AIM: To assess the effect of two different suture methods on the degree of pain and corneal epithelium healing condition after pterygium excision combined with autologous conjunctival flap graft transplantation. ·METHODS: Retrospective case-series study. According to the suture method, a total of 92 patients (92 eyes) with pterygium who received treatment in the First Affiliated Hospital of Huzhou University from June 2015 to June 2016 were divided into two group. There were 48 patients ( 48 eyes) in Group A were received intermittent suture, and 44 patients ( 44 eyes ) in Group B were received continuous interlocking suture. The degree of pain after surgery were evaluated between the two groups at 2h, 1d and 1wk after surgery by visual analogue score ( VAS). The healing status of corneal epithelium were observed between the two groups at 1d and 1wk after surgery by fluorescent staining. ·RESULTS: There was no significant difference in the average pain value 2h after surgery between Group A and Group B (P>0. 05). The average pain values 1d and 1wk after surgery in Group B was lower than that in Group A respectively (P<0. 01). Mean scores of corneal epithelium healing condition at 1wk were significantly better in Group B than in Group A (0. 54 ± 0. 32 vs 0. 86 ± 0. 34, P<0. 05), while not significantly different at 1d after the surgery (4. 04±1. 46 vs 4. 30±1. 42, P>0. 05). · CONCLUSION: Compared to intermittent suture, continuous interlocking suture can release pain response after pterygium excision combined with autologous conjunctival flap graft transplantation and promote the healing status of corneal epithelium.

Objective To evaluate the value of MRI in diagnosing the premature closure and other deformities of the growth plate followed physeal injury. Methods Twenty-one children with suspected or known premature closure of the growth plate followed injury were examined with X-ray and MRI. In addition to conventional T 1WI and T 2WI for all cases, 8 were also examined with spectral pre-saturation inversion recovery sequence. The value of MRI in diagnosing and imaging the premature closure of the growth plate (PCGP) was analyzed. Results PCGP was seen in all 21 cases, 6 in the distal femur, 6 in the proximal tibia, and 9 in the distal tibia. 19 patients with angular deformities and 2 cases with both angular and shorten deformities. MRI can much more clearly visualize the cartilage of the growth plate than conventional X-ray. A stripe of low signal intensity through the cartilage of the growth plate indicated premature closure of the growth plate. 8 cases with spectral pre-saturation inversion recovery sequence can visualize the PCGP more clearly than with Spin Echo and Fast Field Echo. Conclusion MRI has an important role in diagnosing and visualizing the PCGP. The configuraton of the PCGP can be accurately mapped with MR imaging and treatment planning is facilitated.

Objective To simulate the hemodynamic feature in cerebral bridging veins (BVs), in order to provide a morphologic basis for the pathogenesis explanation and imaging diagnosis of cerebral venous thrombosis (CVT). MethodsTotally 6 human cadavers (12 sides) were examined in this study. Each head of the cadavers was injected with blue-coloured latex via the superior sagittal sinus (SSS) and internal jugular veins. The diamter and the angle of BVs entering SSS were measured. Based on the data of cadavers and computational fluid dynamics software pack, the hemodynamic models were established. The wall shear stress (WSS) was carefully studied and compared between different models. Results The total of 137 BVs formed two clusters along the SSS: anterior group and posterior group. Compared with anterior group BVs, the diameter of posterior group BVs was large, and the angle was smaller. In 137 models,when the diameter of a BV was more than 1.2mm, and the angle was between 65 and 105 degree, the local WSS decreased in the downstream wall of SSS. When the diameter of a BV was more than 1.2mm, and the angle was less than 65 degree, the local WSS decreased in the downstream wall of SSS and the upstream wall of BVs. The minimum WSS in BVs was 63% of the minimum WSS in SSS. Compared with the anterior group BVs, the minimum WSS in the wall of posterior group BVs was samller, and the distance from the minimum WSS to the dural entrance was longer. Conclusion CVT occurs easily when the diamter of a BV is more than 1.2mm and the angle is less than 65 degree. The embolus forms early in the upstream wall of BVs entering the posterior part of SSS.

Objective To study the relationship of surgical procedures with clinical effect in herniat-ed lumbar disc in order to improve operative methods and obtain a better outcome.Methods Retrospec-tive analysis was carried out in7235patients with herniated lumbar disc,who had been operated by removal of nucleus pulposus using small incision and fenestration in our hospital since1983,313cases of whom re-ceived second operation because of postoperative complications.There were187males and126females aging from27to62years(mean,45.8years),the incidence of morbidity was4.32%.During the same period,552patients,who had less approved operative result primarily treated in other hospitals,were admitted to our hospital.There were317males and235females aging from31to64years(mean,46.0years).Results The postoperative complications could be divided into short term(within1month after operation)and mid-dle to long term(more than1month after operation)groups.The total446cases with short term compli-cation were133cases primarily treated in our hospital and313cases in other hospital,including of re-herni a-tion or incomplete nuclear extirpation in77treated with second operation,discitis in106treated with con-servative therapy for 67and second operative management for 39,canal hematoma compression in76treated surgi cally,multi-level herniation and leakage in21and mislocalization in59re-operated,injury of nerve root or cauda equina in85treated with nerve exploration,release and anastomosis,residual materials in canal in17with removal of foreign body,venous thrombus in2,and arachnoiditis in3.The total424cases with middle to long term complications were185cases primarily treated in our hospital and239cases in other hospitals,including of nerve root adhesion in159,recurred disc herniation in122,segmental instability in81,and ia-trogenic spinal stenosis in62.Conclusion Many factors may influence the outcome of herniated lum bar disc which can be abolished by sufficient preparation,careful operation and proper managememt.

Objective To observe the intervention effect of electro-acupuncture(EA) on mammalian target of rapamycin(mTOR) expression in hypoxic-ischemic encephalopathy(HIE) newborn rats. Methods Seven-day-old SD rats were randomly assigned into 3 groups, namely sham-surgery group, HIE model group, and EA group. All of the groups were subdivided into 4 subgroups in terms of 4 time periods of 1, 3, 7 and 21 day(s). Hematoxylin-eosin staining was used for the observation of histological changes in the affected cerebral region. Expression levels of cerebral mTOR were detected with Western blotting method. Results The results of HE staining showed that EA group at experimental day 21 had clear organizational structure, ordered arrangement of neurons, relieved cellular swelling, well cell integrity with clear nucleolus and proliferative glial cells. Compared with the sham-surgery group, mTOR level of the model group was dramatically increased on the 1st, 3rd, 7th and 21st day(P<0.05), and the mTOR expression level of EA group was significantly higher than that in the model group at the above time points (P < 0.05). Conclusion EA can promote mTOR expression in brain tissue and can protect the brain of newborn rats from HIE.

Objective To investigate the value and clinical significance of congenital heart diseases (CHD)detection in twins.Methods A total of 1103 twins were included in this study(127 twins were at high risk for CHD).The fetal hearts were scanned by ultrasound using Yagel's heart examination method. Autopsies were done when the pregnancy was terminated.And blood samples from fetal hearts or umbilical veins were used to evaluate fetal chromosomes.A close follow-up was conducted for normal heart cases and another heart examination was done within three months after birth.Results(1)12 twins(1.09%,12/ 1103)had CHD.Among them,4 cases were from the high risk for CHD group(33.3%,4/12),and 8 cases(66.7%,8/12)were from the low risk pregnancy group.(2)Two twins suffered from the same CHD (one pair were both TOF,and the other pair were both rhabdomyoma).One pair of twins had different abnormalities(one baby was TOF,and the other was duodenal atresia with a normal heart).All three pairs of twins chose termination and autopsies were conducted.Unanimous conclusions between prenatal ultrasound and autopsy were obtained.Nine twins were CHD in one baby and a normal heart in the other baby.Seven of them had the same conclusion after delivery.(3)Two twins with CHD were found with fetal abnormal chromosome.(4)1091 cases were not found having any abnormality,however,one fetus from one twin pair was diagnosed with ventricular septal defect(VSD)with abnormal chromosome after birth,and one fetus from another twin pair had patency of ductus arteriosus after birth.(5)The sensitivity of Yagel's heart examination was 82.4% and specificity was 100% in twins.Conclusion Yagel's heart examination is an effective and time-saving method to scan fetal hearts in twins.

In order to further study mouse embryonic stem cells(ES cells),lentiviral vector PLL-IRES-Nanog-Neo was constructed.Mouse ES cells overexpressed nanog by mediation of lentiviral were cultured on mouse fetal fibroblast feeders after 2 weeks under G418 media and examined according to gowth characteristics. Results were showed that 918 bp nanog fragments were expressed in mouse ES cells mediated by lentiviral vector PLL-IRES-Nanog-Neo,mouse nanog-ES cells were taken on mass-like image and positve with alkaline phosphatase staining and Oct4 and SSEA1 immunocytochemistry under no LIF condition in the media. It is concluded that mouse ES cells Elevated nanog gene expression by mediation of lentiviral were constucted and cultured.

Objective To explore the clinical characteristics of neonatal congenital cystic lung lesions. Methods Between January 2008 and June 2014,total 28 cases diagnosed congenital cystic lung lesions in neonatal center of Guangzhou Women and Children's Hospital were collected.The clinical data were analyzed including manifestations,lesion characteristics,imaging,diagnosis,treatment and prognosis,and the related literature were reviewed.Results There were 20 male and 8 female,16 cases of lobar emphysema,7 cases of pulmonary seques-tration,4 cases of congenital cystic adenomatoid malformation and 1 case of bronchogenic cyst.Main symptoms were dyspnea(78.57%),cyanosis (39.29%),wheezing cough (17.86%),feeding difficulties (14.29%),fever (10.71%),asymptomatic(21.43%).Two cases combined with congenital heart disease,4 cases combined with other malformations(such as diaphragmatic hernia,laryngeal stridor,funnel chest,polycystic kidney).There were lesions in chest CT image,4 cases underwent lobectomy,other cases underwent conservative treatment.Seventeen cases got better and discharge,3 cases dead.Conclusion The most common type of congenital cystic lung lesions in neonate is lobar emphysema.Main manifestations are dyspnea,cyanosis.If we suspect congenital cyst-ic lung lesions,we should do chest CT or MRI scan soon ,also do echocardiography and ultrasound to exclude other malformations.The treatment effect is satisfactory,and the outcome need long time to follow up.

Objective To explore the optimal cut-off points of body mass index(BMI),percentage of body fat(PBF) and body fat mass index(BFMI) for identification of cardiovascular risk factors clustering among elderly males. MethodsThe data of physical examinations from 1 052 Shanghai elderly males in 2007 were collected.The relationship between cardiovascular risk factors clustering and different strata of BMI,PBF and BFMI was analyzed.Receiver Operator Characteristic(ROC) curve analysis was employed to determine the optimal cut-points for identification of cardiovascular risk factors clustering,and area under curve(AUC) was worked out.The population attributable risk proportion(PARP) of risk factors clustering was calculated. Results Odds ratios of risk factors clustering tended to increase with BMI,PBF and BFMI.BMI≥24 kg/m2,PBF≥21% and BFMI≥5 kg/m2 were the cut-off points that had approximate sensitivity and specificity,and/or had the shortest distance in ROC curve.AUC of all the three indexes was larger than 0.5.Analysis of PARP indicated that BMI under 24 kg/m2,PBF under 21% and BFMI under 5 kg/m2 could prevent 27.1%,37.44% and 36.63% risk factors clustering,respectively. Conclusion BMI≥24 kg/m2,PBF≥21% and BFMI≥5 kg/m2 can well reflect the cardiovascular risk factors clustering among elderly males.

Objective To evaluate the long term clinical effect of porcelain laminate veneer esthetic restoration for fluorosis teeth. Methods One hundred and thirty-two fluorosis teeth of 11 patients were restored with porcelain laminate veneer for esthetic purpose and the clinical effects were evaluated with modified Rygescriteria at 1.0 week, 0.5-year, 1.0-year, 1.5-year, and 2.0-year recalled time. Results After 2.0 years application, none of the veneers debonded, "A" degree rate of marginal adaptation was more than 85%, "A" degree rate of cavosurface marginal discoloration was more than 90%, "A" degree rate of secondary caries was more than 99%, "A" degree rate of post-operative sensitivity was more than 75%, and "A" degree rate of color match was more than 70%, "B" degree rate of color match was 100%. Conclusions The research indicates that the porcelain laminate veneer is a good esthetic restoration method for fluorosis teeth and the long term clinical effect is stable.