0.1 improved significantly, while the eyesights of the other patients improved slightly or not at all. In the 53 cases of mass diseases,45 cases (84.9 %) required complete removal whereas 8 cases required bulk removal. No cases of sunken eyeball was found. Snuffle was improved in all cases. Most symptoms disappeared and no optic nerve injury resulted after the tumors in the orbital apex were removed. CONCLUSION Selecting the proper operative approach is important to the uncovering of the operative area. The use of navigation systems and endoscope could increase the rate of complete removals,result in fewer injuries of vessels and nerves,and avoid facial incision.

BACKGROUND: Methods to effectively overcome re-stenosis or atresia following reconstruction of external auditory canal are explored.OBJECTIVE: To explore the effect of NiTi shape memory alloy netlike bracket to prevent the restenosis or atresia of newly constructed external ear canal in external canal atresia surgery. DESIGN, TIME AND SETTING: Case analysis of aural atresia patients from Department of Otorhinolaryngology Head and Neck Surgery, Third Hospital of Sun Yat-sen University was performed from January 2001 to June 2003. PARTICIPANTS: Eight cases of aural atresia were selected, including 5 patients with congenital aural atresia, and 3 with postnatal aural atresia. All cases had different degrees of conductive hearing loss. METHODS: All cases underwent external canals reconstruction by using NiTi shape memory alloy netlike brackets. MAIN OUTCOME MEASURES: Diameter of newly constructed aural canal and pure tone auditory threshold. RESULTS: All the eight ears had a smooth and wide external ear canal during follow up. No restenosis of canal or cicatricial contracture was found. Pure tone auditory threshold of 7 ears had improved postoperatively. CONCLUSION: NiTi shape memory alloy netlike bracket has definite effect to prevent the restenosis or atresia of new constructed external ear canal.

Objective To prepare a kind of Gelsolin-targeted ultrasound contrast agent (GSN-PLGA) and to explore its targeting and imaging effection in vitro.Methods The high molecular PLGA-COOH ultrasound contrast agents were prepared by a modified double emulsion technique and then conjugated with Gelsolin monoclonal antibody by carbodiimide technique.The physical property of contrast agent was determined.And the connectivity condition of ultrasound contrast agent with Gelsolin monoclonal antibody was estimated.The targeting ability and the effect of enhancing ultrasound imaging in vitro were explored.Results The average diameter of GSN-PLGA was (575.67 ± 4.71) nm.The potential was (-11.46±1.19) mV.And the binding rate of Gelsolin monoclonal antibody was 96.93％.In vitro experimentshowed more GSN-PLGA could be intaked by Hca-F cells and the ultrasound imaging cloud be enhanced greatly.Conclusion The GSN-PLGA nanoparticle can bind to Hca-F cells specifically and can enhance the ultrasound imaging greatly.

Objective : To learn the epidemiological characteristics of coronavirus disease 2019 (COVID-19) cases reported from January 21 to February 20,2020 in Zhejiang Province,so as to provide basis for formulating and implementing effective control measures. Methods : The COVID-19 cases reported by Zhejiang Province were extracted from the National Diseases Prevention and Control Information System. A descriptive analysis was adopted for the epidemiological characteristics of COVID-19 cases,including time,spatial and population distribution,severity of symptoms, and exposure history. Results : Totally 1 284 cases were reported,of which 1 176 were confirmed cases (91.59%) and 108 were asymptomatic cases (8.41%). The first confirmed case was reported on January 21. The curve of the disease onset peaked from January 22 to 29, with 87 cases as the biggest number a day. The curve of the disease reported peaked from January 28 to 30, with 130 cases as the biggest number a day. Then the number of the cases showed a declining trend. By February 4, totally 79 counties (cities, districts) had confirmed cases, covering 87.78% of Zhejiang Province, and it has not increase since then. A male to female ratio of 1.02∶1 was reported among 1 284 cases,1 021 were 30-69 years old (79.52%) and 339 (26.40%) were business service providers. There were 11 health workers reported to be infected,but not by occupational exposure. Among the confirmed cases, 1 010 (85.88%) were clinically mild cases. One case died. Before January 23, the cases were mainly imported from Hubei Province, local cases were predominant by the end of January. Conclusions The COVID-19 epidemic has spread widely in Zhejiang Province and people are generally susceptible. Most cases were clinically mild, and were aged 30-69 years. No health workers infected were due to occupational exposure. The incidence of COVID-19 in Zhejiang Province has turned into a lower level,suggesting that the early prevention and control measures have achieved initial results. With people returning from holiday, precise prevention and control should be put into effect.

Objective To investigate the changes of indications, degree of difficulty in procedure, complication and its severity in endoscopic retrograde cholangiopancreatography (ERCP) in Changhai hospital from 2001 to 2007. Methods The clinical data, including demographic data, indications, degree of difficulty in procedure, success rate, complication rate and severity of complication, of 2374 patients who underwent ERCP in 2001 and 2007 (966 in 2001 and 1408 in 2007), were retrospectively reviewed. Results Indications of ERCP changed at an interval of 5 years. Operations due to bile duct stone decreased (59.0% vs. 49.3%, P=0.000), while operations due to pancreas disease, especially chronic pancreatitis (6.6% vs. 18.5%, P=0.000) and recurrent pancreatitis (0.2% vs.1.6%, P=0.001), increased. Patients with biliary duct problems after liver transplantation appeared in 2007. The procedures of ERCP performed in 2007 were more difficult (P=0.000), with an increased percentage of Degree 5 procedure (7.3% vs. 33.3%, P=0.000). The number of diagnostic ERCP significantly decreased (Degree 1 + Degree 3, 30.5% +2.8% vs. 5.9% +3.1%, P=0.000). There was no significant difference in the success rate between the two years (P=0.084). The complication rate of ERCP in 2007 was significantly higher than that in 2001 (3.73% vs. 7.88%, P=0.000), but the severity of complication showed no significant difference (P=0.820). Conclusion Cases of diagnostic ERCP decreased in 2007. Indications of ERCP have changed, with a decrease in bile duct diseases and an increase in pancreatic diseases. The procedures are more complicated, but it does not lead to lower success rate. The increase in complication rate is possibly due to increase of therapeutic ERCP.

Objective To investigate the mechanisms of sacroiliac joint pain after lumbar fusion surgery and to present the clinical outcomes after a combining intra-and peri-articular injection.Methods Totally 20 male and 15 female patients (48-75 years old) from January 2013 to December 2016 were retrospectively included in the present study.The patients were all with sustained low back and hip pain after prior posterior lumbar interbody fusion surgery.Nine cases were diagnosed with lumbar disc herniation,22 cases with lumbar stenosis,and 4 cases with degenerative lumbar spondylolisthesis.Ten cases were performed with single level fusion,16 cases with two level fusion,9 cases with 3 or more level fusion.Autogenous iliac bone graft was not applied in any of those patients.The pain of the patients was confirmed from the sacroiliac joint through specific symptoms and signs.They were divided into two groups and were treated with either standard intra-articular injection (17 cases) or a combine of intra-and peri-articular sacroiliac injection (18 cases).Peri-articular injection was conducted at 1 cm above the inferior margin of the sacroiliac joint.Recover ratios of visual analogue scale (VAS) and Oswestry disability index (ODI) at 2 weeks post-operatively were recorded and were compared between the two groups.Results No statistical difference was found in gender,fusion location,fusion levels,pre-operative VAS and ODI score between the two groups (P ＞ 0.05).The combination of intra-and peri-articular sacroiliac injection showed significantly better results than the single intra-articular injection in VAS score immediately after injection (t=2.159,P=0.038),VAS score at 2 weeks after injection and ODI score at 2 weeks after the injection (t=2.705,P=0.011;t=2.156,P=0.039,respectively).Conclusion Both intra-and extra-sacroiliac joint diseases may lead to sacroiliac joint pain after lumbar fusion surgery.A single intra-articular sacroiliac injection could not provide optimistic outcomes.Further extra-articular injection is required at approximate 1 cm above the inferior margin of the sacroiliac joint.The technique combining intra-and peri-articular injection could guarantee improved early clinical outcomes.

Objective:To investigate the value of real-time shear wave elastography (SWE) in the assessment of splenic congestion in patients with chronic right heart failure.Methods:Sixty patients with chronic right heart failure with cardiac function grade Ⅱ-Ⅳ of New York Heart Association (NYHA) treated in Lianyungang First People′s Hospital from March 2020 to February 2021 were collected as the study group, and 20 healthy subjects in the same period were selected as the control group. Routine echocardiography was performed on all subjects; spleen stiffness measurement (SSM) was detected by SWE, and blood biochemical indicators related to patients with right heart failure were detected and recorded. SSM and other related parameters between the two groups were analyzed; the SSM in patients of different cardiac function classifications and course of disease were compared; 60 patients were divided into low SSM group (SSM≤15.0 kPa), middle SSM group (15.0 kPa

Objectives:To establish a grading model on prognosis of drug-coated balloon (DCB) treatment on femoropopliteal de novo lesions, and assess whether patients at high risk could benefit from combination of directional atherectomy(DA).Methods:The clinical data of 114 patients with femoropopliteal de novo lesions admitted to Department of Vascular Surgery, Peking University People′s Hospital from October 2015 to January 2019 were collected retrospectively. There were 95 patients(108 limbs) underwent DCB treatment, including 66 males and 29 females, aged 71.9 years old(range:48 to 91 years), and 19 patients (21 limbs) underwent DA combined with DCB treatment, including 13 males and 6 females, aged 69.5 years old(range: 62 to 80 years). The demographic data, intraoperative and postoperative conditions of the patients were collected. Cox regression model was performed for modeling and then goodness of fit was tested. Kaplan-Meier estimate was carried out between the two groups for patients at high risk and low risk, respectively.Results:All patients were followed up for more than 24 months. Restenosis occurred on 34 limbs in DCB group and 3 limbs in DA+DCB group. Severe calcification( HR=3.804, 95% CI:2.460 to 5.883), popliteal artery involvement ( HR=2.104, 95% CI:1.368 to 3.236), long lesion ( HR=1.824, 95% CI:1.196 to 2.780), poor runoff( HR=1.736, 95% CI:1.025 to 2.940), chronic kidney disease( HR=1.601, 95% CI:1.040 to 2.463) were independent risk factors of restenosis after DCB treatment, and were defined 3, 2, 1, 1 and 1 points, respectively. Total points≥3 was regarded as high risk group. Kaplan-Meier analysis showed that patients in low risk group did not benefit from DA+DCB comparing with DCB with regard to primary patency at 24 months (77.78% vs. 90.31%, P=0.271) while patients benefited from DA+DCB comparing with DCB in high risk group(88.26% vs. 20.80%, P<0.01). Conclusions:The grading model shows satisfying clinical value. The clinical effect of DA+DCB is better than DCB along in high risk group. Patients at high risk are supposed to receive aggressive vessel preparation like DA.

Objectives:To establish a grading model on prognosis of drug-coated balloon (DCB) treatment on femoropopliteal de novo lesions, and assess whether patients at high risk could benefit from combination of directional atherectomy(DA).Methods:The clinical data of 114 patients with femoropopliteal de novo lesions admitted to Department of Vascular Surgery, Peking University People′s Hospital from October 2015 to January 2019 were collected retrospectively. There were 95 patients(108 limbs) underwent DCB treatment, including 66 males and 29 females, aged 71.9 years old(range:48 to 91 years), and 19 patients (21 limbs) underwent DA combined with DCB treatment, including 13 males and 6 females, aged 69.5 years old(range: 62 to 80 years). The demographic data, intraoperative and postoperative conditions of the patients were collected. Cox regression model was performed for modeling and then goodness of fit was tested. Kaplan-Meier estimate was carried out between the two groups for patients at high risk and low risk, respectively.Results:All patients were followed up for more than 24 months. Restenosis occurred on 34 limbs in DCB group and 3 limbs in DA+DCB group. Severe calcification( HR=3.804, 95% CI:2.460 to 5.883), popliteal artery involvement ( HR=2.104, 95% CI:1.368 to 3.236), long lesion ( HR=1.824, 95% CI:1.196 to 2.780), poor runoff( HR=1.736, 95% CI:1.025 to 2.940), chronic kidney disease( HR=1.601, 95% CI:1.040 to 2.463) were independent risk factors of restenosis after DCB treatment, and were defined 3, 2, 1, 1 and 1 points, respectively. Total points≥3 was regarded as high risk group. Kaplan-Meier analysis showed that patients in low risk group did not benefit from DA+DCB comparing with DCB with regard to primary patency at 24 months (77.78% vs. 90.31%, P=0.271) while patients benefited from DA+DCB comparing with DCB in high risk group(88.26% vs. 20.80%, P<0.01). Conclusions:The grading model shows satisfying clinical value. The clinical effect of DA+DCB is better than DCB along in high risk group. Patients at high risk are supposed to receive aggressive vessel preparation like DA.

Objective　We investigated the correlation of MMP-2，MMP-14 with the vulnerability of carotid plaque. Our study was to explore the related factors which influence the stability of the plaques. Methods　Carotid plaques were collected from patients undergoing CEA in the Department of Neurosurgery of the First people’s Hospital of Lianyungang. 55 patients were recruited between January 2018 and June 2019.All of the plaques were divided into 23 stable carotid plaques and 32 vulnerable carotid plaques by imaging and histological analysis. Immunohistochemistry was used toloca lize the expression level of MMP-2 and MMP-14 in stable and vulnerable plaques. Results　Density analysis revealed that the immunohistochemical staining of MMP-2 and MMP-14 were more intense among samples from vulnerable group than those from stable group. MMP-2 and MMP-14 staining was positive in ulcer plaque and the atheromatous lesions. Conclusion　The expression of MMP-2 and MMP-14 were associated with plaque vulnerability of human carotid plaques，which is an important factor affecting the stability of plaques.