Objective To summarize the key point of collaboration during the surgery of endoscopic guided vitrectomy for complicated ocular trauma.Methods From October 2010 to March 2013,a total of 25 cases(25 eyes) of complicated ocular trauma were treated by endoscopic guided vitrectomy.The the key point of collaboration was summarized.Results Surgeries of 25 cases (25 eyes) went smoothly,visual acuity improved,without enucleation cases.Postoperative complications were mainly secondary glaucoma and vitreous hemorrhage,and all were improved after treatment.Conclusions Endoscopic guided vitrectomy for the treatment of complicated ocular trauma is one of the effective means,and the advantage is that the surgery could be done when the refractive medium is opacity.

Hepatocellular carcinoma (HCC) is one of the most common cancers in the worldwide.In recent years,the development of imaging techniques has facilitated the detection of HCC at early stages.However,HCC has a high frequency of portal vein invasion,which is reportedly observed in 11％ to 42％ of patients with HCC.Portal vein tumor thrombus(PVTT) is a crucial factor that can worsen the prognosis of HCC because it can be wide dissemination of tumor throughout the liver and cause a marked deterioration of hepatic function.It was considered that is not appropriate with surgical treatment in the past,which is treatment conservative or even give up,most of the patients died within a few months.Even if the patients have a chance to surgical resection,and the most of patients combined with TACE,portal vein stent implantation or chemotherapy postoperative,some patients can be more prolonged survival,however,due to the small tumor thrombus and micro metastases have exist before the surgery and can not be checked out.it's difficult to clean up in the surgery,easily lead to HCC recurrence postoperative.However,with the constant awareness the PVTT formation mechanism and scientific technology progress,more and more new treatment techniques is applied to clinical.This view focuses on the portal vein tumor thrombus formation mechanisms and Classic Transcatheter Arterial Chemoembolization and new treatment methods such as:Helical tomotherapy,CIK cell therapy (cytokine-induced killer cell therapy),Chemoembolization and stent combined with iodine-125 seed.

Objective To investigate the effects of preconditioning with emulsified isoflurane(eISO)on inflammatory response to myocardial ischemia-reperfusion(I/R)injury in rats.Methods Forty SD rats of both sexes weighing 250-280 g were randomly allocated into 4 groups(n =10 each):groupⅠ sham operation(S);group Ⅱ myocardial I/R + normal saline(NS); group Ⅲ I/R + eISO and group Ⅳ I/R + 30％ intralipid(Ⅱ.)(vehicle for eISO).Myocardial ischemia was induced by occlusion of anterior descending branch of left coronary artery for 30 min followed by 180 min reperfusion.NS,30％ intralipid and elSO 2 ml/kg were infused iv over 30 min at 30 min before myocardial ischemia in groups Ⅱ,Ⅲ and Ⅳ respectively.The animals were killed at the end of 180 min repeffusion.Their hearts were removed for determination of infarct size and myocardial NF-κB p65 and ICAM-1 expression(by immuno-histochemistry)and plasma concentration of TNF-t(by radioimmunoassay).Results Myocardial I/R induced myocardial infarct and significantly increased plasina TNF-a concentration and myocardial ICAM-1 and NF-κB p65 expression in gro up Ⅱ,Ⅲ and Ⅳ as compared with'sham operation group (Ⅰ).Plasma TNF-a concentration and myocardial ICAM-1 and NF-kB p65 expression were significantly lower in group Ⅲ(eISO)than in group Ⅱ and Ⅳ.Conclusion Down-regulation of myocardial NF-kB and ICAM-1 expression and inhihition of inflammatoy response are involved in the mechanism by which preconditioning with iv elso protects against myocardial I/R injury.

ObjectiveTo explore the efficacy of large trauma craniotomy with bilateral frontal coronal incision in treating contusion and laceration of bilateral frontal lobes.MethodsThe clinical data of 68 patients with contusion and laceration of bilateral frontal lobes who were treated with bilateral decompressive craniectomy were analyzed retrospectively.There were 36 cases(observation group) treated with large trauma craniotomy with bilateral frontal coronal incision and 32 cases (control group) given bilateral decompressive craniectomy by stages.The prognosis of two groups were observed and compared.The prognosis was evaluated at 6 months after surgery by Glasgow outcome scale (GOS) score.ResultsThere were 23 cases (63.89％,23/36) who got good recovery,8 cases(22.22％,8/36) with poor prognosis and 5 dead cases (13.89％,5/36) in observation group.There were 11 cases (34.38％,11/32) who got good recovery,9 cases (28.12％,9/32) with poor prognosis and 12 dead cases (37.50％,12/32) in control group.The rate of good recovery and mortality between two groups had significant differences (P ＜ 0.05).ConclusionsThe large trauma craniotomy with bilateral frontal coronal incision can significantly relieve or ease intracranial hypertension of patients with contusion and laceration of bilateral frontal lobes.And it can improve the prognosis and decrease the mortality.

Hemophilia is a common pediatric hereditary bleeding disorder,including hemophilia A (FⅧ deficiency) and hemophilia B (FⅨ deficiency).Children with hemophilia tend to spontaneous bleeding or bleeding after minor injuries or surgery.In this review,we briefly discussed the preoperative diagnosis and classification of hemophilia,dynamic monitoring of FⅧ or FⅨ,dose of clotting factor and duration of treatment and some other perioperative issues when surgery is needed,to guide hemophilia children's surgery and postoperative rehabilitation.

Objective To investigate the protective effect of astragaloside on cardiomyocyte mitochoddria and inhibition effect on cardiomyocytes apoptosis of the rats with heart failure, and explore the treatment mechanism. Methods Sixty SD rats were randomly divided into control group, model group, astragaloside group, and trimetazidine group. The last three groups were injected subcutaneously with isoproterenol to make the heart failure model. Astragaloside group was given astragaloside 50 mg/(kg?d), and trimetazidine group was given trimetazidine 10 mg/(kg?d) orally for three consecutive weeks. At the end of the experiment, the myocardial tissue specimens of each group were made, inverted fluorescence microscope was utilized for measuring mitochondrial membrane potential (MMP), immunoblotting was utilized for detecting cardiomyocyte telomerase reverse transcriptase (TERT) expression, and flow cytometry was untilized for detecting cardiomyocyte apoptosis. Results The MMP ratio of astragaloside group was 3.226±0.371, significantly higher than the model group and trimetazidine group (P<0.01). The cardiomyocyte apoptosis rate of astragaloside group was 8.91±2.12, significantly lower than the model group and trimetazidine group (P<0.01), and the most obvious expression of TERT was found in astragaloside group. Conclusion Astragaloside can protect damaged mitochondria, promote TERT expression, inhibit cardiomyocyte apoptosis and protect cardiomyocytes.

ObjectiveTo get to know the status of health statistics postgraduate teaching and requirements during the study, and provide a basis to improve medical statistics teaching. MethodsPostgraduate students of 2008 grade of Dalian Medical University were selected randomly and filled in the self-designed questionnaire. Results52.6％ of the students considered that medical statistics was more important than other courses. 72.6％ of the students thought that medical statistics was difficult. Up to 30％of the students couldn't master and apply superior statistical analysis technique. ConclusionThe results of the survey offered basis and direction for enhancing the teaching quality and improving teaching methods.

OBJECTIVE: To evaluate three therapeutic schemes for sudden deafness with cost-effectiveness analysis for guiding rational use of drugs. METHODS:Using pharmacoeconomic cost-effectiveness analysis to evaluate 61 patients with 62ears of sudden deafness treated by Salvia Miltiorrhiza(groups A), Salvia Miltiorrhiza and cerebroprotein hydrolysate(groups B) or cerebroprotein hydrolysate(groups C) . RESULTS: The effective rates of three groups were 73.9%, 75.0% and 80.0% respectively without significant difference among them(P ＞ 0.05) . The average drug costs for one patient in three groups were 617.89 yuan, 2 651.29 yuan and 2 647.99 yuan respectively. The costs for 1% increase of effective rate in three groups were 8.36 yuan, 35.35 yuan and 33.10 yuan respectively. CONCLUSION: Salvia Miltiorrhiza scheme is the most rational one for sudden deafness.

Objective:To explore the effects of brain ischemia on the immune system and the expression of Acetyl-cholinesterase(AChE) and Caspase-3 after neuro-immunological injury.Methods:The serum IL-4,IL-10,TNF-?,IL-2 and IL-12 concentrations and AChE level in brain,thymus and spleen of the rat brain ischemia at different time spots were detected by ELISA.The active fragments of Caspase-3 P17 and P32 in brain,thymus and spleen were tested by Western blot.The expression of AChE in nerve cells was examined immunohistochemistry.The relationship between amount of AChE and concentrations of the cytokines or NK activity as well as cell apoptosis was analyzed.Results:The concentration of AChE in brain increased gradually after ischemia,the level reached peak after 12 hours,and then decreased afterward.The AChE level in thymus and spleen increased after 1 h in accordance with the ischemic brain.The NK activity,serum TNF-?,IL-2 and IL-12 levels also increased at 0.5 h,1 h and 2 h after ischemia,but the trend reversed after 3 hours.Serum IL-4 and IL-10 levels did not change significantly at 0.5 h,1 h and 2 h after ischemia,but serum IL-10 raised after 3 hours to 48 hours.Serum IL-4 level slightly increased only appearing at ischemia 12 h point.The ratio of P17/(P17+P32) became higher with ischemic time.Conclusion:Sustained rising of AChE level due to brain ischemia induces the apoptosis of cells in the brain,thymus and spleen via activation caspase-3,leading to Th1/Th2 imbalance and immune dysfunctions.

The effect of endothelin (ET-1) on the function of the isolated perfused working guinea pig has been examined. ET- 1 wasshowed to exert a transient positive inotropic effect on the isolated heart, followed by a marked inhibition of cardiac function. Low dose of ET- 1(30,90 pmol?L-1) produced reversible inhibition. The effect of high dose of ET- 1 was irreversible, accompanied with increasing LDH significantly, indomethacin markedly augmented the vasoconstrictor and cardiac ischemia effects of ET-1. Our results suggest that the apparent inhibition of cardiac function on the isolatedperfused guinea pig heart after administration of ET-1 may be due to the effect of the myocardial ischaemia caused by progressive development of coronary vasoconstriction. In our experimental model, PGI2 has partially antagonizing effect on the vasoconstrictor action of ET-1.