AIM: To compare the efficacy of vitrectomy combined with internal limiting membrane peeling and C3F8 or sterile air tamponade for idiopathic macular hole (IMH).METHODS: In this research, 51 cases of IMH with holes diameter ≤600μm were accepted from the same doctor of department of Ophthalmology in Luoyang Central Hospital from January 2011 to January 2016.All the patients were under taken vitrectomy combined with internal limiting membrane peeling and gas tamponade.All the study subjects were divided into two groups (Group A and Group B).The Group A were tamponaded with perfluoropropane(C3F8)(27 eyes), while the Group B were tamponaded with sterile air (24 eyes).The closure rate and morphology of macular hole, the time of prone position, the best corrected visual acuity(BCVA), the improvement of metamorphopsia and the process of cataract were compared and statically analyzed in these two groups.While the closure rate was compared among ≤200μm, >200-400μm and >400-600μm groups.Postoperative followup time was 1wk, 1, 3mo and half a year.RESULTS: The difference of two groups was no statistically significant in all interval according to holes diameter (P>0.05).The difference of two groups was no statistically significant in morphology of macular hole form(P>0.05).The time of prone position in Group B was significantly shorter than that in Group A, and the difference was statistically significant(P<0.01).The BCVA of postoperative was improved than preoperative, and the difference was statistically significant(P<0.01).However, there was not statistically significant between the two groups in the BCVA of postoperative(P>0.05).The metamorphopsia of postoperative was improved than preoperative in two groups while there was not statistically significant between the two groups in the BCVA of postoperative(P>0.05).Cataract progress rate was reduced in the Group B than the Group A, but the difference was not statistically significant(P>0.05).CONCLUSION: This study shows that sterile air tamponade can obtain same closure rate, morphology of macular hole and the improvement of metamorphopsia and visual function in holes diameter ≤600μm when reducing the time of prone position and the risk of systemic diseases induced by prone position after operation.

In autoimmune thrombocytopenic purpura (AITP) specific autoantibodies bind platelet GP via their Fab fragments. Both splenic CD5+ B and CD5- B cells produce platelet glycoprotein-specific antibodies. There is limited number of antigenic determinants, and the GP-specific autoantibodies are derived from a restricted number of B-cell clones in chronic AITP. Blocking co-stimulatory signals could induce platelet-specific T cell anergy. MMF could be used as a second line agent for the treatment of steroid-resistant AITP. Detection of plasma thrombopoietin levels play an important role in the differentiation of thrombocytopenic states caused by platelet destruction or due to bone marrow hypoplasia. Endogenous TPO level is also important on the differential diagnosis of ET and RT. Quinine- or heparin-dependent antibodies could induce thrombocytopenia. PCR-SSP is useful for the genotyping of the platelet-specific alloantigen HPA. Biotinylated platelets have an impaired response to agonists as evidenced by in vitro platelet aggregation tests.
Antigens, Human Platelet ; immunology ; Blood Platelets ; immunology ; Heparin ; adverse effects ; Humans ; Platelet Membrane Glycoproteins ; immunology ; Purpura, Thrombocytopenic, Idiopathic ; etiology ; immunology ; Thrombopoietin ; blood

Superior Mesenteric Artery (SMA) syndrome is a well-known but rare complication following corrective surgery for scoliosis. It can be easily missed if not thought of in patients presenting with abdominal pain and vomiting post-scoliosis surgery. SMA syndrome is most commonly associated with conditions resulting in significant weight loss but can also occur as a result of biomechanical changes following scoliosis surgery. We present a case of a 13 year-old girl who developed SMA syndrome following scoliosis surgery. A high index of suspicion and early surgical referral are paramount for the successful management of SMA syndrome.

Recent research has gained much depth and details on the response-to-therapy assessment system (RTAS) of DTC. The concept of RTAS was first proposed in the 2015 ATA guidelines, mainly advocating dynamic and ongoing assessment of a disease process after primary therapy is completed. This recommendation is to compensate for the deficiency of a static, single-parametric evaluation system that is conventionally pathology-dominated. The concept of risk-adaptive management has been adopted in individual decision-making processes, so as to tailor treatment plans accordingly with an understanding that therapies (e.g. surgery, etc.) should also be involved as a continuum of risk assessment. The RTAS according to the new guidelines has been clearly highlighted worldwide. This review aims to outline the progress and latest update of RTAS on DTC.

Objective To observe the clinical efficacy of small needle therapy in the treatment of retrograde lumbar spine stenosis. Methods About 30 patients with retrograde lumbar spinal stenosis from June 2015 to March 2016 were set as control group;30 patients with the same disease from ApriI 2016 to December 2016 were set as observation group. The control method of traction and massage therapy, the observation group on the basis of increased by small needle knife therapy. Result The effect of the observation group was better than the control group, the difference was statistically significant (P<0.01). Conclusions Treatment of retrograde lumbar spinal stenosis with small needle knife therapy is effective in treating patients' pain and improving clinical effect. Well condition observation and nursing during the treatment can ensure the smooth progress of treatment, the correct guidance and urged patients to exercise to reduce the recurrence of the disease, has the vital significance.

Objective To investigate the biomechanical changes of internal maxillary distraction with fixation between cleft palate.Methods Three-dimensional FEM models of LeFort Ⅰ osteotomy and soft tissue in CLP maxillary complex were established.Two different conditions were simulated:one was the cleft palate connected by a titanium plate,and the other was the cleft retained.Internal midface distraction which applied in clinic were simulated.Fixation points of the distraction devices on the LeFort Ⅰ osteotomy complex were advanced by 10 mm in the direction of frontage.Biomechanical changes for different conditions were investigated by means of finite element analyses.Results LeFort Ⅰ osteotomy of maxillary complex area in CLP was advanced.Constrictions occurred in alveolar crest and palate,when the cleft was retained.Constriction of alveolar crest and palate was not obvious,when the cleft palate was connected by a titanium plate.There were no differences between sagittal and vertical displacement to internal distraction in LeFort Ⅰ osteotomy.Clockwise rotation occurred in vertical direction.Conclusions Internal maxillary distraction with fixation between cleft palate could avoid constriction of alveolar crest and palate.It provides the options and reference to the surgical plans.

BACKGROUND:As a good candidate for bioresorbable bone graft, carbonate apatite monolith can be prepared by sintering procedure;however, sintering can cause carbonate loss and result in a much lower rate of
biodegradation compared to the human bone, thereby influencing the formation of new bone.
OBJECTIVE:To fabricate low-crystal inity carbonate apatite monolith as bone graft and test its properties. METHODS:Calcium carbonate monolith prepared by carbonation of Ca(OH) 2 monolith was treated in 1 mol/L
RESULTS AND CONCLUSION:The calcium carbonate completely transformed into low-crystal inity B-type
carbonate apatite after treated for 14 days. Diametral tensile strength of the final product was (10.27±1.08) MPa, which is adequate as a reconstruction material for bone defect. The carbonate content was (4.80±0.50)%, similar to that of the nature bone. The molar Ca/P was 1.63±0.01, indicating the Ca-deficient carbonate apatite is
obtained. The present method al ows an easy fabrication of low-crystal inity B-type carbonate apatite block with adequate strength and without sintering process.
ammonium dihydrogen phosphate solution at 60 ℃ up to 14 days. Diametral tensile strength was examined for biomechanical properties;X-ray diffraction analysis, Fourier transform infrared spectroscopy, scanning electron microscope observation and chemical analyses (carbonate, calcium and phosphate content) were also performed for physical and chemical properties.

Antineoplastic Agents ; administration & dosage ; therapeutic use ; Hematologic Neoplasms ; drug therapy ; Humans

OBJECTIVETo compare the effect of three cannulated screws and dynamic hip screw (DHS) combined with antirotation screw in treating patients with comminuted fractures of femoral neck.

METHODSFrom January 2008 to December 2012,67 patients with comminuted fractures of femoral neck were treated with three cannulated screws or DHS combined with antirotation screw. Among them, 36 patients were treated with DHS combined with antirotation screw including 24 males and 12 females with an average of 43.7 years old ranging from 22 to 58 years old; 31 patients were treated with three cannulated screws including 22 males and 9 females with an average of 43.0 years old ranging from 24 to 56 years old. The incision size, operation time, blood loss, blood transfusion rate, postoperative hospital stay, walking time, weight-bearing time, union time, incidence of complication were recorded and compared between two groups, and functional outcomes were evaluated by Harris scoring.

RESULTSAll incision healed at stage I. The differences in operation time, blood loss, blood transfusion rate and postoperative hospital stay between two groups were not significant (P > 0.05). Incision size of DHS group (5.00 ± 0.86) cm was larger than that of cannulated screw group (3.30 ± 0.57) cm (P < 0.01). All patients were followed up more than one year, and the follow-up time showed no significant difference between two groups (P > 0.05). Walking time of DHS group (19.0 ± 3.5) d was less than that of cannulated screw group (37.0 ± 6.3) d (P < 0.01. Partial and full weight-bearing time of DHS group (23.0 ± 7.0) d and (138.0 ± 13.0) d was less than that of cannulated screw group (38.0 ± 5.7) d and (164.0 ± 12.0) d (P < 0.01). Union time of DHS group (151 ± 11) d was less than that of cannulated screw group (162 ± 11) d (P < 0.01). Harris hip score of DHS group (91.0 ± 5.7) was higher than that of cannulated screw group (85.0 ± 12.0) (P < 0.01). No significant differences were found in the incidence of postoperative complications between two groups (P > 0.05).

CONCLUSIONThe DHS combined with antirotation screw is superior to three cannulated screws for treatment of comminuted fractures of femoral neck due to earlier weight-bearing, faster fracture healing and better hip function

Adult ; Bone Screws ; Female ; Femoral Neck Fractures ; surgery ; Follow-Up Studies ; Fracture Fixation, Internal ; adverse effects ; methods ; Fractures, Comminuted ; surgery ; Humans ; Male ; Middle Aged

Objective To detect the normal value of the fetal middle cerebral artery peak systolic velocity (MCA-PSV) with Doppler ultrasonography, and to investigate the association between MCA-PSV and fetal anemia. Methods Doppler ultrasonography was performed in 535 normal pregnant women from the 14th to the 40th week of gestation. MCA-PSV was measured, and the standard value of the normal fetal MCA-PSV was established. Fetuses with abnormal high MCA-PSV were assessed with a standard of MCA-PSV＞mean vale of gestational weeks+2 standard deviation or 1.5 multiples of mean value of gestational weeks. Results The value of normal fetal MCA-PSV correlated well with the gestational weeks (linear regression equation was: MCA-PSV＝-9.955+1.561×weeks; r＝0.795, P<0.0001). Using 1.5 multiples of the mean of different gestational weeks to diagnose the moderate and severe fetal anemia, 7 fetuses were screened out of 209 of obstetric ultrasonography; 4 of them had MCA-PSV＞1.5 multiples of mean value of gestational weeks and were proved with induced labor. Conclusion The value of 1.5 multiples of mean value of gestational weeks of fetal MCA-PSV in prenatal ultrasonography might be an important clue for the diagnosis of fetal anemia.