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 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.

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.

Objective: To study temporomandibular joint function after mandibular fracture. Methods: According to the methods of Helkimo, the questionnaire and clinical examination were administered in 36 cases with mandibular fracture and 32 health controls. Results:There were statistically significant difference between the fracture group and control group in anamnestic dysfunction and clinical dysfunction index(P0.05).Conclusion: People with mandibular fracture have more symptoms and sign of temporomandibular dysfunction in the time ranged.

0.05). Postoperative cataract incidence was higher in the patients without IOL implantation than that in the patients with IOL implantation. Postoperative cataract appeared 6 months after operation in the patients without IOL implantation, while it appeared 14 months after operation in the patients with IOL implantation. There was no significant difference in the postoperative complications between group A and group B. Conclusions Combined surgery is effective and safe for the selected patients of primary retinal detachment accompanied with cataract.

ObjectiveTo determine the effects of perioperative hemodynamic goal directed therapy (GDT) on postoperative infection rates. MethodsWe conducted a systematic review and Meta-analysis.MEDLINE,the Cochrane Library,EMBASE,CNKI and other sources were searched until March 2011.All randomized controlled trials (RCTs) on adult major surgical patients managed with perioperative GDT or according to routine haemodynamic practice were included.Primary outcome measure was specific for type of infection. Two authors independently extracted data and assessed study quality using standardized instruments; Consensus was reached by conference.The Cochrance Collaboration's software RevMan 5.0 was used for data analysis. ResultsSixteen studies were included in the final analysis,providing a sample of 3309 patients. Perioperative GDT significantly reduced surgical site infections (SSI)(OR =0.60; 95％CI0.46-0.74; P ＜0.0001),pneumonia (OR =0.69; 95％CI 0.53 -0.90;P =0.007),and urinary tract infections (UTIs) (OR =0.44; 95％ CI 0.22 -0.88; P =0.02),and there was no heterogeneity between studies (P ＞ 0.1,I2 ＜ 50％ ).A significant decrease in total infection episodes was observed (OR=0.37; 95％CI0.22-0.61; P＜0.00001). ConclusionsA flow-directed hemodynamic therapy protects the high-risk surgical patients against postoperative hospital-acquired infections.

Purpose This paper was to investigate the correlation between in vitro and in situ methods for propafenone transnasal absorption.MethodsUsing excised sheep nasal mucosa permeation test in vitro and rat nasal infusion test in situ. By means of changing the medium pH, drug conoentration, and forming β-cyclodextrin inclusion compound, the permeability coeffident (Pm), mean permeation rate, and permeation fraction were determined in vitro. Under the corresponding conditions the absorption rate oostant(k ) ,mean absorption rate and absorption fraction in situ were also detrmined.ResultsThe linear regression coefficient indicated that,under the various experimental conditions,a good in vitro-in situ correlation could be confirmed.ConclusionsHaving an in vitro-in situ correlation is useful for scientific justifying the different methods for nasal absorption studies.

Objective To find out the incidence tendency and characteristics of bladder tumors during the past 28 yesrs in our institution. Methods The data from 1980 to 2007 were divided into three stages:1980-1989,1990-1999和2000-2007.Microsoft excel and SPSSl3.O were used to analyze the sex,age and histological types. Results There were 2350 cases of bladder tumors in 28 years.There were 92(66 males,26 females)cases of benign tumors and 2258(1788 males,470 females)malignant tumors,the incidence in male was 3.8 times higher than that in female.The cases of bladder malignant tumors increased,and the female increased faster than male.The peak age of incidence changed from 50-69 in 1980-1989 to 60-79 in 2000-2007.The average age of squamous cell carcinomas was 68 years,which was the oldest;and the average of paraganglioma was 35,which was the youngest.The age of urinary bladder carcinoma in 1980-1989,1990-1999 and 2000-2007 were significantly different(male:57.5±11. 7,62.6±12.3,65.9±11.3;female:58.7±13.6,60.75±12.1,65.85±12.0,respectively,P<0.05).In male,the age of squamous cell carcinomas was significantly different from the age of urothelial cell carcinomas and adenocarnomas(68.0±9.7 vs 59.85±14.1 and 63.4±9.9,respectively,P<0.05).Inverted papillomas were the most common bladder benign tumors;urothelial cell carcinomas were the most common bladder malignant tumors,and adenocarcinomas were the second,squamous cell carcinomas were the third. Conclusion The incidence of bladder malignant carcinomas in our institution increased and the female increased more quickly than male.

Objective To evaluate the etiologies of children with gastrointestinal bleeding(GIB), and the relationship between the pathological findings and clinical.Methods Gastroscopy or proctoscope was performed in 153 children with GIB. Pathological studies and tests as for helicobactor pylori (Hp) were undertaken.Results Among 153 children,140 cases(91.5 %) had definite diagnosis,including 74 children with upper gastrointestinal bleeding(UGIB) and 66 cases with lower gastrointestinal bleeding(LGIB). Gastric pathologic study was conducted in 56 cases. All patients had chronic superficial gastritis(CSFG). Hp test was positive in 33 patients. There was significant difference in the positive rate of Hp test between patients with gastritis or duodenitis and those with ulcers (P