Ear Diseases ; diagnosis ; therapy ; Humans ; Magnetic Resonance Imaging

Objective To investigate midwives' role cognition and their working experience.Methods It was a qualitative study using the phenomenological method.10 midwives were interviewed and all the data were analyzed using the categorization method.Results Three main categories were identified:diversified midwife roles; capacities and qualities required to fulfill midwifery roles; positive and negative experiences coexisted.Conclusions Managers should develop humanized management approaches to facilitate the fulfillment of midwives' roles and improve their working experience.The research also revealed the need to improve Chinese midwifery education and the midwifery regulation systems.

Uveitis is a kind of refractory blinding eye diseases.Noninfectious uveitis is an important part of uveitis,which is thought to be an autoimmune disease,and systemic immunosuppressive therapy is usually required to prevent visual loss.As a selective T-cell inhibitor,cyclosporine A is one of the most widely used immunosuppressants,and has obvious therapeutic effect on many kinds of uveitis.Cyclosporine A combined with glucocorticoid,other immunosuppressants or biological agents can improve the therapeutic effect and reduce the side effects.Recently,the inhibitory effect on glucocorticoid-resistant Th17 cells and topical application of cyclosporine A,show its advantage and potential in the treatment of noninfectious uveitis.

Objective To investigate the clinical effect of plastic surgery of double-palpebra with reposition of lacrimal gland for blepharochalasis.Methods We operated on 10 cases (20 eyes) with dermatolysis palpebrarum which stopped attack and was static for more than one year.A double eyelid fold incision was made.Then redundant skin and sphincter palpebrarum as well as protrusion of intraorbital fat were removed.In the operation of dislocation of lacrmial gland we sewed up lacrmial gland in full thickness and fixed it to the periosteum of lacrmial fossa,and the levator muscle of upper eye lid aponeurosis prothesis or plication was choosed when the levator muscle of upper eye lid aponeurosis was broken or not.And for the shorted transverse diameter of coloboma of eye lid we sewed up the external palpebral ligament and fixed it to the periosteum of lateral orbital margin.Results All the 10 patients got satisfactory therapeutic effect,the cutis laxa had been amended obviously,the good upper double eyelid shape could be achieved,the reposition of lacrimal gland was finished,lapsus palpebrae superioris and shorted transverse diameter of coloboma of eye lid had been rectified satisfactorily.All cases we followed up for three monthes to one year,and dislocation of lacrmial gland had been amended in one case,others had been reposited well,without recurrence.Conclusions Blepharochalasis can be effectively treated by surgery,and it is convenient and effective to treat dislocation of lacrimal gland and blepharochalasis through a double eyelid fold incision.This multiple surgical treatment is not only a curative operation but also a cosmetic surgery.

An isocratic high-performance liquid-chromatographic method is-described for the simultaneously determining carbamazepine and its biologically active metabolite, carbamazepine-10, 11-epoxide. Serum samples containing an internal standard (10-methoxycarba-mazepine) are extracted with dichlor-methane and 4 mol ? L-1 sodium hydroxide. The organic extract are evaporated at ambient temperature under a stream of nitrogen. The residues are reconstituted in mobile phase and injected on to a re-versed-phase C18 Column (150?4. 6mm I. D). The mobile phase consists of ace-tontrile/methanol/water (50/210/260 by vol) . The UV detector is operated at 214nm. The elution times of all com-pounds are within 7 min.The least detectable concentrations of carbamazepine and carbamazepine-10, 11-epoxide are 0. 08mg ? L-1 and 0.1mg ? L-1, respectively. The average absolute recovery for carbamazepine is 96.0% and for carbamazepine-10,11-epoxide is 97.3%. Within-run CV is 3. 3%~5.7%. and between-run CV is 4.3%~9.0%. The standard curve is linear at least within 40mg ? L-1 for carbamazepine and within 20mg ? L-1 for carbamazepine-10, 11-epoxide.

Objective To study the security in HBV carried infertility patients during the in-vitro-fertilization procedure. Methods Serologic testing of HBV infection (HBsAg, HBsAb, HBeAg, anti-HBe, anti-HBc-IgG) of blood, follicle fluid/sperm and fertilization culture medium/post-washing sperm in female/male carried patients were detected by ELISA on the day of oocytes collection. Results In 18 female patients who were seropositive for HBsAg, HBeAg and anti-HBc-lgG, the same antigen and antibody could be detected in all 18 folli-cle-fluid and fertilization culture medium(100%, 100%). In 131 female patients who were sernpesitive for HBsAg, anti-HBe, anti-HBc-IgG, the same antigen and antibody could be detected in 84 follicle-fluid(64. 1%), and 8 fertilization culture medium(6. 1%). If the patients'follicle-fluld was negative for all the markers, their fertilization culture medium remained negative. In 23 male patients who were sero-positive for HBsAg , HBeAg,and anti-HBc-lgG, the same antigen and antibody could be detected in only 6 sperm (26. 1%), all the postwashing sperm were exhibited negative. In 121 nude patients who were seropositive for HBsAg, anti-HBe, anti-HBc-lgG, the same antigen and antibody could be detected in only 7 sperm (5. 8%), and all the post-washing sperm were negative. Conclusion In IVF-ET procedures, the risk of HBV transmission by follicle-fluid and fertilization culture medium in those female patients who showed serepesitive for HBsAg , HBeAg, and anti-HBc-lgG can not be decreased. The risk in those female patients who showed seropositive for HBsAg, anti-HBe, anti-HBe-lgG and male patients in IVF-ET procedures can be decreased.

Cell Line, Tumor ; Humans ; Matrix Metalloproteinase 2 ; analysis ; Matrix Metalloproteinase 9 ; analysis ; Melanoma ; enzymology ; Skin Neoplasms ; enzymology

ObjectiveTo investigate the influence of selective soft tissue release on the tension around hip joint through posterolateral approach, and to ascertain the sequence of soft tissue release in total hip arthroplasty. MethodsFive fresh frozen cadavers with ten intact lower extremities were used in the study. All the pelves of cadavers were fixed on the operating table by a special designed fixer on a lateral position. Femoral supracondylar bone traction was employed for axial traction. The force for traction was 15 kg. Posterolateral approach was used for exposure and two sequences for soft tissue release were studied. One Kirschner wire was fixed at the bone near the anterior superior iliac spine, and the wire was perpendicu-lar to the operating table. Another Kirschner wire was fixed into the bone at lateral femoral shaft. The two Kirschner wires were parallel to each other. The distance between the two Kirschner wires was measured be-fore and after each soft tissue structure release. ResultsThere were no significant changes of the distance measured before and after applying traction alone, releasing external rotation muscles, opening the posterior capsule and releasing the gluteus maximus insertion. There were significant changes of distance measured before and after resection of femoral head, release of tensor fasciae latae and/or iliotibial band, excision of anterior capsule, and release of iliopsoas tendon had. The average lengthened distance was 1.5 mm (range, 1-3 mm) after resection of femoral head, and 8.0 mm (range, 2-19 mm) after release of tensor fasciae latae and/or iliotibial band, 5.5 mm (range, 1-13 mm) after excision of anterior capsule, and 1.8 mm (range, 1-3 mm) after release of iliopsoas tendon respectively. The distance lengthened after both release of tensor fasci-ae latae (and/or iliotibial band) and excision of anterior capsule was the most significant, average 13.5 mm (range, 11-20 mm). ConclusionRelease of anterior capsule, tensor fasciae latae and/or iliotibial band, and iliopsoas tendon will decrease the soft tissue tension around hip joint. Among all the soft tissue structures we investigated, the anterior capsule and tensor fasciae latae (iliotibial band) make the most effective result. To maintain the soft tissue tension around hip joint depends on different structures working together, releasing one structure alone may not obtain the optimal result. Careful evaluation of tension of tensor fasciae latae and iliotibial band can help avoiding the limb length discrepancy during hip arthroplasty surgery.

Objective To discuss the necessity and methods of combined reconstruction of the injured posterior cruciate ligament(PCL)and posterolateral complex(PLC)of the knee. Methods From January 2001 to December 2006,28 patients with injury of both PCL(≥Ⅱ°b)and PLC(＞Ⅱ°)of the knee were treated operatively in our department.Eight patients received arthroscopic PCL reconstruction with single bundle of 5-6 strands of hamstring and conservative treatment of PLC during January 2001 to December 2003.Twenty Datients received arthroscopic PCL reconstruction followed by open operative repair of PLC with median 1/3 femoral biceps tendon and gracilis during January 2002 to December 2006. Results All the patients were followed up for 6 to 24 months postoperatively (mean,15 months).By Lysholm scoring,3 cases obtained good results and 5 poor in the first group,while 19 excellent and 1 good in the second group.The mean Lysholm scores were 47.1±8.2 and 86.7±7.2 respectively(P＜0.05).According to IKDC scale,3 patients(37.5%)in the first group and 19 patients (95.0%)in the second group were graded normal or nearlv normal(t=19.277,P＜0.05). Conclusion Arthroseopic PCL reconstruction with single bundle of 5-6 strands of hamstring plus PLC reconstruction with 1/3 femoral biceps tendon and gracilis is more reliable to restore the stability of the knee than PCL reconstruction only.

Background Human Tenon fibroblasts (HTFs) are the main cell component in scar tissue after antiglaucomatous filtrating surgery.To study the in vitro growth and proliferation features will offer an approach to the preventing and treating of scarring following antiglaucomatous filtrating surgery.Objective The goal of present study was to investigate the growth characteristics of HTFs in vitro from patients with bleb scarring after antiglaucomatous filtrating surgery.Methods This study process was approved by Ethic Committee of Beijing Chaoyang Hospital,and informed consent was obtained from each subject prior to the initaion of the study.The specimens of scaring tissue were obtained during the secondary trabeculectomy from 8 eyes with bleb scaring after initial antiglaucomatous filtrating surgery with the tissue size of 4 mm×5 mm,and the normal Tenon capsule specimens were acquired during the strabismus surgery from 8 eyes in the same way.HTFs were primarily cultured and passaged by tissue explants adherent method and identified using immunoinfluorescence technique with vemintin antibody.Nest PCR was used to exclude the mycoplasma infection during the culturing process.The morphology,growth curve and population doubling time (PDT) of the fifth generation of cells were examined and calculated by luminescence method cell vitality method 0,4,7,11,14 days and compared between the patients and normal groups.The stability of the cell growth was assessed by comparing the morphology,growth curve and PDT between the fifth generation and fifteenth generation of HTFs.Results Primarily cultured cells reached confluence 1-2 weeks with the similar shape to HTFs.The growth properties of the cells were same between the scarring group and normal group and showed positive response for vemintin antibody.No react band for mycoplasma was detected.The PDT was (20.54±3.51) hours and (18.86±2.91) hours in the scarring group and normal group,respectively,showing insignificant difference between them (t=0.634,P=0.561).No significant differences were found in the number of cells in 4,7,11 and 14 days after passage (t =2.663,P =0.081; t =0.194,P =0.863 ; t =3.338,P =0.053 ; t =0.627,P =0.565),with a consistent growth curve with the lapse of time between the two groups.The HTFs from scarred Tenon capsule fibrosis were cultured and passaged until the fifteenth generation.The PDT was gained to be (20.54 ±3.51) hours in the fifth generation of cells and (22.84±4.15) hours in the fifteenth generation of cells,without significant difference between them (t =0.733,P =0.505).The number of cellsin 4,7,11 and 14 days was not significantly different between the fifteenth generation and the fifth generation of cells (t=1.528,P=0.235;t=0.269,P=0.786;t=1.954,P=0.139;t =0.730,P =0.506).In addition,a good and stable growth curve also was exhibited in the fifteenth generation of cells compared with the fifth generation of cells.Conclusions Bleb scar-derived HTFs present good and stable growth in vitro.This result demonstrates HTFs were target cells in antifibrosis study after antiglaucoma filtrating surgery.