Objective To evaluate the postoperative complications and visual quality after manual small incision cataract surgery (MSICS) versus phacoemulsification (PHACO).Methods A systematic review of MSICS and PHACO was conducted by a computer search on Medline,Pubmed,CBM and CNKI and a supplementary manual search was also done.The effect was measured as an odds ratio (OR) and weighted mean difference (WMD).RevMan 5.0 software was used to perform the Meta-analysis.Results A total of 9 articles were included in the Meta-analysis.Naked visual acuity at 1 week after surgery (OR =0.93,95％ CI 0.68-1.27),posterior capsular ruptured after surgery (OR =1.07,95％ CI 0.73-1.58),corneal edema after surgery (OR =0.90,95 ％ CI 0.70-1.16),surgically induced astigmatism at 1 month after surgery (WMD =0.08,95％ CI-0.02-0.17) in MSICS and PHACO was no statistically significant difference (P ＞0.05).Conclusion MSICS is safe and reliable surgery as same as PHACO for the patients with cataract,MSICS is more consistent with China' s national conditions.

Adolescent ; Female ; Heart Septal Defects, Atrial ; complications ; Humans ; Hypertension, Pulmonary ; complications ; Scimitar Syndrome ; complications ; Tomography, X-Ray Computed

Objective To discuss the value of tension-free hernia repair to recurrent inguinal hernia in elderly patients.Methods 38 eases with recurrent inguinal hernia in elderly patients were treated with shaped polyproplene tension-free hernioplasty.Results All eases were operated successfully.In the follow-up period ranged from 6 to 42 months.No Serious postoperation complications were found,no recurrent case recurred.This treatment is effective.Conclusion Tension-free hernia repair has many advantages,such as safety,easily manipulation,minimal invasion,rapid recovery,lower recurrence.It is a perfect and ideal surgical operation for the recurrent inguinal hernia in elderly patients.

Objective To investigate the clinical features of acute coronary syndrome (ACS) combined with low T3 syndrome and its prognosis.Method Eighty-seven ACS patients with low free triiodothyronine (FT3) level (low FT3 group) and additional 64 ACS patients with normal FT3 level(control group) were selected in parallel; all the patients underwent coronary angiography.The contents of FT3,N-terminal pro-brain natriuretic peptide (NT-proBNP),cardiac troponin I (cTnI) and high sensitivity-C reactive protein (hs-CRP) were recorded,and the related factors were evaluated.The number of stenotic vessels was calculated.Results The contents of NT-proBNP,cTnI and hs-CRP in low FT3 group were elevated significantly compared with those in control group [(1242.14 ± 226.32) ng/L vs.(1126.36 ±195.55) ng/L,(0.92 ± 0.23) ng/L vs.(0.84 ± 0.19) ng/L,(6.46 ± 2.25) mg/L vs.(5.71 ± 1.78) mg/L],and there were significant differences (P ＜ 0.01 or ＜ 0.05).The contents of FT3 were negatively correlated with NT-proBNP,cTnI and hs-CRP in two groups (P ＜ 0.05).There was no significant difference in the number of stenotic vessels between two groups (x2 =4.512,P =0.105).Conclusion In patients with ACS,there is a negative correlation between contents of FT3 and the prognosis,but there is no correlation between contents of FT3 and the number of stenotic vessels.

Objective: To evaluate effect of refining of the aqneous extract solution of compound Chinese traditional medicine by microfiltration technique of inorganic ceramic membrane. Methods: The aqneous extract solution of Ephedra, Apricot kernel, Gypsum, and Licorice Decoction and Redujing Granules were processed by microfiltration technique of inorganic ceramic membrane. The changes in the characters, whole solids and effective componds before and after process were studied. Results: The aqueous extract solution of compound Chinese traditional medicine all were turbid before microfiltering and became clear after microfiltrating. The whole solid of Ephedra, Apricot kernel, Gypsum, and Licorice Decoction were decreased by 16.12%, and the lost rates of ephedrine and amygdalin were 20.11% and 18.06% respectively. The whole solid of Redujing Granules were decreased by 27.58%, and the lost rates of chlorogenic acid and rhein were 18.28% and 22.86% respectively. Conclusion: The microfiltration technology of inorganic ceramic membrane has the better effects of clarification and removing impurity on the aqueous extract solution of compound Chinese traditional medicine.

Objective: To evaluate effect of refining of decoctions of medicinal materials of radix and rhizome by microfiltration of inorganic ceramic membrane. Methods: The decoctions of 7 medicinal materials of radix and rhizome were processed by inorganic ceramic membrane, and the whole solids and effective ingredients were determined. Results: The decoctions of Chinese traditional medicine became clear after microfiltration. The whole solids were decreased by 15～38%, and the lost rate of effective ingredients was lower than that of whole solids. Conclusion: The microfiltrating technology of inorganic ceramic membrane can make decoctions of Chinese Traditional Medicine clear.

Objective To get further insight into the breakthrough pain experiences in advanced cancer patients in order to provide targeted nursing measures for breakthrough pain patients. Methods Semi structured interviews were performed in 12 advanced cancer patients. Colaizzi analysis program was used to analyze, induct and extract the themes. Results The breakthrough pain experiences of advanced cancer patients were as follows:overall perception of breakthrough pain;the experience when experiencing breakthrough pain; personal growth related to breakthrough pain. Conclusions Nurses should provide sufficient information to patients timely, consider patients′needs and combine with non-drug methods to better manage breakthrough pain to improve patients′experience about breakthrough pain.

OBJECTIVETo compare therapeutic effects of clavicular hook-plate fixation and modified Weaver-Dunn surgery combined with clavicular hook-plate fixation in treating Tossy type III acromioclavicular joint dislocation.

METHODSForty-one patients with Tossy type III acromioclavicular dislocation treated by operation were retrospectively analysis from January 2012 to January 2014. The patients were divided into clavicular hook-plate fixation group (group A) and modified Weaver-Dunn surgery combined with clavicular hook-plate fixation (group B) according to surgical procedures. In group A, there were 15 males and 6 females aged from 17 to 51 years old with an average of (31.60 ± 12.58) years old, preoperative Constant-Murley score was 40.25 ± 9.80, and treated with clavicular hook-plate fixation. In group B, there were 13 males and 7 females aged from 18 to 48 years old with an average of (29.40 ± 11.27) years old, preoperative Constant-Murley score was 41.45 ± 8.81, and treated with modified Weaver-Dunn surgery combined with clavicular hook-plate fixation. Operative time, blood loss, imaging changes before and after operation, postoperative complications were compared; Constant-Murley score at 3, 6 and 12 months after operation were evaluated.

RESULTSIn group A, operative time was 40.50 ± 24.36) min, blood loss was (75.30 ± 30.36) ml; In group B, operative time was (60.10 ± 23.55) min, blood loss was (100.70 ± 40.12) ml. Twenty-one patients in group A were followed-up from 12 to 18 months with an average of (14.8 ± 3.1) months; 20 patients in group B were followed-up from 12 to 14 months with an average of (13.6 ± 1.5) months. There were no significant differences in operative time, blood loss and follow-up time between two groups. Complications were in six patients of group A and 3 patients of group B, and there were no significant meaning between two groups. At 6 months after operation, Constant-Murley score in group A was 88.85 ± 4.23, 92.15 ± 3.82 in group B; and had significant meaning between two groups (t = -2.56, P = 0.022 < 0.05). While there were no differences in Constant-Murley score in other times.

CONCLUSIONBoth of clavicular hook-plate fixation and modified Weaver-Dunn surgery combined with clavicular hook-plate fixation are effective operative methods for the treatment of Tossy type III acromioclavicular dislocation. Clavicular hook-plate fixation has advantage of less trauma, while modified Weaver-Dunn surgery combined with clavicular hook-plate fixation could reconstruct coracoclavicular ligament more stronger, clavicular hook plate could take out earlier, also improve shoulder joint function earlier.

Acromioclavicular Joint ; injuries ; Adolescent ; Adult ; Bone Plates ; Case-Control Studies ; Female ; Fracture Fixation, Internal ; methods ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Shoulder Dislocation ; surgery

OBJECTIVETo evaluate the effect of electro-acupuncture (EA) on gastric mucosal oxygenation and systemic inflammatory response in patients undergoing endoscopic sinus surgery with controlled hypotension (CH), and to explore its protective effect on gastric mucosa.

METHODSFifty-four patients, 18-65 years old, grade I-II of American Society of Anesthesiology (ASA), who were scheduled for endoscopic sinus surgery were randomly assigned to two groups, group A (general anesthesia group) and group B (general anesthesia combined EA anesthesia group), 27 in each group. Conrolled hypotension was executed during operation, and mean arterial pressure (MAP) was maintained at 55-65 mmHg. After tracheal intubation gastric tesiometer catheter was indwelled through nasal cavity or oral cavity. After successful indwelling, it was connected with gastric mucosa monitoring mode of multifunctional parameters monitor. Patients' MAP and heart rate (HR), pHi, partial pressure of carbon dioxide (PgCO2), arterial partial pressure of carbon dioxide (Pg-aCO2) and endtidal pressure of carbon dioxide (Pg-etCO2) were measured and recorded at T, (immediately before induced hypotension), T, (20 min following induced hypotension to target MAP), T2 (40 min following induced hypotension to target MAP), T3 (20 min after ending induced hypotension), and T4(40 min after ending induced hypotension). Blood samples were intravenously collected, TNF-alpha, IL-1, and IL-6 were detected by ELISA 24 h before operation, during operation (T3), and 24 h after operation.

RESULTSAfter hypotension was induced, Pg-CO2, Pg-aCO2 and Pg-etCO2 increased significantly (P < 0.01, P < 0.05), while pHi decreased significantly (P < 0.01) in both groups at T1-T4 than those at T0. During T1-T4, PgCO2, Pg-aCO2, and Pg-etCO2 were higher (P < 0.01, P < 0.05), while pHi was lower in group A than in group B (P < 0.01). Furthermore, TNF-alpha, IL-1, and IL-6 increased significantly in both groups during operation and 24 h after operation, when compared with those 24 h before operation (P < 0.01, P < 0.05). TNF-alpha and IL-1 in group A were higher than those in group B (P < 0.05) during operation and 24 h after operation, but with no significant difference in the plasma concentration of IL-6 (P > 0.05).

CONCLUSIONEA exerted obvious protective effect of gastric mucosal injury in endoscopic sinus surgery with controlled hypotension, which might be achieved by increasing gastric mucosal blood flow, maintaining oxygen supply and demand, inhibiting inflammatory response, and alleviating injury of gastric mucosal barrier.

Acupuncture Analgesia ; methods ; Adolescent ; Adult ; Aged ; Anesthesia, General ; Arteries ; Blood Pressure ; Electroacupuncture ; methods ; Endoscopy ; Female ; Gastric Mucosa ; surgery ; Heart Rate ; Humans ; Hypotension, Controlled ; Interleukin-1 ; Interleukin-6 ; Male ; Middle Aged ; Tumor Necrosis Factor-alpha ; Young Adult

ObjectiveTo observe the influence of Danshen injection on the serum levels of TNF-α,IL-6 in patients with acute pancreatitis(AP).Methods70 patients with AP were randomly divided into the experimental and control group.The two groups were given conventional anti-inflammatory,antisecretory,antispasmodic,inhibition of pancreatic secretion treatment,and the experimental group were treated with Danshen injection.Before trealment and 1,2,4,6 days after treatment,the serum TNF-α,IL-6 levels were measured in both groups.The time of blood and urine amylase(AMS) returned to normal was observed in both groups.Results2,4,6d after treatment,the serum TNF-α,IL-6 of the observation group were lower than that of the control group( all P ＜ 0.05 ) ;The blood AMS recovery time of the observation group was ( 2.55 ± 0.71 ) d,which had no significant difference with that of the control group(2.46 +0.82)d(t =0.32,P ＞0.05 ),while urinary AMS recovery time of the observation group was (4.30 ±0.72 ) d,which was shorter than that of the control group ( 6.84 ± 0.88 ) d ( t =0.02,P ＜ 0.05 ).ConclusionDanshen injection could reduce the serum TNF-α,IL-6 levels in patients with AP,and had no effect on the serum amylase,with the trend of faster lower urinary amylase.