We reported a case of a work-related accident involving periorbital and intraorbital metal foreign bodies. The patient was a 43-year-old woman whose nasal dorsum was struck while she was sawing wood with nails. X-ray plain films of skull bone and computed tomographic scan of nasal sinus revealed two 5-mm-long metal objects lodged in right lacrimal sac and medial bulbar space of the right orbit. No deficits were noted in her visual acuities, visual fields, and ocular movements. Based on accurate positioning by imaging examination, transnasal endoscopic removal of metal foreign bodies was successfully accomplished. The patient recovered well without any complications after surgery.
Adult ; Endoscopy ; Female ; Foreign Bodies ; Humans ; Nasolacrimal Duct ; Nose ; Orbit ; Paranasal Sinuses ; Skull

Drug Interactions ; Humans ; Proton Pump Inhibitors ; pharmacology ; Ticlopidine ; analogs & derivatives ; pharmacology

Objective To observe the analgesic efficacy of epidural morphine for postpartum perineal pain in patients undergoing episiotomy.Methods After institutional reviewing board approval and patient consent,a total of 145 parturients requesting epidural labor analgesia and under-going episiotomy were randomized into three groups:M1,M2,and C,where in morphine 1 mg dis-solved in saline 10 ml,morphine 2 mg dissolved in saline 10 ml,or sole saline 10 ml was epidurally given immediately after umbilical cord clamp,respectively.Perineal pain at rest and movement within 24 hours after vaginal delivery were evaluated with present pain intensity (PPI).Further,the time in-terval between a moderate or severe PPI and epidural drug treatment were recorded.Besides,epidural morphine related side effects including nausea,vomiting,pruritus,and urinary retention were ob-served as well.Results The proportion of patients with moderate or severe pain at rest was signifi-cantly lower in group M2 (2.1%)compared to group M1 (15.7)and group C (19.1%)(P <0.05). Further,the time interval between a moderate or severe PPI and epidural drug treatment was signifi-cantly longer in group M2 (15.7±1.4 h)compared to group M1 (11.0±0.9 h)and group C (11.0 ±1.0 h)(P <0.05).No significant difference was found between groups M1 and group C with regard to morphine efficacy.However,the accumulated side effects including nausea,vomiting,pruritus, and urinary retention prominently increased in group M2 (102.1%)compared to group M1 (43.1%) and group C (12.8%)(P <0.05).Conclusion Although epidural morphine 2 mg may significantly decrease and postpone the occurrence of moderate or severe postpartum perineal pain,however,it de-serves consideration before clinical use owing to the increased side effects.

Objective To investigate the efficacy and feasibility of extra-peritoneal larparoscopic radical prostatectomy (eLRP) in the treatment of patients with high-risk prostate cancer (HRPC).Methods From February 2009 to December 2013,121 patients,who were diagnosed as HRPC according to the D'Amico definition,were received eLRP.The mean age was 70 years old (range 54 ～ 82 years old).The mean PSA level was 25.45 (range 2.40 ～ 111.31) μg/L and mean Gleason score was 8 (range 6 ～ 10).The classification of clinic stage in this study included 52 cases in cT1-cT2b,58 cases in cT2c,8 cases in cT3a,and 3 cases incT3b,respectively.The perioperative data were collected,including operative time,blood loss,intraoperative complications,urine leakage,lymph leakage,incontinent ability,erectile function and changing of PSA level.Results All the operations were successfully performed.The mean operative time was 165 minutes (range 105 ～341min),the average blood loss was 150 ml(range 50 ～ 1500ml).The intraoperative complications included hemorrhage in 4 cases and intra-operative obturator nerve injury in 3 cases.The mean duration of intestinal function recovery was 35h (range 24 ～72h) The mean interval of catheter indwelling was 9 days (range 7 ～14 days).The anastomotic leakage was found in 12 cases,including 1 day after surgery in 5 cases,2 days after surgery in 3 cases,3 days after surgery in 2 cases,4 day after surgery in 1 case and 5 day after surgery in 1 case.The anastomotic stricture in 3 cases within 2 to 4 months after operation,which the symptom improved after urethral dilation in 2 cases and urethrotomy in 1 case.Deep vein thrombosis was noticed in 1 case 5 days after the procedure.And lymphatic fistula was recorded in 1 case after the operation.Positive surgical margin,seminal vesicle invasion,and positive iliac vessel lymph node were found in 18,21,and 9 patients,respectively.The mean hospitalization duration was 10 days (range 5 ～ 22 d).Of the 107 patients followed-up,Ninety-six patients were continent in 1 year,except other 11 patients.Nerve sparing procedure was performed in 51 patients,and thirty-three of them were potent.The mean PSA level was 0.14 μg/L (range 0 ～8.75 μg/L) six weeks after the surgey.Fourty-eight patients had biochemical recurrence with 5 ～36 months followed-up,mean 18 months.Conclusions Extraperitoneal LRP is an efficacious approach for patients with high-risk prostate cancer.

Around the world, the supply of health services faces challenges, especially in developing nations that suffer from inadequate infrastructure and aging equipment, frequent shortages of medicine and supplies, and low capacity and efficiency of primary health care. At present, more and more governments adopt public-private partner-ships to achieve public policy goals. Among those, Brazil, South Africa, and India have made greater achievements in changing the roles of local government, increasing the supply of primary health care and health care quality, pro-moting health care equality, meeting the needs of multi-level medical services, and promoting health capabilities by using public-private partnerships. This paper provides an overview of public-private partnership practices in the three countries, discusses their reform experiences, and concludes with implications which may be helpful for promoting and scaling up PPP in primary health care in China.

Objective To investigate the correlation between EEG severity and secondary epilepsy in elderly patients with cerebral infarction.Methods 128 cases with cerebral infarction were selected as the research subjects. According to whether the patients happened secondary epilepsy,they were divided into the observation group (65 cases) and the control group (63 cases).The difference of EEG severity between the two groups was compared,and its correlation with secondary epilepsy was analyzed.Results There were 18 cases (27.69%)in the observation group graded as moderate differences,which was significantly higher than that in the control group of 12 cases (19.05%), the difference was statistically significant (χ2 =4.43,P =0.04).There were 23 cases (35.38%)in the observation group graded as severe differences,which was significantly higher than that in the control group of 9 cases (13.85%),the difference was statistically significant (χ2 =6.51,P =0.01 ).There were 21 cases(32.31%)of EEG changes of observation group being only diffuse abnormalities forms,which was significantly higher than that of the control group of 11 cases(17.46%),the difference was statistically significant (χ2 =4.18,P =0.04).There were 28 cases(43.08%)of EEG changes of the observation group being both focal abnormalities and diffuse abnor-malities forms,which was significantly higher than that of the control group of 14 cases(22.22%),the difference was statistically significant (χ2 =5.40,P =0.02).Compared open -closed test,hyperventilation provocation test results of the observation group being abnormal or not fit with the control group,the difference was not statistically significant (P >0.05).Conclusion According to the classification of EEG,EEG changes and EEG related tests to determine the severity of EEG.The more severe EEG,the greater the possibility of secondary epilepsy happen in patients with cerebral infarction.

Background and purpose:Visceral pleural invasion (VPI) and vessel invasion (VI) are poor prognostic factors in patients with non-small cell lung cancer (NSCLC). The primary initial recurrence site may be local recurrence in VPI and distant metastasis in VI. The purpose of this study was to validate the prognostic impact and effect of the initial recurrence site of VPI and VI on survival outcomes for NSCLC.Methods:Two hundred and ninety patients who were diagnosed as having NSCLC and underwent lobectomy between Jan. 2007 and Dec. 2013 were retrospectively analyzed. VPI was identiifed in 51 patients as VPI group, the other 239 patients without VPI as non-VPI group. VI was identiifed in 29 patients as VI group, the other 261 patients without VI as non-VI group. Clinical characteristics, overall survival (OS), disease-free survival (DFS) were compared.Results:There were statistically signiifcant differences between VPI group and non-VPI group in tumor size, lymph node metastasis, TNM stage and initial recurrence site (P<0.05). Furthermore, there were statistically signiifcant differences between VI group and non-VI group in lymph node metastasis and TNM stage (P<0.05). The 1-, 3- and 5-year OS rates in VPI group (88.2%, 56.7% and 52.7%) were lower than those in non-VPI group (95.8%, 83.7% and 74.0%,P<0.001). The 1-, 3- and 5-year OS rates in VI group (79.3%, 56.8% and 48.7%) were lower than those in non-VI group (96.1%, 81.3% and
72.3%,P=0.001). Cox regression showed TNM stage was a significant prognostic factor for DFS, whereas lymph node metastasis and VPI were signiifcant prognostic factors in patients with NSCLC.Conclusion:The primary initial recurrence site in VPI patients is local recurrence. Patients with VPI or VI may need more postoperative therapy because of their poor prognosis.

Indirect fluorescent antibody test (IFAT) using frozen sections of Brugia malayi adult worms as antigen was employed in the diagnosis and epidemiological investigation of human filariasis. Sera were collected from 704 cases with bancroftian or malayan microfilaremia. the positive rate was 92.8-99.1%. Of 150 healthy people from non-endemic areas, only one showed a positive reaction (false positive rate 0.7%) (Table 1). This technique proved to be highly sensitive and specific for the diagnosis of filariasis and the antigen is easy to prepare. It might be used in sero-epidemiological investigation for the assessment of filariasis control.

Objective Pathogen and antimicrobial susceptibility in children with bacterial meningitis were reviewed.Methods The positive cultures of cerebrospinal fluid samples or blood samples and its antimicrobial susceptibility were analyzed in 401 patients with the clinical diagnosis of bacterial meningitis.Results 401 cases cerebrospinal fluid samples and blood samples submitted to microbiology laboratory, 97 cases (24%) were microscopically and culturally proven to be bacterial meningitis. The most frequent pathogen was staphylococcus aureus (28%), followed by the streptococcus pneumoniae (19%) and escherichia coli (13%). Pediococci as conditioned pathogen, were found in purulent meningitis patients. One of the isolates of Staphylococcus aureus was simultaneously resistant to both vancomycin and teicoplanin. Three isolates showed simultaneous resistance to imipenem/cilastatin.Conclusions Staphylococcus aureus as the predominant pathogens of pediatric ranks first among pediatric patients of purulent meningitis. Serious drug resistance of isolated pathogenic bacteria and its in antimicrobial susceptibility in the bacterial meningitis should be considered in clinical therapy.

Objective To investigate the inhibitive effect of shRNA (short hairpin RNA) targeting APRIL gene on the pancreatic cancer cells in vitro and in vivo, in order to explore the feasibility of gene therapy for pancreatic cancer. Methods The LV-shAPRIL targeting APRIL gene had been constructed before, and was used to infect the CFPAC-1 cells. Cell proliferation and apoptosis were examined by MTT and flow cytometry. Then CFPAC-1 cells were used to construct the model of transplantation tumor into the nude mice, the tumor growth was assessed after LV-shAPRIL treatment. Results 96 hours after the LV-shAPRIL infection into CFPAC-1 cells, the cell proliferation was significantly inhibited when compared with control group and lentivirus infection group (P＜0.05 ). Flow cytometry showed the apoptosis ratio of the CFPAC-1 cells was (17.35±0.96)% in LV-shAPRIL group, which was higher than that in control group and lentivirus infection group (P＜0.05 ). After LV-shAPRIL injection into the model of nude mice, the tumor growth was slower than that in the two control groups. The tumor's volume of the LV-shAPRIL group was(821.8±123.3) mm3 and the mass was (2.16±0.18)g at 27 day, and were obviously depressed, when compared with two control groups (P±0.05). Conclusions LV-shAPRIL targeting APRIL gene can inhibit the growth of the CFPAC-1 cells in vitro and vivo. This may provide a new gene therapy approach for pancreatic cancer.