Background Fibrin glue has been utilized to adhere the graft during the pterygium excision with conjunctival autografts.Several relevant clinical randomized controlled trial(RCT) and retrospective studies have been published abroad,but the samples for its effectiveness and safety issue of fibrin glue and suture are still underinvestigation.Objective Current study was to quantificationally assess the efficacy and safety of fibrin glue versus sutures in the application of pterygium excision with conjunctival autografts.Methods Based on established search strategy,a computerized literature search was conducted to identify all citations concerning the RCT for effectiveness and safety evaluation of fibrin glue and suture for the graft fixation during the pterygium excision with conjunctival autografts from MEDLINE ( from 2000 to October,2010 ),EMbase ( from 2000 to October,2010 ),Cochrane Central Register of Controlled Trials ( Issue 4,2010 ),CBMdisc ( 2000 to October 2010 ),CNKI ( 2000 to October 2010 ),and the relevant conference proceedings and references searched by hand was performed as supplement.The included literature was scored with Jadad table.The Cochrane Collaboration' s RevMan 5.0 software was used for the test of heterogeneity or test for overall effect.The effective indexes,such as operative duration,recurrence rate and complication,were evaluated by Meta analysis.Results Six RCTs involving 401 eyes of 377 participants were identified.These literatures were published with English in 2004-2010 from China,New Zealand,Sweden,Israel,Turkey and Malasia and the Jadad scores were 4-5.The quantitatively analysis revealed that fibrin glue appeared to short the operative time compared with suturing method (MD =14.23 ;95％ CI:- 16.18- 12.29;P=0.00) and drop the rate of recurrence ( RR =0.49,95％ CI:0.26 -0.95 ; P =0.03 ).No significant differences were found in the rate of postoperative graft dehiscence or absence (RR =3.41,95 ％ CI:0.85-13.68;P =0.08 ).Conclusions Fibrin glue shows the good effectiveness and easy application during the pterygium excision with conjunctival autografts.Long-term follow-up of multi-central RCTs with a larger number of cases are still needed to support this conclusion.

Objective To design Wound Area Measurement System based on the digital image processing.Methods A reference object whose area is known to the wound is set and the digital image processing is utilized to measure the wound area.Results The system was used in the experiment of animal model,and the anticipated results were achieved.Conclusion The system is fit for measuring the wound area in the studies of wound repair.

Objective:To study the effect of Rhizoma Coptidis apozem on expression of AMP-activated protein kinase(AMPK) in skeletal muscle of metabolic syndrome rats. Methods:The models were established by administering high fat diet. Rats were randomly divided into five group: normal control group, metabriolic syndome group, Rhizoma Coptidis apozem group, Berberine group, Metformin group. To estimate insulin resistance by euglycemic hyperinsulinemic glucose clamp(GC) tecchnique. To estimate expression of AMPK by using Western blot. Results: Compared with metabolic syndrome group, Rhizoma Coptidis apozem group had higher M-value, lower wet weight of innards fat, and higher protein level of p-AMPK-?. Conclusion: Rhizoma Coptidis apozem can improve insulin resistance, decrease innards fat, and regulate up expression of AMPK.

Objective To evaluate the performance of trilobed flaps for reconstruction of nasal tip defects. Methods Totally, 23 patients with nasal tip defects after tumor resection were enrolled into this study. Skin defects varied from 1.5 cm × 1.5 cm to 2.5 cm × 2.5 cm in size. According to the location and size of skin defects, trilobed flaps were designed, and the angle between two lobes ranged from 45° to 50°. The size of the first lobe was approximately equal to that of the skin defect, while the size of the second and third lobes decreased successively. During flap design, the integrity of nasal subunits was sufficiently considered, and the incision lines were placed along the boundary lines of the nasal subunit as far as possible, so as to conceal the incision scar with natural skin folds. Results After the operation, skin flaps survived with primary healing of incisions in all the patients. After 6 - 24 months of follow up, the color, texture and thickness of flaps were similar to those of their surrounding skin, and incision scars were inconspicuous. No malformation occurred in the nasal ala, nostril, nasal columella or surrounding organs, and satisfactory nasal appearance and function were achieved. Conclusion Trilobed flaps can be used to effectively repair relatively large skin defects of the nasal tip with satisfactory nasal appearance and function.

Objective To investigate the efficacy and safety of clopidogrel hydrogen sulfate plus nimodipine in treating transient cerebral ischemic attack.Methods A total of 159 outpatients and inpatients with transient cerebral ischemic attack in the neurosurgery department and the neurology outpatient department of our hospital from January 1,2012 to September 1,2016 were divided into 3 groups.The group A(43 cases) orally took clopidogrel hydrogen sulfate plus aspirin;the group B (51 cases) treated with oral clopidogrel hydrogen sulfate plus nimodipine;the group C(65 cases) was treated with clopidogrel hydrogen sulfate plus nimotop.The curative effects were observed in 3 groups.The differences of PT.APTT,FIB and PLT in 3 groups were compared between before and after treatment.Results The total effective rate of the group A and C was significantly better than that of the group B(P<0.05),the curative effect had no statistical difference between the group A and C (P>0.05);the effect of the group B and group C on coagulation was superior to that of the group A(P<0.05).The three group had no severe bleeding events(cerebral bleeding,etc.),the difference was statistically significant.Conclusion Clopidogrel hydrogen sulfate combined with nimotop can significantly reduce the frequency of transient cerebral ischemic attack,has little influence on the coagulation indicators,and is safe and effective.

AIM: To investigate the clinical characteristics, surgical outcome and curative effect of congenital fibrosis of the extraocular muscles ( CFEOM) .
METHODS: The eye exam of members in a Chinese family with CFEOM includes visual acuity, intraocular pressure, dilated fundus exam, extraocular muscle function test, orbital CT scan, and ultrasound. We did extraocular muscle surgery or frontalis suspension procedure for affected subjects in the family.
RESULTS: The incidence of CFEOM in this family was 31%. All patients were affected bilateraly with symptom of congenital eye movement disorder, ptosis, hypotropia, perverted convergence on upgaze and chin up head position. As the age grows, the diseases worsen unobviously. No other systemic disorder was found. Surgical treatment improved the anomalous head position although the ocular movement disorder preserved.
CONCLUSION: The pattern of inheritance in our serial patients are autosomal dominant. Surgery can improve chin up head position and cosmetic appearance. However, the eye movement deficiency cannot be improved.

Objective To retrospectively analyze 45 cases of oral and maxillofacial malignant tumors and to assess the efficacy and feasibility of oral and maxillofacial malignant tumors implanted with 125I radioactive seeds under guidance of ultrasound.Methods A total of 47 focuses in these 45 patients were determined with the size of these tumors by imaging study,the section was planed by ultrasound,the number and distribution of radioactive seeds were determined with the help of the particle treatment planning system,and were percutaneously implanted particles under guidance of ultrasound.The number and the distribution of particles were assessed by CT.Efficacy endpoints were reexamined and evaluated regularly by ultrasonic and CT according to the standards of WHO.Results The total percentage of efficacy was 70.2% (including complete remission,partial remission).The treatment effect of metastatic carcinoma of lymph node is superior to the parotid tumor.There was no serious complication during the period of implanting and 2 patients with oral ulcers were found after operation.Conclusion The oral and maxillofacial malignant tumor treated implanted with 125I radioactive seeds under guidance of ultrasound is very effective and safe,which is deserved to popularize.The ultrasound is the first choice as a guided method for oral and maxillofacial malignant tumors.

AIM: To discuss the clinical applications of methods to localize nasal cut ends and the effects of Z-plasty in the surgeries for lower eyelid longitudinal laceration combined with lower lacrimal canaliculi disruption.
METHODS: From September, 2010 to October, 2013, a total of 37 patients ( 37 eyes ) with lower eyelid longitudinal laceration combined with lower lacrimal canaliculi disruption were operated for anastomosis of lacrimal canaliculi disruption and suture of lower eyelid longitudinal. Different methods to search for the nasal cut ends of lacerated lacrimal canaliculi, such as “under a microscope directly”, “guided by probing needle” and“pigtail curved probe”. Then, to repair lower eyelid longitudinal laceration with Z-plasty transposition flaps. Follow up was 3mo~2a after operation.
RESULTS: All nasal cut ends could be found successfully on 37 patients;Lacrimal duct unobstructed in 31 patients (83. 8%), improved in 5 patients (13. 5%), invalid in 1 patient (2. 7%),the overall successful rate was 97. 3%; the eyelids repair was satisfactory, small scars, the appearance and function was normal.
CONCLUSION: The nasal cut ends can be found successfully by “directly under a microscope”, “guided by probing needle” and“pigtail curved probe”;the effect of silicone drainage tube used as lacrimal canaliculi bracket is satisfactory; most patients gained excellent recovery for both appearance and function after Z-plasty.

OBJECTIVETo establish the HPCE chromatogram of prepared products of Rhizoma Coptidis (RC) for analyzing the difference of Alkaloids in RC prepared by different methods, in order to offering reference for studies on the preparing mechanism.

METHODThe chromatograms were obtained by HPCE, in which the background electrolyte was 0.05 mol x L(-1) Na2B4O7-H3PO4 (pH 7.0) containing 35% MeOH. The voltage was 15 kV, the detection wavelength was 225 nm, and the samples were developed at room temperature. The correlation relativity of retention time and peak area of each chromatographic peak in different prepared samples were explored, respectively, and benzyl tri-ethyl ammonium chloride was chosen as the reference to calculate the relative retention time and the ratio of peak area for each chromatographic peak.

RESULTEight co-possessing peaks were selected as the characteristic of different prepared products of RC. The relative area of the same peak in different prepared products were distinct, but the area ratio of the 8 peaks in each product prepared with the same method was a relative constancy basically.

CONCLUSIONIt is proved that the new method is stable and reliable. It can be used as the characteristic chromatogram of the prepared RC, and it can be useful in the quality control of this material.

Alkaloids ; analysis ; Chromatography, High Pressure Liquid ; methods ; Coptis ; chemistry ; Plant Extracts ; analysis ; Rhizome ; chemistry

Objective To study the correlation between microRNA (miRNA) polymorphism and the risk and clinical prognosis of acute radiation esophagitis in patients with esophageal neoplasms. Methods 256 patients with acute radiation esophagitis during radiotherapy were chosen as the experimental group, and 256 patients matched by age and sex without acute radiation esophagitis during radiotherapy were chosen as the control group. The polymorphism types of miRNA-146a (rs2910164) were determined by Taqman gene typing technology of ABI7900HT. The genotype distribution of miRNA-146a rs2910164 polymorphism in the experimental and control groups was analyzed. Logistic regression was performed to estimate the odds ratio (OR) and 95%confidence interval (95%CI ). Results The genotype frequencies of CC, GG and CG at miRNA-146a polymorphic site rs2910164 in the experiment and control group were 20.70 % (53/256) and 33.20 % (85/256), 45.32 % (116/256) and 40.63 % (104/256), 33.98 % (87/256) and 26.17 % (67/256), respectively. There was a statistically significant difference between two groups (all P< 0.05). Compared with gene type CC, the OR values of acute radiation esophagitis in patients with gene type GC and GG were 0.654 and 0.627, respectively (P< 0.05), indicating that they had a low risk. The negative effect rates in patients with gene type GG, CG and CC were 7.69 % (8/104), 19.40 % (13/67) and 41.18 % (35/85), respectively. There was a statistically significant difference in the clinical prognosis among these genotypes (P< 0.05). Conclusion Gene type CC at miRNA-146a polymorphic site rs2910164 can increase the risk of acute radiation esophagitis and decrease the clinical prognosis in patients with esophageal neoplasms.