Abstract?Since the introduction of 25-gauge/23-gauge ( 25G/23G ) sutureless micro -incision vitrectomy surgery ( MIVS ) at the beginning of the 21 century, we have stepped into an era of micro-incision vitreoretinal surgery more than10a. The current 25/23G MIVS provide numerous advantages over the conventional 20G vitrectomy surgery including simplified surgical procedure, shortened operating time, decreased complications as well as smaller sclerotomy wound.As a result, vitreoretinal surgeons have been shifting gradually from 20-gauge to 25/23-gauge vitrectomy in the past decade. As the 25/23G MIVS adapted worldwide, however, its drawbacks were also increasingly reported. Most criticism regarding to current 25/23G MIVS are focusing on would sealing related complications.Based on stablished notion regarding vitrectomy -“the smaller the better”, researchers and doctors were keeping on exploring the next generation of vitrectomy system. Thanks to the innovation and development in new generation vitrectomy machines, high lumen output light source, more delicate manufacturing technology and clear wild angle fundus view system, Dr.Oshima from Japan launched the first 27-gauge vitrectomy surgery system.It provided us novel surgical experience with smaller sclerotomy wound and faster cut rate. Further development and refinement of vitrectomy with 27-gauge or more are still on its way and will continue in the future. Undoubtedly, MIVS would be heated debated regarding its pro/con, complications, indications and future development.Combined with our own experiences, here we briefly reviewed the 27-gauge vitrectomy surgery.

Objective: To study the relationship among shame, persona li ty and mental health, and to establish a structural model of them Meth o d: Structural equation modeling was used for the data from 178 college s tudents (including 86 male and 92 female, mean age 21), who were tested with SCL -90, EPQ-R Short Scale (EPQ-RS)and shame scale Result: A theor etical model was established for the relationship of personality, shame and ment al health It wa s also confirmed through model comparison that shame has a part-mediating role b etween personality and mental health

Objective: To study social anxiety proneness in college students and factors having influence on it Method: 200 college students were assessed with Social Anxiety Inventory, Shame-Proneness Scale, EQQ-short form, Coping Style Questionnaire, Beck Depression Scale, and Trait Anxiety Scale Result: Social anxiety of college students was influenced by shame-proneness, psychoticism and extroversion of personality Students with high social anxiety proneness were also more easily ashamed by their own behaviors Lack of negative coping styles also contributed to their proneness Low social anxiety proneness could be explained partially by three factors: psychoticism and extroversion personality, self-appraised trait anxiety Conclusion: Shame-proneness, psychoticism and extroversion personality are main factors having influence on social anxiety proneness Positive self-evaluation and coping style are helpful in reducing social anxiety

Objective: To study the direct and moderating effects of Esteem in the model of personality,shame and mental health. Corresponding factors in the whole model were extended. Methods: The SCL-90, EPQ-R Short Scale (EPQ-RS), Shame Scale and Esteem Scale were administered to 365 udergraduates (including 196 males and 169 females, mean age 20.65), and structural equation modeling method was used to study the direct and moderating effects of Esteem in the model. Results: The following conclusions are confirmed through model comparision: (1)Esteem has significant direct effect on the mental symptoms and shame in the model; (2)Esteem has significant moderating effect on the path of neuroticism to the mental symptoms in the model;(3)Psychoticism can independently affect the mental symptoms directly in the model. A new interactive perspective to the raltionship of shame and esteem was discussed in the end.

The effects of ketotifen, cimetidine & erythromycin on thebphy-lline pharmacokinetics in rabbits were studied. The results suggested that the elimination half-life of theophylline decresed from 2.74 ? 0.75 to 2.33 ? 0.56 h & the clearance of theophylline increased from 0.15?0.036 to 0.13 ? 0.047 1/kg?h-1 by ketotifen.The elimination half-life of theophylline increased from 2 .08 ? 0.33 to 2.6l?0.45 h & the clearance decreased from 0.2l?0.03 to 0.16?0.03 1/kg?h-1 by cimetidine.The elimination half-life of theophylline increased from 2.39 ? 0.43 to 3.54?0.89 h & the clearance decreased from 0.15?0.03 to 0.12?0.03 1/kg?h-1 by erythromycin.

In recent years,with the development of neuroimaging and the progress in related clinical studies,people have had a better understanding of posterior circulation ischemia.This article reviews the progress in the causes,mechanisms,clinical manifestations,diagnosis, treatment and prognosis of posterior circulation ischemia.

Objective To observe the renal lesion caused by aristolochia manshuriensis kom(AMK) through 2 infants who had used AMK before hospitalization.Method Retrospecting the 2 cases of infants caused by AMK from 2002 to 2003,and evaluating their pathogenesis,treatment,and prognosis.Result Two infants both presented with symptoms of acute renal failure(ARF),and poor outcome.Conclusions Renal lesion in infant caused by AMK is serious.Some medcines,such as glucocorticosteroid,may be useful for its treatment and prognosis.

Objective To explore the pathogenesis and prognosis of acute renal insufficiency in children.Method The pathogensis,clinical manifestation,treatment and prognosis retrospected and discussed by analysis of the clinical features of 34 children with acute renal insufficiency hospitalized in 2002-2005.Results Of 34 children,there were 15 females and 19 males,the age range from 16 days to 15.5 years old.Among pathogenesis of acute renal insufficiency,primary glomerular diseases occupied 35.3% and drug-induced acute renal insufficiency occupied about 29.4%.The mortality of drug-induced acute renal insufficiency was 20% of and about 30%(deve-)loped chronic renal insufficiency was 30%.Conclusions Primary glomerular diseases rank the dominant causes of acute renal insufficiency,while drug-induced acute renal insufficiency has poor prognosis.So it is important to treat primary glomerular diseases in early stage and emphasize the side effect of drugs to kidney.

Objective The prosthesis used for aortic valve replacement (AVR) may be too small in relation to the body size, thus causing valve prosthesis-patient mismatch (PPM) and abnormally high transvalvular pressure gradients. The aim of this study was to evaluate the prevalence of PPM and the impact of PPM on hemodynamic and early mortality after AVR. Methods A total of 292 patients ( 167 males, 125 females; mean age of ( 52.8 ± 14.6 ) years, with ranging 22 - 82 years) who underwent AVR between January 2007 and December 2009 were retrospectively evaluated. Etiologies were: rheumatic in 243 cases, degenerative in 36, congenitally bicuspid aortic valve in 8, and infective endocarditis in 5. Combined operations with AVR including mitral valve replacement ( 172 cases), mitral valve repair (56 cases), tricuspid valve repair (238 cases), and coronary artery bypass grafting (32 cases). The aortic valve prosthesis effective valve orifice area (EOA) was divided by the body surface area (BSA) to obtain the EOA index (EOAI). PPM was then defined as none or mild if EOAI was ＞0.85 cm2/m2, as moderate for 0.65 -0.85 cm2/m2 and as severe for ＜0.65 cm2/m2. The mean flow rate through aortic prostheses and mean transvalvular pressure gradients were measured by color Doppler after AVR. The prevalence of PPM was compared between the different type ( mechanical or bioprosthetic valve) and the different size ( ＞21 mm or ≤21 mm) of aortic valve prostheses. The effect of PPM on hemodynamic and early mortality after AVR was also studied. Results 219 patients received mechanical AVR and 73 bioprosthetic AVR. Moderate PPM occurs more frequently with bioprosthetic AVR (6.25% versus 48.22%, P ＜0. 01 ). Bigger than 21mm prostheses were used in 191 patients and ≤21 mm prostheses in 101 patients. The prevalence of PPM was 13.61% and 33.66% respectively ( P ＜ 0. 05 ). According to the EOAI of the aortic valve prostheses,all the 219 patients were divided into two group, PPM group and non-PPM group. The mean flow rate of aortic prostheses and mean transvalvular pressure gradients in PPM group was significantly higher than those in non-PPM group [(2.66 ± 0.87 ) m/s versus ( 1. 58 ± 0.47 ) m/s, ( 26.50 ± 6.25 ) mm Hg versus ( 16.75 ± 3.46 ) mm Hg, P ＜ 0. 01]. There were 9 deaths during early period of operation, and the total 30-day operative mortality was 3.08%. The postoperative early mortality of PPM group and non-PPM group was 6.67% and 2.16% respectively, and there were significantly difference between the two group ( P ＜ 0. 05 ). Conclusion Prosthesis-patient mismatch is common present after AVR, especially in patients with bioprostheses and small size valve prostheses. PPM has a negative impact on postoperative hemodynamic and early mortality. PPM results in higher transvalvular pressure gradients and higher early mortality.