? Intraoperative floppy iris syndrome is a particular symptom in phacoemulsification, and it is often occurred in patients with the history of using alpha-1 adrenergic antagonist before cataract surgery. Although the pupil be fully mydriatic before the operation, the progressive constricting of the pupil, the relaxing of iris even the iridoptosis and the unstable anterior chamber still can be found during the phacoemulsification. If treated inappropriately, severe complications and terrible outcomes may happen, which would influenced the surgery effectives. This paper reviewed the epidemiological characteristics, pathogenesis, risk factors, clinical manifestations, complications, and coping strategies of the intraoperative floppy iris syndrome.

Electrocardiography ; Humans ; Myocardial Ischemia ; physiopathology

Adult ; Age Distribution ; Aged ; Aged, 80 and over ; Cause of Death ; Humans ; Male ; Middle Aged ; Mining ; Pneumoconiosis ; mortality ; Retrospective Studies

BACKGROUND:Serious patel ar comminuted fractures can be treated by a number of methods such as cerclage with tension band steel wire or steel wire, or fixation with the nickel titanium patel a concentrator and absorption lines, or cerclage with 10# double-loop wire plus fixation with split-type patel a claws or with the memory al oy patel a concentrator. But it is difficult to achieve strongly fixed effect on patel a fractures by these methods.
OBJECTIVE:To investigate the clinical effects of suture with polyester braided wire and cerclage with belt lock cable on serious comminuted patel ar fractures.
METHODS:A retrospective analysis was performed on the clinical data of 57 patients with serious comminuted patel ar fractures who received suture with polyester braided wire and cerclage with belt lock cable from January 2007 to October 2012. According to AO classification of fractures, there were nine cases of type B3, 22 cases of type C2 and 26 cases of type C3. After satisfactory reduction of comminuted patel ar fractures during the operation, firstly we sewed up both sides of the expansion region of quadriceps muscle and stitched on periosteum and prepatel ar tissue with thick polyester braided wire fol owed by patel ar cerclage with belt lock cable. According to the stability of fracture blocks, tension band fixation with polyester braided wire was partial y added. After the operation, the clinical effects were assessed based on the Bostman score system.
RESULTS AND CONCLUSION:Total y 46 out of 57 cases were fol owed up with an average of 8 months (4-18 months). Al patients obtained bone union within 3-5 months. Wounds healed in the first stage without any infections, and fractures in al patients healed without complications such as implant loosening and skin irritation. According to the Bostman score system, 33 cases were scored excellent, 10 good and three fair. The excellent and good rate was 93.5%. It suggests that treatment of serious patel ar comminuted fracture by the combination of polyester braided wire and belt lock cable leads to closely contact fracture sites and reliably fix bone fragments. It can facilitate early postoperative range of motion exercises.

Objective To compare the differences of prescription pattern, adverse events, economic burden and drug-use adherence between preferred mood stabilizers and preferred antipsychotics in patients with bipolar disorder. Methods We investigated 240 cases of patients with bipolar disorder from 39 mental health institutions in 11 cities in Hebei province. The self-made questionnaire was used to investigate the demographic information, disease characteris-tics, prescription pattern and medical expense. The clinical global impression scale-severity of illness (CGI-SI) was used to assess the disease severity. The treatment emergent symptom scale (TESS) was used to assess the adverse drug reac-tions. The medication adherence rating scale (MARS) was used to assess drug therapy compliance in patients. Results One hundred fifty-two patients (63.3%) used antipsychotics as the first choice (antipsychotics group), 88 patients (36.7%) used mood stabilizers as the first choice (mood stabilizers group). The number of patients in-patient (90.1%vs. 76.1%), patients with psychotic symptom (27.0%vs. 11.4%), incidences of adverse events (46.1%vs. 31.8%), drug daily cost (me-dians 12.00 yuan vs. 8.37 yuan) and drug total cost (medians 344.61 yuan vs. 144.64 yuan) were larger in antipsychotics group than in mood stabilizers group (P<0.05). There was no significant difference between two groups in pattern of pre-scription, severity of adverse events and total scores of MARS (P>0.05). Conclusion The bipolar disorder patients more frequently use antipsychotics as the first choice in Hebei province. The use of antipsychotics does not alter the combina-tion medication pattern. In addition, antipsychotics cause a higher incidence of adverse events and heavier economic bur-den compared with mood stabilizers, suggesting that mood stabilizers should be the first choice to bipolar disorder.

Objective To assess the technical feasibility and efficacy of the combined application of a flexible,self-expanding neurovascular stent(Neuroform)and Gugliebni detachable coils(GDC)in the management of wide-necked intracranial aneurysms in humans.Methods Sixty-five wide-necked aneurysms which underwent 65 endovascular procedures were performed by using intracranial stent and GDC.There was a total of 30 aneurysms at basilar artery including 16 at the basilar tip,9 at the basilar trunk and 5 at the beginning of the basilar artery.And there were 30 aneurysms located at the posterior communicating artery, and 5 aneurysms located at the vertebral artery.The Neuroform stents were deployed to cover the neck of aneurysms.Another microcatheter was introduced into the aneurysm sac through the stent interstices and then detachable coils were released to embolize the aneurysms.Results The combined procedures were successful in all of the 65 patients with wide-necked aneurysms.The stent could pass smoothly through the intracranial artery and got released.Complete occlusion was achieved in 60 patients and incomplete occlusion in 5 patients.In-stent thrombosis occurred in 2 patients.All patients recovered well.Forty-two patients had followe-up angiography at 3 to 6 months after the procedure.Among them,no filling was found for the 39 aneurysms which were densely packed,and 3 aneurysms had neck remnant.Conclusion The implantation of Neuroform stent as a complimentary device to GDC coiling is easy and safe for embolization of wide-necked intracranial aneurysms.It has great advantage for treatment of wide-necked intracranial aneurysms.

Abstract: Objective　To evaluate the value and significance of rifampicin-resistant real-time fluorescence quantitative nucleic acid amplification detection technology (GeneXpert MTB/RIF) in the diagnosis of pulmonary tuberculosis. 　　Methods　The clinical data of 228 patients with suspected pulmonary tuberculosis, who admitted to Hebei Chest Hospital from January 2018 to December 2019, were analyzed retrospectively. The sputum was collected for GeneXpert MTB/RIF, sandwich cup liquid-based bacterial acid-fast staining smear microscopy (referred to as “sandwich cup method”) and Loop-Mediated isothermal amplification (referred to as “LAMP method”) and the results were statistically analyzed by SPSS 17.0 software. Results　Among the 228 patients with suspected cases, 200 cases were clinically diagnosed as pulmonary tuberculosis and 28 were non-tuberculosis. The positive detection rate of GeneXpert MTB/RIF (81.0%, 162/200) was significantly higher than that of sandwich cup method (62.5%, 125/200) and LAMP method (72.5%,145/200) (χ2=16.885, 4.049, P<0.05). Taking clinical diagnosis as gold standard, the sensitivity of GeneXpert MTB/RIF (80.00%,160/200) was significantly higher than that of sandwich cup method (60.00%, 120/200) and LAMP method (70.50%, 141/200) (χ2=19.048, 4.846, P<0.05). The diagnostic consistency of GeneXpert MTB/RIF (K=0.73) was higher than that of sandwich cup method (K=0.39) and LAMP method (K=0.56). Conclusions The GeneXpert MTB/RIF detection method is rapid and simple, and can diagnose pulmonary tuberculosis rapidly and simultaneously detect rifampicin resistance of Mycobacterium tuberculosis with high sensitivity. It has high clinical value for early diagnosis of pulmonary tuberculosis and guidance of treatment in general and specialized hospitals.

Objective To investigate the compartmentalization of human immunodeficiency virus (HIV)infection and CD4~+ T lymphocytes between gastric mueosa and peripheral blood from patients with acquired immune deficiency syndrome(AIDS).Methods Thirty-five AIDS patients and 10 HIV seronegative subjects were enrolled in this study.The gastric mucosal biopsies were done by gastroscope and peripheral blood samples were collected.The digoxin labeled HIV-1 double-stranded cDNA probes for the long terminal repeat(LTR)and gag gene of HIV-1 genome were prepared by polymerase chain reaction(PCR).In situ hybridization was used to detect HIV infection in gastric mucosal tissues and peripheral blood mononuclear cells(PBMC)of AIDS patients.CD4~+ T lymphocytes were determined by immunohistochemistry method.The data were analyzed using t test.Results HIV positive rates were(1.67±1.48)% in gastric mucosa and(19.37±9.23)% in PBMC of AIDS patients who had not received highly active antiretroviral therapy(HAART).The HIV positive rates in gastric mucosa were not significantly different between AIDS patients without treatment and those treated with HAART(t=-0.996,t=-0.794,t=-0.461;P＞0.05).HIV positive rate on PBMC film preparation in patients who had received HAART for 1-4 years was (4.25±3.47)%,which was significantly lower than untreated group[(19.37±9.23)%](t=3.000,P＜0.05).The positive rate of CD4~+ T lymphocytes was(12.53±8.14)% in gastric mucosal mononuclear cells(MMC)and(19.00±9.55)% in PBMC of AIDS patient who had not received HAART.Even after received HAART for 1-4 years,the positive rate of CD4 ~+ T lymphocytes in MMC were(37.44±18.00)%,which was still lower than control group[(50.35±3.41)%](t=-4.620,P＜0.01);while the positive rate of CD4~+ T lymphocyte in PBMC was similar with that of control group(t=-2.094,P＞0.05).Conclusion The compartmentalization of HIV infection and CD4~+ T lymphocyte counts exists between gastric mucosa and peripheral blood from AIDS patients.

Objective To investigate the status quo of quality of life and family environment of children and adolescents with diabetes, also to explore the relationship between family environment and the quality of life, so as to give some support for family nursing. Methods A total of 58 diabetic children and adolescents were asked to complete Pediatric Quality of Life Inventory,meanwhile their parents were asked to complete the family environment scale, relativity of life quality of diabetic children and adolescents with family environment was analyzed. Results The physical function, school function, psychosocial health and total quality of life of diabetic children and adolescents' were lower than healthy children; family conflicts and control were higher than normal, while knowledge was lower than normal. Their quality of life was positively correlated with family knowledge and control, family control and success contributed a lot to life quality. Conclusions The health professionals should improve the communication between children and parents, sharing the diabetes responsibility, reduce the family conflict, in order to manage diabetes effectively and improve the quality of life.