Evidence-Based Medicine ; Humans ; Occupational Diseases ; prevention & control ; Occupational Medicine ; methods

Objective To observe the diameters of macular hole and destroyed boundary line between inner and outer segment (IS/OS) of the photoreceptors and the correlation with the visual acuity in patients with idiopathic macular hole(IMH). Methods The clinical data of 39 eyes (37 patients) with IMH were retrospective analyzed. All the patients had undergone the examinations of visual acuity (Snellen chart), intra-acular pressure, ocular fundus (indirect ophthalmoscope), and Fourier-domain optical coherence tomography (FD-OCT) whose speed was 27 000 A scan/s, area was 6.0 mm×6.0 mm, and the mode was 512×128. The diametres of macular hole and destroyed IS/OS, and the correlations with visual acuity were detected. Results The mean IogMAR was 0.99±0. 44 (ranged from 0. 15 to 2.00), the mean diameter of macular holes was (942.0± 348. 4)μm(ranged from 171 to 1491 μm), and the mean diameter of IS/OS disruption was (1870. 35±673.2) μm(range from 463 to 3176 μm). There was a significant correlation among the diameter of the macular hole, the diameter of the IS/OS disruption, and IogMAR in IMH (P= 0. 038, 0. 002, 0. 000). In eyes with closed macular hole after surgery, the IogMAR and the diameter of the IS/OS disruption had a significant decrease. Conclusion Using FD-OCT the photoreceptor changes can be visualized in vivo. The abnormality in the IS-OS boundary line appears to be involved for a much larger area beyond the macular hole itself, and persists there with small size even after the maeular hole closure surgery.

Health Promotion ; Outcome and Process Assessment (Health Care) ; Workplace

OBJECTIVETo evaluate a expanded reverse island flap with a saphenous neuro-vascular pedicle for repairing the defects of the feet and ankles.

METHODSAn expanded reverse island skin flap, with the Six saphenous neuro-vascular pedicle, was designed to repair the skin defects on the feet and ankles.

RESULTSpatients with the defects of the feet and ankles were treated with the expanded saphenous island flap and all of the The expanded reversed island skin flaps were survived. The largest flap size was 12 cm x 10 cm.

CONCLUSIONSflap could be a good option for repairing the defects of the feet and ankles.

Adolescent ; Adult ; Ankle Injuries ; surgery ; Child ; Female ; Femoral Nerve ; surgery ; Graft Survival ; Humans ; Male ; Middle Aged ; Skin Transplantation ; Soft Tissue Injuries ; surgery ; Surgical Flaps ; blood supply ; innervation ; Young Adult

Objective To compare real-time fluorescence quantitative PCR with general PCR in detecting bovine and porcine derived materials in hydrolysate samples.Methods DNA were extracted from hydrolysate samples which prepared by different steps by real-time fluorescence quantitative PCR and general PCR.Results DNA of bovine and porcine could be detected by real-time fluorescence quantitative PCR and general PCR in samples prepared in the processes before enzymolysis solution, but not detected in samples from supermatant to the fourth ultrafiltrate.Conclusion Both real-time fluorescence quantitative PCR and general PCR can be applied to detect the fragments in hydrolysate samples.And real-time fluorescence quantitative PCR has the advantage such as rapid,convenient, non-environment-polluted, good repeatability, which improves the quality and efficiency.

A sensitive, rapid and specific liquid chromatographic-tandem mass spectrometric (LC-MS/MS) method for quantification of gabapentin in human plasma has been developed. After a single plasma protein precipitation with methanol, gabapentin and metformin (internal standard) were chromatographed on a Inertsil ODS-3 column (50 mm x 2.1 mm ID, 3 microm) with mobile phase consisting of methanol-0.2% formic acid aqueous solution (80:20, v/v) at a flow-rate of 0.2 mL x min(-1). Electrospray ionization (ESI) source was applied and operated in the positive ion mode. Multiple reaction monitoring (MRM) mode with the transitions of m/z 172 --> m/z 154 and m/z 130 --> m/z 71 were used to quantify gabapentin and metformin, respectively. The run time was 2.2 min. The linear calibration curve was obtained in the concentration range of 40.8-8.16x10(3) ng x mL(-1). The lower limit of quantification was 40.8 ng x mL(-1). The intra- and inter-day precision (RSD) was less than 12%, and the accuracy (RE) was within +/-6.4% calculated from quality control (QC) samples. The method was used to determine the concentration of gabapentin in human plasma after a single oral administration of 600 mg gabapentin capsule to 20 healthy male Chinese volunteers. The method was proved to be selective, sensitive, rapid and suitable for pharmacokinetic study of gabapentin in human plasma.

Objective To summarize clinical experience of emergent surgery for severe liver trauma with rupture of major blood vessels. Methods The clinical data of 12 cases suffering from severe liver trauma with rupture of perihepatic and intrahepatic large blood vessels were retrospectively analyzed. These cases were from Dec 2000 to May 2008. All the cases underwent emergency operation, 6 cases were treated with liver lobectomy: among those 1 case with right posterior lobe liver resection, 1 case with irregular right lobe liver resection, 3 cases with left hemihepatectomy, and 1 case with left lateral lobectomy. Seven cases with rupture of major blood vessels were treated by repair or ligature and/or packing including repair of posthepatic inferior vena though the middle fissure in 2 cases, and through retrahepatic space in one case, interrupted suture of the portal vein in 2 cases, interrupted suture of the right hepatic veins in 2 cases. Mattress suture was applied to the ruptured hepatic veins in 7 cases including mattress suture of the branch of right hepatic vein and middle hepatic vein in 1 case, mattress suture of right hepatic vein in 1 case, suture of middle hepatic vein in 2 cases, and suture of left hepatic vein in 3 cases. One case was treated with ligation of hepatic artery and 3 cases with gauzes packing. Results Among all the 12 cases, 9 cases were cured, 3 cases died: two were caused by severe trauma together with hemorrhagic shock, one by sever brain injury together with hemorrhagic shock. Conclusions Prompt operation, precise stop bleeding and correct operation style are the key for successful rescue of patients suffering from severe liver trauma and massive bleeding.

Objective To develop a gas chromatography-mass spectrometry (GC-MS) method for the determination of ephedrine (E) and pseudoephdrine (PE) and to study the pharmacokinetics features of E and PE in healthy human volunteers. Methods The serum concentrations of E and PE were measured by GC-MS. The pharmacokinetic parameters were computed by using WinNonlin program. Results A good linearity was obtained in E from 5 ng/mL to 1000 ng/mL (r2=0.9985) and in PE from 2.5 ng/mL to 500 ng/mL (r2=0.9994). The recoveries were in the range of 107.5 %to 96.2 %and 102.5 %to 93.9 %for E and PE respectively. The interday RSD and intraday RSD of E and PE were both less than 5 %. The E and PE plasma solution were steady within 60 days. Conclusion This GC-MS method is a accurate and reliable method for the determination of E and PE in human plasma.

Objective To evaluate the intraoperative opioid?sparing effect of different duration transcutaneous electrical acupoint stimulation ( TEAS ) in video?assisted thoracoscopic lobectomy. Methods Seventy?five patients, aged 18-64 yr, weighing 40-96 kg, of ASA physical status Ⅰ or Ⅱ, scheduled for elective video?assisted thoracoscopic lobectomy under general anesthesia, were randomly divided into 3 groups (n=25 each) using a random number table: control group (group C), 30 min of stimulation before induction of anesthesia group ( group B) , and stimulation throughout surgery ( group T) . In group B, the patients received TEAS ( frequency 2∕100 Hz ) on acupoints Xinshu ( BL15 ) , Feishu (BL13), Neiguan (PC6), Hegu (LI4) on the operated side starting from 30 min before induction of anesthesia until the beginning of induction, and the intensity was the maximum current that could be tolerated. The intensity for Neiguan ( PC6) and Hegu ( LI4) was 6-12 mA, and for Xinshu ( BL15) and Feishu ( BL13 ) was 9-18 mA. In group T, the patients received TEAS on the four acupoints mentioned above starting from 30 min before induction of anesthesia until the end of surgery. The patients had the electrodes applied, but received no stimulation in group C. After anesthesia was induced with propofol?sufentanil?cisatracurium, double lumen endotracheal tube was inserted. Propofol was given by target?controlled infusion to maintain BIS value within the range of 40-60. Cisatracurium was infused continuously to facilitate muscle relaxation. The infusion rate of remifentanil was adjusted to maintain analgesia nociception index value within the range of 50-70. The intraoperative consumption of remifentanil ( the intraoperative consumption of sufentanil was converted to the consumption of remifentanil producing the equivalent effect by 1∶ 10) was recorded. Results Compared with group C, the intraoperative consumption of remifentanil was significantly decreased in B and T groups. The intraoperative consumption of remifentanil was significantly lower in group T than in group B. Conclusion TEAS on Xinshu ( BL15 ) , Feishu (BL13), Neiguan ( PC6) and Hegu acupoints throughout surgery and for 30 min before induction of anesthesia significantly reduces intraoperative opioid consumption in the patients undergoing video?assisted thoracoscopic lobectomy, while TEAS throughout surgery provides better effect.