ABSTRACT
Objective:To evaluate the effectiveness and safety of phacoemulsification cataract extraction combined with intraocular lens implantation (PEI) plus goniosynechilysis (GSL) and goniotomy (GT) for advanced primary angle-closure glaucoma (PACG).Methods:An observational case series study was performed.Fifty eyes of 50 patients with advanced PACG were enrolled in Zhongshan Ophthalmic Center from August 2020 to June 2021.All the patients received PEI+ GSL+ GT and were followed up for over 6 months, with a mean follow-up of 7.5 (6, 10) months.Intraocular pressure (IOP) was measured with a Goldmann applanation tonometer.Best corrected visual acuity (BCVA) was examined with an ETDRS chart and converted to logarithm of the minimum angle of resolution (LogMAR) units for analysis.Types and number of anti-glaucoma medications applied before and after surgery, and the surgical complications were collected.Success rate of surgery was calculated.Complete surgical success was defined as an IOP of 5-18 mmHg (1 mmHg=0.133 kPa) with a reduction of 20% from baseline without anti-glaucoma medication, no vision-threatening complications, no loss of light perception, and no reoperation.Qualified success was defined as an IOP of 5-18 mmHg with a reduction of 20% from baseline with or without anti-glaucoma medication, no vision-threatening complications, no loss of light perception, and no reoperation.This study adhered to the Declaration of Helsinki.This research protocol was approved by an Ethics Committee of Zhongshan Ophthalmic Center (No.2021KYPJ177). Written informed consent was obtained from each subject before entering the cohort.Results:The mean preoperative IOP was (28.81±7.81)mmHg, and the IOP at the end of follow-up was (13.41±4.10)mmHg, showing a statistically significant decrease ( t=12.260, P<0.001). The postoperative IOP was decreased by 13.80 (9.10, 19.40)mmHg, with a percentage decrease of 51.1% (38.6%, 67.1%). The mean preoperative and postoperative BCVA was (0.92±0.11) LogMAR and (0.88±0.10) LogMAR, respectively, and no significant difference was found ( t=-0.560, P=0.580). The number of anti-glaucoma medications was reduced from 2 (1, 3) before operation to 0 (0, 0) after operation.The complete success rate of surgery was 80% (40/50), and the qualified success rate was 94% (47/50). Surgical complications mainly included hyphema in 7 eyes, IOP spike in 7 eyes, and corneal edema in 3 eyes.No vision-threatening complication occurred. Conclusions:PEI+ GSL+ GT is preliminarily effective and safe for advanced PACG by reducing IOP and application of anti-glaucoma medications with few complications.
ABSTRACT
Objective: To compare CT signs of gastric stromal tumor (GST) and inflammatory fibroid polyp (IFP). Methods The clinical, pathological and CT data of 80 patients with GST and 14 patients with IFP confirmed by surgical operation and pathology were retrospectively analyzed. CT signs, patient's age and CT values were compared. Results There were statistically significant differences between GST and IFP in tumor size, plain CT value, CT value during arterial phase and venous phase, tumor morphology, growth pattern, cystic change, peripheral lymph nodes metastasis, tumor blood vessels, enhancement mode and degree of enhancement (all P0.05). Conclusion CT signs can be used as references for differential diagnosis of GST and IFP.
ABSTRACT
BACKGROUND: Environment pollution due to lead is severe day by day,and the lead-induced developmental toxicity of central nervous system is prominent.OBJECTIVE: To observe the effect of lead at low exposure level on neurobehavioral function of preschool children and provide basis for preventing childhood behavior disorders.DESIGN: Sampling survey.SETTING: Department of Children and Adolescent Health, Public Health College, Sun Yat-sen University.PARTICIPANTS: Totally 211 children of 4-6 years (109 boys and 102girls) were enrolled from a kindergarten of a populated area of Zhuhai City by randomized cluster sampling from September to October 2004.METHODS: 20 mL peripheral blood of finger tip was collected. Blood lead was determined with graphite stove atomic absorption spectrometry.According to the amount of blood lead, the children were divided into high blood lead exposure group (＞100μg/L) and low blood lead exposure group (＜100μg/L). Furthermore, they were also assigned into ＜50 μg/L group, 50μg/L- group, 100μg/L- group, 150 μg/L- group, 250- μg/L group. Achenbach's Child Behavior Checklist (CBCL) and self-designed questionnaire (composed of possibly effective factor on children's neurobehavioral function, such as age, sex, cultivation, family background and so on) were applied, filled by their parents under the instruction of professional staffs. Results and blood lead value were analyzed with first order correlation and multiple factors stepwise regressive analysis.MAIN OUTCOME MEASURES: ①Blood lead level and each factor scores of CBCL, ②correlation analysis between blood lead value and behavioral factor score.RESULTS: A total of 211 questionnaires were sent out, and 211 were retrieved with 211 effective questionnaires. The effective rate was 100%. ①Score on externalizing and behavioral disorder rate in the high blood lead exposure group (13.28±6.26,18.26%) was significantly higher than those in the low blood lead exposure group (9.98±5.46,7.29%)( t=4.067 7,χ2=5.470, P＜0.05). There was insignificant difference in score on internalizing and total score of CBCL between the low and high blood lead exposure groups. ②The behavioral disorder rate of different blood lead level had significance (χ2=13.695,P＜0.01). The behavioral disorder rate in blood lead ≥ 150 μg/L was obviously higher than that of the former 3groups after further pairwise comparison (χ2 were 4.727, 6.261, 5.168;4.503, 5.911, 4.928, P＜0.05), which revealed that the child behavioral disorder rate markedly increased when the blood lead was ≥ 150 μg/L.③Blood lead logarithm value had positive correlation with the scores on hyperactivity, aggression and defiance (r=0.316 4,0.282 8,0.188 6,P ＜0.05), and had no correlation with obesity, desintegration, truculence and sexual questionnaire (r=0.102 4,0.094 2,0.118 3,0.092 6,P ＞ 0.05). ④After the stepwise regression analysis, the scores on hyperactivity, aggression and defiance factors were included in the regression equation. The results suggested that the effect of lead on child externalizing behavior still remained, and kept statistical meaning after confounding factors, such as controlling family and society, etc.CONCLUSION: Low-level lead exposure has adverse effects on externalizing behavior in preschool children.