Efficacy of two kinds of posterior chamber intraocular lens fixation in the treatment of lens dislocation / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To compare the efficacy of 25-gauge(25G)vitrectomy combined with intraocular lens transciliary sulcus scleral suture fixation and sutureless scleral tunnel interlamellar fixation in the treatment of complete lens dislocation.METHODS: Retrospective case-control study. A total of 40 patients(40 eyes)diagnosed with complete lens luxation in the vitreous cavity in our hospital from May 2015 to September 2021 were selected, among which 21 eyes(suture group)underwent 25G vitrectomy combined with intraocular lens fixation via ciliary sulci scleral suture, and 19 eyes(sutureless group)underwent 25G vitrectomy combined with interlamellar scleral tunnel fixation of intraocular lens. The patients in both groups were followed up until 3mo after surgery to observe the operative time, best corrected visual acuity(BCVA), corneal endothelial cell count(CECC), central corneal thickness(CCT)and postoperative complications.RESULTS: The operation time was significantly shorter in the sutureless group than in the suture group(31.79±6.01min vs. 45.38±8.04min, P<0.001). BCVA in both groups was significantly improved after surgery(all P<0.05), and the BCVA(LogMAR)at 1wk after operation in the sutureless group was significantly better than that in the suture group(0.32±0.14 vs. 0.57±0.25, P<0.001). At 3mo after surgery, CECC in both groups was lower than that before surgery(all P<0.01). The CCT at 1wk after operation in the suture group was greater than that before operation and at 3mo after operation(all P<0.01), and there was no significant change in CCT before and after surgery in the sutureless group. During follow-up period, the total complication rate in the sutureless group was lower than that in the suture group(26% vs. 38%, P>0.05).CONCLUSION: 25G vitrectomy combined with intraocular lens sutureless scleral tunnel interlamellar fixation in the treatment of complete lens luxation has shorter operation time, faster postoperative visual acuity improvement and fewer postoperative complications.

Application of partial least squares algorithm to explore bioactive components of crude and stir-baked hawthorn for invigorating spleen and promoting digestion / 中国中药杂志

This study was aimed at identifying the bioactive components of the crude and stir-baked hawthorn for invigorating spleen and promoting digestion, respectively, to clarify the processing mechanism of hawthorn by applying the partial least squares(PLS) algorithm to build the spectrum-effect relationship model. Firstly, different polar fractions of crude and stir-baked hawthorn aqueous extracts and combinations of different fractions were prepared, respectively. Then, the contents of 24 chemical components were determined by ultra-high performance liquid chromatography-mass spectrometry. The effects of different polar fractions of crude hawthorn and stir-baked hawthorn aqueous extracts and combinations of different fractions were evaluated by measuring the gastric emptying rate and small intestinal propulsion rate. Finally, the PLS algorithm was used to establish the spectrum-effect relationship model. The results showed that there were significant differences in the contents of 24 chemical components for different polar fractions of crude and stir-baked hawthorn aqueous extracts and combinations of different fractions, and the gastric emptying rate and small intestinal propulsion rate of model rats were improved by administration of different polar fractions of crude and stir-baked hawthorn aqueous extracts and combinations of different fractions. The bioactive components of crude hawthorn identified by PLS models were vitexin-4″-O-glucoside, vitexin-2″-O-rhamnoside, neochlorogenic acid, rutin, gallic acid, vanillic acid, citric acid, malic acid, quinic acid and fumaric acid, while neochlorogenic acid, cryptochlorogenic acid, rutin, gallic acid, vanillic acid, citric acid, quinic acid and fumaric acid were the bioactive components of stir-baked hawthorn. This study provided data support and scientific basis for identifying the bioactive components of crude and stir-baked hawthorn, and clarifying the processing mechanism of hawthorn.

Research progress on related factors of occult myopia / 国际眼科杂志(Guoji Yanke Zazhi)

Occult myopia refers to a special type of myopia, which is caused by the axial length beyond the normal range of children's normal age, and the corneal curvature is lower than the normal range of children with the normal age range of the vision. Because the vision of occult myopia children is within the normal range, it is easy to be ignored in myopia screening. Without timely myopia prevention and control, occult myopia is very easy to develop into dominant myopia, not only the visual development is seriously affected, but visual function will also produce irreversible changes. It is found that the axial length, corneal curvature, retina and chorioid of occult myopia are different from those of ordinary myopia. The change of these indicators can be used to assist the diagnosis and observe their development process. The purpose of this paper is to summarize the research progress at home and abroad on ocular axis length, corneal curvature, macular retinal thickness, macular choroidal thickness and other related factors in children with occult myopia, in order to provide references for related clinical research.

Risk prediction for deep venous thrombosis after total knee arthroplasty based on modified Caprini risk assessment model:a confirmatory study / 中国骨伤

OBJECTIVE@#To investigate the effectiveness of modified Caprini risk assessment model(Caprini MRAM) in predicting the risk of deep venous thrombosis (DVT) after total knee arthroplasty (TKA).@*METHODS@#A case-control study was used to collect 43 patients with DVT after TKA in lower limb department of Sichuan Orthopedic Hospital from January 2016 to November 2020 in the positive group, and 172 patients without DVT after TKA in the same period according to the 1∶4 ratio between positive and control group were selected in the control group. Caprini MRAM was used to score and grade the risk of DVT. The clinical data, score and risk classification of the two groups were compared. The relationship between the risk of DVT in the patients after TKA and the risk factors in the risk ckassification and assessment of Caprini MRAM was analyzed by multivariate logistic regression model.@*RESULTS@#The average score of caprini in DVT group was significantly higher than that in control group[(8.11±2.91) vs(4.07±2.12), P<0.001];DVT group was mainly at medium and high risk group(66.67%), while the control group was mainly at low risk (77.33%). There was a significant difference between the two groups in risk classification composition (P<0.001). BMI≥30 kg/m2, lower extremity edema (<1 month), severe pulmonary disease (<1 month), acute myocardial infarction (<1 month), bed rest (> 2 h), history of superficial or deep vein or pulmonary embolism and family history of thrombosis were the main risk factors for DVT in patients after TKA(all P<0.05). Preoperative D-dimer elevation (OR=4.380), BMI≥30 kg/m2(OR=2.518), lower extremity edema(<1 month)(OR=7.652), acute myocardial infarction (<1 month) (OR=1.994), bed rest (> 72 h)(OR=3.897), history of superficial or deep vein or pulmonary embolism (OR=13.517) and family history of blood embolism (OR=6.551) were independent risk factors for DVT in patients after TKA (all P<0.05). The risk of DVT was 13.457 and 2.739 times higher in high and moderate risk TKA patients with Caprini MRAM classification, respectively.@*CONCLUSION@#Caprini MRAM can be used to predict the risk of DVT in patients after TKA, especially for patients with high risk.

Case control study on postoperative rehabilitation of patellar fracture by modified seated position of different knee flexion angles / 中国骨伤

<p><b>OBJECTIVE</b>To explore the clinical results of postoperative rehabilitation of patellar fracture by modified seated position of different knee flexion angles, thereby enrich the therapeutic tool of orthopaedics of traditional Chinese and western medicine and provide the evidences for refinement and modernization of traditional Chinese exercise therapy.</p><p><b>METHODS</b>From January 2009 to June 2012,90 patients with patellar transverse fractures were treated with open reduction and internal fixation by tension band wire and rehabilitation exercises. There were 52 males and 38 females, aged from 21 to 77 years old with an average of 50.0 years old. Three methods of rehabilitation exercises were adopted in the patients after fractures clinical union. There were 21 males and 14 females in group A (trained by modified seated position of knee flexion about 60 degree), 21 males and 14 females in group B (trained by modified seated position of knee flexion about 30 degree), 10 males and 10 females in group C (trained by walk). The rehabilitation-training time was 1 month. Fracture healing informations were observed by X-ray films. The Böstman patellar fracture function scores were compared before and after training among three groups.</p><p><b>RESULTS</b>Postoperative follow-up time was 6 months. All fractures obtained bone union and the average healing time was 3 months (ranged,2 to 4 months). Böstman patellar fracture function scores in group A, B, C before training were 18.89 ± 2.19, 18.74 ± 2.03, 18.85 ± 2.92, respectively; there was no significant differences in among three groups (P > 0.05). After training, Böstman patellar fracture function scores in group A, B, C were 29.40 ± 1.14, 26.09 ± 3.86, 25.70 ± 4.09, respectively; group A was highest than other two groups; and there was no significant differences between group A and group B.</p><p><b>CONCLUSION</b>Modified seated position of knee flexion about 60 degree was practical and effective training in postoperative rehabilitation for the treatment of patellar fracture, it can obtain the better clinical results than other training method such as walk or modified seated position of knee flexion about 30 degree.</p>

Minimally invasive percutaneous osteosynthesis with intramedullary nail and close reduction by manipulation for the treatment of femoral shaft fractures / 中国骨伤

<p><b>OBJECTIVE</b>To explore the technique and clinical results of close reduction by manipulation and minimally invasive percutaneous osteosynthesis with intramedullary nail for the treatment of femur shaft fractures. methods: A retrospective study was conducted to analyze 96 patients with the femur shaft fractures who had been treated with close reduction by manipulation and minimally invasive percutaneous osteosynthesis with intramedullary nail. There were 67 males and 29 females. The average age of patients was 39 years old (ranging from 16 to 88). According to AO fracture classification for the femur shaft fractures,there were 29 cases of type A,46 type B,21 type C.</p><p><b>RESULTS</b>All the patients were followed up and the duration ranged from 12 to 24 months (averaged, 15 months). All the fractures showed union. The time required for the bony union ranged from 3 to 10 months (averaged,4 months). The clinical results were evaluated by Thorsen classification system. At the latest follow-up, 87 patients obtained excellent results, 7 good, 2 fair.</p><p><b>CONCLUSION</b>This treatment method combines advantages of intramedullary nail with close manipulative reduction, so can get satisfactory clinical results for the treatment of femoral shaft fracture with minimal trauma.</p>

The arresting phase determines the total healing time of a locally irradiated skin wound in swine / 中华创伤杂志(英文版)

<p><b>OBJECTIVE</b>Radiation is an important cause of delayed wound healing, and there still exist many questions regarding the patterns and mechanisms of wound healing. This study investigated the characteristics of wound healing after varying doses of local radiation and explored possible causes of the delay in healing caused by radiation.</p><p><b>METHODS</b>A full-thickness dorsal longitudinal skin tissue, 2 cm in diameter, was excised after local irradiation on one side of the back of swine, and the other side was wounded as a control. The size of the wound area was recorded every two days after injury. Pathological changes, proliferating cell nuclear antigen (PCNA, immunohisto- chemistry) and apoptosis levels (TUNEL assay) were measured at different time points after wounding.</p><p><b>RESULTS</b>The course of wound healing can be divided into four phases, namely: the arresting phase, the healing priming phase, the fast healing phase, and the healed phase. Although the total wound healing time was closely correlated to the dose of irradiation (R(2) equal to 0.9758), it was more dependent on the length of the arresting phase (R(2) equal to 0.9903) because once the arresting phase ended, the wound healed at a similar speed regardless of radiation doses. Pathological analysis showed that compared with the control side there were more necrotic tissues, slower epithelial crawling, as well as fewer blood vessels and cellular components in the irradiated side at the arresting phase, while other phases revealed no significant difference concerning these measurements. Immunohistochemistry showed that the irradiated wounds had significantly less PCNA-positive and more TUNEL-positive labeling of cells in the arresting phase than in other phases. Moreover, the changes were positively related to the radiation doses, but there was no obvious difference in cell proliferation or apoptosis among the healing priming phase, fast healing phase or healed phase, whether on the control side or on the irradiated side.</p><p><b>CONCLUSIONS</b>After local irradiation, the length of the arresting phase determines the wound healing time. Increased apoptosis and decreased cell proliferation might be an important reason for the formation of the arresting phase.</p>

Close reduction by Chinese traditional manipulation and MIPPO for the treatment of tibial fractures in middle and distal segment / 中国骨伤

<p><b>OBJECTIVE</b>To explore the technique and clinical results of close manipulative reduction and minimally invasive percutaneous plate osteosynthesis (MIPPO) for the treatment of tibial fractures in the middle and distal segment.</p><p><b>METHODS</b>From Jan. 2005 to Dec. 2009, 40 patients with tibial fractures in middle and distal segment were treated with close manipulative reduction and MIPPO fixation, including 28 males and 12 females with an average age of 54 years old (ranging from 21 to 76). According to AO fractures classification for the tibial fractures in the middle and distal segment, there were 26 cases of type A, 8 of type B, 6 of type C.</p><p><b>RESULTS</b>All patients were followed up for 12 to 24 months (averaged 18 months). All the fractures gained bone healing, and the time required for the bony union ranged from 3 to 18 months (averaged 4 months). The patients were evaluated with respect to functional recovery according to Mazur Grating System for the ankle. The aggregate score was 96.67 +/- 3.91, involving pain 48.59 +/- 2.28, hills up 2.95 +/- 0.22, hills down 2.85 +/- 0.37, stairs down 2.92 +/- 0.35, run score 4.95 +/- 0.32, plantar flexion score 4.62 +/- 0.54, dorsiflexion score 4.13 +/- 0.61. The clinical results were excellent in 36 cases, good in 3 and fair in 1.</p><p><b>CONCLUSION</b>Close manipulative reduction and MIPPO fixation is a good method for the treatment of the tibial fractures in the middle and distal segment.</p>

Close reduction by manipulation and minimally invasive percutancous plate osteosynthesis for the treatment of supracondylar femur fractures / 中国骨伤

<p><b>OBJECTIVE</b>To explore the technique and clinical results of close reduction by manipulation and minimally invasive percutaneous plate osteosynthesis (MIPPO) for the treatment of supracondylar femur fractures.</p><p><b>METHODS</b>A retrospective study was conducted to analyze 39 patients with the supracondylar femur fractures who had been treated with close reduction by manipulation and MIPPO. There were 24 males and 15 females. The average age of the patients was 47 years old (ranged, 19 to 81 years). According to AO fracture classification for the distal femur fractures, there were 14 patients with type A1, 16 patients with type A2 and 9 patients with type A3.</p><p><b>RESULTS</b>All the patients were followed up, and the period ranged from 12 to 24 months (averaged 16 months). All the fractures showed union. The time required for the bony union ranged from 3 to 10 months (averaged 4 months). The patients were evaluated according to Kolmert distal femoral fracture functional evaluation system. Twenty-eight patients obtained an excellent result, 10 good and 1 fair.</p><p><b>CONCLUSION</b>This method for the treatment of supracondylar femur fracture can get satisfactory function, high rate of bone union and less complications. Familiar with the close reduction technique and the geometry shape of anatomic plate as well as femoral supracondyar area are important to treat the supracondylar femur fractures.</p>

Reasonable application of minimally invasive percutaneous plate osteosynthesis for the treatment of distal fractures of tibia / 中国骨伤

<p><b>OBJECTIVE</b>To investigate the technique and clinical results of minimally invasive percutaneous plate osteosynthesis (MIPPO) for the treatment of the distal fractures of tibia by an appropriate plate.</p><p><b>METHODS</b>From Jan. 2005 to Dec. 2007, 56 patients with the distal tibia fractures were treated with MIPPO through two approaches and three types of plate involving clover plate in 35 cases, anterior L-shape anatomic plate in 12 cases, medial LCP in 9 cases. There were 38 males and 18 females with an average age of 41 years old ranging from 17 to 72 years. According to AO fracture classification for the distal tibial fractures, there were 28 cases of type A, 11 of type B, 17 type C.</p><p><b>RESULTS</b>All the patients were followed up from 12 to 24 months (averaged 16 months). All of the fractures showed bone union. The time required for the bony union ranged from 3 to 11 months (averaged 4 months). The patients were evaluated on functional recovery according to Mazur Grating System for the Ankle. The results were excellent in 51 cases, good in 5.</p><p><b>CONCLUSION</b>Choosing effective reasonable approach and plate for the treatment of the distal tibial fractures can obtain satisfactory function, high rate of bone union and less complications.</p>