0.05).At post- operative 30 days and 90 days,ECD were(6.39?0.90)%,(6.54?1.24)% respectively in the torsional group and(13.17?1.78)%, (13.67?2.36)% respectively in the US group,the differences between two groups were statistically(P0.05).Conclusion The torsional mode may provide more effective lens re- moval with a lower level of phacoemulsification time and energy.It can reduce the ultrasound energy and the intraocular trauma.(Oph- thalmol CHN,2008,17:82-85)

Abstract?AIM: To evaluate the visual acuity, visual function, q uality of lfi e, and cost/effectiveness of cataract surgery in patients with low soc ioeconomics tatus ( LSES ) who received government subsidies for free cataract surgery.?METHODS: Retrospectively, 334 eyes of 334 patient s were reviewed. Visual function and quality of l ife questionnaires we re available in 83 patie nts. The cost/effectiveness of cataract surgery was analyzed in 225 patients with LSES and 12 0 patients who rec eived standard cataract surgery. Mutl iple linear regression anal ysis and logistic regression analysis were used to assess the factors affecting the postoperative visual acuity.?RESULTS: At 1wk postoperatively, uncorrected visual acuity ( UCVA ) was improved significantly compared to these preoperait vely (P<0.50 ), 235 eyes (70.4%) had UCVA of 20/40 or better, and 16 eyes (4.8%) had UC VA wor se than 20/400. Multiple linear regresis on ana lysis revealed that other ocular diseases and cataract classification wer e factors contributing to po stop erative UC VA. Logistic regression analysis showed that low preoperative visual ac uti y and other ocular diseases were risk factors of postopera tive low vision, and the odds ratio (95%confidence int erval) values were 6.5 (2.8-14.8) and 1.3 (1.0-1.6), respe ctively.Visual fun ction and quality of life were significantly improved after the surgery. Th e cost/effetc iveness of c ataract su rgery in patients with LSES was lower than that in standard cataract patients.?CONCLUSION: Visual acuity and visual function were significantly better after the surgery in catara ct patients wti h LSES, and the operation cost was low.Quality of life in these patients was significantly improved.

The purpose of our present work was to study the discharge of bursting-firing neurons (BFNs) in ipsilateral or contralateral hippocampus (HPC), and its relations to the reestablishment of local epileptic networks. The experiments were performed on 140 Sprague Dawley male rats (150-250 g). Acute tetanization (60 Hz, 2 s, 0.4 -0.6 mA) of the right posterior dorsal hippocampus (ATPDH) was administered to establish rat epilepsy model. The single unit discharges and the depth electrographs were simultaneously recorded from ipsilateral or contralateral HPC. In other experimental rats, acute tetanization of the right anterior dorsal HPC (ATADH) was used. Extracellular unit discharges in the CA1 region were simultaneously recorded from bilateral anterior dorsal hippocampi. Analysis of hippocampal BFN firing patterns before or after administration of the tetanization was focused on according to their location in the HPC epileptic networks in vivo. Single unit discharges of 138 hippocampal neurons were recorded from ipsilateral and/or contralateral anterior dorsal HPC. Of the 138 neurons recorded, 19 were BFNs. 13 BFNs were tetanus-evoked and the remaining 6 were spontaneous ones. The evoked reactions of the single hippocampal neuron induced by the tetanization mainly included: (1) the firing patterns of the BFNs in ipsilateral anterior dorsal HPC were obviously modulated by the ATPDH from tonic firing into rhythmic bursting. The bursting interspike intervals (BISI) decreased. (2) There were mild modulations of the firing patterns of the BFNs in contralateral anterior dorsal HPC following post-inhibition of the firing rate of single neuron induced by the ATPDH. The interspike intervals (ISI) increased obviously. (3) Post-facilitation of rhythmic bursting-firing of the BFNs in contralateral anterior dorsal HPC was induced by ATADH; both the ISI and the IBI increased. (4) Synchronous or asynchronous rhythmic bursting-firing of the BFNs and the network epileptiform events ipsilateral or contralateral anterior dorsal HPC were elicited by the ATPDH. The results obtained suggest that bursting-firing of single BFNs is produced by the ATPDH in the anterior dorsal HPC along the longitudinal axis of the ipsilateral HPC or across the hemisphere to the opposite HPC. Rhythmic activities of the BFN may be implicated in the epileptic network reestablishment of the HPC. On the other hand, synaptic modulation of the BFN temporal series might be responsible for pathophysiological information transmission in the HPC-epileptic network.
Animals ; Electric Stimulation ; Electrophysiology ; Epilepsy, Temporal Lobe ; physiopathology ; Evoked Potentials ; Hippocampus ; physiopathology ; Male ; Nerve Net ; physiopathology ; Neurons ; physiology ; Rats ; Rats, Sprague-Dawley ; Synaptic Transmission

Objective To investigate the bladder function in primipara and bipara within 1 week after delivery using urodynamic study.Methods Investigations on urodynamic changes were performed in 36 primipara volunteers and 12 bipara volunteers according to the recommendations of the International Continence Society(ICS).Fourteen women with upper urinary tract diseases but having normal lower urinary tract function,who had not experienced parturation were included as controls.Results Functional bladder volume(FBV)of primipara and bipara after delivery and normal desire cytometric capacity (NDCC)were respectively lower than those of control group(437?193)ml and(338?120)ml,however FBV and NDCC between primipara and bipara(310?154),(215?90)ml vs(243?141),(225?115) ml were not significantly different.The static Pure.max and Pure.clos.max of primipara and bipara were respectively higher than those of control group(87?7)cm H_2O(1 cm H_2O=0.098 kPa)and(78?8) cm H_2O(P

Objective To discuss the microsurgical treatment of anterior communicating artery (ACoA) aneurysms at acute stage vit the supffontal approach. Methods Thirty-two patients with ruptured ACoA aneurysms,admitted to our hospital from January 2007 to October 2010 and underwent mierosurgery through supfrontal approach, were chosen in our study; their clinical manifestations,surgical methods and treatment efficacy were retrospectively analyzed. Results All 32 ACoA aneurysms in these 32 patients were clipped successfully.Forty-two aneurysm clips were used during the surgery; intraoperative aneurysm rupture occurred in 7 patients (21.88％). According to scores of Glasgow Outcome scale after 6-12 months of follow-up,26 patients (81.25％) enjoyed good results,5 (15.63％) had moderate disability and 1 (3.13％) had severe disability; no patients died,and no patients were having intracranial infection, having cerebrospinal leak or under vegetative state. Conclusion Microsurgical operation of anterior communicating aneurysms via subfronal approach was an effective and rapid method with minimal exposure and reliable neck clipping.

OBJECTIVETo identify the risk factors of deep venous thrombosis (DVT) in hospitalized patients with acute stroke, under a perspective case-control study.

METHODS488 cases with stroke, identified by CT or MRI and admitted to the department of neurology and neurosurgery in Beijing Chaoyang Hospital between December 2001 and December 2002 were consecutively studied. There were 328 male and 160 female patients (95.5% Hans) with a mean age of 65 +/- 11 years, ranging 22 - 93 years. The procedure of study would include: (1) General condition, possible risk factors, symptoms of DVT physical check-up to every eligible patient on first day of admission but the plasma concentrations of D-dimer (ELISA), thrombomodulin, antithrombin-III and blood routine examination were measured on the next morning. (2) The ultrasonography (US) was used for detecting both lower extremities at 7 - 10 days after the onset of stroke, and D-dimer and AT-III tests were repeated on the same or next day that the US was taken. (3) The ultrasound examination was repeated after a week in patients with high suspicion of DVT. (4) The therapy of stroke was recorded before the end of the study. Data of stoke patients with DVT was compared with those without DVT to identify the DVT risk factors. The effect of each variable on DVT was assessed by logistic regression analysis.

RESULTSThe prevalence of DVT was 21.7% among the patients. In multivariate analysis, age >/= 65 years old (OR = 1.655, 95% CI: 1.005 - 2.725), being male (OR = 1.993, 95% CI: 1.221 - 3.253), bedridden (OR = 3.275, 95% CI: 1.653 - 6.486) and DVT assessment scores >/= 2 (OR = 5.019, 95% CI: 2.685 - 9.381) were independently associated with DVT in all the stroke patients. Being male (OR = 2.828, 95% CI: 1.242 - 6.438), white blood cell count > 10.0 x 10(9)/L (OR = 2.032, 95% CI: 0.897 - 4.602) and DVT assessment scores >/= 2 (OR = 8.809, 95% CI: 3.081 - 25.188) were the independent risk factors of DVT in hemorrhagic stroke group. Age >/= 65 years old (OR = 2.167, 95% CI: 1.072 - 4.381), bedridden (OR = 3.008, 95% CI: 1.435 - 6.307) and DVT assessment scores >/= 2 (OR = 2.600, 95% CI: 1.077 - 6.278) were the independent risk factors of DVT in ischemic stroke group.

CONCLUSIONPatients hospitalized with acute stroke were under high risk of DVT. Data suggested that old age, female, bedridden and high DVT assessment scores >/= 2 were independent risk factors for DVT in acute stroke patients that called for supervision and prophylaxis on DVT.

Aged ; Case-Control Studies ; China ; epidemiology ; Female ; Hospitalization ; Humans ; Leg ; blood supply ; Male ; Prevalence ; Prospective Studies ; Risk Factors ; Stroke ; complications ; Venous Thrombosis ; epidemiology ; etiology

AIMTo study the effect of volume expansion by 0.9% and 1.8% sodium solution on cardiac-renal reflex activity and the role of cardiac-renal reflex in the regulation of integrated function.

METHODS18 health pentobarbital-anaesthetized rabbits were divided evenly into 2 groups at random, bilateral sino-aortic denervation, intubated via right jugular vein to monitor CVP, left renal nerve separated and ending sectioned to record ERSNA, bilateral ureter intubated to collect urine, right femoral intubated to get blood sample. 15% of whole body blood volume of 0.9% and 1.8% sodium solution were injected via jugular vein 10 ml per minute respectively. The CVP, ERSNA, bilateral urine volume and coefficient of sodium excretion were measured before treated, during treated, one minute, five minutes and ten minutes after treated.

RESULTSVolume expansion by 0.9% and 1.8% sodium solution respectively resulted in the increase of CVP by 64.00% +/- 15.56% and 77.00% +/- 23.74%; the decrease of the frequency of ERSNA by 44.00% +/- 13.64% and 63.00% +/- 12.49%, the average burst time of ERSNA by 37.00% +/- 16.49% and 31.00% +/- 10.69%, the increase of average interval of ERSNA bursts by 60.00% +/- 18.38% and 68.00% +/- 27.04%; the increase of urine volume by 158.00% +/- 28.10% and 640.00% +/- 155.39% in left kidney, 192.00% +/- 32.26% and 1343.00% +/- 429.95% in the right; the increase of coefficient of sodium excretion by 132.00% +/- 35.23% and 376.00% +/- 121.72% in the left, 300.00% +/- 76.99% and 856.00% +/- 261.48% in the right.

CONCLUSIONVolume expansion by different solution stimulate the receptors of cardiopulmonary and regulate the water and sodium excretion of the kidney by the cardiac-renal reflex to modulate the stabilization of blood volume.

Animals ; Blood Volume ; drug effects ; physiology ; Central Venous Pressure ; Heart ; drug effects ; innervation ; Kidney ; drug effects ; innervation ; Rabbits ; Reflex ; Saline Solution, Hypertonic ; pharmacology

OBJECTIVETo analyse the distribution, drug resistance and epidemiology of pathogenic bacteria in the burn wards of Ruijin Hospital.

METHODSSeventeen strains of Methicillin resistant staphylococcus aureus (MRSA), 52 strains of Pseudomonas aeruginosa (PA), and 11 strains of Acinetobacter baumannii (AB) isolated from the wound secretion, venous catheters, blood, urine and stool etc. were collected from burn patients hospitalized in our department from January 2004 to December 2006. The distribution and the drug resistance profile of bacteria were analyzed, and the homology analysis was performed by randomly amplified polymorphic DNA (RAPD).

RESULTSMRSA, PA and AB were the major strains in our burn wards in recent years, of which Staphylococcus aureus (SA) was the most dominant. During these 3 years, MRSA accounted for 77% (63/82), 85% (63/74), and 75% (74/99), respectively, for SA isolated in this period. MRSA was resistant to Amikacin, Gentamicin, Erythromycin, Clindamycin and Levofloxacin; PA was resistant to Amikacin, Gentamicin, Piperacillin, Ceftazidime, Cefoperazone, Aztreonam and Imipenem; AB was resistant to Amikacin, Gentamicin, Piperacillin, Ceftazidime, Imipenem and Ciprofloxacin. Three bacteria were found to belong to the same type in the RAPD homology analysis.

CONCLUSIONSThere are many kind of multi-drug resistant pathogenic bacteria for nosocomial infection in our burn wards. To control the spread of infection due to above-mentioned 3 bacteria is the focus of nosocomial infection control.

Acinetobacter baumannii ; genetics ; isolation & purification ; Burns ; epidemiology ; microbiology ; Cross Infection ; epidemiology ; microbiology ; Drug Resistance, Multiple, Bacterial ; Genes, Bacterial ; Humans ; Methicillin-Resistant Staphylococcus aureus ; genetics ; isolation & purification ; Microbial Sensitivity Tests ; Molecular Epidemiology ; Pseudomonas aeruginosa ; genetics ; isolation & purification ; Random Amplified Polymorphic DNA Technique ; Sequence Homology

Objective To explore surgical treatment of gliomas involving the motor eloquent area. Methods Twelve cases of gliomas involving precentral gyrus were underwent awake surgery procedures assis- ted with neuronavigation and brain functional mapping by cortical electrical stimulation.Results Eleven ca- ses acquired accurate location of both lesions and eloquent areas by neuronavigation and direct cortical stimula- tion.7 cases of motor cortices and 2 cases of motor speech centers were confirmed during the operation.Re- section,verified by postoperative MRI,was total in 8 cases (66.7%) and subtotal in 4 patients.Histological examination revealed an infiltrative glioma in all cases (8 low grade astrocytomas,2 high grade astrocytomas and 2 glioblastoma).Four patients had no postoperative deficit,while the other 8 patients were impaired, with,in all cases except one,complete recovery in 7 days to one month.Conclusion Direct cortical elec- trical stimulations and awake surgery offer a reliable,precise and safe method,allowing functional mapping es- pecially useful in case of infiltrative cerebral tumors in eloquent areas.This technique allows improvement in the quality of tumoral resection and concurrently a minimization of the risk of definitive postoperative neurologi- cal deficit.

OBJECTIVETo analyze the epidemiology of methicillin resistant Staphylococcus aureus (MRSA) in molecular level in burn centre of Shanghai Ruijin hospital.

METHODSThe vicissitude of Staphylococcus aureus in the burn centre from 2003 to 2005 was analyzed with software WHONET5. Multiprimer random amplified polymorphic DNA(RAPD) was used to analyze the homology of 17 MRSA strains.

RESULTSRAPD analysis (primer ERIC2 and RAPD7) showed that all 17 MRSA strains were identical (Burn-A type).

CONCLUSIONMRSA with same RAPD type is prevalent in our burn centre for many years, so emphasis should be laid on the anti-infection therapy and its cross infection control. Staphylococcus aureus;

Burn Units ; Humans ; Methicillin-Resistant Staphylococcus aureus ; drug effects ; genetics ; isolation & purification ; Microbial Sensitivity Tests ; Random Amplified Polymorphic DNA Technique ; Sequence Homology ; Staphylococcal Infections ; drug therapy ; microbiology