A-prospective-study-comparing-the-outcomes-of-nasal-septal-clip-versus-merocel-application-after-nasal-septal-corrective-surgery

Nasal splint application is an important step of septal corrective surgeries to keep the septum in midline after the surgery. Septal clip is most commonly used. In our study we have compared the use of nasal septal clip and Merocel application post surgery and the morbidities associated with it.

Influence of total femtosecond laser small incision lenticule extraction on corneal surface regularity index / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To analyze the influence of total femtosecond laser small incision lenticule extraction(SMILE)on corneal surface regularity index(SRI).<p>METHODS:Totally 210(401 eyes)myopic patients treated in Qinhuangdao Optometry Ophthalmology Hospital between January 2017 and December 2019 were enrolled in the study. Among them, patients treated with total femtosecond laser SMILE were included in the observation group(<i>n</i>=110, 205 eyes), while those treated with femtosecond laser-assisted <i>in situ</i> keratomileusis(FS-LASIK)were includded in the control group(<i>n</i>=100, 196 eyes). The uncorrected visual acuity(UCVA), best corrected visual acuity(BCVA), anterior corneal surface asphericity index(Q-value)at a diameter of 6mm and SRI were compared between the two groups before and after operation.<p>RESULTS: The UCVA and BCVA of both groups were improved at 3mo and 6mo after operation(<i>P</i><0.05), without significant differences between the groups(<i>P</i>>0.05). The observation group had higher SRI than the control group at 3mo, 6mo and 1a(<i>P</i><0.05). The asphericity parameter Q-values increased at each time point after operation. Besides, the observation group had lower Q-values than the control group at 6mo and 1a(<i>P</i><0.05).<p>CONCLUSION: Compared with FS-LASIK, SMILE can achieve similar visual recovery effect. However, the SRI is larger after SMILE, and the influence on asphericity index Q-value is less.

Progress on the application of tranexamic acid in adolescent spine corrective surgery / 中国修复重建外科杂志

Objective: To review the advances in the application of tranexamic acid (TXA) in adolescent spinal corrective surgery. Methods: The mechanism of action and pharmacokinetic, effectiveness, dosage, safety as well as methods of administration were comprehensively summarized by consulting domestic and overseas related literature about the application of TXA in adolescent spinal corrective surgery in recent years. Results: TXA efficaciously reduce intraoperative blood loss, transfusion rate and volume, postoperative drainage volume in adolescent spinal corrective surgery. At present, the most common method of administration in adolescent spinal corrective surgery is that a loading dose is given intravenously before skin incision or induction of anesthesia, followed by a maintenance dose until the end of the surgery. The range of loading dose and maintenance dose is 10-100 mg/kg and 1-10 mg/(kg·h), respectively. No drug related adverse event has been reported in this range. Conclusion: The effectiveness and safety of TXA in adolescent spinal surgery have been basically confirmed. However, further studies are needed to determine the optimal dosage, method of administration as well as whether it could reduce blood loss after surgery.

Anomalía parcial de retorno venoso pulmonar a propósito de un caso / Partial anomaly of pulmonary venous return, case report aprvp

La anomalía de drenaje o de retorno venoso pulmonar es la inapropiada conexión de las venas pulmonares hacia venas sistémicas, puede ser parcial (de una a tres de las venas pulmonares) o total (todas las venas pulmonares comprometidas). Esta patología pertenece al grupo de cardiopatías congénitas cianóticas con hiperflujo pulmonar. Se presenta el caso de un niño de 6 años de edad, con el diagnóstico de anomalía parcial de retorno venoso pulmonar tipo supracardiaco (retorno de venas pulmonares izquierdas hacia vena innominada) y Coartación de Aorta, diagnosticados desde sus 10 días de vida, a los 5 meses fue operado de Coartación de Aorta, y a los 6 años se realizó la corrección de la anomalía parcial de retorno venoso pulmonar. Clínicamente asintomático, con presencia de soplo sistólico en foco pulmonar y aumento del segundo ruido cardiaco. Entre los datos ecocardiográficos resaltan: Válvula aórtica bicúspide, hipertensión arterial pulmonar leve (PAPS 40 mmHg), para 3600 m.s.n.m. Se realizó cirugía correctora con óptima recuperación y tras un seguimiento de tres años el paciente se encuentra asintomático, con presión pulmonar normal, sin arrítmias ni obstrucciones a nivel de las venas pulmonares.

Effects of corrective surgery on the ocular surface and refractive in children with congenital ptosis / 国际眼科杂志(Guoji Yanke Zazhi)

·AIM: To investigate the ocular surface and refractive change after the surgery of levator resection and frontalis suspension. ·METHODS:One hundred and twenty-one patients (146 eyes) for corrective surgery of congenital ptosis were selected in our department from July 2014 to June 2016. According to the severity of congenital ptosis, all the children divided into mild group (47 eyes), moderate group (68 eyes) and severe group(31 eyes). All the children were divided into group of less than 5 years old (104 eyes) and group of more than or equal to 5 years old (42 eyes) according to the age. According to the surgical approach, all the children divided into group of levator resection (62 eyes) and group of frontalis suspension(84 eyes). The effects of the two surgeries on the ocular surface and refractive were compared. The relationship between age, severity of postoperative ptosis and postoperative ocular surface, refractive of children were analyzed. ·RESULTS: There were no significant differences in break-up time (BUT), keratometry (Km) and corneal astigmatism (Ast) in the levator resection group and frontalis suspension group (P > 0. 05). There was significant difference between the mild, moderate and severe group on the proportion of excellent corrected to uncorrected (Z=-2.936, P=0.003). The proportion of excellent correction in mild group was higher than that of moderate and severe group(93.6%, 83.8% and 67.7%). The indexes of BUT (F=9.793, P=0.041) and Km (F=11.657,P=0.037) in the three groups decreased with the increase of severity. While the Ast (F=28.417, P<0.01) showed an increasing trend, the difference was significant. In addition, the proportion of excellent correction in <5 year old group was significantly more than≥5 years old group(x2=4.082,P=0.043). The index of Km (t= 2.813, P= 0.006) was higher and Ast (t=-7.741, P<0.01) was lower in the <5 year old group. There was no significant difference in the index of BUT between the two groups after surgery (P>0.05). · CONCLUSION: The corneal refractive power and astigmatism can be improved similarly after treated with levator resection and frontalis suspension surgery. And there is some damage of corneal epithelial in the initial postoperation, but the function of ocular surface can return to normal after a period of time. The less severity of ptosis before surgery,the better improvement of ocular surface and refractive after sugery. There is no correlation between the age and postoperative ocular surface, but earlier surgical treatment may improve the children's refractive power and astigmatism and achieve greater benefits.

Application of laryngeal mask airway in pediatric corrective surgery of lingual frenum / 临床外科杂志

Objective To discuss the feasibility of application of laryngeal mask airway(LMA)in pediatric corrective surgery of lingual frenum. Methods Retrospective study was conducted of 42 chil-dren using laryngeal mask airway in selective surgical correction of lingual frenum under general anesthe-sia in our hospital. The childrenˊs vital signs were recorded at five different time points:baseline before an-esthesia(T0),consciousness and eyelid reflex disappear just after anesthesia induction(T1),time right af-ter the LMA insertion(T2),3 ~ 5 min after beginning of operation(T3),and time at the extubation(T4). The success rate of first LMA insertion and the number of changing to other ventilation way were recorded. The shift of LMA and postoperative sore throat within 24h were recorded. Results The success rate of the first LMA insertion was 85. 71% . Intraoperative laryngeal mask airway leak and shift did not occur and the ventilation was also good. Vital signs of the children were stable during operation. The incidence of postop-erative sore throat was 15% within 24h. As to the heart rate,the vital signs of baseline T0 were significant-ly different from other time points(T1,T2,T3,T4). After the anesthesia,there were no significant differ-ences in heart rate among different time points(T1,T2,T3,T4). Compare with T2 and T3,the values of partial end expiratory pressure of CO2 at T0,T1,and T4 were significantly different. Compare with T0,the values of mean arterial pressure at T1,T2 and T3 were significantly different,but there was a significant difference in mean arterial pressure between T1 and T4. As to the pulse oxygen saturation,all the values were above 95% . Conclusion Laryngeal mask airway is a supraglottic airway management method. The advantages of fewer haemodynamic changes and postoperative complication are confirmed. It is feasible and safe for securing the airway in surgical correction of lingual frenum.

Changes in Level of the Conus after Corrective Surgery for Scoliosis: MRI-Based Preliminary Study in 31 Patients

BACKGROUND: Detection of postoperative spinal cord level change can provide basic information about the spinal cord status, and electrophysiological studies regarding this point should be conducted in the future. METHODS: To determine the changes in the spinal cord level postoperatively and the possible associated factors, we prospectively studied 31 patients with scoliosis. All the patients underwent correction and posterior fusion using pedicle screws and rods between January 2008 and March 2009. The pre- and postoperative conus medullaris levels were determined by matching the axial magnetic resonance image to the sagittal scout image. The patients were divided according to the change in the postoperative conus medullaris level. The change group was defined as the patients who showed a change of more than one divided section in the vertebral column postoperatively, and the parameters of the change and non-change groups were compared. RESULTS: The mean pre- and postoperative Cobb's angle of the coronal curve was 76.80degrees +/- 17.19degrees and 33.23degrees +/- 14.39degrees, respectively. Eleven of 31 patients showed a lower conus medullaris level postoperatively. There were no differences in the pre- and postoperative magnitude of the coronal curve, lordosis and kyphosis between the groups. However, the postoperative degrees of correction of the coronal curve and lumbar lordosis were higher in the change group. There were also differences in the disease entities between the groups. A higher percentage of patients with Duchene muscular dystrophy had a change in level compared to that of the patients with cerebral palsy (83.3% vs. 45.5%, respectively). CONCLUSIONS: The conus medullaris level changed postoperatively in the patients with severe scoliosis. Overall, the postoperative degree of correction of the coronal curve was higher in the change group than that in the non-change group. The degrees of correction of the coronal curve and lumbar lordosis were related to the spinal cord level change after scoliosis correction.

Correction of severe kyphosis and kyphoscoliosis by total spinal osteotomy / 中国矫形外科杂志

[Objective]To explore the experience of the correction of severe kyphosis and kyphoscoliosis by total spinal osteotomy.[Method]To correct kyphosis and kyphoscoliosis by total spinal osteotomy and screws-rods internal fixation apparatus,then graft the bone.[Result]From 1984 to 2005,50 patients were cured with the way above.There were no neural injury observed.The clinical symptom was improved in some extent.All patients were follow up from 2 months to 15 years,averaged 2.4 years,and the postoperative X ray and CT scans verifies all screws were in a proper position.No cases of implant failure were observed,and all the patients had a solid bone fusion on radiographs taken 3 months after surgery.[Conclusion]The operation to correct severe kyphosis and kyphoscoliosis by total spinal osteotomy with efficient screws-rods internal fixation apparatus,not only have a larger operate area which made opreation easier and more safe,but combine osteotomy with internal fixation and finished at the same time,it is an efficient way to correct kyphosis and kyphoscoliosis.