OBJECTIVE: To investigate the treatment of retinal redetachment after vitrectomy and silicone oil tamponade, METHODS: Investigating retrospectively on the treatment effect of 8 cases of redetachment of retina with proliferative vitreoretinopathy(PVR) in which the retinas had been attached formerly after vetrectomy and silicone oil tamponade opertion. The reoperative procedures included pars plana vitrectonly, membranes peeling, retinotomy, inner exchange of the fluid and silicone oil tamponade and subretinal membranes were removed out in 2 eyes. RESULTS: Six eyes had anatomical reattachment postoperatively and another 2 eyes still had inferior shallow retinal detachment. Visual acuity was improved in 6 patients and remained unchange in 2 patients. CON CLUSIONS: The cause of recurrent retinal detachment might be the formation of the proliferative epiretinal and subretinal membranes, and vitrectomy to release the traction of proliferative membranes and full fluid silicone oil exchange should do good to reattachment.

Objective　To explore the possibility of R plasmid (pRST98) encoding resistance to antimicrobial agents in S. typhi mediate virulence to its host bacteria. Methods　pRST98 was transferred into a less virulent strain of S. typhimurium RIA for creating a transconjugant pRST98/RIA. The standard S. typhimurium virulence strain SR-11 which carries a 100kb virulence plasmid was used as a positive control, and RIA as a negative one. Infection with S. typhimurium was employed to assess the effect of pRST98 on the virulence of host bacteria by LD50 of peroral (p.o.) and intraperitoneal (i.p.) infection of BALB/c mice. After oral inoculation of the bacteria into BALB/c mice, mesenteric lymph nodes, spleen and liver were examined for quantity of bacteria and for the histopathological changes. The three strains were also studied for their in vitro adhesion and invasion of HEp-2, CHO and HeLa cells. Three chromosomally isogenic strains, i.e., plasmid-containing wild-type S. typhi strain, plasmid artificially cured strain and plasmid-reintroduced into the cured strain were compared for their resistance to the bactericidal activity present in human, rabbit and guinea pig sera. Results　The p.o. and i.p. LD50 of pRST98/RIA was 700 and 75 folds less than that of RIA. The bacteria counting in mesenteric lymph nodes, spleen and liver were more (P<0.05) and more severe histopathological changes were observed in pRST98 harboring S. typhimurium. However, pRST98 did not affect the adhesion and invasion of S. typhimurium to the cells. Experiments showed that pRST98 mediated resistance to serum bactericidal effect in host bacteria (P<0.05). Conclusion　This is the first report about a plasmid carrying genes coding for drug resistance and virulence in S. typhi. The data presented here suggested that novel virulence gene or related sequences, which are important in the pathogenesis of Salmonella infection could exist on pRST98.

Objective To study the immunogenicity of extractable nuclear antigens(ENA)in activateed lymphocytes.Methods The ENA of the normal and activated lymphocytes was extracted according to Sharp's method,then syngeneic BALB/C mice were immunized.The dynamic fluctuation of serum IgG anti-dsDNA antibody level in mice was analyzed by ELISA,so did the ENA polypeptide spectrum.The immunofluorescent staining pattern of ANA and renal immunopathologic changes of the mice were investigated.Results ANA could be detected in the sera of the immunized mice by the ENA extracted from the activated lymphocytes,including anti-dsDNA and anti-ENA.The immunofluorescent staining patterns for ANA manifested as homogeneous pattern,peripheral pattern,speckled pattern and nucleolar pattern.Moreover,marked immune complex deposits in glomerulus could be observed in ANA positive mice.The results in those mice immunized by the normal-lymphocyte-ENA were negative.Conclusion The ENA extracted from activated lymphocytes is immunogenic,can drive the production of ANA and cause SLE-like syndrome.

Objective To investigate the clinical value and safety of thoracoscopic lung biopsy in the diagnosis of diffuse parenchymal lung diseases. Methods 35 patients with diffuse parenchymal lung disease underwent thoraco-scopic lung biopsy were reviewed in order to obtain clinical and pathological data. Results 31 cases were diagnosed by pathology, and the total positive diagnostic rate was 88.6 % (31/35), 10 cases as usual interstitial pneumonial (UIP), 6 cases as Tuberculosis, 4 cases as alveolar cell carcinoma, 3 cases as nonspecific interstitial pneumonia (NSIP), 3 cases as crypto-genieorganizingpneumonia (COP), 2 cases as pulmonary alveolar proteinosis (PAP), 1 case as Wegener's granulomatosis (WG), 1 case as acute interstitial pneumonia (AIP), 1 case as lymphangioleiomyomatosis (LAM). 3 cases (8.6 %) were occurred with postoperative complications, 2 cases as pulmonary infection combined with respiratory failure, 1 case as idiopathic pulmonary fibrosis with acute exacerbation, and 2 cases (5.7 %) were complicated with death. Conclusions Thoracoscopic lung biopsy is a safe and effective method which helps final di-agnosis of diffuse parenchymal lung disease.

Actinomycosis ; diagnosis ; pathology ; surgery ; Adult ; Female ; Humans ; Ovarian Diseases ; diagnosis ; pathology ; surgery

Objective To construct the serine protease gene(sprE)mutant and to study the pathogenicity of sprE gene of Enterococcus faecalis.Methods Recombinant suicide vector pCQ001 of Enterococcus faecalis with pTX4577,was constructed.Then,created isogenic sprE-deficient mu- tant(*sprE)by allelic replacement was constructed.Moreover,the growth ability and the virulence of the mutant were compared with those of the wide type in vitro and in vivo respectively.A mouse peritonitis model and a rabbit endocarditis model were utilized in the study.Results The *sprE was selected by kanamycin and identified by polymerase chain reaction(PCR),pulsed field gel electropho- resis(PFGE)and Southern blot.The evidences showed that the sprE gene had a major role in helping bacteria to resist the elevated temperature and oxidative stress.The virulence of mutant decreased af- ter sprE gene was knocked out.Conclusions The *sprE of Enterococcus faecalis is constructed suc- cessfully,sprE gene is important in the pathogenesis of Enterococcus faecalis,which probably is a major virulence factor of Enterococcus faecali.

Objective To compare the clinical effects of extracorporeal shock wave treatment (ESWT) on lumbar ramus posterior nervorum spinalium syndrome and to compare the effectiveness of applying it in X-ray orientation with pain-point orientation.MethodsSixty patients with lumbar ramus posterior nervorum spinalium syndrome were randomly divided into an X-ray orientation group and a pain-point orientation group with 30 subjects in each group.The two groups then received ESWT with the X-ray orientation and pain-point orientation,respectively.The ESWT was delivered at the energy of 0.12 to 0.20 mJ/cm2 and the frequency of 60-80 pulses per minutes.A total of 1000-1500 shock wave pulses were delivered every time.Three sessions of ESWT were administered,with a 3-5 days of interval between each session.The results were rated using the 75 scores of the lumbar function quantification index recommended by Greenough.Ratings were done before treatment,and after the first,the second and the third treatment.ResultsThere was no significant difference between the groups' average index scores before treatment.There were however significant differences from the baseline scores after the first,the second and the third treatments.There was no significant difference in average lumbar function quantification scores between the groups after the first treatment,but the inter-group differences were statistically significant after the second and the third treatments.After three treatments the cure rate in the X-ray orientation group was 76.7％ and overall effectiveness was 93.3％.Both were significantly higher than in the pain-point orientation group (33.3％ and 76.7％ respectively).ConclusionsThe advantages of X-ray orientation when administering ESWT for lumbar rami posterior nervorum spinalium syndrome are more exact positioning and more effective treatment.The effect was obviously better than with pain-point orientation.

Objective To investigate the correlations between eosinophil counts in induced sputum and lung function (FENO) and evaluate these parameters in medication adjustment in patients with asthma.Methods Sixty-five outpatients with mild to moderate persistent asthma ( mild,32 ; moderate,33 ) from January to August 2008 were enrolled in the study.All were treated with combined medications comprising inhaled corticosteroids plus long-acting β2 agonists for 1 year.Lung function (FEV1％ and PEF％ ),eosinophil counts in induced sputum,FENO,and Asthma Control Test (ACT) scores were obtained at regular follow-up intervals.Twenty-one healthy volunteers served as controls,and lung function,eosinophil counts in induced sputum,and FENO were also obtained.Results Sixty-three subjects completed 1-year or longer follow-up.Lung function of 63 subjects recovered quickly in the early days and improved slowly during the following 6 months.FENO decreased from (61 ± 25 ) nmol/L at baseline to ( 32 ± 19 ) nmol/L by the third month (q =7.32,P＜0.05) and to (22 ± 12) nmol/L by the sixth month,which showed significant difference from normal controls [ ( 13 ± 8) nmol/L; q =6.63,P ＜ 0.05 ].Eosinophil counts in induced sputum of the asthma group at baseline were (0.093 ±0.023) × 109/L and decreased to (0.032 ±0.011)× 109/L by the third month,which was significantly different from baseline and normal controls [ (0.005 ±0.003) × 106/ml; q =5.49,P ＜0.05 and q =5.87,P ＜0.05,respectively].FENO showed a significantly positive correlation with eosinophil counts in induced sputum in the first 6 months (r1 =0.612,r2 =0.558,r3 =0.675; all P＜0.05) and a negative correlation with FEV1 (r1 =-0.537,r3 =-0.658,r6 ＝ -0.623,r9 =-0.537,r12 =-0.597 ; all P ＜0.05 ) at any time point of the study.The ACT score of 63 subjects at baseline was 14 ±3,and the scores after treatment for 1,3,6,9,and 12 months were 18 ±5,19 ±7,23 ±2,24 ± 1,and 24 ± 1,respectively; at the same time,significant difference was found ( F =5.72,P ＜ 0.05).Effectiveness was found according to the ACT score only 1 month after treatment.Conclusion The parameters of FENO and eosinophil counts in induced sputum were sensitive in the detection of airway inflammation and may be useful in evaluation of the efficacy of treatment and adjustment of medication regimens.

Objective To prospectively assess the therapeutic procedure and outcome of MR-guided percutaneous sclerotherapy in patients with venous vascular malformations of the extremities. Methods Fifty-seven percutaneous sclerotherapy treatments were performed under MR guidance in 28 patients with venous vascular malformation. Assessment was conducted to analyze (1) individual success of therapy, (2) improvement of clinical symptoms, ( 3 ) occurrence of complications, (4) volume changes at follow-up examinations, (5) contrast-to -noise ration (CNR) changes. Paired-t test was used to compare the volume and CNR of pre- and postintervention. Results All MR-guided percutaneous sclerotherapy were performed successfully and without serious complications. Individual predominant symptoms were improved, especially about the pain and functional impairment. The mean lesion volumes of pre- and post-intervention were (56. 8 ± 11.7 ) cm3 and ( 27.0 ± 7.2 ) cm3 respectively, which showed significant difference ( t = 8. 90, P < 0. 01 ). The percentage of volume shrinkage ranged from 28. 5% to 74. 4% [ mean ( 54. 4 ± 5. 3 ) % ]. The CNR of the pre and post-interventional images were 21.9 ± 2. 0 and 8.4 ± 0. 9 respectively. There was significant difference(t = 21.76, P < 0.01 ) between them, and the percentages of CNR decrease were 40.0% to 78. 0% [ the mean(61.0 ± 3.6)%]. Conclusion MR-guided sclerotherapy of venous vascular malformations of the extremities is a safe and efficient technique.