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@#AIM: To compare the clinical effect, safety and visual outcome after laser <i>in situ</i> keratomileusis(LASIK)using femtosecond laser or a mechanical microkeratome. <p>METHODS: By retrospective study, 120 cases(240 eyes)of myopia patients had refractive surgery from July 2016 to June 2017. There were 62 cases(124 eyes)were treated with traditional LASIK, and 58 cases(116 eyes)were treated with LASIK using femtosecond laser to create corneal flaps. Visual acuity,corneal flap thickness and aberration were evaluated at 1, 6 and 12mo. <p>RESULTS: The corneal flap was successfully made in all patients, and the operation was successfully completed. There were no obvious complications during and after the operation. There were no statistical differences between the two groups about visual acuity or refractive error after operation(<i>P</i>>0.05). However,the result of corneal flap thickness in the Femto-LASIK was better than the result in the traditional LASIK(<i>t</i>=26.67, <i>P</i><0.01). In addition, the added values of spherical aberration, coma aberration and total higher-order aberrations in the Femto group were smaller than those in the traditional group(<i>t</i>=-4.16, -4.92, -22.19; <i>P</i><0.01). The post operative surface regularity index(SRI)of traditional LASIK was higher than that of Femto-LASIK(0.31±0.09 <i>vs</i> 0.25±0.04; <i>t</i>=6.59, <i>P</i><0.01). <p>CONCLUSION: Femtosecond laser made corneal flap is more accurate than lamellar knife flap. Aberrations of femtosecond laser flap LASIK surgery are smaller than the traditional LASIK.Femto-LASIK may provide relatively better visual quality. However, both of the different surgery can result in satisfactory visual acuity.
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<p><b>OBJECTIVE</b>To retrospective analysis the mid-term follow-up effect of hip joint replacement in elderly patients with failure of intertrochanteric fractures of the hip joint internal fixation.</p><p><b>METHODS</b>From December 2008 to December 2011, 32 elderly patients underwent arthroplasty after intertrochanteric fracture fixation failure, of which, 4 death cases were excluded from the study, and the remaining 28 cases were in the study group. The age of patients ranged from 69 to 83 years old with a mean of 75 years old. The time from the internal fixation to the hip replacement were 8 to 72 months. Among them, 6 patients were Evans I type, 11 patients were Evans II type, 9 patients were Evans III type, and 2 patients were Evans IV type. Nine cases showed fracture of the lateral plate before operation, while 15 cases were femoral head screw cut-out and 4 cases were screw loosening. Harris score was used to compare the changes of hip function before operation with the final follow-up. Imaging results(X-ray) and erythrocyte sedimentation rate(ESR) were performed during the follow-up.</p><p><b>RESULTS</b>All patients were followed up from 4 to 7 years with an average of 5.3 years. Pain was significantly reduced or disappeared in patients compared with pre-operation. And hip function was significantly improved. Two cases had moderate pain after the physical activity and 4 cases had mild pain after the physical activity. At the final follow-up, 19 patients resumed free walking, 8 patients required walking with walking sticks, and 1 patient needed walking aid. The Harris scores improved from preoperative 34.9±2.4 to 83.4±5.7 at the final follow-up, among them, 15 cases were classified as excellent, 10 as good, 2 as fair, and 1 as poor. X-ray examination showed no prosthesis loosening and sinking fracture.</p><p><b>CONCLUSIONS</b>Salvage THA surgery could improve the hip function and the quality of life for old patients with intertrochanteric fracture fixation failure, and the middle-term follow-up results support that.</p>
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Background The main mechanism of diabetic retinopathy (DR) is the formation of retinal neovascularization. Vascular endothelial growth factors (VEGF) is primarily factor for DR. Objective The goal of this study was to investigate the effects of angelicae sinensis decoction for supplementing blood ( ASD), a kind of traditional prescription of Chinese herbal medicine, on vascular endothelial growth factor (VEGF) level in vitreous and serum of STZ-induced type 2 diabetes mellitus. Methods Thirty-four SPF male SD rats were fed using high fat diet for 8 weeks and then the streptozocin of 25 mg/kg was intraperitoneally injected to create the type 2 diabetic models. ASD (3.6 g/kg) and 10 mg/kg Gli of 5 mi were administered intragastrically from the 4th day of high fat die though 8 weeks respectively. Other 10 matched rats were used as normal control group. The body weight, blood glucose level ,triglycerides (TG) and high density lipoprotein (HDL) were detected in 4 and 8 weeks after usage of drug. The vitreous and serum samples were obtained in the 8 th weeks for the VEGF detection by enzyme-linked immunosorbent assay (ELISA). This experiment comlied with the Regulations for the Administration of Affair Concerning Experimental Animals by State Science and Technology Commission. Results The body weight and HDL in DM group were significantly lower than those of normal control group in 4 or 8 weeks ( P＜0. 01 ), but in ASD and Gli groups ,the body weight and HDL were higher than those of the DM group (P＜0. 05 ). the blood glucose level and TG were elevated in DM group compared with normal control group (P＜0. 01 ), but those in ASD group and Gli group were decreased in comparison with DM group ( P＜0.05 ). EIISA revealed that no significant differences were found in VEGF levels between normal control group and ASD group or Gli group (P＞0. 05 ), but in DM group, the serum VEGF level (147.65±4. 55 ng/L) was reduced and vitreous VEGF level (673.45± 100. 85 ng/L) was raised,showing the considerable differences (P＜ 0.05 ). No any correlation was found between serum VEGF level and vitreous VEGF level (r=0.314,P＞0. 05). Conclusion ASD can decrease the VEGF level in vitreous,implying that ASD postpone the occurrence of diabetic retinopathy in DM rat.