To analyze the clinical results of orbicularis muscle shortening surgery and eyelid skin orbicularis muscle resection for senile entropion.
●METHODS: From January 01, 2006 to December 31, 2012, senile patients with lower eyelid were divided into two groups according to different surgical methods. Group A with the orbicularis muscle shortening improved operation in 20 cases (38 eyes), group B used the eyelid skin orbicularis muscle resection in 21 cases (36 eyes). The effects of surgery were followed-up postoperatively.
●RESULTS: Patients were followed up for 1 - 2a, 20 patients ( 38 eyes ) in group A were cured without recurrence; 7 eyes recurred in group B, the recurrence rate was 19%, the recurrence rate after surgery both groups were statistically significant (P<0. 05).
●CONCLUSlON: The effect of orbicularis muscle shortening improved operation for senile entropion is good and stable.

Nonnucleoside reverse transcriptase inhibitors (NNRTIs) play an important roles in the prevention and treatment of AIDS. NNRTIs can specifically target at HIV reverse transcriptase (RT) and have the advantages of high potency and low toxicity, which make them a research focus for a long time. In the guidance of structural optimization strategies (bioisosterism, molecular hybridization and scaffold hopping) in medicinal chemistry, structural modification to lead compounds can be carried out to design new compounds with different levels, which will improve the efficiency of drug discovery and decrease the cost of drug development. It is an effective way to find new NNRTIs. In this review, we will expatiate on the application of different levels of structural optimization strategies in the NNRTIs structural modification with concrete examples.

Both reverse transcriptase (RT) and integrase (IN) play crucial roles in the life cycle of HIV-1, which are also key targets in the area of anti-HIV drug research. Reverse transcriptase inhibitors are involved in the most employed drugs used to treat AIDS patients and HIV-infected people, while one of the integrase inhibitors has already been approved by US FDA to appear on the market. Great achievement has been made in the research on both, separately. Recently, much more attention of medicinal chemistry researchers has been attracted to the strategies of multi-target drugs. Compounds with excellent potency against both HIV RT and IN, evidently defined as dual inhibitors targeting both enzymes, have been obtained through considerable significant exploration, which can be classified into two categories according to different strategies. Combinatorial chemistry approach together with high throughput screening methods and multi-target-based virtual screening strategy have been useful tools for identifying selective anti-HIV compounds for long times; Rational drug design based on pharmacophore combination has also led to remarkable results. In this paper, latest progress of both categories in the discovery and structural modification will be covered, with a view to contribute to the career of anti-HIV research.

Objective To investigate the clinical outcomes of arteriovenous anastomosis by microvascular anastomotic coupler device.Methods From January 2013 to November 2013,23 cases of microvascular anastomotic coupler device were applied in 18 patients with vascular injury of upper limb,and anastomosis time and patency rate was observed.Results In 18 patients,the brachial artery injury in 2 cases,the radial artery injury in 11 cases,the ulnar artery injury in 8 cases,the cephalic vein injury in 1 case,and basilic vein injury in 1 case.23 microvascular anastomotic coupler devices were applied in vascular injury.The post procedure vascular patency rate was 100％ and the average time of anastomosis was 3min 59s.Conclusion Microvascular anastomotic coupler device is charactered by higher patency rate and faster operation.It can not only be used in venous anastomosis of tissue graft,and also has a certain value in the repair of arteriovenous injury.

Human immunodeficiency virus type 1 (HIV-1) viral infectivity factor (Vif), one of the accessory proteins, which is a small basic phosphoprotein, is essential for viral replication and pathogenesis. The best well-characterized function of Vif is its ability to neutralize the host cell antiviral factor, apolipoprotein B mRNA editing enzyme catalytic polypeptide like 3G (APOBEC3G), which makes the viral particles more infective. In addition, Vif can regulate the reverse transcription and the advanced stage of replication of the virus particle, as well as induce the termination of cell cycle at G2 stage and so on. The designed drug aimed directly at Vif can efficiently block the maturation and infectivity of HIV-1. In this review, the structure, function and especially the related inhibitors of Vif are reviewed.

OBJECTIVETo explore the clinical effects of anterior corpectomy decompression and titanium mesh bone graft fusion combined with titanium plate fixation in treatting multilevel cervical spondylotic myelopathy.

METHODSThe clinical data of 48 patients with multilevel cervical spondylotic myelopathy underwent surgical operation were retrospectively analyzed from October 2010 to January 2013. There were 37 males and 11 females, aged from 37 to 76 years old with an average of 54.6 years. Thirty-five cases were two-segment lesion, 7 cases were three-segment lesion, 6 cases were four-segment lesion. All the patients were treated by anterior corpectomy decompression and titanium mesh bone graft fusion combined with titanium plate fixation. ROM, JOA, VAS and SF-36 scores were recorded before and after operation(including 3, 6, 12 months after operation and final follow-up). Fusion degree and spinal canal decompression condition were observed by radiographic data.

RESULTSAll patients were followed up from 14 to 48 months, with an average of 27.3 months. At 12 months after surgery, radiographic data showed that all patients obtained bony fusion, spinal canal decompression were sufficient. Preoperative vertebral canal sagittal diameter of the most serious segment were (5.13 +/- 1.32) mm, 12 months after surgery were (9.94 +/- 1.22) mm, there was statistically significance (t=2.463, P=0.014); the degree of vertebral canal decompression were (92.15 +/- 2.35)%. Postoperative ROM, JOA, VAS and SF-36 scores were obviously improved than that of preoperative (P<0.05); there was no statistically significance of ROM, JOA, VAS and SF-36 scores in each time after operation (P>0.05).

CONCLUSIONAnterior corpectomy decompression and titanium mesh bone graft fusion combined with titanium plate fixation can obtain higher fusion rate, complete thoroughly decompression, improvement of clinical symptoms and well safety in treating multilevel cervical spondylotic myelopathy.

Adult ; Aged ; Bone Plates ; Bone Transplantation ; Cervical Vertebrae ; diagnostic imaging ; surgery ; Decompression, Surgical ; Female ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Prostheses and Implants ; Radiography ; Retrospective Studies ; Spinal Cord Diseases ; diagnostic imaging ; surgery ; Spondylosis ; diagnostic imaging ; surgery ; Treatment Outcome

Objective To investigate the ultrasonographic manifestations of traumatic neuroma after neck dissection in papillary thyroid carcinoma (PTC).Methods A retrospective analysis was performed in 21 patients with 26 lesions who underwent neck dissection.The ultrasonographic characteristics were reviewed,including numbers,location,size,shape,margin,echogenicity,with or without direct continuity to the nerve fiber,the presence of internal hyperechogenicity and blood supply.Results Among the 26 lesions of 21 patients,25 lesions were in the lateral cervical area while the other one was in the central cervical area.The mean shortest diameter of the lesions was (3.5±1.0)mm and that of longest diameter was (9.1±2.9)mm.Totally 13 lesions were oval in shape and the other 13 were round.The clear margin was found in 13 lesions and fuzzy margin was observed in another 13 lesions.All the lesions were heterogeneously hypoechoic.The presence of internal hyperechoic areas were found in 16 lesions.The direct continuity with the nerve fiber was found in 20 lesions,while the other 6 lesions were not continued to the nerve directly.Color Doppler flow imaging showed that 20 of the 26 lesions existed a little blood flow signal and the other 6 lesions showed no flow signal.During the ultrasound-guided fine-needle aspiration biopsy (US-FNAB),21 patients complained about the intolerable serious pain and the pain relieved when the needle removed.Conclusion Traumatic neuromas are hypoecho lesions located in the operation area after neck dissection in PTC with distinctive ultrasonographic features,especially the direct continuity with the nerve fiber,as well as the clinical histories and sharp pain during US-FNAB,which can help to diagnose.

The emerging technologies change rapidly in the medical field, refresh the medical ethical scenari-os, brought some medical ethical blind spot.Therefore, building the platform of academic research, making use of the new media, MOOC and“flipped classroom”, inheriting the native“The Spirits of A Great Physician” in tradi-tional Chinese medicine and western medicine, life ethics education and sublation of new exploration, the ideolog-ical and moral education for medical students is expected to be improved in China.

Objective To discuss the prevention and treatment of bile duct injures io the gallbladder bed during laparoscopic cholecystectomy(LC).Methods A retrospective analysis was made on clinical features,treatment,and curative effects of 15 cases of bile duct injures in the gallbladder bed out of 2 032 cases of LC from January 1997 to December 2004.Results There were 5 cases of acute attack of chronic calculous cholecystitis and 10 cases of chronic atrophic calculous cholecystitis.The location of injury was at the branches of the right hepatic ducts in 8 cases and at aberrant bile ducts in 7 cases.The injury was treated with titanium clipping in 8 cases,primary suture in 5 cases,and open surgery of bile duct repair in 2 cases because the injury was relativly large and the site of injury was near the trunk of the right hepatic duct.Postoperatively,bile leakage happened in 1 case and was cured by drainage for 5 days.Follow-up surveys for 6~36 months (mean,23 months) showed free of symptoms and no jaundice or cholangitis.Conclusions Surgical dissection closely near the gallbladder wall when mobilizing the gallbladder is the key to preventing bile duct injuries in the gallbladder bed during laparoscopic cholecystectomy.Prompt detection and proper management of the injury have satisfactory curative effects.

Objective To investigate the treatment of common bile duct or common hepatic duct transverse injures(CBDTI) in cholecystectomy.Methods From January 1993 to March 2008,3362 patients received cholecystectomy in our hospital,among them 5 developed CBDTI.We reviewed the clinic feature,management,and outcomes of these patients. Results Of the 5 patients,2 had common hepatic duct transverse injuries and 3 showed common bile transverse injuries.One of the five received postenterobiliary drainage and the other four underwent choledoch end-to-end anastomosis.No biliary leakage was found after the operation.One patient developed biliary stenosis and cholangitis after the end-to-end anastomosis and thus received postenterobiliary drainage.This case was followed up for 15 years,during which no abdominal pain,fever or jaundice occurred.The patient who underwent postenterobiliary drainage showed symptoms of cholangitis for 3 times whithin 2 months after the treatment;therefore,conservative therapy was carried out.Afterwards,the patient was cured and showed no abdominal pain,fever or jaundice during a 5-year follow-up.The other 3 patients who received end-to-end anastomosis were followed up for 1,2,or 4 years,no complications were noticed during the period.Conclusions Based on personal experience and the type of injury,surgeons may chose choledoch end-to-end anastomosis or postenterobiliary drainage to treat CBDTI.