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.

OBJECTIVETo compare the efficacy difference in treatment of depression in breast cancer between the combined therapy of acupuncture and auricular acupressure and western medication.

METHODSSixty patients were randomized into an observation group and a control group, 30 cases in each one. In the observation group, the combined therapy of acupuncture and auricular acupressure was adopted. The main acupoints of acupuncture were Hegu (LI 4), Tai-chong (LR 3), Baihui (GV 20), Zusanli (ST 36), Qihai (CV 6), etc. The supplementary acupoints were combined according to the syndrome differentiation. The treatment was given once every day, 5 treatments a week, at the interval of 2 days among weeks. The auricular acupressure was applied to gan (CO12, liver), pi (CO13, spleen), neifenmi (CO18, endocrine), etc., once every 4 days, on each side in one treatment. In the control group, fluoxetine hydrochloride capsules were prescribed for oral administration, 20 mg, once a day. The Hamilton depression rating scale (HAMD) was used to assess the disease severity and efficacy before treatment, in 4 and 8 weeks of treatment separately. HAMD factor changes were observed before treatment and at the end of the 8th week. The Asberg antidepressants scale (SERS) was applied to safety assessment.

RESULTSThe total effective rate was 86.7% (26/30) in the observation group, better than 63.3% (19/30) in the control group (P<0.05). At the end of the 4th and 8th weeks, HAMD scores were all reduced apparently in the two groups (all P<0.01). At the end of the 8th week, the scores of the HAMD factor 1 (anxiety/somatic system), factor 5 (retardation) and factor 6 (sleep disturbance) were all reduced as compared with those before treatment in the two groups (all P<0.01); the results in the observation group were better than those in the control group (P<0.05, P<0.01). SERS score in the observation group was lower obviously than that in the control group (P<0.01).

CONCLUSIONThe combined therapy of acupuncture and auricular acupressure achieves the antidepression effect in treatment of depression in breast cancer and has less side effects and high safety. The efficacy is superior to fluoxetine hydrochloride capsules.

Acupressure ; Acupuncture Points ; Acupuncture Therapy ; Adult ; Breast Neoplasms ; complications ; Depression ; etiology ; therapy ; Female ; Humans ; Middle Aged ; Treatment Outcome

Chronic cerebral hypoperfusion is a common pathological state. Cognitive impairment is its main manifestation in early stage, and it will eventually result in persistent or progressive cognitive impairment and neurological deficits. Chronic cerebral hypoperfusion caused neuronal damage, synapse abnormity, energy impairment and the function defects of central cholinergic system and monoaminergic system are its pathophysiological mechanisms resulting in cognitive impairment.

Objective To evaluate the short and middle-term outcome of metal surface hemiarthroplasty in treatment of femoral head osteonecrosis. Methods Forty-one patients (forty-eight hips) with average age of 40 years were performed hemi-arthroplasties and followed up for minimum 3 years. Thirty-five cases were at the stage of Ficat Ⅲand 13 at the stage Ⅳ and their acetabular were relatively normal. Measurements of the hip reconstruction were made on the anteroposterior pelvic radiograph assisted with computer. The outcome of metal surface hemi-arthroplasty and the correlation between the orientation of the femoral component and the migration of implant was evaluated. Results The mean duration of follow-up was 5.2 years. The average UCLA hip score was improved significantly (P

Objective To investigate the anatomic relationship between the upper thoracic vertebrae and adjacent structures in anterior approach of upper thoracic spine, an anatomy study was conducted and its clinical significance was evaluated. Methods Twenty upper thoracic spine specimens of adult human cadaver were exposed, measured and studied for their anatomic landmarks. The origin, course of the recurrent laryngeal nerve, thoracic duct and blood vessels and their relationship were measured and analyzed. The advantages and disadvantages of different surgical approaches exposing the upper thoracic vertebrae were also evaluated and compared. Results The right recurrent laryngeal nerve reaches the tracheo-esophageal groove at the level of C6-7 disc in 55% of the specimens and derives from vagus nerve at the level of T1,2. The thoracic duct empties into the systemic venous system from T1 to T1-2 disc space in 75% of the specimens and among them, more than 50% up to T1 level. The left brachiocephalic vein is at T3 in 55% of the specimens; and the aortic arch is at T3-4 disc in 80% of the specimens. The anterior aspect of T3 can be easily exposed through a modified anterior approach to the upper thoracic vertebrae in only 45% of the specimens(9), compared with outside space of the brachiocephalic trunk(between the right brachiocephalic vein and the brachiocephalic trunk and left brachiocephalic vein) in 95% of the specimens (19). Conclusion Surgical approach through outside space of the brachiocephalic trunk is simple and adequate to expose the T3,4 vertebra body and can get more exposed space of 0.5-1 of the vertebra body than through inner space of the brachiocephalic trunk and can be utilized selectively during anterior upper thoracic spine surgery. Attention should be paid to avoid injury of vagus nerve in the middle, right recurrent laryngeal nerve on the right and thoracic duct on the left, respectively.

Objective To investigate the procedure of anterior thoracic corpectomy and the surgical outcomes of upper thoracic spine tumors by the right space of the ascending aorta and the right space of the brachiocephalic artery. Methods 12 patients underwent surgery between June 2000 and January 2006. There were 8 cases of primary tumors and 4 metastatic carcinomas, 4 cases of tumor in T3 and 6 cases in T4 and 3 cases in T3,4. The anterior modified transmanubrium approach was made. After the exposure of the tumor through the right space of the ascending aorta and the right space of the brachiocephalic artery, the involved vertebral body and contiguous discs were resected, the spinal cord was decompressed. Curettage was performed in 3 cases for other tumors, en bloc vertebrectomies were performed. As a body replacement, in case of benign disease autogenous bone graft harvested from the dorsal iliac crest was used, and for malignant bone tumors using bone cement. To secure the strut, anterior cervical titanium alloy plates were used until T5. Neurological status was graded according to Frankel grading system. Results 6 cases of bradycardia and hypotension or increasing airway resistance occurred intraoperatively. The mean follow-up period was 28.6 months (range 4-66 months). 3 patients with autogenous bone graft had bone union 6 months postoperatively. According to Frankel grading system, 1 patient improved from grade A preoperation to B postoperation, while another patient from B to C; of the 5 cases with grade C preoperation, 4 patients improved to D postoperation and 1 patient to E; 4 patients improved from D to E; 1 patient with grade E left unchanged. 3 patients died from general metastasis and failure 10-20 months postoperatively. One patient with giant cell tumor recurred 10 months postoperatively. Conclusion Clear exposure and satisfactory outcome can be obtained by the use of the right space of the ascending aorta and the right space of the brachiocephalic artery; it is especially indicated to the upper thoracic spine T3 and T4 tumors, where the spinal compression is located anteriorly.

BACKGROUND: Regeneration of type Ⅱ furcation defects of periodontal tissues is still a great clinical challenge. OBJECTIVE: To compare different densities of autologous bone marrow mesenchymal stem cells (auto-BMSCs) for repairing canine experimental class Ⅱ furcation defects of periodontal tissues. DESIGN: A randomized controlled trial. SETTING: Laboratory in Stomatological Hospital Affiliated to Fujian Medical University and Department of Animal Experiment in Fuzhou General Hospital. MATERIALS: Experiments were performed at the Laboratory in Stomatological Hospital Affiliated to Fujian Medical University and Department of Animal Experiment in Fuzhou General Hospital of Nanjing Military Area Command of Chinese PLA from July 2005 to September 2006. Six 18-month Beagle dogs were provided by Department of Animal Experiment in Fuzhou General Hospital of Nanjing Military Area Command of Chinese PLA. Animal intervention met animal ethical standards. Bio-Gide collagen membrane and BME-10X collagen membrane were used in the study.METHODS: Class Ⅱ furcation defects were induced surgically on the buccal side of canine mandibular second and third premolar (P2, P3) and first molar (M1). The ex vivo expanded auto-BMSCs from six 18-month Beagle dogs were seeded in BME-10X collagen membranes at cell density of 5×108 L-1，5×109 L-1，5×1010 L-1, and delivered into experimental class Ⅱ furcation defects, underneath a Bio-Gide membrane. Bio-Gide membrane alone was used as a control. The percentage of new cementum length and percentage of new alveolar bone area were measured on OLYPUS IX 71 inverted research microscope and OLYSIA BioAutoCell software in a computer.MAIN OUTCOME MEASURES: Each specimen was stained with hematoxylin and eosin. The lengths of new cementum and the area of new alveolar bone were calculated.RESULTS: The percentage of newly formed cementum length and the percentage of newly formed alveolar bone area were (51.5±5.6)% and (27.1±7.7)% in the control group,（84.8±8.9）% and（30.6±7.7）% in the 5×108 L-1 BMSCs group, (91.8±5.2)% and (68.3±11.4)% in the 5×109 L-1 BMSCs group and (88.8±7.2)% and (78.5±12.7)% in the 5×1010 L-1 BMSCs group. There were significant differences when comparing the BMSCs groups to the control group (P < 0.01), but there was no significant difference in each BMSCs group. There were significant differences in the percentage of newly formed alveolar bone when comparing the 5×109 L-1 and 5×1010 L-1 BMSCs groups to 5×108 L-1 BMSCs group and control group (P < 0.05), but there was no significantly difference between the first two groups, and neither was the later.CONCLUSION:Periodontal regeneration can be induced by BMSCs transplantation. The mechanism of regeneration is associated with inoculated density.

BACKGROUND:The factors to affect spinal fusion are suitable bone graft location,good graft bed,enough bone grafts,strict fixation measure and enough fixation time. However,it is unclear which method should be used between intervertebral bone grafting and intertransverse bone grafting,as well as which material should be used between autogenous iliac bone and autogenous spinous process and vertebral lamina of resection. OBJECTIVE:To compare the fusion rate and improvement of clinical symptoms among different bone graft materials and methods which used in bone fusion for lumbar spondylolisthesis. DESIGN:A control observational experiment. PARTICIP ANTS:A total of 92 patients with lumbar spondylolisthesis who received bone fusion treatment. According to Meyerding classificantion,there were 50 cases of degree Ⅰ,40 cases of degree Ⅱ,1 case of degree Ⅲ,and 1 case of degree Ⅳ. There were 1 case in L3,58 cases in L4,and 33 cases in L5. METHODS:All patients received spinal canal decompression. After reduction and fixation was performed by spondylolisthesis reduction system(SRS) ,bone grafting fusion was performed in all patients. They were divided into four groups:autogenous spinous process and vertebral lamina graft placed between transverse processes group(n=21) ,autogenous spinous process and vertebral lamina graft placed between the vertebral bodies group(n=27) ,autogenous iliac bone graft placed between transverse processes group(n=21) ,autogenous iliac bone graft placed between the vertebral bodies group(n=23) . MAIN OUTCOME MEASURES:The fusion rate and the improvement of clinical symptoms were evaluated according to the X-ray pre and post operative,as well as the JOA score. RESULTS:At 6 months after operation,the fusion rate in the autogenous iliac bone graft placed between the vertebral bodies group were significantly higher than that in the other three groups(P 0.05) . According to the JOA score,at 6,9,and 12 months after operation,there were no differences in the score among the four groups. CONCLUSION:Posterior bone graft fusion of the vertebral body or transverse process using the vertebral lamina,spinous process,or iliac bone as autograft along with internal fixation for lumbar spondylolisthesis are effective. However the use of the iliac bone as autograft contributes to a higher fusion rate in the same method at 6 months. Further using the same material as autograft,the fusion rate of the autograft placed between vertebral bodies is better than that of the autograft placed between transverse processes at 6 months.

Objective To summarize the surgical techniques to treat complex stale acetabular fractures through combined approaches. Methods From February 1993 to September 2005, 21 cases (12 males, 9 females, mean age of 33 years old) of complex stale acetabular fracture were treated with open reduction and internal fixation through combined approaches (K- L+ ilio- inguinal). Of the 21 fractures, 3 were transverse and posterior wall ones, 4 T- shaped ones, 11 both column ones, and 3 hemi- transverse and anterior column ones. Results 12 cases (57.1% ) got anatomic reduction, 5 cases satisfactory reduction (23.8% ), but 4 cases unsatisfactory reduction (19.1% ). The rates of anatomic reduction for the early 6 years and for the latest 6 years in this study were 44.4% and 66.7% respectively. 15 cases were followed up for 2 to 12 years. The excellent and good rate for clinical and roentgenographic results were 65.3% and 67.2% respectively. The clinical results for anatomic and non- anatomic reduction groups were 78.6% and 32.8% respectively (P

Objective To explore the relationship between EEG feature and TCD with secondary epileply in cerebrul infarction.Methods EEG and TCD were done and analyzed in 40 patients with secondary epileply in cerebrul infarction.Results The EEG abnormality rate was 95%,TCD abnormaity rate was 87.5%,abnormal EEG mainly showed increase of slow waves with low to middle amplitude,with diffuse or local distribution,epileptiform discharges were foumd only in 9 of the 38 ones,cerebral blood flow(CBF) was increased,decreased or bilateral dissymmetry,abnormal spectral frequency(higher force).Conclusion The abnormality rate of EEG is higher,but the detection rate of epileptiform discharges is lower;Unilateral increased of CBF might predict the side of epileptogenic focus.