A 22-G or a 25-G Needle: Which One to Use in the Diagnostics of Solid Pancreatic Lesions? A Systematic Review and Meta-Analysis.

With the 12th highest incidence and a common late diagnostic at advanced stages, neoadjuvant therapies for pancreatic cancer are important, but they require a confirmed diagnosis. Being a diagnostic standard, the clarification of the clinical relevance of needle gauges is needed, as larger ones may retrieve more tissue for diagnostics, but may also increase the risk of complications. We performed a meta-analysis to compare the efficiency of the most commonly used 22-G and 25-G needles for EUS guided biopsy in solid pancreatic lesions. The MEDLINE (via PubMed), Embase, Cochrane (CENTRAL), and Scopus databases were searched with "EUS", "needle", "FNA", "pancreas", "prospective", "22G", and "25G" keywords. Mixed effects were assessed in the model, with a mean of 86% and a 95% confidence interval. Fourteen prospective studies that compared the efficiency of 22-G and 25-G biopsy needles in 508 and 524 lesions, respectively, were analyzed, along with 332 specimens biopsied using both needle sizes. The groups did not significantly differ in the outcomes. A low degree of heterogeneity was observed overall, except for specimen adequacy. Moreover, 22-G and 25-G needles have comparable safety and efficacy for focal pancreatic lesion biopsies without a high risk of complications.

Validation of the German version of the 25-item hikikomori questionnaire 25.

OBJECTIVES: The 25-item Hikikomori Questionnaire (HQ-25) is an instrument developed to measure a condition characterized by extreme social withdrawal that was first described in Japan. This study aimed to translate the HQ-25 into German and validate the German version (HQ-25-G). METHODS: Translation was conducted according to established guidelines. Validation was based on data from a quota sample of individuals living in Germany, ranging from 18 to 74 years old (representing the distribution of age, sex and federal state, n = 5000). Data collection occurred during August and September 2023. We tested reliability, construct validity and concurrent validity. Moreover, HQ-25 scores for key sociodemographic group were reported. RESULTS: Internal reliability for the HQ-25-G was excellent (Cronbach's alpha = 0.93). We confirmed the original three-factor model. Moreover, higher hikikomori levels were significantly associated with more depressive symptoms (r = 0.50), more anxiety symptoms (r = 0.45), higher loneliness levels (r = 0.56), higher levels of objective social isolation (r = -0.47), higher levels of perceived social isolation (r = 0.59) and a higher preference for solitude (r = 0.45). CONCLUSIONS: In a large population-based sample (including younger adults, middle-aged adults and older adults), the HQ-25-G version proves to be a psychometrically robust instrument, which is useful for further exploring the phenomenon of hikikomori within the German-speaking population.

Visual outcome of 25 Gauge vitrectomy for acute post operative infectious endophthalmitis.

BACKGROUND: The correlation between the change in foveal thickness measured using optical coherence tomography (OCT) following surgery for infectious endophthalmitis and preoperative and postoperative visual acuity is uncertain, and there are few pertinent studies on this topic. OBJECTIVE: We explored the variations in macular thickness using OCT after emergency vitrectomy for post-cataract infectious endophthalmitis and the relationship between macular thickness with changes in visual function. METHODS: We included 10 cases of post-cataract infectious endophthalmitis. Each patient underwent 25-G vitrectomy. RESULTS: The infection in all 10 patients was under control and visual function improved. Postoperative vitreous humor culture was positive in 8 patients, including 7 cases of coagulase-negative Staphylococcus epidermidis and 1 case of Lactobacillus acidophilus. The average age of these 10 patients was 71.60 ± 8.71 years (P< 0.05, two-tailed). There was no significant correlation between time 2 (the time of onset after cataract surgery) and visual prognosis. The average time 1 (the time of the vitrification surgery caused by the onset of the disease) was 1.45 ± 0.76 days (P< 0.05, two-tailed). The postoperative 3dVA ranged from 0.20 to 3.00, with an average visual acuity of 1.87 ± 1.12, which was superior to the preoperative value (P< 0.01, two-tailed). The correlation between the post3dVA and post 1mVA was significant. The post 1mVA ranged from 0.05 to 2.20, with an average visual acuity of 0.94 ± 0.74 (P< 0.05, two-tailed). The correlation between post 1mVA and post3mVA was significant. Also, paired t-tests comparing preoperative and postoperative visual acuity revealed a significant correlation (P< 0.05, two-tailed). The post3mVA was 0-1.00 with an average visual acuity of 0.44 ± 0.41. The postoperative foveal thickness ranged from 176.00 to 514.00 µm, with an average thickness of 281.10 ± 113.12 µm. CONCLUSION: Emergency 25-G minimally invasive vitrectomy can improve visual acuity and decrease the reoperation rate for patients who have acquired post-cataract infectious endophthalmitis. There were significant correlations between age, disease onset to operation time, preoperative and postoperative visual acuity, and postoperative macular thickness.

Effect of Thermal Exposure on Microstructure Evolution and Mechanical Properties of TC25G Alloy.

The microstructure and room temperature tensile properties of heat-treated TC25G alloy after thermal exposure were investigated. The results show that the α2 phase dispersed in the α phase, and silicide precipitated firstly at the α/ß phase boundary and then at the dislocation of the αp phase and on the ß phase. When thermal exposure was 0-10 h at 550 °C and 600 °C, the decrease of alloy strength was mainly due to the dominant effect of dislocations recovery. With the rise and extension of thermal exposure temperature and time, the increasing quantity and size of precipitates played an important role in the improvement of alloy strength. When thermal exposure temperature rose to 650 °C, the strength was always lower than that of heat-treated alloy. However, since the decreasing rate of solid solution strengthening was smaller than the increasing rate of dispersion strengthening, alloy still showed an increasing trend in the range of 5-100 h. When thermal exposure time was 100-500 h, the size of the α2 phase increased from the critical value of 3 nm to 6 nm, and the interaction between the moving dislocations and the α2 phase changed from the cutting mechanism to the by-pass mechanism (Orowan mechanism), and thus alloy strength decreased rapidly.

Efficacy of preoperative intravitreal injection of Conbercept combined with 25G+ pars plana vitrectomy in the treatment of proliferative diabetic retinopathy / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To explore the efficacy of preoperative intravitreal injection of conbercept combined with 25G+ pars plana vitrectomy(PPV)in the treatment of proliferative diabetic retinopathy(PDR).METHODS: The clinical data of 154 patients(176 eyes)with PDR admitted to our hospital from January 2019 to June 2021 were collected for retrospective analysis. According to the treatment methods, 80 patients(92 eyes)in combined treatment group were treated with preoperative intravitreal injection of conbercept combined with 25G+PPV, and 74 patients(84 eyes)in control group were given 25G+PPV only. The postoperative clinical efficacy and levels of adipokines [adiponectin(APN), retinol binding protein 4(RBP4)] before and after surgery were compared between both groups of patients.RESULTS: The combined treatment group showed better clinical efficacy than the control group at 1mo after surgery(P&#x003C;0.05). Both groups had lower RBP4 levels at 3mo after surgery(P&#x003C;0.05), with the combined treatment group showing a lower level than the control group(P&#x003C;0.05). Serum APN levels significantly increased in both groups after surgery(P&#x003C;0.05), with the combined treatment group having a higher level than the control group(P&#x003C;0.05). The combined treatment group had lower incidence rates of retinal proliferation and postoperative complications after than the control group 3mo of follow-up(P&#x003C;0.05).CONCLUSION: Preoperative intravitreal injection of conbercept combined with 25G+PPV is beneficial in improving the therapeutic effect of PDR and reducing the incidence rates of complications, which may be related to the regulations of the expressions of adipokines.

Immobilized BiOCl0.75I0.25/g-C3N4 nanocomposites for photocatalytic degradation of bisphenol A in the presence of effluent organic matter.

The BiOCl0.75I0.25/g-C3N4 nanosheet (BCI-CN) was successfully immobilized on polyolefin polyester fiber (PPF) through the hydrothermal method. The novel immobilized BiOCl0.75I0.25/g-C3N4 nanocomposites (BCI-CN-PPF) were characterized by scanning electron microscope (SEM), energy dispersive spectroscopy EDS, X-ray powder diffraction (XRD), X-ray photoelectron spectroscopy (XPS), and UV-vis diffuse reflectance spectroscopy (UV-vis DRS) to confirm that BCI-CN was successfully immobilized on PPF with abundant oxygen vacancies reserved. Under simulated solar light irradiation, 100 % of bisphenol A (BPA) with an initial concentration of 10 mg·L-1 was degraded by BCI-CN-PPF (0.2 g·L-1 of BCI-CN immobilized) after 60 min. A similar photocatalytic efficiency of BPA was obtained in the presence of effluent organic matter (EfOM). The photocatalytic degradation of BPA was not affected by EfOM <5 mg-C/L. In comparison, the photocatalytic performance was considerably inhibited by EfOM with a concentration of 10 mg-C/L. Furthermore, photogenerated holes and superoxide radicals predominated in the photocatalytic degradation processes of BPA. The total organic carbon (TOC) removal efficiencies of BPA and EfOM were 75.2 % and 50 % in the BCI-CN-PPF catalytic system. The BPA removal efficiency of 94.9 % was still achieved in the eighth cycle of repeated use. This study provides a promising immobilized nanocomposite with high photocatalytic activity and excellent recyclability and reusability for practical application in wastewater treatment.

Simultaneous Vitreoretinal Surgery and Sclerokeratoplasty for Keratoglobus with Intraocular Hemorrhage and Extensive Corneal Rupture.

We reported a case of simultaneous vitrectomy and sclerokeratoplasty (SKP) performed for keratoglobus with extensive corneal rupture and intraocular hemorrhage caused by trauma. A 73-year-old woman was treated for keratoglobus and glaucoma. She was punched in both eyes, her right eye showed corneal rupture and the left eye showed prolapse of the ocular contents due to eyeball rupture. She immediately underwent corneal sutures in the right eye and resection of the prolapsed ocular contents in the left eye at a nearby ophthalmological clinic. Three days after the injury, the patient was referred to our clinic for vision recovery. The best corrected visual acuity of the right eye was measured by counting fingers. Her right eye presented severe corneal edema with a sutured corneal wound in the upper periphery, which was positive in the Seidel test. B-mode ultrasound revealed choroidal detachment and subchoroidal hemorrhage. Fourteen days after injury, simultaneous corneal suture and posterior sclerotomy were performed in the right eye, but corneal fragility and corneal opacity were prominent, and B-mode examination revealed prolonged vitreous hemorrhage and retinal detachment. Twenty-one days after injury, we performed simultaneous SKP and 25-G pars plana vitrectomy (PPV). In this procedure, we initially performed SKP followed by 25-G PPV without a keratoprosthesis or endoscope. The visibility of the fundus through the corneoscleral graft was good during vitrectomy. Three months after surgery, her corrected visual acuity improved to 10/1,000. Although there was mild corneal stromal edema and khodadoust line, there were no obvious fundus complications. Simultaneous SKP and PPV for keratoglobus with extensive corneal rupture and vitreous diseases may be a good option.

[25-Gauge macular surgery: comparison with and without combined phacoemulsification and artificial lens implantation]. / 25-Gauge-Makulachirurgie im Vergleich mit und ohne kombinierte Phakoemulsifikation und Kunstlinsenimplantation.

BACKGROUND: With the surgical methods continuously developed in recent years, macular surgery has become an increasingly less traumatic procedure for the eye. For patients with additional lens opacification, a 1-stage procedure with combined cataract surgery is recommended. OBJECTIVE: The aim of this retrospective study was to record the functional results and complications after elective macular surgery with and without combined phacoemulsification and artificial lens implantation. MATERIAL AND METHODS: The retrospective study included all patients who were operated on with a pars plana vitrectomy (ppV; 25 gauge) for epiretinal membrane, macular hole or vitreoretinal traction between 2010 and 2016 and who had a follow-up period of at least 3 months. The functional results and possible risk factors as well as complications that occurred were then recorded. RESULTS: A total of 781 eyes were identified of which 517 (66%) had a phacoemulsification and artificial lens implantation with a 25-gauge vitrectomy, membranectomy, ILM peeling and SF6 gas or air tamponade. The mean follow-up time was 17 months. The mean logMAR visual acuity was 0.59 preoperatively and 0.4 postoperatively. From 64 phacic eyes which did not receive a combined phacoemulsification and artificial lens implantation 40 (62.5%) required phacoemulsification and artificial lens implantation within 13.6 months due to complicated cataract, 18 even within 6 months. In terms of complications, there were comparable results between ppV alone and the combined operation, particularly with respect to an IOL dislocation or iris capture. CONCLUSION: Overall elective macular surgery is a procedure with few complications both without and above all with combined phacoemulsification and artificial lens implantation. Therefore, a combined operation makes sense in terms of surgical management and postoperative rehabilitation, especially in times of a pandemic with limited surgical resources.

Randomized trial comparing the 25G and 22G Franseen needles in endoscopic ultrasound-guided tissue acquisition from solid pancreatic masses for adequate histological assessment.

BACKGROUND: The effects of the Franseen needle size in endoscopic ultrasound-guided fine-needle biopsy (EUS-FNB) of solid pancreatic masses remain unclear. This study aimed to compare 25G and 22G Franseen needles in terms of adequate tissue acquisition from solid pancreatic masses. METHODS: In this single-center, crossover, randomized noninferiority trial, eligible patients underwent EUS-FNB with both 25G and 22G Franseen needles in a randomized order between November 2018 and August 2020. Tissue specimens from each pass were separately evaluated based on the cellularity scoring system. The primary outcome was the proportion of acquired specimens allowing adequate histological assessment (cellularity score ≥3). A -15% noninferiority margin was assumed. RESULTS: Data from 88 patients were analyzed, which showed malignant and benign lesions in 84 (95.5%) and four (4.5%) patients, respectively. Of the 88 specimens, 62 (70.5%) and 69 (78.4%) acquired using 25G and 22G needles, respectively, allowed adequate histological assessment. The adjusted proportion difference was -6.6% (95% confidence interval -8.8% to -4.5%), indicating noninferiority of the 25G Franseen needle (P < 0.001). The diagnostic accuracies of the 25G and 22G needles were 86.4% and 89.8%, respectively, with no significant difference (P = 0.180). Adverse events occurred in one patient. CONCLUSIONS: The 25G Franseen needle showed a noninferior adequate tissue acquisition and similar diagnostic performance compared to that of the 22G Franseen needle. However, a 15% noninferiority margin was high for clinical use; thus, further consideration is needed (Clinical Trial Registry no. UMIN000034596).

Clinical observation of 25G vitrectomy and phacoemulsification combined with intrascleral fixated IOL implantation for treatment of complete lens luxation / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To evaluate efficacy, safety and complications of 25G vitrectomy, phacoemulsification combined with intrascleral fixated intraocular lens(IOL)implantation for treatment of lens luxation.<p>METHODS: Totally 20 patients(20 eyes)with complete lens luxation and the hardness of lens nucleus was grade 3 or above who underwent 25G vitrectomy, phacoemulsification combined with intrascleral fixated IOL implantation between May 2018 and December 2020 were analyzed retrospectively. The uncorrected visual acuity, best corrected visual acuity, intraocular pressure, the count of corneal endothelium cell, central corneal thickness and complications were observed. <p>RESULTS: The uncorrected visual acuity and best corrected visual acuity after operation were improved than those before treatment(<i>P</i><0.05). The number of corneal endothelial cells in the central part of cornea after operation was lower than that before operation(<i>P</i> >0.05). There was no significant difference in central corneal thickness 2wk after operation compared with that before operation(<i>P</i> >0.05). There were 3 cases of low intraocular pressure and 2 cases of high intraocular pressure, but they all returned to normal at the end of follow-up. The IOL were all centered and there were no obvious eccentricity and inclination. No other complications such as vitreous hemorrhage and retinal detachment occurred.<p>CONCLUSION: 25G vitrectomy, phacoemulsification combined with intrascleral fixated IOL implantation is a fast, safe and simple method for the treatment of complete lens luxation.

Antimicrobial activity of MccJ25(G12Y) against gram-negative foodborne pathogens in vitro and in food models.

The use of bacteriocins is a promising alternative to improve food security through the biocontrol of food pathogens and spoilage microorganisms. Gram-negative produced microcin J25(G12Y), known as (MccJ25(G12Y)) is a variant of the well-studied and characterized antimicrobial peptide, microcin J25 (MccJ25). In the present work, we explored the activity of this microcin against Gram-negative bacteria linked to foodborne diseases. We evaluated the in vitro antimicrobial activity of MccJ25(G12Y) in solid medium against a collection of pathogenic and food-altering strains and studied its activity and stability in meat and dairy food systems. We show that MccJ25(G12Y) exhibited the same in vitro antimicrobial spectrum as its parental microcin (MccJ25) against different Gram-negative foodborne pathogens and spoilage strains. We highlight that low concentrations of MccJ25(G12Y) between 0.45 and 29.4 µM were able to inhibit a substantial number of pathogens, including Salmonella, Escherichia, Shigella and Enterobacter genus. We also demonstrate the antimicrobial effectiveness of the peptide against Escherichia coli O157:H7 NCTC 12900, Enterobacter cloacae CECT 194, and Salmonella enterica CECT 4396 in fish and beef burgers and yogurt. MccJ25(G12Y) was added or not to food matrices inoculated with the foodborne pathogens at 105 CFU/g or mL. Afterward, food products were stored at 4 °C and selective media for the specific enumeration were used to determine the antimicrobial susceptibility of each pathogen to MccJ25(G12Y). The viability of the three pathogens was significantly reduced in the different food biological environments. In yogurt, the peptide decreased E. coli numbers on day 5 by about 4 log 10 CFU/mL as compared to non-treated samples. For S. enterica and E. cloacae no viable cells were detected at the end of the treatment. Adding MccJ25(G12Y) to fish burgers decreased E. cloacae numbers during storage 2 log10 CFU/g on the first day, reaching a difference of about 5 log 10 CFU/g after 10 days compared to non-treated control. Finally, the peptide decreased E. coli O157:H7 numbers on the beef burgers samples during storage on day 10 by about 3 log 10 CFU/g as compared to non-treated samples. The stability analysis demonstrated that MccJ25(G12Y) is capable of remaining active in these food matrices for a considerable time during the storage at refrigeration temperatures. These results reinforce the studies on the potential applicability of this microcin as a biopreservative in the food industry.

A randomized noninferiority trial comparing the diagnostic yield of the 25G ProCore needle to the standard 25G needle in suspicious pancreatic lesions.

BACKGROUND AND OBJECTIVES: The aim of the study was to perform the first randomized trial comparing the diagnostic yield, bloodiness, and cellularity of the 25G standard needle (25S) and the 25G ProCore™ needle (25P). MATERIALS AND METHODS: All patients referred to the tertiary care referral center for EUS guided fine-needle aspiration (EUS-FNA) of suspicious solid pancreatic lesions were eligible. EUS-FNA was performed in each lesion with both 25S and 25P needles (the choice of the first needle was randomized), using a multipass sampling pattern, without stylet or suction. Rapid on-site evaluation was used when possible. Pap-stained slides were read by a single experienced cytopathologist, blinded to the needle type. RESULTS: One hundred and forty-three patients were recruited. Samples were positive for cancer in 122/143 (85.3%) with the 25S needle versus 126/143 (88.1%) with the 25P needle, negative in 17/143 (11.9%) with the 25S needle versus 13/143 (9.1%) with the 25P needle, and suspicious in 4/143 (2.8%) with each needle. There was no difference in any outcome based on the type of the first needle. No carryover effect was detected (P = 0.214; NS). Cumulative logistic regression analyses showed no associations between the type of needle and diagnostic yield for cancer, cellularity, or bloodiness. The difference in the yield for cancer was 2.9% (-4.2; 10.1%); with the confidence interval upper within the predetermined noninferiority margin of 15%. CONCLUSION: The 25S needle is noninferior to the 25P needle for diagnosing cancer in suspicious pancreatic lesions.

25G lens resection combined with anterior vitrectomy in the treatment of congenital cataract / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To observe the clinical efficacy of 25G lens resection combined with anterior vitrectomy in the treatment of congenital cataract.<p>METHODS: This retrospective case series study included 55 eyes of 38 children with congenital cataract, age from 3mo to 5 years old, who were recruited between May 2013 and August 2017. The children were divided into two groups according to the different surgical methods. Group A(25 eyes of 17 children)received a 25G sutureless lensectomy combined with capsulotomy and anterior vitrectomy, and group B(30 eyes of 21 children)received a cataract phacoemulsification combined with capsulotomy and anterior vitrectomy. The mean follow-up time was 43.4(range: 36-74)mo. The postoperative best corrected visual acuity(BCVA), axial length, and complications were compared. <p>RESULTS: The age, sex distribution, duration, preoperative BCVA, and preoperative axial lengths were not significantly different between the two groups(<i>P</i>>0.05). The BCVA improved significantly at postoperative compared with BCVA at baseline in both gorups(Group A: <i>P</i><0.001; Group B: <i>P</i><0.001). The BCVA was better in Group A than Group B at 6mo postoperatively(<i>P</i>=0.043). No statistically significant difference was found in BCVA between the two groups at 12, 24 and 36mo after initial treatment(<i>P</i>=0.727, <i>P</i>=0.286, <i>P</i>=0.889). No statistically significant difference was found in axial lengths between 6mo of postoperation and preoperation in both groups(Group A: <i>P</i>=0.206, Group B: <i>P</i>=0.082). The mean postoperative axial lengths at 12, 24 and 36mo were longer than that at baseline in both group(Group A: <i>P</i>=0.023, <i>P</i>=0.015, <i>P</i><0.01, Group B: <i>P</i>=0.018, <i>P</i><0.01, <i>P</i><0.01). There were no significantly different in mean axial length after operation between the two groups(6mo: <i>P</i>=0.195, 12mo: <i>P</i>=0.313, 24mo: <i>P</i>=0.485, 36mo: <i>P</i>=0.089). The rate of postoperative complications was lower in Group A than Group B(<i>P</i>=0.042).<p>CONCLUSION: 25G sutureless lensectomy combined with capsulotomy and anterior vitrectomy is an effective and safe treatment method for congenital cataract, the visual acuity after treatment was improved significantly.

Efficacy of Conbercept combined with vitrectomy in the treatment of PDR and influencing factors of postoperative rehaemorrhage / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To observe the clinical effect of conbercept combined with 25G minimally invasive vitrectomy in the treatment of proliferative diabetic retinopathy(PDR), and analyze the influencing factors of postoperative vitreous rehaemorrhage.<p>METHODS: Totally 179 eyes of 179 PDR patients confirmed and treated in our hospital from 2017-04/2019-11 were selected and grouped according to patients' condition and intention. 108 patients in the observation group underwent conbercept combined with 25G minimally invasive vitrectomy, while 71 patients in the control group underwent 25G minimally invasive vitrectomy only. The baseline data, intraoperative condition, best corrected visual acuity(BCVA), intraocular pressure, amplitude of N1 wave latency, central macular thickness(CMT)in the macular area before and after operation, and postoperative complications were compared between the two groups. The influencing factors of vitreous rehaemorrhage in PDR patients were analyzed. <p>RESULTS:The operative time, intraoperative bleeding rate, electrocoagulation rate, incidence of iatrogenic retinal hiatal aperture, the number of laser points and silicone oil filling rate of the observation group were all lower than those of the control group(<i>P</i><0.05). After 6mo, BCVA(LogMAR), CMT and N1 wave latencies amplitude of the two groups were improved compared with those before operation, and the observation group was better than the control group(all <i>P</i><0.05). The incidence of total complications in the observation group was lower than that in the control group(14.8% <i>vs</i> 40.8%, <i>P</i><0.05). There were 31 cases and 31 eyes with vitreous rehaemorrhage after operation. Multivariate Logistic regression analysis showed that elevated HbA1c, vascular occlusion, proliferative retinal traction and no use of conbercept were risk factors for postoperative vitreous rehaemorrhage in PDR patients.<p>CONCLUSION: Conbercept combined with 25G minimally invasive vitrectomy in the treatment of PDR can reduce the intraoperative bleeding rate, reduce complications, shorten the operation time, and thus help to improve visual acuity and visual function. Effective control of blood glucose to reduce HbA1c level, intraoperative removal of fibrovascular hyperplasia membrane as much as possible to relieve retinal traction, and combined treatment with conbercept can reduce the risk of postoperative vitreous rehaemorrhage.

Attenuation of glycaemic and insulin responses following tapioca resistant maltodextrin consumption in healthy subjects: a randomised cross-over controlled trial.

Resistant maltodextrin (RMD) from various sources of starch has been extensively studied. However, studies which reported the effects of tapioca RMD (TRM) on glucose and insulin response are lacking. This study investigated the effect of TRM on postprandial plasma glucose and serum insulin in healthy subjects. Additionally, satiety and gastrointestinal tolerability were also evaluated. Sixteen healthy participants received five different treatments on five separate days. Participants received 50 g of either: glucose (GL), tapioca maltodextrin (TM), TRM, MIX15% (7⋅5 g TRM + 42⋅5 g TM) or MIX50% (25 g TRM + 25 g TM). Plasma glucose, serum insulin and subjective appetite responses were measured postprandially over 180 min. Gastrointestinal symptoms were evaluated by questionnaire before and after each test day. Results showed that at 30 min after treatment drinks, plasma glucose after TRM was significantly lowest (104⋅60 (sem 2⋅63 mg/dl) than after GL (135⋅87 (sem 4⋅88) mg/dl; P <0⋅001), TM (127⋅93 (sem 4⋅05) mg/dl; P = 0⋅001), MIX15% (124⋅67 (sem 5⋅73) mg/dl; P = 0⋅039) and MIX50% (129⋅33 (sem 5⋅23) mg/dl; P = 0⋅003) (1 mg/dl = 0⋅0555 mmol/l). In addition, TRM also significantly reduced serum insulin (13⋅01 (sem 2⋅12) µIU/ml) compared with GL (47⋅90 (sem 11⋅93) µIU/ml; P = 0⋅013), TM (52⋅96 (sem 17⋅68) µIU/ml; P = 0⋅002) and MIX50% (33⋅16 (sem 4⋅99) µIU/ml; P = 0⋅008). However, there were no significant differences in subjective appetite between treatments (P > 0⋅05). A single high dose of TRM (50 g) caused flatulence (P < 0⋅05). Tapioca resistant maltodextrin has low digestibility in the small intestine and, therefore, reduced incremental plasma glucose and serum insulin, without affecting satiety in healthy subjects over 180 min. Gastrointestinal tolerability of TRM should be considered when consumed in high doses.

Simultaneous Vitreoretinal Surgery and Penetrating Keratoplasty without a Keratoprosthesis or Endoscopy for Vitreoretinal Disease Associated with Corneal Opacity.

We evaluated the visual outcome of combined penetrating keratoplasty (PKP) and 25G pars plana vitrectomy (PPV) performed without a temporary keratoprosthesis or endoscopy in a patient with vitreoretinal disease complicated by severe corneal opacity. The patient was a 68-year-old woman who had severe corneal opacity and silicone oil in her left eye after several previous intraocular surgeries for rhegmatogenous retinal detachment and proliferative vitreoretinopathy. We successfully performed a combined surgery of conventional PKP followed by 25G PPV without the use of a keratoprosthesis. At 6 months after surgery, visual acuity had not improved, and the density of corneal endothelial cells of the donor cornea had declined from 3,205 to 1,969 cells/mm2. However, corneal transparency remained good, and additional surgery for vitreoretinal disease was not necessary. The combined surgical procedure designed to minimize the number of open-sky steps and to limit vitreoretinal complications thus proved to be safe and achieved stable corneal clarity in a patient with vitreoretinal disease and severe corneal opacity.

Outcomes and prognostic factors of 25G minimally invasive vitrectomy for intraocular foreign body / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM:To explore clinical characteristics, outcomes and prognostic factors for cases with intraocular foreign bodies(IFB)and treated with 25G minimally invasive vitrectomy(PPV).<p>METHODS: Patients traumatized with retained IFB and treated with PPV were retrospectively collected from the Department of Ophthalmology, Affiliated Hospital of Southwest Medical University from 2016-1-1 to 2019-1-1. The clinical records including general condition, time and cause of injury, locations andsize of IFBs, comorbidities, and best corrected visual acuity(BCVA)were reviewed and statistical analyzed.<p>RESULTS: Among the 105 patients, most of them are middle-aged and young men, mostly from townships. The nature of IFB was mainly metals(62 cases, 59.0%). The entrance of IFB of 78 cases(74.3%)located at Zone I of the eye. There were 17 patients with BCVA≥0.1 before surgery, 88 patients with BCVA<0.1. And 43 patients gained BCVA≥0.1 after operation, and 62 patients with BCVA<0.1. Postoperative BCVA was significantly improved compared with preoperative BCVA(<i>P</i><0.05). Through multivariate Logistic regression analysis, poor preoperative BCVA, retinal detachment, and endophthalmitis are risk factors for poor visual prognosis.<p>CONCLUSION: PPV for treatment of IFB can achieve a better outcome. The poor prognosis of visual acuity is related to retinal detachment, endophthalmitis, and the position and size of IFB.

25G micro-invasive vitrectomy combined with internal limiting membrane peeling in the treatment of PVR-C retinal detachment / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM:To observe the effect of internal limiting membrane exfoliation in the treatment of PVR-C retinal detachment. <p>METHODS: A total of 37 cases(37 eyes)of PVR-C retinal detachment were collected from August 2015 to July 2018.All eyes were treated with 25G invasive vitrectomy combined with silicone oil filling. The internal limiting membrane was removed after indocyanine green staining,and the removal size of the inner boundary membrane to the upper and lower vascular arch. Silicone oil was taken out of the retina in 3-6mo. Followed up for 12mo after the first operation, the visual acuity, intraocular pressure, retinal reattachment and the formation of the macular membrane were observed and analyzed retrospectively. <p>RESULTS: The vision of all patients was improved. The intraocular pressure of 6 eyes increased within 2wk after operation, and the intraocular pressure returned to normal after treatment. All patients were followed up for 1a, macular membrane did not occur. Retinal detachment occurred again in 2 eyes due to PVR of the anterior retina. The remaining 35 eyes, silicone oil were successfully removed.<p>CONCLUSION: 25G micro-invasive vitrectomy combined with internal limiting membrane peeling is safe and effective in the treatment of this kind of disease, and effectively prevent the appearance of the macular anterior membrane.

Comparison of surgical outcomes in air versus silicone oil tamponade in rhegmatogenous retinal detachment after 25G pars plana vitrectomy / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To compare the efficacy of air versus silicone oil tamponade for management of rhegmatogenous retinal detachment(RRD)following 25G pars plana vitrectomy(PPV).<p>METHODS: A prospective, randomized comparative study. 146 eyes from 146 patients who underwent 25G transconjunctival sutureless vitrectomy to repair rhegmatogenous retinal detachment were performed. Totally 60 eyes used air tamponade but 86 eyes used silicone oil tamponade. The follow-up time ranged from 6-12mo. The best corrected visual acuity(LogMAR), intraocular pressure, retinal reattachment rate, intraoperative and postoperative complications were compared.<p>RESULTS: One month after surgery, the mean BCVA was 0.45±0.5 in the air tamponade group and 0.78±0.65 in the silicone oil tamponade group, it were both evidently improved in comparison with before surgery, what's more, air tamponade had significantly better BCVA than those in the silicone oil tamponade(both <i>P</i><0.05). 3mo after surgery, the reattachment rate of patients in air group was lower than that of silicone oil group(93.3% <i>vs</i> 97.7%), but had no significant differences between the two groups. 6mo after surgery, the anatomical success rate were 100% in both groups. The main intraoperative complication was iatrgenic retinal breaks in 10 eyes(6.8%). The main postoperative complication was high intraocular pressure, the intraocular pressure 1wk after surgery in the silicone oil tamponade group was evidently higher than that air tamponade group(<i>P</i><0.001). No serious complication such as endophthalmitis and choroidal hemorrhage were observed in both groups.<p>CONCLUSION: For the simple early RRD, air tamponade had equivalent reattachment rate to silicone oil tamponade after 25G PPV. In the early postoperative, the visual acuity of air group was better comparing with silicone oil group, and was lower incidence of high intraocular pressure.

Clinical observation of minimally invasive scleral buckling combined with 25G in the treatment of rhegmatogenous retinal detachment / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To observe the clinical effects of minimally invasive scleral buckling combined with 25G cannula intra-optical fiber lighting in the treatment of rhegmatogenous retinal detachment with the help of non-contact wide angle lens.<p>METHODS: We retrospectively analyzed 43 patients with rhegmatogenous retinal detachment from May 2011 to March 2015 in our hospital. The retinal tear locations of these patients analyzed preoperatively by pre-set lens and three-mirror contact-lens were uncertain. We detected the retinal tears intraoperatively by non-contact wide angle lens with the help of 25G cannula intra-optical fiber lighting. The tears were sealed by minimally invasive scleral buckling. The patients were followed up at 1wk, 1mo, 3mo and 6mo postoperatively. The vison and intraocular pressure were recorded with the same equipment and methods as preoperatively did. The retina reattachment and tear sealing status were also observed.<p>RESULTS: The retina were reattached by one operation in 41 patients and the reattachment rate was 95.3%. One patient suffered from incomplete retina reattachment, effusion under the retina, poor position of compressed retinal area, and succeeded by minimally invasive scleral buckling once again. One patient developed new retina tear and completely reattached by vitrectomy.<p>CONCLUSION:For those patients with uncertain retinal detachment preoperatively, minimally invasive scleral buckling combined with 25G cannula intra-optical fiber lighting could increase the success rate. The statistical analysis in large samples and the long-term complications should be further investigated.