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.

Since the evidence-based medicine (EBM) being evoked widely, to seek out the best evidence is becoming the pivotal step for the development of Chinese medicine (CM), and randomized controlled trial (RCT, at most times, it means explanatory clinical trial--ECT) has been accepted as the general golden standard for the evaluation of clinical intervention. However, it is noted that the traditional RCT (ECT) is unsuitable for the special characteristics of individual treatment in CM. The formation and development of CM theory is found on large amount of clinical experiences, and to evaluate its clinical efficacy and safety is the most primary task. Because the CM intervention measures are complex and individualized, the clinical effectiveness of CM is embodied as a complex system, which impacted greatly by the environment factors. It is deemed that the pragmatic clinical trial (PCT) has the character just fitting for the evaluation. The feasibility of PCT in CM clinical evaluation is discussed in this paper in order to raise a new issue for the evaluation of CM effectiveness.
Clinical Trials as Topic ; methods ; Evidence-Based Medicine ; Humans ; Medicine, Chinese Traditional ; methods ; Randomized Controlled Trials as Topic ; methods ; Research Design

Objective To explore exenatide in the treatment of metformin(MET)alone,sulfonylurea (SU)alone or MET + SU combination therapy with poor glycemic control in type 2 diabetic pa-tients and to find effective nursing measures.Methods 24 patients were randomly divided into the con-trol group and the exenatide group with 12 patients in each group.In the exenatide group,exenatide 5μg twice a day for 4weeks,then 10μg twice a day for 12 weeks.Changes of HbAlc,body weight,BMI,FBG,P2hBG,and rate of adverse reaction were compared between two groups.Results Glycosylated hemoglobin (HbAlc),body weight,BMI,FBG,P2hBG in the control group before and after treatment showed no significant difference,while the exenatide group showed better results compared with those before treatment and the control group.Nursing intervention played evident effect on reducing adverse effect such as nausea,vomiting,diarrhea,low blood sugar,headache.Conclusions For patients with type 2 diabetes,using MET,SU alone or MET + SU combination therapy showed poor results of blood sugar control,addition of exenatide therapy can effectively control blood sugar,nursing intervention can significantly alleviate the adverse effects of patients.

Objective To evaluate effects of the daily average temperature on the daily number of outpatient visits for eczema in Lanzhou city.Methods Clinical data were obtained from outpatients with eczema in the Department of Dermatology of 2 third-grade class-A hospitals in Lanzhou city from January 1st 2007 to December 31st 2015,and meteorological data during this period were also collected.Controlling for confounding factors like long-term trends and day of the week,a distributed lag non-linear model (DLNM) fitted with quasi-Poisson link function was used to assess the effects of daily average temperature on the daily number of outpatient visits for eczema,and the analysis was stratified by season,age and gender.Results The exposure-response relationship between the daily average temperature and daily number of outpatient visits for eczema could be roughly described by a W-shaped curve.Stratification analysis showed that the effect of the daily average temperature on outpatient visits for eczema was strongest in autumn and winter,followed by summer,and weakest in spring.Low temperature may have lagged,cumulative and persistent effects on the daily number of outpatient visits for eczema,with the maximum relative risk (RR) value (1.12 [95％ CI:1.03-1.22]) observed at-9 ℃ on lag day 14.With a 1 ℃decrease in the temperature,16％ (RR =1.16,95％ CI:1.00-1.03),14％ (RR =1.14,95％ CI:1.02-1.26) and 13％ (RR =1.13,95％ CI:1.02-1.25) increases in the daily number of outpatient visits for eczema were observed in men,teenagers and middle-aged adults respectively (P ＜ 0.05).However,low temperature had no significant effects on outpatient visits for eczema among women or the elderly (P ＞0.05).The effect of high temperature usually occurred following exposure without lag periods,and was gradually weakened over lag time (P ＞ 0.05).Conclusions In Lanzhou,the effect of daily average temperature on outpatient visits for eczema was strongest in autumn and winter.Changes of the daily temperature may be one of risk factors for eczema.Low temperature had lagged effects on the daily number of outpatient visits for eczema,and the effects were strongest on lag day 14.

OBJECTIVETo explore the mechanism of acupuncture for treatment of lumbar nerve root compression injury.

METHODSFifty healthy SD rats were randomly divided into 5 groups, a normal group, a model group treated by saline, a medication group treated with Caerulein, an acupuncture group treated with acupuncture at L5, L6 Jiaji (EX-B 2) and a warm needle group treated with acupuncture and moxibustion at L5, L6 Jiaji (EX-B 2). The lumbar nerve root compress injury model was made by placing microsilica gel tablet. After they were treated for 14 days, the compressed nerve root was taken and the ultra-microstructure changes of the injured nerve root were observed by electron microscope and changes of nitric oxide synthase (NOS) and calcitonin gene-related peptide (CGRP) expressions were investigated by ELISA assay.

RESULTSThe changes of ultra-microstructure of the nerve root were the most obvious in the model group and the changes in the medication group, the acupuncture group and the warming needle group reduced in order; the NOS activity and CGRP content in the nerve root tissue of the compressed area in the warm needle group were significantly reduced as compared with the model group (P < 0.05), but with no significant difference as compared with those in the normal group (P > 0.05).

CONCLUSIONWarm needle treatment can effectively maintain cellular form, and ultra-microstructures of nerve root dorsal root ganglia, and effectively inhibit the release of inflammatory factors NOS and CGRP.

Animals ; Calcitonin Gene-Related Peptide ; immunology ; Disease Models, Animal ; Female ; Humans ; Inflammation Mediators ; immunology ; Male ; Moxibustion ; methods ; Nitric Oxide Synthase ; immunology ; Radiculopathy ; immunology ; therapy ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Spinal Nerve Roots ; immunology ; ultrastructure

Epigenesis, Genetic ; Humans ; Molecular Epidemiology

OBJECTIVETo investigate the effect of phenylhexyl isothiocyanate (PHI) on the drug-resistance to imatinib in K562/G01 cell line and to elucidate its possible mechanisms.

METHODSMTT assay was employed to access K562/G01 cell growth inhibition after exposure to PHI and/or imatinib at different concentrations. Apoptotic rate of K562/G01 cells was measured by flow cytometry. The levels of P-gp, P210(bcr-abl) and p-P210(bcr-abl) protein were detected by Western blot.

RESULTSPHI inhibited proliferation and induced apoptosis of K562/G01 cells after treated with PHI alone for 24 h. PHI concentration increased from 0 to 40 µmol/L, the inhibitory rate of cell proliferation from 0 to (51.22 ± 1.41)%, and the apoptosis rate from (3.76 ± 1.46)% to (35.35 ± 3.70)%. Combination of 10, 20, 40 µmol/L PHI and various concentrations of imatinib, IC50 s of imatinib were (10.49 ± 1.24), (6.33 ± 1.42), and (0.85 ± 0.17) µmol/L, respectively. When K562/G01 cells treated with 20 µmol/L PHI combined with 10 and 20µmol/L imatinib for 24 hours, apoptosis rate were (43.62 ± 4.23)% and (55.41 ± 4.35)%, respectively, being significantly higher than that with imatinib or PHI alone. PHI concentrations increased from 0 to 40 µmol/L for 7 hours, the P210(bcr-abl)/β-actin decreased from (0.944 ± 0.034) to (0.392 ± 0.025), and the p-P210(bcr-abl)/β-actin decreased from (0.906 ± 0.019) to (0.361 ± 0.021), while the alteration of P-gp was not seen.

CONCLUSIONSPHI inhibits the proliferation and induces apoptosis of K562/G01 cell line. PHI has synergistic effect with imatinib. It partially reverses the drug-resistance to imatinib. The mechanism of reversal of drug resistance in K562/G01 cells might be by inhibiting P210(bcr-abl) and p-P210(bcr-abl).

ATP-Binding Cassette, Sub-Family B, Member 1 ; metabolism ; Apoptosis ; drug effects ; Benzamides ; pharmacology ; Cell Proliferation ; drug effects ; Drug Resistance, Neoplasm ; Fusion Proteins, bcr-abl ; metabolism ; Humans ; Imatinib Mesylate ; Isothiocyanates ; pharmacology ; K562 Cells ; Piperazines ; pharmacology ; Pyrimidines ; pharmacology

OBJECTIVETo explore the feasibility of bovine pericardium used as a material for guiding bone regeneration.

METHODS1 cm x 1 cm x 0.5 cm defects were created on both buccal sides of the mandibles of 11 dogs. One side was covered with Glutaraldehyde (GA) cross-linking bovine pericardium; no membrane covered side was used as control. The animals were sacrificed in 2 weeks, 4 weeks, 8 weeks and 16 weeks after operation to observe the repair of the bone defects.

RESULTS(1) Wounds healed well in 10 dogs. Meanwhile, wounds in dogs of 16 weeks group healed badly and severe inflammatory response was found in bovine pericardium treated area. (2) The pericardium can be maintained in vivo for 16 weeks without absorption, there were only mild inflammatory cells invading. (3) The bone defects covered with bovine pericardium repaired better than control groups significantly.

CONCLUSION(1) GA bovine pericardium have the effect on guiding bone regeneration in the repair of dog experimental bone defects and it is possible that the bovine pericardium will be used as a new kind of GBR material; (2) GA bovine pericardium has good biocompatibility.

Animals ; Biocompatible Materials ; Bone Regeneration ; physiology ; Cattle ; Dogs ; Feasibility Studies ; Male ; Mandibular Injuries ; surgery ; Pericardium ; physiology

OBJECTIVETo discuss the reasons and the treatments for the femoral refracture.

METHODSFrom 2004 to 2008, 10 cases of femoral refracture after plate removal were selected and treated with open reduction and bone nail internal fixation, included 4 males and 6 females ranging from 19 to 48 years with an average age of 33 years old. According to Müller classification, there were 4 cases of type A, 3 of B, 3 of C. The skeletal tissues were taken for pathological analysis.

RESULTSTen patients were followed-up for 10 to 18 months (averaged 14 months). All wound healed at one stage,there were no complications. The fuction of lower limbs walking and weight loading werer recovered. Pathological section showed that part of the lamellar bone tissues were necrotic. The bone architectures were chaotic, micrangium blocked, Haversian canals were atrophy, new vessels and Haversian canals growed in necrotic bone. The tunnel in rigid bone and new Haversian system were formed. The structure was cutting cone. It was the process of new bone substitutting necrotic bone in bony remodeling.

CONCLUSIONThe internal fixation using ordinary plates overwhelmingly destroy blood circulation of bone and cause necrosis of bone. It can also effect bone remodeling and descent mechanical property. Refracture can readily happen after the plate removal. Treatment of open reduction and bone nail internal fixation can achieve excellent and good effect.

Adult ; Bone Plates ; Female ; Femoral Fractures ; pathology ; surgery ; Fracture Fixation, Internal ; Humans ; Male ; Middle Aged ; Recurrence

OBJECTIVETo analyze the characteristics of injuries between two types of Emergency Department (ED) in China.

METHODSWe selected 25 hospital EDs in the whole country as spots for investigation, and designed one special questionnaire to collect information, from 1st July, 2001 to 30th June, 2002.

RESULTSIn city hospitals (CIH), the proportion of injury to all diseases were 19.65%, and in country hospital (COH) it was 29.88%. The fatality rate of injuries was 1.29% in COH, which was higher than that of CIH's (P < 0.001). In COH, ambulance was more frequently used to treat injury patients than in CIH, but the average rescue time was not different. In cities, machinery was the leading cause (about 32.88%), but in country it was due to transpert (35.34%). Traffic accidents, suicide/homicide and unintentional drowning were the main causes of death. In CIH, the number of unintentional poisoning was almost twice as intentional, but in COH the patients due to poisoning suicide act were more than unintentional poisoning, with 2/3 of the poisoning causes were women. Patients due to chemical, drug and food poisoning accounted for 86.13% in CIH, while in COH the main causes were pesticidal, chemical and druggery (89.80%). In all poisons, pesticide was the leading cause for death.

CONCLUSIONIt's suggested that patients with injury be treated timely since the acute injury patients accounted for important part of ED's patients. The differences between CIH and COH were obvious, with better ability of treatment in CIH than in COH. More relevant measures were needed to improve the ability of acute treatment for injuries.

China ; epidemiology ; Emergency Medical Services ; statistics & numerical data ; Female ; Humans ; Male ; Poisoning ; epidemiology ; etiology ; mortality ; Sex Factors ; Surveys and Questionnaires ; Survival Rate ; Wounds and Injuries ; epidemiology ; etiology ; mortality