Objective　To study the ultrastructure of macular pucker (MP) from the patients with rhegmatogenous retinal detachment (RRD) and the mechanism associated with its development．　Methods　Twenty specimens of MP surgically removed by vitrectomy from 13 patients were dissected into two layers in each of them．The ultrastructure of two layers,i,e,near the vitreous and near the retina,was studied with electron microscopy．　Results　Seven sections of the near vitreous ones appeared prodominant collagen deposits and a few of epithelial-like cells,and pigment particles might be present in the cytoplasm．While cells with foot processes were found in 13 membrane sections near the retina and increasing number of various types of cells rich in collagen around were observed including fibroblast-like cells and glial cells．　Conclusion　The findings suggest that the MP after surgery of retinal detachment may possess a characteristic lamination,and posterior hyaloid cortex was involved in the developmetn of MP．The adhesion between posterior hyaloid cortex and macular area might be a key factor for forming MP．

OBJECTIVETo evaluate the effects on health-related quality of life after short-segment pedicle fixation of thoracolumbar fractures without neurologic injury.

METHODSA total of 55 patients suffered from thoracolumbar fractures without neurological deficit from January 2007 to October 2010 were included in this retrospective study. Of the 55 patients, 35 were male and 20 were female. The mean age was (44.0±10.5) years old (ranged, 7 to 75). Preoperatively, the main clinical symptoms in patients were thoracolumbar pain without neurologic injury and the imaging findings mainly showed that the injured vertebra became wedging or flat with the loss of height. Three questionnaires (ODI, EQ-5D and SF-36) were applied to follow-up in this study.

RESULTSAll operations were successful and incisions got primary healing. The function of thoracolumbar spine fully or basiclly restored and postoperative imagings showed fractures healed without loose screws, broken screws or broken rods. The completion rates of all the queasionnaires were 100% while the mean follow-up period was 4.2 years (ranged, 3 to 6). The ODI scores were 25.8±18.7, which were statistically higher than those of the general population in our country (P<0.05). The EQ-5D index scores were 0.70, which were statistically lower than those of the normal Chinese population (P<0.05). Compared with the normal scores in our country, the scores of 8 items in the SF-36 questionnaire were obviously lower with significant difference (P<0.05).

CONCLUSIONCompared with the normal Chinese population, it should be paid more attention to that the health-related quality of life in patients after short-segment pedicle fixation of thoracolumbar fractures without neurologic injury because of lower scores.

Adolescent ; Adult ; Aged ; Child ; Female ; Fracture Fixation, Internal ; methods ; Humans ; Lumbar Vertebrae ; injuries ; surgery ; Male ; Middle Aged ; Quality of Life ; Retrospective Studies ; Spinal Fractures ; psychology ; surgery ; Thoracic Vertebrae ; injuries ; surgery ; Young Adult

Objective To research the special manifestations of magnetic resonance cholangiopancreatography(MRCP) in carcinoma of pancreatic head.Methods MRCP in 22 cases with pancreatic head carcinoma confirmed by operation and pathology (including SE sequences with T1WI and fat saturation,FSE with T2WI and fat saturation and MRCP in coronal sectior) were performed before operations.Additional CE MRA on abdominal vessels including abdominal ateries, portal veins and superior mesenteric arteries and their veins in 16 cases also examined before operations. Results Carcinomas of the pancreatic head were diagnosed correctly by MRCP in 21 cases, and 1 case was misdiagnosed as chronic pancreatitis. MRCP all demonstrated abrupt interruption at pancreatic head segments of dilated left common bile duct and main pancreatic duct at the pancreatic head ones, their left segments were dilate with higher signal and both didn't cross each other, because they were destroyed by carcinomas of pancreatic head. Destruction and no cross each other of pancreatic head segments of choledochus and main pancreas duct,it was called "no cross sign". CE MRA demonstrated destruction of abdominal ateries in 3 cases, portal vein in 3 cases and superior mesenteric vein in 4 cases and not being resected.Conclusion "No cross sign"on MRCP examination is of important value in diagnosis of carcinoma of the pancreatic head.

Objective To investigate the ingestion, metabolism and subcellular localization of indocyanine green (ICG) in human retinal epithelial (RPE) cells. Methods RPE cells were incubated with 0.25 mg/ml ICG under the condition of 37℃ in the camera. The ICG granule and ultrastructure of RPE cells were observed under the electron microscopy after 1-, 4-, and 24-hour incubation, and the ICG autofluorescence was detected by fluorescence microscopy after the incubation for 1, 2, 4, 8, 12, 24, and 48 hours, respectively. The absorbency (A value) of ICG solution was measured at 805 nm with ultraviolet/visible specrtrometer. The standard curve of concentration of ICG was drawn and the related equation of concentration of ICG and the A value was calculated. After being incubated for 1, 2, 4, 8, 12, 24, 48, and 72 hours, respectively, the A value of supernatant fluid was calculated according to the equation. After incubated with ICG for 24 hours, one sample was observed under electron microscope and fluorescence microscope per week to evaluate the metabolizable period of ICG. Results ICG granules were distributed evenly after entering the RPE cells. After incubated with 0.25 mg/ml ICG for 24 hours, no significant change of the ultrastructure of the RPE cells was found. ICG granules accumulated in the cells as the time goes by and reached the peak after 24 hours, and then they decreased because of the slowdown of the metabolism. Few ICG was still remained in the cells 1 week later. Conclusions RPE cells may take in ICG actively. ICG metabolizable period in RPE cells is long, which may be one of the mechanisms of the toxicity of ICG to the retina in the vitreous operation.

0.05 ). Conclusions With low initial FGF addition of N2O does not affect the uptake of desflurane. The low-flow desflurane anesthesia is safe and economical.

OBJECTIVE:To discuss the issue of medical institution's pharmaceuticals purchase by public bidding and so as to put forward some improvement measures.METHODS:The problem in the pharmaceuticals purchase by public bidding sys?tem was analyzed by the governmental management theory.RESULTS&CONCLUSION:The pharmaceutical purchase by public bidding system was far from perfect which were highlighted in the high cost of governmental management,over-burden of bidding factories,financial loses of medical institutions,and chaos of medicine pricing management.The governmental pricing system should be regulated,the medical reform systems should be speed up,and the efficiency of governmental man?agement should be improved.

0.05). The pathological findings indicated benign lesions in 63 patients(73%) and malignant lesions in 25 patients(27%)in group 1. All the lesions were found benign in group 2. There was significant difference between the two groups(P=0.0033). Conclusion Noninvasive and painless transvaginal two-dimensional ultrasonograpy and color Doppler ultrasonography may have important clinical application value in diagnosis of intrauterine anomaly in post-menopausal women.

Hyperhomocysteinemia is an independent risk factor for arterial and venous obstructive vascular di-seases. Raised plasma homocysteine concentrations are caused by genetic and non-genetic factors. The pathogenic mechanism is not clear. It may be associated with endothelium dysfunction, abnormal lipid metabolism, hypertrophy of intima media, increased platelet aggregation and several clotting factors interfered, etc. The metabolism and pathogenic mechanism of homocysteine are reviewed in this article, which provides theoretical foundation for the treatement of hyperhomocysteinemia.

BACKGROUND:In recent years, bacterial celulose modified by nano-composite technology has been endowed with new properties. OBJECTIVE:To review the combination of bacterial celulose and nanosilver to prepare wound dressing. METHODS: A computer-online search was performed in PubMed (2013-01/2015-04) and CNKI (2007-01/2015-04) databases to retrieve studies on bacterial celulose, nanosilver and their compound method and application using the key words of “bacterial celulose, nano-silver” in English and Chinese, respectively. RESULTS AND CONCLUSION:Bacterial celulose/nano-silver compound can be prepared by three methods: solution impregnation, in situ composite and biocomposite. Solution impregnation method can lower the concentration of nanosilver ions in the fiber matrix to highly control the release of silver ions, but the genetic toxicity and biocompatibility are unclear.In situcomposite method can reduce the damage to the mesh structure of celulose on which silver ions can be bonded firmly to reduce the toxic damage to cels, but the reducing agent used has a higher toxicity, which is difficult to remove. Biocomposite method cannot produce toxic substance, which is friendly to the environment, and the synthetic biomaterials have less harm to the human body and can be controled highly.

ObjectiveTo investigate the value of cavity isolation method on left colorectal obstruction in the anastomosis isolation. Methods60 patients with left colorectal obstruction were randomly divided into two groups:ileostomy group and cavity isolation method group,30 patients for each. After left colon resection was completed, ileostomy anastomosis group used the traditional method for colorectal anastomosis, and protected the anastomosis by ileostomy. Cavity isolation method group protected the anastomosis by cavity isolation method. Then the indexes in the two groups,such as anastomotic height, operation time, anal exhaust time,incidence of anastomotic leakage and its complications,hospitalization time, medical cost and so on were analyzed. Results Longer postoperative hospital stay (9.3 + 4.2) d were observed in ileostomy group than those ( 15.6 + 3.3 ) d ( P ＜ 0.05 ). Earlier time of the first flatusand oral intake(87.2 ± 6.3 ) h, ( 91.2 ± 7.2 ) h were observed in ileostomy group than those ( 101.8 + 7.5 ) h,( 117.3 ± 8.6) h in cavity isolation method group ( all P ＜ 0.05 ). ConclusionThe anastomosis isolation was a safe and feasible new technology that could reduce the complications caused by anastomotic leakage, and it had the advantages of short hospital stay, low cost,less suffering ect.