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    16 October 2010 Volume 24 Issue 5
      
    Articles
    Differentially expressed genes in 3 cases of hypopharyngeal carcinoma and  normal tissues by cDNA microarray
    L Mei1, DONG Pin2, SHE Cui-ping3, DU Cui-ping1, LI Yong1, XU Er-dong1
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2010, 24(5):  5. 
    Abstract ( 1573 )   PDF (822KB) ( 1278 )   Save
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    Objective    To detect differentially expressed genes in hypopharyngeal carcinoma and adjacent normal laryngeal tissues with cDNA microarray. Methods      Three samples of hypopharyngeal carcinoma, pathologically confirmed as squamous cell carcinoma,  were tested.  Total RNAs were extracted and  inversely transcribed to cDNAs.The cDNAs of hypopharyngeal carcinoma were marked by Cy5 and  the cDNAs of normal laryngeal tissues were marked by Cy3. The cDNA probes were then hybridized to DNA microarrays and scanned for fluorescent signals. Differential expression between the two tissues was produced by ImaGene software. The average ratio of gray scale, if equal or more than 2 times,  was considered significant. Results      There were 51 genes significantly expressed in 3 cases. Among them, 39 genes were significantly higher, but 12 genes were significantly lower in hypopharyngeal carcinoma than  normal tisscle.4 new genes were identified. Some highly expressed genes (more than 5 fold difference ) included: 1) Genes of upregulation, such as MMP-1, Integrinβ4, Bcl-2, CXCL13 and PRAME; and 2) Genes of downregulation, such as Egr-1 and MRP1/ CD9. Conclusion     Many genes, which  play important roles in the proliferation, invasion, and metastasis of hypopharyngeal carcinoma, can be picked out by cDNA microarray;  These genes   will serve as targets for further research.

    Expression and significance of serum soluble tumor necrosis factor  receptor  Ⅰ and  Ⅱ in patients with laryngeal cancer
    SHI Da-zhi1, LUO Zhi-qiang1, ZHOU Jun2
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2010, 24(5):  10-12. 
    Abstract ( 1183 )   PDF (317KB) ( 944 )   Save
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    Objective     To measure levels of serum soluble tumor necrosis factor receptors (sTNFR)  and   to explore their clinical significance in the diagnosis and monitoring of laryngeal cancer. Methods     The serum levels of sTNFRⅠand sTNFRⅡ were measured by avidinbiotin complex enzyme-linked immunosorbent assay (ABC-ELISA) in 42 laryngeal cancer patients and 40 healthy adults. Results      The serum levels of sTNFRⅠ in laryngeal cancer patients (1463.34±669.07pg/mL)were significantly higher than in the control group(549.30±293.29pg/mL, P<0.05), but the sTNFRⅡ levels were not  (P> 0.05); There was no significant difference among the levels of sTNFRⅠ and sTNFRⅡ in different types of laryngeal cancer(P> 0.05), while significant differences in the sTNFRⅠ level at the various developing periods of laryngeal cancer were found (P<0.05). The change of sTNFRⅡ levels, in the various periods of laryngeal cancer was of no significant difference (P>0.05). The sTNFRⅠ level of laryngeal cancer patients with lymph node metastasis were much higher than of  patients without lymph node metastasis (P<0.05), however, the difference of sTNFRⅡ levels between patients with and without lymph node metastasis was not significant (P> 0.05).Conclusion      Detection of serum levels of sTNFRⅠ may have practical value in the early diagnosis and  prognosis of laryngeal cancer.

    Clinical effect of recombinant human p53 adv injection (gendicine) in combination with radiotherapy in patients suffering from  recurrent nasopharyngeal carcinoma
    LIU Rong-rong, JI Chang-you, CHEN Ji-chuan
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2010, 24(5):  13-16. 
    Abstract ( 1580 )   PDF (400KB) ( 1436 )   Save
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    Objective    To evaluate the therapeutic effect of and adverse reaction of recombinant human p53 adv injection (gendicine) in combination with radiotherapy in patients suffering from recurrent nasopharyngeal carcinoma. Methods     A total of 30 intermittent patients with diagnoses of recurrent nasopharyngeal carcinoma from January 2005 to December 2006 were included in this study, of which 15 cases received treatment of gendicine in combination with radiotherapy(the experimental group), and the other 15 cases were given typical chemotherapy and radiotherapy (the control group). All patients were followed-up on week 8,  month 6, and month 12 after the first therapy. The therapeutic effect was evaluated by the change of tumor size and living quality measured by CT and Karnofsky Score, respectively. Results      The curative rate of the 5 patients treated by gendicine reached 20%, and the total effective rate was 100%, and except of fever, no other obvious adverse reaction was observed. Both the therapeutic effect and adverse reaction of gendicine were advanced compared with typical chemotherapy in combination with radiotherapy. Conclusion     Gendicine in combination with radiotherapy is effective and safe for  most patients with recurrent nasopharyngeal carcinoma.

    Therapeutic effects of hyoid suspension and uvolopalatopharyngoplasty
    ZHANG Qing-quan, SONG Xi-cheng, ZHANG Hua, SUN Yan, LIU Zhong-lu, WANG Qiang, WANG Yong-fu, ZHANG Tian-zhen, ZHU Yu-hong, WANG Xi-wen
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2010, 24(5):  17-20. 
    Abstract ( 1358 )   PDF (387KB) ( 1113 )   Save
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    Object      To investigate the methodology and therapeutic effects of hyoid suspension in association with uvolopalatopharyngoplasty (UPPP) in the  treatment of severe Obstructive Sleep Apnea Hypopnea Syndrome(OSAHS). Method     21 patients with severe OSAHS underwent surgery of modified hyoid suspension in association with UPPP and were followedup. Polysomnograms (PSG)  were  examined pre-operatively and post-operatively in 21 Patients. All patients were the assessed  with Epworth Sleepiness Scale(ESS) and Berlin Sleep Quality Assessment Questionnaire(BSQAQ) before and after the operation. Results     The  results of follow-up showed that there were significant improvements in the indexes of PSG in  all cases (P<0.01). The average of the ESS was 6.71 6 months after operation and 7.24 after one year. Also, the average of the BSQAQ was 5.57 and 6.14 respectively ,with an obvious decrease compared to the preoperative data(P<0.01). After surgery, the patients told about the alleviation or disappearance of snoring and much less occurrence of sleep apnea while lethargy during the day was almost completely gone. According to the assessment guidelines, the effective rate was 100% 6 months after the operation and remained at 95.24% 1 year after the operation. But cure rate and effectual rate varied. Conclusion       Modified hyoid suspension in association with UPPP has advantages of simple procedure, less days of hospitalization and less expense. The effect of the operation is satisfying. Proper cases should be chosen to be treated with such procedure and more hospitals should adopt it.

    Efficacy of adenoidectomy and tonsillectomy for the children with   obstructive sleep apnea syndrome  
    XIE Li-sheng, HUANG Qun
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2010, 24(5):  21-23. 
    Abstract ( 1313 )   PDF (335KB) ( 1536 )   Save
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    Objective     To observe the efficacy of adenoidectomy and tonsillectomy in children  with obstructive sleep apnea syndrome (OSAS). Methods      Sixty children with OSAS were selected after a PSG(polysomnography) test. The children were randomily divided into group A (30 cases) or group B ( 30 cases). In group A, adenoids and/or tonsils were ablated, while vitamin C (0.1mg) was administered orally in group B. Apnea-hypopnea index (AHI) and lowest blood oxygen saturation (SaO2), before and after 3month treatment in the two groups, were tested.  Clinical outcomes, in light of  the language evaluation form(VRS)furnished by the parents,  were also compared. Results     No obvious difference of AHI and the lowest SaO2  before the treatment was found between the groups. However, after three months of treatment, AHI reduced to 2.6±1.8, and the lowest SaO2 increased to 92.9±2.5 in group A, in which  all improved significantly compared with those before the treatment (P<0.05). Also,  AHI and lowest SaO2 in group B did not significantly change after the therapy (from 18.4±7.8 to 17.1 ±8.2, 79.2 ±11.4 to 81.4±9.1, respectively). According to the clinical outcomes, 86.7%, 93.3% and 86.7% of the children in group A improved in snore,  and suffocation or mouth breathing which were all better than those in group B (6.7%,13.3%, and 13.3%,respectively;all P<0.05). Conclusion      Adenoidectomy and tonsillectomy are effective  procedures to treat OSAS in children.

    Tympanoplasty with tubed pedicle skin flap of  temporalis fasciae 
    ZHANG Hao-liang, YU Feng
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2010, 24(5):  24-26. 
    Abstract ( 1626 )   PDF (348KB) ( 1465 )   Save
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    Objective      To investigate the applications of tubed pedicle tunnel skin flap of the temporalis fasciae and its supportive role in tympanoplasty.  Methods      96 lesions less otitis media ears, pedicled temporalis myofascial flap was used to repair the tunnel film material tympanoplasty I in 46 ears, the other 50 ears used tympanic membrane free temporal fascia, in contrast; select lesions in heavier ear otitis media 73, 23 of which were in the ear canal wall and then were removed to pedicled temporalis fascia flap as a tunnel film canal wall soft support, the other 50 lines had mastoidectomy of ear to make a comparison. Results      After six months of follow-up, the transfer tunnel pedicled temporalis myofascial flap graft healed well, the group survival rate was 97.8% and the free temporal fascia group was 88.0%, after raising similar hearing. The pedicled temporalis myofascial flap for canal wall cases of soft-stent group after six months of dry ear had a rate of 91.3%, radical mastoidectomy dry ear rate was 92.0% for six months, six months after hearing the former than the latter increase, line t test prompted a difference. Conclusion     The tubed pedicle skin slap of the temporalis fasciae can serve as a good patch or pedestal in tympanoplasty.

    Clinical characteristics of nasal diseases in elderly patients
    LIU Yi-qing, SHI Guang-gang
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2010, 24(5):  29-31. 
    Abstract ( 1090 )   PDF (339KB) ( 1050 )   Save
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    Objective     To summarize the clinical features of nasal diseases in elderly patients so as to make the peri-operative treatment safe. Methods     The clinical data of 258 elderly inpatients suffering from nasal diseases during 2007 to 2009 were retrospectively analyzed. Results     In this cohort, 120(46.5%) patients suffered from nasal inflammation, 69 (26.7%)of them suffered from epistaxis, and 64(24.8%) from various tumors.  221(85.6%) were subjected to endoscopic therapy which belongs to the low danger category. It was found that 158(61.2%) of the patients were complicated with  chronic diseases, in which the major complications for the elderly were cadiovascular system diesease and diabetes. There was no statistic significance between gender and different disease groups. Two operations were postponed, and 9 were subjected to non-operative methods. Peri-operative complications happened in 3 of the elderly patients. Conclusions     Geriatric patients have their own specific pathophysiologics. In particular, more attention should be paid to the diagnosis and treatment of co-existent diseases and try to reduce surgical trauma in these elderly patients, which, in turn, can effectively  minimize surgical risk and postoperative complications.

    Relationship between removal of the horizontal part of the middle turbinate base and post-operative middle turbinate drifting synechia
    XU Xue-hai, YAN Xing, AN Fei, WANG Jing-ming, SHI Ya-nan, HAO Tao
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2010, 24(5):  32-33. 
    Abstract ( 1867 )   PDF (287KB) ( 978 )   Save
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    Objective     To study whether removal of the horizontal part of the middle turbinate base has an effect on post-operative middle turbinate drifting synechia. Methods     110 cases of bilateral sinusitis and nasal polyps were enrolled in this study, with removal of parts of the middle tuebinate base due to diseases on one side and integrity of it on the other side. By self-control of the patients, incidence of bilateral post-operative middle turbinate drifting synechia in six months after surgery was observed. Results     Postoperative middle turbinate drifting synechia occurred on 19 sides (17.8%) with removal and on 7 sides(6.4%) without removal in 110 cases. Conclusion     To reserve the horizontal part of the middle turbinate base has clinical significance for maintaining the middle turbinate fixed and preventing post-operative middle turbinate drifting synechia and to reserve it as completely as possible during surgery is recommended.

    Suction electro-coagulator in the treatment of intractable idiopathic epistaxis
    HAN Fei, WANG Qi-rong, CUI Zhao-yang
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2010, 24(5):  34. 
    Abstract ( 1391 )   PDF (311KB) ( 1065 )   Save
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    Objective     To summarize the experiences of using suction electro-coagulator under nasal endoscopy for intractable idiopathic epistaxis. Method     The clinical data of 29 cases of intractable idiopathic epistaxis treated by suction electro-coagulator from November 2008 to January 2010 were retrospectively analyzed. Result      All patients responded well with cessation of bleeding and no recurrence in a follow-up of 2 months after a single operation. Conclusion    Suction electro-coagulator is not only effective and quick, but also safe, economical and practical in treatment of intractable idiopathic epistaxis under nasal endoscopy.

    Investigation of the development and apoptosis of  the mouse olfactory epithelium
    SHI Bao-yuan1, SHI Li2, MA Chao2
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2010, 24(5):  36-39. 
    Abstract ( 1394 )   PDF (798KB) ( 1238 )   Save
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    Objective     To study the expression of neuro-specific enolase(NSE),  ofactory marker protein(OMP)and  apoptosis in the development of olfactory mucosa of mouse fetuses. Methods      Expressions of NSE and OMP in the olfactory mucosa of the different embryonic stages(day 13 to 21)were determined using immunohistochemical technique. The Tdt-mediated dUTP nick end-labeling technique (TUNEL) was used to detect apoptotic cells of the olfactory epithelium in different embryonic stages and to caculate the apoplotic index. Results       NSE immunological positive reactions were seen in different embryonic stages from E13 to E21. Otherwise, few positive OMP cells were observed after E14,  after E15  OMP-positive neurons were noticeably increased in the olfactory epithelium and at E17, they reached the peak. The apoptotic process in the olfactory epithelium was observed form E13 to E21. At E13, the apoptotic cells were few and the AI was low. A massive wave of cell death was evidenced between E16 and E18.The apoptotic index of E16 was noticeably distinction from other embryonic stages. Conclusion      Olfactory receptor neurons of mouse fetuses became mature at E14 and the quantity was small. In the anaphase of the embryo, the olfactory epithelium was mature. The apoptotic process takes part in the development of the mouse olfactory epithelium and comes to a peak in E16. Apoptosis is an active process in the development of mouse olfactory epithelium.

     Application of Lidocaine air atomized by oxygen on the removal of  bronchial foreign bodies in children
    ZHAI Ming-wei1, DUAN Ye2, ZHAO Heng-yong3
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2010, 24(5):  43-45. 
    Abstract ( 1547 )   PDF (339KB) ( 1579 )   Save
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    Objective     To compare children with tracheal foreign body removal surgery, the inhalation of high oxygen surface anesthesia of lidocaine or tetracaine throat spray, which is more conducive to suppress airway reflex. Methods     60 cases were randomly divided into two groups, group A(n=30) was given nebulized  lidocaine and group B(n=30) was given tetracaine spray. Patient′s differences in MAP, HR, SPO2 and adverse effects during the induction of anesthesia  and  bronchiacopy  were observed. Results     There were significant differences of MAP, HR and SPO2 between the two groups(P<0.01). While the rigid bronchoscope stayed inside the trachea, the rate of breath holding, tracheal irritation and spasm  in group B was more common than group A (P<0.01). Conclusion      In the removal of bronchial foreign bodies in children,  nebulized lidocaine can effectively suppress  the reflection of the trachea. Therefore, the operation can proceed smoothly.

    Surgical treatment for secondary glaucoma  - in uveitis with cataract
    YANG Jun1, SUN Yan1, ZHAO Jun1, HAN Jing-li2
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2010, 24(5):  53-55. 
    Abstract ( 1550 )   PDF (380KB) ( 1385 )   Save
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    Objective     To investigate the efficacy of combination of phacoemulsification and anti-glaucoma surgeries (including trabeculectomy and periphery iridectomy) for secondary glaucoma  - in uveitis with cataract. Methods    The clinical data and related ocular manifestation in 28 patients (32 eyes) with secondary glaucoma in uveitis with cataract in our hospital from January 2007 to January 2009 were retrospectively analyzed. Paired t-test was used to compare the changes of the vision and intraocular pressure (IOP). Results     The visual acuity was improved in 30 eyes (93.75%) after operation. The IOP was normal in 25 eyes (78.13%) one week after operation. 7 eyes (29.91%) had antiglaucoma medical treatment, and 2 eye (6.25%) had a secondary operation because their IOPs were still higher than 22mmHg one month after operation.  The visual acuity was significantly higher and the IOP was significantly lower one week and 12months after operation compared with those before operation (all P<0.01). Conclusions     Combination of phacoemulsification and anti-glaucoma surgeries can improve visual acuity and reduce IOP for secondary glaucoma in uveitis with cataract.

    Relationship between anticardiolipin antibodies and  anterior ischemic optic neuropathy
    ZHANG Jie1, ZHANG Hai-xia1, WANG Jia-an2, WANG Qin1, CHENG Dan-fu1, TIAN Yu-feng2
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2010, 24(5):  56. 
    Abstract ( 1275 )   PDF (313KB) ( 1393 )   Save
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    Objective     To investigate the relationship between anticardiolipin antibodies(ACA) and  anterior ischemic optic neuropathy(AION). Methods     Serum ACA of 30 patients with anterior ischemic optic neuropathy and 60 healthy persons were determined by  ELISA. Results     Positive rate of IgG-ACA was significantly higher in AION patients than the control(P<0.05). Conclusion     Positive ACA is closely related to the onset and development of AION.

    Segmental scleral buckling surgery for rhegmatogenous  retinal detachment
    LI Chuan-bao1, ZHANG Chuan-kun2, DING Jian-guang1, LIANG Yong3, HE Shu-yan1, HU Zhao-lei1
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2010, 24(5):  58-61. 
    Abstract ( 1560 )   PDF (355KB) ( 1370 )   Save
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    Objective     To evaluate the results of segmental scleral buckling surgery for rhegmatogenous retinal detachment. Methods      163 cases of rhegmatogenous retinal detachment from Mar. 2005 to Jan. 2009 were enrolled in the study. Each retinal break was located by indirect ophthalmoscopy.Scleral buckling,cryotherapy and drainage of subretinal fluid procedure were applied. Encircling was used in 93 eyes of 89 patients (the test group) but was not used in 76 eyes of 74 patients (the control group).All patients were followed-up for 6-9 months. Results       ①89 eyes in the test group and  64 eyes in the control group got complete retinal reattachment;② postoperative corrected visual acuity improved in 82 eyes of the test group and 64 eyes of the control group. Conclusions      Segmental scleral buckling without combining encircling surgery to treat rhegmatogenous retinal detachment simplifies the surgical procedure and has a better visual prognosis. It is an effective surgical procedure.

    Clinical observation of RVO treated with combined  Chinese herbs and laser coagulation
    LI Jin-qi1, WANG Jing-bo2, ZHAO Jing1
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2010, 24(5):  62. 
    Abstract ( 1272 )   PDF (400KB) ( 964 )   Save
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    Objective     To explore an effective method based on the clinical observation and therapeutic effects of retinal vein occlusion (RVO) treated with combination of Traditional Chinese Medicine (TCM) and Western Medicine. Methods    56 patients with RVO were divided into two groups: the treatment group (n=35) administrated with combined retinal photocoagulation and Chinese herbs, and the control group (n=21) with simple retinal photocoagulation. The visual acuity (VA) and fundus in the two groups were evaluated before and after the administration. Results     The VA and fundus signs in the treatment group revealed a more significant improvement statistically compared with those in the control group(P<0.01). Conclusion     TCM demonstrated an unique advantage in improvement of VA and relevant signs in patients with RVO. Combined Chinese herbs and laser coagulation can remedy the limitations of simple photocoagulation.

    Ultrasound bio-microscopic observation of the ocular anterior segment after combined trabeculectomy with primary angle-closure glaucoma
    LI Jun, YOU Xin-ying
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2010, 24(5):  64-66. 
    Abstract ( 1265 )   PDF (315KB) ( 1046 )   Save
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    Objective     To observe the ocular anterior segment configuration by an ultrasound bio-microscope (UBM) in patients with primary angle-closure glaucoma after trabeculectomy. Methods     Trabeculectomy was performed on 30 patients (30 eyes) with primary angle-closure glaucoma. UBM was used to measure the ocular anterior segment in all eyes. The patients were examined 1 day before surgery and 1 month after surgery. Results     There was a significant difference in glaucoma before and after surgery. Angle width was significantly greater, but no significant changes were observed in anterior chamber depth and other references after surgery. Conclusion    Combined trabeculectomy can partly improve the ocular anterior segment of primary angle-closure glaucoma.

    Nonsurgical therapy of traumatic cyclodialysis
    ZHANG Ning, TIAN Jie, WU Bai-wen
    JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY). 2010, 24(5):  67. 
    Abstract ( 1353 )   PDF (324KB) ( 1024 )   Save
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    Objective     To explore the indication and method of nonsurgical therapy of traumatic cyclodialysis. Methods     10 cases(10 eyes) with traumatic cyclodialysis were given subconjunctival injections of methylprednisolone while medicines to improve retina functions were administered at the same time.  Clinical effects were observed. Results     After  therapy, the vision, intraocular tension, anterior chamber′s depth and the retinas of all cases were  improved and all ciliary bodies recovered thoroughly under UBM(ultrasound bio-microscopy). Conclusions     For  patients with traumatic cyclodialysis, nonsurgical therapy is safer, more effective and practicable.  Treatment should be chosen according to the status of illness and test results.