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AIM: To compare the accuracy of different intraocular lens(IOL)calculation formulas in cataract patients with axial length longer than 28mm and a history of radial keratotomy(RK).METHODS: Retrospective study. The medical records of 19 cataract patients(29 eyes)after RK and with axial length longer than 28mm who underwent cataract surgery from January 2011 to July 2020 in Beijing Tongren Hospital were analyzed. The absolute error(AE)of the difference among three different formulas was calculated. AE refers to the absolute value between the actual spherical equivalent after cataract surgery and the spherical equivalent predicted by the IOL formula. The AE values of the three formulas and the percentages of eyes with AE≤0.5, 0.75, 1.0, and 2.0D were calculated and compared.RESULTS: The AE values of the three formulas were significantly different(χ2=8.759, P=0.013). The Barrett True-K formula had the smallest median AE, which was only 0.62(0.20, 1.15)D, followed by the Haigis formula 0.76(0.34, 1.26)D, and the Holladay 1(D-K)formula had the largest 1.01(0.49, 1.62)D. The percentages of affected eyes with AE ≤0.5, 0.75, 1.0, and 2.0D for the Barrett True-K formula were 48%, 59%, 69%, and 93%, which were equal to or higher than the other two formulas.CONCLUSION: The Barrett True-K formula is more recommended among the three formulas for cataract patients after RK and with axial length longer than 28 mm.
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@#AIM:To analyze the prevalence and influence factors of macular choroidopathy secondary to high myopia, so as to better understand the development of macular choroidopathy in patients with high myopia.<p>METHODS: The current study carried out a retrospective analysis on highly myopic patients aged 40 and above(2016-01/2019-07). A total of 232 patients(461 eyes)with high myopia were included. The fundus images and OCT results of all patients were evaluated to divide the cases into two main categories, non-choroidopathy 99 patients(255 eyes)and choroidopathy 133 patients(206 eyes), with choroidopathy including choroidal atrophy and choroidal neovascularization. The statistical analysis on the prevalence of different disorders and the multivariate regression between the influence factors were performed.<p>RESULTS: The prevalence of macular choroidopathy was 36.0%(166 eyes), of which, the prevalence of choroidal atrophy was 19.5%(90 eyes), and the prevalence of choroidal neovascularization was 16.5%(76 eyes). Multivariate Logistic regression analysis showed that axial length was the influence factor of choroidal atrophy(P<0.01), age and axial length were the influence factors of choroidal neovascularization(all P<0.01), gender, age and axial length were the influence factors of choroidopathy(all P<0.01).<p>CONCLUSION: Choroidal atrophy and choroidal neovascularization were prone to occur in patients with high myopia, and the prevalence was higher in women. In addition, the prevalence increased with the increase of age and diopter.
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@#Posterior scleral reinforcement surgery is a common method for the treatment for high myopia, which can strengthen the intensity of sclera and inhibit the progression of high myopia. The posterior scleral reinforcement materials are very important, including biological materials such as pericardium, donor sclera, umbilical cord, dura mater, acellular allograft dermis and so on; non biological synthetic materials such as polyester fiber, polyester mesh sponge and plasma-modified silicone graft and so on. These materials were used in the experimental animals and clinical patients, and showed obvious effect on controlling the progress of high myopia.
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In order to improve the accuracy and efficiency of automatic seizure detection, the paper proposes a method based on improved genetic algorithm optimization back propagation (IGA-BP) neural network for epilepsy diagnosis, and uses the method to achieve detection of clinical epilepsy rapidly and effectively. Firstly, the method extracted the linear and nonlinear features of the epileptic electroencephalogram (EEG) signals and used a Gaussian mixture model (GMM) to perform cluster analysis on EEG features. Next, expectation maximization (EM) algorithm was used to estimate GMM parameters to calculate the optimal parameters for the selection operator of genetic algorithm (GA). The initial weights and thresholds of the BP neural network were obtained through using the improved genetic algorithm. Finally, the optimized BP neural network is used for the classification of the epileptic EEG signals to detect the epileptic seizure automatically. Compared with the traditional genetic algorithm optimization back propagation (GA-BP), the IGA-BP neural network can improve the population convergence rate and reduce the classification error. In the process of automatic detection of epilepsy, the method improves the detection accuracy in the automatic detection of epilepsy disorders and reduced inspection time. It has important application value in the clinical diagnosis and treatment of epilepsy.
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Objective To analyze the characteristics of pain in children with spastic and dyskinetic cerebral palsy,and to explore the influence of pain on the functional independence and rehabilitation. Methods A self-made Pain Questionnaire for Children with Cerebral Palsy was used to conduct a questionnaire survey on 125 children who were diagnosed as spastic and dyskinetic cerebral palsy from January to October,2017,and the returned questionnaires were analyzed.According to the pain questionnaires,the subjects were divided into pain group(n=40)and no pain group(n=85).Then,15 cases of spastic cerebral palsy and 15 cases of dyskinetic cerebral palsy were selected in each group.Both of them received routine rehabilitation.They were assessed with Gross Motor Function Measure-88(GMFM-88),Fine Motor Function Measure(FMFM)and Wee Functional In-dependence Measure(WeeFIM),and the adductor angle,popliteal angle and foot dorsiflexion angle were record-ed before,and four weeks and eight weeks after treatment. Results The pain characteristics of spastic and dyskinetic cerebral palsy were different.Four weeks and eight weeks af-ter treatment,all the indexes improved in both groups(P<0.01).There was no significant difference in all the in-dexes before and four weeks after treatment between two groups (t<1.732, P>0.05), however, all the indexes were significantly better in the no pain group than in the pain group eight weeks after treatment (t>2.119, P<0.05). Conclusion The pain characteristics are different in children with spastic and dyskinetic cerebral palsy.The pain may af-fect their rehabilitation and functional independence.
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Objective To assess the outcomes of OASIS iris expander in phacoemulsification surgery of cataract with small pupil.Methods A prospective case-control study was conducted in 22 microcoria cataract patients (22 eyes).And they were randomly divided into group A and B,in which the pupils of group A were dilated by tearing instruments in 13 eyes,and the pupils of group B were dilated using OASIS iris expander in 9 eyes.All patient underwent phacoemulsification with 3.2 mm clear corneal incision and were followed up at postoperative 1 week,1 month,3 months and 6 months.Finally,the best corrected visual acuity (BCVA),intraocular pressure (IOP),corneal endothelial cell counts,pupil size before and after surgery were recorded and analyzed by an independent sample t test.Results All procedures were completed successfully by the same skilled doctor.Intraocular lenses were implanted in capsule completely,and no complications occurred.At 6 months after operation,patients'BCVA in group A (0.41 ± 0.30) and group B (0.77 ± 0.23) was significantly higher than that in group A (0.17 ±0.14) and group B (0.16 ±0.14) before operation,but there was no statistical difference between the two groups (all P ＞0.05);whereas there was no significant change in the IOP of group A and B at 6 months after operation (1 kPa =7.5 mmHg) and before operation [(14.22 ±6.00) mmHg vs.(15.70 ± 5.70) mmHg)] (all P ＞ 0.05).Moreover,corneal endothelial cell counts in group A [(1486 ±718) cells · mm-2] and B [(1246 ±516)cells · mm-2] were significantly smaller than those before operation [(2498 ±564)cells · mm-2 vs.[(2424 ± 640) cells · mm-2],with no significant difference (P=0.091).The postoperative diameter of the pupil in group A [(4.00 ±0.88) mm] and group B [(4.70 ± 1.57) mm] after operation was larger than that in group A [(2.30 ±0.35)mm] and group B [(1.94 ±0.50)mm] before operation,and there was no statistical difference between the two groups (all P ＞0.05).Conclusions OASIS iris expander can help to dilate and hold pupils and does not affect the postoperative visual acuity and intraocular pressure in mlcrocoria cataract phacoemulsification.The postoperative pupils become larger,and it is necessary to pay attention to protect corneal endothelial cell during usage of OASIS iris expander.
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Objective To investigate the correlation of wavefront aberration and myopic development in school-age children.Methods Together 150 school-age children (300 eyes) in Beijing city were collected and underwent cycloplegic refractometry for detect the refraction status and Allegretto wavefront aberrometry for the measurement of wavefront aberration for 1-year follow up.Results Totally 132 children were successfully followed up and only 120 children were included in this study.The average increased diopter was (0.74 ± 0.55) D.It was found that the development of myopia was correlated with age,myopic duration and the baseline diopter (all P ＜ 0.01),and the wavefront aberration was correlated with age (P ＜ 0.05).There were significant difference in the third order RMS value and C7 (coma) between the myopic children with rapid progress and slow progress.C12 (spherical aberration) was significantly correlated with the change of diopter (P ＜ 0.05).Conclusion Both third order RMS and C7 (coma) may be the major contributors for myopia progress in school-age children,and the increased diopter may polarize the spherical aberration toward minus values.
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Objective To investigate the differential expression of miR-207 in urine samples and kidney of rat renal fibrosis (renal fibrosis, RF) model and its function was investigated. Methods The rats were divided into two groups,including one undergoing ligation of the right ureter as UUO rat model,the other just under going the same surgery but no ligation for the ureters and as a shamed rat model.Real-time PCR(RT-qPCR) was used to detect the expression of miR-207 in kidney and urine of rat renal fibrosis model. The function of miR-207 was investigated with transfection of miR-207 mimics and inhibitor to the rat renal tubular epithelial NRK-52E cells. Results miR-207 expression in urine and kidney tissues of rat renal fibrosis model was upregulated(P＜0.05). miR-207 in-creased the expression of gene related to fibrosis in rats renal tubular epithelial NRK-52E cells. Conclusions miR-207 may play an important role in renal fibrosis and provide a potential method for the diagnosis of renal fibrosis.
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Objective To investigate the differentially expressed genes of urine samples from renal fibrosis model and carry out bioinformatics analysis.Methods Rat renal fibrosis model was constructed with the method of unilateral ureteric obstruction.Urine were collected from the rats with unilateral obstructive nephropathy and sham group, respectively.Total RNA was extracted and sequencing library was established.Differential expression mRNA were analyzed by GO and KEGG pathway.Known pre-miRNA were detected and novel lncRNA family were classified.Results Compared with the sham group urine, 813 up-regulated mRNA/lncRNA and 213 down-regulated mRNA/lncRNA were collected from the urine of renal fibrosis rats.Conclusions There are significant differential expression profile in urine samples between renal fibrosis rat group and the shame group.With high-throughput transcriptome sequencing and bioinformatics analysis, the exciting possibility was raised for better understanding renal pathologies and development of new diagnostic biomarkers.
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<p><b>OBJECTIVE</b>To study clinical efficacy of autologous bone graft for acetabular defect of Crowe III and IV hip dysplasia.</p><p><b>METHODS</b>The 22 patients with 25 hips of DDH (Crowe type III, IV) from March 2010 to May 2013 were retrospectively analyzed. Total hip arthroplasty (THA) combined autogenous bone grafting was performed for all these patients with osteoarthritis secondary to DDH. Among them, 19 patients were females (21 hips) and 3 patients were males (4 hips), ranging in age from 43 to 67 years old, averaged 55 years old. There were 6 hips with Crowe type III and 19 hips with Crowe type IV. Before surgery, all the patients had hip pain, limb shortening and hip limited function of hip joint. After 12 months, the degree of recovery about limb length, functional recovery, autogenous bone graft fusion were observed.</p><p><b>RESULTS</b>All the patients were followed up and no dislocation were occurred. At 12 months after operation, the average Harris hip joint llzncation score were 83.30±6.13, and 18 cases got an excellent result and 4 good. The length of lower limbs decreased from preoperative (3.20±0.81) cm to 12 months after operation (0.92±0.23) cm (t=14.864, P<0.05).</p><p><b>CONCLUSION</b>THA combined with structural femoral head autograft for patients with osteoarthritis secondary to DDH can obtain favorable results, significantly improving the effect of operation treatment.</p>
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Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Acetábulo , Cirugía General , Artroplastia de Reemplazo de Cadera , Cabeza Femoral , Trasplante , Luxación Congénita de la Cadera , Cirugía General , Osteoartritis , Cirugía General , Trasplante AutólogoRESUMEN
<p><b>OBJECTIVE</b>To observe clinical efficacy of renovation stem revision femoral head arthroplasty for the treatment of unstable intertrochanteric fracture in the elderly.</p><p><b>METHODS</b>Totally 32 elderly patients with unstable intertrochanteric fracture were treated with renovation stem revision femoral head arthroplasty from September 2007 to January 2011. There were 11 males and 21 females with an average age of 83.8 (ranged, 80 to 98) years old,the time from injury to hospital ranged from 4 h to 14 days. According to Evans-Jensen classification, 6 cases were type II a, 20 cases were type II b, and 6 cases were type III. Postoperative mortality, complication rates and Harris hip function score were compared and analyzed to evaluate curative effect.</p><p><b>RESULTS</b>All patients were followed up and no dislocation occurred. Six patients were died during 15 months and 4.5 years; 24 cases recoved to independent wakling at 6 months after operation, and 8 cases walked with stick and walker. The average Harris hip joint function score were (91.56 +/- 2.96), 28 cases got excellent results and 4 cases good. Nine cases occurred complications and healed after treatment.</p><p><b>CONCLUSION</b>Renovation stem revision femoral head arthroplasty is a active and reliable method in treating unstable intertrochanteric fracture in the elderly.</p>