Background The incidence of myopia is gradually increasing,and how to choose a better corrective method of myopia for the best visual demand is very important.Objective This study was to compare visual quality of implantable collamer lens (ICL) implantation with femtosecond laser in situ keratomileusis (FSLASIK) for moderate and high myopia using double-pass optical quality analysis system (OQAS).Methods A non-randomized controlled clinical trail was performed.Fifty-two eyes with-4.00 to-9.00 D of 26 consecutive patients were included in NO.1 Hospital of Xi'an from January 2015 to January 2016.Twenty-four eyes of 12 patients with the corneal thickness ＜500 μm received ICL implantation as ICL group and 28 eyes of 14 patients which corneal thickness was ≥500 μm underwent FS-LASIK surgery as FS-LASIK group.The demography was matched between the two groups (all at P＞0.05).All the patients were followed-up for 3 months after surgery.The preoperative best corrected distance visual acuity (BCDVA),spherical equivalent (SE),postoperative uncorrected distance visual acuity (UCDVA),BCDVA and SE were examined and compared between two groups.The parameters from OQAS were evaluated and intergrouply compared,including the objective scattering inders (OSI),modulation transfer function (MTF) cut off frequency,Strehl ratio and OQAS values under the contrast of 100％,20％ and 9％ (OV100,OV20,OV9).Results The postoperative BCDVA was not significantly different from preoperative UCDVA in both ICL group and FS-LASIK group (-0.04±t0.10 vs.0.05±0.12;-0.07±0.12 vs.0.00±0.12) (t=3.128,2.358,both at P＞0.05).No statistically significant differnces were found in SE,UCDVA and BCDVA after operation between ICL group and FS-LASIK group (t =1.292,0.900,-0.653,all at P＞0.05).OQAS examination showed that MTF cut off,OSI,Strehl ratio,OV100 were not significantly different after operation between ICL group and FS-LASIK group (t=-2.032,-1.440,-0.224,all at P＞0.05).The postoperative OV20 and OV9 were 0.82±0.14 and 0.80±0.21 in the ICL group,which were significantly higher than those in the FS-LASIK group(0.59±0.15 and 0.47±0.13) (t =4.105,4.702,both at P＜0.05).Conclusions Both ICL implantation and FS-LASIK provide good optical and visual quality for moderate to high myopic eyes,and ICL appears to have a better visual quality in comparison with FS-LASIK under the contrasts of 20％ and 9％.

Humans ; Reconstructive Surgical Procedures ; Trachea ; surgery

BACKGROUND:The production and release of a large amount of inflammatory factors caused by immune system inflammatory response mainly contributes to secondary spinal cord injury. OBJECTIVE:To investigate the effects of umbilical cord Wharton’s jely mesenchymal stem cel transplantation on repair of injured neurological function and expression of inflammatory factors monocyte chemoattractant protein 1 and interleukin 10 in rats with acute spinal cord injury. METHODS: Eighty-one healthy adult male Sprague-Dawley rats were randomly and equaly divided into sham operation, model and cel transplantation groups, with 27 rats per group. Rats in the latter two groups were subjected to hemisection of the spinal cord to establish acute spinal cord injury models. Rat models in the cel transplantation group received umbilical cord Wharton’s jely mesenchymal stem cel injection (1×106)via the tail vein. Rat neurological function was evaluated using the BBB score at different time points after spinal cord injury. The expression of monocyte chemoattractant protein 1 and interleukin 10 in injured spinal cord tissue was detected using ELISA assay at different time points after spinal cord injury. Migration and neuronal differentiation of umbilical cord Wharton’s jely mesenchymal stem cels in the injured spinal cord tissue were determined using immunohistochemical staining method. RESULTS AND CONCLUSION:Compared with the sham operation and model groups, rat neurological function was significantly recovered in the cel transplantation group (P < 0.05). Compared to the model group, monocyte chemoattractant protein 1 level in the serum and monocyte chemoattractant protein 1 mRNA and protein expression in the injured spinal cord tissue were significantly lower (P < 0.05), but interleukin 10 mRNA and protein expression in the injured spinal cord tissue was significantly higher (P < 0.05), in the cel transplantation group. In the cel transplantation group, umbilical cord Wharton’s jely mesenchymal stem cels could migrate to the injured region and express glial fibrilary acidic protein. These findings suggest that umbilical cord Wharton’s jely mesenchymal stem cels promote rat neurological function recovery by regulating the inflammatory response in the injured spinal cord tissue, which is likely to be one of mechanisms by which transplantation of umbilical cord Wharton’s jely mesenchymal stem cels treats spinal cord injury.

Objective To evaluate the efficacy of endoscopic balloon dilation for subglottic stenosis.Methods The clinical outcomes of 9 pediatric patients treated with balloon dilation were retrospectively analyzed.There were 8 male and Ⅰ female.Their age ranged from 7 months to 7 years (mean 2.5 years).The degree of stenosis was classified according to Myer-Cotton classification as follows:grade Ⅱ (n =7) and grade Ⅲ (n =2).The causes of the stenosis were postintubation lesions (n =8) and laryngeal penetrating trauma (n =1).Results The patients had undergone 1 to 3 dilations with an average of 1.8 procedures per patient.Six (66.7％) patients were decannulated.Among them,4 (44.4％) were decannulated after one dilation procedure.Pneumothoraces occurred in 2 children postoperatively.Conclusion Endoscopic balloon dilation is an effective,relatively safe and minimally invasive surgical method for patients with low-grade subglottic stenosis.

Objective To evaluate the efficacy of segmental tracheal resection with end-to-end anastomosis for cicatricial cervical tracheal stenosis.Methods The clinical outcomes of 40 patients treated with tracheal resection were retrospectively reviewed.There were 28 male patients and 12 female patients with the age ranged from 6 to 64 years (mean 33.7 years).The degree of stenosis was classified according to Myer-Cotton classification as follows:grade Ⅱ (n =7),grade Ⅲ (n =22) and grade Ⅳ (n =11).The stenosis extension ranged from 1.0 to 4.3 cm (mean 2.5 cm).The causes of the stenosis were postintubation (n =33),cervical trauma (n =6) and resection of tracheal neoplasm (n =1).Results Thirty-four(85.0％) patients were decannulated and 6 failed.Of the 6 patients failed,4 were decannulated after reoperation with the sternohyoid myocutaneous flap or thyroid alar cartilage graft.Complications occurred in 10 patients.In 8 patients granulation tissues formed at the site of the tracheal anastomosis,which needed endoscopic resction,and in 2 patients anastomosic dehiscence occurred.No injury to recurrent laryngeal nerve or trachoesophageal fistula occurred.Conclusion Segmental tracheal resection with end-to-end anastomosis is an effective surgical method for tracheal stenosis,which has a higher successful rate for primary operation and shorter therapeutic period.