Diplopia ; etiology ; Enophthalmos ; etiology ; Exophthalmos ; etiology ; Facial Nerve Injuries ; etiology ; Hemorrhage ; etiology ; Humans ; Intraoperative Complications ; etiology ; prevention & control ; Orbit ; blood supply ; surgery ; Orbital Fractures ; surgery ; Postoperative Complications ; etiology ; prevention & control ; Reconstructive Surgical Procedures ; adverse effects ; Reflex, Trigeminocardiac ; Vision, Low ; etiology

Ophthalmic plastic and reconstructive surgery is an interdisciplinary speciality,it includes cosmetic surgery,oculo- plastic surgery and orbital surgery.The current mainly problems and strategies will be discussed in this paper,the status and progresses of cosmetic surgery,including cosmetic eyelid surgery,anesthetic injection methods,and laser facial rejuvenation.Present existing prob- lems and their countermeasures in ocnloplastic surgery,including eyelid malignant tumor,eyelid defects,blepharospasm and anoph- thalmic socket disorders.Problems and management of orbital surgery,ineluding thyroid-associated orbitopathy,orbital fractures,and orbital deformities.At last,the mainly problems and corresponding measures of development of ophthalmic plastic and reconstructive surgery will be discussed.(Ophthalmol CHN,2007,16:365-367)

Objective To summarize the complications of the single-port transumbilical laparoscopic pyeloureteroplasty.Methods From August 2009 to December 2014, 162 surgical procedures were performed in our institute with the single-port transumbilical laparoscopic pyeloureteroplasty.Medical records of each procedure were retrospectively evaluated.139 patients were male and 23 female, aged from 1 month to 14 years and the median age of 2 years.127 patients were operated on the left side and 32 on the right side.3 patients were operated on the bilateral side.All children were supplemented with preoperative ultrasound, renal dynamic imaging and MRU to identify the ureteropelvic junction obstruction.Intraoperative and postoperative complications were graded according to the Satava and Clavien classifications respectively.Major complications were defined as Satava grade Ⅱ or higher, and Clavien grade Ⅲ or higher.Results There was no injury of vascular or visceral organs and no blood transfusion, and there was no serious intraoperative complications.One hundred and forty-three cases were followed up, and 23 cases (16.1％)presented with postoperative fever (＞ 38 ℃C) (Clavien Ⅰ), 2 cases (1.4％) with urinary extravasation diagnosed by perirenal fluid collection(Clavien Ⅰ).All these cases recovered after being given symptomatic treatment.7 cases (4.9％) presented with postoperative repeated urinary infection (Clavien Ⅱ).5 cases received postoperative reoperation due to the obstruction of the anastomic site (Clavien Ⅲ b), and 2 cases were under debridement as the greater omentum was drawn out along with the negative pressure drainage tube(Clavien Ⅲ a).In summary, the incidence of severe postoperative complications was 4.9％.Conclusions Though there existed some postoperative complications of the single-port transumbilical laparoscopic pyeloureteroplasty, the incidence of serious complications was low and the overall prognosis could be good.

Objective To investigate the indications and surgical approaches of full-thickness eyelid reconstruction with superficial temporal artery island flap and oral mucosa free grafting,and evaluate the safety and efficacy.Methods A total of 13 eyes of 13 patients with wide full-thickness eyelid defect were treated by the eyelid reconstruction with superficial temporal artery island flap and oral mucosa free grafting.The defect area was(33.67?8.35) mm?(16.44?4.45) mm and the size of island flap was(38.56?8.99)mm?(18.44?4.00)mm.Eight cases were treated with oral lip mucosa grafting,while the other 5 with hard plate muco-periosteal free grafting.Follow up was conducted for 6 to 24 months. Results The flaps were clinically viable in 10 cases and partially viable in 2.One was inviable for venous circumfluence failure,and a successful free skin grafting was conducted 3 months postoperation.All the grafted oral mucosa survived.Five cases underwent the second surgery to thin the island flap,among whom 3 were performed eyelid suspension with the frontal muscle.The survived flaps were similar to skin in colour,soft in nature,and could effectively protect the eyeballs. Conclusion The superficial temporal artery island flap along with oral mucosa free grafting works well in wide full-thickness eyelid reconstruction.

OBJECTIVETo investigate diagnostic efficacy of transvaginal three-dimensional hysterosalpingo-contrast sonography (3D-HyCoSy) in assessing tubal patency with chromolaporoscopy.

METHODSA total of 157 infertile women underwent 3D-HyCoSy to evaluate tubal patency. Among these patients, 39 patients were also examined by chromolaporoscopy. The concordance of the two clinical assessment methods was analyzed by the Kappa coefficient test.

RESULTSAmong the 306 oviducts examined by 3D-HyCoSy, 99 (32.4%) were patent, 126 (41.2%) partially obstructed, and 81 (26.5%) completely obstructed. Diagnostic results with 3D-HyCoSy were not statistically different from those obtained in the 39 women (78 oviducts) who also underwent chromolaporoscopy, and the two methods showed a high concordance (k=0.747, P=0.000). The 3D-HyCoSy procedure had a sensitivity of 84.8% (28/33), a specificity of 96.2% (25/26), and positive and negative predictive values of 93.3% (28/30) and 86.2% (25/29) respectively.

CONCLUSIONTransvaginal 3D-HyCoSy can accurately reveal the spatial path and morphology of the oviduct and is a safe and effective method to evaluate tubal patency.

Contrast Media ; Fallopian Tube Patency Tests ; methods ; Fallopian Tubes ; diagnostic imaging ; Female ; Humans ; Hysterosalpingography ; Imaging, Three-Dimensional ; Infertility, Female ; diagnostic imaging ; Laparoscopy ; Ultrasonography

Objective To evaluate the clinical efficacy and safety of combined therapy of Chinese and West-ern medicine in the treatment of schizophrenia.Methods According to the digital table,130 patients with schizophre-nia were randomly divided into the observation group and control group,with 65 cases in each group.The control group was treated with perphenazine and other Western medicine treatment,the observation group was treated based on the control group with Jieyu Kaiqiao pill added,The clinical curative effect,PANSS score and adverse drug reaction of both groups were compared.Results In the observation group,the total effective rate was 96.92%,significantly high-er than that of the control group (72.31%);After treatment,PANSS score of observation group was (42.68 ±6.11), while it was (55.12 ±6.45)in control group.The PANSS scores of both groups were significantly lower than that before treatment,PANSS score of observation group was significantly lower than that of the control group,there was significant difference between groups(t=6.61,P<0.05);the incidence of adverse reaction of the observation group was 10.77%,significantly lower than the control group (58.46%);the difference was statistically significant (χ2 =32.66,P<0.05).Conclusion Jieyu Kaiqiao pill combined with Western medicine for the treatment of schizophre-nia can significantly improve the clinical efficacy,reduce the incidence of adverse drug reactions.

Liver transplantation,a unique effective treatment for end-stage liver diseases,has already been applied in clinical practice for more than half a century.But the shortage of donor liver source has been the bottleneck limiting its development.How to determine the tiny minority donor liver quality to guarantee the prognosis of transplant patients becomes a hot focus for current research.Brain death causes patho-physiological changes of body organs,including liver.How to carry out related pathological and serologic tests to determine the safety of the donor liver is a very important issue.In this paper,the articles published in recent years were overviewed and analyzed to summarize the evaluation index of donating organ quality.We hope this paper may benefit the treatment through ensuring an effective evaluation on the donor liver in the future.

Objective To investigate the effect of peroxisome proliferator-activated receptor γ (PPARγ) agonist pioglitazone on white matter lesions and spatial memory function in chronic hypertensive rats.Methods Thirty-six male Sprague-Dawley rats were randomly divided into a sham operation group (n =6),a hypertensive group,(n =15),and a pinglitazone group (n =15).A model of stroke-prone renovascular hypertensive rat (RHRSP) was induced by the two-kidney two clip method in the hypertensive group and pioglitazone group.At 8 weeks after procedure,the rats were administered intragastrically.10 mg/(kg · d) pioglitazone was given in the pioglitazone group and an equal volume of saline was given in the hypertensive group.Blood pressure was monitored via caudal artery every 2 weeks before procedure,before administration,and after administration,respectively.After 12 weeks of continuous administration,Loyez staining was used to observe the degree of leukoaraiosis,and Morris water maze test was used to detect spatial memory function.Results After modeling,the blood pressure of RHRSP increased gradually.It was significantly higher than the sham operation group (all P =0.001).There was no significant difference in blood pressure between the hypertensive group and the pioglitazone group (P =0.897).The Morris water maze test showed that escape latencies of the sham operation group and the pioglitazone group were significantly shorter than the hypertensive group (all P ＜0.05).The numbers of crossing hidden platform in the 3 groups of rats were 5.200 ± 1.798,4.560 ± 1.592,and 2.333 ± 1.978 times,respectively.There were significantly differences (F =8.143,P =0.001).Both the sham operation group and the pioglitazone group were significantly more than the hypertensive group (all P ＜0.05).Loyez staining showed that the grades of white matter lesions in corpus callosum of the sham operation group,the hypertensive group,and the pioglitazone group were 0.333 ± 0.516,2.600 ± 0.507,and 0.500 ± 0.522,respectively.There were significantly differences among the 3 groups (F =25.652,P =0.000).The grade of the sham operation group and the pioglitazone group was significantly lower than the hypertensive group (all P＜ 0.05).Conclusions PPARγ agonist pioglitazone may protect the spatial memory function by relieving white matter lesions of the chronic hypertensive rats.

Objective To investigate new cases of endemic cretinism in high-risk areas of Inner Mongolia, the prevalence of endemic goiter, the implementation of comprehensive measures, and to provide scientific basis for developing control strategies against iodine deficiency disorders (IDD). Methods In 2007 and 2008, a search for new cretin cases was conducted among children under the age of 10 in 11 historical serious epidemic cretinism prevalent areas of Songshan district, Keshiketeng qi, Kalaqin qi, Zhalaite qi, Zhuozi county,Liangcheng county, Qingshuihe county, Helin county, Dongsheng district, Zhungeer qi and Yinjinhuoluo qi. Three to 5 towns were selected in each qi(county, district) and 3 to 5 village primary schools were selected in each town.One hundred and twenty to 200 children aged 8 to 10 were selected in each school to inspect thyroid by B ultrasound and palpation and to test intelligence and urinary iodine. Two villages were selected in each town and 30 households were selected to determine urinary iodine of housewives and salt iodine. Results A total of 56 cases of suspected cases of endemic cretinism were found from the 11 counties but no case was confirmed. The goiter rate of children aged 8 to 10 was 5.2% (309/5922) by palpation and 4.3% (252/5922) by B-ultrasound. The median urinary iodine of children aged 8 to 10 was 241.5 μg/L, and urinary iodine was 100 to 300 μg/L, accounted 65.9%(3901/5920). Median urinary iodine of the 9 Qis(counties, districts) was in the range of 200 and 300μg/L.Higher than 5% of the 11 Qis(counties, districts) with urinary iodine lower than 50 μg/L was zero. Higher than 10% of the 11 Qis(counties, districts) with urinary iodine lower than 100 μg/L was 1. The median urinary iodine of housewives was 225.6 μg/L, and lower than 50 μg/L accounted for 2.2%(35/1597). Higher than 10% of the 11 Qis(counties, districts) with urinary iodine lower than 100 μg/L was 4. A total of 2109 households were investigated and 97.45%(2055/2109) of them ate iodized salt and 2.55%(54/2109) of them ate non-iodized salt. Conclusions In the 11 investigated counties, goiter rate of children has decreased to less than 10%, and no new cretin was found. It could be concluded that the fulfillment of prevention and control of IDD is effective. The iodine nutrition of children and women of childbearing age is in an adequate level. The coverage rate of iodized salt has maintained at a higher level, the sales network is sound, the salt price is reasonable and salt is easy to get and the children's intelligence is protected effectively. But, the health education about IDD is still weak, need to be reinforced.

Objective To investigate the eyelid and orbital development of congenital microphthalmia. Design Prospective case se- ties. Participants 23 eyes of 23 patients with congenital microphthalmia aged from 6 months to 78 months. Methods The parameters of palpebral fissure length (PFL), palpebral fissure height(PFH) were measured in all patients. Also, combining the computer tomography (CT) imaging with the computer-aided design system, the anteroposterior axis of eyeball and orbital volumn were calculated automatically. To e- valuate the influence factor of eyelid and orbital growth, correlations between age, anteroposterior axis of eyeball and PFL, PFH, orbital volumn were analyzed. Main Outcome Measures PFL, PFH, anteroposterior axis of eyeball and orbital volumn. Results The PFL, PFH, anteroposterior axis of eyeball and orbital volumn in micro-side were (16.44?3.24) mm, (2.47?1.48) mm, (11.99?3.33) mm, (14.19?2.37) ml respectively. These parameters above were all significantly smaller than the unaffected side (all P=0.000). Moreover, orbital volume showed a strong linear correlation with the anteroposterior axis of eyeball and age(r=0.62, 0.63;p=0.037, 0.035). Both PFL and PFH were corelated with the anteroposterior axis of eyeball (r=0.54, 0.53; P=0.030,0.034), while showing no significant difference with age. According to the an- teroposterior axis of eyeball, two groups, including group less than or equal to 12 mm (10 cases) and group more than 12 mm (13cases), whose PFL,PFH and orbital volumn were (13.50?1.97) mm, (1.08?0.66) mm; (12.73?0.95) ml, (18.20?2.49) mm; (3.30?1.16) mm, (15.05?2.57) ml, respectively. They had statistically significant difference in PFL, PFH and orbital volumn (P=0.001, 0.003,0.024). Conclusion The development of eyelid and orbit with congenital microphthalmia is obviously retarded. The smaller the eyeball is, the much worse in- fluence in eyelid and orbital growth is. The intervention therapy in early stage as far as possible is fundamental approach in simulating the eyelid and orbital development, or preventing and reducing the incidence of orbital deformity.