Objective To analyze MRI features of tuberculosis of spinal vertebra, spinal meninges and spinal cord. Methods Fifty cases with tuberculosis of spinal vertebra, spinal meninges or spinal cord confirmed by clinical and pathological evaluation were collected in this study. Findings of plain and Gd-DTPA enhanced MRI were retrospectively reviewed. Results In 40 patients with spinal vertebra tuberculosis, there were 137 involved vertebrae, 52 involved intervertebral discs, 30 peri-vertebra cold abscesses, 23 intraspinal abscesses and compression of spinal cord, 29 athological fractures, 12 posterior process of spinal columns, 2 involved appendix. There were 4 cases of spinal meninges tuberculosis, 4 of tuberculous myelitis and 2 combination of tuberculosis of spinal meninges and spinal column. Conclusion MRI, especially the contrast MRI, could accurately and early demonstrate the morphological and pathological changes of tuberculosis of spinal vertebra, spinal meninges and spinal cord.

Objective To measure ceftriaxone concentrations in aqueous humor of human eye after one gram of the drug was administered intravenously. Methods 75 subjects (75 eyes) were studied, 60 of whom were divided randomly into 4 test groups according to different time intervals between drug administration and extraction of aqueous humor (30min, 60min, 120min, 180min), and the rest 15 were controls. One-gram of ceferiaxone was administered intravenously before cataract operation. About 200-300?l aqueous humor was withdrawn from every patient during the operation at respective time point mentioned above and reversed phase high performance liquid chromatography (HPLC) was used to measure the concentration of the drug. Results The concentrations of ceftriaxone in aqueous humor were 0.235?0.121mg/L, 0.474?0.224mg/L, 0.453?0.162mg/L, and 0.534?0.202mg/L, respectively, after a time interval of 30min, 60min, 120min, 180min. The drug concentration in the 30 min group was lower compared with the other 3 test groups (P0.05), and the concentrations of ceftrixone in aqueous humor were all above the minimum inhibitory concentration for 50%(MIC 50 ) of ceftriaxone against most pathogenic bacteria. Conclusion Ceftriaxone may be an effective antibiotic for prophylactic use in ophthalmic surgery and also for the treatment of intraocular infection due to organisms susceptible to the drug.

Posttraumatic stress disorder (PTSD) which is also moderately heritable is unique among the mental disorders in that it requires exposure to a potentially-traumatic life even. Many advances have been made in the genetics of PTSD. This paper reviewed 5-HTTLPR, DRD2 and some others gene which associated with PTSD.

BACKGROUND:Chitin has been found to be a good biomaterial, but research on chitin carrying corneal epithelial cel s for rabbit corneal epithelial injury is little reported. OBJECTIVE:To investigate the repair outcomes of chitin hybrid membrane carrying corneal epithelial cel s in the rabbit corneal epithelial injury.METHODS:Eighteen New Zealand white rabbits were enrol ed and made into left corneal epithelial injury models, and then randomized into two groups and treated with chitin hybrid membrane carrying corneal epithelial cel s (experimental group) and chitin hybrid membrane (control group), respectively. The damage area, histological changes and ultrastructure of the cornea were observed at 1, 3, and 7 days after implantation. RESULTS AND CONCLUSION:Damage area of the cornea in the experimental group was significantly less than that in the control group at 1 and 3 days after implantation (P<0.05), and the cornea in both two groups healed wel at 7 days after implantation. At 7 days after implantation, in both two groups, the corneal epithelium with six layers adhered to the corneal stroma closely, which was repaired completely and regularly. Comparatively speaking, the cornea in the experimental group possessed smooth outer layer. Besides, in the experimental group, the hexagonal corneal epithelial cel s arranged closely with flat surface;while the hexagonal corneal epithelial cel s in the control group showed no smooth surface and gaps between cel s. These results indicate that chitin hybrid membrane carrying corneal epithelial cel s promotes the repair of rabbit corneal epithelial injury.

BACKGROUND:Chitosan nanoparticles-encapsuled sodium hyaluronate is an effective drug for the burned cornea. OBJECTIVE:To verify the effect of sodium hyaluronate/chitosan nanoparticles on the neovascularization in burned cornea. METHODS:Thirty Sprague-Dawley rats were randomly divided into three groups, and the model of burned cornea caused by base was established in the rats of model and experimental groups, fol owed by respectively treated with 10μL sodium hyaluronate/chitosan nanoparticle suspension and normal saline, once daily, for consecutive 4 weeks. Rats only given normal saline were used as controls. Four weeks later, the dynamic growth of newly formed blood vessels in the cornea was observed using silt lamp. The levels of tumor necrosis factor-αand interleukin-6 were detected by ELISA, histological changes of the cornea were observed by hematoxylin-eosin staining, and the mRNA expression levels of vascular endothelial growth factor and cyclooxygenase 2 were detected by real-time PCR. RESULTS AND CONCLUSION:Compared with the control group, the area of the newly formed blood vessel and the levels of tumor necrosis factor-α, vascular endothelial growth factor and cyclooxygenase 2 were significantly increased in the model group (P<0.05, P<0.01). In the experimental group, al above indicators were significantly lower than those in the model group (P<0.05). There were a large number of inflammatory cel s and neovascularization in the model group, but only few inflammatory cel s in the experimental group. These results show that sodium hyaluronate/chitosan nanoparticles can inhibit the neovascularization in the burned cornea.

BACKGROUND: Endoscopic transnasal lacrimal duct reconstruction by grafting of autogenous tissue is a novel method for treatment of severe lacrimal duct obstruction and it needs detailed anatomical data for surgery.OBJECTIVE: To study the applied microsurgical anatomy of lacrimal duct and to provide anatomical evidence for endoscopic transnasal lacrimal duct reconstruction by grafting of autoganous tissue.DESIGN, TIME AND SETTING: This study was performed at the laboratory of the Department of Ophthalmology, Armed Police General Hospital from July 2006 to June 2007.MATERIALS: Twenty 10% formaldehyde-treated adult cadaveric heads, 14 males and 6 females, comprising 40 lacrimal ducts were included in this study.METHODS: The cadaveric heads were split on the level of the line between the superior border of the superciliary arch and the site 10 mm higher than occipital tuberosity. After removal of brain tissue,the heads were decalcified for approximate 1 week with 10%nitric acid. This promised non-alteration of morphological structure and facilitation for surgical cutting. Following dissection of facial cranium in the median sagittal plane, the nasal septum was excised to expose the lateral wall of the nasal cavity.MAIN OUTCOME MEASURES: The anteroposterior diameter and depth of lacrimal fossa; at middle third level, the thickness of lacrimal fossa at the anterior lacrimal crest, vertical middle line, and posterior lacrimal crest; the cross section area of nasolacrimal canal upper opening, middle part, and lower opening; horizontal distance, 30° oblique distance, and 45°oblique distance from lacrimal caruncie to nasal cavity; distance from lacrimal caruncle to nasolacrimal canal upper opening; and the included angle between lacrimal caruncle-nasolacrimal canal upper opening line and Aeby's plane.RESULTS: The length, anteroposterior diameter, and depth of lacrimal fossa were (17.85±1.72) mm, (6.74+1.28) mm, and (3.09+0.78) mm, respectively. At middle third level, the thickness of lacrimal fossa at the anterior lacrimal crest,perpendicular bisector, and posterior lacrimal crest was (4.03±0.89) mm, (0.61±0.36) mm, and (0.63±0.24) mm, respectively.Anterior lacrimal crest was significantly thicker than vertical middle line and posterior lacrimal crest (P ＞ 0.05). Horizontal distance, 30°oblique distance, and 45° oblique distance from lacrimal caruncle to nasal cavity was (17.23±0.70) mm,(14.51±1.72) mm, and (17.34±2.38) mm, accordingly, with a difference which was not significant (P ＞ 0.05). The distance from lacrimal caruncle to lateral wall middle point of nasolacrimal duct superior opening was (11.86±1.84) mm, and the included angle between lacrimal caruncle-lateral wall middle point of nasolacrimal duct superior opening line and Aeby's plane averaged (49.9±1.8)°.CONCLUSION: The distances from lacrimal caruncle to nasal cavity and lacrimal sac and the included angles between lacrimal caruncle-nasolacrimal canal upper opening line and Aeby's plane provide guidance significance for selection of bony opening position on the lateral wall of nasal cavity and determinations of tunnel oblique angle and autogenous tissue length. Creation of bony tunnel should start from the middle or posterior middle part of lacrimal fossa and then extend towards anterior inferior region with an optimal downward oblique angle of 45°. The length of autogenous tissue used for lacrimal duct reconstruction should exceed 21.22 mm.

BACKGROUND :Although the conventional 20 G pars plana vitrectomy can improve the prognosis of vitreous-retina diseases,but it would also cause serious operation related injury and much complications.OBJECTIVE:To evaluate the practicability and safety of 25-gauge transconjunctival sutureless vitrectomy system (TSV25G) in the macular surgery, so as to elicit the preliminary clinical experience of mimimally invasive vitrectomy system.DESIGN:Case analysisSETTING: Department of Ophthalmology, General Hospital of Chinese People's Armed Police Force; Department of Ophthalmology, Beijing Sino Japen Friendship Hospital; Department of Ophthalmology and Visual Science, Chinese University of Hong Kong; Department of Ophthalmology,Prince of Wales Hospital, Hong Kong PARTICIPANTS: From July 2003 to July 2004, 16 patients with macular diseases were admitted to the Department of Ophthalmology in the General Hospital of Chinese People's Armed Police Force and taken as subjects (n=16), they were confirmed as epiretinal membrane in 9 eyes, idiopathic macular hole in 3 eyes, traumatic macular hole in 2 eyes and vitreo-macu lar tractional syndrome in 2 eyes. The course of disease ranged from 3 to 36 months with eyesight varied between 0.06 and 0.4.METHODS: 16 eyes underwent preoperative ophthalmic evaluation in cluding visual acuity measurement, Amsler chart test, slit lamp microscopy,.indirect ophthalmoscopy tonometry and optical coherence tomography (OCT). For the macular hole patients OCT was performed. 25-gauge Transconjunctival Sutureless Vitrectomy System (TSV25G) was used to carry on minimally invasive surgery under anesthesia state, the surgical parameter was set as: high speed cutter with rate of 1500 cuts per minute,BSS bottle was hang at height of 40-50 cm, the maximum aspiration of TSV25G was 550 mm Hg with the intraocular pressure remained at around 29-35 mmHg during the operation. Three-beveled trocar were used to make three-transeonjunctival incision on sclera of about 0.5 mm long respectively in the infratemporal, superotemporal, and supraotemporal quan drants, meanwhile a transconjunctival cannula was placed. One end of the infusion tube was inserted into the infratemporal cannula to establish infusion with the other two cannulas used for the intraocular operation with 25-gauge vitreous cutter and other instruments, such as vitreoectomy and membrane dislocation. The surgery was terminated by removing the cannula except for ceaseless leak, the conjunctival and scleral incision were not sutured. Patients received follow-up examination for 1-12 months postoperatively.MAIN OUTCOME MEASURES:①The operative time and the time for the establishment of three access. ② Changes of intraocular pressure after operation. ③ The effusion from the puncture after the intraocular perfor mance. ④ The postoperative vision, operative complication and the sealing of the holes.RESULTS:All of the 16 patients completed the vitrectomy; and entered the data analysis.①16 patients complete the vitrectomy with the operative time of 28-56 minutes (the mean of 37 minutes). The average time for the establishment of three access and closing was 84 s and 32 s respectively.②The average preoperative intraocular pressure was 16.4 mm Hg,comparing with 13.5,15.5,17.9 mm Hg at postoperative 1 day, 1 w and 1 m. ③Water leakage were found in 4 wounds of three patients after operation, 3 wounds were sealed after injecting 1-2 mL disinfected air into the eyes, the other one sutured with 6-0 absorbable suture. ④The mean time of inpatients were 5 days postoperatively. The visual acuity improved in 14 patients by the average of three lines, amongst which visual acuity was found improved to above 0.8 in 5 patients and the visual distortion disappeared in 8 eyes and attenuated in 3 eyes. But still there were 2 cases without improvement.No surgical complications were noted and macular hole gained clinical sealing in totally 5 eyes.CONCLUSION: TSV25G system can simplify the surgical procedure with many other advantages such as decreasing the operation related injury and complications, as well as shortening operative time, which benefits the rapid rehabilitation.

Objective To verify the safety and advantages of total transperitoneal laparoscopic nephroureterectomy (ttLNU) in the treatment of upper urinary tract urothelial carcinoma (UTUC).Methods From Jun.2013 to Jun.2014,there were 13 UTUC patients treated with ttLNU,including 7 males and 6 females.The mean age was 70.4 ± 8.3 yrs,and BMI was 23.3±4.1.Of them,11 cases were diagnosed with renal pelvis carcinoma,6 in the left and 5 in the right.2 cases were diagnosed with left ureteral carcinoma.TNM stages were T1-T3N0M0.Patients were put on lateral position and the position was not changed during the operation.A ttLNU was performed,and the specimen was removed from the middle extended inferior umbilical incision.Results The mean operative time was 188±33 (150-240) min,the intraoperative blood loss was 150.5±60.1 (50-700) ml,and the time of out-of-bed activity was between 1 and 4 d.The mean postoperative drainage time was 6.8±4.6 (3-6) d.The mean postoperative bowel function recovery time was 1.5± 1.0 (2-4) d and postoperative hospital stay was 12.8±7.0 (3-27) d.The ttLNU procedures were successfully performed in all cases without conversion to open surgery.Pathological results showed urothelial carcinoma in all cases,including 8 high grade and 5 low grade.All the surgical margins were negative.The followed up was from 2 to 12 mon,and there was no tumor recurrence and metastasis found.Conclusions Total transperitoneal laparoscopic nephroureterectomy in the treatment of upper urinary tract urothelial carcinoma is characterized by short operative time,low blood loss,decreased trauma and quick recovery.This is a safe and effective treatment option for the treatment of upper urinary tract urothelial carcinoma.

ObjectiveToinvestigatetheplasmidgenechangesinquinolone‐sensitivePseudomonasaeruginosa.Methods 31iso‐lates from January 2011 to December 2013 from various qualified clinical samples in the hospital were collected .In the 31 isolateds , 16 isolates proved sensitive to quinolones by using K‐B method were used as research objects in the study .The isolates growing ou‐side the sensitive ring of ciprofloxacin paper were selected to continuously transferred into other culture dishes until the resistance to quinolones were acquired .Plasmid transformation and extraction were performed on those isolates to confirm the existence of drug‐resistanceplasmidsacquired,andthroughPCRandgenesequenceanalysistodeterminethetypeofplasmids.Results 2iso‐lates of quinolone‐sensitive Pseudomonas aeruginosa acquired drug‐resistance plasmids qnrS and were resistant quinolones induced by continuous transferring for 9 times .Conclusion If antibiotics of inhibitory concentration were often used for the treatment of Pseudomonas aeruginosa infection ,drug‐resistance plasmids were acquired easily .

Objective To explore the effects of mulitinational united medical transport of emergency and critical patients in Indonesia after earthquake tsunami disaster.Method Various factors,which affected mulitinational united medical transport in Indonesia after earthquake tsunami disaster were analyzed.Results All of the 217 emergency and critical patients were successfully transported to the destination.Conclusion Mulitinational united medical rescue had advantages on integrating medical resources and improving efficiency.During mulitinational united medical transport,the tasks should be distributed rationally,and self-protection of medical workers was the basis of accomplishing medical rescue.