Objective To explore the clinical effects of calium dobesilate combined with compound thrombosis for patients with diabetic retinopathy due to visual field defect.Methods 112 cases of patients with diabetic retinopathy from February 2014 to February 2016 in our hospital were selected and randomly divided into the observation group and the control group,56 cases in each group.The control group were given compound Xueshuantong, while the observation group were treated with calcium dobesilate orally.And both the two groups were treated for five months.The hemangioma volume , macular thickness, hemorrhagic spot area, visual gray value, visual acuity, CRP, VEGF and IGF-1 levels in two groups were measured before and after treatment, as well as the clinical efficacy and adverse effects during the treatment.Results The total effective rate in the observation group was 94.6%significantly higher than that in the control group 71.4% (P<0.05).After treatment, in the two groups the hemangioma volume, macular thickness, hemorrhagic spot area, visual field gray value, visual acuity and 30°threshold sensitivity were significantly improved (P<0.05),but the improvement in the observation group was more (P<0.05).After treatment, the levels of hs-CRP, VEGF and IGF-1 were all significantly decreased (P<0.05), but the observation group decreased more significantly (P<0.05).Adverse reactions were mainly gastrointestinal reactions, and the incidence of adverse reactions in the two groups had no statistically significant difference.Couclusion Calcium dobesilate combined with compound thrombosis for patients with diabetic retinopathy due to visual field defect can improve the visual field defect of diabetic retinopathy patients.Its clinical effects is better and the safety is higher, which mechanism may be related to reducing the level of inflammatory factors in patients.

Objective To evaluate the value of diffusion-weighted imaging in distinguishing the benign and malignant breast lesions.Methods fifty-six female patients with pathologically proven breast lesions underwent MR diffusion-weighted imaging(MR-DWI)using 2 b values.The mean apparent diffusion coefficient(ADC)values and the relative ADC(rADC)values of lesions were measured and analyzed statistically by SPSS 13.0.Results(1)The mean ADC values of the malignant lesions and the benign lesions were(1.02?0.18)?10-3mm2/s and(1.61?0.32)?10-3mm2/s with b=500 s/mm2,(0.99?0.16)?10-3mm2/s and(1.59?0.33)?10-3mm2/s with b =1000 s/mm2,respectively.The mean ADC values of breast malignant lesions were lower significantly than that of the benign,and had statistical significance(P =0.001

Back ground Superoxide anion produced by oxidative stress combined with nitric oxide(NO)released by cellular NO synthase(NOS)generates peroxynitrite(ONOO-)which was one of reactive oxygen species.Objective To study the role of peroxynitrite in the pathogenesis of myocardial stunning(MS)and the effects of aminoguanidine(AMD).Methods Twenty-four dogs were randomly divided into four groups:(1)Short-time myocardical stunning(MS)group:the animals underwent 15 min occlusion of left anterior descending coronary artery(LAD),followed by 120 min of reperfusion.(2)Long-time MS group:60 min of LAD occlusion,followed by 120 min of reperfusion.(3)AMD group:Dogs were subjected to the same ischemia/reperfusion management as Long-MS group,but AMD was administrated(total 100 mg/kg).(4)Sham-operation group.Left ventricular function was evaluated by echocardiography and blood samples were taken from coronary venous sinus for the examination of NO at different time points.The stunned myocardium was examined immunohistochemically and electronic microscope.Results(1)Systolic thickening of stunned myocardium region and left ventricular ejection fraction were markedly declined during LAD occlusion in the 3 experimental groups,but progressively improved with the time of reperfusion.The improvement was faster in short-MS and AMD groups than in long-MS group.(2)Plasma NO concentrations in coronary venous sinus were greatly increased during reperfusion in short-and long-MS group,while no significant elevation was found in AMD group.(3)A marked increase in the immunoreactivity to nitrotyrosine,a specific "footprint" of peroxynitrite,was shown in the stunned myocardium both in short-and long-MS group,with larger and stronger positive foci in long-MS group.The positive staining was located in myocardial cytoplasm,especially at myofibrils and contractile bands.Treatment with AMD significantly reduced the nitrotyrosine staining in the stunned myocardium.(4)No ultrastructural changes of myocardial cells were noted in stunned myocardium in short-MS group except a slight loss of mitochondrial granules.On the contrary,myocyte edema,myofilament fractures,granule loss and swelling of mitochondrias were significant in long-MS group.AMD significantly ameliorated the ultrastructural abnormalities.Conclusion Myocardial stunning was associated peroxynitrite with production which mainly deteriorate the contractile proteins of myofibrils.AMD significantly inhibit the peroxynitrite formation leading to attenuation of the ultrastructural and functional injuries of stunned myocardium.

AIM:To explore the protective effect of ischemic preconditioning on myocardial capillary bed. METHODS: Anesthetized open-chest dogs in ischemic preconditioning (IP) group ( n =6) were subjected to 5 min ischemia and 5 min reperfusion for 4 times in left descending coronary artery (LDA) while the dogs in sham-operated (SO) group ( n =6) were observed for 40 min without any stimulating. Myocardial contrast echocardiography (MCE) was performed before the surgery, at the end of the first and the fourth ischemia and reperfusion period, respectively. Myocardial samples in ischemic area were obtained for capillaries ultrastructure examination and their quantitative analysis was conducted by corresponding imagine analyzing system, then compared within group and between control group. RESULTS: (1) Comparing fourth 5 min ischemia with first one, the percents of area defect in minimum (AD min%) by MCE decreased from 32.6%?5.7% to 21.8%?5.2%( P

Objective To assess the binding capability of microbubbles targeted to VCAM-1 using the parallel plate flow chamber mimic the pulsatile high-shear flow conditions of artery. Methods Targeted microbubbles were designed by conjugating monoclonal antibodies against mouse VCAM-1 to the lipid shell of the microbubbles via an "avidin-biotin" bridge. The binding and retention of targeted microbubbles to VCAM-1 (MBv) immobilized on a culture dish were assessed in a flow chamber at variable shear stress (0.5～ 16.0 dynes/cm2 ). The pulsatile flow conditions were generated and compared to the continuous flow conditions. The retentive ability of MBv was evaluated by the detachment test. Results The marked binding of MBv were seen in pulsatile and continuous flow conditions at low-shear flow conditions of 0.5 ～ 2dyn/cm2 ,but the binding rate in the pulsatile flow group was higher ( P ＜0. 05) than that in the continuous flow conditions. Furthermore,the marked binding of MBv was still noted at the highest shear rates (4～8dyn/cm2) under pulsatile flow conditions, while it was not observed under continuous flow conditions. The half detachment rate of MBv was high up to (20.7 ± 3. 1)dyn/cm2. Conclusions The targeted microbubbles binding to VCAM-1 specific and effective at high-shear stress under pulsatile flow conditions. The molecular ultrasound imaging can be potentially used in the high-shear conditions artery system.

Objective To investigate the expression levels of IFN-γ, IL-4, IL-6 in the plasma of HBV chronic patients.To acknowledge the correlation between the immune function of T-cell with chronic hepatitis B virus.Methods The expression levels of IFN-γ, IL-4, IL-6 in the plasma were determined by ELISA in 42 cases of chronic hepatitis B (CHB group), 30 cases of cirrhosis (LC group), 30 cases of primary liver cancer (HCC group) and 30 cases of health control (NC group).Combine with the load of HBV DNA, HBeAg and ALT, the expression levels of IFN-γ, IL-4, IL-6 were re-analysed.Results The expression levels of IFN-γ, IL-4 and IL-6 in the researched groups were statistically significantly different.The expression levels of IFN-γ, IL-4, IL-6 in CHB, LC and HCC groups were higher than NC group with significance.The expression level of IL-4 in the CHB group was higher than LC and HCC groups with significance.The expression level of IL-6 in the HCC group was higher than CHB and LC groups with significance.Compared with the control group, the ratio of IFN-γ/IL-4 in CHB, LC and HCC groups were decreased with significance.There was significantly positive correlation between the expression level of IL-4 with the load of HBV DNA (r=0.757, P＜0.001).The expression level of IFN-γhad negative correlation between the load of HBV DNA (r=-0.786, P＜0.001) with the level of ALT (r=-0.713, P＜0.001) with significance.There was no significant correlation between HBeAg with the cytokines in the serum of patients with chronic HBV.Conclusion The results showed the immune function of T-cell play important role in chronic HBV patients.That would provide a good basis on CHB treatment.The expression levels of IL-6 were higher in HCC group with significance, which provided the direction for the deep study of liver cancer.

Objective To investigate the effects of parenteral nutrition with ω-3 fatty acids on nutrition,inflammatory response,immunity and prognosis in criticallyill cancer patients.Methods 60 critically ill cancer patients were randomly divided into study group and the control group,30 cases each.All Patients were given isonitrogen and isocalorie enteral and parenteral nutrition for 2 weeks,which added ω-3 fatty acids in the study group by parenteral nutrition.The indicators of nutrition,inflammation,immune function were detected weekly.prognostic indicators (mortality,intensive care unit [ICU] length of stay,infectious complications) were compared.Results The indicators of nutrition,inflammatory reaction and immune function of study group were significantly improved than control group,and length of stay in ICU of study group was shorter than control group.There were less mortality and morbidity of infection complications in the study group compared with control group,but difference were not significant (P =0.13 and P=0.165).Conclusion ω-3 fatty acids supplementation of parenteral nutrition in critically ill cancer patients can improve nutritional status and immune function,reduce inflammatory response,shorten ICU length of stay,but not significantly improve ICU mortality and reduce infectious complications.

Objective To integrate the best available evidence of preoperative care for ophthalmic patients undergoing day surgery into clinical practice,so as to improve the quality of nursing.Methods This project was performed in an ophthalmic day surgery ward,guided by the Joanna Briggs Institute(JBI)Practice Application of Clinical Evidence System (PACES) program which includes 3 procedures:baseline audit,evidence implementation,and re-audit.Eight audit criteria were made based on evidences from JBI.Twelve nurses and 267 patients were enrolled in baseline audit,and 12 nurses and 234 patients were recruited for re-audit after evidence implementation.Results Six of the audit criteria that nurses showed poor compliance in the baseline audit(0％～28.5％),such as providing preoperative telephone screening and reducing preoperative waiting time through better preparation and planning,were significantly improved in the re-audit(71.43％～100％).The preoperative waiting time was shortened from 109.70±18.34 minutes to 88.22±9.91 minutes;the correct rates of operation-related knowledge in patients increased from 63.0％ to 85.09％;the patients' satisfaction scored 84.23±17.01 in baseline audit and 95.02±7.32 in the re-audit(P＜0.001).Conclusion Application of evidence-based preoperative care of ophthalmic patients undergoing day surgery can improve nurse's behavior and compliance with the implementation of evidence into clinical practice,and increase patient satisfaction.Continuous audits are needed to continuously improve clinical nursing quality.

Purpose/Significance To analyze the current status of residents'health literacy levels in China in the context of new media environment,and to explore the pathways to continuously improve residents'health literacy.Method/Process The monitoring data of residents'health literacy from 2012 to 2022 are collected and an empirical research is carried out based on literature analysis.Result/Conclusion Although the health literacy level of Chinese residents shows a stable upward trend,there are still phenomena such as unbal-anced development and a gap between knowledge and action.In the new media environment,health information dissemination should use big data and artificial intelligence(AI)to implement accurate health information dissemination,optimize health behaviors,establish health information evaluation standards and systems,and strengthen the supervision of new media health information dissemination.

Objective:To investigate the clinical features, diagnosis and treatment of oblique vaginal septum syndrome (OVSS).Methods:The clinical data of 80 patients with OVSS admitted to The Second Hospital of Hebei Medical University from July 2005 to July 2023 were retrospectively analyzed. According to the classification system of OVSS proposed by Female Genital Anomalies Study Group, Chinese Obstetricians and Gynecologists Association in 2021, the patients were divided into four groups. The clinical manifestations, accompanied urinary system abnormalities, diagnosis and treatment methods and treatment outcomes were observed.Results:According to the above classification system, among the 80 patients with OVSS, 35 patients (44%, 35/80) were categorized as type Ⅰ, 33 patients (41%, 33/80) were categorized as type Ⅱ, 2 patients (3%, 2/80) were categorized as type Ⅲ and 10 patients (13%, 10/80) were categorized as type Ⅳ. The main onset symptom of patients was periodic abdominal pain (70%, 56/80), vaginal bleeding (20%, 16/80), dysuria or fecal impaction (15%, 12/80), vaginal mucopurulent discharge (10%, 8/80). The morbidity of combined urinary system abnormalities was 88% (70/80), and the most common urinary system abnormality was ipsilateral renal agenesis (81%, 65/80). Bilateral kidneys were normal in 13% (10/80) patients, and 6% (5/80) were combined with other urinary system abnormalities. A total of 74 patients underwent vaginal oblique septectomy or septum excision. Five of the 10 patients with type Ⅳ underwent hysterectomy on the cervical atresia side, 4 patients received hysteroscopy combined with cervicoplasty+oblique septotomy or septum excision, and one patient selected delayed menstruation. Two patients underwent laparoscopic resection of the dysplasia kidney and ectopic ureter which opening to the vagina. Eleven patients with endometriosis cyst, hydrosalpinx or empyema underwent laparoscopic surgery.Conclusions:The main symptom of type Ⅰ and Ⅳ patients is abdominal pain, while the main symptom of type Ⅱ and Ⅲ patients is bleeding. Magnetic resonance imaging (MRI) has advantages in the evaluation of complex OVSS, and MRI is recommended before operation to exclude other axial reproductive tract dysplasia and complex urinary system dysplasia. If there is leakage of urine, vaginal discharge or complex deformity, it is necessary to multidisciplinary discussion and formulate a reasonable surgical plan. The first treatment is related to the prognosis of patients especially children, and should be highly valued.