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Objective To compare the changes of diopter and axial length(AL) m 2 years after wearing orthokeratology lens,rigid gas permeable contact lens (RGPCL) and spectacles in adolescent myopia,and evaluate the control effects of different methods on adolescent myopia.Methods Prospective clinical study.The date of 99 eyes of 50 adolescent myopia cases wearing orthokeratology,95 eyes of 48 adolescent myopia cases wearing RGPCL,and 100 eyes of 50 adolescent myopia cases wearing full correction single vision spectacles were collected from June 2012 to June 2014.The follow-up time was 2 years.The status of diopter and AL before and wore mirror after 2 years and the uncorrected visual acuity (UCVA) in group of orthokeratology were recorded.The examinations were repeated after 2 years without wearing orthokeratology and RGPCL at least 30 days.Results There was no statistical difference in age,refractive status and AL among three groups before wearing the mirror.After wearing for 2 years,AL and spherical equivalent in three groups were increased (F =278.43,140.12;all P ＜ 0.01).The increase of AL and SE was as follows:orthokeratology group (0.30 ± 0.39) mm,(0.83 ±0.97) D;RGPCL group (0.55 ± 0.41) mm,(1.55 ± 0.63) D;spectacles group (0.59 ± 0.34)mm,(1.73 ± 0.62)D.The increase of orthokeratology group was the least,and there was no statistical difference between the other two groups.UCVA was significantly improved at each time point after wearing orthokeratology(F =486.38,P ＜0.01).Conclusion In the three optical correction methods of orthokeratology,RGP and spectacles,the ortho-keratology is the best on controlling adolescent myopia,and no difference between the other two.At the same time,wearing orthokeratology can also significantly improve UCVA in myooia cases.
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Objective To analyze the operative methods,intraocular lens (IOL) implantation and postoperative complications in children with congenital cataract,and give the references for treating of congenital cataract.Methods From January 2008 to January 2016,children under the age of 13 years with congenital cataract were enrolled.Preoperative and posterior slit lamp microscope,fundus,intraocular pressure were examined.Children under 2 years old were treated with phacoemulsification (PHACO),posterior continuous curvilinear capsulorrhexis (PCCC),anterior-vitrectomy (AV),and ＞ 2-4 years old with PHACO + PCCC + AV + IOL implantation,＞ 4-7 years old children with PHACO + PCCC + IOL implantation,children ＞ 7 years with PHACO + IOL implantation.Results A total of 476 patients (740 eyes) were enrolled in the study,the average age were (33.59 ± 37.14) months,of which 0 ～ 6 months were 166 cases (282 eyes,38.11％).260 eyes were implanted with IOL,aged (5.59 ±2.43) years,480eyes were implanted in the second surgery,aged (4.06 ± 2.12) years.Refaction diopter (equivalent spherical) after IOL implantation in children aged ＞ 2-4 years old was (3.53 ± 0.56) D,＞ 4-6 years old was (2.36 ± 0.32) D,＞ 6-8 years old was (1.65 ±0.52)D,＞8-13 years old was (-0.25 ±0.32) D.The postoperative complications occurred in 326 eyes,of which 115 eyes (35.28％) with iridotic adhesions,97 eyes (29.75％) with posterior cataract on the visual axis,and 54 eyes (16.56％) with glaucoma.At the last follow-up,the best corrected visual acuity were (0.56 ± 0.41) LogMAR for monocular cataract surgery and (0.42 ± 0.27) LogMAR for binocular cataract surgery,the difference was statistically significant (P =0.04).Conclusion One-third of children with congenital cataract are treated with surgical treatment under 6 months old,about half of the children undergo IOL implantation at 2 ～ 3 years of age.The postoperative visual acuity in children with binocular cataract is better than children with monocular cataract.The complications in children are more complicated than adults,which should be paid more attention.
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Objective To select the risk factors and focus on the pathogenesis of anterior ischemic optic neuropathy (AION) after cataract surgery.Methods A retrospective review of all patients with phacoemulsification surgery referred to the Ophthalmology Divisions,the First Affiliated Hospital,Zhengzhou University,from September 1,2010 to September 1,2016 was performed.Eligible patients were 11 206 cases(13 320 eyes),30 cases (30 eyes) were complicated with AION after cataract surgery (AION group),and 90 cases (90 eyes) were selected as control group according to the ratio of 1 ∶ 3 by random sequence.Factors of small cup disc ratios,previous surgery history,cardiac disease,diabetes,hypertension,hyperlipemia,smoking,carotid disease and intraocular pressure (IOP) were collected,x2 test,Logistic regression and t test were performed to analyze risk factors for AION.Results Small cup-disc ratios,diabetes,hypertension,hyperlipemia,carotid disease were influencing factors of AION after cataract surgery.Hyperlipemia and carotid disease were risk factors of AION after cataract surgery.There was no significant difference in preoperative intraocular pressure between two groups(all P ＞ 0.05).The intraocular pressure at postoperative 1 day and 7 days in AION group were higher than those in control group (all P ＜ 0.05).Conclusion Hyperlipemia and carotid artery disease are risk factors for AION after cataract surgery,and high intraocular pressure may be the inductive factor of AION.
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Objective To observe the improvement effects of Qingshen Granule on the life quality of chronic kidney disease (CKD) patients with damp-heat syndrome. Methods The CKD patients with damp-heat syndrome were randomly divided into experimental group and control group. The control group was treated with Western medicine, and the treatment group was treated with Qingshen Granules additionally for 12 weeks. SCr and eGFR were observed before and after treatment, and the life quality was investigated by KDQOL-SFTM1.3. Results Actually 156 cases were completed, including 77 cases in the treatment group and 79 cases in the control group. The total rate of curative effect was 81.82% (63/77) in teatment group, and (63.29%, 50/79) in control group, with significent difference (P<0.05). Multivariate linear regression analysis indicated that gender, education level, TCM syndrome score, CKD stage, eGFR and Hb level could affect the life quality. The scores of KDQOL-SFTM and its containing the MOS item short from health survey (SF-36) and kidney disease targeted areas (KDTA) were significantly improved after treatment in experimental group (P<0.05), while the scores in control group were with no significant improvement. The improving effects of PCS, and SPL, SLEEP, PS in KDTA in treatment group were significantly superior to those in control group (P<0.05). The scores of life quality in effective and stable cases increased significantly after treatment compared with before treatment (P<0.05). Conclusion Qingshen Granules can effectively improve the life quality of CKD patients with damp-heat syndrome, and the effect is not dependent on the improvement of laboratory indexes (renal function).
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Objective To design a novel endoscopic successive hemostasis and closing device, and to validate whether the device can meet the needs of tissue closure by finite element analysis. Methods By using the novel device, the target tissue was clamped and the clip was then pushed to pierce the tissue. Under the compression between the clip and the inner side of the grasper, the thinner arms of the clip were forced to bend and close to stay in the tissue, and then the inverse displacement of 2 mm was applied on the clip. The elastic limit and tensile strength of the clip were set as 239.0 and 901.0 MPa, respectively. Results Deformation did not occur in the piercing process of the clip, with the maximum stress of 212.6 MPa. The deformed shape of the clip in the bending process matched its design expectation, with the maximum stress of 727.7 MPa. The maximum stress of the clip was 75.8 MPa under 2-mm inverse displacement. Material failure was not found in the bending process or with 2-mm inverse displacement, and the maximum stress in the whole process was 741.0 MPa. Conclusions The novel endoscopic successive hemostasis and closing device proposed in this study can deploy 4 clips at one time, together with an independent grasper for gathering tissues, which can shorten the reloading time and improve the accuracy of clip deployment. The effectiveness and safety of the device is also proved by using finite element method.
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Background It has been reported that murine Müller cells conditional medium can promote the survival of retinal ganglion cells (RGCs) and the regeneration of axons,and the survival rate of RGCs improve in the optic nerve axotomy eyes with cataractogenic lens injury in vitro.However,the interaction of Müller cells with pricking of lens in protecting RGCs is unclear.Objective The aim of this study was to investigate the role of Müller cells on survival of RGCs in the optic nerve axotomy with cataractogenic lens injury.Methods Forty-eight clean adult Wistar rats were randomized into sham operation group,optic nerve axotomy group and lens injury combined with optic nerve axotomy group.The optic nerve was exposed only in the rats of the sham operation group,optic nerve was completely transected at 3 mm behind the eyeball in the rats of the optic nerve axotomy group,and lens puncture and optic nerve axotomy were performed in the eyes of lens injury combined with optic nerve axotomy group.The rats were sacrificed at day 7 and day 14 after operation to prepare the retinal specimens.The RGCs were examined and counted by hematoxylin-eosin staining.Müller cells labeled by glial fibrillary acidic protein (GFAP) were counted using immunohistochemisty.Results The number of RGCs was (52.98 ± 1.90) /field and (51.81 ±3.09) /field on the 7th and 14th day in the sham operation group,without significant difference between them (t =0.910,P =0.378).The number of RGCs was significantly lower on the 14th day ([22.67±1.94] /field) than that of the 7th day ([36.61±1.69] /field) in the optic nerve axotomy group (t=15.312,P=0.000).Also,the number of RGCs was (50.76±2.77) /field and (35.69±1.80) /field on the 7th and 14th day in the lens injury combined with optic nerve axotomy group,showing a significant difference between the two timepoints (t =12.920,P =0.000).In addition,the RGCs number in the lens injury combined with optic nerve axotomy group was significantly higher than that in the optic nerve axotomy group both on 7 days and 14 days after operation (7 days:t =102.840,P =0.000; 14 days:t =164.020,P =0.000),and the number of RGCs was lower in the lens injury combined with optic nerve axotomy group than that of the sham operation group on day 14 (t =187.040,P =0.034).None of GFAP-labeled Müller cell was seen in sham operation group at both on 7 days and 14 days after operation,but a significant difference was found in the optic nerve axotomy group between the two timepoints ([29.38 ± 2.04]/field vs.[19.07 ± 2.14]/field ; t =-9.868,P=0.000).No significant difference in the number of the GFAP-labeled Müller cells was found in the lens injury combined with optic nerve axotomy group between 7 days and 14 days after operation([48.96±2.80] /field vs.[46.73±1.50]/field,t=1.987,P=0.067).In postoperative 7 days and 14 days after operation,the number of GFAP-labeled Müller cells increased in the lens injury combined with optic nerve axotomy group compared with the optic nerve axotomy group (7 days:t =-15.997,P=0.000; 14 days:t=-29.938,P=0.000).Conclusions In optic nerve axotomy with cataractogenic lens injury eye,the punctural injury of lens induce the activity of Müller cells and further promote the survival of RGCs in the cataratogenic lens injury combined with optic nerve axotomy rat eyes.
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Objective To investigate the effects and related mechanism of iNO on erythrocyte deformability in septic acute lung injury(ALI).Methods Thirty anesthetized and mechanically ventilated young piglets(3-4weeks old)were allocated to 4 groups:(1)normal(group C,n=6):intraperitoneal injection of normal saline(NS).(2)normal+iNO(group CNO,n=4):NS followed by mechanical ventilation for 4 h,and then treated with iNO at 10 parts per million in volume(ppm).(3)model(group M,n=10):i.p.Escherichia coli at 5 × 109 cfu/ml,5 ml,and(4)NO(group MNO,n=10):i.p.Eschefichia coli at 5×109 cfu/ml lollowed by iNO-at 10 parts per million after ALI.Blood viscosity,malondialdehyde(MDA)in erythrocyte,Ca2+-Mg2+-ATPase and Na+-K+-ATPase of erythrocyte membrane were measured at basdine,establishment of ALI,12 and 24 h during the treatment.Results For normal age-matched piglets,there was little change of whole blood viscosity at high shear rate(110 s-1),which is a measure of erythrocyte deformability,so was the level of MDA in erythroeyte and the activity of erythroeyte membrane Ca2+-Mg2+-ATPase,Na+-K+-ATPase when iNO was provided for 12 or 24 h.At the time ALI was established,whole blood viscosity at high shear rate and MDA levels in erythroeyte increased significantly compared to the baseline level(P＜0.05),while the activity of erythrocyte membrane Ca2+-Mg2+-ATPase and Na+-K+-ATPase decreased significantly(P＜0.01,vsbaseline).Exposure of iNO for 12 h resulted in decreased whole blood viscosity at high shear rate and MDA levels in erythroeyte(P＜0.05,vs group C),and higher activity of erythrocyte membrane Ca2+-Mg2+-AT-Pase and Na+-K+-ATPase.When iNO was administered for 24 h,there was little difference of whole blood viscosity,activity of erythrocyte membrane Ca2+-Mg2+-ATPase,Na+-K+-ATPase and MDA levels in erythroeyte between the C and NO groups.Conclusion In the piglets with septic ALI,there was deterioration of erythrocyte deformability.Inhaled NO for 12 h may alter the deterioration,however,this effect is transient.