ABSTRACT
Objective:To assess the applying value of Chinese shorter version of the Visual Function Index questionnaire (VF-11R-CN) for presenting low-vision cataract pre-operation and post-operation by using minimal clinically important difference (MCID) determined by combination of distribution-based with anchor-based methods, and to compare the improvement rate of vision-related quality of life (VRQol).Methods:A cross-sectional study was performed in this study.Ninety-eight patients with presenting low vision cataract were enrolled at Eye Hospital of Wenzhou Medical University from May 2018 to June 2019.All the patients received a phacoemulsification with intraocular lens implantation.A questionnaire survey was carried out with VF-11R-CN Scale before surgery and 1 month-3 months after surgery, and a complement anchor item was added during the questionnaire after surgery.The applicability of the scale was assessed by floor or ceiling effects, and score difference of the VF-11R-CN over time and effective size was determined.Distribution-based MCID was calculated using 0.5 standard deviation (SD) of score difference and 1.96 standard error of measurement (SEM). Anchor-based MCID was calculated using the slope of the linear regression analysis.In responder analysis, sensitivity and specificity of MCID was reported.The differences of postoperative VRQol improvement rate based-on MCID were compared between male and female, single eye disease and multiple eye diseases, pre-operative and post-operative scores.This study protocol was approved by the Ethics Committee of Eye Hospital of Wenzhou Medical University, and followed the Declaration of Helsinki.Written informed consent was obtained from each patient prior to any medical examination.Results:A total of 85 patients completed the following up.The mean score difference was 399.51±234.92, and that of the presenting visual acuity (PVA) was 0.65±0.36.Both the minor floor and ceiling effects were 1.18% before surgery, and the ceiling effects were 22.35% after surgery.The score before surgery was significantly higher than that after surgery ( t=15.68, P<0.001). The effective size for the surgery was 1.63.The MCID was 122.23 and 123.10 according to 0.5 SD and 1.96 SEM.The linearity regression analysis showed that score difference reduced 106.17 if anchor item option increased 1.The average MCID estimate was 117.17.A total of 76 patients (89.41%) reported an improvement of VRQol.The sensitivity of MCID for the assessment of VRQol was 96.67% and specificity was 46.67%.No significant differences were found in VRQol improvement rate between gender, single cataract and multiple eye diseases or PVA (LogMAR 1.3 as cutoff value) ( P=0.73, 0.88, 0.27). Conclusions:VF-11R-CN scale is available for Chinese presenting low vision cataract patients undergoing surgery.The MCID value for the cataract surgery is 117.17 scores, with a high sensitivity and a relatively low specificity.
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Objective To investigate the effects of ischemic postconditioning (IPOC) on myocardial perfusion and prognosis in patients with acute ST-segment elevation myocardial infarction (STEMI) who were treated with emergency percutaneous coronary intervention (PCI). Methods A total of 203 patients with STEMI who received emergency PCI were randomly divided into IPOC group (n=103) and control group (n=100). For the patients of IPOC group the angioplasty balloon was re-inflated within one minute after the beginning of reperfusion, the procedure was repeated three times, each time the inflation of balloon lasted for 1 minute using low-pressure (4-6 atm), and the interval between the inflation procedures was one minute. For the patients of the control group , no additional intervention was employed during the first 6 minutes of reperfusion. Cardiac troponin I(cTnI) peaks, creatine kinase-MB (CK-MB) peaks, left ventricular ejection fraction (LVEF), wall motion score index (WMSI), corrected thrombolysis in myocardial infarction (TIMI) frame count (CTFC), and major adverse cardiac events (MACE) occurred during hospitalization time in both groups were recorded and the results were compared between the two groups. Results No significant differences in age, sex, risk factors, infarction-related artery, ischemia time, etc. existed between the two groups (P>0.05). The CTFC values of IPOC group were significantly faster than those of the control group, that was (25.3±7.9) vs.(29.4±8.4),(P<0.05). The CK-MB peak and cTnI peak values of IPOC group were remarkably lower than those of the control group, those were (157.3 ±83.6) U/L vs. (201.5 ±77.3) U/L and (2.5 ±1.3) ng/mL vs. (3.1 ±1.0) ng/mL respectively (P<0.05). At the time of admission, there were no significantly differences in the LVEF and WMSI values between the two groups, and three months after PCI the LVEF and WMSI values of IPOC group were significantly better than those of the control group, those were (57.4 ±8.7)% vs. (53.6 ±9.3)% and (1.19 ±0.4) vs. (1.27 ±0.3) respectively, the differences were statistically significant (P<0.05). Three months after PCI, the occurrence of MACE in IPOC group was obviously lower than that in the control group (P<0.05). Conclusion Ischemic postconditioning can improve the infarction-related artery blood flow in patients with STEMI who receive emergency PCI treatment, it can also reduce ischemia-reperfusion injury and improve the cardiac function as well as patient’s prognosis after AMI.
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Prosthesis revision and service life after artificial joint replacement is highly correlated with the biocompatible responses among prosthesis per se, host, and manipulating technique. Artificial prosthesis consists of two parts: metal part and rigid plastic components. Many metals such as stainless steel, cobalt-chrome-molybdenum alloy and titanium alloy can be used as prosthesis materials. The plastic materials mainly include wear-resisting polythene, plastic bone cement that is used to embed the prosthesis into osseous substance. Host defines as the patients with various joint injury, mainly the elderly. Anesthesia is a key step in replacement. Artificial joint replacement is performed in patients under anesthesia. Different anesthesia methods bring variable influences on biocompatibility after surgery. In addition, complications of anesthesia may aggravate tissue lesions around operation sites in the early stage after replacement, leading to joint loosening or inadequate joint range of motion. Appropriate anesthesia, modified artificial joint design and joint replacement technique can prolong the serve life of artificial joint.