Rectal prolapse is a rare disease, has been attracting many surgeons to study it.Surgical treatment of rectal prolapse is currently more than 50 kinds, most of which are modifications of several basic modes treatment, depending on the doctor' s grasp on the patient anatomy.Currently comprehensive treatment of a variety of therapies is a more ideal way for the treatment of rectal prolapse.

Objective To explore the microsurgery technique and outcome of expanding translabyrinthine ap-proach resection large acoustic neuroma .Methods We have retrospectively studied clinical data and follow -up re-sults of 4 patients of large acoustic neuroma (≥5 cm ,the largest was 8 cm ;3 cases with servere sensorineualt hear-ing loss ,1 case with high frequenoy hearing loss ;1 case with blindness) in our hospital between January 2013 and April 2013 .All patients received expanding translabyrinthine approach microsurgery to resecting the tumors .Post-operative follow -up was 6~10 months .Results The large acoustic neuroma of 4 cases were totally removed via MRI reexamination after operation .Facial nerve in 3 cases were dissection retained ,and 1 case received facial nerve anastomosis .Six months after operatin ,one patient’s facial nerve function recovered from level Ⅲ to level Ⅱ ,the patient underwent facial nerve anastomosis with facial paralysis level Ⅵ recovered to level Ⅳ ,and the vision of pa-tient with blindness completely recovered to normal .Conclusion The expanding translabyrinthine approach can to-tally resect large acoustic neuroma and preserve facial nerve function .

Purpose: To evaluate the efficacy, safety and survival of low molecular weight heparin ( LMWH) plus chemotherapy in patients with advanced non-small cell lung cancer. Methods: 46 patients with NSCLC were randomized into chemotherapy plus LMWH. (study group) and chemotherapy only( control group). Both groups received two cycles of MVP regimen (MMC 6 mg/m2, YDS 3 mg/m2 x 2, DDP 90 mg/m2). Patients in the study group were treated with LMWH 5000u twice daily from the third day before chemtherapy up to 7 days. Results: The response rate was 56. 5% (13/23) for the study group and 39. l%(9/23) for the control group. Median survival time( MST) and 1-year survival rate were 12, 1 months(95%CI:8.52~14.64) and 52.2% for the study group compare 8.4 months(95%CI:6.15 ~ 10. 85) and 34. 8% for the control group. There were significant differences for MST( 12. 1 vs 8. 4) and 1 year survival rate(52. 2% vs 34. 8%) in the study group as compared to the control group. No difference in response rate and toxicities were found between the two groups. Conclusions: Chemotherapy( MVP regimen) plus LMWH is effective and safe. Prolonged survival was observed in patients who received MVP regimen plus LMWH.

A prospective study was performed to evaluate the diagnostic value of B- mode ultrasonography and inferior vena cavograme and the value of PTA in Budd-Chiari syndrome.One hundred sixty-eight cases including ninety-two men and seventy-six women, age ranged 11～63(mean,34.8 years).Among them 65 were treated with PTA or stent placement.The authors gave a minute and detail description of clinical feature,ultrasono- graphy,inferior vena cava or hepatic venogram,CT and other radiologic demonstration of Budd-Chiari syndrome retrospectively.Four types of Budd-Chiari syndrome were demon- strated based on anatomy,B-mode ultrasonography,inferior vena cavogram and hepa- tovenograme.(1)IVC membranous webs(76 subjects,45.2%),(2)IVC segmental stenosis or occlusion(65 subjects,38.7%),(3)hepatic vein occlusion(10 subjects,6. 1%),(4)mixed type(17 subjects,10%).The treatment of the Budd-Chiari syndrome with percutaneous transluminal balloon dilatation and stent placememnt of inferior vena cava or hepatic vein was safe and satisfied.Its long-term effectiveness(follow up 3-5 years)is al- so satisfactory.

Two patients of Budd-Chiari syndrome,suffering from the anemalons drainage of inferior vena cava into left atrium were reported including one male of 41 years old and female of 42. togectll with labial cyanosis,fingers and toes symptoms of portal hypertension and IVC hypertension. The obstruction of IVC wastreated with balloon catheter hypertension and IVC hypertension the disrotreaed also after PTA.The echo wasn't discovered with Dopple ultrasound after PTA.

Objective Mapping the responsible gene for congenital nuclear cataract in a family for five generations in Yantai City,Shandong Province,China.Methods Family history and clinical data were recorded.9 unaffected members and 13 affected members in this family were involved in the study.The genes of all the involved members were amplified by polymerase chain reaction(PCR).28 microsatellite polymorphism in the 15 reported disease loci were used as genetic markers.The PCR products from each DNA sample were separated on a 6% polyacrylamide gel and analyzed.Allele-sharing analysis was carried out for exclusion,and linkage analysis was calculated with the LINKAGE(Version 5.1)package.Direct sequencing was used for GJA3 gene.Results The clinical phenotype in this family was isolated congenital nuclear cataract,the pathogenic nutation of the phenotype of which has not been reported yet.For all the 28 markers around the 15 candidate loci,there was no allele-sharing between the affected family members.At the 0.00 recombination frequency,the LOD score was-∝ in 27 of the 28 microsatellite markers with exception of D11S898.No GJA3 gene mutation was found.It indicated that there was no linkage between these markers and the pathogenic gene in this family.Conclusion The responsible gene for the congenital nuclear cataract in this family is not located on the 15 reported loci,which further indicates the clinically and genetically heterogeneity of inherited cataract,and an important clue is provided for finding more cataract responsible genes.The pathogenic gene in this family should be identified through extensive scanning of genes.

Objective To study the interventional therapeutic methods in Budd Chiari syndrome (BCS) complicated with thrombosis. Methods Eighteen patients of BCS complicated with thrombosis, including 2 cases of hepatic vein (HV) occlusion and 16 cases of inferior vena cava (IVC) occlusion, were treated. Therapeutic methods were anti coagulation with Co Danshen and aspirin in 10 cases or the anti coagulation and thrombolysis with urokinase in 8 cases before operation, treatment with PTA and stent during operation,and thrombolysis with urokinase and the anti coagulation after operation. Results Technical success was achieved in all patients without serious complications. The mean blood pressure in IVC dropped from (31 82?0 52)cm H 2O(1 cm H 2O= 0 098 kPa) to (18 17?0 38)cm H 2O immediately after the procedure. The blood pressure in HV dropped from 42 cm H 2O and 41 cm H 2O to 15 cm H 2O and 16 cm H 2O, respectively. All 18 cases were followed up for an average of 38 months (range 6-72 months). The main symptoms and signs completely disappeared in 12 cases and partially alleviated in 6 cases. Conclusion The interventional treatment of BCS complicated with thrombosis was a safe and effective method.

Objective To investigate the value of magnetic resonance diffusion weighted imaging (DWI) and apparent diffusion coefficient (ADC) in detection of central gland prostate cancer (CGPCa).Methods Routine MRI and DWI examination were performed in 25 CGPCa patients and 30 benign prostate heperplasia (BPH) patients.Then the ADC value was measured according to the image of the lesion after DWI,and the receiver op erating characteristic (ROC) curve was analyzed to select the best ADC value for diagnosis of CGPCa.Results The ADC value of CGPCa (0.89±0.12×10-3 mm2/s) was smaller than that of BHP (1.43±0.12x10-3 mm2/s),and the dif ference was statistically significant (P＜0.05).When the cut off point of ADC value was set at 1.192×10-3 mm2/s,the sensitivity was 80.0％ and the specificity was 85.0％.Conclusion DWI and ADC have clinical application value in diagnosis of CGPCa.

Background Epipolis laser in situ keratomihusis(Epi-LASIK) is an potential surgery for myopia because it synthesize advantages of LASEK and LASIK. But its clinical effectiveness and safeness is remarkable.Objective This study was to evaluate the clinical curative effects and safeness of Epi-LASIK for myopia in different diopter of population. Methods Retrospective study was designed for 208 eyes of 104 patients who underwent EpiLASIK for the correction of myopia. The patients were divided into two groups according to preoperative diopter:lower myopia group( ≤ -6.00 D, 111 eyes) and high myopia group ( ＞-6.00 D,97 eyes). The time of epithelial healing, postoperative syndrome, postoperative visual acuity, refraction, intraocular pressure (IOP) , the safe index, the efficacy index and haze were evaluated at 1,3,6,12 months postoperatively. The written informed consent was obtained from each individual before surgery. Results After operation, 20 eyes ( 18.02% ) of lower myopia group and 29 eyes (29.90%) of high myopia group had obvious pain, presenting statistically significant difference between two groups (X2 = 4. 060, P＜0.05 ). The mean time of epithelial healing was (5.49±0. 83 )days in lower myopia group and (5.85± 0.68 )days in high myopia group with a delayed epithelial healing time in high myopia group( u= 3. 377 ,P＜0.05 ).One year after the treatment,the uncorrected visual acuity( UCVA ) ≥ 1. 0 was 90. 99% ( 101 eyes) in lower myopia group and 75.26% ( 73 eyes) in high myopia group, and 9.91% ( 11 eyes) and 15.46% ( 16 eyes) of the eyes improved byl line or more in best spectacle corrected visual acuity(BCVA) ;whereas 3.60% (4 eyes)and 6. 18% (6 eyes)lost a line or more. 91.89% ( 102 eyes) and 85.57% (83 eyes) in both groups gained within 1.00 D of the attempted correction. The safety index and efficacy index were 1.04 and 0. 98 in lower myopia group,and 1. 01 and 0. 96 in high myopia group without statistically significant difference( P＞0. 05 ). haze occurred in 6 eyes in lower myopia group and 9 eyes in high myopia group and the difference in haze grading was not statistically significant between two groups ( P＞0. 05 ). The high intraocular pressure appeared in 10 eyes and 9 eyes in low myopia group and high myopia group respectively during the fellow up duration and back to normal after topical use of timolol. Conclusion Epi-LASIK is an effective and safe method for correction of different diopters of myopia because of its mild symptom and lower incidence of haze.

Background Wearing of soft contact lens,as one of the important methods to correct ametropia,has been widely applied at present.The clinically deleterious effects of soft contact lens have been reported,but researches about influence of apoptosis of corneal epithelial cells are scant.Objective This study was to detect and compare the ratio of apoptosis of corneal epithelial cells between the patients with contact lens wearing and without contact lens wearing,and explore the influence of soft contact lens wearing for long term on growth of corneal epithelial cells after injury.Methods A retrospective nest case-controlled study was designed.Forty eyes of 20 myopic patients with wearing of soft contact lens for ≥5 years and 40 eyes of 20 myopic patients without wearing of soft contact lens were included in Affiliated Hospital of Guiyang Medical College.All the patients received the off-flap epipolis laser in situ keratomileusis (Epi-LASIK) from 2010 October to 2011 June.The corneal flaps were collected during the surgery.The apoptosis of corneal epithelial cells was detected by flow cytometry(FCM),and the difference of apoptotic proportion between the two groups was compared using independent sample t test.Results The FCM scatter plot showed that compared to the without contact lens wearing group,the early stage of apoptotic cells with high staining annexin V and low staining proaium iodide (PI) were much more,and survival cells with low staining annexin V and PI were less,and necrotic and late stage of apoptotic cells with high staining of annexin V/PI were more in the with contact lens wearing group.The early stage of apoptosis proportion of corneal epithelial cells was (11.23 ± 5.31)％ in the with contact lens wearing group,and that in the without contact lens wearing group was (7.31± 5.43)％,showing a significant difference between them (t=2.754,P=0.008).Conclusions A long term wearing of contact lens induce more apoptosis of corneal epithelial cells,which can result in a disorder of structure and function of ocular surface during the wound healing stage.