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Objectives@#. Laryngeal ultrasonography (LUS) has been suggested as an alternative diagnostic tool for unilateral vocal fold paralysis (UVFP). The present study applied LUS and quantitative laryngeal electromyography (LEMG) in female UVFP patients to investigate the pathophysiologic mechanisms of UVFP. @*Methods@#. In this cross-sectional study, vocal fold (VF) length parameters included resting and phonating VF length measured using B-mode LUS, and color Doppler vibrating length (CDVL) measured using the color Doppler mode. @*Results@#. Forty female patients with UVFP were enrolled, among whom 11 and 29 were assigned to the thyroarytenoid (TA) muscle+cricothyroid (CT) muscle group (with CT involvement) and the TA (without CT involvement) group, respectively. In the TA group, the turn frequency in thyroarytenoid-lateral cricoarytenoid (TA-LCA) on the paralyzed side, as observed through LEMG, correlated with the VF length during the resting phase (R=0.368, P=0.050) and CDVL values (R=0.627, P=0.000) on the paralyzed side. In the TA+CT group, the turn ratio in the CT muscle correlated with the normalized phonatory vocal length change (nPLC; R=0.621, P=0.041) on the paralyzed side. @*Conclusion@#. CDVL and nPLC are two parameters that can be utilized to predict the turn frequencies of TA-LCA in UVFP cases without CT involvement, and the turn ratio of CT in cases of UVFP with CT involvement, respectively. The findings suggest that LUS, as a noninvasive tool, can serve as an alternative method for assessing the severity of laryngeal nerve injury and offer valuable insights into the pathophysiology of UVFP.
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Objective:To investigate the effect of edaravone, a free radical scavenger, on the regulation of retinal autophagy and the protection of photoreceptor cells at the early stage of experimental retinal detachment (RD) in rats.Methods:Fifty-one adult male Sprague-Dawley rats were used for RD model establishment, and another 24 rats were served as PBS injection group.The RD model was established via subretinal injection of 0.5% sodium hyaluronate into the right eye of the rats and the rats with successful modeling were randomly divided into RD model group and edaravone treatment group.The rats in the edaravone treatment group were given edaravone of 3 mg/kg intraperitoneally, twice a day after modeling, and the rats in the PBS injection group and RD model group were given equal volume of normal saline.Rats were sacrificed on the 1st day, 3rd day and 7th day following modeling.The T-superoxide dismutase (T-SOD) activity and malondialdehyde (MDA) content in the intraocular fluid was detected.The expression levels of superoxide dismutase 2 (SOD2), nuclear factor E2-related factor 2 (Nrf2), autophagy related gene 4 (Atg4), microtubule-associated protein 1 light chain 3B (LC3B) and other proteins in retinal tissue were identified by Western blot analysis.TUNEL staining was performed on paraffin sections of the whole eyeball to analyze the apoptosis of photoreceptor cells.The study protocol was approved by an Ethics Committee of Xi'an Fourth Hospital (No. 2016016). The use and care of animals complied with the Regulations on the Administration of Experimental Animals.Results:The RD area was more than 60% in rat eyes of RD model.There were significant differences in MDA content and T-SOD activity among different groups at various time points (MDA: Fgroup=385.513, P<0.01; Ftime=13.021, P<0.01.T-SOD: Fgroup=48.865, P<0.01; Ftime=7.700, P=0.003). Compared with the PBS injection group, the MDA concentration was significantly increased and the T-SOD activity was significantly decreased in the RD group and edaravone treatment group on the 1st, 3rd and 7th day after modeling (all at P<0.05). The MDA concentration was significantly reduced and the T-SOD activity was significantly elevated in the edaravone treatment group on the 1st, 3rd and 7th day after modeling in comparison with those of the RD group (all at P<0.05). Compared with the PBS injection group, the relative expression levels of SOD2 and Nrf2 proteins were significantly increased in the RD group and edaravone treatment group on the 1st, 3rd and 7th day after modeling (all at P<0.05), and Atg4 and LC3B-Ⅱ/LC3B-Ⅰ were significantly increased on the 1st, 3rd and 7th day after modeling (all at P<0.05). The expression level of SOD2 in the edaravone treatment group was significantly higher than that in the RD group on the 1st, 3rd and 7th day after modeling (all at P<0.05), and the expression level of Nrf2 was significantly increased in the edaravone treatment group on the 1st and 3rd day after modeling compared with that of the RD group (both at P<0.05), and the expression levels of Atg4 and LC3B-Ⅱ/LC3B-Ⅰ were significantly increased in the edaravone treatment group on the 3rd day after modeling in comparison with those of the RD group (both at P<0.05). No significant TUNEL positive cells were observed in PBS injection group at all time points, and TUNEL positive cells were observed on the 1st, 3rd and 7th day after modeling in the RD group, and the expression level of caspase-3 in the RD group was significantly increased in comparison with that of the PBS injection group ( P<0.05). The apoptosis of photoreceptor cells and the expression level of caspase-3 in edaravone treatment group were significantly decreased in comparison with those of the RD group on the 1st, 3rd and 7th day after modeling (all at P<0.05). Conclusions:The intraperitoneal injection of edaravone, twice a day, can significantly improve the antioxidant capacity of the retina after experimental RD in rats, regulate retinal autophagy and reduce the apoptosis of photoreceptor cells in early-stage RD.
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·AIM:To describe the protocol and economic cost of the Day-care Unit cataract surgery procedure in northwest of China. ·METHODS: Patients who received phacoemulcification and intraocular lens implantation in both Day-care Unit and regular Unit were recruited from January 2016 to December 2016. The baseline data and average cost were recorded and analyzed. Furthermore, satisfaction questionnaire of patients were collected. ·RESULTS: Patients with Day-care Unit showed shorter registration duration, less cost including housing and nursing charge as well as higher rate of patient satisfaction. Meanwhile, Day-care Unit shorten the time the doctors and nurses spending on filling the medical charts. · CONCLUSION: Day - care Unit cataract surgery procedure could benefit both patients and medical staffs and is worthy to generalize.
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Objective To investigate the biological behavior and expression of intergrin-linked kinase (ILK) after exposure to transforming growth factor beta 2 (TGF-β32) in human Tenon fibroblasts (HTFs).Methods The primary ceils of HTFs were cultured by tissue attached culture method and identified by immunofluorescence analysis with Vimentin and keratin.The proliferation levels of HTFs induced by different concentrations of TGF-β2 were analyzed by MTT.The α-smooth muscle actin (α-SMA) and ILK mRNA expression were analyzed by quantitative Real-time PCR.The protein expression of α-SMA,ILK and E-cadherin were analyzed by Western Blot,and the protein expression of α-SMA and E-cadherin were also analyzed by immunofluorescence staining.Results MTT analysis showed that the optical density levels of 5.0 μg · L-1 and 10.0 μg · L-1 TGF-β2 were significantly higher than those of 0.1 μg · L 1,1.0 μg · L-1 and the control after exposure for 48 hours and 72 hours,and all these optical density levels were significantly higher than that for 24 hours (all P ＜0.05).The expression of α-SMA and ILK mRNA increased significantly when cells were treated with 5.0 μg · L-1 TGF-β2 for 48 hours in comparison with the control group (all P ＜ 0.05).The protein of α-SMA,ILK and E-cadherin were expressed both in TGF-β2 treated groups and control group,and TGF-β2 up-regulated the expression of them.There were significant differences when compared with the control group (all P ＜ 0.05).Immunofluorescent staining showed that α-SMA and E-cadherin were detected in TGF-β2 treated groups.α-SMA expressed in cytoplasm,while E-cadherin both in cytoplasm and nucleus.Conclusion TGF-β2 can induce the proliferation,transdifferentiation and adhesion of HTFs,and up-regulate the expression of ILK in vitro,suggests that ILK may play a role in the process of scar formation after glaucoma filtration surgery.
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Objective:To retrospectively analyze the therapeutic effect of subtotal parathyroidectomy (sT-PTX) on uremic patients with secondary hyperparathyroidism (SHPT).Methods:Seventy two SHPT patients treated with sT-PTX in our hospital were enrolled in this study.Serum parathyroid hormone(PTH),calcium(Ca) and phosphorus(P) obtained in the preoperative,postoperative and followup periods were collected and compared.Their symptoms,postoperative complications and relapse were recorded.Results:(1)sT-PTX operation performed successfully in 70/72 patients(97.2％).(2)After sT-PTX,bone pain and itching improved rapidly,with the improvement of nutritional status,Partial patients with renal hypertension were remitted compared with preoperative.Thirteen cases can walk without wheelchair after sT-PTX.(3)Serum PTH,Ca,and P decreased significantly after sT-PTX for one week,one month and 6 months as compared with those before sT-PTX(P＜0.05).(4)Postoperative hypocalcemia was frequently seen(53/72,53.6％) but could be effectively controlled by intravenous calcium infusion.(5)SHPT recurred in the 6 months after sT-PTX in 4 cases (5.7％).Conclusions:T-PTX can effectively decrease PTH level and improve symptoms,and is a safe measure for the treatment of uremic patients with SHPT.
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<p><b>OBJECTIVE</b>Total hip arthroplasty (THA) and hemiarthroplasty (HA) are effective methods currently used to treat femoral neck fracture in elderly patients, but the two options remain controversial in patients over 70 years old. The main purpose of our study was to determine whether THA or HA is a superior treatment of femoral fractures involving a displaced neck in patients who are over 70 years of age.</p><p><b>METHODS</b>A computer-based online search of Medline (1970-2011), PubMed (1977-2011), and the Cochrane Central Register of Controlled Trials (2002-2011) was conducted. Six relevant randomized controlled trials with a total of 739 patients were included for the final analysis. The analysis was performed with software RevMan 5.0.</p><p><b>RESULTS</b>We found that compared with THA, HA needed shorter average time and lost less blood. While over the long-term follow-up, THA patients exhibited significantly less pain and better function and were less likely to require a revision hip surgery. Postoperative infection was equally common among HA and THA patients.</p><p><b>CONCLUSIONS</b>The significant differences in outcomes suggest that THA is a valuable treatment option for active elderly hip fracture individuals. However, patients who are older, impaired or institutionalized benefit from HA.</p>
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Humans , Arthroplasty, Replacement, Hip , Femoral Neck Fractures , General Surgery , Hemiarthroplasty , Postoperative Complications , ReoperationABSTRACT
Objective To study the effect of cyclosporine A drug delivery system (CsA-DDS) on the prevention of posterior capsule opacification (PCO) after experimental intraocular lens implantation in rabbit eyes. Methods Twenty healthy New Zealand white rabbits, whose left eyes and right eyes were used respectively as experiment eyes and controls, were subjected to extracapsular lens extraction and artificial lens implantation. During the operation, CsA-DDS with poly (lactideco-glycolide) as carriers or empty DDS was implanted in the capsular bag for the experimental eyes and controls respectively. After the operation, anterior chamber reaction, intraocular pressure (IOP) and CsA concentration were monitored and twelve weeks after the operation, the eyes were extracted for histopathological and morphological examinations. Results There were no differences between the two groups in conjunctival congestion,IOP change and anterior chamber reaction. PCO was less severe in the experimental eyes than in the controls. Light microscopy revealed that posterior capsular membrane in the experimental eyes was slick, with no obvious proliferation,whereas in the controls, there were lens epithelial cell proliferation and cortex regeneration of different degrees.Morphological examination with electron microscope showed that in the experimental eyes, lens epithelial cells did not function actively and apoptosis occurred, whereas in the controls, epithelial cells presented active function. No marked ultrastructural changes were found in either group. Conclusion Cs-DDS can inhibit PCO after intraocular lens implantation in rabbit eyes and does not have toxic effects on the surrounding ocular tissues. Therefore, it has a good potential for clinical use in prevention of PCO.
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·AIM: To investigate the efficacy and security of the silicone membrane implant through observing intraocular pressure, filtering blebs and histopathologic results.·METHODS; Forty rabbits were randomly divided into 4 groups. Each group consisted of 10 rabbits. Trabecu-lectomy and silicone membrane implantation were performed in one eye of each rabbit, while the other eye was only performed trabeculectomy as control. The change of intraocular pressure, filtering blebs were observed postoperatively. And each eye had undergone histopathologic examination.·RESULTS:The duration of low intraocular pressure and existence of filtering blebs in implanted eyes was longer than that in controlled eyes. Light microscopy revealed that patent drainage tract and biting site could be seen in silicone membrane implanted eye. The activity and regularity of fibroblast proliferation in implanted eyes and controlled eyes were similar. Excessive expression of fibroblast proliferation was not induced by silicone membrane.·CONCLUSION: Characterized by safety, effectiveness and simplicity, silicone membrane implantation can act as a new drainage surgery.KEYWORDS: silicone membrane; drainage surgery;intraocular pressure
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Objective: To study the effect of cyclosporine A drug delivery system (CsA-DDS) on the prevention of posterior capsule opacification (PCO) after experimental intraocular lens implantation in rabbit eyes. Methods: Twenty healthy New Zealand white rabbits, whose left eyes and right eyes were used respectively as experiment eyes and controls, were subjected to extracapsular lens extraction and artificial lens implantation. During the operation, CsA-DDS with poly (lactideco-glycolide) as carriers or empty DDS was implanted in the capsular bag for the experimental eyes and controls respectively. After the operation, anterior chamber reaction, intraocular pressure (IOP) and CsA concentration were monitored and twelve weeks after the operation, the eyes were extracted for histopathological and morphological examinations. Results: There were no differences between the two groups in conjunctival congestion, IOP change and anterior chamber reaction. PCO was less severe in the experimental eyes than in the controls. Light microscopy revealed that posterior capsular membrane in the experimental eyes was slick, with no obvious proliferation, whereas in the controls, there were lens epithelial cell proliferation and cortex regeneration of different degrees. Morphological examination with electron microscope showed that in the experimental eyes, lens epithelial cells did not function actively and apoptosis occurred, whereas in the controls, epithelial cells presented active function. No marked ultrastructural changes were found in either group. Conclusion: Cs-DDS can inhibit PCO after intraocular lens implantation in rabbit eyes and does not have toxic effects on the surrounding ocular tissues. Therefore, it has a good potential for clinical use in prevention of PCO.
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Objective To study the pharmacokinetic characters of cyclosporin A(CsA) in aqueous humor in rabbit after implanting different dosages of CsA in eyes and to provide a theoretical basis for the treatment of after cataract. Methods ECCE was performed in all rabbit eyes. CsA-MS was injected into the anterior chamber and the capsular bag in left eyes as expression group and MS was given in the same way in right eyes as control group. The concentration of CsA in the aqueous humor was monitored with high-performance liquid chromatogram. The follow-up period was 4 weeks. The samples were separated on a C18 column at 60℃ and detected at 210nm. The mobile phase was acetonitrile-water (67∶33). Results The correlation analysis showed a positive correlation within the range of 0.13-1.25mg/L (r=0.9951) and the detection limit was 0.13mg/L. The accuracy was 95.91% and the inter-day and intro-day precision was less than 5%. CsA in aqueous humor sustained a high concentration within 2 weeks. There were no significant differences in t1/2Ka and CL between the two dosage groups. AUC and Cmax increased in a dose-dependent manner. Conclusion The sustain-released CsA ophthalmic gels provided significant ocular bioavailability in rabbit eyes and they can reach the therapeutic dose in order to inhibit after cataract.
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ObjectiveAfter performed the silicone-rubber membrane implantation in rabbits, we investigated the efficacy and security of the silicone-rubber membrane implant through observed intraocular pressure, bleb and morphologic result. MethodsForty rabbits were divided into 4 groups by randomized fashiones. Each group consisted of 10 rabbits. Subscleroflapectomy and the silicone membrane implantation were operated in one eye of each rabbit. And the other eye was only performed subscleroflapectomy, which be controlled eye. The change of intraocular pressure, bleb were observed postoperatively. And every eye for histopathologic examination. ResultsThe lasted time of lower intraocular pressure and filtration bleb in implanted eyes were longer than controlled eyes in two groups. Light microscope revealed that patent drainage tract and bite site could be seen in cilicone membrafe implant eyes. The activity and regularity of fibroblast proliferation in implanted eyes and controlled eyes were similarly. The excessive expression of fibroblast proliferation was not excit ed by silicone membrane. ConclusionIt is characterized by safely, effectively and operate simply that silicone membrane implant drainage surgery act as a new drainage surgery.
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Objective To evaluate the migrating regulation and ultrastructure of the corneal epithelial stem cells in human fetuses. Methods We examined the corneal cryosections of 14-38 weeks of gestation. Hematoxylin-eosin staining showed the stratified corneal epithelium and the corneal epithelial stem cells were localized by mouse monocolonal antibody against human 64-kilodalton keratin (mAE5), and the ultrastructure of the corneal epithelial stem cells was observed. Results At 14 weeks of gestation, the corneal epithelium was composed of a single basal cells layer and 1-2 superficial squamous cells layers. Some superficial squamous cells were mAE5 positive in the limbus as well as the central and peripheral cornea. At 17-29 weeks of gestation, the limbus epithelium developed from 3 to 5 cells layers and the central region from 2 to 3 cells layers. mAE5 positive cells were found in the suprabasal layers of all 3 regions examined but not in the basal layer. At 33-38 weeks of gestation, the corneal epithelium consisting of 4-6 cells layers was morphologically mature. mAE5 immunoreaction showed the negative cells were confined to limbus basal layer. The ultrastructure of basal layer cells showed they had more heterochromatin in the nucleus, less organells in the cytoplasm and less desmosomes among them. Conclusion The migration of corneal epithelial stem cells in the human fetuses was from the whole layers to basal layer and confined to limbus region finally, and their ultrastructure was immature.