Objective To report the clinical results of the treatment for recurrent immunologic disorders of cornea and conjunctiva by conjunctival resection with amniotic membrane transplantation(AMT). Design A retrospective clinical case series. Participants Five patients 5 eyes with recurrent immunologic disorders of cornea and conjunctiva were enrolled into this study, including 2 eyes of phlytenular keratoconjunctivitis with corneal lesion, 1 eye of nodular episcleritis, 2 eyes of corneoscleral interstitial keratitis. Methods Patients were treated with partial conjunctiva resection and AMT. After operation, steroids and cyclosporin eye-drops were given for 2-3 weeks, and patients were followed up for 6-12 months. Main Outcome Measures Complications and recurrent situations were observed. Results The corneal disease kept quiescent, and the blood vessel subsidized. There were no recurrences during the follow up period in 4 cases. Recurrent signs were noted in one patient at 12 months after surgery. But no recurrence of corneal lesion was noted although the conjunctivitis was severe. Conclusion Local conjunctiva resection combined with AMT is a useful method for recurrent cases of immunologic disorders of cornea and conjunctiva. (Ophthalmol CHN, 2006,15:177-179)

Background and purpose: Docetaxel/cisplatin are widely used in chemo-naive patients with advanced non-small cell lung cancer(NSCLC),but the standard 3-weeks'project of docetaxel caused significant toxicity.We performed this study to compare the effect and toxicity of modified and standard 3-weeks'docetaxel/cisplatin as first line chemotherapy for advanced NSCLC.Methods:68 patients with stage ⅢB or Ⅳ NSCLC(proven by histology or cytology) were randomly divided into two groups,modified(A) and standard(B) chemotherapy.Group A: docetaxel 75 mg/m2,divided into 2 days,ivgtt d1 and d 8,cisplatin 25 mg/(m2?d),ivgtt d 1-d 3,q3w;Group B: docetaxel 75 mg/m2,ivgtt d 1,cisplatin was administered as Group A,q3w.The effect and toxicity were assessed after two cycles and one-year survival was followed up.Results:There was no CR in both groups.10 PR,20 SD,4 PD were found in group A,the overall response rate is 29%;whereas 11 PR,20 SD,3 PD were found in group B,the overall response rate is 32%.The one-year survival rate were 38% and 35% in group A and B,respectively.There were no significant difference about the overall response rate(P=0.793) and one-year survival rate(P=0.801) between group A and B.The rates of grade Ⅲ/Ⅳ neutropenia were 18% and 47% in group A and B respectively.The difference was statistically significant(P=0.010).Conclusions:In comparison with the standard 3-weeks'docetaxel/ cisplatin chemotherapy,the modified one has similar response rate but lower hematologic toxicity,and thus it was well tolerated.

Carcinoma, Neuroendocrine ; pathology ; Humans ; Nasal Cavity ; pathology ; Nasopharynx ; pathology

Objective The aim of this study was to observe the growth difference and expression of cytochrome C of skin hair follicles in neonatal mice .Methods The morphology of different skin hair follicles of neonatal mice ( postnatal day 1-9)were observed by HE staining histology and cytochrome C was detected by immunohistochemistry .Results The skin hair follicles in different parts of neonatal mice showed differences not only in morphology but also in developmental pe -riods.Hair follicle growth in the back and tail skin had a nonlinear and growing period .After the nonlinear and growing pe-riod they began to grow rapidly .The tail development was slightly slower than that on the back .The hair follicles of vibris-sae were very special , and started to develop without a stable period .Conclusions The results of morphological observa-tion and cytochrome C immunohistochemistry demonstrate that differences exist in the hair follicle morphology and develop -mental times in the skin of different parts of the body in neonatal mice .

Objective To study the effect of animation in the course of medical statistics.Methods By convenience cluster sampling,271 undergraduates in two classes were recruited from the specialty of medical image,medical anesthesia and medical laboratory.The experimental group (n =139) and control group (n =132) were set up randomly.The animation design is only used in the teaching process among the experimental group,while traditional teaching method without animation was used in the control group.All participants were surveyed by questionnaire for the effectiveness after one week of the curriculum closure.SPSS 15.0 software was used to do data entry and statistical analysis and two-sample t-test was used to compare the differences in text scores between two groups.Evaluation was made on the courseware of animation in experimental group.P ＜ 0.05 signifies that the differences have statistical significances.Results The test scores in experimental group (79.62 ± 9.34)were significantly higher than those in control group (77.10 ± 9.18; P ＜ 0.05).More than 85 ％ of the experimental students think animation can stimulate their enthusiasm in studying medical statistics; and help them better understand the key points and main difficulties of the statistical knowledge.Conclusion It suggests that animation can enable students to study better the course of medical statistics.

Objective To investigate the expression of TMPRSS4 mRNA,protein in human pancreatic cancer tissues and to explore the relationship between the expression of TMPRSS4 protein and the clinicopathologic parameters.Methods Real-time PCR and Western blotting were used to detect the expressions of TMPRSS4 mRNA and protein in 16 samples of pancreatic cancer tissues and adjacent normal pancreatic tissues.The expression of TMPRSS4 protein in 61 samples of pancreatic cancer tissues and 26 samples of adjacent pancreatic tissues and 4 samples of normal pancreatic tissues was detected by using immunohistochemistry and its relationship with clinicopathological features was analyzed.Results The expression of TMPRSS4 mRNA and protein of pancreatic cancer tissues were significantly higher than those in adjacent pancreatic tissues (9.09 ± 7.01 vs.1.27 ± 0.72; 1.223 ± 0.125 vs.0.667 ± 0.106,P ＜ 0.01 ) ;the expression rate of TMPRSS4 protein of pancreatic cancer tissues was 67.2％ (41/61),which were significantly higher than that in adjacent pancreatic tissues[3.8％ (1/26),P ＜ 0.01].There was no TMPRSS4 protein expression in normal pancreatic tissues.There was no significant correlation between the expression of TMPRSS4 protein and the age,gender,tumor location or tumor size was found.There was significant correlation between the expression of TMPRSS4 protein and the degree of differentiation,lymph node metastasis,and clinical staging (P ＜ 0.05 ).Conclusions TMPRSS4 protein is highly expressed in pancreatic cancer tissues,and the expression of TMPRSS4 is associated with the degree of malignancy of pancreatic cancer.

Objective To analyze the clinical outcome and impact factors of twin-to-twin transfusion syndrome (TTTS) with anterior placenta treated by fetoscopic selective laser coagulation of placental vessels(SLCPV). Methods Ten cases of TTTS with anterior placenta and 8 cases with posterior placenta were treated by SLCPV in Shengjing Hospital from July 2011 to April 2014. Clinical data were analyzed retrospectively. Some cases were at Quintero stageⅡor higher stage, others were at Quintero stageⅠbut with cardiovascular score≥5 according to the scoring system of Children′s Hospital of Philadelphia. The anterior placenta cases were treated by curve fetoscopy and the posterior placenta cases were treated by straight fetoscopy. Results (1) Of all the 18 cases, the mean gestational age at SLCPV was 24.1 weeks (17+5 to 27+4 weeks). There were 2 cases at Quintero stageⅠ, 4 at stageⅡand 12 at stageⅢ. The mean gestational age of anterior placenta cases at SLCPV was 25.2 weeks (22 to 27+4 weeks), with 2 cases at Quintero stageⅠ, 2 cases at stage Ⅱ and 6 at stage Ⅲ;5 cases had preterm prelabour rupture of the membranes (PPROM)and 1 case had maternal intestinal obstruction after the operation;the average operation time was 40 minutes. Of the posterior placenta cases, the mean gestational age at SLCPV was 22.7 weeks (17+5 to 27+4 weeks);2 cases were at Quintero stageⅡand 6 cases at stageⅢ. PPROM happened in one case;one case had maternal enterobacter cloacae septicemia;the average operation time was 28 minutes. All the 18 cases could tolerate the operations. There was no intraoperative complication. (2) One anterior placenta case had maternal intestinal obstruction and miscarriage; and one posterior placenta case had enterobacter cloacae septicemia. Karyotype analyses of the all the twins were normal. (3) 17 cases delivered already, including all the 10 anterior placenta cases and 7 posterior placenta cases. One infant had corpus callosum agenesis, but its co-twin was normal. The average gestational age at delivery for anterior placenta cases was 32.6 weeks (24 to 37+1 weeks), an was 28.2 weeks (25+6 to 36+2 weeks) for posterior placenta cases. The fetuses survival rate was 13/17 (one case was still in pregnancy) for at least one twin, and 10/17 for both twins. Both twins survival rates were 5/10, 5/7 for anterior placenta cases and posterior placenta cases, respectively. At least one twin survival rates were 8/10, 5/7 for the two groups respectively. Conclusion SLCPV is suitable for the treatment of TTTS, no matter the placenta is on the anterior wall or posterior wall. The treatment had good outcomes, but more PPROM happened in the anterior placenta cases, which may be associated with operation time and the range of operation.

Objective To discuss the methods and outcomes of twin reversed arterial perfusion sequence in different stage. Methods From August 2012 to December 2013, 11 cases were diagnosed with twin reversed arterial perfusion sequence (TRAP) by 3d color Doppler ultrasound in the Maternal ang Fetal Medicine Center ,Affiliated Shengjing Hospital, China Medical University, including 3 cases in stageⅠa, 7 in stageⅡa and 1 case in stageⅡb. We performed expected therapy to 3 cases in stageⅠa and 4 cases in stageⅡa [1 case (case 9) in stageⅡa developed to stageⅡb and was terminated by emergency cesarean section], radio frequency ablation (RFA) selective reduction to 3 cases in stage Ⅱa, emergency cesarean section to 1 case in stageⅡb. All cases except case 1,4 took cesarean section to terminate pregnancy and would be followed up on the aspect of infant′s growth. Results (1) 3 cases in stageⅠa were monitored by sequential ultrasound examination, all donors grew normally, in which 2 acardias arised spontaneous cessation of flow and were implemented of cesarean section after the normal period of gestation; 1 case suffered premature rupture of membrane and experienced the natural childbirth at 34 gestation weeks plus 5 days. The survived average labor weight was 2 923 g. (2) In the 7 stage Ⅱa cases, 3 cases were implemented of RFA selective reduction, 2 cases survived and the average labor gestation was 35 weeks plus 1 day and average labor weight was 2 050 g;in 3 expected therapy cases, 1 case suffered premature rupture of membrane at 34 gestation weeks plus 5 days and experienced cesarean section; 1 case was observed for 3 weeks and the donor was stillborn; 1 case progressed to stage Ⅱb and experienced cesarean section at 34 gestation weeks plus 5 days;and 1 case was lost of follow up. (3) For 2 cases of stageⅡb cases, one was progressed from stage Ⅱa during expected therapy; the other one had been already in stage Ⅱb since visiting and experimented an emergency cesarean section, but the neonate died of heart failure two days after labor. (4) 7 survived neonates were followed up, all had a normal condition compared to kids of the same age, except one suffering a congenital heart disease, patent ductus arteriosus and atrial septal defect and whose weight (6 kg at 7 months) was lighter. Conclusions We should make the diagnosis of TRAP as early as soon and choose appropriate therapy according to the stage. According to our research, cases in stage Ⅰa can undergo an expected therapy under a sequential ultrasound examination;cases in stageⅡa can undergo a RFA selective reduction to improve the prognosis of the donor, which can make a good perinatal outcome.

Objective To investigate the dynamic changes of endoplasmic reticulum stress-related molecules including glucose regulated protein (GRP78), C/EBP homologous protein (CHOP), and caspase-12 in sciatic nerve of diabetic rats and explore its mechanisms.Methods Rats were randomly divided into normal control group (NC) and diabetes mellitus group (DM) that were induced by intraperitoneal injection of Streptozocin after 4 weeks of high-fat chow feeding.Sciatic nerves were isolated for three times at 4 weeks, 8 weeks and 12 weeks after induction of diabetes.The expressions of GRP78, CHOP,and caspase-12 were detected with quantitative real-time polymerase chain reaction (qRT-PCR) and Western blot analyses.The morphology of sciatic nerve was investigated with electron microscope.Results With the extension of the course, demyelinating and axonal injury appeared in sciatic nerve of diabetic rats.The expressions of GRP78 mRNA and protein in DM group were significantly higher than NC group at 4 weeks and 8 weeks after induction of diabetes(P ＜0.05, P ＜0.01).The expressions of CHOP mRNA and protein in DM group were significantly higher than NC group at 8 weeks and 12 weeks after induction of diabetes (P ＜ 0.05).The expressions of caspase-12 mRNA and protein in DM group were significantly higher than NC group at 8 weeks after induction of diabetes(P ＜ 0.05, P ＜ 0.01).Conclusions Endoplasmic reticulum stress-related molecules (GRP78, CHOP, and caspase-12) contributed to the peripheral nerve injury of diabetic rats, and displayed dynamic changes.

Objective To introduce the treatment efficacy of using allograft muscle ligament anatomical to rebuild anterior cruciate ligament (ACL) of knee joint under the arthroscopy.Methods Sixty-two cases patients with ACL rupture in anterior cruciate ligament reconstruction under arthroscopy.Allograft ligaments were used as graft,a bone tunnel was established in the proximal tibia and distal femur,and the graft was fixed by the extrusion screw.After the operation,the knee joint was fixed for 12 weeks,and the subjective evaluation was carried out according to the Lysholm and Larson knee score standards;in order to assess the stability of the ligament and the functional recovery of the knee joint,objective evaluation was carried out according to Lachman test in patients.Results The preoperative average Lysholm scale was (43.1±2.1) points,the final average score of 2 years after the reconstruction of the ligament was (91.0+2.3) points,there was significant difference (t=3.460,P=0.001).The preoperative average Larson scale was (41.0±2.9) points,the final average score of 2 years after the reconstruction of the ligament was (90.1±3.5) points,there was significant difference (t=3.232,P=0.001).Lachman test results were negative in 62 patients at the end of the review.No serious postoperative complications occurred,no knee infection,deep vein thrombosis and stiffness.All the patients can be completely straight 1 year after operation,knees up to 120 degrees.All patients were satisfied with the function at the end of the follow-up,no joint instability,no re-rupture occurred during the follow-up period.Conclusion Using the allogeneic single beam anatomy of anterior cruciate ligament reconstruction under arthroscopy can obtain satisfactory clinical efficacy.