Ophthalmic plastic and reconstructive surgery is an interdisciplinary speciality,it includes cosmetic surgery,oculo- plastic surgery and orbital surgery.The current mainly problems and strategies will be discussed in this paper,the status and progresses of cosmetic surgery,including cosmetic eyelid surgery,anesthetic injection methods,and laser facial rejuvenation.Present existing prob- lems and their countermeasures in ocnloplastic surgery,including eyelid malignant tumor,eyelid defects,blepharospasm and anoph- thalmic socket disorders.Problems and management of orbital surgery,ineluding thyroid-associated orbitopathy,orbital fractures,and orbital deformities.At last,the mainly problems and corresponding measures of development of ophthalmic plastic and reconstructive surgery will be discussed.(Ophthalmol CHN,2007,16:365-367)

Objective To observe the long- term result of pathological dislocation of the hip with absence of the femoral head treated with trochanteric arthroplasty in infancy. Methods Eighteen cases with absence of the femoral head and pathological dislocation of the hip treated with trochanteric arthroplasty were followed- up for 5－ 16 years, with an average of 9.25 years. The timing of the surgery was average 18.2 months(ranged from 11 to 30 months). Based on Hunka pathological classification, one case was divided as typeⅠ lesion, 2 cases as typeⅡ lesion and 15 cases as typeⅤ lesion. Results There were 8 cases in the excellent group, the morphology and function of the reconstructed femoral heads were nearly normal and the limb shortening were in an average of 0.25 cm. There were 3 cases in good group, the femoral heads were nearly ball sized and the femoral necks were absent, however, the function was good and the limb shortening averaged 1.5 cm. There were 5 cases in fair group, the plastic femoral heads were abnormal and there were acetabular dysplasia and the limb shortening averaged 2.1 cm. There were 2 cases in poor group with redislocation. Conclusion The result demonstrate that surgical treatment of the absence of the femoral head in infancy could obtain a better reconstructed hip and fair function; the shortening of the limb can also be avoided.

Apoptosis ; drug effects ; Cell Line, Tumor ; Cell Proliferation ; drug effects ; Flavonoids ; pharmacology ; Humans ; Isoflavones ; chemistry ; Leukemia, Promyelocytic, Acute ; pathology ; Tretinoin ; pharmacology

Acute promyelocytic leukemia (APL) is a special subtype of acute myeloid leukemia, characterized by the reciprocal chromosomal translocation of t (15;17)(q22;q21), which generates PML-RARαfusion protein. All-trans-retinoic acid (ATRA) and As2O3 could induce APL cells to differentiation and apoptosis, respectively, making APL become the first curable leukemia. Autophagy is one of metabolic mechanisms to maintain cell homeostasis. Recent studies have showed that autophagy plays an important role in the differentiation of APL cells induced by ATRA/As2O3. Meanwhile, autophagy may affect the sensitivity of APL cells to the pro-apoptotic effect of drugs. Therefore, targeting and regulating autophagy might be a new therapeutic approach of APL and even other leukemia in the future. This article will briefly review the advance of autophagy in APL in recent years.

Adult ; Female ; Humans ; Lacrimal Apparatus ; immunology ; Lymphocytes ; immunology ; Male ; Mucous Membrane ; immunology

AIM:Spondylolisthesis is a common spinal disease for adults but rarely found in children.In this study,the treatment effect of spondylolisthesis in 7 children with posterior pedicle screw system after 1 year was explored.METHODS:①Eight children patients with spondylolisthesis treated in Shengjing Hospital of China Medical University between January 1996 and December 2006 were selected including 4 males and 4 females.The average age was 12.25 years(range,8-14 years).According to Meyerding classification,7 cases were of stage Ⅰand one of Ⅳ.②Texas Scottish Rite Hospital(TSRH) posterior pedicle screw system was provided by Wego Ortho Co.,Ltd.,GB1Z type,titanium,No.200511028009.Of the 8 cases,4 were treated by TSRH posterior pedicle screw system,3 were treated via a Wiltse paraspinal approach with autogenous bone graft placed between the transverse processes of L5 and sacral ala in situ fusion,and 1 was not treated by operation.The informed consent of treatment was obtained from the patients.③The changes in the spinal radioactive imaging before and after operation,and the material and host biocompatibility were observed.RESULTS:①Seven of 8 cases were followed up.The mean time of follow-up was 56.6 months with a range from 13 to 111 months.②Three of 4 cases treated by TSRH were vertebral completely reduction with the stability of instrumentation about 75%(3/4),and the other one was partly reduction(about 85%).One person developed the progress again in the X-ray films at three weeks after operation.Three cases treated by Wiltse paraspinal approach with autogenous bone graft placed between the transverse processes of L5 and sacral ala in situ fusion healed well without the recurrence of lumbosacral spondylolisthesis and nonunion.CONCLUSION:TSRH is an efficient and safety option for the treatment of spondylolisthesis in children.

Objective To explore the effectiveness of ω-3 fatty acids in intervening rat models of chronic obstructive pulmonery disease (COPD).Methods The rat COPD models were established by cigarette smoking and intratracheal lipopolysaccharide instillation.Totally 90 rats were randomly divided into 3 groups:normal control group (treated with normal saline),COPD group,and intervention group (the COPD rat models treated with ω-3 fatty acids).Lung tissues were obtained on the 7th,21st,and 28th day.The left lower lobes were analyzed to determine the expressions of nuclear factor-kappa beta (NF-κB) and interferon-γ (IFN-γ)and the right lung lobes were sliced for detecting the cell apoptosis.Double antibody sandwich enzyme-linked immunosorbent assay (DAS-ELISA) was used to detect the serum IFN-γ and interleukin-6 (IL-6).Results (1) The pathological changes of lung tissue:there were a large number of inflammatory exudation,alveolar wall thickening,hyperplasia of vascular smooth muscle and the alveolar structure destruction in the COPD model group,but the lung tissue were part of alveolar cavity and a little inflammatory exudate in ω-3 fatty fish acids treatment group,control rats were almost no alveolar inflammation on the 28th days.(2) On the 28th day,NF-κB protein expression of the lung tissue (18.91 ± 3.07) in rats of COPD model group was significantly higher than the control group and the intervention group (5.47 ±4.86 and 7.23 ±2.21) (P ＜0.01).On the 28th day,IFN-γ protein expression in lung tissue of the rats in the model group was 7.12 ±3.37,significantly lower than the intervention group (18.74 ± 2.65),the difference was statistically significant (P ＜ 0.01).(3) The IL-6 levels of the blood-serum of model group rats were (13.43 ± 2.47) ng/L,significantly higher than the control group and the intervention group [(4.78 ± 1.93) and (4.98 ± 1.89) ng/L],the differences were statistically significant (P ＜ 0.01) on the 28th day,,but the IFN-γ level [(2.23 ± 0.63) ng/L] in COPD group was more poorer than ω-3 fatty acids group and the intervention group [(4.51 ± 0.71) and (7.05 ± 0.52) ng/L] (P ＜ 0.01).Conclusions The ω-3 fatty acids can lower NF-κB protein expressions in lung tissues and serum and IL-6 levels in COPD rats; aslo,it can increase the IFN-γ protein expression in lung tissue and serum.Thus,it can prevent the lung inflammation in COPD rats.

ObjectiveTo investigate the mechanism of protective effect of Xuebijing injection on vascular endothelial cells in rats with heat stress.Methods Ninety Sprague-Dawley(SD) rats were randomly divided into control, model and Xuebijing injection treatment groups, 30 rats in each group. Heat stress model was reproduced by placing rats in constant temperature box at 40℃, 60% relative humidity for 1 hour, Xuebijing injection group was treated by intraperitoneal injection of Xuebijing 2.5 g/kg, while the control and model groups were treated by intraperitoneal injection of normal saline 2 mL/kg, once a day only in 1 day for both groups. After model establishment, the rectum temperature, heart rate and the mean arterial pressure(MAP) were recorded at 2, 6, 12 hours in each group. At the same time, the rat abdominal aortic blood was collected and serum was separated, the enzyme-linked immunosorbent assay(ELISA) was used to determine the aortic serum levels of lipopolysaccharide(LPS), nuclear factor-κB(NF-κB) and p53, and the prothrombin time(PT), activated partial thromboplastin time(APTT) and D-dimer of venous blood were detected by automatic blood coagulation analyzer(ACLTOP).Results Compared with those in control group, the rectum temperature, heart rate, LPS, NF-κB, p53, PT, APTT, D-dimer were significantly increased, and MAP was obviously decreased in model group(P<0.05 orP<0.01). Compared with model group, the above indexes were improved significantly in Xuebijing injection treatment group at 2 hours〔rectum temperature(℃): 38.02±0.22 vs. 39.32±0.33, heart rate(bpm): 507±14 vs. 562±35, MAP(mmHg, 1 mmHg=0.133 kPa): 98±6 vs. 87±13, LPS(ng/L): 0.65±0.03 vs. 0.82±0.05, NF-κB(ng/L): 1.10±0.04 vs. 1.33±0.05, p53(ng/L): 1.33±0.03 vs. 1.73±0.02, PT(s):15.47±1.03 vs. 20.28±2.01, APTT(s): 40.26±2.46 vs. 47.46±3.51, D-dimer(μg/L): 238.54±8.32 vs. 323.12±8.14,P<0.05 orP<0.01〕.Conclusion Xuebijing injection can correct the disorders of blood PT, APTT, D-dimer via decreasing the secretion of the levels of NF-κB, p53 from vascular endothelial cells in rats with heat stress, thus the integrity of the vascular endothelium can be protected, and LPS entering into the blood stream can be inhibited.

Objective To employ intraoperative discography to determine the injured intervertebral disc segments that can not be identified on the preoperative MRI in patients with cervical spinal cord injury without fracture and dislocation for confirming the responsible segments needing surgical decompression and fusion.Methods The study involved 85 patients with cervical spinal cord injury without fracture and dislocation treated from January 2007 to December 2011,among which sixteen patients had not been identified with the responsible segments by preoperative MRI.The average preoperative Japanese Orthopedic Association (JOA) score was (9.1 ± 1.8) points.There was no obvious fracture or dislocation of the cervical spine on preoperative X-ray film,CT and MRI,but all patients displayed high intense signal in cervical spinal cord on MRI T2 weighted imaging.Besides,MRI revealed hemorrhagic swelling of anterior cervical soft tissue in nine patients and cervical intervertebral disk hernia in all patients.Annulus fibrosus rupture of cervical intervertebral disc with contrast leakage in intraoperative discography of suspected injury segments in all patients under direction of C-arm X-ray machine was set as the injury criterion.The patients with pure ruptured discs received cervical discectomy,interbody fusion and titanium plate fixation.The patients associated with multilevel cervical intervertebral disc hernia or ossification of posterior longitudinal ligament underwent anterior cervical corpectomy,bone graft with titanium cageand titanium plate fixation of ruptured discs.Results Nineteen injured discs were identified eventually by discography,including 2 discs at C3/4,4 at C4/5,8 at C5/6 and 5 at C6/7.Moreover,anterior annulus fibrosus rupture with intact anterior longitudinal ligament was found in 11 patients.The follow-up lasted for (24.4 ± 10.0) months.JOA scores were (13.3 ± 1.5) points and (14.5 ± 1.6) points at two weeks and three months after operation,and (15.1 ± 1.5) points at the last follow-up,indicating a relevant improvement rate of 53％,68％ and 76％ respectively.Mean operation time was 110 minutes and blood loss was 120 ml.Three patients had pain on shoulder and back and one patient had hoarse voice,but all the patients were relieved in two weeks after conservative treatments.No serious complications,such as deep infection,deterioration of neurological dysfunction,vertebral artery injury or internal fixation failure were noticed intra-or post-operatively.Conclusion For the intradiscal rupture that is hard to be determined by the conventional imaging methods,intraoperative discography can be used as an auxiliary method of imaging diagnosis in early surgical determination of responsible segments for cervical spinal cord injury without fracture and dislocation.

Objective To investigate the clinical outcomes of microwave heliotherapy in situ on the primary or metastatic malignant tumors of the pelvis.Methods From February 2000 to April 2009,18 patients with primary or metastatic malignant tumors of the pelvis were treated with microwave heliotherapy in situ,and followed a total or partial tumor resection.There were 11 males and 7 females with an average age of 45 years(range,16-72).Twelve cases were diagnosed as primary malignant tumor and 6 as metastases.Locations of tumors involved:the Ⅰ region 6 cases.the Ⅱ region 10 cases.and the Ⅲ region 2 cases.The exposures of all tumors were via aTtype or ilioinguinal approach.The lesions were heated at 50℃ for 20 min by 2450 MHz microwave,with surrounding soft tissue protected by copper.mesh.The necrotic tumor tissues were total or partial excised after treatment,with preservation of the anatomical continuity of the pelvic ring.Results The duration of surgery was 60-180 min (110 min on average).The blood loss was 400-800ml(480 ml on average).All patients were followed-up for 0.5-7 years(3.5 years on average).Tumor local recurred in 1 case with chondrosarcoma,and was survival in tumor-bearing after 6 months follow up.One case with malignant fibrous histiocytoma died due to brain,pulmonary,and all body metastases.One case with osteosarcoma died due to pulmonary metastases.Five cases with the metastases died due to non-pelvis metastases.Functions of hip joint in 18 patients were as follows:flexion 80°-130°,extension 0°-10°,abduction 25°-35°,and adduction 18°-23°.Conclusion The clinical result demonstrated that the advantages of microwave heliotherapy in situ were quick increase of temperature,sensitive responses,easy control of temperature,and effective inactivation of tumor cells in the malignant bone tumors of pelvis.