Acute and chronic infection of sinus could expand to orbital cavity. As the technique and equipment of endoscopic surgery are getting popular and renewal, endoscopic sinus surgery is being used widely and profoundly, which improves the surgical effect of nose and sinus diseases greatly. However, the complications are not decreased rather than traditional surgery. The rate of orbital complication is the highest of all endoscopic sinus surgery. This paper present a case report about orbital complication due to sinusitis or endoscopic sinus surgery and related literature were reviewed.
Endoscopy ; adverse effects ; Humans ; Male ; Middle Aged ; Nasal Surgical Procedures ; adverse effects ; Orbital Diseases ; etiology ; Paranasal Sinuses ; surgery ; Postoperative Complications ; Sinusitis ; complications

Autism spectrum disorder(ASD)is a kind of neurodevelopmental disorder.Despite the high prevalence of ASD, no definite pathogenesis of ASD has yet been elucidated to date.Accumulating evidence indicated that the pathogenesis of ASD may be related to genetic, environmental and immune factors.Studies has been shown that vitamin D(Vit D)deficiency is negatively correlated with the prevalence of ASD, and that supplementation with Vit D may reduce the risk of ASD.Because of the extensive physiological functions of Vit D, it can act as a steroid hormone in multiple aspects such as genetic, environment and immune profiles.Meanwhile, the genetic, environmental and immune changes could also affect the metabolism and function of Vit D, and vice versa.Therefore, Vit D deficiency probably lead to the development of ASD.This review focuses on the relationship between Vit D and environmental, genetic and immune factors of ASD.

Objective To investigate the effect of stroke volume variability (SVV)-guided intraoperative fluid restriction on liver and renal function in patients undergoing hepatic lobectomy. Methods Forty ASA Ⅰ - Ⅲpatients of both sexes aged 33-60 yr weighing 52-80 kg undergoing elective hepatic lobectomy were randomly divided into 2 groups ( n = 20 each): group A routine fluid administration and group B restricted fluid administration.Anesthesia was induced with iv lidocaine, fentanyl and TCI of propofol (target plasma concentration 3-4 μg/ml).Tracheal intubation was facilitated with cisatracurium 0.2 mg/kg. The patients were mechanically ventilated.PETCO2 was maintained at 32-38 mm Hg. Anesthesia was maintained with 1%-2% sevoflurane inhalation and intermittent iv boluses of fentanyl and cisatracurium. BIS value was maintained at 40-60. Radial artery was cannulated and connected to continuous cardiac output monitor (Edwards Lifeaciences, USA). ECG, MAP, CVP and SVVtained at 5-7 in group A and 11-13 in group B. Blood loss, urine output and the amount of RBC and plasma infused during operation were recorded. Serum levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), total protein (TP), albumin (ALB), total bilirubin ( TBIL), direct bilirubin ( DBIL), blood urea nitrogen (BUN), creatinine (Cr) and lactate and Hb, Hct were measured the day before surgery (baseline) and at day 1,3 and 5 after operation. Results The hemodynamic parameters were maintained within normal limits during operation in both groups. The blood loss, the amount of RBC and plasma infused and urine output during operation were significantly less, while the serum TP and ALB concentrations were higher on the 1st postoperative day in group B than in group A. The serum levels of ALT, AST, TBIL and DBIL were significantly increased and serum concentrations of TP and ALB and Hb,Hct decreased, but there was no significant change in serum BUN and Cr concentrations and lactate after operation as compared with the baseline values before operation in both groups. There were no significant differences in serum levels of ALT, AST, TBIL, DBIL, BUN, Cr, lactate,Hb and Hct after operation between the 2 groups. Conclusion SVV can guide effectively intraoperative fluid restriction in patients undergoing hepatic lobectomy.

Objective: To assess the value of transesophageal echocardiography (TEE) during cardiac surgery. Method: Intraoperative TEE was performed to record left atrial gas during and for 15 minutes after bypass in 131 pa tients and to evaluate mitral regurgitation after mitral replacement in 38 patients. The degrees of the gas and mitral re gurgitation by TEE was visually quantified on a 4-point scale(0 to 3) and a 5-point scale(0 to 4), respectively. Result: The left atrial gas was detected in 115(88%)patients, two of which with positive echograms(gas grade=3). There was significant improvement in the mean mitral regurgitation grade after mitral replacement (3.4?0.6 to 0.5?0.2, P

China ; epidemiology ; Female ; Hepatitis B ; prevention & control ; transmission ; Humans ; Infectious Disease Transmission, Vertical ; prevention & control ; Pregnancy ; Pregnancy Complications, Infectious

Column chromatography on silica gel was used to study the chemical constituents of traditional Chinese medicine Siegesbeckia pubescens. The chemical structures of the separated compounds were elucidated by spectroscopic data analyses. As a result, eighteen compounds were obtained and identified as 3, 4'-dimethoxy quercetin(1), 3, 3', 4'-trimethoxy quercetin(2), 3, 3'-dimethoxy quercetin(3), 7, 3', 4'-trimethoxy luteolin(4), ursolic acid(5), 2β,19α-dihydroxyursolic acid(6), 2β-hydroxyursolic acid (7), stigmasterol-7-one(8), 5α, 8α-epidioxy-24(R)-methyl-cholesta-6, 22-diene-3β-ol(9), β-sitosterol(10), 2, 6-di(3-hydroxy-4-methoxyphenyl)-3, 7-dioxacyclo [3. 3. 0] octane (11), aurantiamide acetate (12), 3-(m-hydroxyl-p-methoxy)-N-(2'-p-hydroxyl-phenethyl)-2E-acrylamide(13), p-hydroxy benzaldehyde (14), m-hydroxy-p-methoxy benzaldehyde (15), 3, 4, 5-trimethoxybenzoic acid(16), monoethyl malonate(17), and p-hydroxylcinnamic acid(18). Among them, compounds 1-9, 11-18 were isolated from this plant for the first time.
Asteraceae ; chemistry ; Drugs, Chinese Herbal ; chemistry ; isolation & purification ; Luteolin ; chemistry ; isolation & purification ; Medicine, Chinese Traditional ; Plants, Medicinal ; Quercetin ; chemistry ; isolation & purification ; Sitosterols ; chemistry ; isolation & purification ; Triterpenes ; chemistry ; isolation & purification

?AlM: To analyze the result of ultrasound biomicroscopy ( UBM ) of patients with rhegmatogenous retinal detachment ( RRD ) who need to perform pars plana vitrectomy ( PPV ) to explore the value of clinical application of UBM at preoperation.
?METHODS:Patients who underwent PPV for RRD in our hospital from January to December 2014 were selected. The preoperative results of UBM were recorded and the positive findings of UBM were analyzed, the value of preoperative application of UBM was investigated.
?RESULTS:Totally 356 cases (357 eyes) of patients with RRD were received PPV. All patients were examined by UBM, 122 eyes ( 34. 17%) were positive, 56 eyes were ciliochoroidal detachment, 28 eyes were narrow anterior chamber angle, 6 eyes were chamber angle-closure, 28 eyes were ciliary body cyst, 4 eyes were iris cyst, 11 eyes were anterior proliferative vitreoretinopathy, 1 eye was retinal cyst. There were 12 eyes existing two lesions at the same times. ln this study, patients with choroidal detachment was detected by UBM in 56 eyes, the positive rate was 15. 7%, while 25 eyes was detected by B -ultrasonography, the positive was 7. 0%. The difference was statistical significant(χ2=13. 382, P<0. 05).
?CONCLUSlON: The patients with RRD have underwent PPV for the condition of illness, preoperative UBM can be examined to detect the condition of anterior chamber angle, iris, ciliary and anterior choroid, which is significant for comprehensively understanding the preoperative condition of patients, estimating the difficulty of the operation, and guiding operation and the postoperative follow-up.

Objective To investigate the causes, diagnosis and treatment of gastrolienal portal hypertension. Methods During recent 10 years, 32 cases of gastrolienal portal hypertension were admitted. Clinicopathological features were analyzed. Results The main causes of this entity was chronic pancreatitis or pseudocyst of the pancreas (14 cases), tuberculosis of lymph nodes in retroperitoneum (7 cases) , retroperitoneal malignant lymphoma (3 cases) and pancreatic tumors (8 cases). Definite diagnosis was made in all 32 cases during the hospitalization. Twenty cases underwent surgery including splenectomy (11 cases) , splenectomy plus portal-azygous disconnection (5 cases) , splenectomy plus distal pancreatectomy (4 cases) , endoscopic varicose vein ligation combined with partial splenic embolization (2 cases), and endoscopic varicose vein ligation ( 5 cases). Conclusion A definite diagnosis of gastrolienal portal hypertension lies in the surgeon's recognition of this entity. Splenectomy is the most effective symptomatic treatment.

Objective:To analyze and evaluate the usage and tendency of quinolones before and after the special rectification of antibacterial in one grade III level A hospital in üanjing to provide evidence for the special rectification of antibacterial and manage-ment. Methods:The usage records of quinolones in 2010( before the special rectification)and in 2011-2013( after the special rectifi-cation)were collected,and the sales revenue,DDDs,defined daily cost( DDC),drug resistance and adverse drug reactions( ADR) were analyzed retrospectively. Results:Both the amount and ratio of the sales revenue of quinolones were declined dramatically after the rectification(2011-2013). Among all kinds of quinolones,the sales revenue and DDDs of lomefloxacin aspartate injections was the highest before the rectification while moxifloxacin injections and levofloxacine hydrochloride injections ranked the first and the second respectively in sales revenue after the rectification(2012-2013). As for the DDDs,levofloxacin hydrochloride tablets and levofloxacine hydrochloride injections were the highest after the rectification. Besides,moxifloxacin injections had the highest DDC after the rectifica-tion. Moreover,the drug resistance of the main drug-resistant bacteria( namely staphylococcus,enterobacteriaceae and non fermenta-tion bacteria)to levofloxacin,norfloxacin and ciprofloxacin was declined after the rectification. The adverse drug reactions of levofloxa-cin,lomefloxacin,enoxacin and moxifloxacin were declined year by year after the rectification,and the ADR ratio of quinolones in all anti-bacterial agents was also declined. Conclusion:After the special rectification of antibacterials,the hospital exhibits obvious im-provement in all the application indices of antibacterials,reflecting a good result of the special rectification. However,the hospital still needs to strengthen the inspection over the clinical application of the fourth generation of quinolones.

Objective To observe the effect of early enteral feeding on clinical outcomes and immune function in patients after colorectal cancer surgery.Methods 90 cases of colorectal cancer patients were randomly divided into early enteral feeding group (43 cases) and control group (45 cases).Patients in early feeding group were given small amount of water several times and enteral nutrition early after surgery,while patients in the control group were administrated according to conventional postoperative care protocol.Data were collected on serum IgA,IgG,IgM,CD4 +,CD4 +/CD8 + and CRP on the postoperative first,third and seventh days,postoperative length of stay,complications and quality of life.Results The postoperative fever time [(54 ±6) h vs.(65 ±6) h,t =8.688,P ＜0.01],time to flatus [(58 ±8) h vs.(72±7) h,t=8.573,P＜0.01],postoperative length of stay [(6.9±1.4) dvs.(8.5 ±1.9) d,t=4.277,P ＜ 0.01] and health care cost [(41 868 ± 3 168) RMB vs.(45 950 ± 3 714) RMB,t =5.536,P ＜ 0.01] were significantly in favour of early enteral feeding group than those in control group.Further,the score of quality of life at discharge were significantly higher in early enteral feeding group [(18.4 ± 1.7) vs.(16.4 ± 1.9),t =5.235,P ＜ 0.01],while the complication incidence showed no difference between the two groups [18.6％ (8/43) vs.22.2％ (10/45),t=0.177,P＞0.05].The CD4+,CD4+/CD8+ and IgM on the seventh postoperative day and the IgA and IgG on the third and seventh postoperative day were significantly better in early enteral feeding group while the CRP was significantly lower as compared to the control group (t =3.639,t =2.255,t =2.119,t =2.035,t =2.961,t =2.060,t =2.108,t =7.308,t =3.435,P ＜ 0.05).Conclusions Early oral enteral feeding after elective colorectal cancer surgery can improve patient's immune function,reduce the stress and accelerate rehabilitation.