Diplopia ; etiology ; Enophthalmos ; etiology ; Exophthalmos ; etiology ; Facial Nerve Injuries ; etiology ; Hemorrhage ; etiology ; Humans ; Intraoperative Complications ; etiology ; prevention & control ; Orbit ; blood supply ; surgery ; Orbital Fractures ; surgery ; Postoperative Complications ; etiology ; prevention & control ; Reconstructive Surgical Procedures ; adverse effects ; Reflex, Trigeminocardiac ; Vision, Low ; etiology

Ophthalmic plastic and reconstructive surgery is an interdisciplinary speciality,it includes cosmetic surgery,oculo- plastic surgery and orbital surgery.The current mainly problems and strategies will be discussed in this paper,the status and progresses of cosmetic surgery,including cosmetic eyelid surgery,anesthetic injection methods,and laser facial rejuvenation.Present existing prob- lems and their countermeasures in ocnloplastic surgery,including eyelid malignant tumor,eyelid defects,blepharospasm and anoph- thalmic socket disorders.Problems and management of orbital surgery,ineluding thyroid-associated orbitopathy,orbital fractures,and orbital deformities.At last,the mainly problems and corresponding measures of development of ophthalmic plastic and reconstructive surgery will be discussed.(Ophthalmol CHN,2007,16:365-367)

Objective To investigate the indications and surgical approaches of full-thickness eyelid reconstruction with superficial temporal artery island flap and oral mucosa free grafting,and evaluate the safety and efficacy.Methods A total of 13 eyes of 13 patients with wide full-thickness eyelid defect were treated by the eyelid reconstruction with superficial temporal artery island flap and oral mucosa free grafting.The defect area was(33.67?8.35) mm?(16.44?4.45) mm and the size of island flap was(38.56?8.99)mm?(18.44?4.00)mm.Eight cases were treated with oral lip mucosa grafting,while the other 5 with hard plate muco-periosteal free grafting.Follow up was conducted for 6 to 24 months. Results The flaps were clinically viable in 10 cases and partially viable in 2.One was inviable for venous circumfluence failure,and a successful free skin grafting was conducted 3 months postoperation.All the grafted oral mucosa survived.Five cases underwent the second surgery to thin the island flap,among whom 3 were performed eyelid suspension with the frontal muscle.The survived flaps were similar to skin in colour,soft in nature,and could effectively protect the eyeballs. Conclusion The superficial temporal artery island flap along with oral mucosa free grafting works well in wide full-thickness eyelid reconstruction.

Objective To summarize the complications of the single-port transumbilical laparoscopic pyeloureteroplasty.Methods From August 2009 to December 2014, 162 surgical procedures were performed in our institute with the single-port transumbilical laparoscopic pyeloureteroplasty.Medical records of each procedure were retrospectively evaluated.139 patients were male and 23 female, aged from 1 month to 14 years and the median age of 2 years.127 patients were operated on the left side and 32 on the right side.3 patients were operated on the bilateral side.All children were supplemented with preoperative ultrasound, renal dynamic imaging and MRU to identify the ureteropelvic junction obstruction.Intraoperative and postoperative complications were graded according to the Satava and Clavien classifications respectively.Major complications were defined as Satava grade Ⅱ or higher, and Clavien grade Ⅲ or higher.Results There was no injury of vascular or visceral organs and no blood transfusion, and there was no serious intraoperative complications.One hundred and forty-three cases were followed up, and 23 cases (16.1％)presented with postoperative fever (＞ 38 ℃C) (Clavien Ⅰ), 2 cases (1.4％) with urinary extravasation diagnosed by perirenal fluid collection(Clavien Ⅰ).All these cases recovered after being given symptomatic treatment.7 cases (4.9％) presented with postoperative repeated urinary infection (Clavien Ⅱ).5 cases received postoperative reoperation due to the obstruction of the anastomic site (Clavien Ⅲ b), and 2 cases were under debridement as the greater omentum was drawn out along with the negative pressure drainage tube(Clavien Ⅲ a).In summary, the incidence of severe postoperative complications was 4.9％.Conclusions Though there existed some postoperative complications of the single-port transumbilical laparoscopic pyeloureteroplasty, the incidence of serious complications was low and the overall prognosis could be good.

Objective To investigate the effect of peroxisome proliferator-activated receptor γ (PPARγ) agonist pioglitazone on white matter lesions and spatial memory function in chronic hypertensive rats.Methods Thirty-six male Sprague-Dawley rats were randomly divided into a sham operation group (n =6),a hypertensive group,(n =15),and a pinglitazone group (n =15).A model of stroke-prone renovascular hypertensive rat (RHRSP) was induced by the two-kidney two clip method in the hypertensive group and pioglitazone group.At 8 weeks after procedure,the rats were administered intragastrically.10 mg/(kg · d) pioglitazone was given in the pioglitazone group and an equal volume of saline was given in the hypertensive group.Blood pressure was monitored via caudal artery every 2 weeks before procedure,before administration,and after administration,respectively.After 12 weeks of continuous administration,Loyez staining was used to observe the degree of leukoaraiosis,and Morris water maze test was used to detect spatial memory function.Results After modeling,the blood pressure of RHRSP increased gradually.It was significantly higher than the sham operation group (all P =0.001).There was no significant difference in blood pressure between the hypertensive group and the pioglitazone group (P =0.897).The Morris water maze test showed that escape latencies of the sham operation group and the pioglitazone group were significantly shorter than the hypertensive group (all P ＜0.05).The numbers of crossing hidden platform in the 3 groups of rats were 5.200 ± 1.798,4.560 ± 1.592,and 2.333 ± 1.978 times,respectively.There were significantly differences (F =8.143,P =0.001).Both the sham operation group and the pioglitazone group were significantly more than the hypertensive group (all P ＜0.05).Loyez staining showed that the grades of white matter lesions in corpus callosum of the sham operation group,the hypertensive group,and the pioglitazone group were 0.333 ± 0.516,2.600 ± 0.507,and 0.500 ± 0.522,respectively.There were significantly differences among the 3 groups (F =25.652,P =0.000).The grade of the sham operation group and the pioglitazone group was significantly lower than the hypertensive group (all P＜ 0.05).Conclusions PPARγ agonist pioglitazone may protect the spatial memory function by relieving white matter lesions of the chronic hypertensive rats.

Aged ; Cytoplasm ; Cytoplasmic Granules ; Female ; Humans ; Multiple Myeloma ; pathology ; Plasma Cells ; pathology

OBJECTIVETo investigate diagnostic efficacy of transvaginal three-dimensional hysterosalpingo-contrast sonography (3D-HyCoSy) in assessing tubal patency with chromolaporoscopy.

METHODSA total of 157 infertile women underwent 3D-HyCoSy to evaluate tubal patency. Among these patients, 39 patients were also examined by chromolaporoscopy. The concordance of the two clinical assessment methods was analyzed by the Kappa coefficient test.

RESULTSAmong the 306 oviducts examined by 3D-HyCoSy, 99 (32.4%) were patent, 126 (41.2%) partially obstructed, and 81 (26.5%) completely obstructed. Diagnostic results with 3D-HyCoSy were not statistically different from those obtained in the 39 women (78 oviducts) who also underwent chromolaporoscopy, and the two methods showed a high concordance (k=0.747, P=0.000). The 3D-HyCoSy procedure had a sensitivity of 84.8% (28/33), a specificity of 96.2% (25/26), and positive and negative predictive values of 93.3% (28/30) and 86.2% (25/29) respectively.

CONCLUSIONTransvaginal 3D-HyCoSy can accurately reveal the spatial path and morphology of the oviduct and is a safe and effective method to evaluate tubal patency.

Contrast Media ; Fallopian Tube Patency Tests ; methods ; Fallopian Tubes ; diagnostic imaging ; Female ; Humans ; Hysterosalpingography ; Imaging, Three-Dimensional ; Infertility, Female ; diagnostic imaging ; Laparoscopy ; Ultrasonography

Objective To investigate the influence factors of serum CA125 level in patients with ovarian chocolate cysts,and to study the effect on serum CA125 level of interventional therapy.Methods A total of 103 patients with single unilateral chocolate cyst of ovary underwent interventional treatment.According the serum CA125 level before interventional therapy,the patients were divided into normal group (CA125≤35 U/ml) and abnormal group (35 U/ml＜CA125≤200 U/ml).The clinical indexes of patients and ultrasound characteristics of cyst were compared between the two groups.The changes of serum CA125 levels before and after interventional therapy were analyzed.Results The difference of the course of diseases,dysmenorrhea history,diameter of cysts had statistical difference between the two groups (all P＜0.05).There were no statistical differences of age,history of dilivery,abortion history,history of pelvic surgery,cyst location between the two groups (all P＞0.05).In abnormal group,the mean serum level of CA125 reduced at 3 months (P＜0.000 1) and 6 months (P ＜0.000 1) after interventional therapy.In the normal group,there was no significant difference of the mean serum level of CA125 before and after interventional therapy (all P＞0.05).Conclusion Serum CA125 level is influenced by dysmenorrhea history,course of disease,diameter of cysts.Ultrasound-guided interventional therapy has intervention effect on patients with abnormal serum CA125 level before interventional therapy.

OBJECTIVE To investigate the drug resistance and the prevalence of inducible clindamycin resistance in clinical isolates of Staphylococcus aureus and evaluate the clinical value of cefoxitin disk diffusion method and oxacillin disk diffusion for detection of meticillin-resistant S.aureus(MRSA).METHODS Bacteria identification and susceptibility test were performed by VITEK-2 system and K-B disk method.The PBP2a was detected by latex agglutination and MRSA was identified by cefoxitin disk diffusion method and oxacillin disk diffusion.The inducible resistance of erythromycin to clindamycin was checked by D-test according to the standards of CLSI(NCCLS).The statistical analysis was performed by WHONET 5.4 and SPSS 13.0 software.RESULTS Resistant rate to penicillin and ampicillin was 98.9% and 100.0%,respectively.Vancomycin-resistant(VRE) or intermediate strains were not found.Of the 93 S.aureus isolates,MRSA and meticillin-sensitive S.aureus(MSSA) were 58(62.4%) and 35(37.6%),respectively.The resistant rate of MRSA to 11 antibiotics was higher than MSSA.The sensitivity and specificity of cefoxitin disk diffusion method were 98.3% and 97.1%,respectively,those of oxacillin disk diffusion were 75.9% and 94.3%.Of the 9 isolates resitant to erythromycin but susceptible to clindamycin,5(55.6%) showed inducible resistance to clindamycin.CONCLUSIONS Resistance of S.aureus is quite serious.Cefoxitin disc diffusion method is a simple and reliable method for the detection of MRSA.The inducible resistance of erythromycin to clindamycin in S aureus should be checked by D-test in clinical microbiology laboratory routinely.