AIM:By optical coherence tomography to observe macular thickness change characteristics and foveal images of patients with retinitis pigmentosa (RP).METHODS: From September 2014 to September 2016, 74 patients (148 eyes) with retinitis pigmentosa diagnosed in our hospital were selected, and 50 healthy subjects (100 eyes) as normal controls;two groups received optical coherence tomography and fundus camera detection.The images of the macular were obtained to observe and measure the thickness of the macular fovea and at 4mm temporal side, the center of papillo macular bundle.RESULTS:The results showed that: the thickness of the macular fovea and at 4mm temporal side of RP patients were the same as normal controls without statistically significant(P>0.05);the thickness of the center of papillo macular bundle was less than that of normal control with statistically significant (P<0.05).There were five types characteristics in OCT imges in RP patients: macular edema in 19 patients 38 eyes;retinal pigment epithelium and choroidal capillary thinning in 18 patients 36 eyes;retinal pigment epithelium atrophy in 12 patients 24 eyes;normal in 12 patients 24 eyes;different thickness of pigment epithelium layer in 13 patients 26 eyes.CONCLUSION: Optical coherence tomography (OCT) can be used to detect the macular lesions in a timely manner, to help understanding the development of the disease, and provide the clinical basis for the early diagnosis and treatment of patients.

Objective To study the therapeutic efficacy of Rex shunt in treating pediatric patients with prehepatic portal hypertension (PHPH).Methods Five children with PHPH who were admitted from October 2014 to May 2015 were reviewed.There were three boys and two girls,with age ranging from 50 to 95.5 months [(75.8 ± 1.9) months].They all suffered from recurrent upper gastrointestinal (GI) bleeding.Their red blood cell (RBC),white blood cell (WBC) and platelet (PLT) counts were decreased,but laboratory findings revealed no liver dysfunction.Ultrasound and CT scan diagnosed cavernous transformation of portal vein (CTPV) and splenomegaly.The mean splenic length was (42.8 ± 8.2) cm.Indirect portal venography revealed patent left portal vein.All patients underwent Rex shunt and were followed up for 3 ～ 7 months.Results The mean duration of operation was (566.0 ± 39.7) min.Intraoperative bleeding varied from 10 to 50 ml.The portal pressure significantly decreased after surgery from [(25.6 ± 1.5) mmHg,1 mmHg =0.133 kPa] preoperatively to (19.2 ± 3.3) mmHg postoperatively (P ＜ 0.05).Portal venography indicated patent left portal vein after the Rex shunt.The postoperative course was uneventful in the five patients with a mean hospital stay of (26 ± 9.3) days.There was no further GI bleeding.The RBC,WBC and PLT counts increased.Ultrasound indicated patent anastomotic stomas and decreased splenic size.Conclusion A Rex shunt in treating patients with PHPH is safe,feasible and efficacious.

Objective To assess the mid-term result of laparoscopy in resection of choledoehal cyst,hepaticojejunostomy and discuss the technical improvement.Methods Retrospectively analyzed the data of 31 patients who had undergone laparoscopic choledochal cyst excision from November 2010 to November 2012.Under laparoscopic guidance,intraoperative cholangiogram was performed,Rorx-Y jejunojejunostomy was performed extracorporeally through umbilical incision,then the dilated bile duct were completely excised and a hepaticojejunostomy was carried out intracorporeally.Results Twenty-nine patients successfully underwent laparoscopic choledochal cyst resection,while 2 patients were converted to open surgery because of severe adhesion.The mean operation time was 260 minutes (range from 200 to 460 minutes).A follow-up of 3 to 27 months were achieved in all patients.Three patients developed early complications:one bile leakage,one incision port hemorrhage and one intestinal torsion.The laboratory tests were normal and no dilation of the bile duct was detected in all patients.Conclusions Laparoscopic total cyst excision with Roux-Y hepaticojejunostomy was effective and safe procedure with satisfied results.

Objective To evaluate the diagnostic accuracy of GenoType? M TBDRsl for the resistance to fluoroquinolones anti‐tuberculosis drugs .Methods Systematic and comprehensive literature was searched in PubMed ,Embase ,Web of Science ,CBM , CNKI ,VIP and Wanfang database .The relative studies of GenoType? MTBDRsl to fluoroquinolones anti‐tuberculosis drugs were included .After quality assessment ,Meta‐Disc1 .4 software was used to analyze the data .Results A total of 16 trials ,involving 1 766 participants ,were included .The results of Meta‐analysis showed that the weighted sensitivity ,specificity ,positive likelihood ra‐tio ,negative likelihood ratio ,diagnostic odds ratio ,and the area under summary receiver operation curve were 0 .83 ,0 .96 ,17 .50 , 0 .20 ,108 .46 and 0 .934 9 ,respectively .Conclusion GenoType? M TBDRsl assay for the resistance to fluoroquinolones anti‐tuber‐culosis drugs might be with high sensitivity and specificity ,which could be recommended as efficacy diagnostic tool .

No abstract available.
Humans* ; Macrophages* ; Monocytes* ; Substance P*

Objective To analyze the medical undergraduates'employment intentions and determinants for policy recommendations on how to solve the contraction between the employment and human resources shortage working in the rural place.Methods Descriptive method was used for the employment recognition and unconditional logistic regression was employed for its factors analysis.Results 74.90% interviewees were not high for policy recognition,and only 21.16% undergraduates were willing to work in rural area.Logistic regression analysis found local culture and life environment (OR=2.668),institute performance(OR=0.630)and work challenge(OR=1.509)were key factors to affect their employment.Conclusion To give reform of primary institute performance mainly on pubic health service,take great importance on the medical service,improve work and life environment of rural workers and highly care health workers'career planning and development.

Objective To compare the fetal and maternal outcomes of labor undergoing epidural block anesthesia with and without using hand-and-knee position in the second stage of labor.Methods A total of 1,158 subjects were included in the study.There were 560 subjects in the study group and 598 cases in the control group.All the subjects were divided into study and control group according to the randomized numbers.Both groups underwent epidural block anesthesia and used the same labor way in stage I and stage 3.In the study group,the hand-and-knee position was used for 15～30 minutes combined with uterine contractions and the delivery was done in the lithotomy position.In the control group,the gradidea took the semi-recumbent position with bent knees and bed elevated 40°,combined with uterine contractions until the delivery was done in the lithotomy position.The labor time of stage1,stage2,stage3 and all abor,labor way,perinaueum,complications and newborns were compared.Results The average time of the second stage labor and all labor in the observation group were significantly shorter than those of the control group (P＜0.05).The labor ways in the observation group was better than that of the control group (P＜0.05).The incidence of postpartum urinary retention in the observation group was significantly lower than that of the control group (P＜0.05).The differences of labor time for stage 1,stage2,perinaueum,blood loss rate,newboms' s tomor and neonatal asphyxia between two groups were not statistically significant (P＞0.05).Conclusions Under continuous epidural block anesthesia,the use of the hands-and-knees position in the second stage of labor can reduce the incidence of operative delivery,shorten the labor process,and reduce maternal complications.The method is worthy of promotion.

Objective To study the correlations between bone fracture types and healing time in patients with osteofluorosis. Methods Thirty-seven patients with osteefluorosis and long tubular bone fracture were diagnosed in accordance with radiogram retrospectively. The fractures were divided into two groups: sclerotic and osteoporotic. Twenty four fractured patients with non osteofluorosis were included in the study as controls. All of the patients had operation(open reduction and nickelclad internal fixation). Fracture healing in patients with sclerotic and osteoporotic groups was compared with the control group after operation. Results There were notable differenees(F=4.30,P< 0.05) in term of fracture healing time among the three groups [sclerotic group:(18.4±5.3)weeks; osteoporotic group: (24.5±5.1)weeks; control group: (17.6±3.8)weeks]. Notably, there were significant differences between the osteoporotic and control groups(q=2.34,P<0.05), and between sclerotic and osteoporotic gronps(q=2.51, P<0.05). The healing time of the osteoporotic group was longer than that of sclerotic group. The constituent ratios of fracture healing in sclerotic, osteoporotic and control groups were 73.1% (19/26) ,54.5% (6/11),75.0% (18/24) respectively, and the differences among the three groups were statistically significant(X2=3.67,P<0.05). The healing rate of the osteoporotic group was lower than that of sclerotic and control groups(X2=3.12, 3.36, all P< 0.05). The constituent ratios of healing in the sclerotic, osteoporotic and control groups were 26.9% (7/26),45.5% (5/11),25.0%(6/24), respectively, and there differences among the three groups were statistically significant (X2=4.07 ,P<0.05). The delayed healing rate of the osteoperotic group was higher than those of the sclerotic and control groups(X2= 3.87,3.95, all P<0.05). Conclusions Fracture healing time of osteoporotic osteofluorosis after fracture is longer than normal, and the cause might be the loss of bone mass.

Objective To explore the protective effect of Tea polyphenols(TP) on radiation injury in submandibular glands. Methods Sixty rats were randomly divided into radiation group(R-group) and tea polyphenols combined radiation group (TPR-group), both groups were irradiated with a single exposure of 15 Gy γ-rays delivered to the head and neck area. The rats were intragastrically administered with normal sodium or TP from 14 days before radiation to the experiment ended. On day 3, day 6 and day 30 after radiation, ten submandibular glands glands were taken from each groups. TUNEL method was used to examine the apoptosis of submandibular glands cells and immunohistochemical technique was used to detect the Bcl-2 and the Bax expression in the glands. The morphologic changes of submandibular glands were observed by transmission electron microscopy. Results Apoptosis index in the cell of submandibular glands were significant decreased on days 3, days 6 and days 30 after irradiation, compared with R-group ( F = 56.383, P ＜ 0.01 ). Expression of Bcl-2 and Bax were not significant difference between the two groups. The lesions of submandibular glands in TPR-group were lighter and the apoptosis in cell nuclear were not typical than that of R-group from electron microscope study. Conclusion TP could protect the sumandibular glands against radiation injuries and the mechanism might be realized with the anti-apoptosis in the glands cell.

China ; Congresses as Topic ; Humans ; Integrative Medicine ; Medicine, Chinese Traditional