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BACKGROUND: After phacoemulsification combined with trabeculectomy in patients with cataract and glaucoma, blood lipid ratio and insulin sensitivity are associated with intraocular pressure, visual acuity and corneal endothelial cells, which may be used for the evaluation of efficacy. Interleukins are the main mediators of the inflammatory response and are involved in the pathogenesis of cataract. OBJECTIVE: To examine the postoperative changes in interleukin-10, interleukin-2 and interleukin-13 levels in patients with cataract with glaucoma, and to analyze the correlation between insulin sensitivity and corneal endothelial cell density so as to assess whether inflammatory factors can be used to evaluate efficacy. METHODS: This prospective, single-center, open-label, self-controlled clinical trial will include 160 patients with cataract combined with glaucoma, 35-65 years of age, from the Department of Ophthalmology, First Affiliated Hospital of Kunming Medical University in China. All patients will receive phacoemulsification and trabeculectomy, and will be followed up at 5 days and at 1 and 3 months postoperatively. Data collection and patient recruitment will begin on December 30, 2019 and end on December 30, 2020. Analysis of the results will be performed from May 1, 2021 to May 30, 2021. This study is scheduled to end on June 30, 2021. This study was approved by the Medical Ethics Committee, First Affiliated Hospital of Kunming Medical University, China, on December 15, 2013 (approval No. 20131215085), and will be performed in accordance with the principles of the Declaration of Helsinki, adopted by the World Medical Association. Written informed consent to participate will be obtained from the participants. This study was registered with the Chinese Clinical Trial Registry on September 10, 2019 (registration number: ChiCTRI 900025837). Study protocol version is 1.0. RESULTS AND CONCLUSION: The primary outcome measure will be serum interleukin-2 level, as an index of the inflammatory response, 3 months after surgery. Secondary outcome measures will include serum interleukin-2 level before and 5 days and 1 month after surgery, serum levels of interleukin-1β, interleukin-10, C-reactive protein and tumor necrosis factor-a, best corrected visual acuity, endothelial cell density, mean cell area, coefficient of variation, insulin sensitivity index and intraocular pressure before and 5 days and 1 and 3 months after surgery, and incidence of adverse reactions at 5 days and 1 and 3 months after surgery. From January 2014 to June 2017, our team undertook and completed a small-sample study of 80 cataract patients (95 eyes) with glaucoma. The best corrected visual acuity was significantly improved, endothelial cell density and intraocular pressure were significantly reduced, interleukin-1β, interleukin-2, interleukin-10, C-reactive protein and tumor necrosis factor-a levels were significantly decreased (P < 0.05), and mean cell area, coefficient of variation and insulin sensitivity index were significantly increased (P < 0.05) after phacoemulsification and trabeculectomy. None of the patients had adverse reactions during the treatment. The trial will attempt to explore whether phacoemulsification combined with trabeculectomy has a good therapeutic effect in patients with cataract combined with glaucoma, and clarify whether the effect is associated with the regulation of insulin sensitivity index, comeal endothelial cells and inflammatory factors.
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OBJECTIVE:To investigate the current situation of unreasonable prescriptions in outpatient and emergency depart-ments of our hospital,and to provide reference for rational drug use in the clinic. METHODS:The evaluation of outpatient and emergency prescriptions in our hospital during 2013-2015 were summarized and analyzed. Irrational prescriptions were divided into 3 categories,involving 19 items. The main,secondary and general factors of irrational prescriptions were analyzed by Pareto chart. RESULTS:Among 19 types of irrational prescriptions,main factors included unsuitable drug selection,inappropriate usage and dosage,inappropriate drug combination,prescribing not in accordance with the antibiotics management regulations,incomplete di-agnosis. No indications of medication,drug dosage beyond the regulations ofthree urgent seven slowwere treated as the second-ary factors. Other 12 items were general factors. CONCLUSIONS:According to the main and secondary irrational drug use types, clinical pharmacists should carry out effective intervention and pharmaceutical care to improve the level of rational drug use and en-sure the safety of clinical drug use.
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Objective To investigate the therapeutic effect and analgesic mechanism of percutaneous vertebral angioplasty in the treatment of painful osteoporotic thoracolumbar vertebral compression fracture.Methods80 cases of patients with painful osteoporotic thoracolumbar vertebral compression fracture in Shaoxing second hospital from May 2014 to May 2016 were selected, they were randomly divided into percutaneous vertebroplasty group (40 cases) and conservative treatment group (40 cases) two groups, the clinical efficacy, VAS scores and ODI scores of the two groups were statistically analyzed.ResultsThe total treatment effective rate of the percutaneous vertebroplasty group 95% (38/40) was significantly higher than the conservative treatment group (30/40) (P<0.05);The VAS scores and ODI scores of the two groups after treatment were significantly lower than before treatment (P<0.05);The differences of VAS scores and ODI scores before treatment between the two groups were not significant.The VAS score and ODI score after treatment of the percutaneous vertebroplasty group were significantly lower than the conservative treatment group (P<0.05).ConclusionThe therapeutic effect of percutaneous vertebral angioplasty in the treatment of painful osteoporotic thoracolumbar vertebral compression fractures is more significant than conservative treatment, it has better analgesic effect, so is worthy of promotion in the clinical.
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Objective To investigate the effects of congenital ptosis on refractive power of the corneal surface.Methods Forty-five patients (90 eyes) with congenital ptosis in the First Affiliated Hospital of Kunming Medical University were examined from October 2013 to June 2015.Corneal topographic analysis was performed in both the ptosis and the normal eyes.The comparison between the ptotic eye and the normal eye was done according to the topographic results.Results Among 90 eyes,55 were ptotic and 35 were normal.Amblyopia was detected in 21 ptotic eyes (38.2％).No correlation was found between amblyopia and the severity of ptosis (x 2=2.617,P＞0.05).Ptotic eye showed an asymmetrical bow tie pattern (23 eyes) and an irregular pattern (32 eyes) on corneal photography and the maximum refractive power occurred at the inferior quadrant of the corneal horizontal axis.Difference value of the average refractive power of the cornea between lower side and upper side in ptotic eyes was higher than that of the normal eyes at 5mm and 7mm diameter areas (P＜0.01) except for 3mm diameter area (P＞ 0.05).Conclusion Congenital ptosis may lead to the change of refractive power of the local corneal surface.Amblyopia has no correlation with the severity of ptosis.
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With the development of medical information, Picture Archiving and Communications System (PACS), Hospital Information System/Radiology Information System(HIS/RIS) and other medical information management system become popular and developed, and interoperability between these systems becomes more frequent. So, these enclosed systems will be open and regionalized by means of network, and this is inevitable. If the trend becomes true, the security of information transmission may be the first problem to be solved. Based on the need for network security, we investigated the Digital Imaging and Communications in Medicine (DICOM) Standard and Transport Layer Security (TLS) Protocol, and implemented the TLS transmission of the DICOM medical information with OpenSSL toolkit and DCMTK toolkit.
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Computer Security , Reference Standards , Diagnostic Imaging , Hospital Information Systems , Information Storage and Retrieval , Methods , Reference Standards , Radiology Information Systems , Reference Standards , Remote Consultation , Methods , Reference StandardsABSTRACT
Objective To investigate the current situation and development of geriatrics in Jiangsu Province, and to find out the characteristics and trend in development of geriatrics in Jiangsu Province. Methods The literatures in geriatric field of Jiangsu Province from 1998 to 2007 were collected from the database, www. cnki.net. Bibliometric methods and Mann-Whitney Test (performed by SPSS) were used to analyze the distribution of time, area, author, fund and discipline of the literatures. Results The total number of the literatures about geriatrics of Jiangsu Province from 1998 to 2007 was 4623, accounting for 7.72% of the total number of the literatures about geriatrics of China. The number of the literatures in South Jiangsu was the highest, followed by North Jiangsu and Center Jiangsu (P＜0.001). The authors publishing only one article made up 81.51% of the total number of the authors. The literatures with cooperating affiliations made up 12.24% of the total literatures. There were 212 literatures with research sponsorship. The literatures in geriatrics of Jiangsu province covered 39 subjects, and the literatures about cardiovascular diseases accounted for 14.56%. Conclusions Geriatrics in Jiangsu province shows a slow development and an imbalance between different areas and subjects. The core author team does not exist. This suggests that Jiangsu Province should increase the investment, and carry out a large and cooperating researchplan to promote the development of geriatrics in Jiangsu province.
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Objective To study the expression and significance of metalloproteinase 2(MMP-2)and tisse inhibitor of metalloproteinase(TIMP-2 ) in the degenerative calcific aortic valve.Methods 15 calcific and 10 non-calcific aortic valve acquired through aortic valve replacement.were studied by immunohistochemistry for MMP-2 and TIMP-2.Morphologic changes were observed by light and transmission electron microscopic.Results The expression of MMP-2 and TIMP-2 in calcific group were significantly higher than in non-calcific group(P<0.01).Positive cells were mostly localized subendothelial and the extracellular matrix.Control valves exhibited very weak staining of MMP-2 and TIMP-2 mostly localized in the extracelluar matrix.Various degree of endothelial damage and interstitial calcification were observed.Conculsion The expression of MMP-2 and TIMP-2 may play an important role in the calcific aortic valve.They may be involved not only in matrix degradation but also in matrix remodeling.The mecha-nism of regulation and activation remain to be elucidated.
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Objective: To investigate the feasibility and advantages of supraclavicular approaching thyroidectomy for benign thyroid diseases. Methods: From February 2004 to December 2007, 64 cases of thyroidectomies were performed via the lateral cervical supraclavicular incision, and were selected as experimental group, of whom, there were 37 cases of thyroid adenomas and 27 cases of nodular thyroid goiters, respectively. At the same time period, 63 cases of consecutive thyroidectomies through the conventional anterior neck incision were selected as a control group, of whom, there were 39 cases of thyroid adenomas and 24 cases of nodular thyroid goiters, respectively. Results: All the operations in two groups were successfully accomplished. In the experimental group, there were 9 subtotal thyroidetomies, 40 subtotal lobectomies and 15 nodulectomies. While in the control group, there were 8 total thyroidetomies, 37 subtotal lobectomies and 18 nodulectomies. The statistical analysis between the two groups was carried out in terms of tumor size, operative time-consuming, blood loss, postoperative drain volume, time for return of motion and postoperative complications. There were no injuries of laryngeal recurrent nerve, superior laryngeal nerve and parathyroid glands. Two cases of postoperative complications in the experimental group and 3 in the control group were observed, respectively, the statistical differences were not significant between the two groups. Conclusion: The supraclavicular incision for thryoidectomy for benign thyroid diseases is a feasible and safe technique with a satisfactory cosmetic result. It is accessible to the treatment of bilateral thyroid diseases and can facilitate the detection of lymphatic metastases.
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Objective To compare the different influences on the cornea endothelial cell of surgery methods between human cataract extraction and phacoemulsification.Methods 25 cataract patients(36 eyes) aged 55 to 84 undergoing extra capsula extraction and phacoemulsification combined with implanation ocular lens were analyzed in rate of endothelial cell and density within 2 weeks preoperatively and postoperatively.Results The rates reduced in varying degrees.Conclusions Understanding cornea endothelial cell before operation is clinically significant for evaluating cornea edema after surgery and taking essential measures.