Objective To study the pathologenesis and to evaluate an operative method of blepharochalasis. Methods A double eyelid-fold incision was made. The lacrimal glands were found and repositioned into lacrimal glands fossa behind superolateral orbital rim. Then redundant skin and muscles as well as hernia septal fat were removed. Results Twenty-three patients were successfully treated by the mentioned methods from 1998 to 2002. A good clinical results in both function and appearance were achieved. Conclusion It is convenient and effective to treat blepharochalasis through a double eyelid fold incision.

Objective To study the relation between the pressure in forefoot and the second metatarsalgia in hallux valgus deformity, finally to quantitatively analyze the pressure under the second metatarsal head which is a dangerous factor leading to second metatarsalgia. Methods Three groups volunteered for this study by a self-devised foot pressure measurement system: fifty-eight normal subjects (116 feet) without pain and deformity in foot, thirty-two patients (45 feet) with hallux valgus and pain only under the second metatarsal head, fifty-six patients (102 feet) with hallux valgus without symptoms of metatarsalgia. The percentage of pressure to weight was the criteria for data analysis. First the pressures under second metatarsal head among three groups were compared with each other. Secondly we used case-control study to identify whether it was high pressure that was likely to result in metatarsalgia. Finally we compared the pressure interval under second metatarsal head among three groups to define the pressure interval which might be a dangerous factor to second metatarsalgia. Results 1)The pressure beneath the second meatatarsal head in patients with metatarsalgia was the highest in the three groups (P

Objective To explore the clinical significance of cytokines expression including CD11b,CD18,IL-8 and IFN-? in patients with psoriasis.Methods 55 patients with psoriases,including vulgaris,pustulosa,arthropathica and erthrodermic ones,were enrolled into the case group and 40 healthy persons as control.The expressions of CD11b,CD18 were detected by flow cytometry,while IL-8 and IFN-? with ELISA.Results The expression of CD11b,CD18,IL-8 and IFN-? in patients with psoriasis was significantly higher than those in control.Conclusions The ultra expression of CD11b,CD18,IL-8 and IFN-? might relate with the immunopathology of lymphocyte cell activation in psoriasis.This might provide the dependable basis for its treatment.

Sepsis is defined as an organ dysfunction caused by systemic inflammatory response induced by infection,and may eventually developed into multiple organ failure (MOF).The onset of sepsis often involves the activation of inflammatory cells,over expression of inflammatory cytokines,immune dysfunction,damage of tissue and organ,excessive apoptosis of cell.Mesenchymal stem cells (MSCs) have a wide range of biological activities,including anti-inflammatory,antibacterial,immune regulation,regeneration and repair of tissue and organ,anti-apoptosis,etc.In recent years,a large number of preclinical studies had demonstrated that MSCs has good actions on sepsis.The purpose of this review is to describe the mechanism of MSCs in the treatment of sepsis,and to point out the possible clinical challenges.

Xiaochaihu Decoction comes from Shang Han Lun, which is a main formula for Shaoyang diseases. According to the principle of prescriptions corresponding to syndromes, the clinical application of modified Xiaochaihu Decoction for the treatment of swelling, pain, nausea, vomiting, bloating, and constipation after artificial total knee arthroplasty can achieve good efficacy.

Objective To investigate the clinical efficacy of treatment for chronic pancreatitis and mass in the head of the pancreas.Methods The clinical data of 19 patients with chronic pancreatitis with mass in the head of the pancreas who were admitted to the China-Japan Union Hospital of Jilin University from May 2008 to May 2013 were retrospectively analyzed,including 2 patients with gallstone.Methods of treatment were selected by in traoperative pathological results.All the patients were followed up by outpatient examination and telephone interview till January 2014.Results The operations of the 19 patients were successfully done,including 11 with pancreaticoduodenectomy,5 with exploratory laparotomy and 3 with the laparoscopic cholecystectomy and choledochojejunostomy.The operation time and intraoperative blood loss were (249± 140)minutes (50-390 minutes) and (320 ± 260)mL (50-900 mL).The postoperative mean time of recovery of gastrointestinal function and duration of postoperative hospital stay were 3.0 days (2.0-6.0 days) and 22.6 days (8.0-30.0 days) after the operation.The mean casein-IgG4 of 12 patients was higher (2.64 g/L) after operation.Five patients with operation-related complication were cured after symptomatic treatment,among 2 patients with leakage of the pancreatic fluid,2 with operative incision fat necrosis and liquefaction and 1 with bile leakage.No patients died perioperatively.Nineteen patients were followed up for 11.0 months to 36.0 months with the median time of 28.2 months.The pancreatic head mass of 8 patients with non-pancreaticoduodenectomy were reduced or disappeared by a computed tomography (CT) or magnetic resonance imaging (MRI) rescan,who were treated by the oral prednisone.No complications were detected in the other 11 patients with pancreaticoduodenectomy.Conclusion Method of surgery or medicine treatment for atypical mass in the head of the pancreas is selected according to the pathology results by effective communication with patients and family members,exploratory laparotomy and interpretative aspiration biopsy.

Objective To investigate the relationship between osteoprotegerin ( OPG ) gene polymorphisms and ischemic stroke etiological subtypes, as well as the extent and distribution of cerebral atherosclerosis ( AS) lesions.Methods Patients with ischemic stroke included 285 cases of large-artery atherosclerosis (LAA), 91 cases of small-artery occlusion (SAO) and 42 cases of purely AS, and 165 healthy controls were enrolled in this study.The LAA group was respectively divided into 3 subgroups according to the number and the distribution of stenostic vessels.Genotyping of three single nucleotide polymorphisms (SNPs;rs2073617, rs3134069, and rs3102735) in the promoter region of the OPG gene was performed by polymerase chain reaction-restriction fragment length polymorphism.Results Regarding the three SNPs of OPG gene, the frequence of genotype CC/CT and the prevalence of allele C of rs3102735 were higher in the LAA group contrasting with the control group ( 24.04% vs 14.85%, 44.21% vs 27.88%,χ2 =10.758, 11.804, P =0.001,0.024).However, comparisons of other frequences of genotypes or alleles did not reveal any significant differences among the LAA group, the SAO group, the AS group and the control group, as well as among different subgroups of LAA group.Haplotype analysis revealed that the frequencies of haplotype C-C-T in LAA group and SAO group were significantly lower ( 0.023, 0.017 vs 0.068,χ2 =10.399, 5.841,P=0.001, 0.016), while that of haplotype T-A-C was significantly higher in SAO group(0.043 vs 0.016,χ2 =4.708, P=0.030) compared with controls.Conclusions Our findings indicate that OPG gene polymorphisms might be associated with increased susceptibility to LAA ischemic stroke.But we fail to show association of OPG gene with the extent and distribution of AS.

[A BSTR ACT] OB J ECTI V E To i mprove the recognization of clinical, imaging and pathological characteristics of angioleiomyoma (ALM) in the head and neck region. METHODS We retrospectively reviewed the data of 20 patients with ALM in the head and neck region between 2000 and 2012. RESULTS Seven male and 13 female patients were included in this study. The average age was 52.5 (from 28 to 74 years). The symptom in most cases (n=14) was the painless mass, 4 tumors originating in the nasal cavity presented with nasal obstruction or (and) epistaxis, and the other 3 cases were accidentally found by physical examination. The results of B-ultrasonography in 10 ALM cases of subcutaneous or deep space were homogeneously hypoechoic echo texture, straight and linear vessels in the tumor with convergence to one point with a circumscribed margin. MRI in 5 cases demonstrated typically a well-defined mass, which showed hypointensity or isointensity to muscle on T1WI, and heterogeneous hyperintensity on T2WI. All lesions showed obviously delayed enhancement on contrast MRI. HE stain showed that the tumors were formed by bundles of spindle-shape smooth muscle cells circumscribing numerous slit-like blood vessels in most cases. Immunoperoxidase staining revealed that the tumor cells were strongly positive for calponin, desmin and smooth muscle actin (SMA) in the cytoplasm of the smooth muscle cells. The positive expression of progestogen receptor and estrogen receptor was seen in 7 cases and 4 cases respectively among 10 cases. All patients underwent surgery, and recovered well postoperatively without recurrence or malignancy. CONCLUSION The clinical manifestations of ALM are nonspecific. ALM has distinctive imaging features in B-ultrasonic and MRI examination. Histological examination and immunoperoxidase staining can make a definite diagnosis of the disease. Progestogen receptor and estrogen receptor can be expressed in ALM. The postoperative prognosis is good.

Objective: To study the protective effect of vitamin E in preventing contrast-induced nephropathy (CIN) in patient with coronary artery disease (CAD) after percutaneous coronary intervention (PCI).
Methods: We prospectively studied 206 CAD patients with elective PCI in our hospital and divided them in 2 groups: Treatment group, the patients received oral vitamin E combining vinous hydration,n=102 and Control group, the patients received vinous hydration only,n=104. CIN was deifned by at 48h after contrast media injection, serum cretinin increased up to 25% from the baseline, or reached 44.2 μmol/L. Excluding the other kidney injury factors, the renal functions at 48 h before and after PCI were compared, the occurrence rate of CIN were also compared between 2 groups.
Results:①Overall, there were 19/206 (9.22%) patients suffered from CIN, the occurrence rate in Treatment group (4.90%) was lower than Control group (13.46%), χ2=4.506,P=0.034. For patients with hypertension, diabetes, chronic kidney disease, anemia and mehran risk score<10, the occurrence rate of CIN in Treatment group was lower than Control group,P<0.05.②Compared with pre-operative condition, at 48 h post-operation,Control group showed increased serum creatinine (Scr), blood urea nitrogen (Bun) and decreased creatinine clearance rate (Ccr), allP<0.05.③At 48 h post-operation, compared with Control group, Treatment group presented decreased Scr (86.72 ± 17.73) μmol/L vs (95.13 ± 21.67) μmol/L and increased Ccr (96.75 ± 27.23) ml/min vs (90.70 ± 17.85) ml/min, allP<0.05.④Multivariate regression analysis revealed that elder than 75 years of age (OR=7.278, 95% CI 5.158-11.480), diabetes (OR=3.919, 95% CI 1.330-8.200), chronic kidney disease (OR=6.325, 95% CI 2.137-16.816) and mehran risk score>10 (OR= 4.461, 95% CI 1.589-14.724) were the independent risk factors for CIN occurrence, allP<0.05.
Conclusion: Short-term application of vitamin E may reduce the risk of CIN occurrence at certain degree in CAD patients after PCI.

Objective To report the curative effect of the epitympanoplasty with cartilage obliteration in the treatment of middle ear cholesteatoma .Methods This study retrospectively analysed 123 cases ,with middle ear cholesteatoma treated in our department from November 2009 to July 2012 .The operation included mastoidectomy with posterior canal wall preserved ,lateral wall of attic resected ,facial recess opened to the epitympanum ,epitym-panum obliterated with cartilage and mastoid cavity blocked with bone dust .All cases were followed up on complica-tions and hearing improvement .Results All cases were followed up 6~38 months .In 123 cases ,there were 2 ca-ses had cholesteatoma recurrence in the middle ear cavity ,6 cases had infection of post auricular incision after opera-tion ,3 cases had residual marginal tympanic membrane perforation ,2 cases had ossicular replacement prosthesis ex-clusion ,and 6 cases had canal wall skin swelling or defect .The rest cases acquired full -recovery after 2 or 3 wound dressing changes .Out of 123 cases ,83 cases had the whole hearing document ,the average AB gap at 0 .5 ,1 ,2 kHz reduced from 32 .2 ± 11 .2 dB pre-operation to 20 .7 ± 12 .4 dB post -operation .The AB gap of pre - and post -operation had significant difference (P<0 .001) .Conclusion The mastoidectomy with posterior canal wall preserved greatly shortened the healing time .The resection of lateral wall of epitympanum can exposed operating field more completely and remove lesions thoroughly .The cartilage obliteration in the attic can prevent the retraction pocket formation effectively .This technique provides alternative in treating middle ear cholesteatoma .