High myopia is a complicated disease as it resembles with primary open-angle glaucoma(POAG)in appearance of the fundus.To avoid making mistake,we would think much of similarities and differences between them.Modern equipments give large number of informations about the fundus,which predominate to establish the quantitative analysis when following up other than early diagnosis.Visual field analysis is interfered by HM fundus dystrophy,also relationship with study curve,long wave motion and short wave motion.It is very important in diagnosis and differential diagnosis with routine methods in clinical work.The experience and judgment of the doctors are never replaced by equipment as yet.

Arthroplasty, Replacement, Hip ; Hip Prosthesis ; Humans ; Reoperation

Objective To explore the diagnosis and treatment for primitive neuroectodermal tumor of the adrenal gland.Methods The clinical data of 2 patients with primitive neuroectodermal tumor of the adrenal gland were retrospectively analyzed.Literatures about diagnosis and treatment of primitive neuroectodermal tumor arising from the adrenal gland were also reviewed.Results B type ultrasonography and computer tomography scans showed a cystic and solid soft tissue masses about 3 cm (patient 1) and 15 cm (patient 2) in maximum diameter with rough border.Surgeries were performed successfully in 2 patients.The diagnosis of primitive neuroectodermal tumor arising from the adrenal gland was confirmed by histopathology and immunohistochemistry.During follow up,evidences of tumor recurrence were not found in the first patient.However,the second patient had diffuse retroperitoneal lymph node metastasis 3 months after surgery.Then,the patient died 6 months after surgery.Conclusion The primitive neuroectodermal tumor of the adrenal gland is extremely rare with highly malignant and poor prognosis.Its diagnosis is based on histopathology and immunohistochemistry.Multimodal therapeutic regimens including surgery,combination with chemotherapy and radiotherapy were recommended.

Clavicle ; injuries ; surgery ; Fracture Fixation, Internal ; methods ; Fractures, Bone ; surgery ; Humans

OBJECTIVE:To observe the effects and safety of different treatment courses of rivaroxaban in prevention and treatment of deep venous thrombosis(DVT)after total hip replacement. METHODS:The clinical data of 127 patients under-went selective total hip replacement in our hospital during Dec. 2014-Dec. 2015 were selected and analyzed retrospectively. They were divided into group A [83 cases,subdivided into group A1(40 cases)and A2(43 cases)by treatment course] and group B (44 cases) according to anticoagulant duration. Group A was given Rivaroxaban tablet 10 mg,po,qd,6-8 h after surgery;the treatment course of group A1 was 5 weeks(35 d)while that of group A2 was 2 weeks(14 d). Group B was giv-en Enoxaparin sodium injection 5000 AxaIU,sc,qd,12d before surgery;and then given Enoxaparin sodium injection 5000 AxaIU,sc,qd,after surgery;the treatment course lasted for 2 weeks. The incidence of DVT were compared among 3 groups as well as thrombin time(TT),activated partial thromboplastin time(APTT),hemoglobin(Hb)content,whole blood viscos-ity,plasma viscosity,platelet count and anticoagulant safety 3 days before surgery and after treatment. RESULTS:The inci-dence of DVT in group A1 was 0,which was significantly lower than that in group A2 (9.30%) and group B (11.36%), with statistical significance(P<0.05);there was no significant differences between group A2 and group B(P>0.05). Wheth-er 3 d before surgery or after treatment,there was no statistical significance in PT,APTT,Hb content,whole blood viscosi-ty,plasma viscosity and platelet count among 3 groups (P>0.05). No major bleeding events or pulmonary embolism was found in 3 groups. The incidence of mild bleeding events in group A was 5.00%,which was slightly higher than that in group A2 (2.33%) and group B (2.27%),without statistical significance (P>0.05);there was no statistical significance between group A2 and group B(P>0.05). CONCLUSIONS:Rivaroxiban long-term anticoagulation after total hip replacement has no significant effect on coagulation function and platelet,not only decrease the incidence of DVT,but also will not increase no bleeding with good safety.

Graphite ; Humans ; Spectrophotometry, Atomic ; methods ; Thallium ; urine

AIM: Currently available anti-scarring regimens for glaucoma filtration surgery have potentially blinding complications and safer alternatives would be beneficial. This experiment is to investigate the effect of TGF-β2 antisense oligodeoxynucleotide on differentiation, proliferation of subconjunctival fibroblast following glaucoma filtration surgery.METHODS: Glaucoma filtration surgery were performed on both eyes of 28 rabbits. TGF-β2 antisense oligodeoxynudeotide was subconjunctivally injected in the right eyes (A group), and TGF-β2 missense oligodeoxynucleotide (B group)or PBS(C group) was used at the same method in the left eyes as controls. Rabbits were killed at 4,7,14 and 28 days after surgery. Intraocular pressure (IOP), bleb characteristics were recorded at different time point. Subconjunctival fibroblasts were examined by immunohistochemistry and electron microscopy.RESULTS: The IOP of rabbits in group A was significantly lower at 14 days (6.74± 1.18 mmHg) and 21 days (8.15± 1.97mmHg) after operation than the IOP in group B (8.53± 1.04,9.72± 1.09 mmHg)(P ＜0.01) and group C(8.79± 1.21, 9.43±1.27 mmHg) (P ＜0.05). The mean bleb survival time was longer (17.2 days) in group A than that of group B (14.5 days) and group C (13.5 days)(P＜0.05). The population of the cells expressing α -smooth muscle actin(α -SMA) and proliferating cell nuclear antigen (PCNA) was significantly reduced in group A compared with the group B and C. The ultrastructure of fibroblast was not altered by TGF-β2 anti-sense oligodeoxynucleotide.CONCLUSION:TGF-β2 antisense oligodeoxynucleotide can prevent the scar formation after glaucoma surgery by inhibit the differentiation and proliferation of subconjunctival fibroblast. It could be a potentially useful anti-scarring alternative for the prevention of late surgical failure.

Objective:To observe the influence of post-operative early enteral nutrition(EEN) for oral tumour patients.Methods:Sixty patients with oral tumour were randomly divided into EEN group (30 cases) and tradition enteral nutrition(TEN) group (30 cases). The nutritional support with Nutrision fiber started within the first 12~16 h post-operatively in EEN group, The enteral feeding started within the recovery time of the gut function in TEN group. Nutritional parameters were measured before and after the operation. Results:The mean hospitalization days in EEN group and TEN group were 10.14?1.58 and 15.29?3.26 respectively(P

Objective To compare the therapeutic results of laparoscopic and open treatment for choledocholithiasis. Methods A prospective comparison was conducted between 29 cases of laparoscopic choledocholithotomy and 35 cases of open choledocholithotomy in terms of stone removal,operative time,hospitalization day,hospitalization cost and postoperative complications. Results Stone removal was achieved in 28/29 patients by a laparoscopic approach and in 32/35 patients by a open approach( ? 2=0 71, P =0 399);average operative time was (178 3?32 4) min in laparoscopic approach and (145 8?27 1)min in open approach( t =4 27, P =0 01);the patients in laparoscopic procedures had flatus in (20 8?2 9) hour and those in open procedures did in (58 2?4 9) hours( t =37 8, P 0 05);no major complication was found in laparoscopic approach. Conclusions Laparoscopic choledocholithotomy is safe and effective and it is superier to open treatment.

Objective To investigate the effects of long-term glucocorticoid therapy on bone mineral density(BMD) in the patients with glumerulose disease. Methods 41 patients with glumerulose disease were prospectively studied. The BMD of lumbar spine (L 2-4 ) and femur was measured using dual-energy X-ray absorptiometry at base line, and at every 3 to 6 months interval after receiving glucocorticoid therapy. Vitamin D receptor (VDR) gene polymorphism was detected using PCR-RFLP. Results ⑴ Every measured site BMD decreased(29 9～83 8)mg/cm 2 after 15-month administration of glucocorticorids, and BMD decrease in L 2-4 and femoral trochanter was significantly greater (P