?AIM: To compare the clinical effect of 23G and 25G+vitrectomy for retinal detachment.?METHODS:Forty seven patients with retinal detachment were treated with 23G vitrectomy (27 eyes in 27 cases as group A) and 25G+ vitrectomy (20 eyes in 20 cases as group B ) . The operation time and the incidence of intraoperative complications were recorded. The occurrence of retinal reposition, visual acuity, intraocular pressure ( IOP ) and complications were observed. Postoperative follow-up time of the two groups were 3d, 1wk, 3mo. The relevant records were statistically analyzed and compared.?RESULTS: The operation time of 23G group and 25G+group were 50. 21+4. 52min, 49. 15+5. 14min,respectively and there was no significant difference between the two groups (P>0. 05). The main complications were retinal hemorrhage and iatrogenic retinal hole. There were 3 eyes with retinal hemorrhage, 2 eyes with iatrogenic retinal hole in 23G group, and 1 eye with retinal hemorrhage, 1 eye with iatrogenic retinal hole in the 25G+group, and the difference was statistically significant ( P<0. 05). The postoperative visual acuity of 23G group and 25G + group were significantly improved, and the differences between the two groups were not statistically significant at different time points after operation ( P>0. 05). The number of eyes with hypotonia in 23G and 25G+group were 3 and 1 eyes respectively, the difference was statistically significant ( P < 0. 05 ). But there were no significant differences between the two groups on IOP at 1wk and 3mo after surgery (P>0. 05). At the last follow-up, the results showed that 26 eyes ( 96%) with retinal reposition in 23G group, 19 eyes (95%) in 25G+ group, the difference was not statistically significant (P>0. 05).?CONCLUSION: The clinical effect of 23G and 25G+vitrectomy for retinal detachment is similar, but 25G+vitrectomy can reduce incidence of complications and early postoperative low IOP.

Objective To explore the characteristic manifestations of breast malignant isodense masses using mammography. Methods 121 breast isodense masses with pathological confirmations were collected.Compared indicators with pathological findings were the tumor size,shape,edge,structure changes around the mass,axillary lymph nodes,skin changes,nipple changes,suspi-cious malignant calcification.χ2 test and Logistic regression analysis were used to evaluate the diagnostic values of each indicator.Re-sults In the 121 isodense masses,73 were benign,48 were malignant tumors.According to χ2 test analysis,factors impacted the nature of mass including:tumor morphology (χ2 =14.376,P =0.002),tumor edge (χ2 = 21.555,P =0.000),structure twisted surrounding the mass (χ2 =26.939,P =0.000),axillary lymph nodes (χ2 =1 6.285,P =0.000),skin thickening (χ2 =4.698,P =0.030).According to multivariate binary Logistic regression analysis,risk factors of the Logistic regression model included:edge infiltrating of mass (P =0.014),structure twisted surrounding the mass (P =0.003),axillary lymph nodes (P =0.026).Conclusion The characteristic manifestations of breast malignant isodense masses include edge infiltrating,structure twisted surrounding the mass,axillary lymph nodes.These manifestations are of great significance in differential diagnosis of breast isodense masses.

Background The different incisions in phacoemulsification,including the length,location and shape etc.,can cause surgery-induced astigmatism ( SIA ).But the SIA caused by 2.2 mm,3.0 mm corneal limbal incision after phacoemulsification,especially the change of posterior corneal surface astigmatism is still rarely reported. Objective This study was to investigate the anterior,posterior and total corneal SIA and compare their differences between phacoemulsification and foldable intraocular lens (IOL) implantation with 2.2 mm and 3.0 mm corneal limbal incisions. Methods Seventy-one eyes of 47 cases were randomly divided into two groups with matched age,visual acuity and astigmatism degree.Phacoemulsification and IOL implantation with 2.2 mm incision at the steepest corneal meridian was performed on the patients of 2.2 mm incision group,and the same surgery was adopted with 3.0 mm incision as 3.0 mm incision group.Corneal curvature radius and central corneal thickness were measured by Pentacam at 1 day before surgery and 1 week,1 month and 3 months after surgery respectively.The anterior and posterior corneal surface SIAs were calculated according to the flat axis and steep axis of corneal curvature and the air and the cornea refractive index.Based on the anterior and posterior surface SIAs,the total corneal SIA was then calculated using the vector analysis method.Jaffe/Clayman vector method was used to calculate the anterior and posterior and total corneal SIAs in the different time points,and the differences were compared between the two groups.Oral informed consent was obtained from each subject prior to the trial. Results The mean anterior and posterior surface corneal SIAs appeared to be lower in 2.2 mm incision group compared with 3.0 mm incision group at postoperative 1 day,1 week,1 month and 3 months but were not significantly different among groups at various time points ( anterior SIA:P =0.290 ; posterior SIA:P =0.740 ; total SIA:0.434 ).The mean anterior corneal surface SIAs were significantly lower at the postoperative 3 months than those at postoperative 1 day,1 week in both groups(2.2 mm incision group:P=0.020,0.036;3.0 mm incision group:P=0.006,0.023 ).The posterior corneal surface SIAs were (0.70±0.43 ) D and (0.75 ±0.54 ) D at 1 day in 2.2 mm incision group and 3.0 mm inscision group,respectively,and significantly decreased posterior corneal surface SIAs were found in postoperative 1 week,1 month and 3 months compared with 1 day in both groups ( 2.2 mm incision group:all P =0.001 ; 3.0 mm incision group:P=0.028,0.044,0.032).The total corneal surface SIA showed significant differences between 1 day and 1 week,1 month,3 months after surgery ( 2.2 mm incision group:P =0.015,0.002,0.002 ; 3.0 mm incision group:P =0.049,0.007,0.016 ). Conclusions There are no significant differences in the anterior,posterior and total corneal surface SIAs between 2.2 mm and 3.0 mm incisions after phacoemulsification with IOL implantation.The SIA is gradually reduced with the prolongation of postoperative time.

In recent years, with the extensive development of phacoemulsification and the gradual application of femtosecond laser technology in the field of cataract surgery, femtosecond laser-assisted cataract surgery(FLACS)has become popular year by year, and has been recognized and promoted by more and more doctors. Femtosecond laser technology has high accuracy, automation and repeatability, so it is quite suitable for cataract surgery characterized by precision operation, it can be used in cataract surgery for corneal incision and limbal incision, anterior capsule incision, lens fragmentation and other key operations. FLACS has broad application prospects and can greatly improve the predictability and safety of surgery. The emergence of FLACS is one of the most important developments in modern cataract surgery. With the continuous development of FLACS, cataract surgery will usher in new technological innovations. However, FLACS are relatively new, and longer term, more comprehensive data are still needed to better demonstrate their effectiveness in the future. We review the current research progress of FLACS.

0.05).Our data also showed no significant association between the genotypes and the severity of the disease.One-way ANOVA showed that BDNF genotype had no association to the age of onset for developing AD.Conclusions Our results indicate that Va166Met SNP in BDNF gene is not associated with AD.

Objective To evaluate the effects of measures on the schistosomiasis control after the earth quake in Lushan County so as to provide the experiences for post-disaster schistosomiasis control. Methods The measures taken in schistosomi-asis control after the earth quake were reviewed in Lushan County in 2013 and the epidemic situation of schistosomiasis was in-vestigated and the results were analyzed. Results The schistosomiasis control in floating population and the control of Oncome-lania hupensis snails were enhanced and no schistosome infections were found in both human and livestock. No infected snails and infested water were found. Conclusion The measures of schistosomiasis control after the disaster are effective in Lushan County and the goal to prevent major plague after the earth quake is achieved.

·AIM: To clinical effect of 25G+ vitrectomy combined with intravitreal injection of Conbercept for severe proliferative diabetic retinopathy ( PDR) .·METHODS: A clinical case control study. A total of 35 patients (42 eyes) with severe PDR who underwent 25G+vitrectomy in our hospital from October 2014 to August 2016 were randomly divided into two groups: A and B. Among them, 18 cases (22 eyes) was given conbercept intravitreal injection combined with vitrectomy as Group A;17 cases (20 eyes) was only given vitrectomy without conbercept injection were Group B. Observation of operation duration, intraoperative complications, the incidence of vitreous hemorrhage ( RVH) , macular foveal thickness ( CFT) at 3mo after operation were observed, best corrected visual acuity ( logMAR BCVA ) , and macular foveal thickness ( CFT ) at 6mo after operation were observed too.·RESULTS: The operative time of Group A and B was 58. 23± 8. 18min and 72. 41 ± 10. 31min, the difference was statistically significant ( t = 2. 9, P = 0. 002 ). During the operation, the main complications were iatrogenic hiatus and intraoperative bleeding, Group A of 2 eyes and 1 cases, Group B of 7 eyes and 6 eyes, the difference was statistically significant (P=0. 041, 0. 027). The incidence of vitreous hemorrhage (RVH):at 3mo after operation, that in Group A was 2 eyes, and in Group B was 8 eyes, the incidence of vitreous hemorrhage was statistically significant between the two Groups (P=0. 030). The best corrected visual acuity was 0. 92 ± 0. 35 in Group A and 1. 04±0. 43 in Group B at 6mo postoperatively, but there was no significant difference between the two groups ( t=0. 241, P= 0. 212), but compared with the preoperative visual acuity improved obviously, the difference was statistically significant (t=4. 614, t=7. 355; P<0. 01). CFT:at 3mo after operation, that of Group A was 273. 42 ± 25. 21μm, Group B was 284. 58 ± 27. 44μm, there was no significant difference between the two groups ( t=0. 488, P= 0. 179 ), but there were significantly decrease, the difference was statistically significant( t=3. 152, t=4. 933;P<0. 01 ); at 6mo after operation, CFT of Group A was 238. 16 ± 16. 35μm, Group B was 247. 04 ± 17. 43μm, there was no significant difference between the two groups ( t=0. 571, P=0. 133), but there were significantly decrease, the difference was statistically significant ( t= 2. 474, t=4. 802;P<0. 01).·CONCLUSION: The 25G+ vitrectomy combined with preoperative conbercept intravitreal injection in patients with severe proliferative diabetic retinopathy can effectively improve vision and reduce macular edema, compared with simple vitrectomy, the operation time can be shortened, the incidence of complications can be reduced, and the incidence of vitreous hemorrhage in 3mo after operation can be significantly reduced.

OBJECTIVETo explore the relationship between Chinese medicine (CM) constitutive susceptibility and syndrome diversity in diabetic nephropathy (DN).

METHODSEpidemiologic investigation on constitution adopting the "Constitution in Chinese Medicine Questionnaire" (CCMQ), and survey on syndrome type by CM syndrome scale (preliminary) were carried out in 180 DN patients. Cluster analysis on symptom items was used to determine the syndrome type, and canonical correlation analysis was used to analyze the relationship between patients' constitution and syndrome.

RESULTSBaseline levels in all enrolled patients were not different statistically. Cluster analysis showed 8 syndromes existed in DN patients, namely: I, qi-yin deficiency with qi-stagnancy type; II, yin-yang deficiency with heat-water-blood stasis type; III, qi-yin deficiency with dampness-heat type; IV, yin-yang deficiency with blood-stasis and heat type; V, qi-yin deficiency with stagnant heat type; VI, yin-yang deficiency with inner dampness-heat stagnancy type; VII, yin deficiency with heat stagnancy type; and VIII, Kidney (Shen)-Spleen (Pi) deficiency with stagnant heat type. Correlation analysis on the 8 syndromes and the 9 constitutions showed statistical significant correlations between syndrome III and dampness-heat constitution (P=0.0001); syndrome IV and blood-stasis constitution (P=0.0001); and syndrome VII and yin-deficiency constitution (P=0.0180).

CONCLUSIONCertain relationship revealed between CM constitutions and syndrome types; constitution decides the disease genesis, its syndrome type and prognosis, as well as the change of syndromes.

Aged ; Body Constitution ; Cluster Analysis ; Diabetic Nephropathies ; therapy ; Female ; Humans ; Male ; Medicine, Chinese Traditional ; Syndrome

BACKGROUNDOxidative stress such as low-density lipoprotein (LDL) oxidation is thought to be an important mechanism in Alzheimer's disease (AD). Paraoxonase 1 (PON1), an enzyme located on high-density lipoprotein, can prevent LDL from oxidation to some extent. It is also a potent cholinesterase inhibitor and an arylesterase, combating organophosphate poisoning and metabolization of environmental neurotoxins which might be responsible for neurodegeneration with aging. We evaluated the association of Gln192Arg polymorphism in the PON1 gene with AD in a Chinese Han ethnic population.

METHODSPatients and age-matched controls were recruited from outpatient clinics and a population-based epidemiological survey, respectively. Gln192Arg polymorphism in the PON1 gene was detected by allele-specific PCR technique in 521 patients with AD and 578 healthy controls.

RESULTSThe presence of at least one of PON1 R alleles (Q/R or R/R) was lower in AD patients than in the controls (82.7% vs 87.4%; chi(2) = 4.68, P = 0.03). PON1 gene R allele frequency was lower in AD patients than in the controls (60.7% vs 64.7%; chi(2) = 3.85, P = 0.05). One-way ANOVA showed that PON1 genotype had no effect on the age of onset for developing AD. Logistic regression analysis demonstrated the age and sex-adjusted odds ratio (OR) for the risk of AD in PON1 of PON1 R allele carriers was 0.71 (P = 0.044, 95% CI, 0.51 - 0.99).

CONCLUSIONOur results indicate that Gln192Arg polymorphism in the PON1 gene is associated with AD, and PON1 R allele might be a protective factor for AD in a Chinese Han ethnic population.

Aged ; Aged, 80 and over ; Alzheimer Disease ; genetics ; Aryldialkylphosphatase ; genetics ; China ; ethnology ; Female ; Genotype ; Humans ; Male ; Middle Aged ; Polymorphism, Single Nucleotide

OBJECTIVETo explore the association of Chinese medicine constitution susceptibility to diabetic nephropathy (DN) and transforming growth factor (TGF)-β1 (T869C) gene polymorphism.

METHODSTGF-β1 gene polymorphism detected with polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) was screened for 180 DN cases and 180 type 2 diabetic mellitus (T2DM) cases without combined DN. Patients with DN were surveyed epidemiologically with constitution in the Chinese medicine questionnaire (CCMQ). Binary logistic regression analysis was utilized to study the correlation between nine types of Chinese medicine constitution and TGF-β1 (T869C) gene polymorphisms.

RESULTSThe DN group has a higher frequency of TGF-β1 (T869C) gene polymorphism than the T2DM group, and CC/CT genotypes than the T2DM group [CC, CT, TT (DN group): 88, 87, 5 (cases) versus (T2DM group) 71, 73, 36 (cases), P<0.05]. The phlegm-dampness constitution, damp-heat constitution, and blood stasis constitution have correlations with TGF-β1 (T869C) gene polymorphism.

CONCLUSIONChinese medicine constitutions were associated with TGF-β1 (T869C) gene polymorphism, a potential predictor of susceptibility to DN in T2DM patients.

Aged ; Body Constitution ; genetics ; Diabetic Nephropathies ; genetics ; Female ; Genetic Predisposition to Disease ; Health Surveys ; Humans ; Logistic Models ; Male ; Medicine, Chinese Traditional ; Polymorphism, Single Nucleotide ; genetics ; Transforming Growth Factor beta1 ; genetics