ng/ml vs(308.9±16.8)ng/ml,P＜0.05],but no significant difference was shown when compared with the GET(+)group[(346.5±23.1)ng/ml].Furthermore,serum visfatin levels had no relationship with insulin resistance,metabolic parameter and newbom birth weight.Conclusions Visfatin is elevated in GDM women and closely related with GDM,but not with insulin resistance,metabolic parameters and newborn birth weight.

Male mice of Kunmlng strain were infected with 10 000 tachyzoites intraperitoneally. 2 hours after infection the mice were divided into 2 groups and administered 5 % of amylurn and 200 mg/kg of artemether by gavage for 8 consecutive days. The ultrastructural enzyme cytochemical studles on cytidine monophosphatase (CMP ase) and glucose-6-phosphatase (G-6-P-ase) of the parasites were carried out. CMP-ase was found scattered in the lysosomes of the parasites as well as in the macrophages. No differences were observed in the localization and intensity of CMP-ase activity between the nontreated and treated with drug parasites. G6-P-ase was found surrounding the parasite membrane and scattered in the parasitophorous vacuole in the nontreated parasites. After treatment with artemether, the intensity of G-6-P-ase activity was decreased compared with nontreated control parasites. It is suggested that artemether may exert some action on the G-6-Patase of T. gondii and thus influence the energy metabolism of the parasite.

Objective To obtain panorama X-ray images of the lower extremity with a simple method,eliminate the mosai-cing error,and apply this manual stitching technique for digital radiography to the measurement of the force line in total knee arthroplasty.Methods The track of X-ray tube was preset,and Dicom format data were collected by using digital X-ray ima-ging.Then,the data were imported to photoshop CS4 for manual image registration and image fusion.The reliability of the film was tested by comparing the vertical length of the body symbols proj ection in the coronal plane with that on the panorama X-ray (AutoCAD 2010)images.Moreover,the hip-knee-ankle angle was compared before and after operation.Results The matching sample t-test showed there were no significant differences in the length(4 groups of data)between the greater trochanter femur and the fibular head,and between the fibular head and the lateral malleolus between before and after operation(P>0.05 for all) .The hip-knee-ankles angle was much greater after operation than that before operation.Conclusion This manual stitching technique for digital radiography can produce seamless and precise panorama X-ray images,which can be used to reflect the length and angle of the lower extremity before and after operation.

Multidrug-resistant organisms are growing worldwide public health problem and few therapeutic options remain available.The traditional antimicrobials (glycopeptides) for multidrug-resistant Grampositive infections are declining in efficacy.New antimicrobials that are presently available are linezolid,daptomicin and tigecycline,which have well-defined indications for severe multidrug-resistant organisms infections.Unfortunately,the therapies available for multidrug-resistant Gram-negatives including carbapenem-resistant Pseudomonas aeruginosa,Acinetobacter baumannii and Enterobacteriaceae are limited to colistin and tigecycline only.Distribution of multidrug-resistant organisms are changing in recent years.Strains of multidrug-resistant organisms were dominated by Gram-negative bacteria in most hospital particularly in intensive care unit.Multidrug-resistant/pandrug-resistant Pseudomonas aeruginosa,Acinetobacter baumannii are increasing rapidly in trend.Strategy that includes surveillance,infection control procedures,isolation and antimicrobial principle should be emphasized and implemented to reduce multidrug-resistant organism diffusion.

Objective To observethe effect of continuous veno-venous hemofiltration (CVVH) on serum level of antibrain-antibody (ABAb) in patients with severe traumatic brain injury.Methods Thirtysix patients with severe traumatic brain injury were randomly divided into control group (19 patients) and CVVH group (17 patients).The control group accepted conventional treatment,the CVVH group accepted CVVH treatment additionally for 7 d.ELISA was used to measure serum level of ABAb at 1,3,5,7,14 d after treatment.The change of ABAb in serum of each group was observed.The scores of Glasgow coma scale (GCS) was assessed everyday.Results The level of ABAb in CVVH group was significantly lower than that in control group from the third day after treatment[the third day:(1.28 ± 0.25) kU/L vs.(1.33 ± 0.30) kU/L;the fifth day:(1.37 ±0.17) kU/L vs.(1.42 ±0.22) kU/L;the seventh day:(1.45 ±0.37) kU/L vs.(1.52 ± 0.35) kU/L;the fourteenth day:(1.49 ± 0.41) kU/L vs.(1.67 ± 0.39) kU/L,P ＜ 0.05 or ＜ 0.01].The scores of GCS in CVVH group was significantly higher than that in control group from the seventh day after treatment [the seventh day:(6.95 ± 1.24) scores vs.(5.74 ± 1.51) scores;the fourteenth day:(9.29 ± 1.76) scores vs.(7.22 ± 1.24) scores] (P ＜ 0.01).Conclusion CVVH can decrease the level of ABAb and improve the prognosis.

OBJECTIVE:To provide reference for reasonably designing package inserts of ointment for manufacturers. METH-ODS:According to items included in Management Regulation for Package Insert and Label and Specification for Chemicals and Bi-ological Products for Treatment,labeled items in package inserts of 51 kinds of ointment for external use during Jan.-Jun. 2016 in our hospital were analyzed. RESULTS:Among the 51 kinds of ointment,39 were domestic varieties and 12 were imported variet-ies. In the package inserts of 39 domestic varieties,items with lower labeling rates were overdose,pharmacokinetics,use guid-ance,pharmacology and toxicology,with labeling rates of 2.6%,5.1%,15.4%,28.2%;while the labeling rates of imported vari-eties were 16.7%,83.3%,75.0%,100%. Compared with package inserts of imported ointment,composition,dosage and usage, adverse reactions,contraindications,precautions,drug interactions,medication for special populations were not enough detailed in domestic ointments. CONCLUSIONS:It is suggested that manufacturers consult medicine experts, list all auxiliary materials through Management Regulation for Drug Description and Label,refine and improve the labeling contents of dosage and usage,ad-verse reactions,precautions,medication for special populations,pharmacology and toxicology,overdose,etc. In addition,admin-istrative departments should strengthen the regulatory approval efforts.

OBJECTIVE To identify the risk factors,distribution and kinds of pathogens and control measures for the patients with autoimmune disease(AD) complicated with fungal infections.METHODS Statistical analysis was carried out on the clinical data of 38 patients with AD complicated with fungal infaction.RESULTS The fungal infection in AD mainly occurred in the respiratory tract,urinary tract,digestive tract and on the skin.The main factors of these patients more likely were disturbed immunity,and unreasonable usage of corticosteroids,immunosuppressive agents and antibiotics.CONCLUSIONS It should as early as possible onset the clinical antifungal therapy,reasonable using of corticosteroids,immunosuppressive agents and antibiotics for fungal infaction,and supportive treatment according to the result of antifungal susceptibility test.