AIM: To analyze and summarize the effect of glaucoma trabeculectomy in the department of ophthalmology in basic hospital.
METHODS: Postoperative intraocular pressure ( IOP ) , filtering bleb and complications of 316 cases (405 eyes) of patients with glaucoma after trabeculectomy were analyzed.
RESULTS: After follow- up 12mo, 76. 5% IOP was controlled in normal level. 42. 5% was filtration bleb typeⅠ, 33. 1% typeII, 14. 6% in typeⅢand 9. 9% in typeⅣ. Intraoperative complication rate was 2. 5%, that was 31.4% at postoperative early stage ( before discharge ) , and 6. 7% at postoperative long - term ( 6mo after discharge) .
CONCLUSION:Trabeculectomy for glaucoma can better solve the problem of high IOP. It is more mature in primary hospitals, but there are still a variety of intraoperative and postoperative complications.

Adolescent ; Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Musculoskeletal Manipulations ; methods ; Shoulder Dislocation ; diagnostic imaging ; therapy ; Tomography, X-Ray Computed ; Treatment Outcome ; Young Adult

Cell Line ; Embryonic Stem Cells ; Genetic Vectors ; Green Fluorescent Proteins ; genetics ; Humans ; Lentivirus ; genetics ; Transfection

Objective:To observe the effects of orbital bone density on the stress distribution of implant-bone surface.Methods:The 3D finite element analysis craniofacial model with eight HU values(300 -1 0 000)was established.A force of 20 N along the im-plant axis was applied on the model.The stress values and distribution were calculated and analyzed.Results:The peak of stress val-ue and displacement discreased as HU value increased.In the range of HU value 800 -1 000 HU,the peak of stress value and dis-placement of bone interface did not significantly change with the increasing of HU value.Conclusion:Orbital bone density is an im-portant factor on orbital implant failure when HU value below 800.

Objective:To evaluate the value of Cook MOB-15 system in guiding wire insertion during endoscopic retrograde cholangiopancreatography (ERCP). Methods: The clinical data of 51 patients who received Cook MOB-15 system-guided wire insertion during ERCP between Jan. 2005 to Dec. 2007 were retrospectively analyzed. Forty patients who received conventional ERCP catheter for malignant jaundice between Jan. 2002 and Dec. 2004 were taken as control. The successful insertion rates were compared between the 2 groups. Results: The successful insertion rate was 90.2% (46/51) in the Cook MOB-15 system group and 72.5% (29/40) in the conventional group; there was significant difference between the 2 groups (P

Mesaconitine was incubated with rat liver microsomes in vitro. The metabolites of mesaconitine in rat liver microsomes were identified by ultra performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS) method with high resolution power. A typical reaction mixture of 100 mol L-1 Tris-HCI buffer (pH 7.4) containing 0.5 gL-1 microsomal protein and 50 micro molL-1 mesaconitine was prepared. The above reaction mixture was divided into six groups, and the volume of each group was 200 micro L. The incubation mixture was pre-incubated at 37 degrees C for 2 min and the reactions were initiated by adding NADPH generating system. After 90 min incubation at 37 degrees C, 200 micro L of acetonitrile was added to each group to stop the reaction. The metabolites of mesaconitine were investigated by UPLC-MS/MS method. Mesaconitine and 6 metabolites M1-M6 were found in the incubation system. The structures were characterized according to the data from MS/MS spectra and literatures. The metabolic reactions of mesaconitine in rat liver microsomes included the demethylation, deacetylation, dehydrogenation and hydroxylation. The major metabolic pathways of mesaconitine in rat liver microsomes were determined by UPLC-MS/MS on multiple reaction monitoring (MRM) mode combined with specific inhibitors of cytochrome P450 (CYP) isoforms, including alpha-naphthoflavone (CYP1A2), quinine (CYP2D), diethyldithiocarbamate (CYP2E1), ketoconazole (CYP3A) and sulfaphenazole (CYP2C), separately. Mesaconitine was mainly metabolized by CYP3A. CYP2C and CYP2D were also more important CYP isoforms for the metabolism reactions of mesaconitine, but CYP1A2 and CYP2E1 haven't any contribution to MA metabolism in rat liver microsomes.
Aconitine ; analogs & derivatives ; metabolism ; Animals ; Chromatography, High Pressure Liquid ; Cytochrome P-450 CYP3A ; metabolism ; Cytochrome P-450 CYP3A Inhibitors ; Cytochrome P-450 Enzyme Inhibitors ; Cytochrome P-450 Enzyme System ; metabolism ; Enzyme Inhibitors ; pharmacology ; Ketoconazole ; pharmacology ; Male ; Metabolic Networks and Pathways ; Microsomes, Liver ; enzymology ; metabolism ; Quinine ; pharmacology ; Rats ; Rats, Sprague-Dawley ; Sulfaphenazole ; pharmacology ; Tandem Mass Spectrometry

Objective To observe the influence of triglyceride(TG),hemoglobin(HGB),total bilirubin(TBIL)and rheumatoid factor(RF)on the results of two kinds of D-dimer detection reagent assay.Methods Five samples were prepared into series with 2,4,6,8 and 10 mmol/L triglyceride by adding fat emulsion.Five samples were prepared into series with 1,2,3,4 and 5 g/L of hemolysis degree by adding hemoglobin solution.Five samples were prepared into series with 20,40,60,80 and 100μmol/L total bilirubin by adding bilirubin standard preparation.Ten samples were prepared into rheumatoid factor levels be-tween 0~150 IU/L by adding rheumatoid factor standard solution.Simultaneously with D-dimer detection reagent and D-di-mer HS detection reagent for testing,each sample was measured two times and the results averaged.Results When TG≤2 mmol/L,the D-dimer reagents without interference,and TG≥4 mmol/L,the D-dimer reagents due to “SD baseline data out of range”couldn’t be detected.TG≤10 mmol/L,for D-dimer HS reagents was without interference.When HGB≥1 g/L, the D-dimer reagents due to“SD baseline data out of range”couldn’t be detected.HGB≤4 g/L,for D-dimer HS reagents was without interference.When hemoglobin levels was equal to 5 g/L,the D-dimer HS reagents test results false increased about 30.4%.With total bilirubin concentration increases,D-dimer and D-dimer HS reagents test results were false increase, showed amplitude by a power law,and the two reagents increased consistency.Preparation a series of pooled plasma of rheu-matoid factor levels in 0~150 IU/L,D-dimer test results reagent falsely elevated levels of rheumatoid factor with a linear correlation (Y=59.31X+50.43,R2=0.998).When RF≤150 IU/L,the D-dimer HS reagents was without interference. Conclusion Triglyceride,hemoglobin,total bilirubin and rheumatoid factor may interfere D-dimer testing process,icterus and severe hemolysis will interfere D-dimer HS testing process.D-dimer HS reagents against interfere exceed D-dimer rea-gents.When D-dimer test results does not match with clinicians determine,the influence ofinterfering substances should be considered.

OBJECTIVETo summarize application of rafting K-wires technique for tibial plateau fractures.

METHODSFrom January 2013 to January 2015,45 patients with tibial plateau fractures were treated by locking plate with rafting K-wires, including 33 males and 12 females with an average of 44.2 years old ranging from 22 to 56 years old. According to Schatzker classification, 6 cases were type II, 8 were type Ill, 4 were type IV, 4 were type V, and 5 were type VI. Allogeneic bone graft were performed for bone defects. All patients were fixed with two to five K-wires. Part of weight loading were encouraged at 3 months after operation,and full weight-loading were done at 5 months after operation. Postoperative complications were observed,and Rasmussen clinical and radiological assessment were used to evaluate clinical results.

RESULTSAll Patients were followed up from 10 to 23 months with average of 14 months. According to Rasmussen clinical and radiological assessment, clinical scores 23.58 ± 6.33, radiological scores were 14.00 ± 6.33; and excellent and good rates were 82.2% and 77.8% respectively. Four patients occurred severe osteoporosis and collapse of articular surface; 5 patients occurred traumatic arthritis.

CONCLUSIONRafting K-wires technique with anatomized armor plate could effective fix and support platform collapse and joint bone fragments, increase support surface area and reduce postoperative reduction loss rate.

Adult ; Bone Wires ; Female ; Fracture Fixation, Internal ; instrumentation ; methods ; Humans ; Male ; Middle Aged ; Tibial Fractures ; surgery

OBJECTIVETo explore the clinical outcomes of percutaneous vertebroplasty (PVP) and percutaneous kyphoplasty (PKP) in treating osteoporotic vertebral compression fracture (OVCF).

METHODSFrom January 2007 to February 2010, the data of 40 patients with osteoporotic vertebral compression fracture underwent treatment were retrospectively analyzed. Of them,20 patients were treated with PVP (PVP group), there were 8 males and 12 females with an average age of (66.37 +/- 2.34) years old (54 to 81); 20 patients were treated with PKP (PKP group), there were 11 males and 9 females with an average of (65.12 +/- 3.21) years old (56 to 79). Postoperative at 1 week, 12 weeks, 1 year, pain and daily life function were respectively assessed by visual analogue scale (VAS) and Barthel index (BI); and anterior height of responsibility vertebra, Cobb angle were measured by X-rays.

RESULTSIn PVP group, 1 case complicated with bone cement leakage without clinical symptoms and no operation to treat. No postoperative infection and deep vein thrombosis were found between two groups. All patients were followed up more than 1 year, pain and daily life function has obviously improved than preoperative (P < 0.01); and there was no significant difference on 1 week, 12 weeks, 1 year after operation (P > 0.05); there was no significant difference between two groups (P > 0.05). In PVP group, there was no significant difference in anterior height of responsibility vertebra, Cobb angle before and after operation;and in PKP group, postoperative data has obviously improved than preoperative (P < 0.01), but there was no significant difference postoperative at 1 week, 12 weeks, 1 year (P > 0.05); there was no significant difference between two groups at 1 week, 12 weeks, 1 year after operation.

CONCLUSIONBoth the methods can obviously relieve pain and completely or partly recover daily life function in treating OVCF. But PKP has advantages of recovery of anterior height of responsibility vertebra and correction of Cobb angle, especially for serious compression.

Aged ; Aged, 80 and over ; Female ; Fractures, Compression ; diagnostic imaging ; physiopathology ; surgery ; Humans ; Kyphoplasty ; Male ; Middle Aged ; Osteoporotic Fractures ; diagnostic imaging ; physiopathology ; surgery ; Radiography ; Recovery of Function ; Retrospective Studies ; Spinal Fractures ; diagnostic imaging ; physiopathology ; surgery ; Spine ; surgery ; Treatment Outcome

Objective Acute kidney injury (AKI) is common but usually under-diagnosed in hospitalized patients,of the impact of which on patients is still unclear.The paper was aimed to investigate the impact of delayed recognition of AKI on short-time prognosis of patients through a propensity score matched study.Methods From Oct 2013 to Sep 2014,1401 adult hospitalized patients with AKI in the First Affiliated Hospital of Nanjing Medical University were divided into delayed recognition group and timely-diagnosed group according to propensity score matching (1∶ 1) without replacement method.Primary endpoint was 30-day all-cause mortality,and secondary endpoints included recovery of kidney at discharge,length of hospitalization,length of intensive care unit stay and hospital costs.Results There were significant differences in age,department distribution,complications,stage of AKI,Charlson index,APACHE Ⅱ score,SOFA score between the two groups before matching.After matching,there were no significant difference in demographic data,department distribution,complications,stage of AKI,Charlson index,APACHE Ⅱ score,SOFA score between the two groups except in blood urea nitrogen (P=0.039) and use of diuretics (P=0.018).Delayed recognition of acute kidney injury was not associated with 30-day all-cause mortality in univariate (P=0.711) and multivariate Logistic regression analyses.The secondary endpoints did not differ in two groups.Conclusion Delayed acute kidney injury recognition did not associate with poor short-term outcomes in adult hospitalized patients.