AIM: To discuss the clinical applications of methods to localize nasal cut ends and the effects of Z-plasty in the surgeries for lower eyelid longitudinal laceration combined with lower lacrimal canaliculi disruption.
METHODS: From September, 2010 to October, 2013, a total of 37 patients ( 37 eyes ) with lower eyelid longitudinal laceration combined with lower lacrimal canaliculi disruption were operated for anastomosis of lacrimal canaliculi disruption and suture of lower eyelid longitudinal. Different methods to search for the nasal cut ends of lacerated lacrimal canaliculi, such as “under a microscope directly”, “guided by probing needle” and“pigtail curved probe”. Then, to repair lower eyelid longitudinal laceration with Z-plasty transposition flaps. Follow up was 3mo~2a after operation.
RESULTS: All nasal cut ends could be found successfully on 37 patients;Lacrimal duct unobstructed in 31 patients (83. 8%), improved in 5 patients (13. 5%), invalid in 1 patient (2. 7%),the overall successful rate was 97. 3%; the eyelids repair was satisfactory, small scars, the appearance and function was normal.
CONCLUSION: The nasal cut ends can be found successfully by “directly under a microscope”, “guided by probing needle” and“pigtail curved probe”;the effect of silicone drainage tube used as lacrimal canaliculi bracket is satisfactory; most patients gained excellent recovery for both appearance and function after Z-plasty.

OBJECTIVETo analyze the incidence and survival rates of primary liver cancer (PLC) among residents in Yangpu district of Shanghai.

METHODSA total of 9 730 736 permanent residents (male 4 996 390 and female 4 734 346) of Yangpu district in Shanghai were recruited in the study between year 2002 and 2010; among whom 2726 PLC cases were diagnosed and 2427 death cases were certified. The incidence and mortality of PLC were calculated under the analysis of the new PLC cases and death cases between year 2002 and 2010. The rates were standardized by the demographic composition developed in the Fifth Nationwide Census in year 2000, in order to analyze the survival condition of PLC patients and explore the prognosis of surgical excision treatment.

RESULTSAmong the new PLC cases between year 2002 and 2010, 1966 cases were male, whose average age of onset was 59.81; while 760 cases were female, whose average age of onset was 68.93. The crude incidence rate was 39.35/100 000 in male, which was higher than it in female, as 16.05/100 000. The difference showed statistical significance (U = 7.32, P < 0.01). The standardized incidence rates were 21.98/100 000 and 6.96/100 000 in male and female, respectively. The difference showed statistical significance (U = 221.76, P < 0.01). There were 2427 PLC death cases in total, including 1734 male death cases and 693 female death cases. The crude mortality rate was 34.71/100 000 in male and 14.64/100 000 in female, whose difference were statistically significant (U = 6.68, P < 0.01). The standardized mortality rate was 19.16/100 000 in male and 6.06/100 000 in female, whose difference were statistically significant (U = 207.18, P < 0.01). The incidence and mortality rates both increased apparently since males aging over 35 and females over 45. The 1 - 5 year survival rates of PLC patients were 33.95%, 23.11%, 17.04%, 14.42% and 12.29%, respectively. In the surgical excision treatment group (321 cases), the 1 - 5 year survival rates were separately 66.78%, 52.87%, 41.88%, 33.57% and 32.64%; while in the non-surgical treatment group (2405 cases), the 1 - 5 year survival rates were separately 29.04%, 18.58%, 13.30%, 11.16% and 9.01%. The differences in 1 - 5 year survival rates between surgical and non-surgical groups all showed statistical significance (U = 12.78, 10.52, 8.28, 5.56 and 5.12, respectively, P < 0.01).

CONCLUSIONThe incidence of PLC was close to its mortality in Yangpu district of Shanghai. The male incidence and mortality rates were significantly higher than female corresponding rates. The surgical excision treatment could improve the prognosis of PLC.

Aged ; China ; epidemiology ; Female ; Humans ; Incidence ; Liver Neoplasms ; epidemiology ; mortality ; surgery ; Male ; Middle Aged ; Prognosis ; Survival Rate

OBJECTIVETo analyze the incidence and mortality of lung cancer patients among residents in Yangpu District of Shanghai from 2002 to 2010.

METHODSThe data of lung cancer cases in permanent residents of Yangpu district were collected from the database of the registration and management system in Shanghai city. Temporal trend in the incidence of lung cancer was analyzed by using annual percent change (APC) mode1. The survivals were calculated using SPSS 16.0 and Joinpoint Regression Program 3.5.1 software.

RESULTSA total of 5726 cases of lung cancer were diagnosed from January 2002 to December 2010. Of those, 3865 were males with an average age of onset 70.08 years, and 1861 were females with an average age of onset 70.88 years. The crude incidence rate was 77.36/10(5) in men, significantly higher than 39.31/10(5) in women (U = 24.84, P < 0.01). The standardized incidence rate was 25.23/10(5) in men, significantly higher than 13.47/10(5) in women (U = 13.24, P < 0.01). A total of 5248 cases died of the disease in this period. Of those, 3586 were men. The crude mortality was 71.77/10(5) in men, significantly higher than 35.11/10(5) in women (U = 24.67, P < 0.01). The standardized mortality was 21.72/10(5) in men, significantly higher than 11.08/10(5) in women (U = 13.01, P < 0.01). Both the incidence and mortality rates increased apparently in those older than 45 years. The 1- to 5-year survival rates in all cases were 37.42%, 22.71%, 15.73%, 12.32%, and 10.53%, respectively. The 1- to 5-year survival rates in male cases were significantly lower than those in female cases (P < 0.05 for each comparison). The 1- to 5-year survival rates of the patients whose tumor had been surgically removed were significantly higher than those in the patients without surgery (P < 0.05 for each comparison).

CONCLUSIONSThe incidence of lung cancer is close to the mortality in the residents of Yangpu District of Shanghai city. Surgical resection treatment improves the prognosis of lung cancer.

Adolescent ; Adult ; Age Factors ; Aged ; Aged, 80 and over ; China ; epidemiology ; Female ; Follow-Up Studies ; Humans ; Incidence ; Lung Neoplasms ; epidemiology ; mortality ; surgery ; Male ; Middle Aged ; Sex Distribution ; Survival Rate ; Young Adult

Adult ; Aged ; Carcinoma, Hepatocellular ; etiology ; pathology ; prevention & control ; therapy ; Female ; Hepatitis B ; pathology ; therapy ; Humans ; Male ; Middle Aged ; Phyllanthus ; Phytotherapy ; Precancerous Conditions ; etiology ; pathology ; prevention & control ; therapy

OBJECTIVETo establish a novel and useful rabbit model of lumbar disc degeneration using microinjection of fibronectin fragment (Fn-f).

METHODSThirty-two New Zealand white rabbits underwent injection of N-terminal 30 kDa Fn-f (experimental group) or phosphate buffered saline (PBS) (control group) into the central region of L1-2, L2-3, L3-4, L4-5 discs using a 32-gauge microsyringe. Two rabbits (blank group) with no treatments were sacrificed to examine the proteoglycan synthesis of neucleus pulposus (NP) using (35)S-sulfate incorporation assay. At the 4-, 8-, 12-, and 16-week time points, the discs were examined histologically, radiographically, and with proteoglycan synthesis.

RESULTSHistology demonstrated a progressive loss of the cell numbers in NP and architecture destruction in NP and anulus fibrosus (AF) in Fn-f-injected discs over the 16-week study period. The NP regions in Fn-f-injected discs shrinked distinctly after the 4-week time point, and were not discernible with the inner AF by the 16-week time point. Protoglycan synthesis in Fn-f-injected discs decreased progressively (F = 263.241, P = 0.000). At each time point, the Fn-f-injected discs showed significantly decreased proteoglycan synthesis compared with controls (t = -27.010 - -2.833, P < 0.05). The DHI% of the Fn-f-injected discs at the 4-, 8-, 12-, and 16-week time points were 96.5% ± 1.7%, 85.6% ± 3.8%, 77.2% ± 3.5% and 65.5% ± 5.6%, respectively. Comparing with the DHI% of PBS-injected discs (97.4% ± 1.2%), the Fn-f-injected discs exihibited no significant differences in disc heights at the 4-week time point (P > 0.05), but significant decreases in disc heights at the 8-, 12-, and 16-week time points (t = -21.225 - -10.795, P < 0.01). Apparent anterior osteophytes formed at the 12-week time point and enlarged remarkablely by the 16-week time point in the experimental spines.

CONCLUSIONSFn-f can induce a progressively degenerative process in rabbit discs which is ethical, cost-effective, reproducible, and consistent with the spontaneous degeneration in human. And it seem to be a novel and useful model for the study of disc degeneration at the molecular level.

Animals ; Disease Models, Animal ; Fibronectins ; pharmacology ; Intervertebral Disc Degeneration ; chemically induced ; Lumbar Vertebrae ; Rabbits ; Random Allocation

Objective To investigate the changing trend of mortality and the spectrum regarding causes of death in the population of Hunan, and to analyze the health-related major diseases.Methods With retrospective study method, a sample survey on causes of death and the related information was carried out from 2004 to 2005 among the residents in Hunan province. Results were compared with the data from a retrospective survey on causes of death in Hunan during 1973-1975 and 1990-1992, respectively. Results The crude mortality rates and the standardized mortality ratios (SMR) of the reisidents in Hunan were 901.59/100 000 and 865.14/100 000 during the period of 1973-1975 while 588.64/100 000 and 537.42/100 000 druing the period of 1990-1992, and 608.27/100 000 and 413.67/100 000 during the period of 2004-2005, respectively. During the past 30 years, the SMR of the residents in Hunan decreased by 52.18% and the descending range from the rural areas was more than that of the urban areas, and higher in females than in males. The death proportion of infectious diseases, maternal and perinatal diseases, nutritional deficiencies decreased significantly (P＜0.01), but the death proportion of chronic non-communicable diseases increased significantly (P＜0.01). The changing ranges of the former two proportions were both larger in the rural areas than those in the urban areas. The highest proportions of deaths due to injury and poisoning during the past 30 years were both seen in the 5 year olds, followed by the age groups of 25 year olds (P＜0.01). During the period of 2004-2005, the death proportion of all the infectious diseases,maternal/perinatal diseases and nutritional deficiencies was 8.01% altogether, and those of chronic non-communicable diseases, injury and poisoning were 80.66% and 11.33%, respectively. During the past 30 years, the SMR of the three kinds of diseases all significantly decreased, more significantly seen in infectious diseases, maternal and perinatal diseases, and nutritional deficiencies but less in chronic non-communicable diseases. Among the death cases of chronic non-communicable diseases,the SMR of cerebrovascular disease, malignant tumor, and heart disease showed an increasing tendency and the sequences of them had been advanced to the first, the second, and the fourth in the death ranking during the period of 2004-2005, respectively. Conclusion The SMRs of the residents in the urban and rural areas from Hunan province showed a declining tendency.Cardiovascular, cerebrovascular diseases and malignant tumors had become the important diseases affecting the health of the people, while injury and poisoning had otherwise topped the causes of death among children and adolescents in Hunan province.

Objective To construct a highly efficient approach to the introduction of the single-base mutation in a plasmid containing the adenovirus whole genome larger than 40 kb.Methods The target DNA with a mutation site was achieved by over-lapping PCR.The large plasmid with adenovirus genome and target DNA were co-transformed into Escherichia coli strain DY330 carrying a high rate Red recombination system.The positive clone was selected via colony PCR in combination with enzyme identification.The site-mutation large plasmid was transformed into E.coli strain DH10B in which the backbone of the large plasmid remained was stable.Results Two mutations were continuously introduced into the adenovirus genome,the location of which was pos.9171 and pos.24410 respectively.The integrality and stability of the plasmid backbone were verified by enzyme cutting identification.The two mutations on the plasmid were verified by DNA sequencing.Conclusion An efficient approach to the introduction of the single-base mutation in positions 9171 and 24410 from the adenovirus genome which was integrated into a plasmid is successfully established.The positive selection efficiency ranges from 5%to 15%.The construction of the approach will facilitate the study of adenovirus infection mechanism.

AIM: To evaluate the efficacy of modified folding intraocular lens(IOL)suspension surgery in treatment of traumatic dislocation of lens surgery technique.METHODS: Prospective randomized controlled study. A total of 15 patients underwent the modified folding IOL suspension surgery. Among them, 9 patients chose Akreos AO IOL, and polypropylene sutures were used to thread the haptics of IOL. After guided to puncture out through the sclera, the ends of sutures were thermal expanded and fixed in the sclera. And 6 patients chose Tecnis ZA9003 IOL and no sutures were used. After guided the haptics to puncture out through the sclera, the ends of haptics were thermal expanded and fixed in the sclera. The best corrected visual acuity(BCVA, LogMAR)of all patients and postoperative complication were observed. RESULTS: This study included 15 patients, among them, 7 were male and 8 were female, the mean age was 64.00±9.85 years old, the mean course of diseases was 5.80±3.17 wk. There were no significant differences between the demographic and baseline clinical characteristics. After underwent the modified folding IOL suspension surgery, visual acuity of all patients were obviously improved. After 3mo of the surgery, the BCVA(LogMAR)of patients were improved from 1.28±0.56 to 0.52±0.30. More specifically, the BCVA(LogMAR)of patients who chose Akreos AO IOL were improved from 1.39±0.62 to 0.59±0.25, and those who chose Tecnis ZA9003 IOL of the BCVA(LogMAR)were improved from 1.12±0.45 to 0.42±0.35. Furthermore, there was no severe postoperative complication observed in our study. Only one patient suffered IOL dislocation and the IOL optical surface was mild oblique.CONCLUSION: Modified folding IOL suspension surgery technique resulted in good visual and outcomes with no severe complication, making it an effective option for IOL suspension surgery.

OBJECTIVEThe aim of this study was to assess the long-term clinical outcome of patients with diabetes mellitus and chronic total occlusion (CTO) underwent drug-eluting stents (DES) implantation.

METHODSData of 143 consecutive eligible patients from January, 2006 to May, 2007 were retrospectively analyzed. The endpoint of the study was the major adverse cardiac events (MACE), including death, myocardial infarction, target lesion revascularization. The patients were divided into two groups, event group and non-event group, according to the result of follow-up.

RESULTSLong-term follow-up was finished in 139 (97.2%) patients. Mean follow-up duration was (19.8 + or - 5.1) months. MACE rate was 10.5% during follow-up: 3 deaths, 1 myocardial infarction and 11 repeated target lesion revascularization with PCI. Compared with the non-event group, the percentage of residual lesion [(17.7 + or - 1.8)% vs. (15.4 + or - 5.0)%, P = 0.001] was significantly higher in the event group, however, the final minimal luminal diameter [(2.14 + or - 0.22)% vs. (2.89 + or - 0.37)%, P = 0.004] was lower. Cox regression analysis showed that final luminal diameter (OR: 0.097, 95%CI: 0.013 - 0.694, P = 0.020) was the only dependent predictor at follow-up.

CONCLUSIONFinal minimal luminal diameter is an independent predictor of MACE during follow-up for patients with diabetes and CTO underwent DES implantation.

Adult ; Aged ; Aged, 80 and over ; Blood Vessel Prosthesis Implantation ; Chronic Disease ; Coronary Occlusion ; complications ; diagnosis ; therapy ; Diabetic Angiopathies ; diagnosis ; therapy ; Drug-Eluting Stents ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Prognosis ; Treatment Outcome

BACKGROUNDST-elevated acute myocardial infarction (STEAMI) happening in the first month post percutaneous coronary intervention (PCI) is almost related to acute thrombosis or subacute thrombosis in-stents. This study aimed to investigate the possible causes of myocardial infarction one month later.

METHODSPatients who had a history of successful PCI, and received coronary angiography or re-PCI due to STEAMI were included in this study. The AMI-related lesions and previous angiographic findings such as the number of lesions, the degree of the stenosis, the type of stents and acute results of last PCI were recorded. If the AMI-related lesion was localized in-stents or at the edge of stents (distance apart from the edge < or = 5 mm), it was defined to be late thrombosis; otherwise as a new-lesion induced AMI.

RESULTSOne hundred and ninety-two patients aged 40 - 79 years were included in this study. New lesions, as the cause of STEAMI, were found in 144 patients (Group A, 75%), and late thrombosis in 48 patients (Group B, 25%). Almost all newly built thromboses were found at the sites of previous insignificant lesions (diameter stenosis < 50%). There was a significant difference in the average time from previous PCI to AMI ((30.1 +/- 12.4) vs (20.3 +/- 11.9) months) between the two groups. Diabetes mellitus (DM) and drug-eluting stent (DES) utilization were associated with markedly higher morbidity of late thrombosis in adjusted Logistic regression (hazard ratio (HR) 3.4, 95% confidence interval (CI) 1.1 - 10.9 and 5.3, 95% CI 1.1 - 26.5).

CONCLUSIONSSTEAMIs happening 1 month after PCI are more likely to develop from previous insignificant lesion rupture than from late thrombosis in-stents. Moreover, DM and DES are associated with the high incidence of late thrombosis, which may indicate that intensive antiplatelet therapy should be considered in patients with diabetes.

Adult ; Aged ; Angioplasty, Balloon, Coronary ; adverse effects ; Coronary Angiography ; Coronary Thrombosis ; etiology ; pathology ; Drug-Eluting Stents ; adverse effects ; Female ; Humans ; Male ; Middle Aged ; Myocardial Infarction ; etiology ; pathology