Uveitis is a kind of inflammatory disease affected in ocular posterior segment.Uveitis sustains a long duration and causes a significant damage of visual function.It often leads to serious complications,such as cystoid macular edema (CME),cataract,glaucoma,retinal detachment and choroidal neovascularization (CNV).In the pathological process of uveitis,inflammatory factors promote the release of vascular endothelial growth factor (VEGF) through a variety of pathways.It has been verified that VEGF level is elevated in vitreous in the patients with uveiticinduced CME.Intravitreal injection of anti-VEGF drugs,including ranibizumab and bevacizumab,can improve the visual acuity in most patients with noninfectious uveitic-induced CME and CNV.However,intravitreously repeated injections of anti-VEGF drugs may be required in some patients.Intraocular injection of anti-VEGF drugs is an optional and effective way for those with persist macular edema and not being suitable for the use of corticosteroid or immunosuppressive therapy.However,anti-VEGF drugs may affect the efficacy of corticosteroid.Therefore,more clinical and basic researches are still needed.The status and progresses in the use of anti-VEGF drugs for uveitisinduced CME and CNV were reviewed.

Subretinal fibrosis contributes to the loss of vision associated with agerelated macular degeneration.Anti-vascular endothelial growth factor therapy is the current standard treatment for exudative age-related macular degeneration.In this review,many risk factors of subretinal fibrosis are discussed,the relationship between anti-vascular endothelial growth factor therapy and subretinal fibrosis,some potential novel therapeutic methods to suppresses subretinal fibrosis are also revealed.

Using optical imaging equipment with different wavelength and computer technology,fundus optical imaging diagnostic techniques can record fundus reflected light,auto fluorescence and emitted light after excitation by external light source in order to observe and analyze the structure and pathological process of retina and choroid.Advances in fundus optical image capture technology (including laser,confocal laser,spontaneous auto-fluorescence,multispectral imaging) and storage and analysis technology,promote this field into a high-definition digital imaging era,with features of rapid,non-invasive,wide-angle three-dimensional multi-level integration,dynamic automatic navigation location tracking and combined application of a variety of optical imaging diagnostic techniques.In order to promote clinical and scientific research of ocular fundus diseases,we need to understand the development trend of optical imaging diagnostic technique,interpret the fundus imaging features appropriately,reasonably chose different inspection techniques,establish standardized diagnosis criteria and continue to expand clinical applications.

Objective:To evaluate the implementation effects of critical illness insurance of New Cooperative Medical System(NCMS) on the occurrence rate and economic burden of major disease expenditure.Methods:Based on the peasant household data of China Family Panel Studies(CFPS) in 2014.the two-part model was applied to analyze the changes in major disease occurrence and burden after the implement of insurance.Results:NCMS critical illness insurance did not reduce the occurrence of critical disease expenditure,but signally cut down the economic burden of serious illness peasants in central and eastern China.Conclusion:The implementation effect of NCMS critical illness insurance was well in central and eastern China,but was poor in western China;the prevention and health care system of NCMS should be built,while the implementation plans and compensation level of critical illness insurance should be improved in western region.

Objective To explore the mechanism of hepatic autophagy inhibition induced by ischemia-reperfusion injury in the aging liver.Methods The healthy male Lewis rats aged 3 months (3M) and 24 months (24M) were selected,and then were randomly divided into 3M IRI group,3M sham operation group,24M IRI group,24M sham operation group.In the experimental group,noninvasive vascular clamp was used to clamp the left and middle hepatic lobes (about 70o％ hepatic ischemia).The liver was subjected to ischemia at 37 0.5℃ for 30min and reperfusion for 6h.The hepatic duodenal ligament was dissected only by sham operation.The serum levels of serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were measured at 6 h after operation.Liver tissues of each group were examined by liver pathology and the number of autophagosome of LC3B in liver tissue of each group was observed under confocal microscopy.The changes of autophagyrelated protein were analyzed by Western blotting.Results The levels of serum ALT and AST in 24M IRI group were significantly higher than those in 3M IRI group,the difference was statistically significant (P＜0.05).Pathological analysis showed that 3M IRI group showed spotty necrosis,the 24M IRI group showed massive necrosis and the infiltration of the inflammatory cells;Confocal microscopy showed that the number of autophagosome in the liver tissue of the 24M sham group was slightly lower than that of the 3M sham operation group and the number of autophagosome in the 24M IRI group was significantly lower than that in the 3M IRI group (P＜0.05).The levels of autophagyrelated proteins (Beclin1 and ATG4B protein) in 24M IRI group were significantly down-regulated compare to 3M IRI group (P＜0.05).Conclusion The ischemia-reperfusion injury of liver in aged rats inhibits autophagy,and its mechanism may be related to the decrease of autophagy-related protein level in hepatic ischemia-reperfusion injury.

ObjectiveTo study the occurrence and influence factors of drug-induced injuries of vital organs caused by traditional Chinese medicine injection.MethodsChina Hospital Knowledge Database (CHKD) from 1993-2013 and case reports concerning adverse effects and drug-induced diseases caused by traditional Chinese medicine injection from Wanfang Data Knowledge Service Platformwere retrieved. Indicator systemwasestablished and relevant contentsweresummarized and analyzed.Results34 types of traditional Chinese medicine injectionswereincluded and 699 drug-induced diseasesweresummarized, taking up 53.98% of the total adverse effects. Among them, the top three included in the drug-induced diseaseswere acanthopanax injection, safflower injection and Mailuoning injection. The non-conformance between the traditional Chinese medicine injections in the literature and instructions mainly reflects unreasonable solvent selection, large compatibility concentration and usage and dosage beyond those specified in the instructions. ConclusionThe occurrence of drug-induced injuries of vital organs caused by traditional Chinese medicine injectionis relatively high, drug instructions shall be strictly followed in accordance with requirements during clinical application.

Objective To compare the clinical effects of proximal femoral nail antirotation (PFNA) and dynamic hip screw (DHS) in the treatment of intertrochanteric fractures in elderly patients.And provide a reasonable basis for clinical treatment of elderly patients with intertrochanteric fractures.Methods The clinical and follow-up records of 58 elderly patients with intertrochanteric fractures treated by PFNA and DHS were retrospectively reviewed.For times of operation,blood loss in operation,length of incision,incidents of complication and Harris's hip functional standard score were compared and analyzed.Results PFNA group operation time[(59.61 ± 8.27)min],amount of bleeding[(234.51 ± 38.80)ml] were both better than the DHS group of[(83.54 ± 11.12)min and (446.57 ±54.01) ml] respectively.There were significant differences (t =9.80,18.10,all P ＜ 0.05).The satisfactory rate was 92.8％ in PFNA group,higher than the DHS group's 83.3 ％ (x2 =6.18,P ＜ 0.05).There was significant difference between two groups in the incident of complication,DHS group was higher.Conclusion PFNA internal fixation with a minimally invasive,fixed solid and recovery fast,is the better internal fixation in the treatment of elderly intertrochanteric fracture patients.

To observe the protective effect of Huangban Granule, a compound of traditional Chinese herbal medicine, on rats with retinal damage induced by light.

Objective To study characteristic findings and the diagnostic value of MRI in pituitary stalk interruption syndrome (PSIS). Methods Twenty-one patients with PSIS were included. Small field of view (FOV) MR1 scanning and clinic hormone detection were performed in all patients. Moreover, fluid attenuated inversion recovery (FLAIR)T,1 WI with fat-suppression sequence was performed in 8 cases. The appearance on FLAIR T1 WI and T2 WI were recorded. The shape of pituitary stalk and antehypophysis, and the signal intensity of posthypophysis were analyzed simultaneously. Results Growth hormone deficiency (GHD) was confirmed by clinic hormone detection in all 21 cases. The level of basal GH varied from 0. 03 μg,/L to 1.50 μg/L. The peak value under GH provocation was from 0. 13 μg/L to 4. 14 μg/L, and the GH was absolute default in all patients. Seventeen cases of them were combined pituitary hormone deficiency (CPHD), and 4 cases were isolated growth hormone deficiency (IGHD). The height of antepituitary was in the range from 1 mm to 3 mm, and the average value was (1.9±1.2) mm. Pituitary stalk was absent in 18 cases and showed as linear and discontinuous stalk in the other 3 cases. The high signal intensity was invisible in normal position in all cases, the high signal intensity spot in the region of infundibular recess of the third ventricle was shown in 19 cases, while it could not be found anywhere in 2 patients with diabetes insipidus. Conclusion PSIS often shows characteristic appearance on MRI, and a definite diagnosis can be made by using MRI combined with clinic hormone detection.

Objective:The treatment of late pregnancy complicated with utedne leiomyoma was investigated.Methods:193 Cases of Iate pregnancy complicated with uterine leiomyoma from January 2003 to August 2008 were recruited in our hospital.According to the delivery route,size and subtype of fibroid,blood loss,operation hours and postoperative inpatient period were compared.Results:104 cases of pregnancy complicated with uterine leiomyoma were diagnosed before cesarean section(CS).No significant differences on blood losses and operation hours were found between CS group and CS+myomectomy group(P>0.05).The operation heurs of leiomyoma in corpus uteri was significantly shorter than leiomyoma in lower uterine segment and cervix(P=0.007).Leiomyoma bigger than 8 cm needed significantly Ionger operative hours and lose more blood than the smaller leiomyoma.Operation hours,blood loss and postoperative inpatient period were significantly different between submucous leiomyoma and subserosal leiomyoma(P<0.05).Conclusions:Pregnancy complicated with uterine leiomyoma should be diagnosed as early as possible.During cesarean section on when leiomyoma is bigger than 8 cm,locating at lower uterine segment or cervix or submucous,the treatment should be cautious.