Surgical effect observation of lens dislocation greater than 2 quadrants / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To investigate the clinical effect of cataract combined lens dislocation greater than 2 quadrants` patients after having phase I intracapsular cataract extraction and anterior vitrectomy,postoperative corrected vision greater than 0.3,and then taking phase II small incision suture-fixation of intraocular lens suspension.METHODS: Totally 34 cases with cataract combined lens dislocation greater than 2 quadrants had been treated in our hospital from July 2014 to December 2016.We investigated their 1wk,1 and 3mo postoperative complications and the uncorrected visual acuity,best corrected visual acuity,intraocular pressure,corneal astigmatism who took phase II small incision suture-fixation of intraocular lens suspension with corrected vision greater than 0.3 after having phase I intracapsular cataract extraction and anterior vitrectomy.RESULTS: Along with the recovery time extension,patients` uncorrected visual acuity and best corrected visual acuity increased obviously than preoperative in each phase.On the 3mo postoperatively,the best corrected visual acuity of 1 eyes was between 0.3 and 0.1,8 eyes was between 0.5 and 0.3,16 eyes was between 0.7 and 0.5,and 9 eyes was better than 0.7.The best corrected visual acuity was achieved or near the best corrected visual acuity before surgery.Intraocular pressure rechecked became in the normal range at 1wk,1 and 3mo postoperative.Surgery did not significantly increase the corneal astigmatism.CONCLUSION: It is a safe and effective way in improving eyesight effectively,with stable intraocular pressure and fewer complications towards cataract combined lens dislocation greater than 2 quadrants` patients having phase I intracapsular cataract extraction and anterior vitrectomy,whose postoperative corrected vision greater than 0.3,and then phase II small incision suture-fixation of intraocular lens suspension.

Clinical research strategy for cN0 thyroid papillary carcinoma central lymph node dissection / 中华外科杂志

<p><b>OBJECTIVE</b>To discuss the pattern of central lymph node metastasis of cN0 single thyroid papillary carcinoma and provide clinical evidence-supported proof for central lymph node dissection.</p><p><b>METHODS</b>The performed thyroidectomy and bilateral central lymph node dissection for 150 patients with cN0 single papillary thyroid carcinoma. The bilateral central lymph nodes were divided into 4 parts: the cornu inferius cartilaginis thyroideae region of ipsilateral central area, the lower part of ipsilateral central area, the cornu inferius cartilaginis thyroideae region of contralateral central area, the lower part of contralateral central area on the baseline of 1 cm below the cornu inferius cartilaginis thyroideae. We analyzed the differences and influencing factors of lymph node metastasis in these 4 parts.</p><p><b>RESULTS</b>The lymph node metastasis rate in lower part of ipsilateral central area was the highest (56.7%), followed by the lower part of contralateral central area (28.0%), the cornu inferius cartilaginis thyroideae region of ipsilateral central area (17.3%), and the cornu inferius cartilaginis thyroideae region of contralateral central area (0). In the logistic analysis of multiple factors, invaded thyroid capsule was an independent factor for lymph node metastasis in both the cornu inferius cartilaginis thyroideae region of ipsilateral central area (β = 0.1835, χ(2) = 0.3102, P < 0.05) and lower part of contralateral area (β = 0.3166, χ(2) = 1.4640, P < 0.05). The patients' age ≥ 45 years (β = 0.5737, χ(2) = 6.5923) and invaded thyroid capsule (β = 0.4258, χ(2) = 3.4735) were independent factors for lower part of ipsilateral central area (both P < 0.05).</p><p><b>CONCLUSION</b>The cornu inferius cartilaginis thyroideae region of contralateral central area of cN0 single PTC patients could not be cleared routinely.</p>

Exogenous hydrogen sulfide attenuates gastric ischemia-reperfusion injury via activation of K(ATP) channel / 生理学报

The present study aimed to investigate the protective effect and mechanism of hydrogen sulfide donor NaHS administration against gastric mucosal injury induced by gastric ischemia-reperfusion (GI-R) in rats. GI-R injury was induced by clamping the celiac artery of adult male SD rats for 30 min and followed by reperfusion for 1 h. The rats were randomly divided into sham group, GI-R group, NaHS group, glibenclamide group and pinacidil group. Gastric mucosal damage was analyzed with macroscopic injured area, deep damage was assessed with histopathology scores, and the hydrogen sulfide concentration in plasma was determined by colorimetric method. The results showed that pretreatment of NaHS significantly reduced the injured area and deep damage of the gastric mucosa induced by GI-R. However, NaHS did not significantly alter the levels of hydrogen sulfide in plasma 14 d after NaHS administration. The gastric protective effect of NaHS during reperfusion could be attenuated by glibenclamide, an ATP-sensitive potassium channel (K(ATP)) blocker. However, K(ATP) opener pinacidil inhibited the GI-R-induced injury. These results suggest that exogenous hydrogen sulfide plays a protective role against GI-R injury in rats possibly through modulation of K(ATP) channel opening.

Lateral neck lymph node metastasis in cN0 papillary thyroid carcinoma / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To study the pattern of lymph node spread in papillary thyroid carcinoma (PTC) with clinically negative node (cN0).</p><p><b>METHODS</b>A total of 106 patients with cN0 PTC who underwent total or subtotal thyroidectomy plus unilateral or bilateral lateral neck dissection (LND, level II-V or level I-V) at West China Hospital of Sichuan University between April 2004 and August 2010 were analyzed retrospectively.</p><p><b>RESULTS</b>The lateral neck lymph node metastasis in cN0 PTC was significantly associated with sex (male, P = 0.007), tumor stage (T3/T4, P = 0.006), tumor size (> 1 cm, P = 0.014) and the number of positive central lymph nodes (≥ 2, P < 0.001), but not with age and multifocal tumor. Level III (47/116, 40.5%) was the most prevalent metastatic site, followed by level IV (41/116, 35.3%), level II (18/116, 15.5%) and level V (2/29, 6.9%). Of the cases with lymph node metastases in level III and IV, 89.8% (79/88) of primary thyroid tumors existed in the lower and middle sites of the thyroid lobes, while in the cases with lymph node metastases in level II, 77.8% (14/18) of primary thyroid tumors in the upper sites of the thyroid lobes, and 83.3% of cases with level II metastases were accompanied with level III metastases. Two cases with level V metastases were accompanied with metastases in levels II, III and IV.</p><p><b>CONCLUSIONS</b>LND should be considered for cN0 PTC in male, with T3/T4 lesions and positive central lymph nodes ≥ 2, and the range of dissection should include level III and IV. Dissection of level II should be considered in cN0 PTC with primary tumor localized in the upper site of the thyroid lobe or with level III metastasis. Dissection of level V should be considered at present of metastases in level II, III, and IV. For cN0 PTC with tumor size < 1 cm, confined to the thyroid and without lymph node metastasis in the central compartment, LND is not recommended.</p>

The clinical characters of tear film instability in diabetes patients / 中华实验眼科杂志

Background The current epidemiology study had shown the prevalence of age and sex adjusted dry eye was higher in patients with diabetes than population without diabetes.Further researches demonstrated that the tear film disturbance is common after the phacoemulsification or photocoagulation in the eyes of diabetic patients.Objective The aim of this study was to characterize the clinical features of tear film instability in diabetes patients.Methods One hundred and sixty-two patients with tear-film abnormality referred to Tongren Eye Center from January 1,2010 to September 1,2010 underwent questionnaire about diabetes and other diseases,BUT,Schirmer test.Tear film instability was diagnosed as abnormality of either Schirmer test or BUT and showed as M ( Q25,Q75 ).The right eyes of 162 dry eye patients meeting with the including criteria were enrolled.The patients were assigned to two groups according to with ( 80 patients) or without ( 82 patients) diabetes mellitum.DEQ questionnaire were scored.The percentage of cases with meibomain gland abnormal score ＞ 1 was calculated.Mann-Whitney U analysis and Chisquare analysis were used to compare the difference between the two groups.Results The Schirmer test in diabetic group was 8 ( qualities:5,9 )mm and was longer than 6 ( qualities:5,7 ) mm in non-diabetic patients ( U =2452,P =0.00).The result of BUT test was 3 ( qualities:2,4 ) seconds in diabetic patients and was shorter than 4 (qualities:3,5) seconds in non-diabetic patients( U=2104,P＜0.01 ).The DEQ score of diabetic patients was 15 ( qualities:1 0,19,which was less than21 ( qualities:19,23.25 ) in non-diabetic patients.51.2 ％ ( 41/80 ) diabetic participants and 32.9％ (27/82) nondiabetic participants appeared meibography ( grade larger than 1 ) (x2 =16.07,P=0.00).The percentages of dry eyes were 51.2％ (41/80) and 93.9％ (77/82) respectively in diabetes and nondiabetes groups(x2 =37.24,P＜0.01 ).No significant correlation was found between the diabetes course and DEQ score or meibography( r =0.16,P =0.16 ; r =0.10,P =0.36 ).Conclusions Diabetes patients with tear film instability have longer Schirmer test results,shorter BUT,more severe meibomain glands damage and lower DEQ scores.The dry eye symptom is lack in the diabetic patients though appearing the tear film and meibomain glands damage.Therefore,more attention should be given to ocular surface health in diabetes patients.

Management of blood vessels in the vascularized autogenous submandibular gland transfer for severe keratoconjunctivitis sicca / 中华口腔医学杂志

<p><b>OBJECTIVE</b>To summarize the management of blood vessels in the transfer of vascularized autogenous submandibular gland.</p><p><b>METHODS</b>Sixty-eight cases of vascularized transfer of autogenous submandibular gland for severe keratoconjunctivitis sicca performed from August 1999 to April 2004 were reviewed. Data collected for each patient included general items, donor and recipient vessels, vessel crisis, salvage of the vessel thrombosis, and survival of transferred glands.</p><p><b>RESULTS</b>Among the 68 cases, all the donor and recipient arteries were facial artery and superficial temporal artery respectively. For donor veins, 55 were facial veins, 1 was vein near the duct, and 12 were venae comitantes of facial artery. For recipient veins, 62 were superficial temporary veins and five were veins in the upper neck, one was deep temporary vein. Vessel thromboses occurred in 10 cases, 9 were venous and 1 were arterial. The salvage rate was 10.0%, with the overall survival rate of 86.8% of transferred gland.</p><p><b>CONCLUSIONS</b>Variation in venous outflow is common in microvascular transfer of submandibular gland, and anastomosis between venae comitante of facial artery and superficial temporal vein is most dependable. Vessel anastomosis under microscope may reduce the vessel thrombosis rate after operation.</p>

Identification of BIGH3 gene mutations in the patients with two types of corneal dystrophies / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To identify the mutations of BIGH3 gene in Chinese patients with corneal dystrophies.</p><p><b>METHODS</b>Polymerase chain reaction in exon 4, exon 12 and direct DNA sequencing of BIGH3 gene were performed in fifteen patients with corneal dystrophies and ten normal individuals as controls.</p><p><b>RESULTS</b>Mutations in BIGH3 gene were detected in all the patients with corneal dystrophies. BIGH3 gene mutations were not found in normal subjects. Twelve patients with Avellino corneal dystrophy had the missense mutation R124H in the BIGH3 gene. Three patients with granular corneal dystrophy had the missense mutation R555W in the BIGH3 gene.</p><p><b>CONCLUSION</b>R124H and R555W mutations in BIGH3 gene were found in the patients with Avellino and granular corneal dystrophies. Avellino corneal dystrophy associated with the R124H mutation is the most common form in the corneal dystrophies resulting from BIGH3 gene mutations. Condons 124 and 555 are also the hot spots for the mutations in the BIGH3 gene in the Chinese patients with corneal dystrophies.</p>

Effect of astragalus injection combined with chemotherapy on quality of life in patients with advanced non-small cell lung cancer / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To observe the effect of Astragalus injection (AI) combined with chemotherapy on quality of life (QOF) in patients with advanced non-small cell lung caner (NSCLC).</p><p><b>METHODS</b>Sixty-NSCLC patients were randomly divided into the treated group (n = 30, treated with AI combined with chemotherapy) and the control group (n = 30, treated with chemotherapy alone). Chemotherapy of MVP protocol was applied to both groups. AI was supplemented to the treated group by intravenous dripping 60 ml per day. Treatment of 21-28 days as one treatment cycle, and 2-3 treatment cycles were applied.</p><p><b>RESULTS</b>The effective rate in the treated group was 40.0% and in the control group was 36.7%, the mean remission rate in the treated and control group was 5.4 months and 3.3 months, the median survival period 11 months and 7 months, and the 1-year survival rate 46.75% and 30.0%, respectively, the differences of these indexes between the two groups were all significant (P < 0.05). Moreover, the clinical improving rate and QOF elevation rate in the treated group was 80.4% and 43.3%, as compared with those in the control group (50.0% and 23.3% respectively), the difference was also significant (P < 0.01).</p><p><b>CONCLUSION</b>AI combined with chemotherapy can significantly improve the QOF in NSCLC patients of advanced stage.</p>

Effect of ischemia-reperfusion injury on the retinal functions of rats / 中华眼底病杂志

Objective To explore the effect of ischemia-reperfusion injury on the retinal functions of rats. Methods Seventy Wistar rats were selected, 20 of which were selected randomly and divided into two groups (control group and single-irrigated group). The rats were anesthetized and their anterior chambers of the right eyes were cannulated with a 7-gauge needle connected to a reservoir containing ringers balanced salt solution, which was maintained at the same level of the eye for 1 hour. After that, ERG was recorded in both eyes of all rats. All the left rats were divided randomly into 10 groups and they were treated as the single-irrigated group. Retinal ischemia was induced by raising the reservoir to a height of 150 mm Hg. One hour later except the single ischemia group, all of the groups resumed perfusion after 3,6,12,and 24 hours and 3,5,7,14,and 21 days separately. ERG was recorded in both eyes of all rats. Results There was no difference in the results of ERG between left and right eyes in either the control group or the single-irrigated group. All the waves of ERG vanished in the single-ischemia group after 1 hour. In the ischemia-reperfusion groups, the waves of ERG partly recovered and the amplitude reduced persistently and progressively. Conclusion Ischemia-reperfusion injury may affect the function of the retina persistently and progressively.

Stress on recognition of dry eye in children with ocular allergic disorders / 眼科

Most patients with allergic conjunctivitis in children are vernal keratoconjunctivitis.Dry eye accompanied with al- lergic conjunctivitis in children is correlated with the decline of tear film stability.However,tear film stability decline is correlated with eosinophilic activation and concomitant release of inflammatory mediators.Moreover,conjunctival epithelial,goblet cells and tear film are damaged,then dry eye occur.Main symptom of dry eye in children is twinkling frequency increasing,followed by eye itch,eye red and photophobia.When allergic conjunctivitis in children is diagnosed,dry eye should be considered at the same time.Proper manage- ment for those allergic conjunctivitis can decrease ocular surface damages.

Fourteen cases of rhenmatic diseases associated corneal melting / 眼科

Objectives To analyse the clinical feature,drug and surgical treatment and prognosis of rheumatic diseases associat- ed corneal melting.Design Retrospective case series.Participants 14 patients (22 eyes) with rheumatic diseases associated corneal melting.Methods The clinical data of patients were analysed,including history,visual acuity,slit-lamp microscopy examination,drug and surgical treatment and follow-up results.Main Outcome Measures The clinical feature,therapeutic effects and recurrence. Results The follow-up was 6～24 months.Rheumatic diseases associated corneal melting always firstly occurred from the upper corneal limbus.The marginal lesions of cornea included melting of the stroma,resulting in corneal thinning or even perforation,with neovascu- larization.The corneal lesions in 4 eyes were within 1 quadrant,10 eyes within 2 quadrants,6 eyes within 3 quadrants,and 2 eyes in 4 quadrants.Eight eyes of 5 cases,whose corneal lesions were thinner than 2/3 of normal corneal thickness,received 1% cyclosporine A and 0.5% heparin eyedrops.Among those,the lesions in 3 eyes of 2 cases progressed worse.Fourteen eyes of 9 cases,whose corneal lesions were thicker than 2/3 of normal corneal thickness,received marginal lamellar keratoplasty.Among those,recurrent signs were noted in 10 eyes of 6 cases.Conclusions Rheumatic diseases associated corneal melting has typical clinical features.Local cy- closporine A and heparin treatment are effective for patients in early stage.A high recurrent rate is found for patients in late stage re- ceived marginal lamellar keratoplasty.