Background One of the difficulties in identifying early glaucoma is the variability of perimetry performance.For this reason,a field defect have to be reproduced more than two consecutive examinations before it is confirmed.The relationship between visual field sensitivity and retinal nerve fiber layer (RNFL) thickness may give us a more efficient and objective assessment to the early diagnosis of glaucoma.Objective This diagnostic test was to evaluate the application of functional-structural relationship between automated perimetry and RNFL in the early diagnosis of open-angle glaucoma.Methods Sixty-four eyes of 64 patients with early open-angle glaucoma and 50 eyes of 50 normal volunteers with the matched age and gender were enrolled in Xiangya Hospital January to June 2007.Visual field examinations,including standard automated perimetry (SAP),short wave automated perimetry (SWAP),and imaging of scanning laser polarimetry with variable corneal compensation(GDxVCC),were performed on the subjects with the informed consent.The sensitivity and specificity of the joint or single measurement of GDxVCC,SAP and SWAP under the local diagnostic criteria,and overall diagnostic criteria were calculated.Results According to the overall diagnostic criteria,the sensitivity of GDxVCC,SWAP and SAP were 70％,63％,61％ respectively,and the specificity were 84％,80％,78％,respectively.According to the local diagnostic criteria,the sensitivity of GDxVCC,SWAP and SAP were 78％,86％,78％,respectively,and the specificity were 54％,40％,50％,respectively.With the local diagnostic criteria,the sensitivity and specificity of serial test of GDxVCC,SWAP and SAP were 86％ and 90％ respectively,and the positive likelihood ratio and negative likelihood ratio were 8.59 and O.16,respectively.Conclusions The functional-structural relationship between automated perimetry and RNFL which can provide valuable individual diagnostic information for patients,and serial test of GDxVCC,SWAP and SAP can reduce the false positive rate and improve the diagnostic performance significantly.

To investigate and analyze the epidemiology of serious corneal ulcer.
● METHODS: A total of 133 serious corneal ulcercases from June 2010 to December 2013 in Xiangya Hospital Affiliated to Central South University were retrospectively reviewed for risk factors, demographic characteristics and diagnosis.
●RESULTS: There were 91 male patients (68. 4%) in the 133 patients. A peak incidence age was from 41 to 60 years old (82 cases, 44. 4%). Most of patients were peasant (77 cases, 57. 9%) and the percentage of the low schooling patients was 85. 0% (113 cases). The number of patients who had been sick was 73 before hospitalization (54. 9%) in all cases. The peak incidence season was January (34. 6%). Average length of stay was 9. 84d. The number of emergency cases was 44 (33. 1%). Most of patient were not only corneal ulcer cases but the hypopyon (92 cases, 69. 2%). The figure of inpatients who received operations was 102 cases ( 76. 7%). And the most of operations was amniotic membrane transplantation (31 cases, 39. 2%). Additionally, this data was classified regard to gender differences.
● CONCLUSlON: The peasant of the middle age and elderly represents a distinct clinical group in the serious corneal ulcer in hospital. Severity, ocular trauma in agriculture and health awareness are the major predisposing factors.

AIM: To test the ability of multifocal visual evoked potential (mfVEP) in the detecting of glaucoma by comparing the mfVEP recorded from normal subjects and glaucoma patients.METHODS: The mfVEP of 32 normal eyes (n =21) and of 58 eyes (n =37) with primary glaucoma were recorded with the Vision Monitor electrophysical apparatus by the second kernel analysis and to determine the correlation of the topographic location between them.RESULTS: There were significant variability (the coefficient of variation was 43.05%) in mfVEP RMS amplitude in the normal subjects; The RMS amplitude of eyes with glaucoma were smaller than that of the normal eyes and significantly statistical difference were found in the relatively center (namely the 0° -10° ring zone) and in superior nasal quadrant (P＜0.05) while there were no significantly statistical differences of the latency time between them.CONCLUSION: The normal subjects have large individual variability of mfVEP responses. The RMS amplitude of the mfVEP of glaucomatous eyes descends, especially in center zone and superior nasal quadrant.

Background The surgery for femtosecond laser created laser in situ keratomileusis(LASIK)flaps has made great progression recent year,but the postoperative corneal wound healing and regeneration of nerve fibers after surgery are closely concerned.Objective This study was to compare and analyze the clinical outcomes between FEMTO LDV femtosecond laser flap and mechanical microkeratome Hansatome flap in LASIK.Methods A prospective case-controlled study was designed.The serial 38 myopic eyes of 38 patients were included from March through July,2010 in Henan Armed Police Force General Hospital.The patients were randomized into FEMTO LDV femtosecond laser assisted flap group(20 patients/20 eyes)and mechanical microkeratome Hansatome assisted flap group(18 patients/18 eyes)with the matched age,gender and refraction of spherical equivalent.HRT Ⅲ examinations were performed before surgery,1 week,1 month and 3 months after surgery to compare the morphological changes atthe center and margin of the flaps,and evaluate the similarities and differences of cellular morphology after surgery between the two approaches.Written informed consent was obtained from each patient prior to this medical trial.Results The best corrected visual acuity was ≥ 1.0 and the refract diopter was similar in both groups(+0.21 D±0.48 D and-0.04 D±0.54 D)1 month after LASIK.The corneal thickness was insignificant increased in the first week after LASIK,and the density of shallow stromal cells was decreased in 1 week,1 month and 3 months compared with pre-operation in the femtosecond laser assisted flap group(t =-27.99,-25.49,-28.87,P ＜ 0.01).In the Hansatome assisted flap group,significantly thickened corneal epithelium was seen in the first week after LASIK compared before LASIK(56.73 μm±2.47 μm versus 51.16 μm±1.11 μm)(t=9.29,P＜0.05),and the density of shallow stromal cells was decreased in 1 week,1 month and 3 months compared with pre-operation in the Hansatome assisted flap group(t =-17.57,-14.13,-19.63,P =0.00).The density of high reflective interface particles in cornea was lower in 1 week,1 month and 3 months after LASIK in the femtosecond laser assisted flap group than that in the Hansatome assisted flap group,showing significant differences between them(t =-13.505,-11.900,-14.084,P＜0.01).The active stromal cells were seen beneath the interface in both groups in the first week and gradually decreased after that time.Intact corneal nerve fibers were found in the femtosecond laser assisted flap group,but those in the Hansatome assisted flap group were shorter and smaller 3 months after LASIK.At 3 months after surgery,the flap margin showed stromal higher reflection and irregular secondary fibrosis in the femtosecond laser assisted flap group,and in contrast,the flap margin had the appearance of a unclearly identified fibrotic scar in the Hansatome assisted flap group.Conclusions Compared with the LASIK and Hansatome assisted flap,the LASIK with FEMTO LDV flap shows earlier nerve fiber regeneration and greater fibrotic scarring,which imply a good wound healing process in the LASIK with FEMTO LDV flap.

Objective To investigate the epidemiology of respiratory viruses in children from Wuxi area.Methods A total of 2 747 cases of children diagnosed with acute respiratory infection in Wuxi during 2011 —2014 were collected.Reverse transcription-polymerase chain reaction was used to detect nine kinds of respiratory viruses,including influenza virus A (Flu A),influenza virus B (Flu B),parainfluenza virus (PIV)Ⅰ-Ⅳ,adenovirus (ADV),respiratory sycytial virus (RSV),human metaneumovirus (hMPV), human bocavirus (HBov),human coronaviruses (hCov)and human rhinovirus (HRV).The categorical data were compared using chi square test.Results A total of 856 among the 2 747 samples were tested positive for respiratory virus nucleic acid,with the positive rate of 31 .16%.The viral distribution was uneven in different seasons,and the infection peaked in winter and spring.The virus detection rate was highest in age 1 to 2 year group (up to 40.18%),and followed by age 6 to 12 year group (32.63%).Flu A virus was the most frequently detected virus,accounting for 7.54% (207/2 747);followed by PIV, accounting for 6.95 % (191/2 747);and Flu B accounted for 4.22%(116/2 747).There were 84 cases of mixed infection of two or more kinds of respiratory viruses,with positive rate of 3.06% (84/2 747 ). Conclusions Our study suggests that Flu A is the most common pathogen in children with acute respiratory infections in Wuxi area during 2011 —2014;virus detection rate is highest in age 1 to 2 year group;and parainfluenza virus is almost detected throughout the year,while the rest of respiratory viruses are commonly seen in winter and spring.

· AIM: To investigate the role of intercellular adhesion molecule-1 (ICAM-1) in the graft rejection of rabbit penetrating keratoplasty (PKP).· METHODS: Sutures were used to produce corneal neovascularization (CNV) on New Zealand white rabbits to make PKP model. Graft mean survival time and rejection index were determined. The levels of sICAM-1 in serum and aqueous humor were dynamically determined by enzyme-linked immunosorbent assay (ELISA).Immunohistochemical technique was used on cornea to get the evidence of expression and distribution of ICAM-1.· RESULTS: Graft mean survival time is (12.4±1.3) days.The mean sICAM-1 levels in aqueous humor and serum in the control animals that did not undergo surgery were (16.6±3.6)ng/L and (95.2±6.3) ng/L respectively. Levels in aqueous humor and serum for the graft rejection group increased postoperatively, continued to increase to (53.9±19.2)ng/Land (378.8±30.6)ng/L, compared to those in the other group (P ＜0.01). ICAM-1 positive cells were found in the graft rejection group.· CONCLUSION: ICAM-1 plays a critical role in initiating and maintaining corneal graft rejection. Sequential determination of serum sICAM-1 after operation may be of value in the prediction and diagnosis of acute rejection.

AIM: To investigate the sensibility of pattern visual evoked potential (P-VEP) on the diagnosis of glaucoma in different temporal frequency.METHODS: The P-VEP were recorded in 51 eyes of 30 primary glaucoma (PG) patients, 16 eyes of 13 ocular hypertension (OHT) patients and 46 eyes of 23 age-equivalent normal people using an array of different temporal frequency and then the patients were compared respectively with the normal group.RESULTS: The P100 wave amplitude in OHT group was significantly lowered at 8Hz, and was lowered at all temporal frequency in PG group, especially when the temporal frequency was higher.CONCLUSION: The P-VEP can be abnormal when the PG is still in its early stage, so it can be an index of early diagnosis and this is more obvious when the temporal frequency is higher, especially at 8Hz.

Objective To study the clinicopathological features and differential diagnosis of bizarre parosteal osteochondromatous proliferation (BPOP). Methods The clinicopathological features of 3 patients with BPOP were analyzed , and related literature was reviewed. Results 3 patients included 2 males and 1 female with an average age 40 years old (24-53 years old). The lesions in three patients were located in the left side of the distal radius, the left side of the little finger inside and the right side of ulna coracoid, respectively. Histologically, characterized by unusual mineralized cartilaginous matrix (`blue bone'), the lesion was composed of a heterogeneous mixture of bone, cartilage and fibrous tissue. Conclusion BPOP is a rare benign surface osteocartilaginous lesion, and its diagnosis and differential diagnosis mainly depend on radiographic and histopathologic features.

Adult ; Aged ; Antineoplastic Agents ; pharmacology ; therapeutic use ; DNA-Binding Proteins ; genetics ; metabolism ; Drug Therapy, Combination ; Endonucleases ; genetics ; metabolism ; Female ; Fluorouracil ; pharmacology ; therapeutic use ; Humans ; Male ; Middle Aged ; Organoplatinum Compounds ; pharmacology ; therapeutic use ; RNA, Messenger ; drug effects ; metabolism ; Statistics as Topic ; Stomach Neoplasms ; drug therapy ; genetics ; metabolism ; Survival Analysis ; Treatment Outcome

OBJECTIVETo sum up the clinical experience in the management of benign prostatic hyperplasia (BPH) with the prostate weighing over 80 ml by transurethral resection of the prostate (TURP) combined with 2 μm continuous-wave laser vaporesection (LVR).

METHODSWe retrospectively analyzed the clinical effects of TURP combined with 2 μm LVR in the treatment of 46 cases of BPH with the prostate volume > 80 ml.

RESULTSAll the operations were successfully accomplished. The operation time and intraoperative blood loss were (112.0 ± 20.0) min (range 86-176 min) and (77.9 ± 25.9) ml (range 50-200 ml), respectively. The catheters were withdrawn at 7 days after surgery. Transient urinary incontinence occurred in 6 cases and secondary hemorrhage was found in 2 postoperatively. Six-month follow-up revealed no urethral stricture or other complications. Compared with the baseline, the international prostate symptom score (IPSS) was significantly decreased at 6 months after operation (26.3 ± 1.8 vs 11.6 ± 1.7, P <0.05), and so were the quality of life (QOL) score (5.3 ± 0.7 vs 1.3 ± 1.1, P <0.05) and post-void residual urine (PVR) ([115.5 ± 55.6] ml vs [19.9 ± 11.6] ml, P <0.05). However, the maximum urinary flow rate (Qmax) was remarkably increased from (4.1 ± 2.6) ml/s to (16.2 ± 1.7) ml/s (P <0.05).

CONCLUSIONTURP combined with 2 μm LVR is safe and effective for the treatment of BPH with the prostate volume >80 ml.

Aged ; Blood Loss, Surgical ; Humans ; Laser Therapy ; methods ; Male ; Middle Aged ; Organ Size ; Prostate ; pathology ; Prostatic Hyperplasia ; pathology ; surgery ; Quality of Life ; Retrospective Studies ; Transurethral Resection of Prostate ; methods ; Treatment Outcome ; Urethral Stricture ; Urinary Incontinence ; etiology ; Urinary Retention