AIM: To explore the nursing cooperation highlights of eight osteopetrosis patients underwent optic nerve decompression via transsphenoidal microsurgical approach instead of routine pathway, and to improve the quality of nursing cooperation. ·METHODS: We enrolled 8 cases ( left eye in 3 cases, right eye in 5 cases ) of osteopetrosis patients referred from the Eye Hospital of Wenzhou Medical University during February 2012 to November 2016. Patients received ophthalmic examinations including visual acuity and diagnostic imaging tests in pre-operation and post -operation. All eyes were performed surgical optic nerve decompression through endoscopic approach in assist of image guidance system. We retrospectively analyzed the clinical data and surgical cooperation procedure of these cases and summarized nursing cooperation experience. ·RESULTS:The operations of 8 patients were completed successfully without massive hemorrhage. Mean visual acuity improved from pre-operation (2. 5±2. 1) to post-operation (3. 4±1. 9). Cerebrospinal fluid leakage occurred in 1 patient and was instantly repaired during the operation. We performed the nursing strategy as postural drainage, condition monitoring and conscious assessment intra-and post-operation. ·CONCLUSION: It is the critical for this kind of surgery that both circulating nurse's high-skilled cooperation to the connection and operation of the navigation system, to treat with complication during the surgery, and scrub nurse's sufficient preparation of surgical instruments and consumables, proficient equipment delivery, meticulous management, use and maintenance of equipment.

Objective To study the feasibility of model building methods by analyzing the advantages and disadvantages between the two different methods to build off-pump coronary artery bypass graft animal model. Methods Twenty dogs were randomly divided into two groups:brachiocephalic artery group and descending aorta group. Small-caliber heterogeneous vascular vessels were used as bridge vessels. The incision was in the fourth intercostal space of the left chest. Vascular anastomosis was firstly done between the brachiocephalic artery and bridge vessels,or between descending aorta and bridge vessels,prior to coronary vascular and bridge vessels anastomosis. Results The dogs of two groups were not dead during operation. Brachiocephalic artery group and the descending aorta group:aortic vascular anastomosis times were (33.9 ±4.8) min and (29.6 ±3.5) min respectively (P<0.05),coronary vascular anastomosis time were (28.5 ±3.0) min and (28. 1 ± 2. 3) min respectively (P>0. 05). The surgical blood losses of the two groups were (77. 5 ± 16. 2) mL and (66. 5 ± 12. 3) mL re-spectively (P>0. 05). After side clamping descending aorta,femoral blood pressure significantly decreased in descending aorta group,and the two dogs had melena after operation. Conclusion Off-pump coronary artery bypass graft models were both constructed successfully by the two ways. Descending aorta group of femoral artery blood pressure violently fluctuated and had abdominal organs’ ischemia reperfusion in-jury. Though brachiocephalic artery group anastomosis group spent a little longer time,they had stable artery blood pressure during operation. As a result,the way of constructing animal model of brachiocephalic artery group is safer.

OBJECTIVETo present a new mini-invasive surgery for compressive optic neuropathy (CON) in Graves' ophthalmopathy (GO) by adequately decompressing the orbital apex and correcting proptosis, and to analyze its results.

METHODSA retrospective chart was reviewed in 29 patients receiving orbital decompression for the treatment of CON secondary to GO from October 2006 to May 2011. All patients diagnosed CON were in stable and inactive phase of GO at least for 6 months. All patients received endoscopic transethmoid medial orbital wall decompression to reduce the compression on the orbital apex. In the meanwhile, an endoscopic transethmoid intraconal fat-removal orbital decompression was performed to remove parts of intraconal fat with a special aspiration/cutting instrument to further reduce the proptosis. All patients were followed up periodically.

RESULTSof improvement of visual acuity (VA), color vision, and amount of proptosis reduction and incidence of induced diplopia 9 months after surgery was recorded for analysis its feasibility.

RESULTSForty-five orbits of 29 patients were included in the study. At the 9 months review, 44 of 45 eyes (97.8%) improved their VA from -0.65±0.30 (x±s) preoperatively to -0.24±0.22, with a mean improvement of 0.55±0.17 (t=-13.012, P<0.001), 23 of 29 eyes (79.3%) had improved color vision (P<0.001), and the mean reduction in proptosis was (7.07±1.59) mm (range 4-11 mm). Postoperative symmetry to within 2 mm were achieved in all patients. Except 1 patient complaining of deterioration in diplopia following surgery, no patients presented new on-set diplopia postoperatively.

CONCLUSIONThe endoscopic transethmoid medial orbital wall decompression combined with the endoscopic transethmoid intraconal fat-removal orbital decompression is an effective treatment with minimal morbidity for both visional recovery and improvement of proptosis for CON in GO.

Adipose Tissue ; surgery ; Adult ; Decompression, Surgical ; methods ; Endoscopy ; Ethmoid Bone ; surgery ; Female ; Graves Ophthalmopathy ; surgery ; Humans ; Male ; Middle Aged ; Orbit ; surgery ; Retrospective Studies ; Treatment Outcome

OBJECTIVETo design a device for direct vision intracardiac operation without cardiopulmonary bypass, and assess its applicability preliminarily.

METHODSThe device was designed according to the clinical needs of intracardiac operation and used in operations for repairing atrial septal defect in 5 ex vivo porcine heart models. The practical applicability of this device was thoroughly tested and the results of the operations were evaluated.

RESULTS AND CONCLUSIONDirect vision operation for repairing atrial septal defect was successfully performed using this device, which can be a well applicable in some intracardiac operations, but its clinical effects need further evaluation.

Animals ; Cardiac Surgical Procedures ; instrumentation ; methods ; Cardiopulmonary Bypass ; Heart Septal Defects, Atrial ; surgery ; In Vitro Techniques ; Swine

OBJECTIVE: To investigate the effect of form-deprivation on level of gelatinase in the posterior sclera in chicks. METHODS: Fifty 1-day-old chicks were monocularly deprived to establish the animal model of form-deprivation myopia (FDM). According to the duration of form-deprivation the experimental chicks were divided randomly and equivalently into 5 groups, which were deprived for 3, 7, 14, 21 and 30 days respectively. Meanwhile the other eyes of the deprived chicks were used as self-control groups and chicks of the same days were chosen randomly as the normal control groups for each FDM group. At each form-deprivation point the changes of degree of diopters and axial length of chicks in each group were recorded. The levels of gelatinase in posterior sclera of the experimental eyes were measured by gelatin enzymography. RESULTS: Compared with the normal and self-control groups, the levels of MMP-2 activity in FDM groups were much higher (P <0.01). With the increase of the time of monocular deprivation these changes became more significant and reached the top after 14 days' deprivation with an inter-group statistical difference (P <0.01). The dynamic changes of MMP-2 activity were the same as those of axial length and degree of diopters in each experimental groups. There was positive correlation between the MMP-2 activity and axial length (r = 0.989, P < 0.01). But there was a negative correlation between the MMP-2 activity and refractive degree. CONCLUSION Increase of MMP-2 activity in the posterior sclera of chicks would be a direct key factor to trigger sclera ECM remodeling process in chick FDM.
Animals ; Chickens ; Gelatinases ; metabolism ; Matrix Metalloproteinase 2 ; metabolism ; Myopia ; enzymology ; etiology ; Sclera ; enzymology

OBJECTIVE: The study aimed to evaluate the contributions of levator ani muscle (LAM) injury, vesical neck movement, urethral length and mobility, and urethral sphincter dysfunction observed on magnetic resonance imaging (MRI) towards stress urinary incontinence (SUI) after vaginal delivery. MATERIALS AND METHODS: Fifty primiparous women after 6 months of delivery (15 with SUI and 35 without) and 35 nulliparous as continent controls underwent MRI at rest and Valsalva maneuver. A published levator ani scoring system was used to characterize morphological changes of LAM. The severity of the injury was divided into three categories as none, minor, and major. A series of common parameters including levator plate angle, iliococcygeal angle, and levator hiatus were used to describe the functional conditions of LAM. Urethral mobility was defined based on the rotation of the urethra between Valsalva and rest status. Vesical neck movement was evaluated by its distance to the pubococcygeal line. Urethral sphincter dysfunction was defined as the widening of the proximal urethra and/or funneling at the urethrovesical junction during Valsalva. RESULTS: Primiparous incontinent (PI) women had additional major levator ani defects (33.3% vs. 17.1%) while less minor defects (0.7% vs. 31.4%) than primiparous continent (PC) women. Vesical neck downward movement in PI women was more obvious than PC women (28.5 mm vs. 24.2 mm, p = 0.006). Urethral mobility was more active in primiparous women than in nulliparous continent controls (57.4 vs. 52.4), whereas no difference was observed on urethral mobility in the primiparous group (p = 0.25). Urethral sphincter dysfunction and funneling were present in 80% of PI women versus 22.9% in PC women (p < 0.001). CONCLUSION: The MRI findings revealed that de novo SUI was associated with major LAM injury, vesical neck downward movement as well as urethral sphincter dysfunction. Vesical neck funneling on sagittal images can be treated as a valuable predictor for SUI. The intervention for the PI should focus on the elevation of vesical neck, rehabilitation of LAM as well as recovery of the urethral sphincter muscle.
Female ; Humans ; Magnetic Resonance Imaging* ; Neck ; Pelvic Floor Disorders ; Pelvic Floor* ; Rehabilitation ; Urethra ; Urinary Incontinence* ; Valsalva Maneuver

OBJECTIVETo establish the basis for Chinese dietary exposure assessment database by classifying and coding the data from the national dietary survey and pollutant surveillance.

METHODSThe method, which combined CODEX food classifying and coding of Codex Alimentarius Commission (CAC) with Chinese food classification of food composition table, was applied to classify and code the data of 1 810 703 Chinese dietary consumption and 487 819 pollutant surveillance. The coding system was according to the first two letters of the respective food group that represent the type or source of foods, the last four digits represent the serial number of the food in the CAC food classification. If the foods can be found in CAC food code system, its original food code is used. The new codes corresponding with the foods which are not exist in CAC food code system, is added according to CAC coding methods.

RESULTSDietary consumption data were divided into 6 major categories, 19 types, 75 groups, the agricultural products of pollutant surveillance corresponding to 499 codes. Comparing with CAC food coding system, Chinese dietary consumption data have added F (candy snacks) and G (beverages) 2 major categories, 4 types, 33 groups, 302 new codes. The additional groups most were the processing food groups with Chinese characteristics, such as canned, beverages, candy, meat products.

CONCLUSIONThe foundation of data communication to dietary exposure assessment has been established, and the connection of Chinese food classifying and coding with CAC data have been achieved.

China ; Consumer Product Safety ; Databases, Factual ; Diet ; classification ; statistics & numerical data ; Diet Surveys ; Humans ; Vocabulary, Controlled

OBJECTIVETo detect the expression of membrane-bound HLA-G (mHLA-G) and serum HLA-G (sHLA-G) in acute leukemia patients and investigate the correlation between HLA-G expression and the occurrence and development of acute leukemia.

METHODSEnzyme-linked immunosorbent assay and flow cytometry were used to detect the expression levels of sHLA-G and mHLA-G in 40 newly diagnosed leukemia cases, 10 refractory and relapsed leukemia cases, and 30 leukemia cases receiving chemotherapy. Ten normal individuals served as the normal control group.

RESULTSThe mean serum level of sHLA-G in normal individuals was 5.87±2.07 ng/ml, as compared to 10.05±6.58 ng/ml in newly diagnosed leukemia patients and 12.32±5.85 ng/ml in refractory and relapsed cases. The mean level of mHLA-G in normal individuals, newly diagnosed cases, and refractory and relapsed cases were (0.29±0.20)%, (0.60±0.44)%, and (0.77±0.41)%, respectively. The mean levels of sHLA-G and mHLA-G were significantly higher in the newly diagnosed cases than that in the normal controls (P<0.05), and significantly higher in patients before chemotherapy than in those with complete remission after chemotherapy (P<0.05).

CONCLUSIONHLA-G expression levels might influence the treatment outcomes and can serve as a prognostic factor for acute leukemia.

Acute Disease ; Adolescent ; Adult ; Aged ; Case-Control Studies ; Female ; HLA-G Antigens ; blood ; metabolism ; Humans ; Leukemia ; metabolism ; pathology ; Male ; Middle Aged ; Prognosis ; Young Adult

OBJECTIVETo establish a stable and reliable model of Sertoli-cell-only syndrome in mice.

METHODSWe randomly divided 60 NIH mice into two groups of equal number to receive intraperitoneal injection of busulfan (30 mg/kg) and 30 or 60 minutes of testis cooling. At 2, 4 and 8 weeks after treatment, we recorded the survival rate of the mice, weight of the testis and Johnsen scores, and conducted quantitative analysis on the degrees of spermatogenetic failure.

RESULTSThere were no significant differences in the baseline body weight and survival rate between the intervention and control groups (P > 0.05). At 4 and 8 weeks, the testis weight and Johnsen score were significantly lower in the intervention group than in the control ([0.04 +/- 0.01] g and [0.05 +/- 0.01] g vs [0.09 +/- 0.03] g and [0.11 +/- 0.02] g, P < 0.05; 3.86 +/- 0.50 and 2.70 +/- 0.67 vs 9.60 +/- 0.25 and 9.76 +/- 0.43, P < 0.01). At 2, 4 and 8 weeks, the testis weights were (0.07 +/- 0.02) g, (0.06 +/- 0.01) g and (0.09 +/- 0.01) g, respectively, in the 30-min cooling group and (0.05 +/- 0.01) g, (0.04 +/- 0.02) g and (0.04 +/- 0.02) g in the 60-min cooling group, significantly lower than in the control side at the same time points ([0.11 +/- 0.01] g, [0.11 +/- 0.01] g and [0.12 +/- 0.00] g) (P < 0.05), and the Johnsen scores were 4.70 +/- 0.67, 2.70 +/- 0.84 and 6.10 +/- 1.14 in the 30-min and 1.67 +/- 0.58, 1.20 +/- 0.45 and 1.00 +/- 0.00 in the 60-min cooling group, remarkably lower than in the control side (9.60 +/- 3.23, 9.60 +/- 0.55 and 9.70 +/- 0.45) (P < 0.01). Histopathological examination of the cooled testes revealed considerable atrophy of seminal tubules, necrosis of seminiferous epithelia and peritubular fibrosis.

CONCLUSIONAdministration of busulfan has no obvious influence on the survival of mice, and is a reliable method for constructing a mouse model of Sertoli-cell-only syndrome.

Animals ; Busulfan ; adverse effects ; Cold Temperature ; Disease Models, Animal ; Male ; Mice ; Mice, Inbred Strains ; Organ Size ; Sertoli Cell-Only Syndrome ; chemically induced ; Sertoli Cells ; Testis

OBJECTIVETo investigate the possible reasons and the treating experiences of ophthalmic complications in order to elevate the attention of the nasal endoscopic surgeon.

METHODSThis study was involved 8 categories in 22 cases which had typical characteristic of ophthalmic complications of endoscopic sinus surgery, including injury of lamina papyracea, obstructive cyst of frontal and ethmoid sinuses, orbital infection, injuries of lacrimal passages, injury of extraocular muscles, orbital hemorrhage, optic nerve injury and arterial embolism of optic fundi. The patients were given corresponding treatment.

RESULTSInjury of lamina papyracea was cured by medical treatment while orbital infection, injury of lacrimal passages, obstructive cyst of frontal and ethmoid sinuses were completely recovered by endoscopic surgery. In one of the cases, the injured optic nerve had recovered after transnasal optic and orbital apex decompression but the other 6 sides of 6 patients had not been improved. In one case who had suffered from injury of extraocular muscles, their diplopia disappeared mostly, but the other cases had a slight diplopia after surgery. One case who had visual descending caused by orbital hemorrhage recovered. Two cases of visual loss caused by intraorbital hemorrhage and arterial embolism of optic fundi respectively were not improved.

CONCLUSIONSIt is very difficult to cure if the patients lose the sight because of optic nerve injury, orbital hemorrhage and the ischemia of orbit, however, if the patients had remnant vision the prognosis should be much better.

Adult ; Aged ; Endoscopy ; adverse effects ; Eye Diseases ; etiology ; prevention & control ; Female ; Humans ; Male ; Middle Aged ; Optic Nerve Injuries ; etiology ; prevention & control ; Otorhinolaryngologic Surgical Procedures ; adverse effects ; Paranasal Sinuses ; surgery