Objective: To evaluate the application of CT in the diagnosis of fracture position and the cause of diplopia after orbital trauma. Methods:The CT findings and the clinical informations of orbital fractures accompanying diplopias in 68 patients (70 orbits) were retrospectively analysed. Results: Orbital fractures in 70 orbits were diagnosed by CT. There were burst orbital floor fractures in 45 orbits ( among them orbital floor fracture combined with medial wall fracture in 15 orbits), non-burst obital floor fractures in 10, medial orbital fractures in 5, zygomatic-orbital fractures in 5, orbit roof fractures in 5. The accuracy of CT in diagnosing orbital fracture was 100 percent. In 68 cases, there were 64 patients with vertical diplopia and 4 with horizontal diplopia . Conclusion: CT can correctly locate the orbital fracture and diagnose the cause of diplopia.

Objective To explore the pathological and imaging features of adenosquamous carcinoma (ASC) of pancreas.Methods Both clinical data and imaging findings in seven cases with pathologically proved ASC of pancreas were analyzed retrospectively.Imaging features were compared with pathological results.Results 1 )The disease mainly occurred in people around 55 years, among the 7 cases ,5 located in the pancreatic head, 2 in the body and tail, with abdominal pain and jaundice as the chief complaint.2)Pathologically, the solid part of the tumor was made up of ductal adenocarcinoma and squamous carcinoma components, with a different rate, while the cystic part was made up of necrosis, liquefaction.3) the imaging of 5 cases with ASC of pancreas in which squamous carcinoma components predominate shows solid and cystic tumors of pancreas, furthermore the ratio of central cystic diameter and the whole tumor diameter increase with the the volum of the tumor.4) There is no partitioning in the cystic part of the tumor, with a few irregular microcyst around it.5 ) The tumor shows a pattern of infiltrative growth, associated dilatation of the common bileduct or pancreatic duct in all cases, pancreatic atrophy in part.6) Squamous carcinoma components of the tumor was the pathologic basis for the formation of the solid and cystic structure in imaging.Conclusions ASC of pancreas is a rare aggressive subtype of pancreatic adenocarcinoma with a worse prognosis than the usual type of ductal adenocarcinoma, although symptoms similar to pancreatic ductal carcinoma.Cases of ASC of pancreas in which squamous carcinoma components predominate have certain characteristic imaging and pathologic features,which is important to early diagnosis.

Epilepsy is a common chronic nervous system disease, about one third of patients with intractable epilepsy, which brings a heavy burden to the society. At present, the specific etiology and drug-resistant mechanism are still unclear. Minimally invasive, reliable and economic biomarkers are of great help to improve the diagnosis and prognosis of drug-resistant epilepsy. In recent years, microRNA has gradually become a research hotspot of intractable epilepsy and is expected to become a biomarker. This paper briefly reviews the microRNA related to intractable epilepsy.

Objective:To explore therapeutic effect of carvedilol combined valsartan on patients with chronic heart failure (CHF).Methods:A total of 98 CHF patients were selected from our hospital from Feb 2012 to Dec 2014. According to random number table,they were randomly and equally divided into control group (received valsartan therapy) and combined treatment group (received valsartan combined carvedilol therapy).Therapeutic effect and incidence rate of adverse reactions were compared between two groups.Results:There were no significant differ- ence in all cardiac function indexes before treatment between two groups (P>0.05 all).After treatment,compared with control group,there were significant reductions in HR [(95±14)beats/min vs.(74±16)beats/min],left ventricular end-diastolic dimension (LVEDd)[(74.9±2.9)mm vs.(50.9±1.7)mm],left ventricular end-sys- tolic dimension (LVESd)[(64.9±3.8)mm vs.(45.7±2.0)mm],left ventricular end-diastolic volume (LV- EDV)[(198.7±60.5)ml vs.(165.9±52.3)ml]and left ventricular end-systolic volume (LVESV)[(148.9± 62.7)ml vs.(111.4±51.7)ml];and significant rise in left ventricular ejection fraction (LVEF)[(34.2±6.5)%vs.(56.9±10.1)%]and stroke volume (SV)[(68.4±5.1)ml vs. (81.5±6.0)ml]in combined treatment group,P<0.05 or <0.01.Total effective rate of combined treatment group was significantly higher than that of valsartan group (91.8% vs.71.4%),P<0.01.There were all no apparent adverse reactions in both groups.Con-clusion:The therapeutic effect of valsartan combined carvedilol is significant and its safety is good in patients with chronic heart failure.

Objective To evaluate the modified Physical and Operative Severity Score for the Enumera-tion of Mortality and Morbidity (POSSUM) in predicting the postoperative morbidity in patients with fractures of the pelvis and acetabulum. Methods The clinical data of 94 patients with pelvic and acetabular fractures were retrospectively analyzed. Their postoperative prognosis during hospital stay was evaluated with the POSSUM scoring system modified according to the features of orthopedics and pelvic and acetabular fractures. The peritoneum in-fection in the severity index of operation was replaced by operative approach, the several operations at one time by operative duration, and the cancer by the associated injury. The size and type of operation were made into 4 grades with corresponding orthopedic scores. The scores were compared between the complication group and the non-complication group. The receiver operator characteristic (ROC) curve was drawn to describe the coincidence degree, define the cut points, and evaluate its predicting capability. Results The mean preoperative physi-ological score (PS) and operative severity score (OS) in the complication group (38 cases) were significantly higher than those in the noncomptication (56 cases) (17.26 ± 2.84 vs 16.04 ± 2.77; 19.50 ± 5. 14 vs 13.00 ±3.81 ) ( P ＜ 0.05) . In the modified POSSUM, the area under ROC curve was 0. 856, the cut point 43%, sen-sitivity 73.68%, specificity 80. 36%, and coincidence degree 77.66%. Conclusions Since the modified POSSUM scoring system has a high capability of predicting postoperative morbidity for fractures of the pelvis and acetabulum, it can be helpful for surgeons to lower operative risks and ensure safety in operation. When the score is higher than the cut point, the risk is too great for an operation. Therefore, the fracture should be treated non-operatively or mini-invasively until the score is lower than the cut point.

Oncocytic papilloma (OP) of nasal cavity and paranasal sinuses are uncommon. We report 3 cases of oncocytic papilloma arising in the nasal cavity and paranasal sinuses, and review the relevant literatures. Unilateral sinonasal lesions are the main clinical manifestation. Pathological feature is multiple layers of epithelial cells. The cytoplasm contains abundant eosinophilic granular and microcapsules filling with mucus. The neutrophils aggregate in the microcapsules which form microabscess. The tendence of recurrence and malignant transformation are the biological character. The best treatment choice is surgical excision completely, and long-term postoperative follow-up is necessary to prevent relapse.
Cell Transformation, Neoplastic ; Humans ; Nasal Cavity ; pathology ; Neoplasm Recurrence, Local ; Nose Neoplasms ; diagnosis ; Papilloma ; diagnosis ; Paranasal Sinuses ; pathology

120 teeth with wedge-shaped defects at subgingival depth of 0 ~2 mm were selected and divided into 3 groups(n =40).Gingival retraction code and EXPASYL gingival retraction paste were used for gingival retraction in the 2 retraction groups,and none retraction was used in the control group.After restoration of the defects,all cases were followed up for 1 year and 2 years.The results were evaluated by modified USPHS criteria.No significant difference was detected for 1 year and 2 year successful rates between the extraction groups(P >0.05).The successful rate in extraction groups was higher than that in the control group(P ＜0.05).

Objective:To estimate the safety and feasibility of flexible laryngeal mask airway (FLMA) for lumbar vertebral surgery in prone position.Methods: In the study,120 adult patients scheduled for lumbar vertebral surgery under intravenous general anesthesia were divided into group FLMA and reinforced tracheal tube (RTT) group at random.Heart rate (HR),systolic blood pressure (SBP) and diastolic blood pressure (DBP) were recorded at the beginning of anesthesia induction (T0) and on the time of artificial airway intubation (T1),1 min after intubation (T2),extubation (T3),1 min after extubation (T4) as well.The number and time required for intubation were recorded.Peak airway pressure (PPEAK),airway sealing pressure (PAS) in group FLMA and fiberoptic bronchoscopy scale (FBS) were recorded after artificial airway intubation,turned over into prone position and after the operation started,as well as on the time of 1 hour after the operation started,2 hours after operation started and when the operation stopped.Finally,respiratory complications after extubation,including hypoxemia,laryngospasm,coughing,vomiting,hoarseness,and pharyngalgia,were observed and whether there was blood or sewage inside and outside the artificial airway was recorded.Results: There was no difference in the number and time required for intubation between the two groups (P>0.05).There was no difference in PPEAK and FBS between the two groups,and also the same at the different time points in each group (P>0.05).PAS in group FLMA was the same at the diverse time points during anesthesia (P>0.05) and always higher than PPEAK in the perioperative period.In group FLMA,there was no difference in HR,SBP and DBP between the time points of T2 and T1,also of T4 and T3 (P>0.05).In group RTT,HR,SBP and DBP were significantly higher between the time points of T2 and T1 (P<0.01);SBP was significantly higher between the time points of T4 and T3 (P<0.01),DBP and HR were higher between the time points of T4 and T3 (P<0.05).SBP in group FLMA was significantly lower than in group RTT at T2 (P<0.01),HR and DBP were lower than those in group RTT simultaneously (P<0.05).On the time point of T4,SBP,DBP and HR in group FLMA were lower than those in group RTT (P<0.05).The incidence of coughing and pharyngalgia after extubation was significantly lower in group FLMA than in group RTT (P<0.01),with the incidence of hoarseness was lower in group FLMA than in group RTT (P<0.05).There was no difference in the incidence of hypoxemia,vomiting and blood seen outside the cuff between the two groups (P>0.05) while no laryngospasm and sewage seen outside the artificial airway in each group.Conclusion: For suitable patients,FLMA can be used in mechanical ventilation forlumbar vertebral surgery in prone position with more stable circulation and less respiratory complications than RTT.Further clinical validation is needed for the safety of FLMA.

Objective To study on the ultrastructural characteristic of segments of photoreceptors from neonatal retinas for supporting donor retina choice of retinal transplantation. Methods Photoreceptors from neonatal calf and adult calf were analysed by scanning electron microscopy and transmission electron microscopy. Results Segments of photoreceptors from neonatal calf appeared the mushroom pattern, in which, distal end of outer segment which was ball shaped formed the head with mushrooms appea rance, and the inner segments along with some of outer segments formed the body with mushrooms appea rance. Within the outer segment, plasma membranes of adjacent evaginations form a disk subsequently. The array of most disks were vertical to the entire length of segments, but some were parallel and slope to. Owing to the incomplete formation, some rim of disk near distal end of outer segment revealed step shaped appearance. The distal end of outer segment displays some processes consisted of membranous discs, much vesicular material and mitochondria, much rough endoplasmic reticulum (RER) and numerous polysomes. Segments of photoreceptor connected with outer nuclear layer via the external limiting membrane. Conclusion The typical morphological structures of outer segments suggest the immature and strong gowth ability of photoreceptors of the retina of neonatal calf, and therefore the competence for donor material of retinal transplantation.

Objective To evaluate the clinical efficiency of laparoscopic operation for the treatment of ureteropelvic junction obstruction(UPJO).Methods A total of 19 patients with UPJO underwent laparoscopic dismembered pyeloplasty.The operation was performed under general anesthesia.The patients were maintained in a lateral decubitus on unaffected side.After the establishment of pneumoperitoneum,3~4 trocars were introduced at proper sites.During the operation,the lateral peritoneum was opened and the ureteropelvic junction obstruction was dissociated and dissected.The end-to-end anastomosis of the renal pelvis and ureter was conducted and a double-J stent was placed in the ureter.Results All the operations were performed successfully.The operation time was 110~240 min(mean,150 min),the blood loss was 50~100 ml(mean,80 ml),and the postoperative hospitalization time,6~10 d(mean,7.8 d).No severe complications occurred.Follow-up assessment with intravenous urography for 3~15 months(mean,6 months) in 14 patients showed no ureteral stricture.Conclusions Laparoscopic dismembered pyeloplasty is an effective and safe procedure in the treatment of UPJO.It can replace the open surgery.