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OBJECTIVE@#To explore the clinical effect of modified interlaminar approach for the treatment of single-segment lumbar spinal stenosis.@*METHODS@#From February 2015 to August 2017, 80 patients with single-segment lumbar spinal stenosis planned to undergo endoscopic surgery were selected, including 38 males and 42 females;aged 33 to 69 (47.6±9.5) years old. Using random number table method, the patients were divided into study group and traditional group, 40 cases in each group, and underwent surgical treatment through modified translaminar approach and traditional approach respectively. The operation time, intraoperative blood loss, and hospital stay were recorded;visual analogue scale (VAS) and Oswestry Disability Index (ODI) before and after operation were compared between two groups;spinal canal arca, spinal canal diameter, disc yellow space and surgical complications were observed.@*RESULTS@#All 80 patients were followed up for at least 3 months. Two patients had incision infection, both of them were in traditional group;there was no significant difference in operation time between two groups(@*CONCLUSION@#Compared with the traditional approach, the modified interlaminar approach has advantages of less trauma, faster recovery and better postoperative spinal space recovery in the treatment of single-segment lumbar spinal stenosis.
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Adult , Aged , Female , Humans , Male , Middle Aged , Case-Control Studies , Lumbar Vertebrae/surgery , Retrospective Studies , Spinal Fusion , Spinal Stenosis/surgery , Treatment OutcomeABSTRACT
Objective To compare the correlation between transcutaneous bilirubin(TcB) measurement and serum bilirubin (TSB) measurement at covered and exposed skin sites during phototherapy in neonates.Methods Two sites of exposed skin and two sites of covered skin were chosen to measure the transcutaneous bilirubin.The serum bilirubin was monitored at admission and during phototherapy,while the transcutaneous bilirubin was tested and recorded at the same time of monitoring the serum bilirubin.Results A total of 112 cases were included from January 29th to April 15th in 2016.At the four monitoring points during phototherapy,the differences between the transcutaneous bilirubin of the two exposed sites and the serum bilirubin were statistically significant (P＜0.01).For the covered site 4,there were no significant differences between transcutaneous bilirubin and serum bilirubin at every test point (P＞0.05).When the serum bilirubin was higher than 307.8 μmol/L (18mg/dl),the serum bilirubin measurement was larger than the transcutaneous bilirubin measurement.Conclusion The transcutaneous bilirubin level of covered skin was more close to serum bilirubin,especially when the covered median skin of the second rib was chosen to monitor the transcutaneous bilirubin.When the serum bilirubin was greater than 307.8 μmol/L(18mg/dl),the transcutaneous bilirubin couldn't represent serum bilirubin quite well.
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By reshaping the cornea without the creation of a stromal flap, excimer laser corneal surface ablation eliminates flap-related complications and avoids the risk of ectasia that may occur after laser assisted in situ keratomileusis ( LASIK ) . Post-operative pain is one of the most significant disadvantages of surface ablation and thus the management of pain and discomfort following surface ablation is of great importance. We summarize mechanism of corneal pain and current approaches to pain management after surface ablation.
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<p><b>OBJECTIVE</b>To compare the sensitivities of two different serotypes of Streptococcus pneumoniae in acute otitis media of C57BL/6 mice.</p><p><b>METHODS</b>The middle ear cavity of C57BL/6 mice were inoculated via intratympanic injection of Streptococcus pneumoniae TIGR4 or 6B 1×10(8) CFU, and the control group were inoculated equivalent phosphate buffered solution (PBS). The incidence of mice, development of otitis media and the middle ear lavage fluid pathological changes by HE staining, as well as cell counts and cytokine levels were investigated.</p><p><b>RESULTS</b>After inoculated with Streptococcus pneumoniae TIGR4, 6B and PBS, the survival rate of 6B group was significantly less than TIGR4 group and PBS control group (P < 0.01). Inflammatory cells in the middle ear cavity were mainly neutrophils, and the inflammatory cells recruitment in TIGR4 group were more than 6B group; The levels of IL-6 and TNF-α in the middle ear lavage fluid in TIGR4 group and 6B group were significantly increased compared with PBS control group, while the TIGR4 group were significantly increased compared with 6B group;6B group had delayed bacterial clearance in the middle ear.</p><p><b>CONCLUSION</b>The study implied that Streptococcus pneumoniae 6B had higher pathogenicity for acute otitis media in C57BL/6 mice than TIGR4.</p>
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Animals , Female , Male , Mice , Acute Disease , Cytokines , Allergy and Immunology , Mice, Inbred C57BL , Otitis Media , Allergy and Immunology , Microbiology , Streptococcus pneumoniae , Classification , VirulenceABSTRACT
<p><b>BACKGROUND</b>Frozen or dried corneal grafts are commonly used for stromal transplantation such as lamellar keratoplasty (full or partial thickness), keratophakia, epikeratophakia. Structural properties are important for the final optical results of these surgeries but the effects of freezing/thawing and drying/rehydration on the properties of the stroma are known little compared with the corneal endothelium, mainly because of lack of non-invasive technique to evaluate the stromal structure. This study aimed to investigate the swelling and structural properties of the bovine corneal stroma following freezing or drying by X-ray diffraction which was a non-invasive technique and could give ultra-structural information in hydrated tissues.</p><p><b>METHODS</b>Bovine corneas were either frozen at -40 degrees C or dried to constant weight in a dessicator over silica gel. Swelling was carried out by placing the corneas into dialysis tubing and equilibrating them against various concentrations of polyethylene glycol (PEG) to obtain a range of tissue hydrations. This method minimises the loss of soluble tissue components during the swelling process. Synchrotron X-ray diffraction was used to measure the average intermolecular spacing, the interfibrillar spacing and the fibril diameter as a function of hydration. Changes in light scattering were detected using a microdensitometer.</p><p><b>RESULTS</b>Freezing and thawing of the cornea caused an increase in light scattering by 63.9% at tissue hydration (H) = 3.4, and by 50.0% at H = 4.9. Repeated freezing and thawing causes further increased by 38.9% at the second time and another 36.0% at the third time (P < 0.05). There was a tendency for both the frozen and the dried corneas to lose some swelling ability, achieving hydrations respectively of 10% and 18% below those of fresh corneas at 0 PEG. There were no changes in the fibril diameters, interfibrillar or intermolecular spacings as measured by X-ray diffraction in the equilibrated fresh, pre-frozen and pre-dried corneas.</p><p><b>CONCLUSIONS</b>The increase in light scattering and the loss of swelling ability after freezing and thawing probably results from structural changes following the close association of the collagen molecules and fibrils whilst the tissue is in the dry or frozen state. Some unknown changes in the extracellular matrix between the collagen fibrils may also play a role in the light scattering. The equilibration technique may improve the quality of rehydrated corneal graft or lenticules used for corneal surgeries.</p>
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Animals , Cattle , Cornea , Chemistry , Desiccation , Freezing , X-Ray DiffractionABSTRACT
AIM: To determine whether hydroxyapatite modified titanium promotes superior adhension and proliferation of rabbit corneal fibroblast in comparison with pure titanium.METHODS: We used bioactive hydroxyapatite to modify titanium surfaces. Fourth passage fibroblasts of rabbit cornea were seeded on hydroxyapatite modified titanium surfaces, pure titanium and glass surfaces. Cell adhension, proliferation and morphology were detected at 24 hours, 48 hours, and 72hours using a acridine orange stain. Further studies of cell morphology were performed using scanning electron microscopy.RESULT: Ceil counts were significantly greater on hydroxyapatite modified titanium surfaces at each time point(P＜0.05).At 24 hours, cell spreading was greater on hydroxyapatite-coated titanium and glass than on the pure titanium. At 72 hours, compared with pure titanium and glass surfaces, the cells on hydroxyapatite modified titanium surfaces had greater spreading area and longer stress fibers.CONCLUSIONS: Hydroxyapatite modified titanium promotes superior adhension and proliferation of rabbit corneal fibroblast in comparison with pure titanium.
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AIM:To evaluate the efficacy of vitrectomy in combination with intravitreal dexamethasone and vancomycin Derfusion in the management of severe post-traumatic endophthalmitis.METHODS:30 eyes diagnosed as posttraumatic infectiouis endophthalmitis were analyzed retrospectivly from April 2004 to April 2006.All the patients underwent vitrecLomy in combination with intravitreal drugs perfusion and were followed up for 12 to 24 weeks.The visual acuity,traumatic causes and microorganisms culture were analyzed.RESULTS:There are significant reduction in inflammation at 3 months after surgery.Infectious symptoms were completely controlled in 97% of the Cases(29/30).Final visual acuity were improved in 93% of cases (28/30).Among traumatic causes,foreign body is the most common cause (57%).StaphylococCUS aureus is the commonest microorganism.CONCLUSION:Vitrectomy in combination with intravitreal dexamethasone and vancomydn peffusion iS the most effective method in the treatment of Severe posttraumatic endophthamitis.
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@#ObjectiveTo observe the retinal function and nerve fiber layer (RNFL) thickness after laser in situ keratomileusis (LASIK). MethodsLASIK was performed in 15 cases (30 eyes) with myopia after strict preoperative examination. All examinations such as vision, correction vision, diopter, intraocular pressure, corneal thickness, ocular axis, topography scan and fundus of eye examination were performed before and 1 day, 1 week, 1 month,3 months and 6 months after operation, as well as electroretinography (ERG), visual evoked potential (VEP), optical coherece tomography at same time. ResultsThere was not significant difference in the intraocular pressure, ERG and VEP 1 day after LASIK. The thickness of RNFL decreased 1 week after LASIK (P<0.05) and recovered 1～6 months later. ConclusionLASIK does not disturb the retinal function and RNFL thickness irreversiblely.
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AIM: To evaluate visual outcome and wearing times in eyes fitted with a rigid gas permeable contact lenses and to assess the role of these lenses in therapeutic contact lens practice.METHODS: Patients fitted with RGP from May 2004 to December 2005 were retrospectively reviewed. Ocular diagnosis,flat and steep curvatures by corneal topography. The data included initial base curve, power, and the number of changes made in parameters during the follow-up. The outcome data included visual acuity and the duration of follow-up and lens wear. Complications and complaints were also noted.RESULTS: Forty-Three eyes of 25 patients had keratoconus were reviewed. The mean age of patients was 19.88 ±3.11years. 26 (60.5%)eyes achieved 20/20 visual acuity;15(34.9%) eyes achieved 20/25 to 20/40; and 1 (2.3%) eyes achieved 20/50 to 20/70. 37 (86.0%) eyes achieved visual improvement. No infection or neovascularization was noted; a corneal abrasion occurred in one eye.CONCLUSION: RGP may be a better alternative in selected patients with keratoconus rather than penetrating keratoplasty.
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· AIM: To study the in situ relative intraocular position of the iris-claw phakic intraocular lens (PIOL)for high myopia using an anterior chamber optical coherence tomography (AC OCT)prototype.· METHODS: Six PIOLs (11.50 to 22.00D lens powers) were implanted in phakic myopic eyes. Using AC OCT, tomography was taken in the anterior chamber to measure the preoperative anterior chamber depth, postoperative distance between the PIOL and the corneal endothelium (endothelial-optic distance), and the postoperative distance between the PIOL and the crystalline lens.· RESULTS: Preoperative anterior chamber depth ranged from 3.27 to 3.91 mm and the postoperative endothelial-optic distance measured 2,07 to 2,24 mm. The distance between the crystalline lens and the posterior surface of the IOL ranged from 0.82 to 1.32 mm. Several tomography revealed the position of the PIOL on the iris, The pigment layer of the iris did not seem to be disturbed by the presence of the PIOL.· CONCLUSION, The original anterior chamber depths were reduced by 36,1% to 44.6% after implantation. This study of 6 eyes revealed that tomography taken by AC OCT are useful in verifying the intraocular position of the PIOL within the anterior chamber. Adequate space was maintained between the iris-fixated phakic intraocular lens and the corneal endothelium, angle, and crystalline lens.
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AIM: to assess the effectiveness of a combined procedure ( pars plana vitrectomy with temporary keratoprosthesis, vitreoretinal surgery, and penetrating keratoplasty). in the complicated cases and the risk factors for the surgical failure.METHODS: Restrospectively reviewed charts of patients who underwent penetrating keratoplasty in combination with vitreoretinal surgery between 1990 and 2005, with a follow-up of 3mo to 9a. Analysis was focused on ocular history, indications for surgery, visual acuity (VA), anatomic results, and complications.RESULTS: 18 eyes had light perception or VA of hand motions only. The best-corrected VA improved during the first 3mo, increased in 72.2% of all eyes, remained unchanged in 27.78%, and no decreased. In 3 of 18 eyes (16.67%), VA was better than finger counting and hand motions, and nine eyes(50%) showed useful vision (0.05) postoperatively. 10 eyes showed a clear corneal graft (55.56%). 2 eyes needs the second keratoplasty, Bullous corneal edema was evident in 3 eyes, band keratopathy was evident in a 3 eyes. 10 patients were observed for more than 2a;6 had a clear graft (60%). Two eyes (11.11%) had silicone oil-corneal endothelium contact and all of these grafts failed.CONCLUSION: Although the functional outcome of a combined procedure is limited by primary and secondary tissue destruction, preserving ambulatory vision is possible and thus improves the quality of life, at least in patients with single remaining eyes.
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@#ObjectiveTo investigate the effect of filtering surgery on glaucoma.Methods50 glaucoma cases (60 eyes) were underwent trabeculectomy, including paracentesis in advance, suturing of sclera flap and conjunctiva flap, using mitomycin (MMC) and forming anterior chamber as soon as finished operation. All cases were followed up 1 year.ResultsPostoperative IOP was lower than 21 mmHg in 54 eyes, 6 eyes were <30 mmHg when treated with drugs. After operation, there were only 2 eyes had lower vision, the others had higher vision. Two eyes had conjunctiva filtering, two eyes had choroidal separation, but they recovered after non surgical therapy.ConclusionFiltering surgery can decrease common complications, increase vision of early stage, and make IOP recovered to normal.