ABSTRACT
Objective:To investigate the efficiency, safety and complication of 0.7 mg dexamethasone sustained release agent (Ozurdex ?) vitreous cavity implantation for macular edema secondary to vitrectomy. Methods:A total of 15 patients (16 eyes) were included in this retrospective case series study. There were 7 males (8 eyes) and 8 females (8 eyes). Age ranged from 47 to 72 years old with an average age of (60.2±8.6)years. Among them, 8 cases were diabetic retinopathy (6 cases combined cataract surgery). 4 cases were silicone oil removal after retinal detachment surgery (all combined cataract surgery). 2 cases were epi-macular membrane (all combined with cataract surgery) and 1 case was vitreous hemorrhage (combined with cataract surgery). Ozurdex ? was implanted for macular edema after vitrectomy. The number of implantation was from 1 to 3 times (mean 1.67 times). The follow-up time was from 3 to 12 months, with an average of (7.33±3.50)months. Results:The best corrected visual acuity (BCVA) was improved in 10 cases (11 eyes), unchanged in 4 cases and decreased in 1 case within 3 months after Ozurdex ? implantation in the 15 cases (16 eyes). The macular edema was significantly improved in all cases. The central macular thickness (CMT) measured by optical coherence tomography (OCT) was from 350 to 1 370 γm before surgery with average thickness (621.60±235.48)γm, and the CMT postoperative was 118 to 556 γm with average thickness (269.87±118.14)γm, with statistically significant difference ( P<0.001). Cataract was not progressive after Ozurdex ? implantation. Macular edema was recurrent in 7 cases after first implantation and stable for additional 1-2 injections. Intraocular pressure elevation occurred in 3 cases 1 to 2 months after implantation with the highest intraocular pressure of 36 mmHg, which were controlled by local anti-glaucoma eye drops. Drugs entered into the anterior chamber in 2 cases and was taken out in 1 case. Conclusions:The efficiency of Ozurdex ? vitreous cavity implantation is definite and the complications are controllable, so it is a safe and effective method to treat macular edema after vitrectomy.
ABSTRACT
Objective:To investigate the clinical, ophthalmological and pathological features of primary uveal lymphoma.Methods:Retrospective clinical study. From 2012 to 2018 in Beijing Tongren Eye Cener, 4 cases and 4 eyes of patients with primary uveal lymphoma were included in the study. Among them, 3 cases were male and 1 case was female. The average age was (54 ± 13.58) years old. The average time from initial diagnosis to pathological diagnosis was (18.50 ± 9.29) months. 3 cases were enucleated and 1 case was biopsied. Extranodal marginal zone lymphoma (EMZL) of the mucosa associated lymphoid tissue (MALT) was confirmed by pathological examination. BCVA, fundus color photography, color Doppler ultrasound and orbital MRI were performed in all eyes. UBM, OCT, FFA and ICGA were performed in 2 eyes, 3 eyes, 3 eyes and 2 eyes respectively. The clinical, imaging and pathological changes were observed. Following up time was ≥ 6 months.Results:At the initial diagnosis, BCVA was 0.6, 0.02 and 0.01 in 1, 2 and 1 eye respectively. Choroid, ciliary body and iris were involved in 3 eyes, choroid in 1 eye. The fundus of the eyes showed infiltration of choroid in yellow and white color, and the lesions were beyond the vascular arch to the equator and peripheral areas. Color Doppler ultrasonography showed that choroidal diffuse thickening and extrascleral extension (ESE) which was the corresponding hypoechoic areas behind the sclera. Among them, ESE showed crescent thickening in 1 eye and nodular thickening in 3 eyes. UBM showed that the echo of ciliary body was thicken and the internal echo was decreased with the iris involved. OCT showed that RPE was wavy and local retinal neuroepithelial layer detached. FFA showed that the early lesions were mottled with strong and weak fluorescence, and the late fluorescence leakage. The posterior wall of the eyeball was thickened and enhanced in MRI.Conclusion:The clinical manifestations of uveal lymphoma are various, color Doppler ultrasound has characteristic manifestations and ESE of crescent or nodular thickening is valuable in diagnosis.
ABSTRACT
Objective@#To investigate the difference of clinical efficacy between metaphyseal locking intramedullary nail and locking plate in the treatment of humeral surgical neck fracture.@*Methods@#64 patients with Neer II humeral surgical neck fracture who were treated in our hospital from January 2010 to December 2015 were selected. According to the operation plan, the patients were divided into epiphyseal locking intramedullary nail fixation group (observation group, n=42) and locking plate fixation group (control group, n=22). The differences of clinical data (sex, age, time from injury to operation, number of injured cases, follow-up time), clinical indicators (neck-trunk angle, last neck-trunk angle, number of complications, amount of operative bleeding, amount of operative blood transfusion, operation time, fracture healing time): Neer shoulder function score and Constant shoulder score were compared between the two groups.@*Results@#There was no significant difference in gender, age, time from injury to operation, number of cases of injury and follow-up time between the two groups, and the subjects were comparable (P>0.05). There was no significant difference in the neck-trunk angle, the last neck-trunk angle and the number of complications between the two groups (P>0.05); the observation group had longer operation time, less operation bleeding volume and blood transfusion volume, shorter fracture healing time (P<0.05). Two cases of wound infection occurred in the observation group and the control group after operation. The wound healed after anti-infection supportive treatment and dressing change. The excellent and good rate of Neer shoulder function score in the observation group was 88.10%, which was significantly higher than 63.64% in the control group (P<0.05). There was no significant difference in internal rotation between the two groups (P>0.05). The Constant score, external rotation, abduction and flexion in the observation group were significantly higher than those in the control group (P<0.05).@*Conclusions@#The use of metaphyseal locking intramedullary nail in the treatment of humeral surgical neck fracture has a definite clinical effect and a low incidence of complications, which is worthy of clinical application.
ABSTRACT
Objective To investigate the difference of clinical efficacy between metaphyseal locking intramedullary nail and locking plate in the treatment of humeral surgical neck fracture.Methods 64 patients with Neer Ⅱ humeral surgical neck fracture who were treated in our hospital from January 2010 to December 2015 were selected.According to the operation plan,the patients were divided into epiphyseal locking intramedullary nail fixation group (observation group,n =42) and locking plate fixation group (control group,n =22).The differences of clinical data (sex,age,time from injury to operation,number of injured cases,follow-up time),clinical indicators (neck-trunk angle,last neck-trunk angle,number of complications,amount of operative bleeding,amount of operative blood transfusion,operation time,fracture healing time):Neer shoulder function score and Constant shoulder score were compared between the two groups.Results There was no significant difference in gender,age,time from injury to operation,number of cases of injury and follow-up time between the two groups,and the subjects were comparable (P ＞0.05).There was no significant difference in the neck-trunk angle,the last neck-trunk angle and the number of complications between the two groups (P ＞ 0.05);the observation group had longer operation time,less operation bleeding volume and blood transfusion volume,shorter fracture healing time (P ＜ 0.05).Two cases of wound infection occurred in the observation group and the control group after operation.The wound healed after anti-infection supportive treatment and dressing change.The excellent and good rate of Neer shoulder function score in the observation group was 88.10％,which was significantly higher than 63.64％ in the control group (P ＜ 0.05).There was no significant difference in internal rotation between the two groups (P ＞ 0.05).The Constant score,external rotation,abduction and flexion in the observation group were significantly higher than those in the control group (P ＜ 0.05).Conclusions The use of metaphyseal locking intramedullary nail in the treatment of humeral surgical neck fracture has a definite clinical effect and a low incidence of complications,which is worthy of clinical application.
ABSTRACT
Objective To investigate the compliance of follow-up and the associated factors of diabetic retinopathy screening among diabetes patients in Muping District,Yantai City.Methods 438 diabetes patients who received free diabetic retinopathy (DR) screening in Traditional Chinese Medicine Hospital of Muping District of Yantai City from April 2012 to June 2013 were enrolled in the cross-sectional study.The re-examination rate at five years later,as well as the possible associated factors,including age,gender,height,weight,education level,occupation,past medical history,smoking and drinking habits,diabetes process,diabetes medication history,severity of DR,glycosylated hemoglobin (HbA1 c),renal functionand blood lipid were analyzed and evaluated.Results Among 438 patients,159 returned for check up five years later,with a follow-up rate of 36.3％.Further analysis revealed that follow-up rate was related to occupation types (P =0.003) and HbAlc level (P =0.006).Other factors did not show statistical significance (P ＞ 0.05).Conclusions The compliance of DR screening visits is related to occupational type and blood glucose control.It is suggested that in the screening of DR in China,we should pay attention to the propaganda and education of diabetic patients to control blood glucose,and focus on some occupational diabetes people,such as housework workers and farmers.
ABSTRACT
BACKGROUND:Different operation approaches can be selected during the repair of thoracolumbar fractures. Traditional posterior median approach wil cause great wound on patients, and easily induces some adverse consequences. OBJECTIVE: To compare the effects and biocompatibility of conventional posterior median approach and paraspinal approach fixation for treatment of thoracolumbar fractures. METHODS: A retrospective analysis was performed on clinical data of 53 cases of thoracolumbar fracture in the Shaanxi Province Nuclear Industry 215 Hospital from December 2012 to December 2013. They were divided into two groups according to approach method. The control group (n=27) received pedicle screw placement fixation through conventional posterior median approach. The observation group (n=26) underwent pedicle screw placement fixation through paraspinal muscle approach. After repair, they were folowed up for 12 months. Imaging results, pain score and perioperative relevant indexes were observed and compared in both groups. RESULTS AND CONCLUSION: Imaging examination was conducted before repair, immediately after repair and during final folow-up in both groups. The height of vertebral anterior border and kyphosis correction effect were good after different therapies in both group, but no significant difference was detectable between the two groups (al P > 0.05). These findings suggest that height of vertebral anterior border and kyphosis correction effect were identical between the two groups. Pain visual analog scale score was significantly lower in the observation group than in the control group at 24 hours and 3 days after repair and during final folow-up (al P < 0.05). Perioperative relevant indexes were analyzed in both groups. Intraoperative bleeding amount, drainage and bed time after repair were observed in the observation group, which showed significant advantages as compared with the control group (al P < 0.05). These results confirmed that compared with the traditional posterior median approach surgery, minimaly invasive pedicle screw placement through paraspinal muscle approach for thoracolumbar fractures can obtain better repair effects and biocompatibility.
ABSTRACT
<p><b>BACKGROUND</b>Bardet-Biedl syndrome (BBS) is a genetically heterogeneous disease, and information about BBS in Chinese populations is very limited. The purpose of the present study was to determine the genetic cause of BBS in a Chinese Han family.</p><p><b>METHODS</b>Clinical data were recorded for the 4-year-old female proband and the available family members. The proband was screened for mutation by Sanger sequencing for a total of 142 exons of the 12 BBS-causing genes (BBS1-BBS12). The variants detected in the proband were further confirmed in the other family members.</p><p><b>RESULTS</b>We identified a novel homozygous nonsense mutation (c.70A>T, p.K24X) in the BBS4 gene exon 2 in the proband. Such mutant allele was predicted to cause a premature truncation in the N-terminal of the BBS4 protein, and probably induced the nonsense-mediated decay of BBS4 messenger RNAs. The proband's parents and brother were heterozygous for the nonsense mutant allele. It was absent in 50 Chinese control subjects. An additional rare heterozygous missense single nucleotide polymorphism (SNP) named rs200718870 in BBS10 gene was also detected in the proband, her father and her brother. Some manifestations of the proband including atypical retinitis pigmentosa, choroidal sclerosis, high myopia, and early onset of obesity might be associated with this mutation in BBS4 gene. The proband's father also reported surgical removal of an extra finger during childhood.</p><p><b>CONCLUSIONS</b>The present study described a novel nonsense mutation in BBS4 gene in a Chinese family. This homozygous mutation was predicted to completely abolish the synthesis of the BBS4 protein. We also detected a rare heterozygous missense SNP in BBS10 gene in the family, but did not find sufficient evidence to support the triallelic inheritance.</p>
Subject(s)
Child, Preschool , Female , Humans , Bardet-Biedl Syndrome , Genetics , Codon, Nonsense , Genetics , Proteins , GeneticsABSTRACT
Objective To observe the clinical manifestations,therapeutic efficacy and results of bacterial culture of seven patients of scleral buckle (SB) infection after scleral bulking surgery.Methods Seven patients (seven eyes) underwent SB removal for SB infections were enrolled in this study.The patients included four males (four eyes) and three females (three eyes).The patients aged from 12 to 69 years,with a mean age of 42.7 years.There were four right eyes and three left eyes.The duration (interval between primary surgery and SB removal) ranged from two weeks to ten years,with a mean of 47.5months.Six patients were concurrent with systemic disease.All the patients were examined for visual acuity,slit lamp microscope and indirect ophthalmoscope examination.Some patients also received external eye examination and fundus photography.Whether SB exposure or not and the clinical manifestations were observed.SB removal was performed in all the patients and the SB were sent to the laboratory for bacterial culture.The follow-up time ranged from two weeks to eight months,with a mean of 3.2 months.Whether infections recurrence and retinal detachment or not were observed.Results SB exposure was in three eyes.Obvious ocular pain and swelling,conjunctival hyperemia and visible yellow-white discharge in the conjunctival sac were presented in two eyes; irritation and discharge were in one eye.No SB exposure was in four eyes.Ocular pain and swelling,conjunctival hyperemia and visible yellow-white discharge in the conjunctival sac were presented in two eyes.Repeated subconjunctival hemorrhage and diplopia were presented in one eye.Visual acuity decline,conjunctival sac discharge and total retinal detachment were in one eye.All patients had no intraocular inflammation.The infection was controlled after SB removal and the retina was attached during the follow up.The bacterial culture were all positive,which included Staphylococcus aureus,Staphylcoccus epidermidis and Erysipelothrix rhusiopathiae,Gram positive corynebacterium,Aspergillus flavus,Kocuria roseus,Streptococcus oralis,Maxwell Corynebacterium.Conclusions The clinical manifestations of SB infection and the pathogenic microorganisms are variable.SB removal can control the infection.
ABSTRACT
Corticosteroids are widely used to treat ocular fundus diseases such as inflammatory disease,macular edema and choroidal neovascularization.To increase local drug concentration and reduce systemic side effects,corticosteroids are often delivered by periocular or intravitreal iniection.However there are still more and more clinical complications with the expanded scope of application of these drugs.In order to achieve the best risk-benefit ratio,fully understanding the pharmacological characteristics,indications,contraindications and complications of corticosteroid is critical for clinicians to prescribe this drug to their patients.
ABSTRACT
Objective To analyze the effect of intensive pupillary dilation on intraocular pressure(IOP) in early stage after vitreoretinal surgery(VRS).Design Retrospective case series.Participants 32 patients(34 eyes) with 30 mmHg or more of IOP at the first day after VRS were enrolled in this study.Methods Tropicamide-phenylephrine eyedrop(Mydrin-P~(?)) was applied to the operated eye 3 times with interval of 5 minutes and IOP was measured again 2 hours later.IOPs were compared with t test.Main Outcome Measures IOP.Results The mean IOP was 37.26?6.07 mmHg before using tropicamide-phenylephrine eyedrop and 34.82?8.46 mmHg after using it two hours later(P=0.02),and mean decline of IOP was 2.44 mmHg in general.IOP was decreased in 20/34 eyes(58.82%) with mean decline 6.2 mmHg.IOP was unchanged in 4/34 eyes(11.76%).IOP was increased in 10/34 eyes(29.41%) with mean IOP up 4.1 mmHg.Conclusions The IOP increasing after vitreoretinal surgery is not the reason for stopping pupillary dilator.On the contrary,the IOP of about 60%patients can decrease with rational using pupillary dilator.
ABSTRACT
Objective To study the electrophysiological properties of rat skeletal muscle within the frequency from 100Hz to 100MHz.Methods The AC impedance of rat sural muscle tissues was measured using the Agilent 4294A impedance analyzer, then the electrophysiological properties of the normal rat sural muscle cells were established in the respect of cell dielectric spectroscopy, Cole-Cole plots, spectrum of loss factor and loss tangent.Results (1) The dielectric response of rat sural muscle cells was frequency-dependent, such as increase in frequency caused decrease in permittivity. At the same time the conductivity trended to arise; (2) The dielectric parameters(?_L,?_h,?_L,?_h,△?″_ max,△tg?_ max,f_ C1,f_ C2) cell fiber parallel to the applied electric field differed from that cell fiber perpendicular to the applied electric field; (3) The effect of alternating current electric field on rat sural muscle cells showed a dielectric dispersion phenomenon, representing two characteristic frequency: the 1 st frequency(f_ C1(∥)=f_ C1(⊥)=1.02 kHz) and 2 nd frequency(f_ C2(∥)=59.31 kHz,f_ C2(⊥)=380.04kHz). Conclusion The method for studying the electrophysiological properties of rat skeletal muscle cells was established in the respect of the frequency domain,providing a possibility for investigating muscle fatigue in the future.