OBJECTIVETo examine the prognosis of preretinal hemorrhage following vitrectomy and silicone oil tamponade for severe proliferative diabetic retinopathy.

METHODSClinical data of 76 cases of proliferative diabetic retinopathy treated with vitrectomy and silicone oil infusion tamponade in Sir Run Run Shaw Hospital from October 2006 to September 2013 were retrospectively reviewed. Intraoperative bleeding,postoperative preretinal bleeding,blood reabsorption time, and preretinal fibrosis were assessed.

RESULTSAll preretinal hemorrhage developed within 1 week after surgery, blood was distributed in thin and scattered patterns (32 cases), thick and localized patterns (25 cases) or thick and scattered patterns (19 cases). The preretinal hemorrhage was ceased in 1 day after operation in 35 cases, in 2 days after operation in 18 cases, in two weeks after operation in 23 case. Recurrent hemorrhage occurred within 1 week after operation in 15 cases. Thin blood was largely reabsorbed in about two weeks, and thick blood was largely reabsorbed in about five weeks. Fibrosis tissue was resulted in 15 cases(34.1%) with thick blood.

CONCLUSIONMost of preretinal hemorrhage occurs within 1 week after surgery and is reabsorpted with 5 weeks in patients with proliferative diabetic retinopathy undergoing vitrectomy and silicone oil tamponade. The major complication of preretinal bleeding is the formation of preretinal fibrosis.

Diabetic Retinopathy ; surgery ; Fibrosis ; Humans ; Postoperative Complications ; Prognosis ; Retrospective Studies ; Silicone Oils ; therapeutic use ; Vitrectomy ; Vitreous Hemorrhage ; epidemiology

Objective To evaluate the melancholia incidence in the convalescence period of cerebral hemorrhage and its correlated factors.Methods Ninety-eight cerebral hemorrhage patients in the convalescence period were involved in this study.Melancholia was assessed by Hamilton depression scale (HAMD),neural functional deficiency was assessed by the national institute of health stroke scale (NIHSS),cognitive function deficiency was assessed by the Montreal cognitive assessment (MoCA) and neural functional deficiency recovery was assessed by modified Rankin scale (mRS).Hemorrhagic site and blood quantity were detected with CT.The blood flow of middle cerebral artery (MCA),anterior cerebral artery (ACA),posterior cerebral artery (PCA) was detected by TCD.Results The melancholia incidence in the convalescence period was 51.0％(50/98),34.0％(17/50) in males and 68.8％(33/48) in females,there was significant difference between the two (P ＜ 0.05 ).The scores of NIHSS and mRS had significantly positive correlation with HAMD (P ＜ 0.05 ),and had significantly negative correlation with MoCA (P ＜ 0.05 ).When the hemorrhagic site was in frontal lobe and blood quantity was 20-40 ml,the melancholia incidence was increased [76.2％ (16/21),62.5％ (25/40)].The average blood velocity of MCA,ACA and PCA in melancholia patients was significantly slower than that without melancholia patients,while resistance index was significantly higher in melancholia patients (P ＜ 0.05).Conclusions Melancholia incidence in the convalescence period of cerebral hemorrhage has positive correlation with sex,NIHSS,MoCA,hemorrhagic site and blood quantity.The average cerebral blood flow in the melancholia patients is significantly slower and resistance index is significantly higher.

Objective: To examine the feasibility of the modified gasless trans-subclavian approach endoscopic thyroidectomy for lateral neck dissection (LND) in papillary thyroid carcinoma (PTC). Methods: The clinical data of 31 patients with PTC who underwent modified gasless trans-subclavian approach endoscopic LND in the Department of Head and Neck Surgery, Run Run Shaw Hospital, from January to October 2022 were retrospectively analyzed. There were 2 males and 29 females, aged (32.6±8.3) years (range: 17 to 55 years). The maximum diameter of the primary thyroid lesion (M(IQR)) was 1.06 (1.16) cm (range: 0.53 to 2.44 cm), and the maximum diameter of the metastatic lymph node was (1.04±0.37) cm (range: 0.44 to 1.88 cm). Operation time, postoperative hospital stay, number of lymph nodes dissected, and postoperative complications were recorded. Outpatient follow-up was conducted until November 30, 2022. Results: All operations were successfully completed with the endoscopy approach without conversion to open surgery. The operation time was 160 (20) minutes (range: 100 to 215 minutes), and the postoperative hospital stay was 4 (2) days (range: 2 to 14 days). The number of lymph nodes obtained by dissection in the central and lateral compartment of the neck was 11 (12) (range: 0 to 37) and 34.7±14.8 (range: 15 to 69), respectively. Temporary hypoparathyroidism occurred in 4 cases and all recovered within 1 month after the operation. One case suffered from recurrent laryngeal nerve injury (continuing followed up to assess whether it is a temporary injury). The complication of LND included 1 case of chylous leakage that was recovered with conservative treatment, 1 case of Horner syndrome returned to normal 3 months after surgery. During follow-up, there was no residual tumor or recurrence. Conclusion: The modified gasless trans-subclavian approach endoscopic LND for PTC is feasible, with a thorough dissection and concealed incision.

Permeability is a key factor in the bioavailability of oral drugs. Therefore, in the early stage of drug discovery, accurate and efficient evaluation of drug permeability is essential. The parallel artificial membrane permeability assay (PAMPA) with Caco-2 cells model was used by the industry as early evaluation methods. At present, the Ussing chamber rat model is also widely used. This review summarizes the human data for the in vivo single-pass perfusion technique (Loc-I-Gut) – the gold standard, and then focuses on the basic principles, experimental operation, and efficiency of the three in vitro methods, with correlation to the effective permeability coefficient (P_eff) and fractional absorbed (Fa) in man. We provide recommendations for the use of proper permeability methods at different stages in drug discovery and development.

Most patients with trauma-hemorragic shock, prior to ICU admission, have been resuscitated and stabilized in the emergency room (ER) and/or operation room (OR). Many of them suffer from systemic edema. This extra-vascular fluid is caused by massive infusion of fluid and blood for the maintenance of blood pressure. During the recovery stage, the patients exhibit spontaneous diuresis followed by negative fluid balance. Urine volumes of some patients are more than 10000 ml/d. Do we need to maintain a balance between daily input and output of water at this situation? There are many references in the medical literature and textbooks about fluid resuscitation and the principles in maintaining the balance between input and output of water, but rarely about when and how to restrict it, that is, when and how to permit a negative balance. In this retrospective review, we examined the resuscitation records of 205 patients with systemic edema after trauma-hemorragic shock.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Cause of Death ; Child ; Critical Care ; methods ; Diuresis ; physiology ; Female ; Fluid Therapy ; methods ; Humans ; Injury Severity Score ; Intensive Care Units ; Male ; Middle Aged ; Multiple Trauma ; diagnosis ; mortality ; therapy ; Predictive Value of Tests ; Probability ; Prognosis ; Retrospective Studies ; Risk Assessment ; Shock, Hemorrhagic ; diagnosis ; mortality ; therapy ; Survival Rate ; Water-Electrolyte Balance

OBJECTIVETo study the clinicopathologic characteristics of metaplastic thymoma.

METHODSResection specimens of 3 cases of metaplastic thymoma were studied by light microscopy, immunohistochemistry and electron microscopy.

RESULTSAll the 3 patients were females and aged 33, 58 and 45 years respectively. Histologically, a biphasic growth pattern, consisting of intimate admixture of epithelial cells and spindle cells, was noted. The epithelial cells showed mild cytologic atypia, sometimes nuclear grooves and pseudonuclear cytoplasmic inclusions. These cells were arranged in nests and anastomosing cords. Mitotic figures were rarely seen. On the other hand, the spindle cells were bland-looking, mitotically inactive and arranged in fascicles. Immunohistochemical study showed that the epithelial cells strongly expressed cytokeratin (AE1/AE3) but not vimentin or CD5. The proliferation index, as demonstrated by Ki-67 immunostaining, was about 3% to 5%. In contrast, the spindle cells were diffusely positive for vimentin and epithelial membrane antigen. Staining for CD5 and CD20 was negative. The background lymphocytes were positive for CD3, but not for TdT and CD99. Ultrastructurally, well-formed desmosomes or hemidesmosomes were identified in the epithelial element. They were not detected within the spindle cells.

CONCLUSIONMetaplastic thymoma is a rarely encountered indolent or low-grade thymic tumor and may represent a distinct clinicopathologic entity.

Adult ; CD5 Antigens ; metabolism ; Diagnosis, Differential ; Female ; Follow-Up Studies ; Humans ; Immunohistochemistry ; Keratins ; metabolism ; Mediastinum ; pathology ; Microscopy, Electron ; Middle Aged ; Thymoma ; metabolism ; pathology ; ultrastructure ; Thymus Neoplasms ; metabolism ; pathology ; ultrastructure ; Vimentin ; metabolism

BACKGROUNDNumerous studies from Europe and North America have provided a wealth of information regarding the epidemiological and clinical characteristics of inflammatory bowel disease (IBD) in Caucasians. Previous studies in mainland China have been limited by small patient numbers or by lack of detailed information about clinical subgroups of the disease. This study was carried out to assess the demographic and clinical characteristics of IBD in Chinese patients.

METHODSIn the Sir Run Run Shaw Hospital between 1994 and 2003, 379 patients were diagnosed as IBD. Demographic and clinical data were collected and analysed.

RESULTSOf 379 patients, 317 had ulcerative colitis (UC) (83.6%, 168 male, 149 female, male-female ratio 1.13:1, age range at diagnosis 14-79 years, mean age 44 years) and 62 had Crohn's disease (CD) (16.4%, 39 male and 23 female, male-female ratio 1.70:1, age range at diagnosis 13-70 years, mean age 33 years). In UC, 11.4% of patients had proctitis, 25.2% had proctosigmoiditis, 18.6% were diseased to the splenic flexure and 44.8% had extensive colitis. Nine patients with UC (2.8%) had arthritis, three patients (0.9%) had iritis or conjunctivitis. Of the 62 CD patients, 16 (25.8%) had diseases restricted to the terminal ileum; 15 (24.2%) had colonic diseases; 20 (32.3%) had ileocolonic disease and 11 (17.7%) had disease involving the upper gastrointestinal tract.

CONCLUSIONSThis study shows similar characteristics of IBD to that in the West but there are some differences with respect to severity and extraintestinal manifestations. The ethnic and geographic differences may give important clues to the aetiology of IBD.

Adolescent ; Adult ; Aged ; China ; epidemiology ; Female ; Humans ; Incidence ; Inflammatory Bowel Diseases ; complications ; epidemiology ; genetics ; Male ; Middle Aged ; Retrospective Studies

OBJECTIVETo explore the management for blunt abdominal trauma victims with probable positive diagnostic peritoneal lavage (DPL) findings.

METHODSData of 76 patients with probable positive DPL findings accepted to ICU in previous 10 years were reviewed. After admission, the patients were evaluated in a settled time according to the protocols of Advanced Trauma Life Support (ATLS). Vital signs were continuously monitored and DPL, ultrasound and/or CT scan were repeated when necessary.

RESULTSEighteen (24%) of 76 patients presented positive DPL findings after repeated DPL. Surgical findings confirmed 7 cases of spleen rupture, 3 hepatorrhexis (infra-Glisson capsule), 4 intestinal perforation, 2 gastric perforation, 1 colon perforation and 1 injured mesentery.

CONCLUSIONSPatients with probable positive DPL findings were admitted to ICU with vital signs continuously monitored. Repeated DPL with supplemental ultrasound and/or CT scan can work together to increase the sensitivity and accuracy of the diagnosis, reduce the rate of exploratory laparotomy, ensure patients' safety and provide a reliable basis for therapeutic operations.

Abdominal Injuries ; diagnosis ; Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Female ; Humans ; Intensive Care Units ; Male ; Middle Aged ; Peritoneal Lavage ; Wounds, Nonpenetrating ; diagnosis

OBJECTIVE: To research the value of frozen section examination for intraoperation diagnosis of thyroid nodule and determination of extent of thyroidectomy. METHOD: A retrospective evaluation of a group of 1 057 patients with thyroid nodular disease was analyzed. The group was divided into frozen section examination group (FS group) and non-frozen section examination group (NFS group). RESULT: There were 750 cases in FS group. The diagnosis made by frozen section examination was carcinoma in 117; benign lesion in 626. Diagnosis was deferred in 7 patients. The final pathology diagnosis was carcinoma in 127; benign lesion in 623. The sensitivity, specificity, accuracy and disaccord rate of frozen section examination were 95. 9%, 100. 0%, and 98. 4%, and 1. 6%, respectively. There were 307 cases in NFS group, and the final pathology diagnosis was carcinoma in 30; benign lesion in 277. The disaccord rate with clinical diagnosis was 9. 77%. The binomial distribution analysis indicate that the difference of disaccord rate between the FS group and the NFS group was remarkable ( P <0. 01). CONCLUSION Frozen section examination has value in diagnosing the thyroid nodular, and is capable of determination of the extent of thyroidectomy.
Adolescent ; Adult ; Aged ; Female ; Frozen Sections ; methods ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Sensitivity and Specificity ; Thyroid Gland ; pathology ; Thyroid Nodule ; diagnosis ; pathology ; surgery ; Thyroidectomy ; Young Adult

Microalgae biodiesel can solve these problems currently of plants materials,such as:shortage of arable land,impact of climate change for production and to lead high crop prices and so on.Constructing "engineered microalgae" through transgenic technology,the microalgae have capacity of high growth,shorter periods of growth and several times higher oil production than terrestrial plants.Furthermore,sea water can be as its natural medium for industrial production.The advantages of microalgae biodiesel,current status and progress of researches on engineered microalgae as well as product technologies of microalgal biodiesel was introduced.