Exfoliation syndrome (XFS),one of the most common causes of glaucoma,represents an age related,complex,multifactorial and late-onset disease worldwide.The etiopathogenesis involves both genetic and environmental factor.However,the exact etiopathogenesis of XFS is still unclear.The purpose of this review was to discuss the recent research progress of the molecular genetics of XFS.Some candidate genes linked to XFS include lysyl oxidase-like 1 (LOXL1) gene,clusterin (CLU) gene,contactin associated protein-like 2 (CNTNAP2) gene,apolipoprotein E (ApoE) gene,matrix metallo proteinases (MMPs) gene,glutathione S-transferase (GST) gene,transforming growth factor-β1 (TGF-β1) gene,tumor necrosis factor-α (TNF-a) gene and so on.These genes may be modifying genes for the development of XFS.

Adult ; Catheter Ablation ; methods ; Humans ; Male ; Radial Artery ; surgery ; Tachycardia, Supraventricular ; surgery

Accidents, Occupational ; Humans ; Hydrogen Sulfide ; poisoning

OBJECTIVETo retrospectively analyze therapy comparison between hinged external fixator combining with internal fixation, soft tissue repair and plaster fixation after routine surgery for terrible triad of the elbow.

METHODSFrom January 2003 to June 2011,26 patients with terrible triad of the elbow (posterior dislocation associated with fracture of both the radial head and the ulnar coronoid process) were treated respectively by unilateral hinged external fixator and plaster fixation. Fourteen patients were treated with external fixator combining with internal fixation, soft tissue repair and reconstruction, including 8 males and 6 females,ranging in age from 20 to 62 years with an average of (33.60 +/- 8.53) years. The mean time of fixation was 7.5 weeks (ranged, 6 to 8 weeks), and forearm rotation exercise was performed after the first day of operation, elbow flexion and extension activities after 4 to 6 days. Twelve patients were treated with plaster external fixation combining with open reduction and internal fixation,including 8 males and 4 females,ranging in age from 21 to 63 years with an average of (34.80 +/- 7.41) years. The mean time of plaster fixation was 30.4 days, and functional exercise was carried out after 4 to 6 weeks of plaster removal. JOA assessment score were used to evaluate the elbow joint function.

RESULTSAll the patients were followed up, and the duration ranged from 12 to 36 months,with an average of 18.6 months. The mean time of fracture healing was (8.6 +/- 3.1) weeks in plaster group and (9.0 +/- 2.7) weeks in fixator group, with no statistical difference between the two groups (t =1.47, P > 0.05). The function and are of motion in plaster group and fixator group showed significant difference. While the pain, articular instability and deformity showed no statistical difference. The total assessment score between two groups indicated markedly difference (t = -2.66, P < 0.01).

CONCLUSIONHinged external fixator can enhance lateral stability of elbows,benefit the reduction of fracture dislocation, guarantee early and safe functional exercise, prevent elbow stiffness, and reduce heterotopic ossification. In treating terrible triad of the elbow, the hinged external fixator is superior to other therapies with respect of improving the function of elbow joint.

Adult ; Case-Control Studies ; Elbow Joint ; diagnostic imaging ; injuries ; surgery ; Female ; Humans ; Male ; Middle Aged ; Orthopedic Procedures ; methods ; Retrospective Studies ; Tomography, X-Ray Computed ; Young Adult

Objective To evaluate the safety and local control rate and short term survival status of the treatment for primary liver cancer by microwave ablation.Methods From January 2006 to January 2014,a total of 209 lesions in which the average diameter was 3.92 cm in 187 patients was performed the microwave ablation therapy.There were 12 lessions adjacent to lung,diaphragm,abdominal wall,stomach,colon and gallbladder area. Enhanced CT examination was performed one month after ablation and the imaging data,liver function,AFP level and quality of life were followed up every three month to evaluate the effectiveness.Results 88.99 percent of le-sions achieved complete elimination after an average 1.35 times ablation.The completed elimination ratio for small lesions less than 3 cm was up to 100%.Local tumor progression occurred in 23 lesions.Seventheen patients had mild complications.The slight complication rate was about 5.82%.Death and other serious complications did not occur in this study.Conclusion Microwave ablation is safe and feasible for the lesions of liver cancer with live cancer less than 5 cm,which is located in the special dangerous area of liver cancer.Microwave ablation can significantly prolong the survival time of patients,especially for small HCC patients with <3cm.

To observe the relation between the course and therapeutic effect of electroacupuncture in treating prolapse of lumbar intervertebral discs, and the different effects improved by electroacupuncture between different clinical symptoms of lumbar intervertebral discs, according to the symptoms of lumbago, pain of leg or pains of both lower back and leg, the cases were divided into different therapeutic groups. Every group was treated for three courses of treatment. There was a significant difference between the therapeutic effect and the course of treatment (P＜0.01). There was a difference between the symptoms and the therapeutic effects (P＜0.05). Among the clinical symptoms of lumbar intervertebral disc improved by electroacupuncture,lumbago was most obvious, pain of leg was worst. The therapeutic effect of the second course of treatment was relatively marked.

Objective To investigate the relationship between scattered or single lesion of acute cerebral infarction in middle cerebral artery territory on diffusion-weighted imaging (DWI) and stenosis of middle cerebral artery (MCA) or internal carotid artery (ICA). Methods With exclusion of cardioembolism, 73 consecutive patients with acute cerebral infarction of the unilateral MCA territory on DWI were analyzed. All patients got magnetic resonance imaging (MRI) and angiography (MRA) within 24 hours after onset, and 7 patients also had digital subtraction angiography (DSA). The patients were classified into single lesion group or scattered lesions group according to the DWI findings. The incidence of stenosis or occlusion of ipsolateral MCA, intracranial and extracranial ICA were compared between the two groups. Results 42 patients had scattered lesions and 31 patients had single lesion. The scattered-lesions group had a high incidence of ipsilateral extracranial ICA or MCA occlusion or severe stenosis ( 25.6%versus 0, x2 = 10.6, P = 0.001 ) and a high incidence of ipsilateral intracranial ICA or MCA moderate or mild stenosis (31.0% versus 9.7% ,x2 =4.717, P =0.03 ). A positive correlation was found between the scattered lesions and severe or multifocal stenosis of ipsilateral ICA and MCA ( OR: 13.7, 95% CI: 3.6 to 52.5). There was a low incidence of absence of extra- and intracranial stenosis on MRA or DSA in the scattered-lesions group ( 11.9% versus 32.3%, x2= 4.526, P = 0.033 ). A negative correlation was found between the scattered lesions and absence of large-artery stenosis ( OR: 0.284, 95% CI: 0.09 to 0.94).Conclusions ( 1 ) Patients with acute cerebral infarction and scattered lesions on DWI were more likely to suffer from stenosis or occlusion of ICA or MCA, especially over the extracranial ICA. (2) Patients with single lesion were less likely to have severe or multiple stenosis of MCA and ICA, indicating the relevance of small-vessel pathogenesis.

OBJECTIVETo study the synergistic effects of electroacupuncture on the treatment of knee osteoarthritis after arthroscopic debridement.

METHODSFrom May 2008 to July 2010, 78 patients with knee osteoarthritis were randomly divided into two groups. There were 42 patients in the experimental group, including 16 males and 26 females, ranging in age from 41 to 63 years, with an average of (53.62 +/- 6.53) years; the disease course ranged from 8 to 24 months, with an average of (10.35 +/- 6.42) months. The patients were treated with arthroscopic debridement combined with electroacupuncture after operation. There were 36 patients in the control group, including 14 males and 22 females, ranging in age from 40 to 62 years, with an average of (54.34 +/- 7.67) years; the disease course ranged from 6 to 25 months, with an average of (11.94 +/- 5.13) months. Those patients were treated only with arthroscopic debridment. All the patients performed isometric quadriceps femoris contraction exercise and knee flexion and extension activities after operation. The visual analog scale(VAS) score and Lysholm knee score were used to evaluate the therapeutic effects.

RESULTSAll the patients were followed up, and the duration ranged from 12 to 30 months, with an average of 15.6 months. At the final follow-up, VAS score was significantly decreased, and the Lysholm score, except for the item demanding for support, significantly increased, compared with those before surgery respectively in both groups. There was significant difference in VAS score between two groups after treatment. As to Lysholm score, there were significant differences in limp, pain, swelling, stair activity and squat, but there were no significant differences in items of interlocking and instability between two groups after treatment.

CONCLUSIONElectroacupuncture can effectively improve the clinical symptoms and knee joint's motor function of knee joints in patients with knee osteoarthritis, as well as the synergistic effects on the treatment of knee osteoarthritis after arthroscopic debridement, leading to a much better long-term therapeutic effect with respect of improving the function of knee joint. This therapy, combined with traditional Chinese medicine and Western Medicine,is worth of clinical application in the treatment of knee osteoarthritis.

Adult ; Aged ; Arthroscopy ; Case-Control Studies ; Combined Modality Therapy ; Debridement ; Electroacupuncture ; Humans ; Knee Joint ; physiopathology ; surgery ; Male ; Middle Aged ; Osteoarthritis, Knee ; physiopathology ; surgery ; therapy ; Treatment Outcome

The ratio of plasma aldosterone concentration to renin activity (ARR) is a sensitive parameter for screening of primary aldosteronism (PA) and for predicting prognosis after adrenalectomy in patients with PA.Study of the influencing factors for ARR,especially medications,sodium intake and posture,is of great significance for improving the screen efficacy of ARR.This paper introduces the current application of ARR in screening for PA and optimization of its determining conditions.

Objective To study the comparison of the therapeutic effect of Ultrasound guided and freehand botulinum toxin type of the treatment in children with cerebral palsy.Methods From March 2014 to September 2016,98 cases of children with cerebral palsy in our hospital by injection of botulinum toxin were treated.According to the way of injection,the children were divided into ultrasound group and free group(n =49).They were respectively gave botulinum toxin injection by guided Ultrasound guided and freehand ultrasound injection of hotulinum toxin injection.The amount of two groups of children was 3U/kg.Children muscle spasm degree of before and after treatment was assessed by modified Ashworth spasm scale.And exercise capacity of children before and after treatment was assessed by the gross motor function rating scale.The follow-up time was 3 months,the clinical curative effect of two groups of children was observed.Results The total efficiency of ultrasound guided group (98.0％) was significantly higher than the free group (79.6％),with statistically significant (P ＜ 0.05).Both groups before and after treatment in children with Ashworth score and GMFM score were significantly improved,with statistical significance (P ＜ 0.05).Ashworth score and GMFM scores of ultrasound guided group were significantly better than the free group,with statistically significant (P ＜ 0.05).Conclusion Botulinum toxin injection in the treatment of cerebral palsy children can effectively solve the spastic problem.Treatment of children with cerebral palsy by injecting botulinum toxin with ultrasound guided injection of botulinurn toxin is better than manual injection of botulinum toxin.