Objective To evaluate the anatomical and functional results of retinotomy in treatment of complicated retinal detachment. Methods Twenty three eyes were treated with retinectomy during vitrectomy for complicated retinal detachment with proliferative vitreoretinopathy when complete reattachment of retina was not obtained despite careful mambrane peeling. After released the peripheral vitreoretinal contraction or pulled subretinal membranes, perfluorocarbon liquid injection, laser retinopexy and silicone oil tamponade were performed. Retinotomy size ranged from 30 degree to 360 degree (average 132 degree). Results Retinal attachment were obtained in all of the operated eyes at the end of the operation. Silicone oil was removed from 15 eyes (65.0%) within 3～11 months postoperatively. After a minimum follow up of 6 months, the retinae were completely attached in 17 eyes ( silicone oil was not removed in 4 eyes ) and visual acuity of 0.02 or better was obtained in 11 eye (48.0%). Recurrent retinal detachment occurred in 2 eyes in which the silicone oil had been removed. The major complications were recurrence of the proliferation in 6 eyes (26.0%) and hypotony in 3 eyes (13.0%). Conclusion Retinotomy is beneficial to reattach the retina for eyes with advanced proliferative vitreoretinopathy in seemingly inoperable cases.

Objective To investigate the clinical effect of loading dose of phenobarbital in neonatal hypoxic-ischemic encephalopathy(HIE).Methods Three hundred and fifty-six patients with neonatal HIE were randomly divided into treatment group and control group by systematic sampling,with 178 patients in each group.Two groups were given comprehensive therapy,with or without convalsions,early application of loading dose of phenobarbital in 20 mg/kg intramuscular injection,12 h beck to a maintenance dose 5 mg/(kg·d)in treatment group,while a conventional dose of phenobarbital in 5 mg/(kg·d)was used in control group after convulsion happened.Clinical effect of short-term and long-term were observed.Results The rates of eelampsia,choloplania and total effect was 11.2％(20/178),7.9％(14/178)and 87.1％(155/178)in treatment group,and 68.0％(121/178),50.6％(90/178)and 77.5％(138/178)in control group,there were significant differences between two groups(x2 =6.403,78.459 and 8.308,P ＜ 0.05).DQ score in treatment group was higher than that in control group(P＜ 0.05).The patients in two groups were followed up to age 18 months,the deformity rate in treatment group[7.9％(14/178)]was lower than that in control group[28.1％(50/178)],there was significant difference between two groups(x2 =29.085,P ＜ 0.05).Conclusion Loading dose of phenobarbital is very effective to treat neonatal HIE.

ObjectiveTo study exogenous surfactants disaturated phosphatidyl choline (DSPC) kinetics in full term infants with respiratory distress syndrome(RDS) who were treated with different dose of poractant alfa.MethodsOne hundred and twenty-two full term infants with RDS undergoing mechanical ventilation were divided into group A (80 cases) and group B (42 cases) by simple random method,who received 100 mg/kg or 200 mg/kg poractant alfa mixed with DSPC.Clinical manifestation and respiratory parameters were recorded,and DSPC half-life period and pool size and endogenous DSPC synthesis rate were calculated.ResultsFifty-six infants (70.0％) received a second dose after(25 ± 11) h and 18 infants (22.5％) received a third dose after(41 ± 11 ) h in group A.Twelve infants ( 28.6％ ) received a second dose after (33 ± 8) h and 2 infants (4.8％) received a third dose in group B.DSPC half-life period in group B was longer than that in group A[the fast:(32 ± 19) h vs.(15 ± 15) h;the second:(43 ±32) h vs.(21 ± 13) h],there was significant difference (P＜ 0.01 or ＜ 0.05).DSPC synthesis rate and pool size before the first and second doses had no difference between the two groups.But the oxygenation index at the first and the second dose in group B was less than that in group A,there were significant differences (P ＜ 0.01 or ＜ 0.05).ConclusionPoractant alfa given to full term infants with RDS at a dose of 200 mg/kg results in a longerDSPC half-life period,fewer retreatments,and better oxygenation index values.

ObjectiveTo study the effects and mechanisms of hypoxia-ischemia (HI) on long-term learning and memory abilities and astrocytes in hippocampal formation and the efficacy of nimotop in treating hypoxic-ischemic brain damage. MethodsThe rats were subjected to right common carotid artery ligation followed by exposure to 8% oxygen at 37℃ for 2 h and then 13 rat pups received an introperitoneal injection of nimotop per day immediately following cerebral hypoxia-ischemia for 5 days. When the rats were 80-day-old, they were given test of Y-maze to determine their learning and memory abilities, and then their brain tissues were studied by immunohistochemistry for glial fibrillary acidic protein (GFAP) that marked astrocytes. ResultsThe learning and memory abilities of the HI group were lower than those of the normal control and nimotop treated group (P<0.01), nimotop significantly increased Y-maze learning abilities (P<0.05) of rats received HI, but did not affect their memory abilities. The numerical density of GFAP-positive cells in CA1 radiatum stratum of hippocampal formation were markedly higher in the HI group than those in the other two groups (P<0.01), but the others strata showed no difference. ConclusionHypoxic-ischemic brain damage cause rats to disorders of learning and memory that may be correlated with increase astrocyte in hippocampal formation which became easy to be damaged of declining regulation abilities of neurons microenvironment. Nimotop may be effective to counteract hypoxic-ischemic brain damages.