Objective To investigate the efficacy and safety of hydrogel soft contact lens(HSCL) for persistence corneal epitheliopathy after intraocular surgery.Design Retrospective case series.Participants 36 patients(36 eyes) with bullous keratopathy(n=5) or other keratopathy(n=31) including corneal erosion,epithelium missing,and dendritic keratopathy after intraocular surgery,which failed to medicine treatment 2 weeks ago.Method All patients were fitted with HSCL after suitable processing of the corneal foci.The lenses were removed immediately as long as the keratopathy recovered.A new lens was replaced after 3 weeks if still needed.Main Outcome Measures Changes of keratopathy,pain relief and complications.Result 35 patients(97.22%) fitted with HSCL were very comfort within 3 days.At the follow-up of 6 months,30 patients(83.33%) achieved complete remission of keratopathy,6 patients (16.67%) remarkable remission.30 patients(86.11%) had vision increase.All of the non-bullous keratopathy recovered within 3 weeks,while the lenses were fitted much longer in bullous keratopathy.No other lens-related complications appeared.Conclusion The application of hydrogel soft contact lens to persistence corneal epitheliopathy after intraocular surgery is safe,effective,and practical.

BACKGROUND: In patients undergoing transoral atlantoaxial reduction and internal fixation, anterior atlantoaxial plate placement, soft tissue swelling and other factors may affect oropharyngeal space. Up to now no anatomical factors regarding dysphagia or dyspnea after anterior approach for atlantoaxial dislocation have been reported. OBJECTIVE: To observe the spatial changes of oropharyngeal airway after atlantoaxial dislocation and internal fixation with transoral atlantoaxial reduction screw-rod system and analyze the related influencing factors. METHODS: Sixty-six patients with atlantoaxial dislocation undergoing transoral atlantoaxial reduction screw-rod system surgery were retrospectively included from January 2012 to December 2016 in the General Hospital of Southern Theater Command. There were 38 males and 28 females aged from 11 to 71 years. All patients signed the informed consent. This study was approved by the Hospital Ethics Committee. The narrowest oropharyngeal airway space, thickness of soft tissue before C2 vertebra, anterior atlantodental interval, O-C2 angle, and C2-C6 angle were measured in the neutral position before and after surgery. Changes of postoperative data and their effects on the narrowest airway distance in oropharynx were analyzed. RESULTS AND CONCLUSION: (1) The narrowest airway distance in oropharynx, anterior atlantodental interval and C2-C6 angle were significantly decreased after surgery compared with that before surgery (P <0.001). Thickness of soft tissue before C2 vertebra and O-C2 angle increased significantly after surgery compared with that before surgery (P < 0.001). (2) In the multiple regression analysis, the change in the anterior atlantodental interval (0=7.070) and thickness of soft tissue before C2 vertebra 03=0.387) were significant variables related to the change in the narrowest airway distance in oropharynx. On the contrary, there was no significant correlation with the O-C2 angle. (3) It is indicated that reduction of atlantoaxial dislocation and the thickness of soft tissue before C2 vertebrae have negative effect on the oropharyngeal airway space. Therefore, reduction of atlantoaxial dislocation during transoral reduction screw-rod surgery may cause postoperative dysphagia despite maintenance of the O-C2 angle.

Objective To investigate the effect of lacosamide on expression of Nav1 .8 in dorsal root ganglia (DRG) in a rat model of chronic neuropathic pain.Methods Thirty-six female specific-pathogen-free (SPF)SD rats were randomly assigned into 3 groups ( n = 12 each): sham operation group (group S), model group (group M) and lacosamide group (group L) . Chronic neuropathic pain was produced by insertion of a small stainless steel rod (4.00 mm in length and 0.63 mm in diameter) into the L, intervertebral foramen in the rat, producing a chronic steady compression of the DRG in M and L groups. The mechanical threshold was measured 2 days before operation and on the 2, 4, 6, 7, 8, 9 and 10 days after operation (T0-7 ) . Intraperitoneal lacosamide 20mg/kg (in normal saline 0.5 ml) was injected at T4-7, twice a day in S and L groups. In group M, normal saline 0.5 ml was injected at T4-7 twice a day and the mechanical threshold was measured after the last administration everyday . The L, DRG on the operated side was removed after measurement of pain threshold to detect the expression of Na, 1.8 mRNA and protein by RT-PCR and immuno-histochemistry respectively. Results Compared with group S, the mechanical pain threshold was significantly decreased at T1-7 and the expression of Navl .8 mRNA and protein was up-regulated in M and L groups ( P < 0.05) . Compared with group M, the mechanical pain threshold was significantly increased at T4-7 and the expression of Nav 1.8 mRNA and protein was down-regulated in group L ( P < 0.05) . Conclusion The mechanism by which lacosamide reduces chronic neuropathic pain is related to the down-regulation of the expression of Nav 1.8 in rat DRG.

Objective To assess the diagnostic value of IMA,NLR,hs-CRP and CK-MB individually and the combined detec-tion for early acute myocardial infarction using ROC curve and Logistic regression.Methods To detect levels of IMA,NLR, hs-CRP,CK-MB and cTnI in serum or whole blood of AMI patients that had chest pain within 3 hours or between 3 and 6 hours,compared with 60 healthy people from Physical Examination Center.Applied Logistic regression,plotted ROC curve and calculated the area under ROC curve (AUC)to assess the diagnostic value of each index.Results The serum IMA,hs-CRP,CK-MB and cTnI or whole blood NLR levels of AMI patients with 3 hours were remarkably higher than normal con-trol,showing significant statistical difference (P<0.01)(AMI group:mean values of IMA,NLR,hs-CRP,CK-MB and cTnI were 96.04 U/L,3.77,13.39 mg/L,43.26 U/L and 0.063 ng/ml;normal control group:mean values of IMA,NLR,hs-CRP,CK-MB and cTnI were 78.10 U/L,2.02,3.12 mg/L,19.37 U/L and 0.040 ng/ml.The serum IMA,NLR,hs-CRP, CK-MB and cTnI levels of AMI patients in the group between 3~6 hours were higher than in the group within 3 hours (P<0.05).The AUC of combined detection of IMA,NLR,hs-CRP and CK-MB for early AMI was 0.98,higher than solo de-tection of IMA,NLR,hs-CRP and CK-MB,which were 0.89,0.83,0.79 and 0.85 respectively.Meanwhile,the AUC of com-bined detection for four markers also surpassed that of cTnI alone that was recognized as a classic serological marker to diag-nose AMI (AUC=0.78).Conclusion The combined detection of IMA,NLR,hs-CRP and CK-MB is superior to a single in-dex detection,which can significantly improve diagnostic efficiency for early AMI.

ObjectiveTo investigate the imaging characteristics of solitary fibrous tumor(SFT).MethodsThis study included 11 cases with SFT proved by pathological results.The imaging manifestations were retrospectively reviewed and analyzed in comparison with surgical and pathological results. Among them,8 patients underwent CT plain scan (1/8) or enhanced scan (7/8),4 patients underwent MR plain scan (2/4) or enhanced scan (2/4),and only 1 patient underwent both CT and MR scan.Results( 1 )SFT were located in the thoracic cavity(2/11 ),abdominal and pelvis(5/11 ),and somatic soft tissues (4/11 ).The average tumor size was 11.8 cm ( 2.5 to 23.0 cm).Among them,4 tumors were round or ellipse,and 7 tumors were irregular.Eight tumors had well-defined contours,and the others showed illdefined contours.(2)On CT scan,all SFTs showed inhomogeneous density with low density areas.Calcification was seen in I case,and hemorrhagic foci were detected in 2 cases.(3)On MR scan,all SFTs showed intermediate signal intensity on T1 WI.Three tumors were slightly hyperintense and the other was hypointense on T2WI.All of them were rich of vascular signal voids.Three tumors,including 2 tumors with scattered long T1 and T2 signal and 1 tumor in the liver with hyperintense haemorrhage,displayed inhomogeneous mixed signal.One tumor in the orbit showed homogeneous signal.(4)On enhanced scan,9 tumors showed irregular enhancement with multiple circuitous vessels in the arterial phase,and continuous or progressive enhancement with patch non-enhanced areas in the venous phase.( 5 ) Histologically,SFTs were composed of juxtaposed hyper- and hypo-cellular spindle cells,dense collagenous stromas and numerous thin-walled blood vessels with a staghorn configuration.Conclusion The possibility of SFT should be considered when a single soft tissue mass with sharp border,inhomogeneous density is detected,especially with inhomogeneous enhancement maintaining in the venous phase.

Objective Myofascial pain syndrome (MPS) is a common muscle function disturbance.This study was to investigate the clinical value of acoustic radiation force impulse (ARFI) imaging in assessing the therapeutic effect of acupuncture for patients with trapezius MPS.Methods A total of 116 patients diagnosed with trapezius MPS received acupuncture therapy once a day for 10 days in Pudong Hospital from August 2015 to June 2016.Using ARFI imaging, we recorded the shear wave velocity (SWV) of the trapezius and obtained the short-form McGill Pain Questionnaire (SF-MPQ) scores of the patients before, at the end of, and at 7, 15 and 30 days after treatment.Then, we analyzed the interaction and correlation between the SWV values and SF-MPQ scores of the patients at different time points.Results Both the SF-MPQ scores and SWV values were first decreased, falling to lowest values (5.19 points and 1.43 m/s) at 7 days after treatment, and then increased again.The interaction between the SF-MPQ scores and SWV values were significantly different at different time points (Finteraction=2.553, Pinteraction=0.038), and there was a strong linear correlation between the two indexes (r=0.755, P=0.000).Conclusion ARFI imaging combined with SF-MPQ has a certain clinical value in assessing the effect of acupuncture on trapezius MPS.

Objective: To explore correlation among clinic blood pressure (CBP), ambulatory blood pressure (ABP) and cardiovascular diseases in diabetic populations.Methods: A total of 336 patients complicated with type 2 diabetes mellitus, who received 24h ambulatory blood pressure monitoring, were selected.According to complicated with coronary heart disease or stroke or not, they were divided into cardiovascular disease group (CVD group, n=122) and no cardiovascular disease group (NCVD group, n=214).Blood lipids, blood pressure, CBP and ABP etc.were compared between two groups;according to median of 24h mean SBP (122mmHg), they were divided into <122mmHg group (n=168) and ≥122mmHg group (n=168), incidence of cardiovascular diseases was compared between these two groups.Results: (1) Compared with NCVD group, there were significant rise in age, percentages of smoking and hypertension, and plasma hsCRP level in CVD group (P<0.05 or <0.01);for ambulatory blood pressure,there were significant rise in levels of 24h mean SBP(mSBP) [(119.8±8.7)mmHg vs.(124.4±9.6) mmHg], daytime SBP (dSBP)[(121.4±9.3) mmHg vs.(128.0±10.3) mmHg] and nighttime SBP(nSBP) [(114.4±4.2) mmHg vs.(120.8±4.7) mmHg] in CVD group, P<0.01 all;there was no significant difference in CBP between two groups;(2) compared with <122mmHg group, there were significant rise in percentages of stroke (20.2% vs.25.0%) and total cardiovascular diseases (32.7% vs.39.9%) in ≥122mmHg group, P<0.01 both;(3) Logistic regression analysis indicated that diabetic patients no matter complicated with hypertension or not, 24h mean SBP was always an independent risk factors of diabetic patients complicated cardiovascular diseases (OR=1.83, 1.36, P<0.05 all).Conclusion: ABP is superior to CBP in predicting cardiovascular risk in patients with diabetes, and 24h mean SBP may be a good ABP index to predict cardiovascular risk.

Objective To demonstrate the incidence and relative factors of hypothyroidism after partial thyroidectomy (PTC). Methods The records of all euthyroidsm patients who underwent hemithyroidectomy from 1988 to 2000 were reviewed to determine the incidence of postoperative hypothyroidism and the predisposing factors. All the patients age, gender, serum TSH TGA and TPO levels,and the weight of resected thyroid tissue were evaluated. Hypothyroidsm patients were evaluated for the symptoms , timing of diagnosis , and thyroxine therapy. Results Hypothyroidism was diagnosed in 41(3.4%) of 1 210 patients ,inclnding subclinical hypothyroidsm in 28 and overt in 13.The mean postoperative serum TSH level was (9.22?3.36)mU/L. The mean preoperative serum TSH level was (3.14?1.05)mU/L in hypothyroidsm patients but in euthyroid patients was (1.07?0.72)mU/L(P

Adult ; Aged ; Aged, 80 and over ; Antiviral Agents ; therapeutic use ; Carcinoma, Hepatocellular ; epidemiology ; virology ; Female ; Hepatitis B ; drug therapy ; epidemiology ; Humans ; Liver Neoplasms ; epidemiology ; virology ; Male ; Middle Aged ; Retrospective Studies ; Young Adult

Objective:To evaluate the feasibility of placement of S 2 alar iliac screw (S 2AI) using free-hand technique for sacrapelvic fusion in lumbar degenerative scoliosis. Methods:Eighteen patients with Lumbar Degenerative Scoliosis treated by S 2AI screw fixation at Department of Orthopedics, General Hospital of Southern Theater Command of People′s Liberation Army and Department of Orthopedics, 89th hospital of People′s Liberation Army from August 2014 to October 2018 were analyzed retrospectively. There were 5 males and 13 females, aged 63.2 years old (range:55 to 71 years old).Parameters of spine including: Cobb Angle, C 7 plumb line -center sacral vertical line (C 7PL-CSVL), lumbar lordosis(LL), sagittal vertical axis(SVA), pelvic incidence(PI), pelvic tilt(PT), sacral slope (SS) and pI-LL were measured on the whole spine X-ray before operation and at final follow-up. Pelvic CT scan was performed postoperatively to assess the accuracy of S 2AI placement. Oswestry disability Index (ODI) was also recorded. The data were compared by paired t test or Wilcoxon tests. Results:All patients were followed up for 23.7 months (range: 12~62 months).At the last follow up, Cobb Angle decreased from (32.28±4.97) °preoperative to (6.56±3.20) ° ( t=41.142, P<0.01) and C 7PL-CSVL deceased from (1.11±2.07) cm preoperative to (0.18±1.08) cm ( t=41.142, P=0.06) .LL improved from (-22.39±13.07) °preoperative to (-36.39±4.29) ° ( t=4.470, P<0.01) , PI-LL decreased from (26.83±14.83)°preoperative to (13.72±8.3)° ( t=4.396, P<0.01) , PT decreased from (27.94±4.26) °to (23.39±6.08) ° ( t=2.680, P=0.02) , and SS increased from (22.22±6.36) °to (26.28±7.24) ° ( t=-2.178, P=0.04) .SVA decreased from (6.54±4.51) cm preoperative to (2.62±1.29) cm ( t=3.052, P=0.01) .ODI decreased from 0.58(0.40) ( M( QR)) to 0.18 (0.15) ( Z=-4.567, P<0.01) .No complications such as nerve and blood vessel injury occurred during the operation. A total of 32 S 2AI screws were placed, 3 screws were placed with mild to moderate cortical breaches, 2 were perforated the pelvis ventrally, 1 was perforated posteriorly, with no clinically notable neurovascular or visceral complications. Eight patients finished the SRS-22 questionnaire, with mean score of 4.4 in terms of satisfaction with management. Conclusions:Free-hand technique of S 2AI screw placement for sacrapelvic fusion in degenerative lumbar scoliosis is safe and feasible.S 2AI fixation in DLS can provide great correction of deformity, maintain the stability of lumbo-pelvic area and improve the clinical symptoms.