Thrombotic microangiopathy is a group of clinical and pathological syndrome,characterized mainly by hemolytic anemia,thrombocytopenia,and multiple organ dysfunctions,caused by a variety of reasons.Classic types of thrombotic microangiopathy include hemolytic uremic syndrome,and thrombotic thrombocytopenic purpura.Hemolytic uremic syndrome is a critically ill glomerular disease,of which 90％ found in children.Depending on the pathogenesis,hemolytic uremic syndrome is currently divided into 2 categories,namely,typical and atypical hemolytic uremic syndromes.Atypical hemolytic uremic syndrome onsets rapidly,is dangerous disease,tends to recurring easily,and has high mortality in its acute phase.Nowadays,great interest is focused on the important role of the excessive activation of the alternative complement pathway in the pathogenesis of atypical hemolytic uremic syndrome.This article report the recent advances on the cause,diagnosis,and treatment of thrombotic microangiopathy.

There are many reasons for children with anemia of chronic kidney disease (CKD), such as chronic renal insufficiency due to lack of raw materies erythropoietin(iron,folic acid, vitamin B12 deficiency), shortening of the life of red blood cells and blood loss, bone marrow suppression by urine toxins such as erythropoietin.But the main reason is decreased production of renal erythropoietin accompanying chronic renal insufficiency.Anemia affects tissue's oxygen supply, utilization, and cardiac output, and patients often show a series of pathophysiology of immune dysfunction,such as fatigue, difficulty in breathing, enlargement of the hearts, ventricular hypertrophy, heart failure, cerebral insufficiency ,cognitive decline ,affecting the prognosis and quality of life of patients.Renal anemia requires aggressive treatment,which is closely related to the survival and quality of life in patients with chronic renal failure.This paper elaborates on the diagnosis of anemia in children with CKD, the evaluation strategies of anemia,iron therapy and erythropoiesis stimulating agents treatment.

Peritonitis is a primary complication of peritoneal dialysis.In the past concentration was the treatment after peritonitis became evident.With the study of the causes of peritonitis, it becomes evident that, in order to better protect the peritoneal function, more focus should be on the prevention of peritoneal dialysis-related peritonitis, correction as soon as possible the risk factors of peritonitis, and the reduction of the incidence of peritonitis.The main causes of peritonitis include pollution, outlet exports and catheter-related infections bacterial biofilm formation tunnel.Emphasis should be on the occurrence of malnutrition.Albumin levels are risk factors for peritonitis.To reduce the risk of infection new ideas include VitD supplements that regulate immune function.Endogenous microbes associated peritonitis caused by intestinal infections.Future research directions should focus on reducing the risk of intestinal bacteria translocation, regulating intestinal flora, taking a long-range antimicrobial therapy during the critical period, and implementing fecal bacteria transplant.This paper gives an overview of these issues and how to prevent their occurrence.

Objective To explore the techniques of epicanthoplasty with concurrent double eyelid plasty. Methods Epicanthoplasty was performed based on the principle of transverse-vertical plasty. The curvilinear incision of epicanthoplasty was made from the desired point of the new medial canthus to the point 1 mm below the lower lacrimal point, the malpositioned orbicularis oculi muscle excised after skin undermining, the superficial head of the medial canthal tendon plicated or anchored to the lateral nasal aponeurosis and the incision closed after skin redraping. Double eyelid plasty was performed as usual, however, the incision of eyelidplasty was connected with the incision of epicanthoplasty by skin tunnel in which a strip of orbicularis oculi muscle was excised. Results From Oct. 2006 to Feb. 2009, 189 cases were treated. The follow-up period ranged from 3 to 24 months. The cosmetic results of the medial canthi were satisfactory with inconspicuous scar and no recurrence. The contours of the double eyelids were natural. No incisional scar presented between the medial canthi and the upper eyelids. Conclusion The modified transverse-vertical epicanthoplasty with concurrent double eyelidplasty is a simple and reliable surgical approach for correction of epicanthus and creation of supratarsal fold.

Refractory macular hole (MH) has lower surgical anatomical closure rate and poor recovery of visual acuity due to its clinical characteristics.Refractory macular hole includes unclosed MH,reopening MH,large MH,high myopic MH,traumatic MH and secondary MH.Some modified surgeries were employed to improve the surgical results.Inverted internal limiting membrane flap,autologous transplantation of the internal limiting membrane,laser photocoagulation,extended internal limiting membrane peeling,arcuate retinotomy,lens capsular flap transplantation and mesenchymal stem cell transplantation can improve the prognosis partially.Loosening MH traction,providing a scaffold for Müller cell proliferation and promoting photoreceptor reconstruction will be the key points in future.

Plasma exchange as an important technique for blood purification,its treatment involves a wide range of atypical hemolytic uremic syndrome,nervous system disease,kidney disease,poisoning disease,metabolic disease etc.Clinical in pediatric patients for blood purification treatment must be considered in children with primary disease and clinical symptoms,in order to reduce the incidence of various types of complications,ensure the clinical efficacy.

There are many topics in clinical studies of diabetic retinopathy (DR).The current hot topics include the relationship between DR and systemic diseases,major factors for initiation and progression of DR,early DR screening strategies,DR prevention strategies and how to improve the therapeutic effects of DR.However,due to the complexity of DR pathogenesis,multiple risk factors,long cycle of DR prevention and control,it is difficult to exclude all the confounding factors in the DR clinical research.From the long-term perspective,delaying the occurrence and progression of DR and establishing an efficient and practical prevention and control system is the focus of the future DR research in China.

With the indepth studies of molecular mechanisms of renal cell carcinoma ( RCC),people have made great progress in the targeted therapy drugs which targeted at vascular endothelial growth factor (VEGF) and their receptors,which dramatically improve the treatment outcome for patients with advanced or metastatic RCC.However,recent clinical trails show that the targeted therapy drugs may cause adverse events,such as hypertension,bone marrow toxicity,pneumonitis and so on.It is important to manage the adverse events promptly not only to improve the therapeutic efficacy but also to improve the quality of life for patients with RCC.

Diabetes mellitus is a systemic and chronic disease induced by abnormal carbohydrate metabolism,and hyperglycemia,hyperlipidemia and hypertension are main clinical characteristics.Long-term high blood glucose level causes the disorders of microvessels and macrovessels in human tissue and organ,resulting in serious complications and extremely high morbidity and mortality worldwide.Diabetes mellitus increases the risk of eye complications,and the incidence of diabetic eye complications is gradually increased in recent years,which is one of important problems that should not be ignored.Diabetic ocular complications include diabetic retinopathy (DR),diabetic optic neuropathy (DN),glaucoma,cataracts,diabetic ocular surface diseases,etc.So the prevention,early diagnosis and effective management for diabetic eye diseases are challenges.Ophthalmologists should pay more attention to diabetic ocular complications and keep a watchful eye on the renewal of managing guidelines of diabetic eye diseases to reduce the blinding rate and economic cost by early detection and timely treatment.

There are some prevailing problems in the management team,such as low competency,lack of innovative ideas,lack of pioneering spirit,and serious brain drain,etc. Therefore our college has taken measures to pay close attention to the development of our management team and has made remarkable achievements with the help of assement.