The corticosteroids are the first-line therapeutical agents for non-infectious uveitis patients, but systemic corticosteroids are ineffective for some chronic or recurrent patients, and have many long term usage-related side effects; these patients may need treatment of immunosuppressive agents and/or biologic agents. However, the mechanism, indication, efficacy and side-effects of each type of the immunosuppressive agents or biologic agents are not identical. In clinical practice, we should use different and sensitive immunosuppressive agents or biologic agents for different types of uveitis, and watch their efficacy and toxic effects closely. In order to improve the effectiveness of the treatment, the classification,efficacy and existing concerns of commonly used uveitis drugs need to be further clarified.

Objective To observe the clinical features,the complications and treatment effects of intermediate uveitis. Methods The clinical data of 36 patients(66 eyes)with intermediate uveitis were retrospectively analyzed,including the clinical features,fundus fluorescein angiography(FFA)features,complications,treatment effects and prognosis.The patients,21 males and 15 females,aged from 8 to 70 years,with the mean age of 34.8 years.There were 30 eases with bilateral lesions and 6 cases with unilateral lesions. Results The main clinical manifestation were vitreous opacity.peripheral retinal venous lesions,optic disc edema,macular edema and posterior subcapsular cataract.The results of FFA showed that peripheral retinal venous lesions,optic disc hyperfluorescence,cystoid maeular edema and retinal vein staining.After the treatment.the visual acuity of 31 cases(60 eyes,90.9%)were improved,4 cases(5 eyes,7.6%)were stable and 1 case(1 eye,1.5%)was worsening.The main complications were cystoid macular edema,posterior subcapsular cataract and vitreous hemorrhage which Ieads to visual damage. Conelusions Intermediate uveitis was a common bilateral and chronic progressive intraocular inflammation,the anterior vitritis,pars plana and peripheral retinal vascular changes were mainly involved.Early diagnosis and proper treatment may prevent the permanent visual damage.

Objective To examine the levels of interferon-γ(INF-γ).tumor necrosis factor-α (TNF-α)and interleukin-6(IL-6)in serum of patients with acute uveitis before and after treatment,and to explore the possible roles of those cytokines in the initiation and progression of the u,ieitis. Methods A series of 75 patients with acute uveitis.and 30 healthy persons from our hospital were investigated.The Ievels of INF-γ,TNF-α and IL-6 in acute phase and convalescent phase were measured by the enzymelinked immunosorbent assay. Result The serum 1evels of INF-γ,TNF-α and IL-6 in acute phase were significantly higher than that of the convalescent phase and the healthy controls(F=65.805/50.418/155.381,P=0.000).A significant negative correlation was found between the serum leveis of INF-γ,TNF-α and IL-6 in acute phase with their initiaI visual acuity(r=-0.656,-0.592 and-0.653,P＜O.01).There was also a positive correlation among the serum levels of INF-γ,TNF-α and IL-6(r=0.340,0.467 and 0.338,P＜0.05). Conclusions There are high serum levels of INF-γ,TNF-α and IL-6 in patients with acute uveitis,and the cytokines levels were decreased after the treatment.The results suggested that the INF-γ,TNF-α and IL-6 involved in initiation and progression of uveitis.

Objective To evaluate the clinical characters of retinal arterial macoraneurysms. Methods The routine eye examination and fundus fluorescein angiography in 15 cases with macroraneurysms were reviewed. Results The macroaneurysms in the first,second and third bifurcation were 6,7 and 2 cases respectively.The macroaneurysms in the superio temporal and inferio temporal artery were 4 and 10 cases respectively.There was on case in both superio and inferio temporal artery.The number of macroaneurysms was single in unitary form were 13 cases.The diameter of the macroaneurysms were between 250～500 ?m. Conclusions The FFA is helpful in diagnosis of macroaneurysms,and treatmnet of laser photocoagulation for the bleeding endangering the macular area.

Objective　To explore the clinical characters and distributions of the endogenous uveitis.Methods　Both clinical examinations and immunologic investigations were performed in 354 patients with cases of uveitis within six years.Results　Among 354 uveitis, the anterior uveitis were 165 cases(46.6%), the posterior uveitis 118 cases (33.3%),the pan-uveitis 57 cases(16.1%) and the intermediate uveitis 14 cases(4.0%). The blind rate among the patients was 5.9%, the main causes were proliferative retinopathy, secondary glaucoma and complicated cataract. 167 cases(47.2%)of patients were related to the systemic changes, the bone-joints disease, Vogt-Koyanagi-Harada syndrome, Behcet syndrome and toxoplasma infection were common.Conclusion　Complete clinical and immunologic examinations can ensure the defined diagnosis and proper treatment for the patients with endogenous uveitis.

Objective　The retrospective case-control study was applied to investigate the crossing characteristics and the distance between the disc and the first crossing site in super-temporal branch retinal vein obstruction.Methods　Fifty-three cases of branch retinal vein obstruction and 53 cases of controls were collected to observe the artery-vein crossing characteristics and to measure the distance between the disc and the first crossing site.Results　The average distances of super-temporal and infer-temporal branch in case group were significantly different. The distance of the super-temporal branch in case group was significantly different from that in the control group. The distances of the super-temporal branch and infer-temporal branch were not significantly different in control group. The numbers of the arteries over the veins in the super-temporal branch in case and control group were significantly different. Conclusion　The mechanism of super-temporal branch retinal vein obstruction is related with the near distance between the disc and the first crossing, and is also related with the numbers of the arteries over the veins in the crossing site.

Objective To explore the clinical manifestations and the characteristics of images of indocyanine green angiography (ICGA) and fundus fluorescein angiography(FFA) of multifocal choroiditis. Methods Eight patients (10 eyes) with multifocal choroiditis were gathered. The clinical manifestations and the images of ICGA and FFA were analyzed. Results Foci of multifocal choroiditis were found in posterior pole and peripheral areas of ocular fundi of all of the 10 eyes. The images of ICGA revealed hypofluorescence in focal area. The images of FFA showed hypofluorescence at the early phase and fluorescein leakage at the late phase in the active focus, and fluorescein staining and window defect fluorescence in the inactive focus. Conclusions The clinical manifestations of multifocal choroiditis varied with disease course, location and numbers of the lesions. ICGA and FFA can show the development of the disease clearly, which may guide the treatment.

Objective To establish an animal model by placing one end of PICC in the hepatic portal vein of a beagle dog and leaving the other end out of its body.Methods Six Beagle dogs were given respiration anesthesia through orotracheal intubation.An incision was made through the right rectus abdominalis to locate the superior mesenteric vein (SMA) and the main hepatic portal vein.The left branch of SMA was separated and cut to put PICC into the main hepatic portal vein before being ligated and fixed.The other end of PICC was elicited through the right abdominal wall and passed beneath the skin to the back neck and fastened in case of movement.Results The anesthetic effect was good and all the operations were successful.The mean operation time was about an hour and the mean blood loss was about 15 ml.The incision healed 5-7 d after operation.Conclusion The establishment of the model can improve the effects of liver-targeting drugs,which can cut down the dosage,lower the cost of treatment and experiment and reduce the adverse effect of medicines.Through PICC,we can directly draw blood from the hepatic portal vein to measure the blood concentration before the first pass elimination.Then according to the concentration,we can calculate the absorption rate in the gastrointestinal tract,which can facilitate related experimental studies.

Objective To study the methodology and results of the auricle repair with expanded skin flap in mastoid process area and Medpor support in children with congenital malformation.Methods Thirty cases of congenital malformation were enrolled with age ranged from 5～16 years old.Whole auricles were all reconstructed with an expanded skin flap in mastoid process area and Medpor support.Resuits In all successful cases.their repaired auricles had the natural complexion and profile,and the positions were symmetric with healthy one,but in 2 cases(age group of 11-16 years),the expanded skin flap had less skin grafting.Conclusion It is suggested that optional operation time might be selected before 10 years old,because their psychological trauma could be avoided owing to microtia and in that age the size of the expanded flap is larger enough to reconstruct the ear as their auricle iS well-developed.

Objective:To investigate the status quo of pain management for cancer patients in hospice care wards of community health service centers.Methods:The electronic medical records of 373 cancer patients admitted in hospice wards of Kangjian Community Health Center of Xuhui District and Jinshanwei Town Community Health Center of Jinshan District from January 2015 to July 2021 were collected. The characteristics of cancer pain, the use of analgesic drugs, the effects of analgesic drugs and its influencing factors were analyzed.Results:The incidence of cancer pain in 373 patients was 93.0% (347/373), and the proportion of moderate to severe cancer pain was 55.6% (193/347). Analgesics were used in 304 patients, among whom 233 (76.6%) patients used oral analgesics, 297 (97.7%) used on time, 97.6%(285/292) used sustained-release opioids, and 94 (30.9%) used combinedly. Breakout pain occurred in 100 cases (32.9%), all of which was controlled with immediate-release morphine. Cancer pain was not relieved in 132 cases (43.42%), and multivariate logistic regression analysis showed that the pain degree on admission (moderate: OR=3.69, 95 %CI:2.09-6.49; severe: OR=5.52, 95 %CI:2.43-12.53), the presence of burst pain ( OR=3.28, 95 %CI:1.77-6.06), the type of analgesics used (non-steroidal+weak opioids: OR=0.39, 95 %CI:0.20-0.76; nonsteroidal+strong opioids: OR=0.20, 95 %CI:0.08-0.51) and the adverse reactions ( OR=1.92, 95 %CI:1.03-3.60) were the influencing factors of pain relief in cancer pain patients (all P<0.05). Conclusion:The pain of cancer patients admitted to community palliative care wards cannot be ignored. Although most cancer pain patients use analgesic drugs in a standard way, there are still a high proportion of patients whose pain is not controlled. Various factors affect the effect of analgesic treatment.