Stereoscopic reconstruction in adults with intermittent exotropia after surgery / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To investigate the status of stereoscopic reconstruction in adults with intermittent exotropia after surgery, and analyze related influencing factors.METHODS: A retrospective study was conducted among 196 adults with intermittent exotropia who were admitted to our hospital from January 2019 to January 2021. All patients underwent strabismus surgery, and their preoperative and postoperative data were collected.RESULTS: Near and distal stereo visual function was not found in all the included 196 patients before surgery. The reconstruction rates of near stereo visual function and distal stereo visual function were 52.6%(103/196)and 50.5%(99/196), respectively. There were significant differences in surgical age, age of onset, course of disease, and postoperative level of horizontal strabismus between patients with near stereoscopic reconstruction(103 cases)and those without reconstruction(93 cases; P<0.001). Multivariate Logistic regression analysis showed that age of onset, course of disease, and postoperative level of horizontal strabismus were factors influencing near stereo visual function reconstruction(P<0.05). The receiver operating characteristic(ROC)curve showed that the area under the curve(AUC)values of age of onset, course of disease and postoperative level of horizontal strabismus to predict near stereo visual function reconstruction were 0.757, 0.737 and 0.727, respectively(P<0.001). There were significant differences in surgical age, age of onset, course of disease, and postoperative level of horizontal strabismus between patients with distal stereoscopic reconstruction(99 cases)and those without reconstruction(97 cases; P<0.001). Multivariate Logistic regression analysis showed that age of onset and course of disease were factors influencing distal stereo visual function reconstruction(P<0.05). ROC curve showed that the AUC values of age of onset and course of disease to predict distal stereo visual function reconstruction were 0.672 and 0.821, respectively(P<0.001).CONCLUSION: Stereoscopic reconstruction in adults with intermittent exotropia after surgery is affected by many factors, such as age of onset and course of disease. The influencing factors of near stereo visual function reconstruction and distal stereo visual function reconstruction are different, which deserves attention.

Reconstruction effect of postoperative visual training on visual function in children with intermittent exotropia / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM:To investigate the effect of visual training on the reconstruction of visual function in children with intermittent exotropia. <p>METHODS: A total of 94 children with intermittent exotropia diagnosed in our hospital from August 2016 to January 2019 were selected and 94 eyes were affected. According to whether the postoperative visual training was divided into two groups, 47 patients(47 affected eyes)were not visually trained after operation and were included in the control group; 47 patients(47 affected eyes)were visually trained 2wk after operation and were included in the observation group. Follow-up for 6mo was performed to observe the recovery of visual function and eye position regression.<p>RESULTS: Six months after surgery, the proportion of children in the observation group with simultaneous visual function(89%), fusion function(85%)and stereoscopic function(40%)was significantly higher than that in the control group(53%, 47%, 19%), and the orthotopic rate of children in the observation group was significantly higher than that in the control group(91% <i>vs</i> 66%).<p>CONCLUSION: The binocular visual function training after intermittent exotropia in children can promote the recovery of binocular visual function and reduce the risk of postoperative eye position regression.

Analysis of clinical effects of artificial dermis in functional reconstruction in the late stage of extremely severe burn / 中华烧伤杂志

Objective@#To explore the clinical effects of artificial dermis combined with autologous split-thickness skin transplantation in the treatment of functional reconstruction in the late stage of extremely severe burn.@*Methods@#From May 2015 to May 2017, medical records of 40 patients with limited activity after scar hyperplasia and conforming to the study criteria, injured in August 2nd Kunshan factory aluminum dust explosion accident in 2014, and had surgeries in our hospital and rehabilitation treatment in our hospital′s alliance rehabilitation hospital, Rehabilitation Hospital of Kunshan Zhou City, were retrospectively analyzed. According to the treatment methods, 20 patients (12 males and 8 females, aged 20 to 45 years) were enrolled in artificial dermis group. They were conducted with stage Ⅰ functional site scar loosening and artificial dermis (PELNAC) implanting+ stage Ⅱ transplantation of autologous split-thickness skin. Another 20 patients (14 males and 6 females, aged 20 to 45 years) were enrolled in conventional skin grafting group. They were conducted with stage Ⅰ functional site scar loosening and transplantation of autologous thin medium-thickness skin. After 5 days of autologous skin transplantation, the survival rates of autologous skin in patients of 2 groups were calculated. The autologous skin infection and complete healing time of skin grafting area in patients of 2 groups were recorded. In 3, 6, and 10 months after autologous skin transplantation, the Vancouver Scar Scale (VSS) was used to assess the scar condition of recipient site in patients of 2 groups. The complete healing time of donor site in patients of 2 groups was recorded. In 10 months after autologous skin transplantation, VSS was used to assess the scar condition of donor site in patients of 2 groups. In 12 months after autologous skin transplantation, the functional recovery of surgical function reconstruction site in patients of 2 groups was evaluated and rated. Data were processed with t test, analysis of variance for repeated measurement, Wilcoxon rank-sum test, chi-square test, Fisher′s exact probability test, and Bonferroni correction.@*Results@#(1) After 5 days of autologous skin transplantation, the survival rate of autologous skin in patients of artificial dermis group was (95±3)%, similar to (93±3)% in conventional skin grafting group (t=1.262, P>0.05). The results of autologous skin infection of patients in the 2 groups were similar (P>0.05). (2) After autologous skin grafting, the complete healing time of skin grafting area in patients of artificial dermis group was (12.3±2.5) d, similar to (12.7±2.0) d of conventional skin grafting group (t=-0.139, P>0.05). In 3, 6, and 10 months after autologous skin transplantation, the VSS scores of scars in recipient site of patients in artificial dermis group were significantly lower than those of conventional skin grafting group (t=-4.428, -5.655, -6.839, P<0.01). (3) After autologous skin grafting, the complete healing time of donor site in patients of artificial dermis group was obviously shorter than that in conventional skin grafting group (t=-12.435, P<0.01). In 10 months after autologous skin transplantation, the VSS score in donor site of patients in artificial dermis group was significantly lower than that of conventional skin grafting group (t=-16.971, P<0.01). (4) After 12 months of autologous skin transplantation, the functional improvement levels of the functional site of patients in artificial dermis group were good in 4 patients, fair in 15 patients, and bad in 1 patient, while the functional improvement levels of the functional site of patients in conventional skin grafting group were good in 5 patients, fair in 8 patients, and bad in 7 patients. The functional improvement levels of the functional site of patients between the two groups were similar (Z=371.5, P>0.05).@*Conclusions@#Compared with conventional stage Ⅰ functional site scar loosening and transplantation of autologous thin medium-thickness skin, stage Ⅰ functional site scar loosening and artificial dermis implanting+ stage Ⅱ transplantation of autologous split-thickness skin does not affect the survival of skin in the early stage and can effectively improve functional site function, reduce VSS scores of donor site and recipient site, and shorten complete healing time of donor site.

Experimental study on repairmen of high deep peroneal nerve injury by nerve transposition methods using different proximal tibialnerve muscular branches / 中华显微外科杂志

Objective To study the effect of using different tibial nerve proximal muscle branchs to repair deep peroneal nerve injury in animal experiment, and to screen out the most optimal donor nerve branch. Methods From June, 2016 to August, 2016, 64 adult female SD rats were randomly divided into 4 groups, which were LHG (using lateral head of gastrocnemius to repair peroneal nerve), MHG(using medial head of gastrocnemius to repair peroneal nerve), SNB (using soleus nerve branch to repair peroneal nerve), and blank. There were16 rats in each group. At 4 and 8 weeks after surgery, each group were tested on behavior, electrophysiology, muscle tension, muscle wet weight and histology, to evaluate function recovery of the muscles controlled by deep peroneal nerve in each group, and to compare recovery of the deep peroneal nerve repaired by different tibial nerve branches. Results Eight weeks after surgery,right foot of the rats in LHG,MHG and SNB group can be extended,toes can be completely opened. Rats in blank group showed limping gait, whose right foot can not be extended, right toe can not be opened, and muscle atrophied. At 4 and 8 weeks after the operation, the recovery rate of LHG, MHG, SNB group (at 4th weeks, 33.60 ±2.22)%, 33.07 ±2.38% and 35.91 ±2.02%; at 8th weeks, 67.16 ±5.74)%, 66.56 ±3.18% and 73.17 ± 5.33%, respectively)was higher than blank group(7.71±1.05% and 7.84±0.78%, respectively)on CMAP amplitude, tibialis anterior muscle contractility, tibialis anterior muscle cell area, muscle cell area. SNB group was superior to the LHG group and LHG group.And the difference was statistically significant(P<0.05). Conclusion All the proxi-mal tibial nerve muscle branchs can be used to repair the deep peroneal nerve injury, and the soleus nerve branch is the preferred donor nerve.

Observation on postoperative binocular visual function reconstruction in intermittent exotropia children with binocular visual training / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To investigate postoperative binocular visual function reconstruction in intermittent exotropia children with binocular visual training. <p>METHODS: The clinical data of 108 cases of intermittent exotropia children admitted to our hospital from April 2013 to April 2016 were retrospectively analyzed. Among them, 45 cases with binocular visual function training were included in the control group; the other 63 cases with TSJ-IV synoptophore training software for binocular vision training were included in the observation group. The binocular visual function reconstruction and eye position regression of the two groups were observed. <p>RESULTS: Baseline data of binocular visual function and strabismus in two groups had no significant difference before surgery(<i>P</i>>0.05). At 3mo after operation, the visual function of grade three in the observation group was significantly improved, and the proportion of simultaneous vision, visual fusion and stereopsis in the observation group were significantly higher than those in the control group(<i>P</i><0.05). The proportion of patients with macular stereopsis and foveal stereopsis in the observation group was significantly higher than that in the control group, and the proportion of patients without stereopsis in the observation group was significantly lower than that in the control group, and the difference was statistically significant between groups(<i>P</i><0.05). At 3mo after operation, the proportion of strabismus ≤30^△ in the observation group was significantly higher than that in the control group, with statistical significance(<i>P</i><0.05). In addition, the eye position regression rate of the observation group was significantly lower than that of the control group in the postoperative 1a follow-up, and there was significant difference between the two groups(<i>P</i><0.05). <p>CONCLUSION: The children with intermittent exotropia taking postoperative synoptophore training can promote binocular visual function reconstruction, ameliorate the degree of strabismus, and avoid postoperative eye recession.

Survey on Awareness of Upper Limb Function Reconstruction in Patients with Cervical Spinal Cord Injury / 中国康复理论与实践

@#Objective To survey the attitudes and acceptance level of upper limb function reconstruction in patients with cervical spinal cord injury and analyze the related factors. Methods From October, 2013 to June, 2014, a total of 104 patients with cervical spinal cord injury were surveyed with self-designed questionnaire. Results There were 81 valid questionnaires, in which 3 patients (3.7%) heard of upper-extremity reconstructive surgery. The patients longed for upper limb function improvement most. After they had a understanding of the surgery, their willingness improved (P<0.01). No significant difference was found in the satisfaction degree and operation willingness between different hand function groups (P>0.05). The patients focused on the operation cost, the operation risk, recovery time after operation and the satisfaction of assistive devices, however, they were not correlated with the willingness of upper limb function reconstruction (P>0.05). Conclusion There is a clear gap between strong desire for functional improvement of upper limb and surgery awareness. It is important to communicate upper limb among patients with cervical spinal cord injury.

Application of Diaphragm Pacing Technology in Respiratory Function Reconstruction in Patients with Cervical Spinal Cord Injury (review) / 中国康复理论与实践

@#The incidence of spinal cord injury is becoming higher and higher, of which more than half are cervical spinal injury. The main cause of death in high cervical spinal injury is respiratory function failure. The patients who survived must rely on ventilators to sustain life. In view of the shortcomings of ventilators, many researchers tried to use diaphragm pacing technology instead of ventilator to reconstruct the function of respiratory. This article introduced the application of diaphragm pacing technology in patients with cervical spinal injury.

Application of Diaphragm Pacing Technology in Respiratory Function Reconstruction in Patients with Cervical Spinal Cord Injury (review) / 中国康复理论与实践

The incidence of spinal cord injury is becoming higher and higher, of which more than half are cervical spinal injury. The main cause of death in high cervical spinal injury is respiratory function failure. The patients who survived must rely on ventilators to sus-tain life. In view of the shortcomings of ventilators, many researchers tried to use diaphragm pacing technology instead of ventilator to re-construct the function of respiratory. This article introduced the application of diaphragm pacing technology in patients with cervical spinal injury.

Perioperative Rehabilitation Nursing of Thoracic Breathing Reconstruction for Cervical Spinal Cord Injury / 中国康复理论与实践

@#Objective To summarize experience of nursing for thoracic breathing reconstruction in patients after cervical spinal cord in-jury (CSCI). Methods 6 cases accepting thoracic breathing reconstruction in our hospital from March 2013 to June 2014 were reviewed from 1 week before operation to 4 weeks after operation. Results All the patients, aged (41.7 ± 16.2) years, received tracheotomy (6.0 ± 5.8) days after injury because of weakened cough, retention of respiratory secretions and dyspnea;the ventilator was used for (45.3±25.9) days, and they received thoracic breathing reconstruction surgery (84±26.7) days after injury. Their vital capacity was (1085±92) ml before opera-tion and was (1680±283) ml 2 weeks after operation with 55%increment (P<0.01). Only 1 patient underwent a delayed wound healing. No pulmonary infection, urinary tract infections and pressure sore occurred until 4 weeks after operation. Conclusion Enhancement of airway care and prevention of pressure sore are the keys to reduce postoperative complications of thoracic breathing reconstruction.

Using the extensor carpi ulnaris as the motor tendon in reconstruction of ulnar nerve palsy / 中华显微外科杂志

Objective To investigate the efficacy of using the extensor carpi ulnaris as the motor tendon in correcting claw hand deformity and improving hand function.Methods A total of 12 patients with ulnar nerve palsy and claw finger deformity were included into this study from October, 2009 to September, 2011.Results All ceses had an average followed-up of 15.5 months, ranging from 12 months to 24 months.According to the Total Active Movement (TAM) score, there were 4 cases receiving excellent results, 6 cases receiving good results and 2 cases receiving fair results.The claw finger deformity was corrected and intrinsic hand function improved significantly.The average increase in grip strength was 41％ at the 12 months post operation, compared with the preoperative data (P ＜ 0.05).The mean DASH score decreased from 53.6 ± 11.4 preoperatively to 20.4 ± 6.8 postoperatively (P ＜ 0.05).Conclusion The technique of using the extensor carpi ulnaris as the motor tendon is effective in correcting claw fingers, increasing the grip strength and improving overall hand function.This surgical procedure is also beneficial for patients accompanied by the median nerve injury.

Application of Diaphragm Pacing Technology in Respiratory Function Reconstruction in Patients with Cervical Spinal Cord Injury (review) / 中国康复理论与实践

@#The incidence of spinal cord injury is becoming higher and higher, of which more than half are cervical spinal injury. The main cause of death in high cervical spinal injury is respiratory function failure. The patients who survived must rely on ventilators to sustain life. In view of the shortcomings of ventilators, many researchers tried to use diaphragm pacing technology instead of ventilator to reconstruct the function of respiratory. This article introduced the application of diaphragm pacing technology in patients with cervical spinal injury.

Function Reconstruction of Lower Extremities of Patients with Spinal Cord Injury:Orthosis,Functional Electrical Stimulation and Surgical Treatment (review) / 中国康复理论与实践

@#Patients with spinal cord injury(SCI)required higher level of quality of life(QOL),in fact,the disorder of lower limbs motion is the major factor which restricted the independence of social involvement.Routine rehabilitation training,lower extremity orthosis,functional electrical stimulation(FES)and the combined application of those are still the widely used approaches.Meanwhile,the auto-nerve transferring and auto-tendon operation are also the fields that researchers focus on.In practice,we have to choose proper method individually according to the patients' conditions to restore the lower limbs function,so as to improve the QOL.

Reconstruction of neuron synapses is involved in the function reestablishment of rat neuroimmunoreglation network / 基础医学与临床

Objective To reestablish neuroimmunoregulation network and its function.Methods Whole-some gene array was used to analyze the gene expression involved in neuroimmunoregulation function of the lateral hypothalamic(LH) in rats at different immunizational time.The function trees of different genes were analysed with the PathWay Miner public database.Results 632 genes were differentially expressed: including 374 of 2-day immunized group,62 of 4-day immunized group and 196 of 6-day immunized group.Function signal pathway analysis for 398 up-regulated genes showed 27 genes were involved in 31 cell functional signal conduction pathways,including the well-known signal conduction pathways of synaptic reconstruction.Conclusion Synapses reconstruction appears to be the important pattern of functional reestablishment of neuroimmunoregulation network.