AIM: To comprehensively investigate the current status of cataract surgery in Leshan city, and find the existing problems according to the survey results as a guide to cataract prevention and treatment in future.
METHODS: We surveyed the status of cataract surgery containing equipments, surgeons and surgery conditions in 17 ophthalmology departments of general hospitals from Leshan including 6 counties, 1 county-level city and 4 districts during 2012. Cataract surgery methods, according to various surgery financial resources, surgical performances and surgical incision, were divided into phacoemulsification and intraocular lens implantation ( Phaco + IOL ) , extracapsular cataract extraction and intraocular lens implantation ( ECCE + IOL ) , and each method contained 2 groups. We analyzed the outcomes following preoperative examination, surgeons, surgical methods, surgical equipments, types of IOL, surgical quantity, surgical results, and intraoperative complication.
RESULTS: In whole city there were 16 operating microscopes, 43 slit lamp microscopes, 12 non-contact tonometers, 1 intraocular lens Master, 8 optical A/B type ultrasonic examination systems, 4 YAG lasers and 12 phacoemulsification instruments. There 15 doctors could complete cataract surgery independently, and 5 of them were phacoemulsification surgeons. The total number of completed cataract surgeries reached 6 211 eyes, containing 3 564 eyes for Phaco+IOL ( 57%) ( preoperative visual acuity ≥0. 3 in Phaco+IOL1 were 1 520 eyes, 24%) and 2 647 eyes for ECCE+IOL ( 43%) ( 1 533 eyes in ECCE+IOL1, 25%). In various groups, off-blindness rate was 94. 80%-100%, off-disability rate was 90. 41%-100%, and 94. 96% - 100% received intraocular lens implantation, intraoperative complication rate was 1. 00%-15. 10%.
CONCLUSION: The distribution of surgeons and equipments in the whole city is unbalanced, and the utilization rate of phaco equipment is low. The levels are different in various hospitals on surgical technique, surgical quantity and surgical results. Phacoemulsification and intraocular lens implantation is considered as the main therapy for cataract, and as a transition to dioptric and personalized cataract surgery. The surgical condition of the city is good, but the proportion of cataract surgery for prevention of blindness in Leshan city is low, and the surgical technique remains to be further improved.

Objective To identify risk factors for anastomotic leakage after low anterior resection (LAR) in rectal cancer patients and study its impact on patients'long-term prognosis.Methods Chnical data were analyzed from 720 patients who underwent low anterior resection(LAR) for rectal cancer between 1996 and 2006.Results Anastomotic leakage after anterior resection occurred in 44 cases(6.1%).The median time of anastomotic leakage after operation was 5.6 days.Muhivariate analysis showed male patients.history of preoperative chemoradiation therapy,diabetes,cancer distance from anus less than 7 cm and hand-sewed anastomosis were independent risk factors predisposing anastomosis leakage (P<0.05).Tumor local recurrence rate was 13.6% in patients suffering from leakage and 5.9% for those without leakage (χ2= 4.116,P<0.05).The distant metastasis rates were 25.0 and 14.1 percent for the leakage and noaleakage groups,respectively(χ2=3.943,P<0.05).The survival rates were 56.8 and 72.5 percent in the leakage and nonleakage groups,respectively(χ2=4.979,P<0.05).Conclusion Sex,preoperative chemoradiation therapy,diabetes,cancer distance from anus less than 7 cm and hand-sewed anastomosis were found to be independent risk factors for anastomotic leakage after rectal cancer surgery.Anastomotic leakage was associated with poor prognosis.

Objective To explore the effect of sealing tube with regular urokinase for the malfunction of central venous catheter(CVC) in patients with hemodialysis (HD).Methods This was a prospective randomized controlled study,132 HD patients with cuff CVC were studied.In the early stage,52 H D patients without 80 patients with regular catheter-locking solution of urokinase.To analyze effect of cuff CVC malfunction,blood flow(BF),dialysis adequacy,anemia and serum albumin (ALB) with regular catheter-locking solution of urokinase.The incidence of catheter malfunction was calculated based on the catheter dysfunction in the first 3 months.Clinical index was measured,recorded BF and calculated urea clearance rate (Kt/V).Results HD patients catheter-locking solution with regular urokinase could reduce the incidence of dialysis catheter malfunction ( 26.3％ vs 32.7％,x2 =32.727,P ＜0.01 ),increase the BF,Kt/V,levels of hemoglobin(HGB) and ALB(P＜0.05 or P ＜0.01).Conclusion Regular catheter-locking solution with urokinase is effective in reducing HD patients incidence of dialysis CVC malfunction,increasing patients BF,dialysis adequacy and the level of ALB,improving anemia.

Objective To investigate the association between carotid atherosclerosis(AS) and serum magnesium(Mg) in hemodialyzed (HD) patients.Methods Clinical index was measured,and intimamedia thickness (IMT) of extracranial common carotid artery and presence of atherosclerotic plaques were determined by high-resolution B-mode ultrasonography.The data were analyzed between plaque positive group and plaque negative group.Results The age,serum phosphate (P),total cholesterol (TCH),low density lipoprotein (LDL),serum C-reactive protein (CRP),serum albumin(Alb),and serum Mg all had significant difference between two groups(t =4.153,2.908,2.301,6.322,5.791,2.341,7.778,P ＜0.01 or P ＜ 0.05).The risk factors of HD patients with AS were serum Mg and CRP(P ＜ 0.01).Conclusions The occurrence of AS was related to low Mg and high CRP in HD patients.

Holistic education is an important philosophy of medical education.Medical graduate students can show their skills of medical specialties,improve their abilities of communication and cooperation,and promote their sense of social responsibility through social practice.Through conducting questionnaire among medical graduate students of Peking University Third Hospital who major in internal medicine,we have got to know the effect of social practice on holistic education philosophy.Meanwhile,social practice is a crucial approach to implementing holistic education.

Acupuncture Points ; Acupuncture Therapy ; instrumentation ; Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Spinocerebellar Ataxias ; therapy ; Treatment Outcome ; Young Adult

Objective To observe the effect of adenosine A1 receptor on pain and electroacupuncture analgesia, and to explore the action mechanism of electroacupuncture in analgesia.Method Adjuvant arthritis rats were taken as the study subjects. 24 rats were randomized into a normal group, a model group and an electroacupuncture (EA) group, 8 rats in each group. The pain threshold was evaluated by using thermal radiation method, immunohistochemical method and real-time fluorescence quantitative PCR were adopted to observe the expression of adenosine A1 receptor in hypothalamus and spinal cord.Result One day after modeling, the pain thresholds of right hind paw in the model group and EA group were significantly changed compared to that before modeling in the same group (P<0.01). The pain thresholds of right hind paw in the model group and EA group were significantly different from that in the normal group one day after modeling (P<0.01). 7 d after modeling, the pain threshold of right hind paw in the model group was still significantly lower than that before modeling in the same group (P<0.01), and it was significantly different from that in the normal group and EA group (P<0.01). The pain threshold was significantly enhanced in the EA group 7 d after modeling, and was significantly different from that of 1 d after modeling in the same group (P<0.01). The positive cell expression was lower in the model group and was significantly different from that in the normal group (P<0.01). The expression of adenosine A1 receptor in the EA group was markedly higher than that in the model group (P<0.01). The expression of adenosine A1 receptor in hypothalamus and spinal cord of the model group was significantly lower than that of the normal group (P<0.01). The expression of adenosine A1 receptor in hypothalamus and spinal cord of EA group was markedly higher than that of the model group (P<0.01).Conclusion EA can up-regulate the expression of adenosine A1 receptor in hypothalamus and spinal cord of adjuvant arthritis rats.

Objective To define the indications and evaluate the results of various surgical treatment options in patients with nonparasitic hepatic cysts. Methods The clinical data of 284 patients with nonparasitic hepatic cysts treated in our hospital from January 1995 to December 2005 were retrospectively analyzed. Results Percutaneous aspiration and sclerotherapy were performed in 161 cases and complications occurred in 9 (5.59%), recurrence in 53 (32.92%) and the mortality was 0%.Open surgery was conducted in 71 cases and the complications occurred in 16 (22.54%), recurrence in 8 cases (11.27%) and the mortality was 2.82%. Laparoscopic surgery was employed in 52 cases and complications occurred in 7 ( 13.46%), recurrence in 6 (11.54%) and the mortality was 1.92%.Conclusion There is currently no general agreement in the literature concerning when nonparasitic hepatic cysts should be treated. Laparoscopic surgery was more favorable than other therapeutic options.However, we should choose individually suitable methods according to different clinical symptom of patients.

The paper analyzes and discusses the necessity of integrating computational thinking into basic computer teaching by combining characteristics of medical undergraduates and the current situation and tendency of basic computer teaching,and states the thought and method of solving problems with the computational thinking by taking mind mapping and program design thought as the teaching cases,in order to cultivate the consciousness and ability of students in constructing problem solutions by taking advantage of the computational thinking.

Objective To explore the significance of day surgery mode on cataract patients for achieving win-win among patient, hospital and medical insurance.Methods 120 cataract patients (selected from December 2015 to June 2016, in the Ophthalmic Center of Leshan People′s hospital) were included in this retrospective study and day surgery group (n=60) was observation group and hospitalization surgery group was control one (n=60).All cases underwent cataract phacoemulsification and intraocular lens implantation.Treatment process, average day on the waiting list, average preoperative stay, average length of stay, medical cost and patient satisfaction were compared between the two groups.Results Days on the waiting list in day surgery group (1.2 d) reduced 8 days than in hospitalization surgery group (9.2 d).Preoperative stay in day surgery group reduced 1.5 days than in hospitalization surgery group.Length of stay ware reduced by 3 days as compared to the control group.The average medical cost in day surgery group was much less than the control group and the patient satisfaction was much higher.Conclusion The high efficiency of day surgery mode can shorten the length of hospital stay, lessen the cost of medical expense, realize the security management of medical service, so as to provide more convenience, more safety, better quality and cheaper medical service for patients.It achieves social and economic benefits and finally achieves win-win among patient, hospital and medical insurance.