Objective To evaluate the clinical efficacy of biological amniotic membrane transplantation in complicated ocular surface disease and ocular surface reconstruction. Methods The data of 74 eyes of 74 patients with complicated ocular surface disease from Jan. 2011 to Dec. 2016 were analyzed retrospectively. They underwent biological amniotic membrane transplantation. Results The most common primary diseases was recurrent pterygium in 25 eyes (33.78%), followed by corneal ulcer in 20 eyes (27.03%), chemical injury in 15 eyes (20.27%), symblepharon in 10 eyes (13.51%), persistent epithelial defects (PED) in 2 eyes (2.70%), eyelid basal cell carcinoma in 1 eye (1.35%) and Stevens-Johnson syndrome (SJS) in 1 eye (1.35%). After 6 - 24 months follow-up, there were 12 eyes (16.22%) reoperated, including pterygium recurrence in 3 eyes (3/25, 12.00%), corneal ulcer in 2 eyes (2/20, 10.00%), chemical injury in 4 eyes (4/15, 26.67%), symblepharon in 2 eyes (2/10, 20.00%), SJS 1 in eye (1/1, 100.00%). No infection, graft rejection or allergic reaction after surgery occurred. Conclusion Amniotic membrane transplantation is an effective method for the treatment of complicated ocular surface diseases. Key words: Transplantation, biological amniotic membrane; Diseases, ocular surface; Pterygium; Ulcer, corneal; Injury, chemical

患者男,68岁.因"腹胀、腹痛伴排便不畅20 d",于2011年11月30日入院.既往有"高血压病"2年余.查体:心肺无特殊,腹平坦,腹肌无强直,全腹未触及肿块;上腹有压痛,无反跳痛;肝脾肋下未触及;肝肾区无叩击痛;肠鸣音消失.入院胸、腹部平片示:心肺未见异常.腹部未见急腹症X线征象,结肠较多内容物.腹部超声示:肝实质回声增粗,肝左外叶胆管局部扩张,腹膜后实性占位,性质待定.上腹部CT示:肝脏Ⅱ段病灶,性质待定;腹腔干右侧及腹主动脉旁多发肿大淋巴结.磁共振胰胆管成像(MRCP)示:腹膜后(腹腔干右旁)肿大淋巴结,考虑转移瘤.胃镜、肠镜、胶囊内镜检查皆未见明显异常.糖类抗原CA19-9 1 047.49 U/ml.术前初步诊断为腹腔转移瘤:胆管癌并腹腔转移?15 d后行剖腹探查手术,术中可见肝左外叶约1.5 cm直径大小结节,质地韧,边界清,胆囊稍肿胀及肝十二指肠韧带中下方肿物,约3 cm×4 cm,质硬,不规则,下方与胰体部边界不清,粘连明显,胰头未见肿块.术中冰冻提示肝十二指肠韧带淋巴结见低分化癌转移,遂行"肝十二指肠韧带淋巴结微波消融+肝十二指肠韧带淋巴结活检+胆囊切除术".术后病理报告示:1. 肝十二指肠韧带淋巴结见低分化癌转移,伴显著的纤维组织增生;2. 左肝肿物见肝内胆管明显扩张,小胆管增生,纤维组织增生,少量慢性炎症细胞浸润;3. 慢性胆囊炎,胆囊泥沙样结石.术后1个月开始先后进行4次化疗,方案为:奥沙利铂150 mg+氟尿嘧啶3.25 g+亚叶酸钙0.6 g+吉西他滨1.2 g.

·AIM:To observe the clinical effect of limbal conjunctival autograft transplantation (LCAT) or amniotic membrane transplantation ( AMT ) in treatment of primary pterygium. ·METHODS:Analysis of 96 cases(96 eyes) with primary pterygium treated at Shenzhen People's Hospital from January 2013 to December 2015 was taken. Depending on the surgical methods, the patients were divided into two groups: excision of pterygium and limbal conjunctival autograft transplantation being performed in LCAT group (46 cases,46 eyes); excision of pterygium and amniotic membrane transplantation being performed in AMT group (50 cases, 50 eyes). Two groups were followed-up for 12mo to compare the operation time, the corneal epithelium repair time, postoperative complications and the recurrence rate. ·RESULTS:The operation time of LCAT and AMT group was 33. 83 ± 1. 65min, 23. 60 ± 1. 51min respectively, the LCAT group was higher than the AMT group (t=-31.683, P<0.001). The corneal epithelium repair time of LCAT and AMT group was 4.04±0.95d,4.67±1.18d respectively, the LCAT group was lower than the AMT group (t=-2.922,P=0.004); 1 case was recurred in LCAT group, 3 cases were recurred in AMT group. The recurrence rate was 2% in LCAT group and 6% in AMT group, but it hadn't show a significant statistical difference between the two groups (P = 0. 618). One case of conjunctival granuloma was observed in 2wk after surgery of LCAT group, but no serious complications were observed in AMT group. · CONCLUSION: Limbal conjunctival autograft transplantation and amniotic membrane transplantation are effective and safe methods to primary pterygium, which have advantages of rapid recovery, fewer complications and the lower recurrence rate.

Objective To analyze and explore the management for tunnel bleeding during endoscopic thyroidectomy via complete areola approach . Methods A retrospective analysis was made on clinical data of 37 patients suffering tunnel bleeding caused by trocars during puncture out of 1080 cases of endoscopic thyroidectomy via complete areola approach from June 2005 to March 2014.Parameters reviewed included bleeding tunnel , bleeding site, operative time, operative blood loss, postoperative drainage, postoperative hospital stay , and postoperative complications . Results The total incidence of tunnel bleeding was 3.4%(37/1080).Hereinto, the incidence of bleeding in observation tunnel was 2.7%(29/1080), which was significantly higher than that in the main operating tunnel (0.2%, 2/1080) and the auxiliary operating tunnel (0.6%, 6/1080) (χ2 =34.830, P=0.000).The incidence of bleeding in the middle part of the tunnel was 2.9% (31/1080), which was significantly higher than that at the exterior edge (0.5%, 5/1080) and the inner edge (0.1%, 1/1080) (χ2 =43.524, P=0.000).The tunnel bleeding was successfully treated in 37 cases without postoperative bleeding .The mean operating time was 112.6 ±17.5 min;the mean intraoperative blood loss was 22.5 ±9.6 ml;the mean drainage volume after 2 postoperative days was 91.2 ±17.9 ml;the mean postoperative hospital stay was 3.8 ±1.5 d.Local skin ecchymosis occurred in 3 cases and subcutaneous hydrops occurred in 1 case postoperatively , which were recovered after symptomatic treatment . Conclusions Bleeding often occurs in observation tunnel and the middle part of the tunnel . It is effective to treat bleeding at the exterior edge by using harmonic scalpel , and in the middle part of the tunnel and at the inner edge by using percutaneous suturing .

Infectious endophthalmitis may occur after ocular trauma.When endophthalmitis occurs,massive inflammatory cells infiltration in vitreous cavity,loss of sight,pain of eye and hypopyon were major pathologic characteristics.It may further develop to panophthalmitis or orbital ethmyphitis,proceed to the next step,trauma eye would be atrophic.The occurrence of the potential risk factors,clinical manifestations and management describe as follows.

患者,女,60岁,上腹部胀痛不适半年,伴有恶心,消瘦、食欲减退,于2009年3月20入院.体格检查:生命体征平稳,浅表淋巴结未触及肿大,心肺正常,腹部平软,肝脾未触及,剑突下压痛,左下腹壁内可触及5.0 cm×4.0 cm肿块,边界较清楚,活动度可,质软,无明显压痛.肿瘤标志物CEA、AFP、CA19-9均正常.

Different to other nomadic nationalities in history,Genghis khan decided to conquer the west regions.The empire of Mongolian was founded in the first expedition.Through analyzing the background of the conquer war,we can investigate the historical reasons behind the up and down of the nomadic culture.

In the mid and late 19th century. Kanjut lied in the southwest of the Pamirs and bordered with Qitelar and Kashmir as a dependent state of the government of the Qing Dynasty. The important strategic position determined that it was unable to be independent in the tussle for Mid Asia between Britain and Russia. After complicated struggles, Kanjut was identified as the dependent state of both Britain and China. Due to the indispensable relation between Kanjut and Pamir, a study on the issue helps to clarify the historical fact concerning the tussle between Britain and Russia.

Britain had surveyed Pamir organically and programmably several times because of its colonial expansion strategy and the need of preventing Russianinvasion in the nineteenth century. The conclusion through the survey had great effect on British India's Northern Frontier Policy made by Britain. At the same time it has proved that in British affairs of Asia the acquisition of geographical knowledge is the prerequisite to the diplomatic activities.