Clinical analysis of 42 cases of scleral rupture revealed that the injures were caused by blunt objects in 42.9％ and by sharp objects in 38.1％ of the cases. The wound was mostly on the nasal side of the eye (71.43％ OD) and (78.95％ OS) with no correlation to the causes. The concurrent manifestations included hyphema (63.4％), posterior uveal or vitreous prolapse or vitreous heamorrhage (52.3％), and lens opacity or missing (over 21.4％). Enucleation was performed in 9 cases,of which 7 cases followed blunt contusion. The indications for enucleation were that the scleral wound extending posteriorly beyond the rectus muscle insertions or≥10mm in length,visual acuity≤LP, hyphema, lens dislocated or missing and vitreous heamorrhage.

Submacular Hemorrhage (SMH) in age-related macular degeneration (AMD) represents a challenging disorder for vision protection. Varied surgical interventions have been suggested in its management. The author herein reviewed some aspects related to SMH in AMD such as its risk factors, secondary damages, natural course and surgical management including different techniques,outcomes and complications.

To evaluate the role and efficacy of vitrectomy in the treatment of eye injuries in children with posterior segment involvement, forty-six eyes in 45 children aged under 16 with injuries involved posterior segment treated with pars plana vitreetomy are studied retrospectively. Six eyes underwent vitreetomy only, the others combined with seleral buekling and/ or gas-fluid exchange, and rarely, silicon oil tam-ponade; Seventeen eyes with lensectomy. Thirty-four (73.91%) of the 46 eyes achieved surgical success. Of 13 (28.26%) eyes with retinal detachments, six (46.15%) achieved reatachment. The failure of surgery was mainly due to retinal detachment, which mostly characterized by anterior proliferative vitreoretinopathy (PVR). We conclude that pars plana vitrectomy is an important therapeutic operation for eye injury in children with posterior segment involvement. The key factor that influence the outcome of eye injury in children is the treatment of traumatic retinal deatchment.

Nocardia asteroides endophthalmitis is a rare and severe intraocular bacterial infection.In this paper we present the first reported ease in China,to our knowledge,of chronic suppurative endophthalmitis caused by Nocardia asteroides after ocular perforative trauma.Cases of exogenous Nocardia endophthalmitis in foreign literature are reviewed,and the clinical characteristics,diagnosis,treatment,as well as prognosis of exogenous Nocardia endophthalmitis, are extensively discussed.

Objective To investigate effects cytokine of rhIFN-a and their on ultrastructure of hypertrophic scar derived fibroblasts and explore its mechanism.Methods Hypertrophic scar fibroblasts cultivated in vitro were observed and analysed through transmission elextron microscope(TEM).Then the effects of rhIFN-a on biological behavior and pathological changes of hypertrophic scar fibroblasts have been determined.(Results) Compared with the control group,the experimental rhIFN-a group could be observed changes in inhibition of fibroblasts growth and proliferation with the mitochondrion swelling,its ridge dissolving and apoptosis promoting.Conclusions rhIFN-a can suppress growth and proliferation of hypertrophic scar fibroblasts and promotes apoptosis.This indicates that ,as a negative modulation factor,rhIFN-a is important in the treatment of hypertrophic scar.

Objective To discuss the indications and efficacy for treating tibia insertion avulsion fracture of the posterior cruciate ligament(PCL)by the mean of the end of ligament suture via arthroscopy.Methods Twenty-one cases of tibia insertion avulsion fracture of PCL were treated with suture the end of ligament via arthroscopy from June 2007 to June 2009,including 14 males,7 females,with a mean age of 31.5 years(range,13-52 years).The insertion avulsion fragment was fixed to the tibia with two strands of 5Ethibond threads via arthroscopy.Two bone tunnels(2.5 mm in width)were made from the anterior part of the tibia to the posteromedial(at 4:30 toward)and posterolateral(at 7:30 toward)of the tibia bone bed respectively.Then the sutures were pulled out through the two bone tunnels and tied to the door-nail.Reduction and healing of the avulsion fragment,relaxation and mobility degree of knee,and the influence of osteoepiphysis to teenage patients were observed after surgery.KT-2000 value and Lysholm score were calculated.Results All cases were followed up from 10 to 24 months,with an average of 13.5 months.All the fragments were united without displacement in all cases according to X-ray films.One case showed posterior drawer test(+),but the tibia insertion was healed.The knee extension in all cases was unlimited,and 10° to 15° flexion limitation was found in 2 cases.The average range of flexion was 140.5°±3.8°.On average,KT-2000 value was(1.2±0.4)mm,Lysholm score was 95.2±2.7.Conclusion For treating the avulsion fracture of PCL,suture the end of ligament via arthroscopic transfixion can get a reliable fixation and a satisfied function of the knee,especially,which is suitable for the small avulsion fracture fragments,the adolescent patients with premature epiphysis.

In recent years, there has been a growing emphasis on use of human adipose-derived stem cells (hADSCs) for cartilage tissue engineering owing to their ability to differentiate into chondrocytes, which is mainly induced by growth factors (GFs). In general, GFs for chondrogenic induction come from the transforming growth factor beta (TGF-beta) superfamily. To date, the most commonly used GFs for chondrogenes is TGF-beta1/3. However, the response of hADSCs to GFs may differ significantly from that of human bone marrow stem cells (hBMSCs). It has been reported that bone morphogenetic protein-6 (BMP-6) treatment induced TGF-beta receptor-I expression of hADSCs. It seems that these two cell populations varied strongly in their potency to undergo chondrogenesis in the same medium conditions. Here, we provide a concise review on various GFs used in chondrogenic differentiation of hADSCs in vitro.
Adipocytes ; cytology ; Cartilage ; Cell Differentiation ; Chondrocytes ; cytology ; Chondrogenesis ; Humans ; Stem Cells ; cytology ; TGF-beta Superfamily Proteins ; Tissue Engineering

OBJECTIVE:TO summarize the newest clinical application of permanent cardiac pacemaker, and introduce the relationship between the therapy efficacy and mechanism.DATA SOURCES: Related papers were searched in Pubmed from January 2000 to December 2006 with the terms of "pacemaker,application",and the language of paper was limited to English,at the same time,related papers were searched in WangFang Database with the same terms and the language of paper was limited to Chinese.STUDY SELECTION:The papers relevant to the newest large-scale clinical trial about the cardiac pacemaker were primarily collected.Exclusion criteria:repetitive studies.DATA EXTRACTION:A total of 203 pieces of papers related to the newest clinical application of cardiac pacemaker were collected,among which,30 pieces accorded with the inclusion criteria.DATA SYNTHESIS:The pacemaker can simulate the normal myocardium cell's function pacing and conducting the rhythm. Consequently it can substitute the abnormal myocardium cell to ensure the sequence and completeness of the cardiac pacing and conducting system,the natural electrophysiological activity,and the efficiency of the cardiac ejection and blood supply.The clinical application is not only for single bradycardia, but also for cardiac electric failure, cardiac electric turbulence,and some heart diseases without cardiac electric abnormity.With pacemaker miniaturization,digital signal processing, improved diagnostics and endocardial electrograms, modern pacemakers are able to offer a sophisticated therapeutic and diagnostic platform for the patients with refractory symptoms.CONCLUSION:The pacemaker can simulate the normal myocardium cell's function pacing and conducting the rhythm.It therapy for congenital heart disease.

Objective To evaluate the value of plasma N-terminal pro-B-type natriuretic peptide (NT-proBNP),C-reactive protein(CRP) and D-dimer(D-D) in prognosis of elderly patients confined to bed.Methods The clinical data of 150 elderly patients confined to bed were reviewed retrospectively,and 35 patients were in dead group and 115 patients were in survival group.The level o f plasma NT-proBNP,CRP and D-D were measured before treatment,during treatment and after treatment.Their characteristics and dynamic change were analyzed,and the value of NT-proBNP,CRP and D-D was evaluated in prognosis of elderly patients confined to bed.Results The level of NT-proBNP,D-D and CRP in dead group before treatment,during treatment and after treatment were significantly higher than those in survival group (P ＜ 0.05 or ＜ 0.01).The peak level of NT-proBNP,D-D and CRP in dead group emerged after treatment.By the way,the peak level of NT-proBNP,D-D and CRP in survival group emerged before treatment.Incidence of two or three markers positive in dead group [37.1％ (13/35),54.3％ (19/35)] was significantly greater than that in survival group [20.9％ (24/115),8.7％ (10/115)] (P =0.032,0.008).Multivariate Logistic regression analysis showed that the level of NT-proBNP,D-D and CRP were independent predictors of 28-day mortality (P ＜0.05).Conclusions The level of NT-proBNP,CRP and D-D are increased in severe elderly hospitalized patients.The level of above indexes have a dynamic change and reach peak before death.They are the independent prognostic markers of hospital mortality.Combined detection of NT-proBNP,D-D and CRP can improve the predictive value of hospital mortality in elderly patients confined to bed.

Objective To study the image findings and clinical characteristics ofmultislice helical CT (MSCT) in intrahepatic mass-forming cholangiocarcinomas.Methods Fifteen patients of pathologically confirmed intrahepatic mass-forming cholangiocarcinomas were studied retrospectively.The image findings of MSCT and clinical manifestations,laboratory tests of each case were recorded respectively.Results All patients image findings of MSCT:density was uneven,moderately low congestion densities was 14 patients.High and low congestion densities was 1 patient,pathologically confirmed bleeding.Obscure boundary and atrophy of liver lobe was 10 patients,adjacent liver capsule retraction was 11 patients,combined with ductal dilatation was 11 patients,intrabepatic calculi was 5 patients,ductal wall thickening with or without narrowed bile duct was 9 patients,satellite nodules was 10 patients.Enhancement scanning showed:peripheral enhancement was 11 patients,arterial phase border enhancement was 11 patients,all had delayed enhancement,honeycomb-like enhancement was 3 patients,obliteration or invasion of portal vein was 11 patients.Conclusion There are some clinical characteristics of MSCT findings in intrahepatic mass-forming cholangiocarcinomas.