Objective To explore the feasibility of CT-guided puncture and cystoperitoneal shunt in the treatment of septum pellucidum cysts.Methods Twelve patients with symptomatic septum pellucidum cysts were treated by CT-guided puncture and cystoperitoneal shunt.There were 8 patients with accompanying hydrocephalus.Before operation,routine coronal CT scans were carried out to determine the relationship between the center of the cyst and the baseline.Results Symptoms of headache and dizziness disappeared in all the 12 patients.No recurrence of epileptic attack was found in 3 patients with epileptic history.Clear consciousnesss was observed in 2 patients with loss of consciousnesss.All the 12 patients were followed for 2~36 months(mean,11 months).Postoperative CT and MRI examinations showed that the cyst disappeared in 10 patients and decreased in size in 2 patients(the maximum diameter decreased by 3~18 mm,with a mean of 12.6 mm).The enlarged ventricle in 8 patients with hydrocephalus was 30% or more smaller than that before operation.All the patients were discharged from hospital without any complications.Conclusions CT-guided puncture and cystoperitoneal shunt in the treatment of symptomatic sepeum pellucidum cysts is feasible and it has advantages of minimally invasion,simple to perform,less complications.

Objective To evaluate the efficacy of double flap reconstruction after craniectomy through transpetrosal-presigmoid approach in the treatment of petroclival tumor.Methods A total of patients with petroclival tumor were enrolled in this study.Craniectomy was performed on them through the transpetrosal-presigmoid approach,and then double flap reconstruction was carried out.After the temporo-occipotal free osseous flap(retrosigmoid flap)was obtained,the superficial flap of the mastoid process(presigmoid flap)was freed by grinding and drilling.During the operation,partial petrosectomy and mastoidectomy were avoided to protect the semicircular canals and cochlea.Results Among the 14 cases,radical resection of the tumor was performed on 8 patients,subtotal resection on 3,and partial resection on 3.Two patients developed CSF leak through the ear.No subcutaneous hydrops or intracranial infection was found in the patients.The patients were followed up at 3 and 6 months after the operation,during which no complications were detected.Conclusions The rates of CSF leak,subcutaneous hydrops,and intracranial infection are low after applying double flap reconstruction to craniectomy through the transpetrosal-presigmoid approach.The procedure are mini-invasive and safety.

Neovascular glaucoma is a rare and severe complication of hypoperfusion retinopathy.The appearance of hypoperfu- sion retinopathy complicating neovascular glaucoma in ophthalmolscopy and fundus fluorescein angiography shows a special feature. Neovascular glaucoma occurs when new fibrovascular tissues proliferate onto the chamber angle and obstruct the trabecular meshwork. The stenosis or occlusion of internal carotid artery is the most common reason of hypoperfusion retinopathy in elder people.Early recog- nition and treatment of patients with carotid occlusive diseases may prevent more serious complications.

Background Traction of epiretinal membrane results in macular morphologic change and visual functional impairment in eye with idiopathic epiretinal membrane (IERM),therefore figuring out their relationship is helpful for evaluation of disease prognosis.Objective This study was to observe the morphological change of macula and microstructure,and analyze the relationship between retina thickness,integrity of cone outer segment tips (COST) line in fovea and visual acuity.Methods This was a retrospective case-observational study.Fifty-six consecutive cases diagnosed as IERM in Zhongshan Ophthalmic Center from March 2011 to December 2011 were enrolled in this study,and all the patients showed unilateral IERM with the normal fellow eyes.Sixteen patients were males and 40 were females,with a mean age of (61.05 ± 6.58) years old.Spectral-domain optical coherence tomography (SD-OCT) examination was performed on the eyes,and Macular Cube (512×128) and HD 5 Line program were selected.Mean retinal thickness of central area (＜1 mm diameter),inner ring area (1-3 mm diameter) and outer ring area (＞3-6 mm diameter) of macula and the status of COST line (intact or fractured) was recorded.Mean thickness of whole macular areas and the difference of foveal microstructure were compared,and the correlation between retinal thickness and visual acuity was analyzed using Pearson linear correlation analysis.Related parameters including age,visual acuity,retinal thickness were also compared between the continuous COST lines group and the fractured COST lines group by independent sample t test.Results The flatted or disappeared fovea was seen in IERM eyes on the SD-OCT image.Retinal thicknesses were (446±89)μm,(418±64)μm and (328±34)ttm in the central area,inner ring area and outer ring area of macula in the IERM eyes,exhibiting significant increasing in comparison with (250±22) μm,(319±17) μm and (279±17) μm in the normal fellow eyes (t=13.370,9.523,7.769,all P =0.000).Significantly negative correlations were found between the visual acuity and the central macular thickness,inner ring thickness or outer ring thickness (r=-0.686,-0.653,-0.417,P＜0.05).In the IERM eyes,COST band was intact in 20 eyes and lack in 36 eyes.Compared with COST band intact group,aging,worse vision and increased retinal thickness were seen in the COST band absent group (t =2.109,P =0.039 ; t =-4.093,P =0.000 ; t =6.669,P=0.000;t=5.376,P=0.000;t=4.247,P=0.000).COST band was clear in all the normal fellow eyes on the SD-OCT image.Conclusions Increase of macular thickness and disruption of COST band reflect the visual function damage in IERM eye.Deficiency of COST band on OCT image seems to be an early indication of photoreceptor damage.Incomplete fovea COST band is often seen in older patients.

Objective To observe the clinical effects of eyehd reconstruction by regional flap combined with xenogeneic acellular dermal matrix transplantation for eyelid defect after malignant tumor excision.Methods Thirty-five cases (35 eyes) in our hospital were selected as the objects.Among them,basal cell carcinoma was 21 cases,meibomian gland carcinoma was 13 cases,squamous cell carcinoma was 1 cases;12 cases of upper eyelid and 23 case of lower eyelid were involved.All patients were subjected to intraoperative frozen,and the incision margin was determined according to the frozen results.After resection of the tumor,the eyelid had full-thickness defects in different degrees.The xenogenic acellular dermal matrix was used to replace the conjunctival tarsal tissue,and the adjacent flap or transposition flap was used to repair the eyelid defect according to the size of skin defect.The healing of flap,oral repair film,eyelid closure and adhesion were observed.Results After half a year follow-up,the acellular dermal matrix were completely dissolved by crawling the conjunctival epithelium covering,the flap healed with no flap necrosis.28 patients recovered well after operation without hypophasis and entropion,ectropion.4 patients had mild hypophasis,and there was no case of exposure keratitis.3 patients were with mild symblepharon.Conclusion The acellular dermal matrix can replace tarsal conjunctival tissue,which combined with regional flap has good clinical curative effect for eyelid defect after malignant tumor excision.This treatment can reduce the pain of patients who take oral mucosa and avoid the reoperation of eyelid reconstruction.

Objective To explore the clinical characteristics and prognosis factors of child hemophagocytic syndrome(HPS)in different age groups.Methods Eighty-five children cases of HPS were divided into 3 age groups,0-2 years old (group A),＞2-8 years old (group B) and ＞8-14 years old (group C).The etiology,pathology,clinical symptoms,laboratory detection and prognosis were retrospectively analyzed.Results In the etiology,the etiology in the group A,B and C was dominated by EB virus infection,the infection positive rate in the group C was significantly higher than that in the group B and C;in the bone marrow examination:the occurrence rate of granulocytes to erythrocytes ratio ＜1.0 in the group A was higher than that in the group C;in the clinical symptoms,cervical lymph node enlargement mostly occurred in the group B,hepatosplenomegaly was most rare in the group C,and the serous cavity effusion commonly occurred in the group B;in the laboratory detection,the LDH level in the group B was higher than that in the group A,the above differences were statistically significant(P＜0.05).There were no statistically significant differences in other clinical symptoms and laboratory detection results among the three groups (P＞0.05);In the comparison between the survival group and death group,the serous cavity effusion,triglyceride(TG),CD4/CD8 ratio and granulocytes to erythrocytes ratio in bone marrow had statistical difference(P＜0.05).The above factors were performed the Logistic analysis,the results showed that TG＞3.5 mmol/L,CD4/CD8 ratio ＜1.24 and bone marrow granulocytes to erythrocytes ratio ＜1.02 were the unfavorable risk factors affecting the prognosis of child HPS (P＜0.05).Conclusion Partial clinical characteristics of child HPS are related with the onset age,TG level,CD4/CD8 ratio and bone marrow granulocytes to erythrocytes ratio are the risk factors affecting prognosis.

Objective To investigate the value of advanced virtual monoenergetic technique(mono-plus) of dual-energy CT (DECT) in improving imaging quality of the lliofemoral arteries.Methods Forty consecutive patients underwent DECT scan.Mono-plus images (40 keV),optimal monoenergy images and mixed energy images were obtained by using Siemens Syngo.via VB10A workstation.CT values,signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR) and subjective image quality were calculated in the abdominal aorta,iliac artery,external iliac artery,femoral artery,profound femoral artery, lateral circumflex femoral artery,transversal branch of lateral circumflex femoral artery,medial circumflex femoral artery and profound branch of medial circumflex femoral artery and compared among the three groups.Results Compared with the optimal monoenergy and mixed energy groups,CT value and CNR of the 9 arteries were significantly higher in the mono-plus group (P<0.003).SNR of the transversal branch of lateral circumflex femoral artery and the profound branch of medial circumflex femoral artery showed no significant difference (P>0.05) among the threegroups,whereas SNR of the arties bigger than the 6th grade branch were significantly lower in the mono-plus group (P<0.05).The subjective image quality in the mono-plus group was significant better than the other two groups(P<0.001).Conclusion 40 keV mono-plus technique in DECT can improve the display of lliofemoral arteries especially the small and distal branches.

OBJECTIVE:To determine serum concentrations of western medicines in patients treated with "traditional Chinese antiepileptic medicine" alone and to evaluate the curative effects.METHODS:A total of 60 epileptic patients who visited our hospital between Feb.1997 and June 2006 were subjected to plasma drug level monitoring and during which the patients were treated with "traditional Chinese antiepileptic drugs" alone.Plasma concentrations of 4 kinds of western medicin-es were determined by FPIA.RESULTS:Of the 60 cases,valproic acid,carbamazepine,phenytoin and phenobarbitone were detected in 18,40,41,and 47 cases/times,respectively.On average,more than two kinds of western medicines were detected in every patient,and the blood concentrations were mostly beyond effective plasma drug concentration.The total curative effects were unsatisfactory.CONCLUSION:The fact that western medicine ingredients detected in these traditional Chinese antiepileptic medicines is inconformity with medication principle of epilepsy.Traditional Chinese antiepileptic medicines should be used with caution in the clinic in the treatment of epileptic patients.

Adult ; Facial Hemiatrophy ; Humans ; Male

BACKGROUND:Retinoic acid is the most promising inducer for neuroblastoma minimal residual lesion, and it can induce cel differentiationin vivo, accompanied by reducing tumor cel proliferation.
OBJECTIVE:To study the effect of nanoparticle labeling on biological characteristics of neuroblastoma stem cels, and the role of 13-cis retinoic acid to induce differentiation of neuroblastoma stem cels.
METHODS:Neuroblastoma stem cels were isolated and culturedin vitro using serum-free suspension culture method, labeled with polylysine-modified γ-Fe2O3 nanoparticles and induced in culture medium containing 13-cis retinoic acid. RT-PCR was used to detect the expression of Oct-4 before and after labeling as wel as before and after induction. Immunofluorescence method was used to detect the expression of nestin before and after labeling as wel as before and after induction.
RESULTS AND CONCLUSION:Neuroblastoma stem cels were successfuly cultured in the bone marrow samples from 5 of 20 cases. Polylysine-modified γ-Fe2O3 nanoparticle labeling did no influence the viability and proliferation ability of neuroblastoma stem cels, and also had no effect on Oct-4 mRNA and nestin expression. After cultured in the culture medium containing 13-cis retinoic acid, the cel shape changed and the growth rate slowed down. Moreover, the expression of Oct-4 mRNA and nestin was gradualy reduced. These findings indicate that polylysine-modified gamma-Fe2O3 nanoparticles can be used to label neuroblastoma stem cels, and 13-cis retinoic acid can induce the differentiation of neuroblastoma stem cels.