Background Suprachoroidal hemorrhage (SCH)is a rare but devastating complication of ophthalmic surgery,and it is crucial to be aware of the risk factors and select effective treatment. Objective Present study was to assess the treatment and risk factors of SCH induced by intraocular surgery. Methods Retrospective case series were carried out to investigate the clinical data of 15 eyes from 15 patients with SCH at Peking Union Medical College Hospital.The risk factors of SCH were analyzed.Written informed consent was obtained before any medical examination and treatment.SCH was occurred in 10 eyes during intraocular surgery,while the SCH was diagnosed in other 5 eyes 1-3 days after operation.Surgical drainage was carried out in 8 eyes,of which 3 eyes combined with vitrectomy besides surgical drainage and other 5 eyes were treated with medication alone.Results SCH was completely removed and absorbed in 12 eyes.The visual acuity was improved in 6 eyes,unchanged in 6 eyes and decreased in 3 eyes.Nine eyes complicated with retinal detachment and reattached in 6 eyes after treatment.Seven eyes combined with hypermyopia,6 eyes combined with glaucoma,and 1 eye was aphakia.Four patients combined with hypertension,and 2 patients had diabetes mellitus. Conclusions SCH induced by intraocular surgery develops rapidly and violently,and it can result in vision loss without effective treatment.Suturing surgical incision immediately,applying hypertonic agents and sclerotomy drainage are the urgent approaches to treat SCH.Medicines and/or sclerotomy could be optional according to the amount of bleeding and other ocular complication.The risk factors of SCH include myopia,glaucoma and the instantly dropping of intraocular pressure.

Adult ; Aged ; Dermis ; transplantation ; Female ; Humans ; Male ; Middle Aged ; Mouth Mucosa ; pathology ; Reconstructive Surgical Procedures ; methods ; Wound Healing

Objective To investigate the value of DNA-image cyt-ometry (DNA-ICM) in the diagnosis of urothelial cell carcinomas (UCC). Methods Totally 162 voided urine specimens (92 cases from urothel-ial car-cinomas patients and 70 cases from benign urinary system diseases patients ) were detected with DNA-ICM and liquid-based cytology (LBC), respectively. Results The sensitivity and specificity of DNA-ICM were 65.2%and 100% respectively in the diagnosis of UCC but those of LBC were 27.2% and 98.6%, respectively. The sensitivity of DNA-ICM was significantly higher than that of LBC in the diagnosis of UCC (P < 0.01). The sen-sitivity of DNA-ICM in upper urinary tract urothelial cell carcinomas (UTUC) were 77.1%, which was much higher than that in bladder urothelial cell carcinomas (57.9%) but no statistical significance was found (P >0.01). Conclusion DNA-ICM, which improves the positive rate of urinary cytology, has great application value in the diagnosis of urothelial cell carcinomas and it is an effective screening method for urothelial cancer in diag-nosis and follow-up.

Objective To investigate the effects of neurolytic celiac plexus block(NCPB) on stress response during the early stage of partial hepatectomy(PH) postoperation in rats.Methods Thirty healthy SPF-grade male Sprague-Dawley rats were randomly divided into control group and NCPB group,and then were constructed the 70％ PH model.NCPB group received NCPB with 0.5 ％ lidocaine before closing abdominal,and control group received the same procedures,but 0.9％ physiological saline was injected instead of 0.5 ％ lidocaine.The serum concentration of CRP,GC,ACTH,NA and AD,and the levels of serum TNF-α and IL-1β were determined at 6 hours,12 hours and 24 hours after PH.The western blot assay was performed to examine the expression of GR in the peripheral blood mononuclear cells (PBMCs).Results The obvious stress response was produced within 24 hours after PH in rats,postoperative serum CRP,GC,ACTH,NA and AD concentrations increased in the different extent,but the NCPB group were significantly lower than those in the control group in the corresponding time point (P ＜0.01 or P ＜0.05).The expression levels of GR in PBMCs in the control group were significantly decreased after PH,and markedly lower than those in the NCPB group in the corresponding time point(P ＜ 0.01).The serum TNF-o and IL-1β levels were gradually increased in the control group and NCPB group within 24 hours after PH.But at the respective time points,the levels in the NCPB group were significantly lower than those in control group(P ＜ 0.01 or P ＜ 0.05).Conclusion Intraoperation NCPB can effectively inhibit postoperative stress response at the early stage after PH,and thereby help to reduce the degree of systemic inflammatory response.

0. 05), and there seemed to have some statistical correlation between the incidence of Eales disease and PPD (P

Objective To investigate the peripheral blood Th17 and CD4 + CD25 + regulatory T cell levels and their correlations in patients with primary hepatocellular carcinoma (PHC).Methods Peripheral blood samples were collected from 30 PHC patients and 25 healthy controls in the First Affiliated Hospital of Zhejiang University from June 2008 to May 2009.Mononuclear cells were isolated and the Th17 and CD4 + CD25 + regulatory T cells were detected by flow cytometry and compared between patients and controls by t test.Spearman test was performed to analyze the correlation of Th17 with CD4 + CD25 +regulatory T cell concentrations.Results The levels of Th17 and CD4 + CD25 + regulatory T cells in peripheral blood in healthy controls were (2.10 ± 0.87) ％ and (7.10 ± 2.32) ％ ; while those in PHC patients were (3.38±1.68)％ and (11.78±5.62)％ (t=3.640 and 4.162,P＜0.01).The level of Th17 cells was positively associated with that of CD4 + CD25 + regulatory T cells in PHC patients (r =0.821,P ＜0.01).Conclusion The levels of Th17 and CD4 + CD25 + regulatory T cells in peripheral blood are high in PHC patients and positively correlated with each other,which indicates that CD4 + CD25 + regulatory T cells may contribute to the disease progression and pathogenesis of carcinoma through inducing Th17 cells differentiation.

Objective To evaluate the incidence and imaging features of tibial plateau fracture combined with dislocation.Methods A total of 298 patients with intact imaging data treated for tibial plateau fracture from December 2012 to June 2014 were analyzed retrospcctively.Tilt angle of medial fragment fracture line,ratio of width of medial fragment to total plateau,surface area percentage,fragment height,and major displacement were measured on CT images using picture archiving and communication system (PACS).Results Eighteen patients (6.0％) had tibial plateau fractures combined with dislocation,with tilt angle of medial or posteromedial fragment fracture line of (62.1 ± 14.1)°.Eleven patients (61％) had split of the medial tibial plateau with surface area percentage of (46.3 ± 2.5) ％,fragment height of (43.9 ± 6.2) mm,and major displacement of (5.3 ± 2.1) mm.Seven patients (39％) had posteromedial fragment fracture with surface area percentage of (25.1 ± 5.7) ％,fragment height of (40.0 ± 10.1) mm,and major displacement of (4.8 ± 6.45) mm.Conclusions Fracture line of fracture-dislocation tibial plateau fracture is much often through the eminence or located at the lateral eminence with large medial or posteromedial fragments.Surgical approaches and directions of nailing should be considered properly according to the morphological characteristics.

Objective To genotype Yersinia pestis and explore intrinsic relationship among different ecotypes of Yersinia pestis in Yunnan foci.Methods A total of 171 strains from three types of Yersinia pestis,house mouse,wild-type mouse and Yulong Yersinia pestis,were tested.Twenty-three different regions (DFR) were used to genotype and cluster analysis was performed using BioNumerics 5.0.Results A total of 171 Yersinia pestis were divided into 7 genotypes by 23 DFRs,which were Genomovar5,Genomovar7,Genomovar9 and 4 newly discovered genotypes.The genotypes of all Yulong plague were Genomovar5.The genotypes of the 16 strains of wild-type mouse plague (the highland of northwestern Yunnan Province type) were divided to 3 genotypes,13 of them were Genomovar 7,2 of them were Genomovar9,and 1 of them was newly discovered genotype Genomovaryn1.The genotypes of the 148 strains of house mouse plague(the residential area of Yunnan and Fujian Provinces type) were divided into 4 genotypes,145 of them were Genomovar9,and 3 of them were newly discovered including Genomovar-yn2,-yn3 and-yn4.The ecological typing results of clustering showed genotype of Yulong plague was similar to the highland of northwestern Yunnan Province type(wild-type mouse plague),and the percentage of similarity was up to 87.20％,but only up to 73.75％ to the residential area of Yunnan and Fujian Provinces type (house mouse plague).The genotypes of 2 wild-type strains of the highland of northwestern Yunnan Province type(wild-type mouse) and main genotypes of the residential area of Yunnan and Fujian Provinces type(house mouse)were Genomovar 9.The genotype of Genomovar-yn 1 of the highland of northwestern Yunnan Province type was similar to Genomovar 7,but lack of DFR 11.The genotypes of Genomovar-yn2,-yn3 and-yn4 of the residential area of Yunnan and Fujian Provinces type were similar to Genomovar 9,but lack of DFR 10,DFR 9 and DFR 11,respectively.Conclusions One newly genotype strain is found in wild-type mouse plague and 3 newly genotype strains are founded in house mouse plague.Wild-type mouse strains are founded in the house mouse strains.The similarity of genotype between Yulong plague and the highland of northwestern Yunnan Province type (wild-type mouse plague) is high while the similarity between Yulong plague and the residential area of Yunnan and Fujian Provinces type(house mouse plague) is low.

Objective To observe the effects of recombinant human bone morphogenetic protein-2 (rhBMP-2) on patients with type A thoracolumbar fractures treated by pedicle screw fixation via dorsal-approach and vertebral body bone graft.Methods A retrospective case-control study was conducted to analyze the clinical data of 64 patients with type A thoracolumbar fractures treated from June 2012 to July 2015.The patients were divided into control group (32 cases) and research group (32 cases) according to the random number table.There were 22 males and 10 females aged (48.2 ± 11.2)years old in control group.The injury was located at T11 in 2 cases,T12 in 4,L1 in 9,L2 in 7,L3 in 7 and L4 in 3 in control group.There were 24 males and 8 females aged (50.7 ± 11.4) years old in research group.The injury was located at T11in 2 cases,T12in 4,L1in 8,L2 in 8,L3 in 7 and L4 in 3.The control group was treated with posterior pedicle screw reduction,internal fixation and allograft cancellous bone grafting through pedicle of vertebral arch.The research group was treated with rhBMP-2 (mixed with cancellous bone implants) on the basis of the control group.The time of operation,the amount of bleeding during operation,the volume of postoperative bleeding,the amount of postoperative drainage,the recovery of the injured vertebra,the Lane-Sandhu score,the time of fracture healing,and the postoperative complications were compared.Results There was no difference between two groups on operation time,amount of bleeding during operation or amount of postoperative drainage (P ＞ 0.05).No difference existed in two groups about Cobb angle and injured vertebral leading edge height at one week after operation (P ＞ 0.05).At the time of last follow-up (12 months),in research group,Cobb angle was lower while injured vertebral leading edge height was much higher than that of control group (P ＜ 0.05),both of which were better than before (P ＜ 0.05).At 12 months after surgery,the lost Cobb angle of [(2.0 ± 0.7) °] and lost height of injured vertebral leading edge [(3.2 ± 1.0) ％] were smaller than those in control group [(5.6 ± 1.7) ° and (6.8 ± 2.4) ％ respectively] (P ＜ 0.05).The Lane-Sandhu score and healing time of fracture in research group were (8.9 ± 0.8) points and (6.9 ± 0.9) months,which were better than that (6.8 ±0.8)points and (8.4 ± 1.6)months in control group respectively (P＜0.05).The complication rate of research group was lower than that of control group,with no significant difference (P ＞ 0.05).Conclusion Compared with simple vertebral bone graft,posterior thoracolumbar vertebrae pedicle screw fixation with vertebral bone graft and hBMP-2 treatment for type A thoracolumbar fractures can restore vertebral stability,shorten the time of fracture healing and reduce the incidence of complications.

Objective To evaluate the feasibility of histogram analysis of susceptible signal intensity in differentiating papillary (pRCC) from chromophobe renal cell carcinoma(ChRCC). Methods Thirteen cases with pRCC and 9 cases with ChRCC, who underwent susceptible-weighted imaging(SWI), MR common scanning and enhancement, were assessed retrospectively. The histogram parameters of susceptible signal intensity were measured, including maximum, minimum, mean, median, skewness and kurtosis. The independent samples t test(normal distribution) and Mann-Whitney rank sum test(skewed distribution) were used to compare the differences in SWI parameters between pRCCs and ChRCCs. Receiver operating characteristic curve was used to evaluate the efficiency of the whole-tumor SWI parameters in differentiating pRCCs from ChRCCs. Results The significant differences of the minimum, mean, median and skewness between pRCCs and ChRCCs were present(P<0.05), and there was no significant differences in maximum and kurtosis between between pRCCs and ChRCCs(P>0.05). In all the histogram parameters, the area of ROC curve of mean value was largest(0.80). The sensitivity of minimum value (84.62％) was the highest and and the specificity of skewness(100.00％) was the highest. Conclusion Histogram analysis of susceptible signal intensity can help differentiate pRCCs from ChRCCs.