AIM:To investigate the effects of 1.8mm coaxial micro-incision phacoemulsification in cataract patients with diabetic.

METHODS: Totally 130 eyes in 130 patients with type 2 diabetes mellitus were underwent phacoemulsification from January 2017 to December 2018, and they were randomly divided into observation group of 63 cases(63 eyes)and control group of 67 cases(67 eyes). The best corrected visual acuity(BCVA)of the two groups were compared. Average phacoemulsification energy(AVE), effective phacoemulsification time(EPT)were recorded of two groups. Corneal endothelial cell counts, corneal astigmatism and complications of two groups were compared preoperatively and 1wk, 1mo and 3mo postoperatively.

RESULTS: The BCVA in observation and control groups were improved after 7d, 1, 3mo operation(P<0.05). The differences of AVE(t=3.89, P<0.05)in observation and control groups were significant, while EPT(t=0.773, P=0.221)between them were not. The corneal endothelial cell counts between the two groups was not significantly different before surgery(t=1.21, P=0.114), while it reduced a lot postoperatively in both groups. The surgically induced corneal astigmatism of the observation group was much smaller than that of the control group, and the differences were statistically significant. The main complication was corneal edema.

CONCLUSION: The 1.8mm coaxial micro-incision phacoemulsification is helpful to reduce surgically induced astigmatism and has less effect on corneal endothelial cell of patients with type 2 diabetic comparing to normal 3.0mm incision phacoemulsification.

Aim To establish and evaluate the simple and effective animal model of rheumatoid arthritis in SD rats induced by heat-killed mycobacterium tuberculosis H37Ra(Mtb).Methods SD rats were immunized s.c.at the base of the tail with Mtb(1 mg/rat) in mineral oil,and then body weight,blood routine,clinical signs of arthritis were observed regularly.And also hind paw volume in SD rats with AA was tested.Meanwhile,T-lymphocyte subset was determined by flow cytometry in peripheral blood,the level of TNF-?in serum and IL-1 and IL-6 and vascular endothe-lial growth factor(VEGF) in joint tissue were tested by ELISA.The ankle pathological change and radiographic evidence of the hind paws of SD rats were observed to evaluate the AA model effects and availability in SD rats.Results When compared with normal control rats,the total number of white blood cells,platelets and monocytes in peripheral blood and ratio of CD4/CD8 was markedly raised after immunization with Mtb.But body weight of model rats was significantly low from day 14 to 28 after injection of Mtb.The inflammatory arthritic lesions such as edema and erythema in the paws appeared after 9～10 d.The peak of inflammation was 14～16 d.The level of TNF-?in serum and IL-1,IL-6 and VEGF in joint tissue was significantly higher in SD rats with Mtb than that in normal control rats at d 28.The histopathological examination revealed cellular infiltration,synovial and cartilage hyperplasia in ankle joints of SD rats.Conclusions The model induced by Mtb in SD rats is more similar in clinical characterization of rheumatoid arthritis in human being.It is a more efficient and simpler manipulative procedure for screening of new anti-arthritis drugs and experimental studying of anti-rheumatoid arthritis.

Fifty percent of the deaths caused by severe trauma occur within 1 h after injury. With the concepts of "golden 1 h" and "platinum 10 min", the professionals in the field of emergency trauma treatment have agreed on the necessity of establishing a rapid and efficient trauma rescue system. However, due to the size of the hospital, the population in the neighborhood, the local economic conditions and geographical features, how to establish an optimal trauma rescue system remains an issue. In this paper, we introduced our experiences in a county-level hospital located in middle-and high-income areas.

5-(4-Hydroxyphenyl)-3H-1,2-dithiole-3-thione (ADT-OH) is a slowly releasing H2S donor with some neuroprotective effect.In order to study the structure-activity relationships,seventeen compounds (Y1-Y17) were synthesized by modification of ADT-OH at the aromatic ring position,and their structures were confirmed by 1H NMR,13C NMR and HR-MS.Among them,6 compounds (Y4,Y13-Y17) were novel compounds.Their effects had been evaluated on HT-22 hippocampal neuron cells damaged by glutamate with MTF method.The pharmacological results demonstrated that all the Y compounds had potent neuroprotection at most of the tested concentrations (1-100 μmol/L).Compounds Y1-Y9 and Y11 significantly improved the survival rates of the damaged cells at 1-100 μmol/L (P ＜0.01).Specially,compounds Y1,Y4,Y6-Y9,Yu are more potent than their parent compound ADT-OH at concentration of 1-10 μmol/L,which is worthy of further study.

Objective: To evaluate the clinical value of 16-slice spiral CT low dose chest scanning in the diagnosis of pulmonary tuberculosis. Methods: From June 13, 2014 to June 20, 2017, 80 patients with pulmonary tuberculosis in Yuyao People's Hospital were selected in the study.The conventional chest dose(control group) and low dose(observation group) of 16-slice spiral CT were used.The diagnostic accuracy, radiation dose of the two methods, lymph node or vascular space display and image features were observed. Results: The diagnostic accuracy of the two methods had no statistically significant difference (P>0.05). The dose product length, the CT dose index in the observation group were (32.98±2.57) mGycm, (44.29±3.47), respectively, which were significantly lower than those in the control group[(127.66±5.03)mGycm, (44.29±3.47)](t=106.01, 21.05, all P<0.05). The display clarity of lymph nodes or vascular space of the observation group was 90.00%, which of the control group was 92.50%, there was no statistically significant difference between the two groups (P>0.05). The rates of ground glass shadow, burr of the observation group were 29.32%, 31.58%, respectively, which were significantly lower than those of the control group(41.35%, 47.37%), the differences were statistically significant (χ²=4.21, 6.94, all P<0.05). Other signs detection probability are similar between the two groups and had no statistically significant differences (all P>0.05). Conclusion The low dose chest CT scan with 16 rows spiral CT has high clinical value, low radiation dose and high diagnostic accuracy in the diagnosis of pulmonary tuberculosis.

To observe the effect of tripterygium glycosides combined with Danshen injection on blood coagulation mechanism in children with allergic purpura nephritis, and investigate its treatment efficacy through a randomized controlled study. The results showed that before treatment, there were no significant differences in levels of D-D, APTT, PT, FIB and PLT between treatment group and control group; while after treatment, there were significant differences in levels of D-D, PT, FIB and PLT between two groups, but no difference in level of APTT. The effective rate was 90.38% in treatment group, significantly higher than 79.25% in the control group. There was no significant difference in incidence of adverse reactions between two groups. The results suggested that tripterygium glycosides combined with Danshen injection can enhance treatment efficacy and improve blood coagulation mechanism of children in the treatment of purpura nephritis, with high safety and no adverse effects.

OBJECTIVE: To compare the clinical efficacy of micro steel plate and Kirschner needle oblique and transverse internal fixation of adjacent metacarpal bone in the treatment of metacarpal diaphyseal oblique fracture. METHODS: Fifty-nine patients with metacarpal diaphyseal oblique fractures admitted between January 2018 and September 2021 were selected as the study subjects and divided into the observation group (29 cases) and the control group (30 cases) based on different internal fixation methods. The observation group was treated with Kirschner wire oblique and transverse internal fixation of adjacent metacarpal bones, while the control group was treated with micro steel plate internal fixation. Postoperative complications, operation time, incision length, fracture healing time, treatment cost, and metacarpophalangeal function were compared between the two groups. RESULTS: No incision or Kirschner wire infections occurred in the 59 patients, except for one in the observation group. No fixation loosening, rupture, or loss of fracture reduction occurred in any of the patients. The operation time and incision length in the observation group were (20.5±4.2) min and (1.6±0.2) cm, respectively, which were significantly shorter than those in the control group (30.8±5.6) min and (4.3±0.8) cm (P<0.05). The treatment cost and fracture healing time in the observation group were (3 804.5±300.8) yuan and (7.2±1.1) weeks, respectively, which were significantly lower than those in the control group (9 906.9±860.6) yuan and (9.3±1.7) weeks (P<0.05). The excellent and good rate of metacarpophalangeal joint function in the observation group was significantly higher than that in the control group at 1, 2, and 3 months after operation (P<0.05), but there was no significant difference between the two groups at 6 months after operation (P>0.05). CONCLUSION Micro steel plate internal fixation and Kirschner wire oblique and transverse internal fixation of adjacent metacarpal bones are both viable surgical methods for treating metacarpal diaphyseal oblique fractures. However, the latter has the advantages of causing less surgical trauma, shorter operation time, better fracture healing, lower cost of fixation materials, and no need for secondary incision and removal of internal fixation.
Humans ; Metacarpal Bones/injuries* ; Fractures, Bone/surgery* ; Fracture Fixation, Internal/methods* ; Bone Wires ; Bone Plates ; Treatment Outcome

OBJECTIVE: To investigate clinical effect of open reduction and internal fixation in treating proximal humeral fracture by using long head of biceps tendon cutted-off and re-fixation. METHODS: From January 2014 to January 2017, 50 patients with proximal humeral fractures were treated by open reduction and internal fixation. According to whether long head of biceps tendon cutted-off and re-fixation, patients were divided into control group and treatment group, 25 patients in each group. There were 13 males and 12 females with an average of (73.8±4.5) years old in control group, treated with conventional open reduction and internal fixation. There were 15 males and 10 females, with an average of (74.1±5.4) years old in treatment group, treated by using long head of biceps tendon cutted-off and re-fixation on the basis of control group. Fracture healing time and complications after operation were compared between two groups, VAS score was used to evaluate relieve degree of pain, and Neer functional score at 1, 3, 6, 12 months after operation was applied to access clinical efficacy. RESULTS: All patients were followed up for 12 to 24 months with an average of (14.5±3.6) months. There was no statistical difference in following-up between tow groups. Postoperative VAS score at 1 week between treatment group and control group were 2.92±1.10 and 5.88±0.90 respectively, and had significant difference(<0.05). Postoperative Neer functional scores at 1 month between treatment group and control group were 77.88±5.70 and 73.68±4.90 respectively, while 85.88±5.30 and 79.88±3.90 respectively at 3 months after operation, and there were significant difference between two groups at 1 and 3 months after operation(<0.05). There were no statistical differences in Neer functional score between two groups at 6 and 12 months after operation(>0.05). According to postoperative Neer score at 12 months, 9 patients got excellent results, 14 moderate and 2 poor in treatment group; while 4 patients got excellent results, 18 moderate and 3 poor in control group; but there was no difference between two groups. Fracture were healed without postoperative complications between two groups. CONCLUSIONS Open reduction internal fixation with in treating proximal humeral fracture by using long head of biceps tendon cutted-off and re-fixation could reduce pain, speed up early recovery of joint function, is worthy of further promotion.
Aged ; Bone Plates ; Case-Control Studies ; Female ; Fracture Fixation, Internal ; Fracture Healing ; Humans ; Humeral Fractures ; surgery ; Male ; Shoulder Fractures ; Tendons ; Treatment Outcome

AIM: To compare the effects of defocus incorporated multiple segments(DIMS)lens with highly aspherical lenslets(HAL)on delaying the progression of myopia in adolescents.METHODS: Clinical randomized controlled study. Totally 301 students aged 7-12 who underwent optometry in our hospital from January 2021 to June 2023 were randomly divided into two groups. The first group consisted of 154 patients who were fitted with DIMS lenses(DIMS group). In the second group, 147 cases were fitted with HAL(HAL group). Both groups used 0.01% atropine eye drops to control myopia and all students wore glasses for more than 12 h every day. The spherical equivalent(SE)and axial length(AL)after rapid mydriasis were recorded. The data of the right eyes were taken, and the results after fitting for 12 mo were compared between the two groups.RESULTS: Multiple linear regression analysis showed that baseline age was significantly correlated with the changes of SE and AL(all P<0.01). After controlling baseline variables, the adjusted changes in SE for 12 mo after wearing glasses in the DIMS group and HAL group were -0.41±0.18 and -0.34±0.13 D, respectively(P<0.001); the changes of AL in the DIMS group and HAL group were 0.31±0.08 and 0.27±0.06 mm, respectively(P<0.001). Patients were divided into younger group(7-9 years old)and older group(10-12 years old). The changes in SE(t=2.250, P=0.025)and AL(t=3.120, P=0.002)of the younger group who wearing DIMS lens were greater than those with HAL after 12 mo, and the same was true in the older group(t=5.931, 5.033, both P<0.001).CONCLUSION: Under the condition of combined use of 0.01% atropine eye drops, HAL is more effective than DIMS lens in controlling myopia diopter and AL of adolescents.

10cm in 11 cases), with an average of 9.2cm. Of all cases,14 were restored by using combined transplantation of mandible itself and a Titanium Support, and another 7 by using only mandible itself. 3 cases have been followed up for more than 1.5 years, 10 cases for 1 -1.5 years, 4 cases for 0.5-1 years, another 4 cases less than 0.5 years. The results of reconstruction, from the stand-point of both shape and function, were satisfactory.