Ultra-wide-field fluorescein angiography (UWFA) can obtain very wide retinal images (up to 200°), and is a very helpful tool to detect peripheral retinal lesions which cannot be found by other imaging methods. Analyzing the characteristics of the UWFA images may improve our understanding, treatment outcomes and management strategies of ocular fundus diseases. However this technology is still in its premature stage, there is still a lot of work to be done to improve its clinical application and study the characteristics and clinical meanings of these peripheral retinal lesions.

Objective: To summarize our experience on laparoscopic radical prostatectomy via single incision in treatment of early localized prostate cancer. Methods: From June 2009 to August 2009, five patients with localized prostate cancer(T1c) received laparoscopic radical prostatectomy via single incision. A home-made multichannel port was inserted extraperitoneally through a 3 cm incision under the umbilicus. A 10 mm TROCAR and two 5 mm TROCAR were inserted. The prostate was isolated and excised, then the bladder urethral anastomosis was performed. Results The procedures were successful in all the five cases with no transversion to open or standard laparoscopic approach. The mean operating time, the mean operative time for prostate excision, and the mean time for urethrovesical anastomosis were (167±31. 5) min(ranging 135-210 min), (115±26) min (ranging 90-150 min), and (52±5. 7) min(ranging 45-60 min), respectively. The estimated blood loss averaged (90±62) ml (ranging 50-200 ml). Positive margin occurred in one case. Transient incontinence occurred in two cases after the catheter was removed one week later. All patients had a prostate-special antigen level < 0. 2 μg/L during a follow-up of 4-12 weeks. Conclusion: Laparoscopic radical prostatectomy via single incision is feasible and safety. Excellent instruments and skilled surgeon are the keys for the success of the operation.

Objective To evaluate the detection efficiency of residual reagent used in electrochemiluminescence immunoassay an-alyzer .Methods Alpha fetoprotein (AFP) ,carcino-embryonic antigen(CEA) and total prostate specific antigen(TPSA) were de-tected by using remaining reagents .The precision and recovery rate of remaining reagents were analyzed .Referring to the document of NCCLS EP9-A2 ,8 clinic samples were detected everyday by residual reagent and new reagent respectively .The test results of to-tal 40 samples were recorded within 5 days .The test results derived from 2 kinds of reagents were analyzed comparatively and their bias was evaluated by using new reagent as a control method and residual reagent as experimental methods .Results The within-run and between-run coefficients of variation(CV) of the 3 items measured by residual reagents in low and high levels of quality control products met the related standard .The recovery rate was variable from 90% to 110% .The test rewults of the 2 kinds of reagents were positively correlated(r2 >0 .95) .Their anticipated biases were within allowed biases on the medical decision level of CEA ,AFP and T PSA .Conclusion Residual reagent of electrochemiluminescence immunoassay analyzer can meet the clinical practice needs , which also can ensure the quality of measurement and the reduction of the cost .

ObjectiveTo investigate the effects of chitosan/PVA nerve conduits which used for repairing sciatics nerve defect in rats.MethodsTwenty-seven rats were divided into 3 groups randomly,with 9 rats in each group. Firstly, the 15mm defects in the left sciatic nerves were made in the rats and were respectively repaired with chitosan/PVA conduits graft (group A), the silicon conduits graft (group B),and autografts (group C). At 12 weeks after the operations, the left sciatic nerves were taken out, and the comparative evaluation was made on the repairing effects by wet weight of gastrocnemius and soleus muscles, histological examination,computerized imaging analysis and True Blue retrograde tracing. ResultsThe wet weight of gastrocnemius and soleus muscles showed no significant difference between the chitosan/PVA graft and autograft groups (P ＞ 0.05). The wet weight of gastrocnemius and soleus muscles in significant difference between the chitosan/PVA graft and the silicon group at 12 weeks after the operation(P ＜ 0.05). The nerve fiber density showed no statistically significant differences between the chitosan/PVA and autograft groups(P＞ 0.05).The regenerative nerve fiber in group B had normal morphological and structural characters under transmission electron microscope.True Blue-labeled neuron cell bodies were found within both anterior horn of gray matter in the spinal cord and dorsal root ganglions (DRGs) ipsilateral to the operated side of the tested rats on illumination with ultra-violet light 1 week after the injection of True Blue.Conclusion Chitosan/PVA nerve conduit can effectively promote the nerve regeneration and myelinization of rat sciatic nerve, which is expected to substitute for autograft to repair nerve defects succesfully.

Background Aheration of eyeball wall caused by ocular axial extension is associated with multiple complications of high myopia.However,the study on quantitative analysis of choroidal thickness and axial length in adult high myopic patients is less.Objective This study was to investigate the choroidal thickness in high myopic eyes of adult patients and estimate the correlation of choroidal thickness with axial length,age,and spherical equivalent(SE).Methods A prospective cohort study was designed.Seventy-five eyes of 75 adult patients with high myopia were entrolled from December 2012 to May 2013,and 70 eyes of 70 age-and gendermatched healthy volunteers were included in Renmin Hospital of Wuhan University.Enhanced depth imaging (EDI)on Cirrus spectral-domain optical coherence tomography (SD-OCT) was used to measure the choroidal thickness from the outer border of the retinal pigment epithelium through the inner scleral boarder among the 11 meridians in a 500 μm intervals and range of 2 500 μm for each from fovea toward temporal and nasal lateral.The differences of choroidal thickness and axial length were compared between the high myopia group and normal control group,and the correlation of choroidal thickness with axial length,age,SE were analyzed.Results The subfoveal and mean choroidal thickness values were (146±52) μm and (142±63) μm in the high myopia group,and those in the normal control group were (306±60) μm and (271 ±71) μm,with significant differences between the two groups (t =-17.130,P=0.000; t=-15.890,P=0.000).Choroid was thickest in the temporal and then was subfovea and nasal in the high myopia group,but in the normal control group,it was subfovea,temporal and nasal in turn,and the choroidal thicknesses in various areas were thinner in the high myopia group than those in the normal control group.A negative correlation was found between the choroidal thickness and axial length in high myopia group(r =-0.580,P =0.000),and the regression equation determined a decrease of 17.943 μm per millimeter of axial length.Conclusions SD-OCT determines that choroidal thickness is decreased in highly myopic eyes compared with normal eyes.Choroidal thickness varies with the change of axial length in adult high myopia patient.These findings indicate that abnormalities of the choroids may play a role in the pathogenesis of complication of high myopia.

This article introduced professor WANG Shu-chen's experience in picture treating bronchiolitis obliterans syndrome (BOS) after hematopoietic stem cell transplantation with tougue picture as the key link. Patients with BOS showed deficiency of essence of tongue crack, which should be treated by warming kidney yang, replenishing essence and marrow; fester tongue for qi disorder, inflammation caused by fire, which should be treated by regulating qi, and clearing heat; exfoliative fur accumulation, which should be treated with blood stasis and toxin, removing blood stasis and toxin; thick and greasy fur, which should be treated by warming spleen and activating spleen.

Objective To explore the clinical features of benign paroxysmal positional vertigo (BPPV) in patients of 40 years old or younger. Methods The clinical features of 40 patients (age ≤40 years) with BPPV admitted from August 2009 to July 2011 were retrospectively analyzed, and compared with that of 286 middle and old-aged patients (age >40 years) with BPPV admitted in the same period. Results The incidence of BPPV in young patients showed a relatively higher incidence (12.3%), with the sex ratio of male to female 1:3 and a mean age of 32.1±6.2 years. The mean latent period of vertigo attack was 1.2±1.3 seconds, and 10 patients (25%) showed no obvious latent period. The median duration of vertigo was 10s. The posterior semicircular canal was involved in 27 patients (67.5%). Cupulolithiasis was found in 6 patients, and all the otolithiasis was found to involve the posterior semicircular canal. The proportion of BPPV with no obvious latency was higher in the young patients than in the middle and old-aged patients (25.0% vs 11.5%, χ2=5.554, P=0.018), but no significant difference in sex ratio, the course of disease, the ratio of involved semicircular canal, the latency and the duration of vertigo attack was found between two groups (P>0.05). Conclusions The incidence of BPPV is relatively higher in youth, more common in females, and the posterior semicircular canal is commonly involved. Compared with the middle and old-aged patients with BPPV, the proportion patients with no obvious latency of vertigo attack in young patients is higher, and the incidence of cupulolithiasis involving posterior semicircular canal is higher in the youth.

Medical assistance is an important part of China's foreign aid. At present, the literature about teaching and training of foreign medical assistance is not frequent to find. Cambodia is a friendly diplomatic country of China, and the Changzheng Hospital has undertaken medical assistance about 13 years. This paper summarized the medical training and teaching experience of Changzheng Hospital to Preah Ket Mealea Hospital of Cambodia, including Department of Anesthesiology, Neurosurgery, Cardiovascular Center, Radiology and so on in recent years, and found that teaching methods combining various teaching approaches, cooperating with multiple departments, teaching students in accordance with their aptitude, and having flexible time and space are more suitable for Cambodia. The experience of assisting Cambodia can be further used in other countries, and establish an improved teaching system which is suitable for their national conditions and educational systems according to different medical status of different countries.

Objective To discuss the diagnostic value of cytokeratin 19 fragment(CYFRA21-1) in non small-cell lung cancer (NSCLC) .Methods The serum CYFRA21-1 levels were tested in 1 046 healthy adults(healthy group) ,244 benign pulmonary dis-ease patients(benign disease group) and 90 NSCLC patients(NSCLC group) .The results were analyzed statistically .Results There was not significantly difference between man and women in healthy group for CYFRA21-1 level(P>0 .05) .The CYFRA21-1 level in more than 60 years cases was obviously higher than that in less than 18-40 years group and >40-60 group .The upper limit of serum CYFRA21-1 was 4 .00 ng/mL according 95% confidence interval of benign disease group .A cut-off value of 4 .70 ng/mL in NSCLC group was suggested when compared with receiver operating characteristic curve(ROC curve) ,and its sensitivity and speci-ficity were 62 .1% and 92 .6% respectively .Conclusion The diagnostic value for serum CYFRA21-1 in NSCLC was 4 .70 ng/mL .

Objective To evaluate the changes of the waveform of the photopic negative response in flash-electroretinogram, visual acuity and central retinal thickness in the treatment of intravitreal injections of bevacizumub. Design Retrospective self-comparative case series. Partidpants 8 subjects (9 eyes) with exudative age-related macular degeneration and 3 subjects (3eyes) with proliferative diabetic retinopathy. Method Evaluation protocol included examinations of the Early Treatment Diabetic Retinopathy study visual acu-ity, visual field, intraocular pressure, fundus fluorescein angiography, optical coherence tomography and flash-electroretinogram. Intravit-real injections of bevacizumab, 1.25 mg (0.05ml), were given under an operating microscope and aseptic conditions. All the subjects were followed-up one month later. Main outcome Measure The amplitudes of PhNR, visual acuity and central retinal thickness. Re-sult At 1 months, the mean amplitudes of PhNR and mean visual acuity in all cases had no obvious change (n=12, P>0.05).The central retinal thickness reduced obviously (n=12, P<0.05), but it was neither significantly correlated with PhNR (r=0.294, P=0.145) nor with visual acuity(r=-0.358, P=0.073). Conclusion The single intravitreal injection of bevacizumab is showed promising in absorption of in-traretinal edema and subretinal fluid in patients with exudative age-related macular degeneration and proliferative diabetic retinopathy, but the changes of visual function (including PhNR) might need further investigation. (Ophthalmol CHN, 2009, 18: 243-246)