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·AIM:To investigate the therapeutic effect of intravitreal injection of Ranibizumab combined with laser for diabetic macular edema (DME). ·METHODS: Totally 60 cases (60 eyes) of DME patients treated in ophthalmology department of our hospital from June 2014 to June 2016 were selected and divided into the observation group and the control group. The control group were treated with laser therapy, and the observation group received intravitreal injection of ranibizumab on the basis of the treatment of the control group. Comparison between two groups on the best corrected visual acuity before operation and at 1wk,1,3, 6mo after operation was taken. The non - contact tonometer was used to measure intraocular pressure before and after treatment. The optical coherence tomography(OCT) was conducted to assess preoperative and postoperative central macular thickness (CMT).The postoperative complications of two groups were recorded subsequently. ·RESULTS: The two groups' postoperative visual acuity was significantly improved,data of the observation group at 1,3mo after operation was sharply higher than that of the control group, there was statistical significance (P<0.05), and data at 1wk, 6mo after operation had no evident difference (P>0.05). After 1wk of treatment, the two groups'intraocular pressure increased,with statistical significance (P<0.05);there was no significant difference between the two groups on intraocular pressure before treatment and at 1,3,6mo after treatment(P>0.05). The postoperative CMT of two groups significantly decreased, data of the observation group at 1, 3mo after treatment was evidently lower than that of the control group, there was statistical significance (P<0. 05), and data before treatment, at 1wk, 6mo after treatment showed no significant difference(P>0.05). In the observation group, 5 cases (5 eyes) recurred within 6mo,the recurrence rate was 17%. In the control group, 10 cases (10 eyes) relapsed,the recurrence rate was 33%,the difference was statistically significant (P<0.05). At postoperatively 2d, 2 cases(2 eyes) of the observation group and 3 cases (3 eyes) of the control group had high intraocular pressure, and then returned to normal by given the carteolol eye drops. ·CONCLUSION: Compared with laser therapy alone, intravitreal injection of ranibizumab combined with laser therapy has a significant and safe short-term treatment effective for DME patients with a fast visual acuity recovery.
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AIM: To investigate the changes of corneal biomechanical indexes after femtosecond laser-assisted in situ keratomileusis ( LASIK ) , so as to provide theoretical basis for the safety study of femtosecond laser LASIK.?METHODS: Totally 85 myopia patients ( 170 eyes ) treated in our hospital from June 2014 to June 2016 were selected and underwent femtosecond laser LASIK surgery. The medical records of patients met the inclusion criteria were retrospectively analyzed. Corneal compensated intraocular pressure ( IOPcc ) and corneal resistance factor ( CRF ) , corneal hysteresis ( CH ) and Goldmann correlated to IOP value ( IOPg ) before operation, and at 3 and 6mo after surgery were measured by the ocular response analyzer, and central corneal thickness was measured by A type ultrasonic measuring instrument.?RESULTS:At postoperative 3 and 6mo, central corneal thickness was sharply lower than that before surgery, with a statistical significance ( P<0. 05 ); postoperative IOPcc, CRF, CH, IOPg and other corneal biomechanical parameters decreased distinctively, with statistical meaning ( P<0. 05 ); data at postoperative 3 and 6mo showed no evident differences ( P>0. 05 ); the cornea cutting thickness was 98. 67 ± 7. 56μm, CH and CRF variation were 3. 40 ± 0. 34mmHg, 3. 55 ± 0. 43mmHg respectively, the cornea cutting thickness was positively correlated with CH, CRF variation ( r=0. 232, 0. 254; P<0. 001).? CONCLUSION: Femtosecond laser LASIK can apparently reduce corneal thickness as well as the corneal biomechanical indexes, the data at postoperative 3mo tends to be stable.
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AIM:To investigate the effect of intravitreal injection of anti-vascular endothelial growth factor (VEGF) drugs combined with other methods in the treatment of Coats disease.METHODS:Selected 13 patients 13 eyes with Coats disease in our hospital from May 2013 to May 2016.All eyes were treated with intravitreal injection of ranibizumab and combined with scleral drainage, laser photocoagulation and so on.We observed visual acuity and retinal reattachment.RESULTS:In 13 eyes, the treatment of 4 eyes with intravitreal injection of ranibizumab and combined with scleral drainage, 3 eyes combined laser photocoagulation, 6 eyes combined vitrectomy, membrane peeling, freezing, silicone oil filling or other treatments.Eyeball retention rate was 100%.Visual acuity at 6mo after treatment significantly improved compared with before treatment (P<0.05).The visual acuity was ≥0.05-0.1, 0.01-<0.05, counting finger, light perception and hand moving before treatment in 0, 0, 38%, 38% and 23%, after treatment were 23%, 23%, 38%, 15% and 0.Complete retinal reattachment was achieved in 5 eyes, accounting for 38%;basic reset in 3 eyes, accounting for 23%;5 eyes were not reset, accounting for 38%.CONCLUSION:Intravitreal injection of anti-VEGF drugs combined with other methods for the treatment of Coats disease have a certain effect, can improve or maintain the limited visual function, avoid enucleation of eyeball due to disease progression.
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AIM: To investigate curative effects of excimer laser corneal refractive surgery for adults or older adolescent with hyperopic anisometropic amblyopia.METHODS: From March 2014 to March 2016, we selected 26 cases 26 eyes of adults or older adolescent with hyperopic anisometropic amblyopia in our hospital.All eyes underwent laser in situ keratomileusis, observed for the uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), diopter and stereopsis.RESULTS: At the end of the follow-up, the patient`s spherical equivalent and anisometropia were 1.47±0.51D and 1.15±0.22D, were significantly lower than that before operation (P<0.05).At the end of the follow-up, the distance and near UCVA and BCVA were 0.26±0.13 and 0.23±0.09, 0.42±0.09 and 0.31±0.16, which were significantly higher than those before operation (P<0.05).At the end of follow-up, the visual function of the patients was significantly improved (P<0.05), the rate of postoperative visual function < 100 eyes was 23%.CONCLUSION: In adult or older adolescent with hyperopic anisometropic amblyopia, excimer laser corneal refractive surgery has a certain effect.
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<p><b>OBJECTIVE</b>To investigate the feasibility and significance of modified paramedian forehead flap for nasal defect and reconstruction.</p><p><b>METHODS</b>Modified paramedian forehead flaps with forehead muscle in the pedicle were used in 2 patients with nasal reconstruction and 7 patients with nasal defects. The flaps were elevated subcutaneously with only forehead muscle in the pedicle at the supraorbital site. The degree of flap axis ranged from 90 degrees to 50 degrees. Inverted L-shape design was used for 3 cases with low hair line.</p><p><b>RESULTS</b>Skin branch of supratrochlear vessel was observed running at the subcutaneous layer during the operation. 8 flaps all survived successfully with good texture and color. Partial necrosis happened in the distal end of one flap with subcutaneous pedicle, which healed through dressing.</p><p><b>CONCLUSIONS</b>Modified paramedian forehead flap, which includes muscle just in the pedicle, is based on the skin branch of supratrochlear vessel. The flap is very flexible and has reliable blood supply, leaving less morbidity in donor site. It also has good texture and skin color.</p>
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Adolescent , Adult , Aged , Female , Humans , Male , Middle Aged , Young Adult , Forehead , General Surgery , Nose , General Surgery , Rhinoplasty , Methods , Skin Transplantation , Methods , Surgical FlapsABSTRACT
<p><b>OBJECTIVE</b>To study the efficacy and safety of Chinese drugs for expelling evil-wind, removing dampness, promoting blood circulation and invigorating yin in treating active rheumatoid arthritis (RA).</p><p><b>METHODS</b>Sixty-seven patients with active RA were randomized into 3 groups, the Group A, B and C. They were made coequal in terms of age, sex and condition of disease and treated respectively with basic treatment (non-steroid anti-inflammation drug combined with immune inhibitor) only, basic treatment + small dose prednisone, and basic treatment + Chinese herbal medicine, all for 8 weeks. The efficacy and adverse effects of treatment were analyzed by scoring.</p><p><b>RESULTS</b>The total effective rate was 20.0% (4/20) in Group A, 810% (17/21) in Group B and 85.7% (18/21) in Group C, the latter two were superior to the former one (P <0.01). Before treatment, comparison of disease activity score (DAS) among the three groups showed no significant difference (P > 0.05). After treatment, improvements of Ritchie arthritis index (RAI), number of swollen joint, erythrocyte sedimentation rate (ESR), general health (GH), and DAS were shown in Group B and C (P <0.05), while in Group A, improvement was only shown in GH (P <0.05). The difference of DAS between pre- and post-treatment was 0.25 +/- 0.77 in Group A, 0.87 +/- 0.60 in Group B and 0.92 +/- 0.59 in Group C, showing statistical significance between Group A vs B and A vs C (P = 0.0000). The total accumulative score of adverse reaction was 3.76 +/- 2.72 in Group C, 9.10 +/- 6.01 in Group A and 14.38 +/- 9.36 in Group B, also showing statistical significance among groups (P < 0.05).</p><p><b>CONCLUSION</b>The combination of Chinese and Western medicine for active RA is effective and safe.</p>
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Arthritis, Rheumatoid , Drug Therapy , Drugs, Chinese Herbal , Therapeutic Uses , Treatment OutcomeABSTRACT
<p><b>OBJECTIVE</b>To evaluate the feasibility of treating pneumothorax with automatic intermittent decompression with micro-catheter instead of traditional thorax water sealed drainage (TWSD).</p><p><b>METHODS</b>The automatic decompression instrument (ADI), which decompressed intermittently with programmed control, was designed and assembled by the authors (Patent No. ZL 01242081.6). A prospective study of the efficacy of this device was conducted in 87 pneumatothorax cases, and the results were compared with those of TWSD.</p><p><b>RESULTS</b>The average time of closure in ADI group was 4.12+/-0.98 days, which was significantly shorter than that with TWSD (6.83+/-2.06 days, P<0.01). The incidence of complications was also significantly lower in ADI patients (P<0.01), and none of them developed severe complications. Clinical cure was achieved in all the patients in ADI group except for two patients who gave up treatment voluntarily and one transferred for open surgery.</p><p><b>CONCLUSIONS</b>Application of ADI allows faster healing and safer and easier operation, and causes fewer complications and less pain with shortened hospital stay as compared with conventional therapy for open and tension pneumothorax.</p>
Subject(s)
Adolescent , Adult , Aged , Female , Humans , Male , Middle Aged , Catheterization , Decompression, Surgical , Methods , Pneumothorax , Classification , General Surgery , Prospective StudiesABSTRACT
<p><b>OBJECTIVE</b>To explore the relationship between TCM Syndromes types, Xin-qi deficiency (XQD) and Xin-yang deficiency (XYD), and contents of cytokines, including tumor necrosis factor alpha (TNF-alpha), interleukin-6 (IL-6), IL-1beta and IL-10 in patients with congestive heart failure (CHF).</p><p><b>METHODS</b>Sixty-seven CHF in-patients with Xin-qi deficiency or Xin-yang deficiency syndrome were enrolled, their NYHA (New York Heart Association) cardiac function was assessed, ejection fraction (EF) and E peak/A peak (E/A) ratio were determined by Doppler ultrasonic echocardiograph, and serum TNF-alpha, II-6, IL-1beta and IL-10 were measured by double antibody sandwich ELISA assay.</p><p><b>RESULTS</b>The cardiac function grading in patients of XQD was mostly of I and II grade, while that in patients of XYD was mostly of III and IV grade (by Ridit analysis, P<0.01). The E/A and EF values were higher in patients of XQD than those in patients of XYD (P<0.01). Levels of TNF-alpha, IL-6 and IL-1beta were higher and IL-10 was lower in patients of XYD than those in patients of XQD (P<0.05 or P<0.01) respectively.</p><p><b>CONCLUSION</b>TNF-alpha, IL-6, IL-1beta and IL-10 probably play an important role in the development process of XQD to XYD, and could be taken as the microcosmic indexes for differentiation of the two syndromes.</p>