Adult ; Ethylene Dichlorides ; poisoning ; Female ; Humans ; Magnetic Resonance Imaging ; Male ; Neurotoxicity Syndromes ; etiology ; pathology ; Young Adult

Hemoglobinuria, Paroxysmal ; therapy ; Humans

Background Rigid gas permeable (RGP) contact lens,as a kind of new correction of refraction error,has been wildly used,but whether it will cause eye optical system of the change and influence on the visual acuity is unclear.Objective Present study was to evaluate and compare the visual quality of low to moderate myopia following wearing of RGP contact lens and spectacles.Methods Sixty-eight eyes of 35 subjects with low or mediate myopia were included in this study.Wave-front aberrations and visual acuities under the different contrasts (10％,30％,40％,52％,76％,92％) in the light or dark environment were examined before and 3 months after wearing of RGP corneal contact lens.These parameters were compared with those after wearing of spectacles with paired t test.Results The best corrected visual acuity (BCVA) was improved significantly from 0.94±0.10 to 1.26±0.03 3 months after wearing of RGP corneal contact lens (t=-9.266,P=0.000).After fitting of RGP corneal contact lens,the total higher order wave-front aberrations,the 3rd and 4th order aberrations were significantly declined in comparison with those of before fitting (total:t=4.683,P=0.000;RMS3:t=4.656,P=0.000;RMS4:t=3.929,P=0.000).However,no significant differences were detected in the 5th and 6th order aberrations between RGP corneal contact lens fitting and spectacles wearing (RMS5:t=1.766,P=0.083 ;RMS6:t=1.150,P=0.256).In both bright and dark environments,BCVA values were much better in the eyes with RGP corneal contact lens wearing than that in the eyes with spectacles wearing (all P＜0.05).The BCVA was always reduced with the decline of contrast level whether bright or dark backgrounds both in RGP corneal contact lens wearing eyes and spectacles wearing eyes.Conclusions Wearing of RGP corneal contact lens provides better visual quality for low to moderate myopia than the spectacles wearing.

0.05). Conclusion Preproghrelin-Leu72Met is not significantly associated with T2DM and DN in Shanghai Han populations,while T2DM with AA genotype is characterized by significant declination in urine microalbumin when compared with CA and CC genotypes.Leu72Met polymorphism(C→A)may postpone the development of microalbuminuria in T2DM subjects.

Objective To investigate the value of carotid and lower limbs arteries atherosclerosis in prediction of intracranial atherosclerosis combined with type 2 diabetes (T2DM). Methods Seventy-four patients with T2DM received the carotid artery , lower limbs arterial color Doppler ultrasound and cranial MRA examination. The data was analysised by Pearson correlation and Binary Logistic methods. Results With the increasement of degree of peri-arterial atherosclerosis , the intracranial arteriosclerosis was in a trend of increase. The correlation coefficients, OR values and AUC of LLAS and CAS + LLAS for intracranial atherosclerosis were 0.28 (P < 0.05) and 0.33 (P < 0.05), 0.14 (P < 0.05) and 9.28 (P < 0.05), 70.30% (P < 0.05) and 70.60% (P < 0.05), respectively. The cut-off point of LLAS and CAS + LLAS was lever 2. Conclusion The LLAS and CAS + LLAS with T2DM are independent risk factors for intracranial atherosclerosis , owning certain forecast values.

0.05).Frequencies of P12A12 genotype and A12 allele in DN group were significantly decreased respectively,when compared with DN-0 group(for P12A12 genotype,9.1% vs 18.1%,P=0.034,OR=0.453;for A12 allele,4.5% vs 9.0%,P=0.041,OR=0.479). Conclusion The observations suggest that P12A polymorphism of PPAR?2 gene is associated with Chinese type 2 diabetic nephropathy,and A12 allele may protect the development of diabetic nephropathy in type 2 diabetic patients of Chinese.

Objective To explore the relationship between Arg913Gln(G→A) polymorphism of solute carrier family 12 member 3 (SLC12A3) gene and diabetic nephropathy (DN) in type 2 diabetes mellitus (T2DM) in Han population of Shanghai. Methods Two hundred and fifty-eight Han ethnic people in Shanghai with T2DM (T2DM group) were divided into non-DN group (DN0 group, n=95) and DN group (n=163) according to 24 h urine albumin excretion rate (AER), and those in DN group were subdivided into microalbuminuria group (DN1 group, n=95) and macroalbuminuria group (DN2 group, n=68). Besides, 82 people with normal results of oral glucose tolerance test (OGTT), without diabetes mellitus and nephropathy were served as controls. PCR-sequencing was used to detect the genotypes of Arg913Gln polymorphism of SLC12A3 gene. Genotypic and allelic frequencies and clinical characteristics were compared among groups. Results Three genotypes (GG, GA and AA) were detected. The frequencies of GA+AA genotype and A allele in T2DM group were higher than those in control group, while there was no significant difference between groups (P>0.05). There was no significant difference in genotypic or allelic frequencies among subgroups of T2DM group (P>0.05). The level of triglyeeride (TG), AER, level of fasting insulin (FINS) and HOMA-IR in patients with GA+AA genotype were significantly higher than those in patients with GG genotype in T2DM group (P<0.05). Conclusion Arg913Gln(G→A) polymorphism of SLC12A3 gene is not significantly associated with T2DM and DN in Han population of Shanghai. The AER of people with GA+AA genotype is significantly higher than that with GG genotype. Arg913Gln (G→A) polymorphism of SLC12A3 gene may predict the risk of increase of albuminuria in patients with T2DM in Han population of Shanghai.

·AlM: To investigate pathogeny and effects of surgery on paralytic strabismus.
· METHODS: A retrospective study was done in 46 patients with paralytic strabismus who underwent squint correction in our hospital from June 2010 to June 2013. Among 26 horizontal strabismus, the cases of extra rectus palsy was 16, internal rectus palsy was 10.Among all20 vertical strabismus, the cases of superior oblique palsy, superior rectus palsy, inferior rectus palsy, double elevator palsy counted for 7, 8, 2 and 3, respectively. Pathogenesis: trauma was 19 cases, followed by 10 cases that the causes could not be identified.Nine was congen ital paralytic strabismus, 8 o ccurred after nose or brain surgery. The surgery methods included rectus muscle recession, rectus muscle resection, partial rectus muscle transposition, Jensen procedure, inferior oblique myectomy and anterior transposition of inferior oblique. Statistical software SPSS10.0 was used in chi-square test between two groups, while the situation of paralysis eye movements improved by two methods in the horizontal strabismus group was compared with t test.
· RESULTS: Among all horizontal strabismus the rate of cure, improvement and inefficiency was 20 ( 77%) , 5 ( 19%) and 1 ( 4%) , respectively. Among vertical strabismus the ratio of cure, improvement and inefficiency was 15 (75%), 3 (15%) and 2 (10%).There was no significantly difference between the two groups ( P >0.05 ). The movements of paralytic eyes were improved. Two procedures used in horizontal strabismus, can improve paralysis eye movements were 3.76 ±0.91, 3.72 ±0.84mm, with no significant difference (P=0.93) statistically.
· CONCLUSlON: Paralytic strabismus in adults had complicated conditions. Choosing different operation methods in treating paralytic strabismus according to the degree of paralysis can result in satisfactory cosmetically alignment of the eyes and modify head position and diplopia.

OBJECTIVE: To investigate the clinical characteristics of the coal workers' pneumoconiosis( CWP) complicated with both tuberculosis and nosocomial infection of stenotrophomonas maltophilia. METHODS: The clinical data of 36 CWP patients complicated with tuberculosis and nosocomial infection of stenotrophomonas maltophilia were collected and retrospectively analyzed. RESULTS: The results of sputum cultured for more than 3 times showed positive stenotrophomonas maltophilia. The main clinical manifestations were cough,sputum,fever and wet rale of lung. Most of the chest X-rays showed light and patchy infiltrated shadows. Drug susceptibility testing indicated that this kind of bacteria was extensively drug-resistant. The drug resistance rates to imipenem,cefepime,aztreonam and cefoperazone were 100. 0%,96. 1%,94. 5% and 89. 8%,respectively. The sensitivity of patients to sulfanilamide methyl isopropyl pbo, ciprofloxacin,levofloxacin and gentamicin were > 60. 0%. After antituberculosis therapy combined with 2 or more sensitive antibiotics treatment based on the sputum cultured results,there were 21 cases( 58. 3%) cured,2 cases( 5. 6%) improved,3 cases( 8. 3%) ineffective and 10 cases( 27. 8%) dead. CONCLUSION: The clinical features of tuberculopneumoconiosis combined with the nosocomial infection of stenotrophomonas maltophilia are un-typical. This disease is severely antibiotic-resistant.Timely pathogenic bacteria culture and drug sensitivity test have important significance in diagnosis and treatment.

This article introduced the features and categories of emergency medicine.Combining the comprehension of teaching practices for many years,we considered that paying great attention to basic concepts is the primary problem in emergency medicine teaching.