Infectious endophthalmitis refers to the acute suppurative inflammation of the uveal and retinal, with acute onset, severe symptoms, and poor prognosis.Early diagnosis and effective treatment is particularly important.Based on the way of intraocular infection, endophthalmitis can be divided into endogenous endophthalmitis and exogenous endophthalmitis.In the East Asian, liver abscess is the main source of endogenous endophthalmitis, and Klebsiella pneumoniae is the main pathogen.Liver abscess endophthalmitis is a serious cause of blindness caused by intraocular infection.A liver infection disseminated through hematogenous and the primary focus was hidden, which makes the disease was easy to be confused with immune related uveitis, causing high misdiagnosis rate, delaying the best time for diagnosis and treatment.In this article we reviewed the etiology, clinical features, diagnosis and treatment and prognosis of endogenous endophthalmitis caused by liver abscess.Clinicians should maintain a high index of suspicion to the endogenous endophthalmitis caused by liver abscess.

Asteroid Hyalosis (AH) is a common clinical disease,which has been considered a benign disorder as it rarely impairs visual acuity.It was often discovered when the patient was treated for other eye diseases.The mechanism was unclear.Its characteristic B-ultrasound property makes the B-ultrasound a very helpful diagnostic technique.In the case of the patients with other fundus diseases associated with AH,optical coherence tomography (OCT) and fluorescein angiography (FA) may be used to reduce the interference from asteroid bodies,therefore improve the fundus visibility.Recent studies have shown that AH can incorporate with many other eye diseases.For example,in patients with cataracts,asteroid hyalosis can cause surface calcification of silicone plate intraocular lenses,which in most cases may lead to the need for explantation of the calcified intraocular lenses.The efficacy of pars plana vitrectomy (PPV),the removal of some,or all,of the eye`s vitreous humor for AH remains controversial.In this paper,we provide a review of the recent literature on AH disease: the etiology,diagnosis and treatment.We hope to thus improve the awareness and outcomes of AH disease.

Objective：This study was designed to investigate the effect of brain irradiation on blood-brain barrier (BBB) quantitatively by measuring cis-diamminedichloroplatinum (DDP) concentration in cerebrospinal fluid (CSF). Methods：Twenty-two patients with brain metastases from non-small cell lung cancer (NSCLC) received brain irradiation (BI). During BI, DDP (20mg/m2) was given before radiotherapy and after cumulative doses of 10gray, 20gray, 30gray， and 40gray separately 3h prior to CSF collection and blood collection. Ten NSCLC patients without brain metastases were given the same dose DDP and the CSF and blood samples were collected. Samples were assayed for DDP levels by using flameless atomic absorption spectrophotometry. Results：There were 20 patients with and 10 without brain metastases assessable. The average DDP level in CSF was 1.02mg/L for patients with brain metastases before BI, which was significantly higher than the average level of 0.33mg/L for patients without brain metastases. The DDP level in CSF increased with the dose of BI and reached the highest level after 30gray irradiation(2.36mg/L). Conclusion：The BBB of patients with brain metastases is impaired in a certain degree and DDP could reach its therapeutic level in the CSF. The BBB would gradually open following BI, and DDP would reach the highest level after a dose of 30gray whole brain irradiation. In the CSF of patients with normal BBB, the DDP concentration is much lower than the therapeutic level.

Adult ; Aged ; Case-Control Studies ; Female ; Humans ; Male ; Middle Aged ; Myelodysplastic Syndromes ; immunology ; metabolism ; T-Lymphocytes, Regulatory ; metabolism ; Th17 Cells ; metabolism

Adenocarcinoma/surgery* ; Esophageal Neoplasms/surgery* ; Esophagogastric Junction/surgery* ; Gastrectomy ; Humans ; Margins of Excision ; Neoadjuvant Therapy ; Retrospective Studies ; Stomach Neoplasms/surgery*

OBJECTIVETo explore a better operative approach to resect complicated pelvic retroperitoneal tumors.

METHODSA total of 28 patients with complicated pelvic retroperitoneal tumors who received surgical resection in our hospital from 2006 to 2010 were included in this study. The surgical operation was assisted with an arc-shaped transperineal incision in front of the apex of coccyx. The operation time, intraoperative blood loss, death toll and length of hospital stay of the patients were retrospectively analyzed.

RESULTSThe median operation time was 122.5 minutes. The median blood loss was 420 ml, and the median length of hospital stay of the patients was 17.5 days. There was no postoperative death in this group of patients.

CONCLUSIONWith the assistance of this arc-shaped transperineal incision in front of the apex of coccyx, the resection of pelvic retroperitoneal tumors can be effectively improved and the surgery risk is reduced.

Adult ; Aged ; Blood Loss, Surgical ; Coccyx ; surgery ; Epidermal Cyst ; pathology ; surgery ; Female ; Gastrointestinal Stromal Tumors ; pathology ; surgery ; Humans ; Length of Stay ; Male ; Middle Aged ; Neurilemmoma ; pathology ; surgery ; Pelvic Neoplasms ; pathology ; surgery ; Retroperitoneal Space ; Retrospective Studies ; Teratoma ; pathology ; surgery

Objective: To discuss the characteristics of symptoms improvement based on the follow-up evaluation of Eustachian tube balloon dilation medium to long-term efficacy in patients with symptomatic Eustachian tube dysfunction (SETD). Methods: Patients from 2015 to 2017 were followed up after Eustachian tube balloon dilation (with the sense of aural fullness, or tinnitus and hearing ambiguity). All participants had been done ETDQ-7 before surgery and were re-evaluated with ETDQ-7 in follow-up. The improvement of overall and individual symptoms scores in ETDQ-7, the effects of gender and the difference of scores at different stages (12-18 months, 18-24 months and 24-30 months) after the operation were analyzed. Results: There were 29 patients, including 16 males and 13 females, whose age ranged from 20 to 62 years old. The medium to long-term score of ETDQ-7 significantly declined after surgery (27.0±7.9 vs. 14.1±7.5, P<0.05). Among all symptoms, symptoms like "blockage feeling in ear or being like under the water, constriction feeling" , "sound of blisters or explosions in the ear" decreased obviously (P<0.05). Comparing different stages after surgery, the scores of ETDQ-7 existed no difference (P>0.05). And the difference of gender showed no significant influence on surgery effects. Conclusion The subjective symptoms of patients with Eustachian tube dysfunction diagnosed with SETD can be significantly improved in the medium to long-term follow-up after Eustachian tube balloon dilation, and the degree of improvement is not linearly related to the postoperative time.

OBJECTIVETo evaluate the effectiveness of open reduction and internal fixation and repair of palmar ligment in treating trans-scaphoid perilunate dislocation.

METHODSFrom June 1995 to June 2001,14 patients with trans-scaphoid perilunate dislocation were treated with open reduction and internal fixation and repair of palmar ligment. Among them,there were 13 males and 1 female,the ranging in age from 21 to 38 years,averaged 25.4 years. All patients were posterior dislocation and all operations were performed within 2 weeks after injury.

RESULTSAll patients were followed up from 24 to 60 months with an average of 28.3 months. Thirteen scaphoid fractures were primary healed and functions of wrist joint were good. Bone disunion was found in 1 case and part functions of wrist joint were limited. No found necrosis of lunate and scaphoid. According to clinical scoring system of Cooney, 9 case got excellent results, 3 good, 1 fair and 1 poor.

CONCLUSIONOpen reduction and internal fixation and repair of palmar ligament is effective in treating trans-scaphoid perilunate dislocation,which can early provide steady fixation for scaphoid,and profit to recover blood supply of lunatum and subterminal scaphoid.

Adult ; Early Diagnosis ; Female ; Humans ; Joint Dislocations ; diagnosis ; physiopathology ; surgery ; Lunate Bone ; injuries ; physiopathology ; Male ; Recovery of Function ; Scaphoid Bone ; injuries ; physiopathology ; Treatment Outcome ; Young Adult

BACKGROUNDTo evaluate the efficacy and toxicity of concomitant chemoradiotherapy in patients with brain metastases from non-small cell lung cancer (NSCLC).

METHODSThirty patients suffering from NSCLC with brain metastasis were prospectively included in this study. Twenty-four patients had neurological symptoms and an ECOG performance index between 0 and 3. Treatment consisted of concomitant whole brain radiotherapy (WBRT) with a dose of 30 Gy in 15 fractions, followed by a local boosted dose of 20 Gy in 10 fractions for those that the number of the remained lesions were less than 3, or by WBRT with a total dose of 50 Gy for those that the number of the remained lesions were more than 3. Concomitant chemotherapy of FVP regimen with floxuridine 600 mg/(m²*d), teniposide 60 mg/(m²*d), cisplatin 20 mg/(m²*d) on d1 to d5,repeating every 3 or 4 weeks. The response was evaluated by brain CT or MRI after WBRT and 2 cycles of chemotherapy being completed.

RESULTSAll the patients completed WBRT and concomitant chemotherapy including 68 cycles (2 to 4 cycles for each patient). The follow-up rate was 93.3% with a median survival duration of 11.3 months. Total response rate was 46.7%, with CR for 2 and PR for 12. Specific evaluation of brain response demonstrated CR for 8 patients, and PR for 10 patients (the objective brain response rate, 60.0% ). The objective primary disease response rate was 18% for 22 cases of previously untreated primary NSCLC. Other specific evaluation of metastases included 1 PR patient in 6 patients with lung metastases, 3 CR patients and 4 PR patients in 17 patients with lymph node metastases, 1 PR patient with liver metastases, and 1 PR patient with eye metastasis. Twenty four patients with neurological symptoms benefited improvements to different extent. The main adverse effects were myelotoxicity, nausea/vomiting, constipation and alopecia. Grade III and IV toxicities were observed as following: leucopenia (19.1%), anemia (10.3%), thrombocytopenia (7.4%), nausea/vomiting (4.4%), diarrhea (2.9%), alopecia (5.9%), glutamio oxaloacetic transaminase (GOT) and glutamio pyruvic transaminase (GPT) elevation (1.5%). Dehydration therapy was needed at 2 weeks after WBRT in all patients.

CONCLUSIONSConcomitant WBRT plus FUDR+VM-26+DDP chemotherapy is tolerable in NSCLC patients with brain metastases and the short term response is comparable to the results of others.

OBJECTIVETo compare the therapeutic effects of video-assisted thoracoscopic extended thymectomy (VATET) and transsternal extended thymectomy (TET) for myasthenia gravis (MG).

METHODThis study included 21 patients undergoing VATET through the "three holes" approach on the right chest and 32 undergoing TET with sternum dissection. The thymus was excised and the anterior mediastinum adipose tissue removed in both groups.

RESULTSVATET was associated with reduced intraoperative blood loss and longer operative time without the use of postoperative analgesics; very few patients were admitted into the intensive care unit (ICU), showing significant differences from the TET group (P<0.05). No significant difference was found between the two groups in tracheal tube removal time, length of stay in ICU, closed thoracic drainage removal time, and postoperative hospital stay, total hospital stay, postoperative complications, total hospitalization costs, or the rate of remission and improvement (P>0.05).

CONCLUSIONSCompared with TET, VATET requires only a small incision without leaving metal foreign body in the body, and the patients experience less postoperative pain and rapid recovery, with similar mid- and long-term clinical outcomes.

Adolescent ; Adult ; Case-Control Studies ; Child ; Child, Preschool ; Humans ; Intraoperative Period ; Male ; Myasthenia Gravis ; surgery ; Postoperative Complications ; Thoracic Surgery, Video-Assisted ; adverse effects ; methods ; Thymectomy ; adverse effects ; methods ; Young Adult