Objective To study two different methods in treatment of primary pterygium surgery on corneal epithelial wound repair and the influence on the recurrence rate.Methods Used prospective controlled study,accord-ing to a number table 128 patients with 128 eyes were randomly divided into control group (64 cases),and observa-tion group (64 cases).The two groups of patients underwent pterygium excision and limbal stem cell transplantation. The observation group (64 eyes)received 0.2 mg/mL mitomycin C of mitomycin -C(MMC)adjuvant therapy. Corneal epithelial wound repair speed was observed.The patients were followed up for 6 -12 months,average 8.5months,the recurrence rate of pterygium was observed in the two groups.Results The grafts were smooth,and the conjunctival flap healed well in the two groups.The postoperative corneal epithelial healing time of the control group and the observation group were (2.13 ±0.37)d,(2.87 ±0.41)d,there was statistically significant difference (t =4.91,P <0.01);The postoperative recurrence rates were 6.25%,4.69% respectively,there was no statistically sig-nificant difference (χ2 =0.48,P >0.05).Conclusion There was no difference in recurrence rate between two kinds of pterygium surgical method,but the combined MMC can cause corneal epithelial healing delay.

Objective To investigate the risk factors of sexual dysfunction in male patients with obstructive sleep apnea and hypoventilation syndrome (OSAHS).Methods One hundred and twenty-one OSAHS male patients aged 22-50 years were stratified into two groups based on scores on the rating scales of international index of erectile function-5 (IIEF-5).Patients' characteristics and polysomnography data of the sexual dysfunction group (n =56) were compared with that of the normal group (n =65).Continuous positive airway pressure(CPAP) treatment was carried out in some patients with abnormal sexual function.Results There were significant differences between the two groups in body mass index (BMI),history of hypertensive disease and diabetes mellitus,the rise of morning blood pressure,respiratory disturbance index (RDI),the longest apnea time(Tmax),the lowest oxygen saturation(LSpO2),percentage of recording time with oxygen saturation of 90％ or less(T90％),slow wave sleep(S1 + S2) over total sleep time(TST),rapid wave sleep (S3 + S4) time over TST,and rapid eye movement (REM) sleep time over TST in bivariate analysis (P ＜ 0.05).There were statistical significance of the history of diabetes mellitus,slow wave sleep (S1 + S2) over TST,RDI,and LSpO2shown in Logistics regression analysis,and ORs were 2.10 (1.17-5.01),3.52 (1.33-5.97),1.45 (1.08-2.95),and 0.86 (0.67-0.93) respectively (P ＜ 0.05).Moreover,20 OSAHS patients with sexual dysfunction were revaluated after the CPAP treatment in two months,and 14 patients returned to the normal scores.Conclusion The history of diabetes mellitus,slow wave sleep (S1 + S2) over TST,RDI,and LSpO2 were independent risk factors for sexual dysfunction in male patients with OSAHS,and treatment with CPAP could significantly improve sexual function in male patients.

Objective To explore the curative effect of the operation of double wedge osteotomy of the first metatarsal for correction of severe hallux valgus.Methods The data of 62 patients (87 feet) with severe hallux valgus caused by enlarged distal metatarsal articular angle (DMAA) who were followed up after receiving the treatment of double wedge osteotomy of the first metatarsal from January 2008 to December 2011 were analyzed retrospectively.There are 9 males (14 feet),and 53 females (73 feet),with an average age of 56 years (range,28-70 years).Preoperative radiographs showed hallux valgus angle (HVA) was 48.6° in average,intermetatarsal angle (IMA) was 19.8° in average,and DMAA was 22.1° in avcragc.Thc opcration plan was made based on the preoperative deformity,and the osteotomy site,the angle,the capacity of osteotomy was all based on preoperative measurement.Compare the changes of HVA,IMA,DMAA before and after operation.The changes were also compared before and after the internal fixation extraction.The curative effect was observation based on American Orthopaedic Foot and Ankle Society (AOFAS) propodium score standard.Results Sixty-two patients (87 feet) were followed up for 10 to 57 months,with an average of 21 months.HVA (14.6°±1.2°),IMA (7.9°±0.7°),DMAA (7.7°±0.9°) were all satisfied 6 months after the operation.Stiff occurred in 2 patients after the operation.Cutaneous nerve injury occurred in 2 patients,and metastatic metatarsalgia occurred in 1 patient.No sever recurrence of deformity,bone nonunion and bone necrosis was found in all the patients.AOFAS score reached 91.8±1.8 one year after the operation,which was 28.4±9.1 preoperatively.Among them,49 feet were rated as excellent,31 as good,and 7 as fair.The excellent and good rate was 92％ (80/87).Conclusion The first metatarsal double osteotomy can effectively correct the severe hallux valgus deformity with enlarged DMAA with few complications.It achieves good effect.Patients can bear part of the loading in the early stage of recovery after operation.

Objective To explore and evaluate the micro-anatomic structure of posterior-middle cra nial fossa in the retrosigmoid keyhole approach for clinical application. Methods Ten formalin-fixed adult cadaver heads of 20 sides were used to apply the retrosigmoid keyhole approach to reach and observe the structure of posterior-middle cranial fossa.Results The retrosigmoid keyhole approach can reach petroclival region from post-lateral aspect and through this approach the lateral potion of cerebellar hemisphere、petrosal bone,CN Ⅴ,Ⅶ,Ⅷ,part of CN Ⅸ-Ⅻ,lateral potion of pons、vertebral artery and anterior inferior cerebellavar artery can be exposed cleady.Resecting part of supra-tubercle of IAM can enlarge the exposure of IAM and CN V.After cutting off the edge of tentorial part of CN Ⅳ and middle cranial fossa can be exposed.Conclusion Through retrosigmoid keyhole approach we can use the small but compatible bone hole to diminish the ineffective exposure of the cerebellum.Meanwhile the wound because of the approach and complication can be cut down.It's an effective,safe and convenience approach in clinical application to resect the tumor mainly located in posterior cranial fossa.

Objective To investigate the implication of C-reactive protein in development and prognosis of acute lower limb deep venous thrombosis (DVT) complicated by malignant tumor.Methods34patients with acute lower limb DVT complicated by malignant tumor(observation group),34 patients with acute lower limb DVT complicated by operation or wound(case control group)and 34 normal volunteers (normal control group) were included in this study.The observation group and case control group were treated with conventional therapy such as thrombolysis and anticoagulation.The serum concentrations of CRP before treatment and 14 days after treatment were detected. Recanalization of lower limb DVT and therapeutic efficacy were compared between observation group and case control group.ResultsThe serum concentrations of CRP in observation group before treatment were significantly higher than those in case control group and normal control group [(47.72±29.88) mg/L vs (30.04±15.84) mg/L and (6.19±2.99) mg/L,F =38.444,P ＜ 0.01].At the 14th day of post-treatment,the serum CRP concentrations in observation group and case control group were significantly lower than those before treatment (P ＜0.05).At the 14th day of post-treatment,the CRP concentrations of observation group and case control groups were significantly decreased,although those of observation group were still significantly higher than those of case control group and normal control [(32.77±19.68) mg/L vs (7.76±7.52) mg/L and (6.19±2.99) mg/L,F =50.087,P ＜ 0.01].However,there was no significant difference between case control group and normal control group on the 14th day of post-treatment (F =1.277,P =0.263).The recanalization rate of observation group at the 14th day of post-treatruent were significantly lower than those in case control group(x2 =7.731,P =0.021).The therapeutic effect rate of observation group at the 14th day of post-treatment were also significantly lower than those in case control group (x2 =6.969,P =0.031).ConclusionCRP may play important roles in occurrence,development and therapeutic effect of acute lower limb DVT complicated by malignant tumor.

Tongbu therapy, involving removing in reinforcing, is an important thought proposed by China’s famous TCM doctor ZHOU Le-nian in treating spleen and stomach diseases. This article discussed the significance of understanding of the pathogenesis, treating rules and methods, and specific prescribing and medication of chronic diarrhea, which will enlighten clinical doctors.

Objective To assess the diagnostic performance of real-time contrast-enhanced ultra-sound Sonovuein diagnosing minute rabbit liver VX 2 tumors with diameter ≤10.0 mm.Methods Thir-ty New Zealand white rabbits inoculated with VX 2 tumor ( left, right lobe of each ) were examined by two-di-mensional ultrasound and CEUS .The contrast enhanced mode of small rabbit liver VX 2 tumors in different phase was observed and tumor in the rabbit's liver was pathologically verified .The diagnostic performances of two-dimensional US and CEUS in detecting the rabbit VX 2 tumors were analyzed and compared .Results Thirty-nine tumors were pathologically verified .The detection rates of small tumors by CEUS and two-di-mensional US were 12.8% and 79.5%, respectively , yielded significantly higher than that of 2-D US. Conclusion Real-time CEUS significantly improves the detection rates of small rabbit VX 2 liver tumors less than 10.0 mm in diameter .

Objective To investigate the association of excessive daytime sleepiness(EDS) and the quality of life in patients with moderate to severe obstructive sleep apnea and hypoventilation syndrome (OSAHS).Methods 123 patients with moderate to severe OSAHS were diagnosed by polysomnography(PSG),and 52 cases ruled out by PSG were controls.Patients and controls were completed the Calgary sleep apnea quality of life index (SAQLI) and the Epworth sleepiness score(ESS).Results There were statistical significance of body mass index (BMI),respiratory disturbance index(RDI),the lowest oxygen saturatioo( LSpO2 ),the longest apnea time( Tmax),the percentage of recording time with oxygen saturation of 90％ or less(T90) between the patients and the controls.Daily Functioning,Social Interactions,Emotional Functioning,Symptoms,and total scores of SAQLI in patients with moderate to severe OSAHS were(3.88 ± 1.05),(4.48 ± 1.39),(4.76 ± 1.59),(2.98 ± 1.10),(3.94 ± 1.22),which were less than that of controls respectively.The ESS scoree of patients with moderate to severe OSAHS were higher than that of controls[ ( 13.98 ± 4.05 ) vs (5.78 ± 2.45) ],( P ＜ 0.01 ).ESS were related to the daily Functioning,social interactions,emotional functioning,symptoms,and total scores of SAQLI in patients with moderate to severe OSAHS,and the coecient of correlation were - 0.52,- 0.48,- 0.40,- 0.48 and - 0.44,respectively,and all p value were less than 0.01.Conclusion Patients with moderate to severe OSAHS have the EDS,which associate with the impairment of quality of life.The higher ESS may indicate the decrease of quality of life in patients with moderate to severe OSAHS.

Objective To investigate the change of prevalence of autoimmune thyroiditis in Guiyang city after adjustment of salt iodine content, and to study the link between the level of iodine intake and the development of autoimmune thyroiditis. Methods With cluster sampling method, a cross-sectional study was conducted among adults aged 20 years old or above in Guiyang in 2009 (before adjustment, n=1 509) and 2015 (after adjustment, n=1 368). After an overnight fasting, thyroid stimulating hormone (TSH), thyroid peroxidase antibody (TPOAb), and thyroglobulin antibody (TgAb) were measured. The serum FT4 and FT3 were determined for the subjects with abnormal TSH. Meanwhile, urine iodine levels of children aged 8-10 years old in the same community were measured after an overnight fasting in these two studies. Results In 2009, the median level of 8-10 years old children′s urinary iodine was 228.7 μg/L. The prevalence of positive TPOAb, positive TgAb, and thyroid autoantibodies (TAAs) were 14.38%, 13.59%, 18.89%, the standardized prevalence were 14.35%, 13.59%, 18.89% respectively. The prevalence of subclinical hypothyroidism, autoimmune thyroiditis were 14.12% and 4.44%, with the standardized prevalence were 14.12%, 4.42% respectively. In 2015, the median urinary iodine level of 8-10 years old children was 190.1 μg/L, the prevalence of positive TPOAb, positive TgAb, and TAAs were 8.77%, 7.82%, 11.77%, the standardized prevalence were 8.98%, 7.97%, 12.13% respectively; the prevalence of subclinical hypothyroidism, autoimmune thyroiditis were 22.89%, 2.92%, with the standardized prevalences of 23.19%, 3.02% respectively. Conclusion After adjustment of salt iodine content, the iodine nutrition in Guiyang is at the appropriate level, and the values of TPOAb, TgAb, TAA, and autoimmune thyroiditis in adults of Guiyang city were all decreased.

Objective To explore the relationship between behavioral psychological symptoms in Alzheimer' s dementia(AD) patients and region-specific alterations in cerebral blood flow. Methods 60 patients with AD randomly selected from a psychiatric outpatient department and 30 randomly selected healthy elderly community controls were administered the Mini-Mental State Exam (MMSE). All subjects underwent a perfusion CT scan to assess blood perfusion in brain regions of interest. The AD subjects were administered the behavioral patholigy in alzheimer' s disease(BEHAVE-AD) Rating Scale classified as mild, moderate or severe based on the results of the Clinical Dementia Rating scale. Results The most incidence was conduct disorder and the next was delusion.The score was 81.7% and 58.3% in turn. The conduct disorder score was higher in the severe demented group than in the mildly and moderate demented group(P＜0. 05). The delusion score was higher in the moderate demented group than that in the mildly demented group(P＜0.05). The time to peak(TTP)scores in the four groups of subjects were significantly different in the bilateral hippocampal formation, anteroinferior subiculum and entorhinal area. The TTP score was significantly higher in the moderately demented group than that in the mildly demented group and the control group(P＜0. 05 ). Correlation analysis identified a positive correlation between conduct disorder, delusions and TTP in cerebral heteroplasia cortex (P ＜ 0. 05 ), also identified a negative correlation between mood disorder and TTP(P＜0. 05 ). Conclusion The conduct disorder,delusions and mood disorder in AD are associated with the chronicity ischemia of cerebral heteroplasia cortex leading to neural conduction disorders.