AIM: To determine the effect of suction duration on thickness and diameter of corneal flap created by microkeratome in porcine eyes in laser in situ kerato-mileusis (LASIK).METHODS: Sixty porcine eyes were randomly assigned to three groups according to different suction durations: group 1 (10 seconds), group 2 (20 seconds), and group 3 (30 seconds). A Moria M2 microkeratome (Moria, France) with a 160μm head was used to create a corneal flap. Corneal flap thickness was measured by automated ultrasonic pachymetry, and the flap diameter was measured by a vernier caliper.RESULTS: The flap thickness of group 1, group 2 and group 3 was 146.05±13.46μm, 157.35±18.95μm and 169.25±21.02μm, respectively. There was a statistically significant difference among three groups (P=0.001). The mean flap diameter in groups 1, 2 and 3 was 8.63±0.19mm, 8.89±0.24mm and 9.06±0.18mm, respectively. A statisti-cally significant difference was found among groups (P<0.01).CONCLUSION: In LASIK in porcine eyes, an increase in suction duration resulted in a thicker and greater flap.

Adult ; Bronchoalveolar Lavage ; methods ; Bronchoalveolar Lavage Fluid ; Humans ; Male ; Middle Aged ; Pneumoconiosis ; therapy

Animals ; Epitopes, T-Lymphocyte ; immunology ; Equine Infectious Anemia ; immunology ; virology ; Horses ; Infectious Anemia Virus, Equine ; immunology ; physiology ; T-Lymphocytes, Cytotoxic ; immunology ; physiology

BACKGROUND:Semi-shoulder or total shoulder arthroplasty for complicated proximal humerus fractures is better in the rapid elimination of pain and restoration of joint function.
OBJECTIVE:To analyze the surgical techniques and clinical effects of semi-shoulder arthroplasty on the treatment of complicated proximal humerus fractures.
METHODS:The surgical efficacy of 12 cases of complicated proximal humerus fractures who had al received semi-shoulder arthroplasty was analyzed. According to Neer classification, there were two cases of three-part fractures and 10 cases of four-part fractures. X-ray observation and Neer scoring criteria were also used to conduct a clinical evaluation of shoulder joint function after operation.
RESULTS AND CONCLUSION:Al the patients were fol owed up for 18 months in average (6 to 48 months). Based on Neer scoring, excellent was in 10 cases, good in one case, fair in one case. The excellent rate was 92%. During the fol ow-up period, prosthesis location was good and there were no complications, such as periarticular fractures, nerve injury, infection, dislocation or looseness. Attention should be paid for the effective restoration of shoulder cuff and the correct reconstruction of the large and smal nodules in semi-shoulder arthroplasty. Besides, it also should be combined with the early and standard functional exercises. The clinical effect of semi-shoulder arthroplasty is satisfactory and it is an effective way to treat complicated proximal humerus fractures.

Objective To investigate the effects of different clipping time of first time using permanent aneurysm clips on common carotid artery wall in rabbitsMethods Sixty healthy male Japanese white rabbits were selected.The first time permanent aneurysm clips were used to clip common carotid artery for 30 min or 60 min respectively according to the random number method (n=30 in each group).Thirty segments of common carotid artery specimens clipped by aneurysm clips were collected respectively.Mean-Whitney U test was used to conduct the comparison of histopathological damage grade of vascular wall.Results The aneurysm clips were use to clip 30 min and 60 min caused vascular wall injury could observe the middle elastic plastic plate deformation and endothelial denudation.The vascular walls in the clipping 60 min group had local necrosis with inflammatory response,and even rupture of vascular wall.There were significant differences in overall damage degree of vascular wall (U=324.00,P=0.045) and severe injury rate (0%[0/30] vs.20.0%[6/30],P=0.031) between the clipping 30 min group and the clipping 60 min group (all P<0.05).Conclusion The vascular wall injury of using disposable permanent aneurysm clips for clipping 60 min was more severe than 30 min.Attention should be paid to shortening the time of carotid artery occlusion in operation.

Objective The frequency and the anatomic distribution of involved regional nodes in recurrent and locally advanced breast cancer were analyzed, in order to evaluate the rational of conventional regional node radiation technique and provide evidence for target definition of breast cancer . Methods Patients with recurrent or locally advanced breast cancer who were treated in our hospital from August 2003 to December 2009 were included in this study. 111 patients had contrast enhanced chest CT images of the whole regional nodes before treatment. The regional nodes were categorized into 8 anatomical substructures including medial and lateral supraclavicular nodes ( SC-M, SC-L), axilla nodes ( ALN )- Ⅰ , Ⅱ , Ⅲ,infraclavicular nodes (IFN), Rotter's nodes (RN) and internal mammary nodes (IMN). The frequency of involvement and anatomical distribution of the involved nodes on CT images were analyzed. Results A total of 111 patients were enrolled this study and 199 anatomical substructures with involved nodes were identified. The frequency of involvement were :SC-M 33, SC-L 21, ALN- Ⅰ 30, ALN-Ⅱ 25, ALN-Ⅲ + IFN 35, RN 27, IMN 28. Supraclavicular region and axilla were the most frequently involved area (72. 3% ).The average depth of the SC-M and SC-L nodes was 33.48 mm ± 10. 57 mm and 45.62 mm ±20. 45 mm,and 51.5% and 71.4% of the SC-M and SC-L nodes were located more than 3 cm deep from the skin. The axilla nodes were located cranial and caudal to the axillary vein in 5 and 20 locally advanced breast cancer patients and in 64 and 28 patients who received prior axillary dissection. The majority of involved IMN was located within the first 3 intercostal spaces (26/28). The average distance between the center of involved IMN and chest skin was 24. 23 mm ± 10. 28 mm. The average distance between the center of involved IMN and midline of the body was 29. 38 mm ±6. 7 mm. The center of involved IMN was 6.19 mm ±5.73 mm lateral and 5.73 mm ± 4. 56 mm posterior to the internal mammary vessels. Conclusions Conventional field design is unlikely to provide sufficient dose to the entire risk region because of individual differences.Individualized treatment planning based on CT would become feasible with increasing knowledge of natural risk of nodal involvement.

Objective To investigate the changes in systemic and pulmonary hemodynamics in patients with liver cirrhosis and portopulmonary hypertension(PPH)during liver transplantation.Methods Eight patients with liver cirrhosis and PPH(5 male,3 female)aged 50-63 yr weighing 45-80 kg were included in PPH group. Another 8 liver-cirrhotic patients without PPH served as control group.The patients were premedicated with intramuscular phenobarbital 0.1 g and atropine 0.5 mg.Anesthesia was induced with midazolam 3-5 mg,fentanyl 0.15-0.2 mg,propefol 1 mg?kg~(-1) and vecuronium 0.1 mg?kg~(-1) and maintained with 0.5%-3% isoflurane inhalation and intermittent Ⅳ boluses of fentanyl and vecuronium.The patients were mechanically ventilated after tracheal intubation.P_(ET)CO_2 was maintained at 30-45 mm Hg.Right subclavian vein was cannulated for fluid and drug administration and blood transfusion.Radial artery was cannulated for BP monitoring.Swan-Ganz catheter was placed via right internal jugular vein.BP,CVP,MPAP,PAWP,CI,PVRI and SVRI were monitored and recorded before operation(baseline),during preanhepatic phase,at 3 and 30 min of anhepatic phase and 3,7, 15,60 min of neohepatic phase and at the end of operation.Results(1)The two groups were comparable with respect to fluid balance,the amount of vasoactive drugs used during anhepatic and neohepatic phase,duration of anhepatic phase and operation.(2)MPAP and PVRI were significantly higher before operation in PPH group than in control group.(3)CI,MPAP, PAWP and CVP were siguificanfly decreased during anhepatic phase as compared to the baseline values(before operation)in both groups and then gradually returned to and even exceeded the baseline values during neohepatic phase.(4)During neohepatic phase PVRI in PPH group was significantly increased as compared to the baseline value and was significantly higher than that in control group.Conclusion MPAP and PVRI are significantly increased during neohepatic phase in patients with PPH and need to be treated.

Obstructive sleep apnea-hypopnea syndrome (OSAHS) is a common clinical disease that seriously threatens human health and life. Accurate location of the upper airway obstruction is the key to the diagnosis and treatment of OSAHS. Acoustic pharyngometry uses sound reflection to quickly assess the cross-sectional area and volume of the upper airway. Acoustic pharyngometry represents a simple, quick, non-invasive method for measuring upper airway dimensions which could predict sleep apnea risk. In this article we sought to introduce the application of acoustic pharyngometry in the diagnosis and treatment of OSAHS.
Acoustics ; Humans ; Larynx ; Pharynx ; diagnostic imaging ; Sleep Apnea, Obstructive ; diagnosis ; therapy ; Syndrome

OBJECTIVETo evaluate the role of thrombin-activated microglia in the neurodegeneration of nigral dopaminergic neurons in the rat substantia nigra (SN) in vivo.

METHODSAfter stereotaxic thrombin injection into unilateral SN of rats, immunostaining, reverse transcription polymerase chain reaction (RT-PCR) and biochemical methods were used to observe tyrosine hydroxylase (TH) immunoreactive positive cells, microglia activation, nitric oxide (NO) amount and inducible nitric-oxide synthase (iNOS) expression.

RESULTS(1) Selective damage to dopaminergic neurons was produced after thrombin injection, which was evidenced by loss of TH immunostaining in time-dependent manner; (2) Strong microglial activation was observed in the SN; (3) RT-PCR demonstrated the early and transient expression of neurotoxic factors iNOS mRNA in the SN. Immunofluorescence results found that thrombin induced expression of iNOS in microglia. The NO production in the thrombin-injected rats was significantly higher than that of controls (P < 0.05).

CONCLUSIONThrombin intranigral injection can injure the dopaminergic neurons in the SN. Thrombin-induced microglia activation precedes dopaminergic neuron degeneration, which suggest that activation of microglia and release of NO may play important roles in dopaminergic neuronal death in the SN.

Animals ; Disease Progression ; Dopamine ; biosynthesis ; Encephalitis ; chemically induced ; metabolism ; physiopathology ; Female ; Gliosis ; chemically induced ; metabolism ; physiopathology ; Immunohistochemistry ; Inflammation Mediators ; toxicity ; Injections ; Microglia ; drug effects ; metabolism ; Nerve Degeneration ; chemically induced ; metabolism ; physiopathology ; Neurons ; drug effects ; metabolism ; pathology ; Nitric Oxide ; biosynthesis ; Nitric Oxide Synthase Type II ; drug effects ; metabolism ; Oxidative Stress ; drug effects ; physiology ; Parkinsonian Disorders ; chemically induced ; metabolism ; physiopathology ; RNA, Messenger ; drug effects ; metabolism ; Rats ; Rats, Sprague-Dawley ; Reverse Transcriptase Polymerase Chain Reaction ; Substantia Nigra ; drug effects ; metabolism ; physiopathology ; Thrombin ; toxicity ; Time Factors ; Tyrosine 3-Monooxygenase ; drug effects ; genetics ; metabolism ; Up-Regulation ; drug effects ; physiology

BACKGROUNDPercutaneous microballoon compression (PMC) for trigeminal neuralgia is an important therapeutic method. The aim of this study was to review the effects of PMC for trigeminal neuralgia in 276 patients.

METHODSFrom December 2000 to May 2003, 276 patients with trigeminal neuralgia were treated with PMC. The course of the disease ranged from 3 months to 38 years. Under the guidance of C-arm X-ray, 14# needle was placed into the foramen ovale using the classical Hakanson's technique. Fogarty balloon catheter was navigated into the Meckel's cave tenderly. A small amount of Omnipaque was slowly injected to inflate the balloon and compress the trigeminal ganglion for 3 to 10 minutes.

RESULTSA total of 290 PMC were performed on the 276 patients. Among them, 252 had immediate relief from pain. The patients were followed up for a mean of 18.7 months (range, 4 to 32), 14 of them had a recurrence. Of the 14 patients, 12 were re-operated with PMC, and the pain was all controlled successfully.

CONCLUSIONSPMC is an effective and technically simple method for trigeminal neuralgia. For older patients with trigeminal neuralgia, it may be the first choice.

Adult ; Aged ; Aged, 80 and over ; Blood Pressure ; Catheterization ; methods ; Female ; Follow-Up Studies ; Heart Rate ; Humans ; Male ; Middle Aged ; Trigeminal Neuralgia ; physiopathology ; therapy