BACKGROUND:Currently, in pterygium excision combined with limbal epithelial transplantation, there were stil some controversies about whether the medical fibrin glue could instead of stitch fixing autologous conjunctival graft. OBJECTIVE:To compare the therapeutic effect of medical fibrin glue and stitch in pterygium excision combined with limbal epithelial transplantation using Meta analysis. METHODS: The randomized controled trials about the therapeutic effect of medical fibrin glue versus stitch in pterygium excision combined with limbal epithelial transplantation were reviewed from PubMed database, CNKI ful-text database, Chinese Biomedical Literature Database, VIP database and Wanfang database from database creation to June 2015. The operative time, complications and recurrence rate of these two groups were analyzed using Meta. RESULTS AND CONCLUSION:A total of 14 randomized controled trials, and 879 patients were enroled. Meta-analysis results showed that the operative time, incidence of postoperative complications, the relapse rate after six months and one-year in the fibrin glue group were lower than those in the suture group [MD=-15.58, 95%CI (-18.96,-12.21),P < 0.000 01]; [OR=0.39, 95%CI(0.19, 0.68),P=0.02]; [OR=0.28, 95%CI(0.12, 0.65),P=0.003]; [OR=0.23, 95%CI(0.07, 0.76),P=0.02]. These results demonstrate that the application of fibrin glue in pterygium excision combined with limbal stem cel transplantation can promote graft attachment, shorten the operation time, reduce postoperative complications and reduce the postoperative recurrence of pterygium.

Objective:Cardiovascular interventional therapy for children Statistics and Analysis of X-ray radiation dose to explore low-dose technology in the protection of children. Methods:The hospital nearly two years the use of low-dose technology in the interventional diagnosis and treatment of children, a retrospective analysis of 18 patients under the age of three kinds of treated me institutes common childhood intervention operations radiation levels were nearly two years and two years ago the same operation of the radiation levels in patients with technical analysis, a total of 300 cases. Among them, 60 cases of atrial septal defect occlusion in patients with ventricular septal defect occlusion in patients with 90 cases, patent ductus arteriosus occlusion in patients with 150 cases. Using digital subtraction angiography machine automatically adjusts the exposure conditions. Including entrance dose ED(mGy), dose area product DAP and fluoroscopy time F were measured. Results:The two groups results in the perspective of time, entrance dose, there was a significant difference, nearly 2 years statistics show a significant reduction in radiation dose in children suffered, both between entrance dose and fluoroscopy time was significantly a linear relationship. Area of operation of different doses of the product of cardiovascular intervention there was a significant difference, ventricular septal defect occlusion area dose product is still large. Conclusion:Low-dose technology effectively reduces the radiation dose for children, worthy of promotion.

UNLABELLED: The patient chiefly complained about headache and facial pain with recurrent epistaxis during the past two months. The pain started from the teeth and intermittent pinching headache especially on the left side. She also had mild epistaxis which healed itself. Later on the epistaxis became severe which couldn't be easily cured. Her nasopharyngoscopy examination showed a mass in nasopharynx while cranial CT scan indicated a huge mass in nasopharynx with erosion of skull base. Enhanced CT scan showed significant thickness in nasopharynx, upwards which became a huge mass breaking through skull base especially on the left side. Adjacent parapharyngeal space and paranasal sinuses and skull base were widely involved with the enlargement of neck lymph nodes. The chronic mastoiditis, ethmoiditis and maxillary sinusitis were also found. DIAGNOSIS nasopharyngeal nonkeratinizing squamous cell carcinoma (T4N2M0 stage IV).
Carcinoma ; Child ; Female ; Humans ; Nasopharyngeal Carcinoma ; Nasopharyngeal Neoplasms ; pathology ; Skull Base ; pathology

Objective To study the expression of elastic fibers,Collagen type Ⅳ and CD44v6 in the metastasis of the pulmonary adenocarcinoma.Methods In paraffin-embedded specimens from 56 cases of pulmonary adenocarcinoma,the elastic fibers were stained with histochemical method and the expressions of collagen type Ⅳ and CD44v6 were detected with immunohistochemical method.Results The positive expression rates of elastic fibers,collagen type Ⅳ and CD44v6 were 11.5%(3/26),11.5%(3/26) and 80.8%(21/26)in the group with lymph node metastasis,and were 69.0%(20/29),55.2%(16/29) and 24.1%(7/29) in the group without lymph node metastasis,respectively.The expression of elastic fibers,collagen type Ⅳ and CD44v6 were significant difference in the two groups with and without lymph node metastasis(P=0.000).There was statistically significant correlation among elastic fibers,collagen type Ⅳ,CD44v6 and lymph node metastasis(all P

Objective To investigate the main causes and risk factors of recurrent retinal detachment (RRD) after silicone oil removal (SOR) in eyes with complex retinal detachment.Methods It was a retrospective case series study.A total of 458 eyes of 455 consecutive patients who underwent pars plana vitrectomy with silicone oil tamponade were recruited in this study.All patients underwent vitrectomy operation.Additionally,they were given heavy water,membrane peeling,retinotomy or partial cutting,intraocular laser photocoagulation or frozen,gas-liquid exchange or direct oil exchange operation accordingly.Ninety-eight eyes with multiple holes,old retinal detachment,hyperplasia and serious traction lesions underwent scleral buckling surgery simultaneously.Intravitreal silicone oil was padded at the end of operation.Cutting,stripping or resection and 360° preventive laser photocoagulation were applied while the epiretinal membrane was found and need treatment during SOR.Holes or suspicious hiatus underwent intraocular laser photocoagulation or cryotherapy during the operation.One week after SOR and during follow-up,the visual acuity,intraocular pressure (IOP),slit lamp microscope,and ophthalmoscope examination were examined with the same technique and methods as preoperation.The eyes were divide into two groups based on the attachment status of retina after SOR,which were reattached group (419 eyes) and redetached group (39 eyes) respectively.The following data were recorded.,the age of patients,ocular axial length,logarithm of minimum angle of resolution (logMAR) best corrected visual acuity (BCVA) and IOP before vitrectomy operation and before and after SOR,the number of retinal breaks,the duration of silicone oil filling,the duration of follow-up,and the related factors during vitrectomy operation and SOR.The relation of age,sex,high myopia,the size and location of holes,aphakic eye,proliferative vitreoretinopathy (PVR) C3 level and above,previous history of failed retinal detachment operation,360° preventive laser photocoagulation,assistant scleral buckling surgery,SOR via corneal puncture to RRD after SOR were analyzed.Odds ratio (OR) and its 95％ confidence interval (CI) were calculated for the age ＜40 years old and gender.High myopia,assistant scleral buckling surgery and SOR via corneal puncture were further analyzed by multiple regression equation.Results After SOR operation,the total average logMAR BCVA was 0.86 ± 0.63.The average logMAR BCVA was 0.82 ± 0.59 and 0.99 ± 0.70 respectively for the reattached and redetached groups,which was not statistically different (F=1.559,P＞0.05).The number of high myopia eyes in the reattached and redetached groups were 116 and 22 eyes,respectively,accounted for 27.7 ％ and 56.4 ％,and the difference was statistically significant (x2=13.984,P＜0.01).Three eyes underwent vitrectomy with scleral buckling occured RRD,accounting for 3.1％; while 36 eyes underwent vitrectomy without scleral buckling occured RRD,accounting for 10.0％.The incidence of RRD between them was statistically significant (x2 =4.761,P＜0.05).The incidence of RRD was not retated to the PVR levels before the operation,previous history of failed retinal detachment operation,aphakic eye and preventive laser photocoagulation (OR=1.626,1.699,1.986,0.709; 95％ CI:0.836-3.162,0.832-3.658,0.921-4.279,0.268-1.875; P＞0.05).RRD had a close relation with high myopia and assistant scleral buckling surgery (OR=3.380,0.284; 95％CI:1.733-6.595,0.086-0.944; P＜0.05).The raise of risk derived from SOR via corneal puncture had no statistical significance (OR=2.119; 95％CI:1.043-4.306; P＞0.05).The incidence of RRD after SOR was 8.5％; of which,35.9％ originated from new breaks and 69.2％ were related to new breaks,in contrast,only 5.1％ originated from PVR but 51.3％ were related to PVR.Conclusions High myopia is an independent prognostic risk factor of RRD after SOR.Combined scleral buckling surgery is a protective factor of RRD after SOR.To the well reattached eyes before SOR,the new breaks seems to be the main cause of RRD,wheras PVR was probably a secondary phenomenon.

Objective Hypothyroidism during pregnancy has been associated with impaired cognitive development and increased fetal mortality.In this retrospective study we attempt to identify the timing and adjustment of levothyroxine during pregnancy.Methods 20 women planning pregnancy after thyroidectomy because of thyroid cancer were observed before and throughout their pregnancies.Their thyroid function was measured before conception,and approximately every 4 weeks during pregnancy.The dose of levothyroxine was increased to maintain the thyrotropin concentration at preconception values throughout pregnancy.Results 21 pregnancies occurred in the 20 women and resulted in 20 full-term births.One woman had abortion.Their basal dose was all 100 μg.The dose increased by 12.5 μg a time to target the thyrotropin concentrations (0.1-0.25 mU/ml).The mean levothyroxine requirement increased 50 percent during the first half of pregnancy and plateaued by the 16th week.This increased dose was required until delivery.All the newborns and their mothers were healthy according to the follow-up.Conclusions We propose that women after thyroid cancer surgery should increase levothyroxine dose as soon as pregnancy is confirmed.Thereafter,serum thyrotropin level should be monitored and the levothyroxine dose adjusted accordingly.The adjustment dose is set at 12.5 μg and the maternal thyrotropin concentration is between 0.10 and 0.25 mU/ml,which guarantees healthy growth of fetus while suppresses thyroid tumor growth simultaneously.

Objective To investigate the relationships between Cyclooxygenase(COX-2) and angiogenesis and expressions of COX-2 and vascular endothelial growth factor(VEGF) in thyroid cancer and its clinical significance.Methods Immunohistochemistry was used to detect the expressions of COX-2 and VEGF in 60 thyroid cancer,(15 thyroid)adenomas and 10 normal thyroid tissues.Results The expression rates of COX-2 and VEGF in thyroid cancer were higher than those in thyroid adenomas and normal tissues(P

Objective To explore the current status of social support and its influence factors among MSM in Chongqing .Meth‐ods The status of social support was measured by Social Support Rating Scale(SSRS) in 803 males who have sex with man (MSM) .Results Eight hundred and three MSM were selected as the subjects ,whose average overall scores of social support were 29 .240 ± 6 .228 .Increasing with the growth of the number of friends in gay circles ,MSM tended to obtain more social supports . SSRS score displayed that MSM with features like same gender sexual orientation ,infecting STDs ,only child and did not have regu‐lar homo sex partners got lower social support(P<0 .05) .Conclusion Their social support system should be improved .Therefore , the quality of life and social support will be improved ,thus to maintain their physical and mental health .

Objective To investigate the effect of precondition with Toll-like receptor 4 monoclonal antibody (TLR4mAb) on lipopolysaccharide (LPS) -induced acute lung injury in mice.Methods A total of 45 male BALB/c mice were randomly divided into 3 groups:the control group ( group C),the sepsis group (group S) and the pretreatment group (group P).Mice in the group P and group S were injected intraperitoneally with LPS ( 10 mg/kg) to produce acute lung injury models.Mice in the group P was injected intraperitoneally with TLR4mAb (5 μg/g) 1 h before the injection of LPS.Expression of TLR4mRNA in lung tissue,expression of TNF-α and IL-6 in serum,water content of lung,and the pathomorphologic changes of lung were detected after 6 h,12 h and 24 h.One-way ANOVA was used for inter-group comparison and two-way ANOVA was used for intra-group comparison.Results Compared to group C,water content significantly increased at 12 h and 24 h in group S and group P; compared to group S,water content significantly decreased in group P at 12 h and 24 h.Compared to group C,the expression of IL-6 and TNF-α significantly increased in group S and group P at 6 h,12 h and 24 h; compared to group S,the expression of IL-6 and TNF-α significantly decreased at 6 h,12 h and 24 h in group P.Compared to group C,the expression of TLR4 mRNA increased significantly in group S and group P at 6 h,12 h and 24 h; compared to group S,the expression of TLR4 mRNA decreased significantly in group P at6 h,12 h and 24 h.Compared to group S,pathological damage of the lung was improved significantly in group P.Conclusions Precondition with TLR4mAb can attenuate LPS-induced acute lung injury,suppress the expression of inflammatory factors.Regulation of TLR4 pathway may be a promising therapeutic strategy for ALI.

Objective To explore the changes of matrix metalloproteinase-9 and blood brain barrier in cardiopulmonary resuscitation rats and effects of MMP-9 inhibitor on them.Method One hundred and twenty Sprague-Dawley(SD) rats were randomly divided into 3 groups:the sham-operated group,the resuscitation with treatment group and the resuseimfion without treatment group as control.The experiment was made in the animal experiment center of Sun Yat-sen University in Gtlangzhou.The rat eardiopulmonary resuscitation model was made by clipping trachea until asphyxia,and the restoration of spontaneous circulation(ROSC)Was defined by restoration of superventricular rhythm and mean artery pressure (MAP)≥60 mmHg for more than 5 min utes.The rats of sham-operated group were anesahetized only and endotracheal intubation WaS performed.In the resuscitation with treaUnent group ss-3cr(25,ng/ks body weight)Was given intraperitoneally after ROSC.The rats were sacrificed and samples of the brain tissue were taken inmaediately and 3 h,9 h,24 h and 48 h later.After that,the expression of MMP-9 and MMP-9 mRNA in brain tissue were detected.Water oontent and Evans blue in brain tissue Were observed.The uhmmicrostructure of brain tissue was observed under electron microscope.Analysis ofvariance wilE, done with Spssll.0 software.Results 11le expressions of MMP.9 and MMP-9m RNA ofbraintissueiUthe shanloperated group didn't show significant changees in all specimens taken at different intervals and neither the water content and tvans blue did.The Pvalue were 1.0000,0.6831,0.7124 and 0.99r75,respectively.There was no u1.tramicrostruclure change in the sham-operated group.The expressions of MMP_9 and MMP-9 mRNA in the resuscitation control group obviously increased after eardiopulmonary resuscitation,80 did the water content and Evans blue content.Compared with sham-operated group,the P value were 0.0264,0.0163,0.0000 and 0.0412,respee.tively.111e elge of ultmmicrostmeture in the resuscitation control group at different intervals were obvious.The changes of obove biomarkers in the resuscitation treatment group Was siroilar to but less in magnitude than those in the resuscitation control group.The P valHe were 0.0392,0.0373,0.O004 and 0.0180,respectively.Conclusions The expressions of MMP-9 and MMP.9 mRNA obviously increases in the cerebral ischemia model of rats with CPR,and reaches peak at 24 h.Water content and Evans blue content in brain risque obviously increases in the cerebral ischemia model of rats with CPR.BBB iS destroyed.and the peak time iS at 24 h.The injury of ultrami.crostructure of brain tissue under electron microscope iS obvious,and the peak time is at 24 h.The SB-3CT.specif-iC inhibitor of MMP-9 could decrease the expression of MMP-9 and decrease cerebral edema in the cerebral is.chemia modeJ of rats with CPR,and the protection from cerebral isehemia/reperfusion injury after CPR is obvious.