AIM: To observe the therapeutic effect of combined trabeculectomy with improved conjunctival incision at 1mm of corneoscleral limbus posterior
METHODS: A retrospective analysis of 171 cases ( 220 eyes ) with primary glaucoma who were randomly divided into 3 groups according to the differences of conjunctival incision and the way of suture. Group A:44 eyes of 33 cases underwent corneoscleral limbus conjunctival incision; Group B: 94 eyes of 76 cases underwent conjunctival incision at 1mm of corneoscleral limbus posterior; Group C: 82 eyes of 62 cases underwent conjunctival flap running suture based on group B. All cases were followed up for 1a. Intraocular pressure, morphology of filtering bleb, depth of anterior chamber and water leakage in conjunctival incision were observed and compared after operation among three groups.
RESULTS: The incidence of postoperative water leakage inconjunctival incision and shallow anterior chamber were group A >group B>group C and there were significant differences among the three groups ( P<0.05), The success rate was 94. 5%. The intraocular pressure and morphology of bleb had no significant differences among the three groups.
CONCLUSION: Conjunctival incision at 1mm of corneoscleral limbus posterior and conjunctival flap running suture can not only reduce the rate of water leakage in conjunctival incision and accelerate the speed of incision adhesion after operation, but also significantly enhance the therapeutic effect of combined trabeculectomy.

Objective To observe the structural characteristic of Marshall ligament and coronary sinus of 40 dog hearts. Methods The Marshall ligament and coronary sinus of 40 dog hearts fixed with 10% formaldehyde were observed in gross anatomy. Results The Marshall ligament begins at the right external side edge of left atrium appendage, via the left inferior pulmonary vein to the inner surface of pericardium. The length and the width of Marshall ligament of dog hearts were (2.61?0.95) cm, (0.18?0.04) cm respectively. The angle between Marshall ligament and the coronary sinus was (116?11), and the shortest length between Marshall ligament and left atrium was (0.58?0.52) cm. The length and the width of coronary sinus was (2.84?0.85) cm, (0.28?0.07) cm respectively. There are lots of cardiac fibers of ring (47.5%), vertical (37.5%) and diagonal (15%) shape on the surface of coronary sinus. Conclusion A lot of muscle fibers attaching to the surface of Marshall ligament and coronary sinus in dog hearts are abnormal atrial channels. Dog is the favorable animal for research of focal atrial fibrillation.

OBJECTIVETo evaluate the ASES, Constant and HSS score systems and their significance on postoperative function of the shoulder.

METHODSTotally 172 cases of proximal humeral fracture of five affiliated hospital from September 2004 to September 2008 were analyzed. All the functional outcome of the involved shoulder were evaluated by ASES, Constant, HSS score and patient self score. The correlations and agreement of three shoulder scales were analyzed with Pearson correlation test and Bland-Altman plot in different age groups and fracture types.

RESULTS(1) The Constant score were lower than other two scores in the same age group and fracture type (F = 13.62 and 4.80, P < 0.05). (2) The correlations between three shoulder scales: ASES and Constant (r = 0.754, P = 0.0003), ASES and HSS (r = 0.755, P = 0.0001), Constant and HSS (r = 0.858, P = 0.0002). The correlations between three shoulder scales and patient self evaluation: ASES (r = 0.602, P = 0.0002), Constant (r = 0.705, P = 0.0001), HSS (r = 0.663, P = 0.0037). The Bland-Altman plot shows three shoulder scales have good agreement. (3)The correlation between Constant score and patient self evaluation decreased in the elder group and severe fracture type.

CONCLUSIONSASES, Constant, HSS shoulder score systems are all fit to evaluate the functional outcome of the shoulder, they have good correlation and agreement. Constant score in recommended for its high correlation coefficient with patient self evaluation score. However, its age bias must be paid attention in clinical practice. ASES shoulder score can be used in remote follow-up.

Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Male ; Middle Aged ; Postoperative Period ; Retrospective Studies ; Shoulder Fractures ; physiopathology ; surgery ; Shoulder Joint ; physiopathology ; Trauma Severity Indices ; Young Adult

Nucleos(t)ide analogues (NAs), which are widely used as the first-line anti-hepatitis B virus (HBV) drugs in clinical practice, can effectively inhibit the replication of HBV DNA, significantly slow down disease progression in chronic hepatitis B (CHB) patients, and reduce the development of end-stage liver diseases such as liver failure and liver cancer. However, for some CHB patients receiving first-line NAs for 48 weeks or longer, serum HBV DNA is still persistently or intermittently higher than the lower detection of limit of sensitive nucleic acid detection reagents. After discussion by the authors, low-level viremia (LLV) is defined as follows: persistent LLV refers to the condition in which CHB patients, who receive entecavir, tenofovir disoproxil fumarate, or tenofovir alafenamide fumarate for ≥48 weeks, test positive for HBV DNA by two consecutive detections with sensitive quantitative PCR, with an interval of 3-6 months, but have an HBV DNA level of ＜2000 IU/ml; intermittent LLV refers to the condition in which patients test positive for HBV DNA intermittently by at least three consecutive detections with sensitive quantitative PCR, with an interval of 3-6 months, but have an HBV DNA level of ＜2000 IU/ml. For the diagnosis of LLV, the issues of poor compliance and drug-resistant mutations should be excluded. LLV might be associated with the increased risk of progression to liver fibrosis or hepatocellular carcinoma in patients with liver cirrhosis under NA treatment, but there are still controversies over whether the original treatment regimen with NAs should be changed after the onset of LLV. This article summarizes the incidence rate of LLV under NA treatment and the influence of LLV on prognosis and analyzes the possible mechanisms of the osnet of LLV, so as to provide a reference for the management of LLV in patients treated with NAs.