Objective To have a research on the improvement of visual field of advanced primary glaucoma with tubular visual field after the surgery.Methods Twenty-six patients in the hospital during Nov.2010-Dec.2011 were treated with the compound trabeculectomy.Have a comparison between the preoperative period and postoperative period about the visual field index,visual acuity,intra-ocular tension,bleb After 6-18 mouths following-up,have a summary on the complication rate.Results The visual field index,visual acuity,intra-ocular tension,bleb in the postoperative period were much better than that in the preoperative period.There were no serious complications after the surgery.Conclusion To use the compound trabeculectomy to treat the advanced primary glaucoma with tubular visual field patients is worthy to be promoted and applicated in clinical practice.This method is full of safety and availability.

Objective To clone the full length staphylococcal protein A(SPA) gene from Staphylococcus aureus (ATCC6538), and subsequently study the gene structure and antibody binding ability.Methods The full length and the functional region of the SPA gene were cloned into pHisSUMO vector respectively, and expressed in E. coli. The full length and the functional fragment of the SPA protein were detected for antibody binding ability and stability. The functional fragment of the SPA protein fused with SUMO was coupled to the CNBr-activated agarose for antibody purification from rabbit serum. Results A variant of the full length SPA gene was cloned, which has been submitted to GenBank (the accession number is EU695225). Two fusion proteins had the same antibody binding ability as the untagged SPA protein. However, the formers was more stable than the latter at the tested conditions. SUMO-SPA conjugated-agarose kept high efficiency for antibody binding. Conclusion To our knowledge, the full length SPA gene of S.aureus(ATCC6538) is a novel variant. The SUMO tag can improve the stability of the functional region of the SPA protein without damaging the antibody binding ability. This fusion protein has been used for antibody purification successfully.

BACKGROUND: With further understanding of deep venous thrombosis(DVT)following total hip replacement,reduction and prevention of DVT has become hot topic in clinical studies.The reports of DVT formation factors remain controversial due to small samples,little statistical significance,confusion of basic experimental and clinical results and lacks of science.OBJECTIVE: To explore the causes and factors for the early DVT following total hip replacement and summarize measures to prevent and treat early DVT to reduce incidence of complications.METHODS: A total of 1780 cases of primary total hip replacement operation were analyzed retrospectively.The statistical indexes included sex,age,body mass,other system disease,previous hip joint operation,anesthesia,operative time,prosthetic fixation,blood transfusion,postoperative functional exercise,antithrombotics,and complication.Standardized database was built and analyzed by SPSS(version 13).Regression analysis was performed using Binary Logistic Regression.RESULTS AND CONCLUSION: Of 1780 cases,136 had DVT.Age,other system diseases,anesthesia,prosthetic fixation,blood transfusion,postoperative functional exercise and antithrombotics were correlated with early DVT(P < 0.05).Old age,hypertension or diabetes,general anesthesia,fixation of bone cement,whole blood transfusion were the risk factors for early DVT following total hip replacement,while postoperative functional exercise and antithrombotics were the protective factors for DVT.The incidence rate of early complications can be reduced by the methods such as dealing with perioperative treatment carefully,effectively controlling the chronic diseases,efficient evaluation before surgery,precise manipulation,and the postoperative prophylactic treatment and nursing.

BACKGROUND:At present, the incidence rates of knee joint diseases such as knee osteoarthritis, knee joint degenerative are high. The major clinical treatment is total knee replacement in the clinic, so it is necessary to evaluate the changes in stress and bone mineral density of the regions surrounding the prosthesis after replacement. ＜br> OBJECTIVE:To explore periprosthetic stress and bone mineral density and to analyze their correlation after total knee arthroplasty. ＜br> METHODS:A total of 20 cases undergoing total knee arthroplasty were chosen.The hospital for special surgery scores were used to evaluate patients’ functional recovery at 12 months after total knee arthroplasty. The periprosthetic femur was divided into four regions of interest (ROI), respectively ROI 1-4;periprosthetic tibia was divided into three regions of interest, respectively ROI 5-7. Stress surrounding the prosthesis was analyzed using three-dimensional finite element analysis at 1, 3, 6 months, 1, 2, 3 years after replacement. Simultaneously, bone mineral density surrounding the prosthesis was measured using dual-energy X-ray absorptiometry. ＜br> RESULTS AND CONCLUSION:No patients affected infection or loosening of the prosthesis. At 12 months after replacement, the score of hospital for special surgery was (90.23±2.37), which showed significant differences as compared with before replacement (39.68±1.31) (P＜0.05). The level of stress shielding was highest in ROI 5 and lowest in ROI 3. Stress shielding rate of ROI increased with statistical difference at 6 months after operation (P＜0.05). At 1, 2, 3 years after operation, shielding rate in periprosthetic femoral stress in ROI 1 decreased. Compared with 1 month after operation, the difference was statistical y significant (P＜0.05). However, shielding rate of tibial periprosthetic stress in ROI 6 increased. Compared with 1 month after operation, the difference was statistical y significant (P＜0.05). Bone mineral density after 1 month after operation had no significant decrease (P>0.05). At 3 months after operation, bone mineral density began to decline significantly (P＜0.01). The decrease was most obviously in ROI 5 and the change was least in ROI 3. After 1 year of operation, bone mineral density did not change significantly. These data indicated that changes in bone mineral density were correlated with stress shielding after total knee arthroplasty. Monitoring two variations can provide theoretical data for preventing bone loss, which provides references for clinical rehabilitation guidance.

Objective To identify the application of puncture biopsy under ultrasound guidance in diagnosis of bone tumor.Methods The results of ultrasonic puncture biopsy were comparatively analysed with that of imaging diagnosis and postoperative-pathological diagnosis in 17 patients with bone tumors.Results The giant cell tumor of bone were diagnosed by puncture biopsy in 8 cases,by imaging in 12 cases and by pathology,postoperation in 9 cases,the corresponding rate was 66.7% and 88.9% respectively.Bone cyst in 2 cases,fibrous dysplasia in 2 cases,metastasis from lung carcinoma in one case,osteosarcoma in 2 cases were confirmed by both pathology and puncture biopsy.The aneurysmal bone cyst in one case was diagnosed by imaging,but no blood-like fluid was harvested in puncture,one case of metastasis in proximal femur,one case of fibrous dysplasia and one case of osteosarcoma were diagnosed by imaging,while one case,2 cases and one case diagnosed by puncture respectively.One case of bone cyst was confirmed by imaging,puncture biopsy and pathology.Conclusion The puncture biopsy under ultrasound guidance is of high diagnostic rate in bone tumors,it is a good choice for the diagnosis of bone tumor.

OBJECTIVE:To establish a method for determination of Edaravone cont en ts in injection METHODS:The Kromasil C18 column(4 6mm?200mm,5?m) was use d The mobile phase was consisted of 0 1mol/L NaH2PO4-methanol(45∶55) with detection at 242nm,flow rate was 1 0ml/min RESULTS:The linear range was 1 2 4?g/ml～24 8?g/ml(r=0 9 999),the mean recovery was 100 3% with RSD=0 9 5%(n=6) CONCLUSION:This method is simple,sensitive and accurate,and can b e used to control the quality of Edaravone injection

BACKGROUND:Currently, surgical treatment for Sanders III type, IV type fractures to restore damaged subtalar surface of the calcaneus and calcaneal shape, in order to reduce the incidence of traumatic arthritis has reached a consensus, and whether bone grafting is selected during surgery for calcaneal fractures has been a controversial issue. OBJECTIVE:To observe the clinical effect of Genex synthetic bone transplants and locking plate on comminuted calcaneal fractures. METHODS:Twenty-one cases of Sanders III type, IV type calcaneal fractures were retrospectively analyzed, including 16 males and 5 females, aged 22 to 55 years. After fracture reduction, a dough-like Genex bone graft was implanted into the defect region via lateral“L”shaped approach, and then the lateral wal of the bone was reset fol owed by internal fixation with the pre-curved locking plate. Fol ow-up observation was performed for fracture healing, Bolher angle and the Maryland Foot Score. RESULTS AND CONCLUSION:Total y 21 patients were fol owed up for 8-16 months. The fractures were healed without displacement, col apse and rejection. The bone graft was degraded within 6 months and completed absorbed after 1 year. According to Maryland Foot Score, the excellent rate was up to 86%, and the Bolher angle was increased from an average preoperative (5.3±3.35)° to postoperative (24.3±1.06)°. Genex artificial bone meal is a biomaterial that can be completely absorbed, has good plasticity and strong supporting force, and it is able to ful y fil bone defects, be easy to fracture reduction, induce bone formation, and promote fracture healing.

Objective To discuss how to reduce the incidence of postoperative infection and am-putation of patients after earthquake.Methods The wound infection and corresponding therapeutic outcome were analyzed in 592 patients in front line hospitals and station hospitals.Results The inci-dence of infection was 30. 7% in patients treated in front hospital within 8 hours post-trauma but 79. 9% after 8 hours post-trauma. There included 1 patient(0. 2%) with amputation due to clostridial myonecro-sis and 5(1. 2%)with amputation due to serious infection. Incidelice of postoperative wound infection was 7. 1% after selective operation for close injury. The incidence of infection in patients in station hospi-tals was 50. 8%, with no amputation, because they received debridement and antibiotics in site or front line hospitals. No postoperative infection was found in patients with close injury treated with selective op-eration in station hospitals. The major bacteria of wound infection in either front line hospitals or station hospitals were enterococcus faecalis and Eschrichia Coli. Incidence of combined infection was higher than that of single infection. And Gram-Negative bacillus infection exceeded Gram-Positive bacillus infection. The major wound infection obrained effective control through treatment with sensitive antibiotics.Con-clusions After earthqiale, the incidence of infection in patients with open injury is high, with high am-putation rate due to serious infection. Therefore, we propose performing as soon as possible debridement and external fixation with antibiotic treatment but reducing internal fixation. The postoperative infection late of patients with close injury in front line hospitals is much higher than that in station hospitals;their-fore, patients with stable vital signs should be transported to station hospitals as early as possible in order to reduce incidenee of infection.

Objective To investigate and summarize the clinieal effects and cosmetic results of 5-aminolaevulinic acid-photodynamic therapy (ALA-PDT) on cephalic and facial skin tumors.Methods Patientswith skin basal eell carcinoma(BCC),squamous cell carcinoma (SCC),keratosis seborrheica (KS),and solar keratosis (SK) were included in this study.Inoperable cases were given topical ALAPDT,and received clinical response evaluation and satisfying questionnaire after 3 months follow-up.Resalts28 patients including 16 BCCs,8 SCCs,2 KSs and 2 SKs received ALA-PDT.100% BCC had responseto PDT,including 15 cases with complete response (CR);only one recurred.Overall response rate was 67% for SCC,2 of 8 cases failed to continue the treatment,3 eases CR,1 case partial response (PR) and 1 patient with no response.Response rate was 0% in KS.100% of SK had response to PDT,and 2 cases showed CR and PR,respectively.64.2% patients (18/28) showed extreme satisfaction for cosmetic outcome,11% (3 cases) satisfaction,7.1% (2 cases) little satisfaction,and 10.7% (3 cases) no satisfaction.Conclusion Topical ALA-PDT is an effective and satisfied treatment with lower recurrent rates, especially for cephalic and facial skin tumors including BCC,SCC and SK,but no response for KS.

Objective To study the effects of He-Ne laser irradiation on the pH value of gastric juice, the ultrastructure of gastric parietal cells and the content of nitric oxide ( NO ) in chronic atrophic gastritis ( CAG ) . Methods Sixty healthy male Wistar rats were randomly divided into a normal control group, a model group, a drug group, an acupuncture group and a laser acupoint group, each of 12. A CAG model was successfully intro-duced to all except those in the normal control group through the administration of sodium salicylate and alcohol, combined with fasting and water deprivation, running fatigue and other interventions. The rats of the drug, acupunc-ture and laser acupuncture groups were given medications, acupuncture at Zusanli acupoint and laser irradiation at Zusanli acupoint accordingly. After 14 days of treatment, all of the rats were executed and diluted gastric juice and gastric tissues were collected. NO content in serum was determined using a nitrate enzyme reduction method, the pH value of gastric juice was measured, and the ultrastructure of the gastric mucosa was observed using a transmis-sion electron microscope. Results The average pH of the gastric juice and the average serum NO content were both significantly higher in the model group than in the normal control group. In the model group the membrane structure of the parietal cells was absent or partly dissolved and the mitochondria were swollen. Drugs, acupuncture and laser irradiating at the Zusanli acupoint all corresponded with reduced pH and NO content, but the most signifi-cant improvements were observed in the laser acupuncture group. In the laser acupuncture group the membrane structure of parietal cells was complete, and the cytoplasmic organelles had nearly returned to normal. Conclusions Laser irradiation can promote recovery from CAG, increasing the secretion of gastric acid and de-creasing the serum level of NO. Both have a good curative effect for CAG. Laser irradiation deserves further clinical research and promotion.