AIM:To observe the clinical effects of 23-gauge (23G) transconjunctival sutureless vitrectomy for idiopathic macular hole.
METHODS: In this retrospective study, 28 eyes of 28 consecutive patients who underwent 23 - gauge transconjunctival sutureless vitrectomy for idiopathic macular hole between January 2013 and October 2013 in our hospital were evaluated. The follow-up time was 3-12mo. The operation effects were analyzed.
RESULTS:The macular hole was closed in 27 eyes of 28 eyes which underwent 23G transconjunctival sutureless vitrectomy and not closed in 1 eye after surgery. Best-corrected visual acuity at postoperative 1, 3mo was significantly improved compared to pre-operation (χ2=8-65, P=0. 003;χ2=10. 33, P=0. 001). The macular hole was closed as shown by OCT. Intraoperative incision was sutured in 5 cases ( 18%) . There was no statistically significant difference in intraocular pressure between pre-operation and post - operation. No post - operative complications such as endophthalmitis, retinal detachment, vitreous hemorrhage came up.
CONCLUSION: 23G transconjunctival sutureless vitrectomy is observed to be safe and effective technique in the treatment of macular hole. It is therefore our preferred system for straightforward macular surgery.

Activins ; administration & dosage ; pharmacology ; Animals ; Animals, Newborn ; Apoptosis ; drug effects ; Cerebral Cortex ; drug effects ; pathology ; ultrastructure ; Disease Models, Animal ; Dose-Response Relationship, Drug ; Female ; Hippocampus ; pathology ; ultrastructure ; Hypoxia-Ischemia, Brain ; drug therapy ; pathology ; Injections, Intraperitoneal ; Male ; Microscopy, Electron ; Neuroprotective Agents ; administration & dosage ; pharmacology ; Rats ; Rats, Wistar ; Treatment Outcome

Objective To investigate walking ability of amputees with unilateral transtibial prosthesis. Methods From April to Decem-ber, 2016, 20 unilateral transtibial amputees (patients) and 20 healthy adults (controls) were tested with L test, balance test, 6-minute walk test (6MWT) and 1000 m walking outdoor on various terrain. Results There was no significant difference in time of L test between the am-putees wearing Solid Ankle Cushion Heel (SACH) and Storage Foot (t=0.675, P>0.05). In balance tests, there was no significant difference in the total track length, confidence ellipse area, maximum horizontal deviation and maximum vertical deviation between the patients and the controls (t<0.803, P>0.05). Each parameter was significantly different in 6MWT between them (t>2.774, P<0.01), as well as the time and energy expenditure of outdoor 1000 m walk test (t>4.130, P<0.001). Conclusion The walking ability of the unilateral transtibial ampu-tees wearing prostheses is different from normal people. The transtibial prosthetic feet that the amputees wear may impact their walking abil-ity.

Objective To systematically review the evaluation tools for walking ability of lower limb amputees wearing prostheses. Methods A computer-based search of PubMed, Wanfang Data and CNKI.net was performed for articles related to the evaluation of walking ability of lower limb amputees wearing prostheses published from January, 1995 to December, 2015. Results and Conclusion A total of 20 papers were selected, including 18 foreign literatures and 2 Chinese articles. There were many evaluation tools for walking ability of lower limb amputees wearing prostheses, and should be chosen according to the actual situation.

Objective To evaluate the effect of alveolar recruitment maneuver on the perioperative pulmonary function in the morbidly obese patients undergoing laparoscopic sleeve gastrectomy.Methods Forty morbidly obese patients of both sexes,of American Society of Anesthesiologists physical status Ⅰ or Ⅱ,aged 18-64 yr,with body mass index ≥ 40 kg/m2,scheduled for elective laparoscopic sleeve gastrectomy,were randomly divided into either control group (group C) or alveolar recruitment maneuver group (group R) using a random number table,with 20 patients in each group.Patients in group C were treated with volume-or pressure-controlled ventilation after creation of pneumoperitoneum,maintaining the peak inspiratory pressure (Ppeak) ≤ 30 cmH2O and partial pressure of end-tidal CO2 35-40 mmHg.Patients in group R received alveolar recruitment maneuver once every 30 min starting from creation of pneumoperitoneum until the end of surgery.Patients were transfered to post-anesthesia care unit (PACU) with endotracheal tube which was extubated when the unified extubation standard was achieved in PACU.The patients who stayed in PACU for 2 h showing no indications for extubation were transfered to intensive care unit for continuous ventilation support.Immediately after intubation,immediately after creation of pneumoperitoneum,at 30,60 and 90 min of pneumoperitoneum,and at the end of pneumoperitoneum,blood samples were collected from the radial artery for blood gas analysis.Immediately after intubation,immediately after creation of pneumoperitoneum,at 30,60 and 90 min of pneumoperitoneum,at the end of surgery,and immediately before discharge from PACU,Ppeak,plateau pressure (Peat),and dynamic lung compliance were recorded.The time for achieving extubation standard and time for achieving the standard for discharge from PACU were recorded.Patients were followed up until discharge,and the feeding time and duration of hospital stay were recorded.Results Compared with group C,PaO2 and oxygenation index were significantly increased at 90 min of pneumoperitoneum,at the end of surgery,and immediately before discharge from PACU,Ppeak was decreased at 60 and 90 min of pneumoperitoneum and immediately after the end of pneumoperitoneum,Pplat was decreased at 60 and 90 min of pneumoperitoneum,the dynamic lung compliance was increased at 30,60 and 90 min of pneumoperitoneum and immediately after the end of pneumoperitoneum,and the time for achieving extubation standard,time for achieving the standard for discharge from PACU,feeding time,and duration of hospital stay were shortened in group R (P＜0.05 or 0.01).In group C,one patient did not present with indications for extubation and were transfered to intensive care unit for continuous ventilation support.Conclusion Intraoperative alveolar recruitment maneuver can effectively improve the intraoperative pulmonary function and promote the recovery of postoperative pulmonary function in the morbidly obese patients undergoing laparoscopic sleeve gastrectomy.

OBJECTIVE To enhance the rational usage of antimicrobial agents in hospitalized patients by comprehensive interventional measures in clinics.METHODS The selected indictors recommended by WHO were applied to evaluate the use of antimicrobial agents in hospitalized patients.The hospital information was gained from hospital administration section.The prescription and treatment data were collected from the discharged patients′ medical history.Intervention was involved in managerial and educational strategies.RESULTS After intervention,the average number of antimicrobial agents prescribed per inpatient fell from 2.13 to 1.97.The average cost of antimicrobial agents prescribed per inpatient fell from 1765.23 yuan to 1136.18 yuan(P

Background Optic neuritis is closely associated with multiple sclerosis (MS).Its pathogenesis is uncompletely clear,and less basic researches are carried out at home and abroad. Objective This study was to reveal the expression of myelin basic protein (MBP) in the optic nerve of rat with experimental allergic encephalomyelitis (EAE) and to provide a theoretical evidence for the research of the relationship of optic neuritis with MS. Methods Fifty clean Wistar rats were randomized into the control group and immune 8,12,18 and 25 days groups.Myelencephalon was collected from 5 guinea pigs to prepare the homogenate and mixed with the isovolumetric complete Freud' s adjuvant (CFA).The 0.5 ml mixed antigen emulsifier was subcutancously injected into the 4 maps together with Bordetella pertussis 0.2 ml under the cutancous of dorsalis pedis at 0 and 48 hours to induce the EAE.Behavior of the rats was evaluated to score the neurological function.The optical nerve sections were prepared 8,12,18 and 25 days after immunology for the histopathological examination,and immunochemistry and Western blot were used to detect the expression of MBP in optic nerve.The use of the animals complied with the Regulation for the Administration of Affairs Concerning Experimental Animals by State Science and Technology Commission. Results The disorder of motor nerve was seen 12 days following the immune,and the clinical neural functional scores were significantly higher 12 day and peaked on 18 days myelination and then gradually reduced.The histopathological examination showed that the irregular alignment of neural fiber was found at 12 days,and changes of cellular structure,edema of neural shaft bunch were observed at 18 days.However,the abnormal cells were significantly less 25 days following the immune.Immunochemistry showed that the MBP was expressed mainly in the myelination of optic nerve fibers.The numbers of positive cells for MBP were (115.75±26.49)cells/5 fields at the 12th day,showing a significant lowing in comparison with (167.44±22.49)cells/5 fields of control group (t=4.537,P＜0.05 ).The positive cells were lest at the 18th day with the values ( 75.57 ± 34.54) cells/5 fields ( t =6.362,P＜0.01 ).At the 25th day,positive cells increased to ( 117.63 ± 13.78) cells/5 fields,which still was lower than those of the control group ( t =4.068,P＜0.05 ).Western blot assay illuminated that with the prolong of immune time,MBP/β-actin ratio in optic nerve was gradually reduced and followed the same pattern at the 12th day( t =4.639,P＜0.05 ).At 18 days after immune in comparison with the control group,the expression of MBP/β-actin ratio in optic nerve was the least (t=8.427,P＜0.01). Conclusions MBP can be degraded in rat optic nerve.This is a further evidence that optic neuritis is a severe demyelination disease.It is clearly related to MS.

0bjectlve To examine the metaphase II spindle and chromosome configurations of human oocytes cultured for different times after thawing.MethodsUsing slow.cooling and raid—thawing protocol combined with 0.3 mol/L sucrose and 1.5 mol/L 1,2-propanedio 1(1,2-PROH)to cryoprotect human mature oocytes(n=102),the 64 survival oocytes without abnormal zona pellucida and cytoskeletal were randomly assigned to three groups after thawing:group A:culture 1 hour(n=20),group B:culture 3 hour(n=22),group C:culture 5 hours(n=22),the flesh oocytes served as control group(n=18).Immunocytochefifical staining and fluorescence microscopy were used to assess the morphology of the metaphase II spindle and chromosome.Results(1)The normal spindle rates of groups A,B and C were 10％(2/20),46％(10/22)and 41％(9/22)respectively,significantly decreased compared with control group(83％,15/18;P<0.05).The rates of absent spindle in group A(45％,9/20)was significantly higher than control group(6％,1/18;P<0.01).Also,the rates of absent spindle in group A was higher than groups B(14％,3/20)and C(14％,3/20;P<0.05).However,no significant differences were observed in groups B and C(P>0.05).(2)A significant increase in abnormal chromosome rate was observed in group A(30％,6/20)compared to groups B(68％,15/22),C(64％,14/22)and control group(78％,14/18;尸<0.05).No differences in chromosome morphology were observed in groups B,C and control group(P>0.05).Conclusions The cryoproteetant protocol leads to a deleterious effect on the organization of the meiotic spindle and chromosome at MI stage.The 3—5 hours post—thawing incubation could permit restoration of the meiotic spindles and chromosome.

Objective To study the vitamin D nutritional status in the elderly people from organs and institutions in Jinan urban district. Methods 564 cases were available from institutions enjoying a public medical care in Qianfoshan Hospital by stratified random sampling.The subjects aged (69.5±6.5)years were divided into two groups:60-74 years and≥75 years.The [25(OH)D] levels was measured by enzyme linked immunosorbent assay (ELISA).It was defined that [25(OH) D] levels ≥ 75 nmol/L was sufficient,50.0 74.9 nmol/L was critical,25.0-49.9 nmol/L were insufficient and ＜25 nmol/L was deficient.All data processing and statistical analysis were finished by SPSS13.0. Results The numbers of sufficient,critical,insufficient and deficient vitamin D in 564 subjects were 114(20.2％),180(31.9％),234(41.5％) aud 36(6.4％),in subjects aged ≥75years were 13(9.8％),36(27.3％),70(53.0％) and 13(9.8％),and in subjects aged 60-74 years were 101(23.4％),144(33.3％),164 (38.0％),23 (5.3％),respectively. There was significant difference in the vitamin D nutritional status between the two age groups (x2=19.097,P＜0.01 ).The numbers of sufficient,critical,insufficient and deficient vitamin D in the 246 male were 57 (23.2％),91(37.0％),86 (35.0％％) and 12(4.9％),in the 318 female were 57(17.9％),89 (28.0 ％ ),148(46.5 ％ ) and 24(7.5 ％ ).The percentages of insufficient and deficient vitamin D in the female were higher than in the male (x2 =11.445,P＜0.01 ). Conclusions Insufficient and deficient vitamin D nutritional states are common in the elderly people from organs and institutions in Jinan urban district and are increasing with age,especially in the female.

Objective To investigate the distribution of uranium in rats after inhalation with depleted uranium aerosols. Methods The depleted uranium aerosols were inhaled by Wistar rats. At 30, 90, 180, 270, 360, and 540 d after inhalation, the rata were sacrificed and tissue samples were collected. The contents of uranium in lung, kidney, liver, heart, brain, thighbone, spleen and thymus were measured by laser time-dependent spectroscopy analysis. Resulits The uranium contents of lung increased in the high-dosc and low-dose groups [(499833.3 ± 14214.8) ng/g and (25 424.0 ± 6193.4)ng/g, respectively] after inhalation, and significantly differed from the control (28.8 ± 13.9)ng/g, (P < 0.05).At 30 d after inhalation, the contents of uranium in lung, kidney and thighbone were higher than those of control, and then decreased time-dependently. At 60 d, the contents of uranium in liver, heart, brain, spleen and thymus were higher than those of control. Curve of the eontenta were biphasie, whieh went up first, reached at peak value and then went down. The contents of uranium were high in lung, thighbone, brain and thymus. Conclusions After inhalation of depleted uranium aerosols, lung and thighbone are the primary reservoirs for uranium redistributed, and accumulations in brain and thymus suggest other two organs for unanticipated injury by depleted uranium.