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 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.

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.

Aged ; Cytoplasm ; Cytoplasmic Granules ; Female ; Humans ; Multiple Myeloma ; pathology ; Plasma Cells ; pathology

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.

OBJECTIVE To investigate the drug resistance and the prevalence of inducible clindamycin resistance in clinical isolates of Staphylococcus aureus and evaluate the clinical value of cefoxitin disk diffusion method and oxacillin disk diffusion for detection of meticillin-resistant S.aureus(MRSA).METHODS Bacteria identification and susceptibility test were performed by VITEK-2 system and K-B disk method.The PBP2a was detected by latex agglutination and MRSA was identified by cefoxitin disk diffusion method and oxacillin disk diffusion.The inducible resistance of erythromycin to clindamycin was checked by D-test according to the standards of CLSI(NCCLS).The statistical analysis was performed by WHONET 5.4 and SPSS 13.0 software.RESULTS Resistant rate to penicillin and ampicillin was 98.9% and 100.0%,respectively.Vancomycin-resistant(VRE) or intermediate strains were not found.Of the 93 S.aureus isolates,MRSA and meticillin-sensitive S.aureus(MSSA) were 58(62.4%) and 35(37.6%),respectively.The resistant rate of MRSA to 11 antibiotics was higher than MSSA.The sensitivity and specificity of cefoxitin disk diffusion method were 98.3% and 97.1%,respectively,those of oxacillin disk diffusion were 75.9% and 94.3%.Of the 9 isolates resitant to erythromycin but susceptible to clindamycin,5(55.6%) showed inducible resistance to clindamycin.CONCLUSIONS Resistance of S.aureus is quite serious.Cefoxitin disc diffusion method is a simple and reliable method for the detection of MRSA.The inducible resistance of erythromycin to clindamycin in S aureus should be checked by D-test in clinical microbiology laboratory routinely.