Comparison of squint angle measured by right angle prism and isosceles angle prism / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To investigate the differences in squint angle measured by right angle prism and isosceles angle prism.METHODS: Case control study. A total of 176 cases of concomitant strabismus admitted to our hospital from June 2021 to April 2022 were selected, among which 79 cases were concomitant esotropia and 97 cases were concomitant exotropia. The squint angle of all patients was measured respectively by alternating cover right angle prism and isosceles angle prism.RESULT: For patients with concomitant esotropia, the right angle prism degree was 49.167△±13.573△ and the isosceles angle prism degree was 38.250△±10.756△ (P<0.01), with a difference of 10.917△±3.752△; the measurement of right angle prism converted to circular degree was 19.096°±2.456°, and the isosceles angle prism value was 20.847°±5.364°(P<0.05), with a difference of 2.443°±2.702°. For patients with concomitant exotropia, the right angle prism degree was 51.875△±13.567△, and the isosceles angle prism degree was 40.492△±11.753△ (P<0.01), with a difference of 11.383△±4.783△; the measurement of right angle prism converted to circular degree was 19.589°±2.521°, and the isosceles angle prism value was 21.947°±5.864°(P<0.01), with a difference of 3.200°±3.077°. There was no significant statistical difference in the differences of the two prism degree and the circular degree for concomitant esotropia and concomitant exotropia(P>0.05).CONCLUSIONS: The squint angle measured by different shaped prisms is different. The degree measured by right angle prism is larger than that by isosceles angle prism.

The effectiveness of a three-step sterilization method for Goldmann tonometer prism: A cross-sectional study

Purpose: To propose a three?step sterilization method for Goldmann tonometer prism (GTP) and to analyze the sterilization effects of each step. Methods: 120 patients (240 eyes) who underwent Goldmann applanation tonometer (GAT) IOP measurement were enrolled in this study. GTPs were used individually for each patient and wiped by swabs soaked with 75% ethyl alcohol, ofloxacin eye drops, and 75% ethyl alcohol for at least 5 s. GTPs were directly pressed onto the surface of agar plates before (W0) and after three?step sterilization (W1, W2, and W3). All the agars were sent to the laboratory in 2 h and incubated at 37°C for 48 h. Subsequently, the growth of microbial species was assessed through visual inspection of the colonies at the inoculation points on the agar surface. Results: Staphylococcus. epidermidis was the most frequently isolated bacterium and was observed in 23.33% of all prisms. Most of the bacteria were eliminated at W3 except Staphylococcus. epidermidis and Kocuria roseus in one case. The isolation rates of Staphylococcus genus and Staphylococcus. epidermidis were significantly decreased (both with P < 0.001). The number of bacteria types isolated from prisms at time point W2 and W3 had a statistically significant difference compared with W1 and W (both with P < 0.05), while W2 and W3 exhibited no significant difference. Conclusion: This three?step sterilization method for GTP proved to be effective and safe for repeated use. We recommend using ofloxacin to prevent the transmission of pathogens based on ethyl alcohol, which could also bring some economic benefits.

Desempenho do PRISM III e do PIM 2 em unidade de terapia intensiva pediátrica oncológica / Performance of PRISM III and PIM 2 scores in a cancer pediatric intensive care unit

RESUMO Objetivo: Avaliar o desempenho do Pediatric Risk of Mortality (PRISM) III e do Pediatric Index of Mortality (PIM) 2 em unidade de terapia intensiva pediátrica. Métodos: Estudo de coorte retrospectivo. Os dados retrospectivos foram coletados dos prontuários de todos os pacientes admitidos na unidade de terapia intensiva pediátrica de um hospital infantil oncológico, entre janeiro de 2017 a junho de 2018. Resultados: A média do PRISM III foi de 15 e do PIM 2 de 24%. Dos 338 pacientes estudados, 62 (18,34%) morreram. A mortalidade estimada pelo PRISM III foi de 79,52 (23,52%) e pelo PIM 2 de 80,19 (23,72%) pacientes, correspondendo a taxa padronizada de mortalidade (intervalo de confiança de 95%) de 0,78 para o PRISM II e 0,77 para o PIM 2. O teste de ajuste de Hosmer-Lemeshow obteve qui-quadrado de 11,56, 8df, com p = 0,975, para PRISM III, e qui-quadrado de 0,48, 8df, p = 0,999, para o PIM 2. Foi obtida área sob a curva Característica de Operação do Receptor de 0,71 para o PRISM III e 0,76 para o PIM 2. Conclusão: Os dois escores superestimaram a mortalidade e demonstraram poder regular de discriminação entre sobreviventes e não sobreviventes. Devem ser desenvolvidos modelos para quantificar a gravidade de pacientes pediátricos com câncer em unidade de terapia intensiva pediátrica e predizer o risco de mortalidade que contemplem suas peculiaridades.

ABSTRACT Objective: To assess the performance of Pediatric Risk of Mortality (PRISM) III and Pediatric Index of Mortality (PIM) 2 scores in the pediatric intensive care unit. Methods: A retrospective cohort study. Data were retrospectively collected from medical records of all patients admitted to the pediatric intensive care unit of a cancer hospital from January 2017 to June 2018. Results: The mean PRISM III score was 15, and PIM 2, 24%. From the 338 studied patients, 62 (18.34%) died. The PRISM III estimated mortality was 79.52 patients (23.52%) and for PIM 2 80.19 patients (23.72%), corresponding to a standardized mortality ratio (95% confidence interval: 0.78 for PRISM II and 0.77 for PIM 2). The Hosmer-Lemeshow chi-square test was 11.56, 8df, 0.975 for PRISM II and 0.48, 8df, p = 0.999 for PIM 2. The area under the Receiver Operating Characteristic curve was 0.71 for PRISM III and 0.76 for PIM 2. Conclusion: Both scores overestimated mortality and have shown a regular ability to discriminate between survivors and non-survivors. Models should be developed to quantify the severity of cancer pediatric patients in Pediatric Intensive Care Units and to predict the mortality risk accounting for their peculiarities.

Application of fresnel prism in patients with different types of binocular diplopia / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To discuss the efficacy of fresnel prism in different types of binocular diplopia patients.<p>METHODS: This retrospective study reviewed 20 patients who received fresnel prism treatment between June 2018 and November 2020 in Jiangmen Central Hospital. Eight of them were diagnosed as acute acquired comitant esotropia, five patients were thyroid-associated ophthalmopathy, and seven patients were eye misalignment caused by cranial nerve palsies. The outcome measures were deviation, near stereoacuity, asthenopia and driving ability at pre-treatment and post-treatment.<p>RESULTS: The deviations were decreased after treatment. There were significant differences between pre-treatment and post-treatment(<i>P</i><0.05). The patients with acute acquired comitant esotropia or eye misalignment caused by cranial nerve palsies recovered near stereoacuity meanwhile significant difference between before and after treatment(<i>P</i><0.05). There were no significant differences between before and after treatment in patients with thyroid-associated ophthalmopathy(<i>P</i>>0.05). Thirteen patients recovered in the driving ability while fifteen patients were cured of asthenopia. There were significant differences between before and after treatment(all <i>P</i><0.05).<p>CONCLUSION: Fresnel prism treatment could decrease deviations in binocular diplopia patients, improved near stereoacuity and quality of life.

Clinical study on camera-assisted measurement for measuring squint angle of concomitant strabismus / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To investigate camera-assisted measurement in evaluating the accuracy of Hirschberg Test in measuring squint angle of concomitant strabismus.<p>METHODS:The clinical data of 105 patients with concomitant strabismus who were admitted to the hospital during the period from January 2016 to January 2018 were collected. After admission, they were given traditional Hirschberg Test and picture Hirschberg Test for squint angle examination.Taking the prism cover test as golden standard, the deviation values between squint angle measured by golden standard and those measured by the traditional Hirschberg Test and the picture Hirschberg Test were recorded.The influence of Kappa angle on the deviation value was analyzed.The application value of camera-assisted measurement in squint angle of concomitant strabismus was analyzed.<p>RESULTS:There was a significant difference in the value of squint angle measured by traditional Hirschberg Test, picture Hirschberg Test and prism cover test test(<i>P</i><0.05), and the squint angle measured byprism cover test test was higher than that of picture Hirschberg Test method(<i>P</i><0.05), and the angle in picture Hirschberg Test method was higher than that in traditional Hirschberg Test method(<i>P</i><0.05), and the consistency of picture Hirschberg Test method and prism cover test test in measuring squint angle was higher than that of Traditional Hirschberg Test method(<i>P</i><0.05).There were significant differences in the deviation values of squint angle measured by traditional Hirschberg Test among the 4 examiners(<i>P</i><0.05).The deviation values of all examiners measured by traditional Hirschberg Test were higher than those by picture Hirschberg Test(<i>P</i><0.05).The deviation degree of picture Hirschberg Test was lower than that of traditional Hirschberg Test in terms of the examination of squint angle in patients with positive and negative Kappa angle(<i>P</i><0.05).<p>CONCLUSION: The deviation of camera-assisted measurement picture Hirschberg Test is lower than that of traditional Hirschberg Test for the measurement of squint angle of concomitant strabismus, and it is more suitable for young patients who cannot cooperate with.

The Effect of a Complex Intervention Program for Unilateral Neglect in Patients with Acute-Phase Stroke: A Randomized Controlled Trial

OBJECTIVES: The purpose of this study was to examine the combined effects of Prism Adaptation (PA) plus functional electrical stimulation (FES) on stroke patients with unilateral neglect, and suggest a new intervention method for acute-phase stroke patients. METHODS: There were 30 patients included in this study from April to October 2016 that had unilateral neglect whilst hospitalized following a stroke (diagnosed by a professional). The participants, who were patients receiving occupational therapy, understood the purpose of the study and agreed to participate. The patients were randomly divided into 3 groups: PA plus FES group (Group A), PA group (Group B), and FES group (Group C). Treatments lasted for 50 minutes per day, 5 times per week, for 3 weeks in total. Reevaluation was conducted after 3 weeks of intervention. RESULTS: All 3 groups showed unilateral neglect reduction after the intervention, but PA plus FES (complex intervention method) was more effective than PA or FES alone [effect size: Motor-free Visual Perception Test (0.80), Albert test (0.98), CBS (0.92)]. CONCLUSION: The results of this study support further studies to examine complex intervention for the treatment of unilateral neglect.

Calidad y uso de información para mejorar la respuesta nacional ante el VIH / SIDA / Quality and use of information to improve the national response to HIV / AIDS

La finalidad de todo sistema de información rutinario de salud es el uso adecuado y oportuno de la información que produce para mejorar la salud de la población. Su desempeño depende de procesos determinados por factores técnicos, organizacionales y de comportamiento. El objetivo de este estudio ha sido evaluar el desempeño del sistema de información rutinario de VIH SIDA en el sistema público de salud del Paraguay. Para ello se realizó un estudio transversal descriptivo durante el año 2016, aplicando un cuestionario estándar de evaluación según el modelo PRISM. Se incluyó a 154 trabajadores del sector salud de 76 establecimientos públicos de 4 regiones sanitarias, mediante un muestreo basado en el aseguramiento de la calidad de lote. Los resultados señalaron que el uso de la información fue de 25,8% y que la calidad de los datos fue de 75,6%. Presentaron bajo desempeño los procesos de recolección, presentación, retroalimentación y análisis de los datos. Entre los determinantes se identificó bajo desempeño en los siguientes factores: a) el nivel de conocimiento de los formularios y la capacidad de resolver problemas; b) uso de software; y c) gestión de datos. La promoción de la cultura de la información fue de 75,8%. Como conclusión se demuestra que la calidad no garantiza el uso de la información, que ésta no está vinculada a la toma de decisiones y que para revertir el bajo desempeño es necesario desarrollar capacidades e incidir sobre los determinantes identificados

The purpose of any routine health information system is the adequate and timely use of the information it produces to improve the health of the population. Its performance depends on processes determined by technical, organizational and behavioral factors. The objective of this study was to evaluate the performance of the routine HIV AIDS information system in the public health system of Paraguay. To this end, a descriptive cross-sectional study was carried out during 2016, applying a standard evaluation questionnaire according to the PRISM model. 154 health sector workers from 76 public health establishments in 4 health regions were included, through sampling based on batch quality assurance. The results indicated that the use of the information was 25.8% and that the quality of the data was 75.6%. The processes of collection, presentation, feedback and analysis of the data presented low performance. Among the determinants, low performance was identified in the following factors: a) the level of knowledge of the forms and the ability to solve problems; b) use of software; and c) data management. The promotion of the information culture was 75.8%. In conclusion, it is demonstrated that quality does not guarantee the use of information, that it is not linked to decision-making and that in order to revert low performance it is necessary to develop capacities and influence the identified determinants

Competencias percibidas y observadas en el Sistema de Información de Salud del Instituto de Previsión Social (IPS). Evaluación PRISM OBAT / Perceived and observed competences in the Health Information System of the Social Security Institute (IPS). PRISM OBAT evaluation

Las competencias del personal asignado al sistema de información rutinario de salud son factores asociados al desempeño de utilizar la información para producir mejoras en la salud de la población. El objetivo de este trabajo ha sido evaluar las competencias percibidas y las competencias observadas para realizar tareas claves del sistema de información de salud en el Instituto de Previsión Social. Como método se realizó un estudio en el año 2012, de tipo observacional, descriptivo de corte transversal, que abarcó a instituciones públicas del Sistema Nacional de Salud . El muestreo fue por conglomerados donde participaron 109 personas que participan en el sistema rutinario de salud del IPS. Se aplicó un cuestionario estándar según el modelo PRISM/OBAT. Los resultados señalaron que existen importantes diferencias entre lo que el personal cree que puede hacer y lo que realmente es capaz de hacer. Sobre todo, en cuanto a la capacidad de interpretar y utilizar la información. Bajo este modelo, la motivación fue de 82,1%, autoeficacia percibida 78,6% y las competencias observadas 57,5%. Las competencias para interpretar la información y para utilizarla tuvieron los más bajos resultados 28% y 51% respectivamente. Palabras claves: Sistema de información rutinario de salud, determinantes de comportamiento, PRISM, OBAT.

The competences of the personnel assigned to the routine health information system are factors associated with the performance of using the information to make improvements in the health of the population. The objective of this work was to evaluate the perceived competences and the observed skills to perform key tasks of the health information system in the Social Security Institute. As a method, a study was carried out in 2012, of an observational, descriptive cross-sectional type, which included public institutions of the national health system. Cluster sampling was made, where 109 people involved in IPS routine health system participated. A standard questionnaire was applied according to the PRISM / OBAT model. The results indicated that there are significant differences between what the staff believes they can do and what they are actually capable of doing. Especially regarding the ability to interpret and use information. Under this model, the motivation was 82.1%, perceived self-efficacy 78.6% and the observed competences 57.5%. The skills to interpret the information and to use it had the lowest results 28% and 51% respectively. Key words: Routine health information system, determinants of behavior, PRISM, OBAT

Therapeutic Outcomes of Prism Glasses for Diplopia Unrelated to Strabismus Surgery

PURPOSE: To evaluate the therapeutic results of the patients wearing the prism glasses due to strabismus with diplopia unrelated to strabismus surgery. METHODS: Between May 2002 and October 2016, this retrospective study evaluated medical records of 23 patients who were wearing prism glasses due to strabismus with diplopia unrelated to strabismus surgery. The patients failed to adjust to the prism glasses and stopped within 3 months were defined as the adaptation failure group. The patients wearing prism glasses for 3 months or more was defined as adaptation success group. In the prism adaptation success group, he patients who underwent strabismus surgery during follow up were defined as treatment failure. Data were collected the types and causes of strabismus, the deviation angle at starting treatment of prism glasses and last visits, best corrected visual acuity, Titmus stereo test and Worth 4 dot test. RESULTS: Of the total 23 patients, 18 patients had horizontal strabismus, four patients had vertical strabismus and one had horizontal and vertical strabismus. The causes of strabismus were acute acquired comitant esotropia (12 patients), paralytic strabismus (9 patients), and thyroid associated ophthalmopathy (two patients). There was no significant changes in deviation angle as well as the prism diopter of prism glasses after prism glasses treatmet. The prism glasses-adaptation group was 70%, and 31% of them were performed strabismus surgery. There was no reduction in visual acuity in all patients. Among the prism glasses adaptation group, 33% of the prism glasses-adaptation group had poor binocular function. CONCLUSIONS: In the strabismus patients with diplopia unrelated to strabismus surgery 70% of the patients adapted prism glasses more than 3 months and 31% of them required strabismus surgery. Therefore, prism glasses treatment may be one of the non-surgical approaches in the strabismus patients with diplopia unrelated to strabismus surgery.

Clinical Characteristics and Outcomes of Smartphone Overusers with Acute Acquired Comitant Esotropia

PURPOSE: To evaluate the clinical features and treatment outcomes of smartphone overusers with acute acquired comitant esotropia. METHODS: We retrospectively reviewed the medical records of patients ≥ 15 years of age who used a smartphone for > 4 hours a day for > 1 year, and who were diagnosed with acute acquired comitant esotropia from May 2011 to January 2016. We analyzed sex, age at the time of manifestation and duration of esotropia, refractive error, deviated angle at the first and final visits, and the results of refraining from smartphone use, use of the Fresnel prism, and surgery for esotropia. RESULTS: A total of 13 patients were studied, including 8 males and 5 females. The mean age at development of esotropia was 22.7 ± 9.7 years. The mean duration of esotropia before the first visit was 28.0 ± 33.0 months, and the mean follow-up period was 16.4 ± 16.4 months. The mean angle of esotropia was 21.8 ± 7.0 prism diopters (PD) at distance and 22.2 ± 7.9 PD at near. There were eight myopic patients; the other patients were emmetropia. The esotropia of all patients did not improve after refraining from smartphone use. There was no improvement in five patients who were wearing the Fresnel prism for ≥ 4 months. A total of six patients were treated with bilateral medial rectus recession; only one patient remained orthotropic at postoperative 6 months, three patients were undercorrected, and two had a recurrence. CONCLUSIONS: Esotropia persisted after refraining from smartphone use or wearing a Fresnel prism in acute acquired comitant esotropia patients who were smartphone overusers, and the surgical prognosis of these patients was relatively poor.

Study of protein interaction based on the triplets combination pairs of the residue groups / 药学学报

The protein-protein interactions play an important role in life science. At present, many methods are developed with preferences of the amino acid residues, which do not offer the relative spatial information for the residue groups. However, the spatial information for the residue groups is important in the design of the protein-protein interactions. We proposed a new model, which is named ‘tri-prism’ model, by deep mining the existing protein-protein interaction patterns and refining the preference and the relative spatial information for the combination pairs of the residue groups. The model not only provided the preferences, but also offered the relative spatial information for the triplets combination pairs of the residue groups. The model was able to analyze the triplets combination pairs of the residue groups based on the preference factor, amino acid composition, and protein secondary structure. The model was applied to the interface of the PD-1/PD-L2 protein. According to the diversity characters of the composition and the spatial information between the combination pairs of the residue groups at the interface of the PD-1/PD-L2 protein and the predicted ones, we put forward the suggestions for the mutations of the residues, which offered a new view in the study of protein-protein interactions.

Association of fluid overload with acute kidney injury and prognosis in critically ill children / 临床儿科杂志

Objectives To investigate the association of fluid overload (FO) with the development and mortality of acute kidney injury (AKI) and to evaluate the predictive value of FO in mortality of critically ill children. Method A prospective study was conducted among critically ill children who were admitted to the children's intensive care unit (PICU). FO levels were assessed during the course of the disease and PRISM Ⅲ scores were evaluated within 24 hours of admission. Binary logistic regression analyses were conducted to evaluate the association of FO with the development and mortality of AKI after adjusting for confounding factors. The area under the receiver operating characteristic curve (AUC) was calculated to assess the predictive value of FO for mortality. Results In 362 children included, there were 26 children (7.18%) having average FO≥5%, and AKI in 24 children (6.63%) and 18 children (5.0%) died. The mean FO (OR=1.26, 95%CI: 1.10～1.43, P=0.001) and the maximum FO (OR=1.12, 95%CI: 1.02～1.23, P=0.018) were significantly correlated with the development of AKI in critically ill children within 7 days of admission to PICU. However, after adjusting for age and PRISM Ⅲ, both factors had no association with AKI (all P>0.05). After adjusting for the potential confounders such as AKI and the severity of disease, the average FO was significantly associated with mortality (AOR=1.34, 95%CI: 1.12～1.60, P=0.002). The AUC of mean FO that predicted mortality risk was 0.801 (P<0.001). Conclusion Fluid overload is associated with the development and the prognosis of AKI in critically ill children, and has important predictive value for mortality.

Characteristics and therapeutic effect evaluation of divergence paralysis / 眼科新进展

Objective To investigate the clinical features of divergence paralysis improve the diagnostic and therapeutic ability,and evaluate the effect of surgical and non-surgical treatment.Methods It was a retrospective case series study.11 cases with complete data,diagnosed and treated as divergence paralysis in Tianjin Eye Hospital from September 2014 to January 2016,were summarized.The observation items included general date,neurologica consultation,comprehensive eye examination,and the eye position and movement,deviation degree,binocular vision,AC / A,diplopia examination of pre-treatment and post-treatment.The patients were followed up from 3 months to 1.5 yeas,averaged 6.9 months.Results In our study,1 patient was MillerFisher syndrome,3 cases had a history of hypertension,and 1 case had the history of intaking sleeping pills for about 3 months.The rest of the patients denied the nervous system disease,cardiovascular disease and other medical history.All patients complained about uncrossed diplopia only at distance.All of the 11 patients had a sudden onset of their symptoms.Each patient was examined by same neurologist,meanwhile MRI or CT were performed.All the results showed normal.All patients had refractive error.The angle of esotropia for distance of 5 meters was from + 25 △ to + 55 △ and was from + 8 △ to + 40△ for near(33 cm)before treatment while changed into-4△ ～ + 12△ for distance (5m) and to-8△ ～ +8△ for near (33 cm) after treatment.The ratio of AC / A ranged from 1.3 to 4.0,with an average of 2.6.Conclusion The clinical characteristics of divergence paralysis are a greater angle of esotropia and ipsilateral diplopia.Lateral rectns resection and non-surgical treatment have better effects on the improvement of diplopia and esotropia.

Analysis of diversity between synoptophore and triple prism strabismometry / 国际眼科杂志(Guoji Yanke Zazhi)

? AIM: To investigate the differences between synoptophore and triple prism strabismometry and its possible cause.?METHODS: There were 347 patients with horizontal concomitant strabismus involved, in which 76 patients were esotropia, 37 patients were male while 39 were female, with average age of 13. 27 ± 7. 77 years old. There were 271 patients with exotropia, 131 cases were male while 140 were female, with average age of 15. 43 ± 8. 42 years old. All the patients were examined by synoptophore and prism plus shaded strabismometry in a long distance of 6m. Datas were analyzed by SPSS 17. 0.?RESULTS:In the exotropia patients, the conversions of circular degree(°) and prism degree(△) were:1°=0. 29△ ~1. 78△, which was statistically significant with intermittent strabismus (P=0. 001). While in the esotropia patients, the conversions were:1°=2. 01△ ~2. 15△.?CONCLUSION: The diversity between the two methods is enlarged with the increase of squint angle for exotropia patients. While in esotropia patients, the diversity decreased with the increase of squint angle. Synoptophore equipped with +7. 00D, defects of the triple prism itself and proximal convergence during exam may be the reasons for the diversity.

Postoperative Exodrift Patterns after Bilateral or Unilateral Lateral Rectus Recession in 20 Prism-diopter Intermittent Exotropia

PURPOSE: In the present study, the surgical outcome and postoperative exodrift pattern between bilateral lateral rectus recession (BLR) and unilateral lateral rectus recession (ULR) in intermittent exotropia of 20 prism diopters (PDs) were compared. METHODS: In this retrospective study, 5.0 mm BLR or 8.5 mm ULR was performed on 82 patients for the treatment of intermittent exotropia of 20 PDs with a follow-up period of 2 years. The main outcome measures were postoperative 1-week, 1-month, 6-month, 1-year and 2-year exodeviation angles with their patterns and success rates. A surgical success was considered an alignment within 10 PDs and sensory success was defined at 100 seconds of arc. RESULTS: The mean deviation angles at postoperative 1 week were 4.7 ± 5.1 PD esodeviation in the BLR group (44 patients) and 1.2 ± 4.2 PD esodeviation in the ULR group (38 patients). The BLR group was significantly more overcorrected than the ULR group (p = 0.001), but postoperative exodrift occurred in the BLR group at 1 week, 1 month, 6 months, 1 year, and 2 years. In the ULR group, the postoperative exodrift occurred at 1 week, 1 month, and 6 months which was followed by stabilized alignment. Surgical success rate at the postoperative 2-year follow-up was 75.0% in the BLR group and 81.6% in ULR group (p = 0.717). CONCLUSIONS: ULR showed less overcorrection and early exodrift up to only 6 months, resulting in stabilization of the alignment afterwards; surgical success rate at the final 2-year follow-up was similar to BLR.

Strabismus Following Scleral Buckling Surgery.

Purpose: The purpose was to assess the incidence of strabismus, relationship of strabismus with type, and width of the scleral buckle (SB) after SB surgery for retinal detachment. Methods: Retrospective analysis of 360 eyes of 344 patients, treated for rhegmatogenous retinal detachment with SB surgery between January 2008 and January 2013 was done. Results: The mean age of patients was 38.45 ± 18.12 years (range: 7-89 years) was detected in 48 out of 344 (13.95%) patients at 6 weeks after SB surgery. Horizontal deviation was the most common type. Incidence of strabismus was higher after repeat SB surgery (4/9, 44.4%) compared to patients who had single SB surgery (44/335, 13.1%) (P = 0.02). Strabismus was observed in 18.5% of patients with implants, compared to 11.3% of patients who received explants (P = 0.02). Strabismus surgery was performed on 2 (4.1%) cases. Conclusion: Horizontal strabismus is common after SB surgery for repair of retinal detachment. Repeat scleral buckling and use of implants resulted in a higher incidence of strabismus in the post-operative period. Majority of these cases resolve with conservative management.

Influences of prisms on accommodative response and microfluctuation in emmetropias / 中华实验眼科杂志

Background How to control progression of myopia is a central issue in clinical optometry.Some clinical trials showed that wearing base-in (BI) prism can slow down progression of myopia to certain degree.However,whether BI prism or base-out (BO) prism should be used is worth discussing.Objective This study was to investigate the influences of different prisms on accommodative response and microfluctuation in emmetropias.Methods This clinical trail was approved by Ethic Committee of Peking University People's Hospital.During July in 2014,twenty-two emmetropias of 22 normal volunteers aged 21-27 years were recruited from Peking University People's Hospital under the written informed consent.An open-field infrared refractometer was used to monitor and record pupil diameter and accommodative response under three conditions including non-prism,3△ BI prism,and 3△ BO prism.The accommodative response value was calculated as the difference between reading value and-3.0 D,and root mean square (RMS) of accommodative response value served as amplitude of accommodative microfluctuation.Spectrum of accommodative response was analyzed by one dimension discrete Fourier transformation.The differences of accommodative response value,amplitude of accommodative microfluctuation and pupil diameter among three conditions were compared using repeated one-way ANOVA.Results The accommodative response values were (+0.31±0.78),(+0.51±0.75) and (+0.18±0.72) D under the non-prism,3△BI prism and 3△BO prismconditions,respectively,with a significant difference among them (F =28.078,P =0.000),and compared with the non-prism condition,the accommodative lag of 3△BI prism condition was increased and that of 3△BO prism condition was reduced (P =0.000,0.012).No significant difference was found in the amplitude of accommodative microfluctuation among the three conditions (F=0.062,P =0.879).The percentages of low frequency signal power (0-0.5 Hz)/total power (0-2.5 Hz) was 97.5％,98.3％ and 91.4％ under the non-prism,3△BI prism and 3△BO prism condition,respectively.The pupil diameter was (5.37-±0.69) mm under the 3 △ BI prism condition,which was larger than (5.07±0.66) mm under the non-prism condition and (5.01 ±0.69) mm under the 3△ BO prism condition (both at P =0.000).Conclusions Compared with wearing 3△ BI prism,wearing 3△ BO prism lessens the accommodative lag,decreases the pupil diameter and reduces the power of low frequency component in accommodative response.

Application of prism alternate cover test and perimeter strabismometry in strabismic operation / 国际眼科杂志(Guoji Yanke Zazhi)

AlM:To discuss the application of prism alternate cover test ( PACT) and perimeter strabismometry in strabismic operation.METHODS: A total of 145 patients with concomitant esotropia or exotropia, aging 2 ~ 50 years old, were included. They were examined by PACT and perimeter strabismometry before operation. The strabismic operations were performed, the orthotropia rate of postoperation was assessed.RESULTS:Using PACT and perimeter strabismometry, there was a significantly difference of deviating angle ( P0. 05) in moderate strabismic group. The functional cure rate of postoperation was respectively 70. 83%, 67. 01%; the clinical cure rate was 20. 84%, 24. 74%; invalid rate was 8. 33%, 8. 25% .CONCLUSlON: The application of PACT and perimeter strabismometry in strabismic operation design, referring to the eye axial length, this can be helpful of improving the cure rate postoperation and decreasing the danger of reopreation.

Lactate Clearance as a Marker of Mortality in Pediatric Intensive Care Unit.

Objectives: To correlate lactate clearance with Pediatric Intensive Care Unit (PICU) mortality. Methods: 45 (mean age 40.15 mo, 60% males) consecutive admissions in the PICU were enrolled between May 2012 to June 2013. Lactate clearance (Lactate level at admission – level 6 hr later x 100 / lactate level at admission) in first 6 hours of hospitalization was correlated to in-hospital mortality and PRISM score. Results: Twelve out of 45 patients died. 90% died among those with delayed/poor clearance (clearance <30%) compared to 8.5% in those with good clearance (clearance >30%) (P<0.001). Lactate clearance <30% predicted mortality with sensitivity of 75%, specificity of 97%, positive predictive value of 90%, and negative predictive value of 91.42%. Predictability was comparable to PRISM score >30. Conclusion: Lactate clearance at six hours correlates with mortality in the PICU.