Vogt-Koyanagi-Harada (VKH)syndrome is an autoimmune disease attacking against pigmented cells, resulting in blindness and usually affecting multiple organs including ears, meninges, hair and skin.Correct diagnosis and immediate treatment in the early stage is vital to visual prognosis.Currently, corticosteroids is first-line drug.In addition, VKH patients refractory to corticosteroids can choose other treatment such as immunosuppressive agents and biological agents.

Basic research program is essential to the investigation of the pathogenesis of ocular diseases and the development of novel strategies for the prevention and treatment for these diseases. With increasing support of research grants at various levels, basic research in ophthalmology has gained great achievement in China in recent years. A number of studies have recently been published in well known peer-review international journals and won the State Scientific and Technological Progress Awards. However, we have to keep it in mind that basic research in ophthalmology should be improved qualitatively meanwhile, the imbalance in basic study among different areas needs to be resolved in the near future.

?Acute retinal necrosis syndrome ( ARN) is a serious eye disease, which caused by Herpes virus mostly, with unknown pathogenesis. Because of the aggressive progression, treatment of ARN is difficult, and the blindness rate is extremely high. Current treatment strategies are the combination of the drug therapy and the operative treatment. Drugs commonly used are antiviral drugs, glucocorticoids, and antiplatelet drugs, and the operative treatment includes laser photocoagulation and vitrectomy.

ObjectiveTo evaluate the safety,therapeutic effect and complications of the operation of multi-section osteotomy and intramedullary fixation for children with osteogenesis impeffecta.Methods One hundred and twenty-three children with osteogenesis imperfecta,including 85 males and 39 females,were selected from August 2005 to August 2008.According to the modified Sillence classification,45 cases was in type Ⅲ,74 in type Ⅳ,and 5 in type Ⅴ.Patients' age was ranging from 2 years and 1 month to 15 years and 7 months (mean,8 years and 3 months).The location of osteotomy was established according to the pre-operative measurement of X-ray image,and all the procedures of osteotomy were completed under direct vision.Then we chose the intramedullary pin with suitable size and insert the pin into femur from greater trochanter,and tibia from pelma.After the surgery,external fixation (spica cast for the femur,long leg plaster cast for the tibia) was made for further stabilization.Plaster supporters were removed 6 weeks later and all children began to stand and walk under the protection of orthoses.In addition,all patients received the treatment of pamidronate disodium periodically.ResultsAll 123 children were followed up for an average of 38months (range,13-64 months).Parents of all children were satisfied with the result of surgical operation,and the children's self-care and motion ability improved obviously.Fourteen children were performed the second operation due to the translocation of Rush pin,and 25 children changed the internal fixation because of the shorter Rush pin 2 years postoperatively.Bone delayed union was not found in all patients.Conclusion Multi-section osteotomy and intramedullary fixation for children with osteogenesis imperfecta could correct skeletal deformity,improve motion ability and avoid second fracture efficiently.However,such complications as translocation of intramedullary pin and changing the internal fixation with the growth of child need to pay more attention.

ObjectiveTo evaluate and compare the outcomes of missed Monteggia fractures in children treated with ulnar angulation-distraction osteotomy and plate fixation or external fixation.Methods Nineteen patients,including 11 boys and 8 girls who presented with missed Monteggia fracture,were reviewed from July 2005 to June 2011.Twelve children (Group A) were treated with ulna angulation osteotomy and plate fixation,and 7 eases(Group B) with ulna angulation-distraction osteotomy and external fixator.Thirteen patients were classified as type Bado Ⅰ,and six as type Bado Ⅲ.The age,the delay from injury to surgery,complications,elbow and forearm function,and the healing time of the osteotomy were compared.ResultsAll 19 patients were followed up.The duration of missed dislocation was from 6 to 36 months (mean,10 months).Redislocation of the radiocapitellar joint occurred after surgery in one case in group A.Forearm compartment syndrome occurred in one case after surgery in group B.All patients,except one,regained full elbow flexion in group A and B,various forearm pronation limitation were noted in all patients (mean,15°).The average healing of osteotomy of group A and B was 8 weeks(6-15 weeks) and 22 weeks (10-44 weeks).ConclusionThe ulnar angulation-distraction osteotomy could correct the ulnar deformity in children of missed Monteggia fractures,which is the key issue to be corrected.Both of the fixation strategies can obtain the same treatment results.Preoperative assessment is most important,plate internal fixation was recommended for young age and short delay cases,on the contrary,we prefer to choose external fixator.

Objective To evaluate the safety and efficacy of mesohepatectomy for large and centrally located hepatocellular carcinoma.Methods A retrospective study was carried out on 136 pa tients who underwent mesohepatectomy for large and centrally located hepatocellular carcinoma at Xiangya Hospital,Central South University,from 2001 to 2007.Intraoperative/post operative data and long-term survivals were analyzed.Results Vascular occlusion time,operative time,intraoperative blood loss,intraoperative blood transfusion and hospital stay were (13.3 ± 9.1) min,(173.1 ±41.1)min,(548.7±320.5)ml,(511.4±231.7)ml and (18.6±8.8)d,respectively.Four patients developed major complications.There was no in-hospital death.The 1-,3-,and 5-year overall survival rates and disease-free survival rates were 71％,46％,29％ and 65％,40％,24％,respectively.Conclusions Mesohepatectomy for large and centrally located hepatocellular carcinoma preserved the maximum amount of functional liver parenchyma.It is safe and reliable and may be used as the treatment of choice.

Objective To evaluate the effect of greater trochanteric transfer for the treatment of coxa brevis in children and adolescents.Methods From August 2005 to January 2011,twenty patients (22 hips)with coxa brevis underwent greater trochanteric transfer.Among them 18 patients (20 hips) were available for evaluation,including 4 boys and 14 girls,with an average age of 11.4 years (range,7.5-15.0 years) at operation.Five cases (6 hips) were caused by Perthes disease,and 13 cases (14 hips) were caused by developmental dysplasia of hip.Four patients (4 hips) had undergone greater trochanteric epiphyseodesis ever before.All patients were fixed with tension screw after the deformity was corrected during the operation.After operation,the human plaster spica was used for 6 weeks in all patients.Results All patients were followed up for 14 to 79 months (average,31 months).At the last follow-up,fatigue or pain in the hips disappeared or improved in 13 patients.Sixteen patients had limping and positive Trendelenburg sign preoperatively,at the last follow-up 9 patients got improvement.Twelve patients (13 hips) had limitation of abduction of the hip,the average range of abduction was 25.38°±1.20°,which was improved to 45.38°±1.05° at the last follow-up.The average articulotrochanteric distance and ratio of the distance from the greater trochanter tip to femoral head center and the radius of the femoral head at the last follow-up was (17.47+3.14)mm and 2.10±0.21,respectively,there were statistical differences compared with those before operation [(-2.89±4.62) mm and 1.59±0.22,respectiovely].The average leg-length discrepancy at the last follow-up was (0.78t±0.26) cm,which had on statistical differences compared with that [(0.83 ±0.33) cm]before operation.Conclusion Greater trochanteric transfer for the treatment of coxa brevis in children and adolescents could improve the clinical symptom,recover the normal anatomy of the proximal femoral,restore the hip biomechanics environment,but could uot improve the leg-length discrepancy.

Objective To study whether 3D computerized pre?operative planning is accuracy and reliability in CroweⅣtype developmental dysplasia of the hip (DDH) patients undergoing total hip arthroplasty (THA). Methods Between September 2009 and February 2011, 20 CroweⅣtype DDH patients (20 hips) were included in this study. The 3D pre?operative planning was performed using Mimics software to predict the acetabular component size, acetabular component abduction angle, hip rota?tion center position, the acetabular component coverage and number of patients received structural bone graft. The results were compared with traditional acetate templating technique and post?operative results. Results 70%(14/20) components were pre?dicted exactly and 30%(6/20) components were predicted with one size using 3D computerized planning, comparing with 25%(5/20) components were exactly, 45%(9/20) components were with one size and 30%(6/20) were with two size or more using conven?tional acetate templating technique. Statistically analysis revealed that 3D planning was more accuracy than templating technique regarding acetabular component prediction (t=-4.66, P=0.00). There was no significant difference between the 3D computerized planned acetabular component abduction angle (3D plan 41.10°±4.87°, postoperative 44.98°±10.83°, t=0.88, P=0.42), hip rota?tion center distance (horizontal distance:3D plan 77.51 ± 7.78 mm, postoperative 79.85 ± 8.61 mm, t=-1.95, P=0.11;vertical dis?tance:3D plan 42.79±8.22 mm, postoperative 44.98±10.83 mm, t=-1.27, P=0.26), acetabular component host coverage (3D plan 77.73%± 10.51%, postoperative 78.98%± 10.24%, t=-1.84, P=0.09), and that found post?operatively. Five patients were consid?ered to need structural bone graft according to 3D computerized planning, which was highly coincident with the intraoperative find?ings in all five cases. Conclusion 3D computerized pre?operative planning using Mimics software is an accurate and reliable technique in treating CroweⅣtype DDH patients undergoing THA.

Objective To evaluate the effects of rigorous surveillance and retroperitoneal lymph node dissection (RPLND) in the treatment of low-risk patients with clinical stage Ⅰ nonseminomatous germ cell testicular tumors (NSGCT) after radical orchiectomy.Methods The data of 71 patients with clinical stage Ⅰ NSGCT were analyzed retrospectively in Hunan Provincial Tumor Hospital,Xiangya Third Hospital of Central South University and Hunan Provincial People's Hospital between Feb,2001 and Apr,2012.Excluding lymphatic and vascular invasion,percentage of embryonal carcinoma＞50％ and increasing tumour markers (AFP/β-HCG) following orchiectomy,46 low-risk patients out of 71 patients with clinical stage Ⅰ NSGCT were selected and divided into rigorous surveillance group (30 cases) and RPLND group (16 cases) according to different therapeutic methods after radical orchiectomy.Univariate analysis was used to confirm variables associated with disease progression,and the disease free survival rates (DFSR) were compared by using Kaplan-Meier analysis.Results Five cases were lost,and 41 cases were followed up for an average of 61 months (range,15-147 months),with 58 months in rigorous surveillance group (range,19-147months) and 65 months in RPLND group (range,15-144 months).The survival rate was 100％ in 2 groups.The DFSR was 89％ (24/27) and 86％ (12/14),respectively,and there was no significant difference between the 2 groups (x2 =0.08,P=0.78).The DFSR was 83％ in patients with small amout of embryonal (percentage of embryonal carcinoma ＜ 50％),and 92％ in patients without embryonal carcinoma,and there was no significant difference between the 2 groups (x2=1.07,P=0.30).Also there was no significant difference between the patients less than 15 years and patients more than 15 years (x2=1.59,P =0.21).Conclusions There is no significant difference in recurrence rate and DFSR between rigorous surveillance group and RPLND group.Low-risk patients with clinical stage Ⅰ NSGCT may achieve satisfactory prognosis with surveillance after radical orchiectomy.

In order to investigate the hygienic characteristic of anti-immersion trousers, ten male soldiers dressed in the trousers or in camouflage trousers were subjected to exercise test and sedentary test respectively at room temperature of 17?2℃. In the test, eleven parameters such as core temperature, skin temperature, heat flow and so on were observed. The results indicated that in sedentary tests, the low limb heat flow of the subjects dressed in anti-immersion trousers was larger than that dressed in camouflage trousers; the heat insulation value of anti-immersion trousers was smaller than that of camouflage trousers; and for the other parameters, there was no evident difference between the two group. It suggested that when used on land, hygiene characteristic and effect on body heat balance of the anti-immersion trousers were similar to those of camouflage trousers.