Objective To investigate the clinical effecl of trabeculectomy with scleral tunnel in the treatment of refractory glaucoma. Design Prospective, randomized and comparative clinical study. Participants 87 patients (98 eyes) with refractory glaucoma. Methods The patients were randomly assigned to receiving trabeculectomy with or without scleral tunnel. The tunnel group (50 eyes) underwent trabeculectomy with an additional deep scleral tunnel of 5.0mm?1.5mm beneath the superficial scleral flap. The control group (48 eyes) underwent conventional trabeculectomy. The average follow-up period was 6 to 12 months posloperatively. Main Outcome Measures Visual acuity, intraocular pressures (IOP), filtering blebs, operative and postoperative complications. Results (1) No significant differences in visual acuity were found between two groups. (2) The postoperative IOPs were significantly lower than the preoperative IOPs in both groups, while the IOPs on the 7th day after the surgery between the two groups were not different significantly. The average postoperative IOP at the 6th month in the tunnel group was 14.34?3.95 mmHg and 19.57?7.76 mmHg in the control group, which were different significantly (P

BACKGROUND: Previous research has indicated that graphite carbon nanoparticles have a strong adsorbability. While, when the concentration is effectively controlled, graphite carbon nanoparticles also have well compatibility and sensitizing effect. OBJECTIVE: To observe the morphology of graphite carbon nanoparticles, and to investigate the effects of graphite carbon nanoparticles on cell proliferation and ultramicrostructure.METHODS: Graphite carbon nanoparticles (0.5 g) were put in 100 mL triple distilled water to obtain graphite carbon nanoparticle mother liquid after oscillation and microfiltration. HepG2 cells, L02 cells, HI7702 cells, and 3T3 cells in the logarithmic phase were adjusted to the concentration of 5×10~7/L and inoculated in 6-well culture plate with 0.5 mL per well. Thereafter, the cells were cultured with RPMI-1640 culture media (1.5 mL) containing fetal bovine serum, penicillin, and streptomycin. The original culture solution was removed after 24 hours. The 1-5 wells were considered as the experimental group, and 25, 10, 7.5, 5, 0.25 mg/Lgraphite carbon nanoparticles (2.0 mL) were respectively added into each well; while, the sixth well was considered as the blank control group without graphite carbon nanoparticles. The cells in the blank control group were cultured for 24 hours. Particle diameter was measured using atomic force microscopy; morphology was observed using electron microscope; effect of different concentrations of graphite carbon nanoparticles on cell number was detected using hemacytometry under optic microscope; the effect of 7.5 mg/L graphite carbon nanoparticles on ultramicrostructure was observed under transmission electron microscope. RESULTS AND CONCLUSION: Graphite carbon nanoparticles were around and 20 nm diameter. Compared with the blank control group, cell numbers except HepG2 cells were increased, especially the effect of 7.5 mg/L graphite carbon nanoparticles was greatest (P < 0.05). Transmission electron microscope indicated that graphite carbon nanoparticles were distributed into cells, including cytoplasm, nucleus, and mitochondrion; while, subcellular structure damage and cell apoptosis and necrosis were absent. Graphite carbon nanoparticles have no side effects on in vitro cultured cells and can promote cell proliferation, showing a dose-dependence correlation, especially the concentration of 7.5 mg/L.

On October 23, 2017, a 52-year-old male patient with 3 recurrences of dermatofibrosarcoma protuberans in the left shoulder and chest was admitted to the Department of Burns and Plastic Surgery of Dali Bai Autonomous Prefecture People′s Hospital. Dermatofibrosarcoma protuberans on the skin were completely resected, leaving wound defect of 10 cm×10 cm. The wound was planned to be repaired by the transplantation of right anterolateral thigh perforator free flap. However, the anterolateral thigh perforator branch was absent during flap removal, and only one small perforating branch was found. Moreover, it was difficult to separate. Therefore, this flap cutting was given up. The anteromedial thigh perforator was explored through the same incision, and a thicker perforator was found, which was supplied by an independent iatrogenic artery. The length and diameter of the vascular pedicle matched with the blood vessels in the receiving site. An anteromedial thigh perforator flap (10 cm×10 cm) was cut to repair the defect. The postoperative 9-month follow-up revealed that the color, texture, and thickness of the flap were good, the two-point discrimination distance was 30 mm, and the linear scar remained at the donor site of right thigh.

From November 2015 to July 2017, six patients with skin and soft tissue defects of vulva, vagina, and buttock after resection of vulvar tumors were hospitalized in our unit. All patients were female, aged 45-70 years. Among them, four patients had bilateral defects, and two patients had unilateral defect. The defect area on each side ranged from 6 cm×4 cm to 12 cm×6 cm. Internal pudendal artery perforator " angel wing" island flaps were used to repair and reconstruct the defects. The area of flaps ranged from 7 cm×5 cm to 14 cm×7 cm. The donor sites were sutured directly. All 10 flaps of 6 patients survived. Two patients had local incision infection 3 days after operation. One of the two patients was healed 2 weeks after dressing change, and the other one underwent debridement and suture 1 week after dressing change and was healed 1 week after surgery. Follow-up for 6-12 months after surgery showed no recurrence of tumors, no eversion of vagina, better shape of vulva in bilateral reconstruction cases, and slightly worse symmetry in unilateral reconstruction cases. The skin of the reconstructed area was soft, with sensations of pain, temperature, and touch recovered in varying degrees. The distance of a two-point discrimination was 20-30 mm. Linear scars were left in the flap donor sites, with no impact on squatting or striding. In vaginal examination, 1.5 to 2.0 fingers could be inserted in bilateral reconstruction cases, while 2.0 to 3.0 fingers could be inserted in unilateral reconstruction cases. The anus functioned well during defecation.