AlM: To compare the effects of external approach microsurgery and conventional external approach surgery for retinal detachment ( RD) .METHODS: From January 2010 to January 2013, 60 patients (60 eyes) in our hospital were randomly divided into experimental group (29 cases, 29 eyes) and control group ( 31 cases, 31 eyes ) , the external approach microsurgery and conventional external approach surgery were performed respectively ( by the same skilled doctor ) . Retinal reattachment rate, visual acuity improvement rate and operative time were compared between two groups.RESULTS:lt cost shorter time for the external approach microsurgery than that of conventional external approach surgery ( P = 0. 0087 ). The once successful retinal reattachment rate in experimental group was 93% ( 27 cases ) , which was higher than that in control group (90%, 28 cases), there was no statistical difference. The vision improvement rate in control group was 86% ( 25 cases ) , compare to 90% ( 28 cases ) in experimental group, there was no statistical differences. CONCLUSlON: No statistical differences showed in visual acuity improvement and the once retinal reattachment rate between the two groups for rhegmatogenous retinal detachment. However, it is believed that external approach microsurgery could be faster, easier to learn with satisfactory effect.

OBJECTIVE:To establish a HPLC method for the determination of 5-fluorouracil in human plasma METHODS:The plasma samples were extracted with ethyl acetate-isopropanol(85∶15,V/V)following precipitation of plasma proteins with ammonium sulfate The solvent was evaporated to dryness under a stream of nitrogen The dry extract was dissolved in mobile phase and then injected into the Diamonsil C18 column(150mm?4 6mm,5?m)and 0 01mol/L KH2 PO4(pH5 5) was taken as mobile phase The flow rate was 1 5ml/min,UV detection wavelength was 267nm The internal standard was 5-bromouracil RESULTS:The minimal detectable drug concentration in plasma was 0 025?g/ml The calibration curve was linear over a range from 0 3?g/ml to 10?g/ml The intra-day RSD≤5 0%(n=5) and the inter-day RSD≤11 5%(n=5) CONCLUSION:The method can be used for studying the pharmacokinetics and bioavailability of 5-fluorouracil

Objective To screen and identify the dengue virus-specific antigens,then establish the ELISA detection method for dengue virus antibody.Methods Using bioinformatic software DNAStar and ANTHEPROT to analyze the hydrophilicity,flexibility,surface probability and antigenicity of dengue virus type 1-4,Japanese encephalitis virus and Yellow fever virus M,E and NSI protein amino acid sequence and also consider the influence of secondary structure.Then in accordance with epitopes localion and amino acid sequence similarity,forecast the share and specific epitopes.Reference the sequence information of different dengue virus strains in GenBank to analyze the epitopes conservative.Based on the results of bioinformatic analysis,5 specific epitopes were amplified and inserted into prokaryotic expression vector pMAL-C2x or pET32a.Then the vectors was transferred into E.coli Rosetta( DE3 ).lsopropyl-β-D-thiogalactoside(IPTG) was used to induce the expression of gene segments.SDS-PAGE were used to identify the expression proteins,and the antigenicity were tested using Western blot.Using the antigen selected by Western blot,ELISA method for dengue virus antibody detection was established.Results Eighty shared epitopes and 25 specific epitopes were forecasted,and 5 antigenic fragments encloude analyzed epitopes from dengue virus type 2 and 3 were expressed in E.coli successfully.One dengue virus type 1-4 shared antigens (Den-Ag5),one dengue virus type 2 and 4 shared antigens( DenAg3),one dengue virus type 1-3 shared antigens(Den-Ag2) and two dengue virus type 1,2 and 4 shared antigens( Den-Ag1,Den-Ag4)were conformed using Western blot.Using antigens Den-Ag5,Den-Ag1 and DenAg2,the ELISA method for dengue virus antibody detection were established.Conclusion Based on the bioinformatic analysis and Western blot verification,5 dengue virus specific antigen were conformed,and the ELISA detection method for dengue virus antibody were established.

OBJECTIVE:To eualuate the situation and the tondency of antihyperlipidemics used in Guangdong Province.METHODS:The sales volume,DDDs and daily expense of antihyperlipidemics in Guangdong Province from2000to2003were investigated and analyzed.RESULTS:The sales volumes of cardiovascular agents from2000to2003had been increasing.The proportion of antihyperlipidemics to cardiovascular agents in respect of sales volume assumed a decreasing tendency from2001.Simvastatin dominated over all other drugs in respect of sales volume and DDDs.CONCLUSION:HMG-CoA reductase in-hibitor and natural drugs dominate in the antihyperlipidemics market of Guangdong Province.

Objective To observe the effect of Tongqiao Huoxue decoction on the changes of motilin (MTL) and vasoactive intestinal peptide (VIP) and its protective effect on gastric mucosa in rats with cerebral infarction at acute stage.Methods According to random number table, 96 Wistar rats were divided into six groups: normal control, sham operation, cerebral infarction model, cimetidine, Tongqiao Huoxue decoction routine dose and low dose groups, eachn = 16. Cerebral infarction model group was established by using a suture to ligate the middle cerebral artery, resulting in its occlusion. The rats of cerebral infarction model group and sham operation group were lavaged with 2 mL of normal saline. Tongqiao Huoxue decoction routine dose group was lavaged with 2 mL of Tongqiao Huoxue decoction (1.3 g/mL), while Tongqiao Huoxue decoction low dose group was lavaged with 1 mL of Tongqiao Huoxue decoction (1.3 g/mL) plus 1 mL of normal saline. Cimetidine group was lavaged with cimetidine (0.1 g/kg), and nothing was done for the normal control group. On the 4th and 7th day after the delivery of treatment, inferior vena venous blood samples were collected to detect the plasma MTL and VIP concentrations. Then the gastric tissues were obtained and examined under an electron microscope.Results There were no statistically significant differences between the normal control group and sham operation group in plasma levels of MTL and VIP (bothP > 0.05). The plasma levels of MTL and VIP at 4 days and 7 days after the delivery of treatment in cerebral infarction model group were higher than those in the normal control group and sham operation group [4 days MTL (ng/L): 189.51±13.48 vs. 117.01±11.38, 117.67±12.73, VIP (ng/L): 94.86±4.14 vs. 60.98±5.42, 62.55±6.60, bothP < 0.05; 7 days: MTL (ng/L): 183.05±14.49 vs. 119.79±10.64, 120.27±11.48, VIP (ng/L): 91.92±3.77 vs. 59.63±4.29, 58.10±4.99, bothP < 0.05]. Plasma levels of MTL and VIP in cimetidine group, Tongqiao Huoxue decoction routine dose group and low dose group were significantly lower than those in cerebral infarction model group. Compared with Tongqiao Huoxue decoction low dose group and cimetidine group, the degrees of descent in plasma levels of MTL and VIP were apparently lower on the 7th day in Tongqiao Huoxue decoction routine dose group [MTL (ng/L): 138.72±8.02 vs. 152.16±12.66, 156.60±11.87, bothP < 0.05; VIP (ng/L):68.18±3.41 vs. 81.12±3.98, 78.89±2.13, bothP < 0.05]. The results of electron microscope: compared with normal control group and sham operation group, obvious pathological changes in gastric mucosa in model group were found. In Tongqiao Huoxue decoction routine group, Tongqiao Huoxue decoction low dose group and cimetidine group, the gastric mucosal lesions were milder, and the curative effects of Tongqiao Huoxue decoction routine group were much better.Conclusions During the acute stage of cerebral infarction, significant damage is seen in gastric mucosa in rats. Tongqiao Huoxue decoction not only can effectively regulate the expression levels of MTL and VIP, but also has certain protective effect on gastric mucosa, and its efficacy being directly proportional to the dosage.

Objective To study the application effect of antiskid steel plate internal fixation via exposing lateral and posterior ankle fracture through fibula posterolateral approach in the treatment of Lauge-Hansen supination-eversion ankle fracture.Methods From January 2009 to December 2012,exposed the lateral and posterior ankle fracture through fibula posterolateral approach of 36 patients suffering from the Lauge-Hansen supination-eversion ankle fracture,and fixed the lateral and posterior ankle by the antiskid steel plate.Adopt Olerud-Molander ankle function scoring system to evaluate the postoperative effect of the ankle.Results All the patients were followed up for 7-27 months,with an average follow-up of 19 months.There was no complications such as incision infection and cutaneous necrosis.Only 1 patient occurred with peroneus myotenositis,and the symptom was relieved after taking out the steel plate.The fracture was healed within 16 weeks.Among the 36 cases,22 cases were excellent,9 cases were good,4 cases were medium and 1 case was poor.The fine rate was 86.1％(31/36).Conclusion Using the antiskid steel plate to treat the lateral and posterior ankle fracture through fibula posterolateral approach,can fully expose a single incision,fix the lateral and posterior ankle and reduce the tension in suture,improve the incision healing rate and fracture stability,provide a new method for treating ankle fracture.

Objective To analyze the MR manifestations of the focal nodular hyperplasia (FNH)in liver and observe the MRI changes after 30-36 months.Methods 12 (14 lesions)of the 13 patients (1 5 lesions)were firstly diagnosed as FNH by MRI with plain scan and dynamic Gd-DTPA enhancement,and then were confirmed by the follow-up survey with similar MRI after 30 - 36 months.The last one patient was also scanned with Gd-EOB-DTPA enhancement but with similar plain scans.The size,signal,en-hancement patterns of the lesions were analyzed and compared with those in the follow-up survey.Results Typical MR manifesta-tions were found in 93.33%(14/1 5)of the lesions with hypo-or iso-intensity on T1 WI,hyper-or iso-intensity on T2 WI,marked en-hancement in arterial phase and attenuation but still equal to or higher than normal liver parenchyma in portal and delayed phases af-ter Gd-DTPA administration.In addition,the central scar showed hypointensity on T1 WI,hyperintensity on T2 WI,and enhance-ment in delayed phase.The enhanced small vessels inside lesions and the pesudocapsule enhancement could be seen in delayed phase. The only one lesion with Gd-EOB-DTPA enhancement showed marked enhancement in arterial and portal phases,and slight hyperin-tensity in hepatocellular phase with hypo-intense central scar in any phases.As for the only one lesion with atypical manifestation,it showed isointensity on T1 WI,slightly hyperintensity on T2 WI,nonenhancement in arterial phase,slightly enhancement in portal phase,and small vascular enhancement inside the lesion in delayed phase.After the follow-up survey of 30-36 months 92.86%(13/14)lesions did not change,however one lesion (10mm)disappeared.Conclusion Typical FNH shows similar MRI characteristics, iso-intense or slightly hypo-intense signal on T1 WI,iso-intense or slightly hyper-intense signal on T2 WI,marked enhancement in ar-terial phase,the central scar enhancement and the inside small vascular enhancement of lesions in delayed phase.It is valuable in dif-ferential diagnosis.

Objective To evaluate the usefulness of real-time three-dimensional transesophageal echocardiography (RT-3D TEE) in the perventricular device occlusion of the ventricular septal defect (VSD).Methods Sixty patients underwent perventricular device occlusion of VSD were divided into two groups.Group A:30 patients,3D images of VSD were obtained intraoperatively by RT-3D TEE.3D images were analyzed and the maximal and minimum area and maximal diameter of VSD were measured in the cardiac cycle.The size of selected VSD occluder was the diameter calculated from the maximal area based on the formula πD2/4 and plus 1～2 mm.Simultaneously,two dimensional transesophageal echocardiography (2D TEE) images of VSD were obtained and measured on standard views.Group B:other 30 patients,intraoperative 2D TEE was performed to measure the diameter of VSD on standard views.The selection VSD occluder was based on the maximal diameter plus 1～2 mm.Results The VSDs shape showed oval,class round and irregular by RT-3D TEE imaging.There was a significant difference between the maximal area and smallest area of VSD appeared in the cardiac cycle obtained by RT-3D TEE (P<0.01).There was a significant difference between the maximal diameter by measurement of RT-3D TEE and 2D TEE (P<0.01).Of all 30 patients with evaluation of VSD size based on the RT-3D TEE,1.1 times attempts of device occlusion were performed on one patient (33/30).Of the other 30 cases with evaluation of VSD size by 2D TEE,2 cases were failed with device occlusion because of instant residual shunt.Of the remaining 28 cases,1.43 attempts of device occlusion were performed on one patient (40/28).Conclusions RT-3D TEE can accurately reveal the size of VSD,and aid in the selection of VSD occluder in the device occluding procedure of VSD.

Objective To investigate the application of real-time three-dimensional transesophageal echocardiography (RT-3D TEE) in quantification of the aortic anuulus diameter in patients with severe aortic stenosis.Methods RT-3D TEE image of aortic root was get perioperatively in 65 patients with sever aortic valve stenosis during the surgery procedure.The aortic annulus was reconstructed in the quantitative analysis software to generate the parameters of 3-dimensional area based aortic anuulus diameter(3D-AAAD) and 3-dimensional circumference based aortic anuulus diameter(3D-C-AAD).The parameters was compared with intraoperative aortic anuulus diameter(IO-AAD),which was get by the standard cylindrical valve sizer.Results The three dimensional form of the aortic annulus was related to the number of the valves.The value of 3D-C AAD and 3D-A-AAD were (22.4 ± 2.1) mm,(23.4 ± 1.9) mm,no significant difference could be detected between them and the IO-AAD (P ＜ 0.05).The 3D-C-AAD had a better agreements with IO-AAD than 3D-A-AAD.Conclusions RT-3D TEE can reconstruct the three dimensional sharp of aortic anuulus,and can be used as quantitative tools to calculate its diameter.

This paper aims to discuss the use and management of operation instrument in treatment of the wounded on the sea by using the new type of field operation instrument set so as to improve the rescue ability on the sea. The operation set has a new structure and is designed reasonably. It is easy to be washed and disinfected. It can be packed sterilizedly for a long time and deployed rapidly. All of the operation instrument is fixed in the box to prevent it from falling when it is used on the sea and it is convenient to count and arrange. The new type of field operation instrument set is fit for rescuing the wounded on the sea. It is convenient to be used, sterilized, stored and carried.