Background The measurement of the extraocular muscle is critical for the diagnosis of extraocular muscle diseases,but conventional medical imaging techniques present some shortcomings because of the contact pattern.The anterior segment optical coherence tomography (OCT) is thought to be an in vivo noninvasive optical diagnostic imaging method.Objective This clinical study attempted to seek an available approach to the evaluation of the anatomic structure of human horizontal rectus insertion with Visante OCT.Methods One hundred and fourteen eyes of 58 subjects were included in this study and were divided into the low refractive power group (≤-3.00 D) with 43 eyes,moderate refractive power group(＞-3.00 D-≤-6.00 D) with 49 eyes and high refractive power group(＞-6.00 D) with 22 eyes.The horizontal rectus insertion distance to the scleral spur and its thickness were measured by Visante OCT.The correlation of the refractive power with the rectus insertion distance or thickness was analyzed.Written informed consent was obtained from each subject before medial assessment.Results The average distance from the scleral spur to the lateral and medial rectus insertion were (5.23±0.50)mm and (3.81±0.46)mm respectively.The average thickness of the lateral and medial rectus insertions were (0.39±0.06)mm and (0.39±0.06)mm respectively,showing no significant differences in comparison with those of ultrasound biomicroscopy (P=0.338,P=0.759).The lateral and medial rectus insertion distances were (5.25±0.45)mm and (3.74±0.53)mm in the low refractive power the group,(5.22±0.60)mm and (3.81±0.42)mm in the moderate group and (5.20±0.35)mm and (3.90±0.42)mm in the high refractive power group,presenting inconsiderable difference among these three groups(lateral rectus: χ2=0.054,P=0.974;medial rectus: F=0.508,P=0.604).The thickness of the lateral and medial rectus insertions were (0.41±0.06)mm and (0.40±0.06)mm in the low refractive power group,(0.40±0.07)mm and (0.37±0.07)mm in the moderate refractive power group,(0.36±0.05)mm and (0.39±0.05)mm in the high refractive power group with a significant difference among lateral rectus (F=4.922,P=0.009) but not medial rectus (F=2.152,P=0.125).The lateral rectus insertions thickness in the high refractive power group was thinner than that in low refractive power group (P＜0.05).A positive correlation was found between refractive power and the thickness of lateral or medial rectus insertions (r=0.284,P＜0.01).Conclusion Visante OCT is a uscful way in measuring the distance and thickness of the extraocular muscles.Lateral rectus insertions thickness tends to be thinner with the worsening of myopia,which is obvious in high myopia.

Carcinoma, Papillary ; pathology ; Humans ; Lymphatic Metastasis ; Male ; Middle Aged ; Pharynx ; pathology ; Thyroid Neoplasms ; pathology

BACKGROUND:Large randomized trials have demonstrated carotid endarterectomy or stenting for symptomatic and asymptomatic extracranial carotid stenosis is effective.
OBJECTIVE:Using the meta analysis method, to evaluate efficacy and safety of carotid stenting and carotid endarterectomy for the treatment of carotid stenosis.
METHODS:Computer-based retrieval of databases both at home and abroad was performed for randomized control ed trials related to carotid stenting and carotid endarterectomy for the treatment of carotid stenosis. According to exclusion criteria, literature screening was done fol owed by quality evaluation. Then, the enrol ed literatures were analyzed by Cochrane col aboration with RevMan5.0 Meta analysis software.
RESULTS AND CONCLUSION:There were 14 enrol ed studies, including 7 693 patients among whom, 3 835 cases were in stenting group and 3 858 in carotid endarterectomy group. Compared with the carotid endarterectomy group, the stroke event rate within 30 days postoperatively, death and stroke event rate within 30 days postoperatively, myocardial infarction event rate within 1 year postoperatively and non-disabling stroke event rate within 30 days postoperatively were higher in the stenting group (P ≤0.000 1);the myocardial infarction event rate within 30 days postoperatively was lower in the stenting group (P=0.001 0). There were no significant differences in the death event rate and disabled stroke event rate within 30 days postoperatively between the two groups. These two treatments are complementary rather than antagonistic. We should optimize the treatment choice based on the comprehensive analysis of each patient's condition.

OBJECTIVETo investigate the color stability and opacity of seven resin-based composite products after ultraviolet irradiation.

METHODSSeven kinds of light-cured resin-based composite products (Aelite Flo, Filtek Z350 Flowable, Clearfil AP-X, Dyract AP, Z100, Durafill VS, Filtek Z350 Universal) were tested in the study (five for each group). Changes in color and opacity of test samples were determined before and after 8, 16 and 24 h ultraviolet irradiation using the CIE 1976 L*a*b* system and CIE 1931 XYZ system by a colorimeter.

RESULTSThe color of resin disks suffering ultraviolet irradiation was different in different irradiating time. Color difference values ranged from 1.85-3.21 for 8 h ultraviolet irradiation to 2.88-4.55 for 24 h ultraviolet irradiation. Opacity values ranged from 0.75-0.82 before ultraviolet irradiation to 0.80-0.98 after 24 h ultraviolet irradiation. Among all the groups, Z100 and Filtek Z350 Flowable showed the biggest color change, while Filtek Z350 Universal showed the highest opacity.

CONCLUSIONIt can be concluded that for some products, ultraviolet irradiation leads to color instability and opacity variation.

Color ; Colorimetry ; Composite Resins ; Humans ; Light ; Materials Testing ; Methacrylates

Adenoids ; diagnostic imaging ; pathology ; Child ; Child, Preschool ; Female ; Humans ; Hypertrophy ; Magnetic Resonance Imaging ; Male ; Radiographic Image Enhancement ; methods ; Tomography, Spiral Computed ; methods

Objective To study the indication and clinical application of lateral neck incision for the removal of cervical esophageal foreign bodies. Methods From January 1999 to January 2009, 2189 cases esophageal foreign bodies were treated. The clinical data of 137 cases (6. 25% ) with lateral neck incision were retrospectively analyzed. In these 137 cases, 114 cases were over 16-years-old (adult group) , while 23 cases were under 16-years-old( children group). In adult group, 67 cases(58. 8% ) had esophageal perforation (esophageal perforation with neck abscess 29 cases, esophageal perforation without neck abscess 38 cases); 47 cases did not have esophageal perforation ( impacted foreign body without neck abscess 40 cases, foreign body with esophageal abscess 7 cases). In children group, 19 cases (82.6%) had esophageal perforation including 15 cases with neck abscess; 4 cases without esophageal perforation, 3 cases had esophageal abscess and one case without abscess but of huge foreign body. Results All 137 patients with foreign body were cured through lateral neck incision. Nineteen cases(13. 9% ) had hoarseness and recovered in 3 months. Five adult patients had post-operative cicatrical stricture of the esophagus, but it was mild and completely recovered by the treatment of dilatation in 3 to 11 months. Nine adult patients with esophageal perforation were cured by secondary suture, the remaining esophageal perforation cases were healed by first intention. One case with common carotid artery impairement by the foreign body was successfully treated by carotid artery ligation without hemiplegia, aphasia and other sequelae. Two cases had cardiopulmonary arrest, 2 cases had febrile convulsions and 1 case had acute respiratory failure, 5 cases had septic shock, all these patients were effectively controlled and cured. Seven of the 9 cases with tracheotomy had the tracheal tube removed during hospitalization; 1 of the two obese patients had the extubation 3 months after the discharge and the other one still had the tube. All esophageal perforation cases in children group had primary healing by perforation apposition suture. Four of the 5 children had successful tracheotomy decannulation, one child had extubation by 2 months through continuously reduced tracheal tube model. Conclusion Penetrating esophageal foreign body and neck abscess were indication of the lateral neck incision, and positive prevention and cure the complications of lateral neck incision could achieve good curative effect .

OBJECTIVEIn order to investigate whether the presence of distant metastases is associated with serum lipid abnormalities.

METHODSThe fasting serum lipid profile and various clinicopathological data of 324 breast cancer patients with and without synchronous distant metastases were collected and analyzed. The serum lipid profile, including total cholesterol (TC), triglycerides (TG), low-density (LDL-C) and high-density lipoprotein cholesterol (HDL-C) was determined. The nutritional status, the serum albumin was measured and body mass index (BMI) was calculated. Univariate analysis and multiple logistic regression analysis were carried out to investigate the association of serum lipid profile with distant metastases.

RESULTSUnivariate analysis showed that the distant metastasis rate was significantly higher in the breast cancer patients with an higher level of serum TC, TG, LDL-C, and LDL-C/HDL-C ratio (P < 0.05). Multiple logistic regression analysis showed that higher serum levels of TC, LDL-C and LDL-C/HDL-C ratio were independent risk factors for distant metastasis in breast cancer (OR = 2.324, 2.648 and 4.862, respectively).

CONCLUSIONSHyperlipidemia is significantly associated with the distant metastasis in breast cancer patients. Monitoring of serum lipid profile may be helpful to predict the occurrence of distant metastasis in breast cancer patients.

Adult ; Aged ; Aged, 80 and over ; Body Mass Index ; Breast Neoplasms ; blood ; pathology ; Cholesterol ; blood ; Cholesterol, HDL ; blood ; Cholesterol, LDL ; blood ; Female ; Humans ; Lipids ; blood ; Middle Aged ; Multivariate Analysis ; Neoplasm Metastasis ; Neoplasm Staging ; Nutritional Status ; Risk Factors ; Serum Albumin ; Triglycerides ; blood

Objective: To assess the relationship between the characteristic of drug resistance in Pseudomonas aeruginosa and the syndrome of traditional Chinese medicine(TCM)in ICU.Methods: The 73 strains of Pseudomonas aeruginosa were isolated from sputum specimenpatients of in-patients in our ICU from March 2005 to February 2006.The data of the drug sensitivity test in vitro was analysised.The relation between the syndrome of TCM and drug resistance in Pseudomonas aeruginosa was probed.Results: The 73 strains of Pseudomonas aeruginosa were drug resistant to majority kinds of anti-infective except Piperacillin-Tazobactam,Piperacillin,Cefoperazone-Sulbactam,and Amikacin.The mains syndromes of TCM of all patients infected Pseudomonas aeruginosa were deficiency-excess complex(虚实夹杂证) and excess pattern(实证)(97.26%).The mains of deficiency-excess complex(虚实夹杂证) were Qi vacuity and phlegm obstruction(气虚痰阻证)and Yin vacuity internal heat(阴虚热郁证).The mains of excess pattern(实证) were phlegm-heat(痰热郁阻证)and phlegm-stasis(痰瘀互阻证).Conclusions: Combined ?-lactam antibiotics and aminoglycoside antibiotics is the first selection to treat the multidrugresistant Pseudomonas aeruginosa.Indentifing patterns and determining treatment in TCM could be tried in the treatment of patients infected Pseudomonas aeruginosa.

OBJECTIVETo evaluate the clinical efficacy and study the mechanism of combining plasma exchange and continuous veno-venous hemofiltration in treating patients with chronic severe viral hepatitis B in their mid- and late stages.

METHODS94 patients suffering from chronic severe viral hepatitis B were divided into three groups. 29 patients were treated with plasma exchange plus continuous veno-venous hemofiltration (group A). 31 patients were treated with plasma exchange alone (group B). 34 patients received routine treatment (group C). The efficacy of treatment and survival rate of the three groups was investigated. Before and after artificial liver support system treatment the levels of cytokine were examined.

RESULTSIn group A, hyponatremia improved, the levels of interleukin 8 (IL-8) obviously decreased, the level of IL-10 increased, 5 of the 10 patients in coma regained normal consciousness (50.0%) and their survival rate was 48.3%. In group B, hyponatremia did not change, the level of IL-8 and IL-10 did not change. 2 of 11 patients in coma regained normal consciousness (18.2%) while survival rate was 22.6%. In group C, 1 of 11 patients in coma regained normal consciousness (9.1%) while survival rate was 20.6%.

CONCLUSIONSIt shows that plasma exchange with continuous veno-venous hemofiltration in treating patients with mid- and late stage chronic severe viral hepatitis B can increase the survival rate. IL-8 can be significantly removed, IL-10 significantly increased. This combined therapy is easy to practice, and should be used as an artificial liver support system.

Adult ; Female ; Hemofiltration ; Hepatitis B, Chronic ; therapy ; Humans ; Interleukin-10 ; blood ; Interleukin-8 ; blood ; Liver, Artificial ; Male ; Middle Aged ; Plasma Exchange ; Severity of Illness Index ; Treatment Outcome

OBJECTIVETo explore clinical effects of Ilizarov technique at stage I for repairing tibial post-traumatic osteomyelitis with bone and skin defect.

METHODSFrom June 2010 to December 2013,44 patients with tibial post-traumatic osteomyelitis with bone and skin defect were treated with Ilizarov technique at stage I . Among them, there were 35 males and 9 females aged from 18 to 70 years old with an average of 42.5 years old. Bone defect ranged from 4 to 16 cm, skin defect ranged from 3 cm x 4 cm to 5 cm x 16 cm. The operation was performed debridement thoroughly, removed inflammatory bone section, osteotomy invasively, install circular external fixator by Ilizarow technique; screw nut were rotated at 1 week after operation, and prolonged 0.5 to 1.0 mm everyday. Wound surface, new born callus and bone healing were observed to evaluate clinical effects.

RESULTSAll patients were followed up from 11 to 36 months with an average of 18.5 months. Bone defect after osteotomy was from 6 to 22 cm with an average of 11.5 cm; the time of wound healing time ranged from 21 to 79 d with an average of 38 d; bone defect healing time was from 8 to 15 months with an average of 12.5 months. All patients were cured, no recurrent infection, refracture and shorten of calf deformity were occurred.

CONCLUSIONRepairing tibial post-traumatic osteomyelitis with bone and skin defect by llizarov technique at stage I has advantages of less trauma, low inflammatory recurrence rate, could avoid multiple complex operation, and receive definite curative effect.

Adolescent ; Adult ; Aged ; Female ; Humans ; Ilizarov Technique ; Male ; Middle Aged ; Osteomyelitis ; surgery ; Osteotomy ; Tibia ; surgery