Objective To observe and compare the clinical effect of treating benign primary blepharospasm(BPB)with acupuncture and injection of type A botulinum toxin. Methods Between January 2012 to July 2013, 80 cases of BPB patients in ophthalmology of Tongren hospital were randomly recruited into a acupuncture group and a control group, with 40 cases in either group. The acupuncture group was treated with acupuncture on points of strengthening spleen and distributing liver and the control group was treated by type A botulinum toxin injection around effected eyes. Then effective rate, visual impairment of quality of life scale and self-rating depressive scale were tested after the treatments. Results The total effective rate of acupuncture was 95%, which was better than injection with type A botulinum toxin, with statistical difference(P<0.01). There was no statistical difference in visual impairment of quality of life scale in both groups after the treatment compared with before treatment(P>0.05). Visual impairment score was (121.88±30.16) and (121.00±28.72) in the acupuncture group and control group respectively before the treatment, However, acupuncture group(70.00±22.88)reduced less than control group(95.25±28.39)after the treatment, and there was statistical difference(P<0.01). There was no statistical difference in self-rating depressive scale in groups before treatments(P>0.05), (acupuncture group was(15.90±7.99) and control group was(15.75±6.26). However, acupuncture group(10.40±4.95)reduced less than control group(13.38±6.32)after the treatment, and there was statistical difference(P<0.01). Conclusion It proved that the therapy of acupuncture with strengthening spleen and distributing liver method for benign primary blepharospasm has a better result than injection with type A Botulinum toxin. Moreover, acupuncture can promote optical function and prevent depression for BPB patients.

Optic nerve glioma (ONG) is a rare central nervous system tumor that occurs in children and adolescents. It’s main pathological type is low-grade pilocytic astrocytoma. It is divided into sporadic ONG and neurofibromatosis type 1 (NF-1) related ONG. Due to the close relationship between ONG and the optic nerve, there is its particularity in diagnosis and treatment. The diagnosis of ONG mainly relies on medical history, symptoms and signs, as well as imaging examinations such as MRI and CT. ONG should be differentiated from optic nerve sheath meningioma, optic neuritis, optic nerve metastasis and other diseases. In recent years, newly discovered molecular targeted therapy and anti-vascular endothelial growth factor drugs are a powerful supplement to ONG. When chemotherapy is not sensitive or resistant, radiotherapy can be considered, but it is only recommended for patients over 7 years of age. Surgery can be considered when the patient’s visual impairment is severe and the appearance of the eye is significantly affected. In addition, due to the susceptibility of NF-1 patients to tumors, the chemotherapy regimen should take into account the risk of secondary leukemia caused by the drug, and the timing of radiotherapy should be after the age of 10. We look forward to further ONG clinical research, which will bring more references for future clinical work.

Background Many methods of ocular hypertension modeling have been used before,but these models remain short-duration ocular hypertension only.A new method of elevating intraocular pressure in mice by anterior chamber injection of polystyrene microspheres was reported abroad.However,this model is rarely used in China.Objective This study was to evaluate the application value of anterior chamber injection of polystyrene microspheres to establish glaucoma model in mice.Methods Forty-two SPF adult female C57BL/6L mice were divided into three groups according to random number table.Polystyrene microspheres (2 μl) were injected into the anterior chamber monocularly in the microspheres group,and the equal amount of PBS was used in the same way in the PBS group.No intervene was performed in the normal control group.The eyes of mice were examined by slit lamp microscope,and the intraocular pressure (IOP) was measured with TonoLab rebound tomometer in a 3-day interval after injection.Ocular histological sections were prepared 2 and 4 weeks after injection,and the anterior chamber angle was examined under the optical microscope.Neurons retrograde labeling was performed by 4％ fluorogold to calculate the survival number of retinal ganglion cells (RGCs) and the nerve fiber density was detected to assess the degree of RGCs and axon damage in retinal flat mounts,and the β-Ⅲ-tubulin-positive cells in the RGCs layer were examined by immnofluorescence method.The use and care of the animals complied with the instruction of Association for Research in Vision Ophthalmology (ARVO).Results IOP was significantly higher in the mice of the microspheres group than that in the normal control group or PBS group 2 and 4 weeks (all at P＜0.05).In the microspheres group,IOP reached peak in 2 weeks after injection and was significantly higher than that of 4 weeks after injection ([29.67±2.34] mmHg versus[15.71±1.23] mmHg) (all at P＜0.05).In 2 and 4 weeks after the anterior chamber injection of polystyrene,corneal edema was found under the slit lamp microscope,and under the optical microscope,microspheres accumulated at the anterior chamber angle.Additionally,in 2 and 4 weeks after injection,the number of survival RGCs was (4 542.82 ± 653.72)/mm2 and (3 623.12 ± 628.79)/mm2,respectively in the microspheres group,which showed significantly decrease in comparison with (6 979.33 ± 678.49)/mm2 and (6963.91 ±497.29)/mm2 in the normal control group (t =17.729,28.569,both at P＜0.05) and (6 843.21 ±573.42)/mm2 and (6 937.53±465.24)/mm2in the PBS group (t =16.975,29.145,both at P＜0.05).The number of RGCs was significantly less in the fourth week compared with second week after injection (t =6.951,P＜0.05).The β-Ⅲ-tubulin positive RGCs were (4 576.36± 479.64)/mm2 and (3 712.90 ± 660.31)/mm2 in 2 and 4 weeks in the microspheres group,respectively,which were significantly decreased in comparison with (6 725.94 ± 619.42)/mm2 and (6 741.90±663.60)/mm2 of the normal control group (t =18.811,22.182,both at P ＜ 0.05) or (6 757.85 ±463.59)/mm2 and (6 773.17± 471.35)/mm2 in the PBS group (t =18.953,22.605,both at P＜0.05),and in the microspheres group,β-Ⅲ-tubulin positive cells in the fourth week were decreased than those in the second week after injection (t=7.253,P＜0.05).The neural fiber density in the microspheres group in 2 and 4 weeks after injection was (193.08 ±32.75)/mm2 and (139.O0 ±38.24)/mm2,respectively,with a significant decline in comparison with (305.57±81.21)/mm2 and (297.46±52.60)/mm2(t=8.900,16.883,both at P＜0.05) of the normal control group or (312.63±70.62)/mm2 and (269.37±61.63)/mm2 of the PBS group (t=7.731,15.959,both at P＜0.05),and the neural fiber density was significantly lower in the fourth week than that in the second week after injection (t =7.442,P＜0.05).Conclusions Single injection of polystyrene microspheres into the anterior chamber can induce chronic ocular hypertension in mouse,which leads to the progressive damage of RGCs and neural fibers.This animal model shows a similar chronic pathogenic process to human glaucomatous eye.

Objective To evaluate the safety of percutaneous radiofrequency ablation (RFA ) in hepatic malignant tumors under the guidance of ultrasonography .Methods The clinical data and the follow‐up radiographic images of the patients with hepatic malignant tumors treated by percutaneous RFA between January 2012 and February 2014 were retrospectively reviewed ,and the major or minor complications of RFA were both calculated .Results 1 568 lesions were ablated by 1 080 percutaneous RFA procedures in 900 patients with hepatic malignant tumors under the guidance of the sonography .The average size of the tumors was (2 6.± 1 2.)cm .The total complications rate of 1 080 RFA procedures was 5 9.3% (64/1 080) , which including intra‐abdominal bleeding 2 7.8% (30/1 080) ,hepatic abscess 0 7.4% (8/1 080) ,biliary tract damage 0 6.4% (7/1 080 ) ,vascular damage 0 5.6% (6/1 080 ) ,tract seeding 0 4.6% (5/1 080 ) ,pleural hemorrhage 0 3.7% (4/1 080) ,gastrointestinal damage 0 1.8% (2/1 080) ,hepatic encephalopathy 0 0.9% (1/1 080) ,and death 0 0.9% (1/1 080) .While major complications was 1 9.4% (21/1 080) vs minor 3 9.8% (43/1 080) .Sixty three patients with complications recovered after treatments including blood transfusion , ablation ,surgery ,interventional drainage procedure and liver transplantation ,only one patient died for irreversible liver failure .Conclusions RFA for hepatic malignant tumors under the guidance of sonography is a safe method with lower complications rate ,however ,the potential major complications and the indications of RFA liver malignant tumors should be carefully focused on .

Objective To evaluate the diagnostic value of contrast enhanced ultrasonogrphy(CEUS) and quantitative analysis in differentiating between thyroid solid malignant masses and solid benign masses.Methods 40 patients with thyroid solid mass were enrolled into this prospective study between March 2012 and June 2012.A total of 45 thyroid solid masses were evaluated by CEUS,and the final pathology diagnosis was confirmed by core biopsy or thyroidectomy.The diagnostic yield of enhancement patterns and quantitative parameters were assessed for differentiating between the solid malignant and benign masses.Results Enhancement patterns were classified into five types (nonenhancement,early hypo enhancement,hypo enhancement,isoenhancement,hyperenhancement).Two malignant masses had nonenhancement pattern,and 6 malignant masses had early hypoenhancement pattern,and 14 malignant and 4 benign masses had the hypo enhancement pattern,and 5 malignant and 7 benign masses had the isoenhancement pattern,and 1 malignant and 6 benign masses had the hyperenhancement pattern.There was a significant difference between malignant and benign enhancement patterns of thyroid solid masses (x2 =12.184,P =0.016).Nonenhancement,early hypoenhancement and whole phase hypoenhancement pattern predict thyroid solid malignant masses with sensitivity of 78.5 ％ and specificity of 76.5 ％.Among seven quantitative parameters used to predict thyroid malignant mass,the relative maximum intensity (IMAX％) of lesions had highest value in differentiating between the malignant and benign masses with sensitivity of 80.8 ％ and specificity of 82.6％,and area under receiver operating curve (AUC) of the IMAX％ was 0.878.RT (rising time),TTP (time to peak intensity),mTT (mean transit time) had almost non differentiation value with AUC of 0.619,0.601,0.656 separately.And mTT-Ratio (mTT of lesion/mTT of parametric area),RT-Ratio (RT of lesion/RT of parametric area),TTP-Ratio (TTP of lesion/TTP of parametric area) had less differential diagnostic value with AUC of 0.749,0.744,0.704 comparing with IMAX％.Conclusions Nonenhancement and early or whole phase hypoenhancement could be characteristic enhancement pattern of malignant thyroid solid masses,and IMAX％ had good diagnostic value in differentiating between malignant and benign masses among the quantitative parameters.

Objective To evaluate the short-term efficiency and risk factors for effects after percutaneous radiofrequency ablation (RFA) for hepatic malignant tumors under the guidance of sonography.Methods The clinical data and the follow-up radiographic images of the patients with hepatic malignant tumors treated by percutaneous RFA were reviewed between June 2011 and May 2012,and the short-term incomplete ablation rate,recurrance rate and tumor progression rate were calculated,and the factors affecting the incomplete ablation rate,recurrence rate and progression rate were analyzed.Results 610 lesions were ablated in the total of 462 RFA procedures for 405 patients under the guidance of sonography with percutaneous method.The average size of the tumor was (2.5 ± 1.1)cm.During at least 3-month follow-up,complete and incomplete ablation rate was 89.2％ (544/610) and 10.8％ (66/610)separately,and recurrance rate and progression rate of tumor was 17.5％ (81/462) and 23.8％ (110/462).The numbers (≥3) and the size (≥3 cm) and the location (close to vessels) of the lesions reduced the complete ablation rate.The numbers (≥3) of lesions affected the recurrence rate and progression rate of lesions as only risk factor.Recurrent hepatocellular carcinoma (HCC) and metstasis from gastrointestine or non-gastrointestine had higher recurrence rate and progression rate comparing with primary HCC.Conclusions RFA can effectively control local progression of hepatic maglinant tumors,and the tumor's size,number and location close to velssels could effect complete ablation rate,the number of tumors could effect the recurrence and porgression rate.Recurrent HCC and metstasis from gastrointestine or nongastrointestine had higher recurrence and progression rate comparing with primary HCC.

Objective To study the set-up errors by CBCT in IMRT with two different immobilization techniques for thoracic and abdominal tumors.Methods Sixty patients with thoracic and abdominal tumor were included in this study and separated into study group and the control group.The study group were immobilized with carbon fiber holder,vacuum bag and thermoplastic mask.The control group were immobilized with carbon fiber holder and thermoplastic mask.CBCT scan and auto-match online were regularly performed before the treatment.The setup of left-right(x),superior-inferior(y),anterior-posterior (z) were received.The value of the Mptv was calculated,meanwhile.The grouped t-test of was carried out between these two methods.Results The shift errors in x-,y-,z-dimension of the study group were (0.32 ± 2.58) mm,(-0.40 ± 3.89) mm,(-0.75 ± 2.43) mm.The Mrrv were 5.60 mm,6.08 mm,6.32 mm.The translation set-up errors in x-,y-,z-dimension of the control group were(0.62 ±3.60),(2.44 ± 4.93),(0.66 ±2.85) mm,respectively.The MPrv were 8.07,10.63,6.90 mm,respectively.The t-test value were t =-0.78,-5.11,-4.22,P =0.440,0.000,0.000,respectively.Conclusions The immobilization techniques with carbon fiber holder,vacuum bag and thermoplastic mask would be better than the techniques without the vacuum bag in reducing the setup errors.

Objective: To retrospectively characterize and analyze the thyroid ultrasound images of thyroid cancer patients, to classify thyroid nodules according to thyroid imaging reporting and data system (TI-RADS), and to evaluate the diagnostic value of TI-RADS. Methods:Clinical data of 160 thyroid cancer patients with 235 nodules from September 2008 to August 2011 were retro-spectively analyzed. All patients underwent conventional color Doppler ultrasonography to evaluate the size, number, shape, boundary, and extent of lesions and blood distribution of the nodules. All nodules were analyzed according to TI-RADS classification and scored to evaluate the diagnostic value of TI-RADS. Results:Among 176 malignant nodules, 144 (81.8%) had lesions showing a mass of irreg-ular boundary with no envelope and halo, 152 (86.4%) were inhomogeneous hypoechoic or slightly hypoechoic, or 144 (81.8%) exhibit-ed microcalcification. TI-RADS scores of 4 or 5 and 2 or 3 were obtained in 160 (90.91%) and 16 (9.09%) of the malignant nodules, re-spectively. Conclusion:Thyroid ultrasound sonogram of ill-defined, irregular shape, hypoechoic or slightly hypoechoic mass, microcal-cification within the mass, and rich blood flow is an important index for the diagnosis of thyroid cancer. Thyroid nodules with a TI-RADS score 4 or 5 have higher possibility for cancer. Therefore, TI-RADS has a significant diagnostic value for thyroid cancer be-fore operation.

Objective To observe the therapeutic effect of reformed subhibernation therapy on status epilepticus in patients with severe viral encephalitis.Methods 96 children with severe viral encephalitis complicated by status epilepticus were randomly divied into control group and experimental group.Control group: routine treatment was given that includes anticonvulsivus,ice compress and conventional therapy.The anticonvulsivus was applied in five drugs: the same doses of wintermin and phenergan mixed up,10% chlorpromazine hydrochloride,luminal,valii,the drugs were delivered when convulsion occurred otherwise not.Experimental group: in addition to routine treatment reformed subhibernation therapy was given.The anticonvulsivus drug's was delivered in return each 4-6 h according to the drugs half life.And anticonvulsivus drugs were applied for 2 d then gotten off.The clinical manifestation,auxiliary examination and therapeutic efficacy of patients in two groups were observed.Results All of 96 cases were analyzed.The lotal effective rate in experimental group is higher than that in control group(?2=5.872,P

Objective To evaluate right ventricular (RV)systolic function in type-2 diabetes mellitus (T2DM)patients.Methods Fifty T2DM patients and fifty normal controls were included in the study and underwent echocardiographic examinations.The following parameters were measured:1 ) Right heart dimensions,pulmonary artery (PA)diameter,pulmonary acceleration time (AT)and PA systolic pressure (PASP);2)RV systolic function:RV fractional area change (RVFAC),tissue Doppler-derived tricuspid lateral annular systolic velocity (S'),tricuspid annular plane systolic excursion (TAPSE),longitudinal strain of six RV segments by 2-dimensional speckle tracking imaging (2D-STI);3 )RV diastolic function:E,A ratio of the tricuspid inflow spectrum (E/A),E,E'(peak early diastolic velocity of the tricuspid annulus) ratio (E/E');4)RV Tei index.Results Statistic analysis showed that T2DM patients had thicker RV walls,wider PAs and shorter AT than the control group (P =0.000,0.001 and 0.000),while their right heart chamber sizes and PASP remained unchanged.Among systolic parameters,absolute values of RV longitudinal strain at the lateral wall-mid (lat-m),septum-mid (sep-m)and septum-basal (sep-b)segments were significantly lower in the diabetic group than the control group (P =0.001 ,0.000 and 0.005),whereas strain of the other three RV segments and RVFAC,TAPSE.S'were not significantly different.Moreover, E/A,E/E'and Tei index were all significantly different between the two groups (P = 0.000,0.000 and 0.006),indicating declined diastolic and general function of RV in the T2DM group.Conclusions RV myocardial strain by 2D-STI is more sensitive in detecting RV systolic dysfunction than TAPSE,S' and RVFAC.Among the six segments of RV walls,lat-m,sep-m and sep-b are better locations for 2D-STI than the other three.