With the widespread use of high-resolution spectral-domain OCT (SD-OCT) in clinical practice,one of the greatest progresses to the ophthalmologists is more dctailed image analyses of outer retina in the macular region.There are four clear hyper-reflective bands of outer retina in the SD-OCT images,instead of three bands in the time-domain OCT (TD-OCT),the bands from inner to external are external limiting membrane (ELM),inner segment/outer segment (IS/OS) junction,cone outer segment tips (COST),and retinal pigment epithelium (RPE),respectively.From a perspective of corresponding retinal histological structure,all of the three bands of ELM,(IS/OS) and COST are within the photoreceptor cells.Therefore,the integrity of the three bands correlates well with the status and function of photoreceptor cells.It is one of the hot topics to study the status and function,as well as injury and repair of the photoreceptor cells using SD-OCT.This article reviewed the relevant clinical studies about the three bands of ELM,IS/OS and COST,including macular hole (MH),idiopathic epiretinal membrane (IERM),rhegmatogenous retinal detachment (RRD) and age-related macular degeneration (AMD).

Objective: To investigate the quality of life and its influencing factors among HIV-infected college students among men who have sex with men (MSM), so as to provide the evidence for improving the quality of life among HIV-infected MSM college students. Methods HIV-infected MSM college students were sampled from those with follow-up management by Shaanxi, Chongqing and Guangdong Centers for Disease Control and Prevention using a convenience sampling method, and participants' demographics, AIDS-related knowledge, attitude and practice were collected using questionnaire surveys. The scores for physical, psychological, social and environmental domains, and the overall quality of life were measured using the Chinese version of the World Health Organization Quality of Life-Brief (WHOQOL-BREF), and their influencing factors were identified using a multivariable linear regression model.

Objective To study the value of multiphasic contrast-enhanced 3.0T MRI in the preoperative assessment of resectability in pancreatic cancer.Methods 38 patients with pancreatic cancer proved by operation and pathology were performed with multiphasic contrast-enhanced imaging at 3.0T MRI.The resectability of lesions was judged according to the status of vascular and adjacent organ involvement,lymphadenopathy and distant metastases on MRI images,which were compared with the results of operation.Results Of 38 pancreatic cancer,32 lesions located in the head,4 tumors in the body and 2 lesions in the tail of pancreas.MRI predicted that 1 9 tumors were resectable in which 1 7 lesions were successful resection,the accuracy of the positive predictive value for resectability was 89.5%.19 lesions were predicted to be unresectable by MRI,which were verified by surgery,the positive predictive value for un-resectability was 100%.The primary causes of unresectability contained peripancreatic main vessels involvement,liver metastasis, lymphadenopathy and peritoneal metastasis.Conclusion MRI multiphasic contrast-enhanced imaging has important value in preoper-ative resectability assessment of pancreatic cancer,which provides an useful reference for clinic to select appropriate treatment options.

Objective To investigate the relationship between Clq/tumor necrosis factor (TNF)-related protein 9 (CTRP9)and coronary heart disease.Methods A total of 232 patients diagnosed with coronary heart disease(CHD)by coronary angiography at our hospital were selected as the CHD group,and 90 cases with normal coronary angiography served as the control group.The double antibody sandwich enzyme-linked immunosorbent assay(ELISA)was used to determine serum CTRP9 levels.Results Serum CTRP9 levels were lower in the CHD patients than in the controls [(116.9±19.5)ng/ml vs.(142.3±17.9)ng/ml,t＝-5.404,P＝0.000].SerumCTRP91evelswere negatively correlated with body mass index,fasting plasma insulin,fasting blood glucose,insulin resistanceindex(IRI),triglyceride and TNF-α(r＝-0.230,-0.225,-0.267,-0.235,-0.230and-0.222,P＝0.017,0.011,0.002,0.010,0.011 and 0.022).Multiple logistic regression analysis revealed that uric acid,IRI,CTRP9,and TNF-α were independent influencing factors for CHD,of which CTRP9 was a protective factor for CHD occurrence(OR ＝ 0.907,95％C1:0.854～0.963,P＝ 0.001).Conclusions Decreased serum levels of CTRP9 are associated with coronary heart disease,indicating that CTRP9 may play a protective role in coronary heart disease occurrence.

Objective To study the clinical diagnostic value of carcinoembryonic antigen (CEA) ,cytokeratin(CK)19-2G2 and EB virus capsid antigen Ig (EB-VCA-Ig) combined detection for nasopharyngeal carcinoma .Methods Serum CEA ,CK19-2G2 and EB-VCA-Ig of 82 patients with nasopharyngeal carcinoma (malignant group) ,65 patients with benign nasopharyngeal diseases (benign group) and 58 healthy people(control group) were detected .Chemiluminescence was employed to detect CEA and CK19-2G2 ,and enzyme-linked immunosorbent assay(ELISA) was used to assay EB-VCA-Ig .Results Serum CK19-2G2 and EB-VCA-Ig concen-trations of patients in malignant group were higher than those in the benign group and control group ,respectively (P<0 .05) .The sensitivity and specificity of individual CK 19-2G2 detection for nasopharyngeal carcinoma were 48 .78% ,and 83 .74% ,respectively , those of CEA and EB-VCA-Ig combined detection were 53 .44% and 86 .99% ,respectively ,and those of three indicators combined detection were 71 .95% and 80 .49% ,respectively .Three indicators combined detection significantly increased the positive detection rates in patients with early and advanced stages .Conclusion CEA ,CK19-2G2 and EB-VCA-Ig combined detection possesses impor-tant value for nasopharyngeal carcinoma diagnosis .

Objective To investigate the effect of Lokomat gait training rehabilitation robot on joint motion and lower limb function in hemiplegic patients after stroke.Methods Forty hemiplegic patients after stroke were randomized equally into a robotic group and a control group (20 cases in each group).The robotic group received robotic rehabilitation therapy in addition to routine rehabilitation training,while the control group was only given instructions for routine rehabilitation training.All the patients were assessed at the beginning of the training and at the end of 4,8 and 10 weeks of treatment.The Fugl-Meyer Assessment of lower extremities (FMA),range of motion (ROM) in hip and knee,force and tone of bilateral hip/knee flexors and extensors were used to evaluate stepping function before training,and after 4,8 and 10 weeks of treatment.Results There was no significant difference between the 2 groups with regard to FMA scores,the ROM in hip and knee,as well as force and tone of bilateral hip/ knee flexors and extensors (P ＞ 0.05).After treatment,the robotic group was significantly improved with all the evaluation indexes when compared to its baseline values (P ＜ 0.05).It was also shown that the robotic group improved to a significantly greater extent than the control group (P ＜ 0.05).Pearson's correlation analysis demonstrated a positive relationship between the ROM of knee or hip and lower limb function (P ＜ 0.05).Conclusions The Lokomat gait training rehabilitation robot can improve the lower extremities functions,as indicated by increase of ROM and muscle strength as well as decrease in muscle spasticity in hemiplegic patients after stroke.

Regarding the prevention and treatment of hepatocellular carcinoma (HCC) recurrence after curative resection,surgeons do not have a clear consensus to evaluate the risk factors of recurrence and effectiveness of surgical resection.Therefore,postoperative HCC recurrence patterns were reviewed in this article,including differentiating intrahepatic metastasis (IM) and multicentric occurrence (MO),which play a key role in manifesting recurrence and patient prognosis.Additionally,the definitions of small HCC and curative resection,and the prophylactic and therapeutic values of anatomic resection and repeated hepatectomy in patients with recurrent HCC were reviewed.Fully understanding these issues might allow for a more objective,precise,and consistent clinical assessment of HCC.

Objective To compare the optical properties and visual quality between Tecnis ZMB00 and AcrySof ReSTOR SN6AD1 multifocal intraocular lens (MIOL) in patients undergoing cataract surgery.Methods A total of 120 patients (130 eyes) who umderwent elective cataract surgery in our hospital from March 2012 to July 2015 were selected prospectively.All patients were treated with diffractive MIOL,and divided into group A (Tecnis ZMB00 group) and group B (AcrySof ReSTOR SN6AD1 group).The uncorrected distance visual acuity (UCDVA),uncorrected near visual acuity (UCNVA),uncorrected medium distance visual acuity (UCIVA),best corrected distance visual acuity (BCDVA) and best corrected near visual acuity (BCNVA) were measured before and after surgery.The defocusing curve was drawn for analysis of the contrast sensitivity,and the postoperative visual function and survival quality questionnaire (VF-14) was used to evaluate the postoperative visual quality.Results At 1 week,1 month and 3 months after surgery,recovery of UCNVA,UCIVA and BCNVA in group A was better than that in group B (all P ＜ 0.05).At 1 week and 3 months after surgery,the recovery of UCDVA in group A was better than that in group B (all P ＜ 0.05).At 3 months after surgery,the spherical equivalent was lower in group A than group B (P ＜ 0.05).The contrast sensitivities under scotopia,photopic glare and scotopic glare of different frequencies in group A were higher than those in group B (all P＜0.05).The VF-14 score in group A at 3 months after surgery was lower than that in group B (P＜0.05).In group A,0.0 D and-2.5 D formed 2 peaks,and from-2.0 D to-2.5 D formed the platform stage,while in group B,only 0.0 D and-3.0 D formed 2 peaks.Conclusion The implantation of Tecnis ZMB00 MIOL after cataract surgery can improve the uncorrected visual acuity of treated eye,contrast sensitivities,postoperative visual function and quality of life of patients.

Objective To analyze the efficacy of umbilical one trocar laparoscopic appendectomy (UOTLA) in treatment of complicated appendicitis in children. Methods Clinical data of 78 cases of children patients with complicated appendicitis from January 2012 to October 2015 was summarized, including 44 cases as UOTLA group received umbilical one trocar laparoscopic appendectomy, 34 cases as OA group received open appendectomy. Then statistically analyzed all the patients' operation time, postoperative hospital stay, postoperative abdominal abscess, incision infection, early inflammatory intestinal obstruction and pain level. Results The laboratory test results of C reaction protein (CRP) had no significant difference between the two groups, while peripheral white blood cell count decreased more significantly in UOTLA group than that in OA group; the operation time of UOTLA group was shorter than that in OA group with no statistical difference [(66.59 ± 33.24) vs (72.86 ± 30.36) min, P > 0.05], but postoperative hospital stay was shorter [(8.21 ± 1.67) vs (9.21 ± 2.01) d, P < 0.05]. Abdominal abscess after operation: 3 cases in UOTLA group, while 1 case in OA group (P > 0.05); incision infection: 6 cases in UOTLA group, 9 cases in OA group (P > 0.05); early inflammatory intestinal obstruction: 1 cases in UOTLA group, 5 cases in OA group (P > 0.05); the pain level, postoperative recovery time was significantly shorter in UOTLA group compared with OA group (P < 0.05). The average expenses comparison of the two groups has no statistical difference [(10639.37 ± 2970.92) vs (10765.04 ± 2902.64) yuan, P > 0.05]. Conclusion UOTLA is safe and effective for complicated appendicitis in children due to minimally invasive, less pain and faster recovery without significant increase in the cost and postoperative complications. It can be applied in children with purulent, perforated appendicitis and gangrene, perforated appendicitis and other complicated appendicitis.

Objective To investigate the anatomy of the skull base for minimally invasive keyhole approach to sellar lesions.MethodsSixty-seven samples of adult skull bone(134 sides) were collected and sawed at the levels of the supraorbital arch and anterior skull base.After inspecting the opening of the frontal sinus,we observed the appearance of the orbit roof(cerebral juga),and measured the maximum height of the two cerebral jugas.Afterwards,the operation distances and angles with regard to the anterior and posterior clinoid processes through the trans-upper orbit,trans-lateral front,trans-pterion,and trans-sub-temple keyhole approaches in 15 skull bone samples were measured.And then,we statistically analyzed the variance in these measurements among the four operative approaches.ResultsOf the 67(134 sides) adult skull bone samples,52 sides showed frontal sinus openness(38.8%,52/134).Most of the skull bases were clawed(multicuspidity or oblique ridge multicuspidity).The maximum height of the cerebral juga that was less than 2.50 mm was found in 36 sides(26.9%),and over 2.51 mm in 98 sides(73.1%).Among the four methods,the shortest distances between the keyhole and the anterior and posterior clinoid processes were found in the trans-sub-temple keyhole approach [(4.87?0.47) cm and(4.93?0.45) cm],and the longest were observed in the trans-lateral front keyhole approach[(6.45?0.30) cm and(7.83?0.54) cm],and trans-upper orbit keyhole approach[(6.47?0.28) cm and(8.31?0.34) cm].The angle between the sagittal section and the keyhole in the trans-lateral front keyhole approach [(40.83?1.11) ? and(37.86?1.37)?] was larger than that in the trans-upper orbit one [(10.23?0.90) ? and(12.29?0.86)?],while the angle between the cross section and the keyhole in the trans-sub-temple keyhole approach [(21.21?0.45) ? and(20.10?0.63)?] was larger than that in the trans-pterion one [(5.49?0.30)? and(9.84?0.58)?].ConclusionsThe size of the frontal sinus,shape and height of the cerebral juga,depth of the skull base operation,and angle between the operational and the skull base planes play important roles in the selection of minimally invasive keyhole approach for sellar lesions.