Objective:This article has summarized the second generation cognitive screening exam(NCSE) about it's subtests,methods of use,applicability,characteristics and flaws.

Epilepsy is a common nervous system disease,with a morbidity of 4.8‰-11.2‰,so there has been about 50 million patients globally.Drug treatment is a major mean to treat epileptic patients.Recently,researches illustrated that cellular immunity disorder and humoral immunity disorder were coexist in epleptic patients,but there was no consensus on whether it was induced by anti-epileptic drugs(AEDs) or epilepsy itself up to now.This article is aimed to explain the impact of AEDs on immunity through review recent literature internal and abroad.

Objective To analysis the clinical characteristics, treatment and prognosis for patients with cervical cancer with lymph lode of paraaortic and /or supraclavicular metastasis after combined treatment in two years. Methods Data of 20 patients with lymph lode of paraaortic and /or supraclavicular metastasis of cervical cancer were analyzed retrospectively. Results There was no evidence of lymph node of paraaortic and supraclavicular metastasis before the first combined treatments according to the MRI/CT/SPECT scans in these 20 patients. However, lymph lode of paraaortic and/or supraclavicular metastasis were seen in two years after treatments, the shortest is two months. One patient was progressing during treatment whose pathologic diagnosis is mucinous adenocarcinoma, died in 6 months from treatment start. There was only paraaortic metastasis in 15 patients, among these, 4 patients were found lymph lode of left supraclavical metastasis after retreatments in 3-6 months. Both paraaortic and left-supraclavical lymph node metastasis in 4 cases. Among these 20 cases, recurrence and to give up treatment, whose median survival time is 7.50 months, recurrence and to gain treatment, whose median survival time is 18.98 months, there was significant difference (x2=7.23, P<0.01). Conclusion Patients with cervical cancer with lymph lode of paraaortic and/or supraclavicular metastasis after combined treatment will obviously extend survival time after retretments, which has positive therapy significance.

Objective To evaluate the treatment and p re vention of urethral stricture complicated by transurethral vapo-resection of pr ostate (TVP). Methods Retrospective analysis was conduct ed by reviewing medical records and following up the patients under study.Among 3012 patients with benign prostatic hyperplasia treated with TVP, urethral stric ture occurred 4 weeks to 22 months following surgery in 95 cases (3.15 %), inclu ding anterior in 47 (49.5%),posterior in 31 (32.6 %) and bladder neck contractur e or occlusion in 17 (17.9%).Their mean age was 68.7 years (range, 55 to 85 year s). Results The 95 patients were followed up for 4～36 m o nths (mean,14 months).Of them,65 cases underwent conventional dilation, in them 59 (90.8%) were cured and 6 had failure,then turning to internal urethrotomy;19 cases underwent internal urethrotomy plus dilation,in them,13 (68.4%) were cured and 6 had failure,then turning to urethroplasty;17 cases of bladder neck contra cture or occlusion underwent transurethral resection of bladder neck scar tissue ,with a cure rate of 88.2% (15 were cured and 2 experienced failure). Conclusions Urethral stricture is a common complication after TVP. The key points of managing the strictures are patients’ alert,close follow-up and early effective treatment.

Objective To study the HLA-DR gene frequency in systemic lupus erythematosus (SLE) patients and its relationship with renal involvement and AN As profile. Mefliods HLA-DRB1 genotype frequency assigned by PCR amplification with sequences-specific primers (PCR-SSP) in 89 Chinese patients with SLE and 106 ethnically and geographically matched controls. Results HLA-DR2 and DR9 were significantly more frequent in SLE patient group (0.36/0.20, RR= 2.36, P

Objective To ensure the quality of live attenuated measles vaccine on the market,viral titers were determined as the market surveillance test.Methods The measles vaccine was sampled from sites located in 24 provinces (cities,autonomous regions) of China,including provincial CDC,municipal CDC,county CDC,and primary users.The virus titer of samples was tested to evaluate the quality status of measles vaccine on the market.Results For all the 54 lots of measles vaccine sampled in this study,the virus titers were in compliance with the requirements of the China Pharmacopeia Vol.III (2005 edition).In comparison with the original test results provided by the manufacturers,the mean virus titer was decreased 0.2 lg?0.3.Conclusion Viral titers of measles vaccine batches sampled from the market were all in compliance with the requirements of the China Pharmacopeia Vol.III (2005 edition).It showed that the measles vaccine in China market has good stability,and the cold chain system for measles vaccine conveyance and storage could ensure the vaccine efficacy.

· AlM:To compare the therapeutic effects of different surgical methods in treating pterygium patients and to observe tear film stability.
· METHODS: A total of 120 pterygium patients ( 120 eyes) were divided into three groups, each 40 cases (40 eyes).Data including SchirmerⅠtest (SⅠt), tear break-up time ( BUT) , corneal fluorescein staining ( CFS) were recorded preoperatively and postoperatively to evaluate the clinical efficacy of surgery and the effects of tear function changes.
·RESULTS:There were no significant differences in BUT in group A before the operation and one month after operation.Groups B and C showed significant difference before and after operation, but differences were not statistically significant ( all P<0.05 ); One month after operation, there was significant difference in CFS among group A, B and C (P<0.05), but the difference was not satistically significant between groups B and C; After 3mo, BUT in group A was not significant difference compared with the preoperative; but there was significant difference in groups B and C (P<0.05).When
compared it between groups B and C, there showed no significant difference; Group A showed no significant difference in SⅠt compared with preoperative, SⅠt of groups B and C were significant differences compared with preoperative (P<0.05), but no significant difference between the two groups;After 3mo, CFS of preoperative group A and group B and group C had no significant difference. After 10mo follow - up, there was axsignificant difference ( P<0.05 ) in recurrence rate in group A comparing with groups B and C, there were differences between groups B and C, but no statistically significant.Surgery is more likely to relapse in summer than in winter.
·CONCLUSlON: Pterygium excision combined with self-corneal limbal stem cell transplantation and Tenon capsule closed is an ideal surgical to reduce the recurrence and improve tear film function to some extent.

AIM:To investigate efficacy of ranibizumab combined with laser treatment for patients with branch retinal vein occlusion (BRVO) and macular edema.METHODS: We selected 67 patients (67 eyes) with BRVO and macular edema in our hospital from March 2013 to June 2016, they were randomly divided into observation group (n=31) and control group (n=36).The observation group was treated with ranibizumab combined with laser treatment.The control group was treated with macular grid photocoagulation.We observed best corrected visual acuity (BCVA), centre macular thickness (CMT) and macular leakage of two groups.RESULTS: The BCVA of observation group at 1, 2 and 3mo after treatment were 0.41±0.07, 0.42±0.05 and 0.48±0.05, significantly higher than those of the control group (P<0.05).The CMT of observation group at 1, 2 and 3mo after treatment were 203.11±59.13μm, 201.41±56.22μm and 204.22±60.13μm, significantly lower than those of the control group (P<0.05).The blood vessel leakage of observation group at 3mo after treatment was significantly better than that of the control group (P<0.05).No leakage ratio in the observation group was 71%.There were no postoperative infection, aseptic endophthalmitis and other complications in the two groups.CONCLUSION: Ranibizumab combined with laser treatment in patients with BRVO and macular edema has better curative effect, can improve the visual acuity of patients, eliminate macular edema, and is safe and reliable.

Objective:To observe the dexmedetomidine by nasal drip on perioperative spinal surgery patients sedation and the effect of hemodynamic changes.Methods:90 ASA grade Ⅰ ～ Ⅲ,years 18 to 65,and in general anesthesia spinal surgery,and postoperative patients have to extube the endotracheal,were randomly divided into three groups:control group (group C),the dexmedetomidine 0.1 μg/kggroup (D1) and dexmedetomidine 1.5 μg/kggroup (D2),(n=30).Record into the OR (T0),before the induction (T1),1 min before intubation (T2),1 min after intubation (T3),start surgy (T4),began to stop general anesthetics (T5),1 min before extubation (T6),3 min after extubation (T7),and into the PACU (T8).The patient's heart rate (HR),mean arterial pressure (MAP),oxygen saturation (SPO2),finish operation from the general anesthetics toextube the endotracheal tube,stay time,patients in the postoperative recovery room Ramsay sedation scores.Results:Three groups of patients when T0 HR,MAP,SPO2,Ramsay sedation scores had no statistical difference (P≥ 0.05);Compared with group C,D1 and D2 group significantly lower each time point of HR,MAP,Ramsay sedation scores increase (P≤ 0.05),SPO2 no significant change (P≥ 0.05);Each time point compared with group D1,D2 group HR,MAP,significantly decreased,Ramsay sedation scores increase (P≤ 0.05),SPO2 no significant change (P≥ 0.05);D1 group HR,MAP,SPO2 at each time point,Ramsay sedation scores have no obvious difference (P≥ 0.05);D2 group HR,MAP,SPO2,Ramsay sedation scores significantly difference (P≥ 0.05).Group C T3,T4,T5,T6,T7 has each time point,T8 HR,MAP,up from T1,T2,Ramsay sedation scores were significantly improved (P≤ 0.05),SPO2 no significant change (P≥ 0.05).Conclusions:40 min before anesthesia induction dexmedetomidine by nasal drip can effectively inhibit intubation and extubation reaction,make the hemodynamic changes is more stable,and significantly reduce the incidence of patients with postoperative agitation.

Objective To optimize the CT pulmonary angiography (CTPA)using right atrium (RA)CT value monitoring to determine the accurate time to peak CT value of pulmonary artery.Methods Sixty patients were randomly divided into two groups and 30 patients for each.Group PT:CTPA acquisition was triggered by pulmonary trunk monitoring,holding breath and 70 mL contrast agent (CA).Group RA:CTPA was performed using triggering from RA with spontaneous respiration and 40 mL CA.Imaging quality, average CT values of pulmonary arteries and veins,as well as their density difference were compared.Results The imaging quality, average CT values of pulmonary arteries and artery-veins density difference were significantly higher in group RA (P <0.05),while the CT values of pulmonary veins were significantly lower in group RA (P <0.05).No significant differences were showed in the proportion of subjects where sixth grade pulmonary arteries were opacified between the two groups (P >0.05).Conclusion CTPA imaging is optimized by triggering from RA CT value monitoring.This technique provides the optimal enhancement of pulmonary artery and minimal contrast filling of pulmonary venous with reduced doses of CA.