With the widespread use of high-resolution spectral-domain OCT (SD-OCT) in clinical practice,one of the greatest progresses to the ophthalmologists is more dctailed image analyses of outer retina in the macular region.There are four clear hyper-reflective bands of outer retina in the SD-OCT images,instead of three bands in the time-domain OCT (TD-OCT),the bands from inner to external are external limiting membrane (ELM),inner segment/outer segment (IS/OS) junction,cone outer segment tips (COST),and retinal pigment epithelium (RPE),respectively.From a perspective of corresponding retinal histological structure,all of the three bands of ELM,(IS/OS) and COST are within the photoreceptor cells.Therefore,the integrity of the three bands correlates well with the status and function of photoreceptor cells.It is one of the hot topics to study the status and function,as well as injury and repair of the photoreceptor cells using SD-OCT.This article reviewed the relevant clinical studies about the three bands of ELM,IS/OS and COST,including macular hole (MH),idiopathic epiretinal membrane (IERM),rhegmatogenous retinal detachment (RRD) and age-related macular degeneration (AMD).

Objective: To investigate the quality of life and its influencing factors among HIV-infected college students among men who have sex with men (MSM), so as to provide the evidence for improving the quality of life among HIV-infected MSM college students. Methods HIV-infected MSM college students were sampled from those with follow-up management by Shaanxi, Chongqing and Guangdong Centers for Disease Control and Prevention using a convenience sampling method, and participants' demographics, AIDS-related knowledge, attitude and practice were collected using questionnaire surveys. The scores for physical, psychological, social and environmental domains, and the overall quality of life were measured using the Chinese version of the World Health Organization Quality of Life-Brief (WHOQOL-BREF), and their influencing factors were identified using a multivariable linear regression model.

Objective To study the clinical diagnostic value of carcinoembryonic antigen (CEA) ,cytokeratin(CK)19-2G2 and EB virus capsid antigen Ig (EB-VCA-Ig) combined detection for nasopharyngeal carcinoma .Methods Serum CEA ,CK19-2G2 and EB-VCA-Ig of 82 patients with nasopharyngeal carcinoma (malignant group) ,65 patients with benign nasopharyngeal diseases (benign group) and 58 healthy people(control group) were detected .Chemiluminescence was employed to detect CEA and CK19-2G2 ,and enzyme-linked immunosorbent assay(ELISA) was used to assay EB-VCA-Ig .Results Serum CK19-2G2 and EB-VCA-Ig concen-trations of patients in malignant group were higher than those in the benign group and control group ,respectively (P<0 .05) .The sensitivity and specificity of individual CK 19-2G2 detection for nasopharyngeal carcinoma were 48 .78% ,and 83 .74% ,respectively , those of CEA and EB-VCA-Ig combined detection were 53 .44% and 86 .99% ,respectively ,and those of three indicators combined detection were 71 .95% and 80 .49% ,respectively .Three indicators combined detection significantly increased the positive detection rates in patients with early and advanced stages .Conclusion CEA ,CK19-2G2 and EB-VCA-Ig combined detection possesses impor-tant value for nasopharyngeal carcinoma diagnosis .

Objective To study the value of multiphasic contrast-enhanced 3.0T MRI in the preoperative assessment of resectability in pancreatic cancer.Methods 38 patients with pancreatic cancer proved by operation and pathology were performed with multiphasic contrast-enhanced imaging at 3.0T MRI.The resectability of lesions was judged according to the status of vascular and adjacent organ involvement,lymphadenopathy and distant metastases on MRI images,which were compared with the results of operation.Results Of 38 pancreatic cancer,32 lesions located in the head,4 tumors in the body and 2 lesions in the tail of pancreas.MRI predicted that 1 9 tumors were resectable in which 1 7 lesions were successful resection,the accuracy of the positive predictive value for resectability was 89.5%.19 lesions were predicted to be unresectable by MRI,which were verified by surgery,the positive predictive value for un-resectability was 100%.The primary causes of unresectability contained peripancreatic main vessels involvement,liver metastasis, lymphadenopathy and peritoneal metastasis.Conclusion MRI multiphasic contrast-enhanced imaging has important value in preoper-ative resectability assessment of pancreatic cancer,which provides an useful reference for clinic to select appropriate treatment options.

Objective To investigate the relationship between Clq/tumor necrosis factor (TNF)-related protein 9 (CTRP9)and coronary heart disease.Methods A total of 232 patients diagnosed with coronary heart disease(CHD)by coronary angiography at our hospital were selected as the CHD group,and 90 cases with normal coronary angiography served as the control group.The double antibody sandwich enzyme-linked immunosorbent assay(ELISA)was used to determine serum CTRP9 levels.Results Serum CTRP9 levels were lower in the CHD patients than in the controls [(116.9±19.5)ng/ml vs.(142.3±17.9)ng/ml,t＝-5.404,P＝0.000].SerumCTRP91evelswere negatively correlated with body mass index,fasting plasma insulin,fasting blood glucose,insulin resistanceindex(IRI),triglyceride and TNF-α(r＝-0.230,-0.225,-0.267,-0.235,-0.230and-0.222,P＝0.017,0.011,0.002,0.010,0.011 and 0.022).Multiple logistic regression analysis revealed that uric acid,IRI,CTRP9,and TNF-α were independent influencing factors for CHD,of which CTRP9 was a protective factor for CHD occurrence(OR ＝ 0.907,95％C1:0.854～0.963,P＝ 0.001).Conclusions Decreased serum levels of CTRP9 are associated with coronary heart disease,indicating that CTRP9 may play a protective role in coronary heart disease occurrence.

Regarding the prevention and treatment of hepatocellular carcinoma (HCC) recurrence after curative resection,surgeons do not have a clear consensus to evaluate the risk factors of recurrence and effectiveness of surgical resection.Therefore,postoperative HCC recurrence patterns were reviewed in this article,including differentiating intrahepatic metastasis (IM) and multicentric occurrence (MO),which play a key role in manifesting recurrence and patient prognosis.Additionally,the definitions of small HCC and curative resection,and the prophylactic and therapeutic values of anatomic resection and repeated hepatectomy in patients with recurrent HCC were reviewed.Fully understanding these issues might allow for a more objective,precise,and consistent clinical assessment of HCC.

Objective To investigate the effect of Lokomat gait training rehabilitation robot on joint motion and lower limb function in hemiplegic patients after stroke.Methods Forty hemiplegic patients after stroke were randomized equally into a robotic group and a control group (20 cases in each group).The robotic group received robotic rehabilitation therapy in addition to routine rehabilitation training,while the control group was only given instructions for routine rehabilitation training.All the patients were assessed at the beginning of the training and at the end of 4,8 and 10 weeks of treatment.The Fugl-Meyer Assessment of lower extremities (FMA),range of motion (ROM) in hip and knee,force and tone of bilateral hip/knee flexors and extensors were used to evaluate stepping function before training,and after 4,8 and 10 weeks of treatment.Results There was no significant difference between the 2 groups with regard to FMA scores,the ROM in hip and knee,as well as force and tone of bilateral hip/ knee flexors and extensors (P ＞ 0.05).After treatment,the robotic group was significantly improved with all the evaluation indexes when compared to its baseline values (P ＜ 0.05).It was also shown that the robotic group improved to a significantly greater extent than the control group (P ＜ 0.05).Pearson's correlation analysis demonstrated a positive relationship between the ROM of knee or hip and lower limb function (P ＜ 0.05).Conclusions The Lokomat gait training rehabilitation robot can improve the lower extremities functions,as indicated by increase of ROM and muscle strength as well as decrease in muscle spasticity in hemiplegic patients after stroke.

[Objective]To explore the operative methods and curative effect of the damage of the deltoid ligament.[Method]From April 2002 to April 2005,all 40 cases with ankle fractures were treated by open reduction and firm internal fixtion,by repairing of the deltoid ligament and restoration of stability of medial and lateral structures of ankle joint.If separation of the tibio-fibular joint was still unstable,transverse internal fixtion was adopted with one cortical bone screw.[Result]All cases were followed up from 6 months to 3 years with an average of 18 months,and were evaluated according to the criteria of QI Bin:the results showed excellent in 30 cases,fair in 8 cases and poor in 2 cases,the rate of excellent results was 75%.[Conclusion]The authers emphasized that,in order to obtain satisfactory result,open anatomical reduction and rigid internal fixtion must be adopted in the fractures,the deltoid ligament should be treated properly.

[Objective]To investigate the clinical features,reasons of missed diagnosis and treatment for ipsilateral fractures of femoral neck and shaft.[Method]Twelve cases of ipsilateral fractures of femoral neck and shaft treated from 1999 to 2005 were retrospectively reviewed.Seven cases' neck fractures were diagnosed separately before operation,2 cases' were diagnosed during operation and 3 were diagnosed after operation.Among the 12 cases,3 cases were treated with reconstructive intramedullary nail to fix both shaft and neck fractures;2 cases were treated with DHS to fix both shaft and neck fractures;1 case was treated with retrograde interlocking intramedullary nail to fix shaft fracture and with canulated screws to fix neck fracture;2 cases were treated with interlocking intramedullary nails and canulated screws;1 case combined supracondylar fracture of femur,was treated with LISS-DF to fix shaft and supracondylar fracture,canulated screws to fix the neck fracture;the neck fractures were found in 3 cases after shaft fixation with plate,then fixed with canulated screws.[Result]All cases were followed up for 1~6 years,with an average of 3.4 years.All femoral shaft fractures were united and 11 neck fractures were united,1 neck fracture was malunion,1 case was osteonecrosis of femoral head.[Conclusion]The ipsilateral fracture of femoral neck and shaft is rare,and the neck fracture is easy to miss diagnosis.The orthopaedic surgeons should consider the femoral neck fractures by analyzing the mechanism of high energy injury patient with femoral shaft fracture.Pelvic X-ray should be taken conventionally or CT scan when necessary.The surgical treatment for ipsilateral fractures of femoral neck and shaft depends on the position of femoral shaft,and the situation of femoral neck.

Objective To investigate the anatomy of the skull base for minimally invasive keyhole approach to sellar lesions.MethodsSixty-seven samples of adult skull bone(134 sides) were collected and sawed at the levels of the supraorbital arch and anterior skull base.After inspecting the opening of the frontal sinus,we observed the appearance of the orbit roof(cerebral juga),and measured the maximum height of the two cerebral jugas.Afterwards,the operation distances and angles with regard to the anterior and posterior clinoid processes through the trans-upper orbit,trans-lateral front,trans-pterion,and trans-sub-temple keyhole approaches in 15 skull bone samples were measured.And then,we statistically analyzed the variance in these measurements among the four operative approaches.ResultsOf the 67(134 sides) adult skull bone samples,52 sides showed frontal sinus openness(38.8%,52/134).Most of the skull bases were clawed(multicuspidity or oblique ridge multicuspidity).The maximum height of the cerebral juga that was less than 2.50 mm was found in 36 sides(26.9%),and over 2.51 mm in 98 sides(73.1%).Among the four methods,the shortest distances between the keyhole and the anterior and posterior clinoid processes were found in the trans-sub-temple keyhole approach [(4.87?0.47) cm and(4.93?0.45) cm],and the longest were observed in the trans-lateral front keyhole approach[(6.45?0.30) cm and(7.83?0.54) cm],and trans-upper orbit keyhole approach[(6.47?0.28) cm and(8.31?0.34) cm].The angle between the sagittal section and the keyhole in the trans-lateral front keyhole approach [(40.83?1.11) ? and(37.86?1.37)?] was larger than that in the trans-upper orbit one [(10.23?0.90) ? and(12.29?0.86)?],while the angle between the cross section and the keyhole in the trans-sub-temple keyhole approach [(21.21?0.45) ? and(20.10?0.63)?] was larger than that in the trans-pterion one [(5.49?0.30)? and(9.84?0.58)?].ConclusionsThe size of the frontal sinus,shape and height of the cerebral juga,depth of the skull base operation,and angle between the operational and the skull base planes play important roles in the selection of minimally invasive keyhole approach for sellar lesions.