Background Compare with the lamellar laser refractive surgery,the laser slip on the surface operation is a better method in the correct of refractive error without the flap-related complications.However,whether to remain corneal epithelial flap and its influence for epithelial healing and visual restoration are still under investigation.Objective The aim of this study was to compare the short-term clinical efficacy of epipolis laser insitu keratomileusis (Epi-LASIK) and flap-free Epi-LASIK for correction of refractive error in high myopia.Methods The paired control design was adopted.Sixty eyes of consecutive 30 patients with high myopia were collected in this study.The written consent form was obtained from each patients prior to operation.Regular EpiLASIK was performed in the right eyes and the flap-free Epi-LASIK was carried out in the left eyes.Patients were followed-up for one month.The postoperative ocular irritation symptoms were scored,and the healing period of corneal epithelium and uncorrected visual acuity were examined at 1,3 and 5 days after operation.The naked visual acuity,diopter,best corrected visual acuity and the grading of haze were recorded and compared between the two groups at one month after operation.Results After surgery,the scores of corneal irritation were 3.13 ±0.43 and 3.30±0.47on the first day,showing insignificant differences between these two groups (t =- 1.54,P＞0.05 ).However,there existed statistically significant difference in the scores of corneal irritation on the third day after operation between the two groups (t =- 17.95,P＜0.01 ).The average time of corneal epithelial healing were (2.58 ±0.49 ) days in the flapfree Epi-LASIK group and ( 3.98 ±0.74) days in Epi-LASIK group with the significant difference between them (t=-11.36,P＜0.01 ).There was no statistical difference in uncorrected visual acuity in the first day (0.59±0.12 vs 0.58±0.11,t=0.39,P＞0.05),the fifth day (0.69±0.08 vs 0.67±0.09,t=0.84,P＞0.05) and 1 month (t =-1.90,P＞0.05 ).No significant difference was seen in the diopter between the two groups in 1 month after surgery (-1.03±0.45 vs -1.07 ±0.38,t =-0.31,P＞0.05 ).The eye numbers of corneal haze for 0 grade were 27 ( 90.00％ ) and over the 0.5 grade were 3 ( 10.00％ ) in flap-free Epi-LASIK group respectively,and those of corneal haze for 0 grade were 26(86.66％ ) and above the 0.5 grade were 4 (13.33％) in Epi-LASIK group respectively,showing a considerably difference between the two groups (x2 =0.0031,P＞0.05).Conclusions Both the flapfree or reserved epithelial Epi-LASIK allow the safe and effective correction of refractive error in high myopia,showing good predictability and stability in short term.Flap-free Epi-LASIK can relieve the corneal irritation symptom and accelerate the healing of corneal epithelium and recovery of visual acuity.

Antibodies, Viral ; blood ; China ; epidemiology ; Humans ; Yellow Fever ; epidemiology ; Yellow fever virus ; immunology

Objective To investigate the effect of recombinant chlamydiaphage phiCPG1 capsid protein Vp1 on Chlamydia trachomatis(Ct) after Vp1 was co-cultured with Ct (reference strains and clinical strains).Methods The recombinant chlamydiaphage phiCPG1 capsid protein Vp1 was expressed and purified.Equal amount of Ct standard strains (E/UW-5/Cx and D/UW-3/Cx) or clinical strains,which had been incubated with Vp1 protein at the concentration of 53 μg/ml for 3 h at room temperature,were inoculated into McCoy.After cell culture,idione stain and transmission electron microscope were used to observe the effect of Vp1 on the Ct.The effect of Vp1 protein on the cell line McCoy was determined by MTT assay,the responses of Escherichia coli BL21 and DH5α toward Vp1 protein were determined using broth microdilution assays.Results Vp1 had obviously inhibitive effect on Ct,the inhibition ratios were about 40％-70％in clinical strains,72％ in reference strain D and 78％ in E,respectively.Abnormally enlarged RBs were observed after Vp1-treatment and Vp1 could arrest chlamydial developmental cycle using electron microscope.There was no effect of Vp1 on McCoy cells or bacteria BL21 or DH5α.Conclusion The recombinant Vp1 from phiCPG1 has obviously inhibitive effect on the growth of Ct,it will be helpful for the treatment of Ct infection in clinic.

OBJECTIVETo investigate the influence on fracture stability by different pin construct during percutaneous pinning for the treatment of proximal humerus fractures.

METHODSEighteen pairs (36) adult fresh-frozen humeri were match-paired and divided into 4 groups. Dual-energy bone density scan had been used in order to rule out the influence by different degrees of osteoporosis of the cadaver. Two-part surgical neck fracture model was carried out unanimously in all 36 humeri. Four terminal threaded pins (2.5 mm in diameter) were used in fixation for all specimen. Parallel type pinning (box type) were carried out in 2 groups and convergent type pinning (fan shape) in the other 2 groups. Instron5566 biomechanical tester was applied in determining both anti-shear and anti-torsion ultimate load of each specimen.

RESULTSThere was no statistical difference between parallel pin construct and convergent construct in regard of anti-shear resistance (P = 0.73). But by mean of anti-torsion resistance, the parallel construct had significant advantage over the convergent construct (P = 0.04).

CONCLUSIONAccording to our biomechanical data, parallel pin construct seems to have better torsional stability. We suggest that parallel pin fixation should be applied whenever possible. Convergent pin construct should be considered when parallel construct is not possible or the distance between pins are too small (< 1 cm).

Biomechanical Phenomena ; Bone Nails ; Cadaver ; Fracture Fixation, Internal ; instrumentation ; methods ; Humans ; Shoulder Fractures ; physiopathology ; surgery

OBJECTIVETo investigate the fit of self-inhalation air-purifying dust respirator for Chinese workers, to improve the respirators according to Chinese facial features and to evaluate the protective effects of improved respirators.

METHODSTwo types of self-inhalation air-purifying dust respirators (cup respirators A1 and folding respirators B1) were tested by Condensation Nuclei Counting method (CNC) in 25 representative subjects (15 males and 10 females). According to the Chinese facial features and fit factors, A1 and B1 respirators were improved. The fit tests were performed for the improved A1 and B1 respirators.

RESULTSThe fit factors ≥ 100 served as the qualified standard of self-inhalation air-purifying dust respirators. The qualified rate for cup respirator A1 was 0.0%. Its geometric mean fit factor was 20.7 (6.9 ∼ 46.9). The qualified rate for cup respirator B1 was 4.0%. Its geometric mean fit factor was 26.0 (6.8 ∼ 154.9). After improvement, the qualified rates and fit factors significantly increased. The qualified rate for cup respirator A2 was 72.0% and geometric mean fit factor was 223.5 (2.2 ∼ 5932.7). There were significantly differences between respirator A1 and A2 (χ(2) = 25.09, P < 0.05). The qualified rate for cup respirator B2 was 88.0 % and geometric mean fit factor was 429.8 (41.5 ∼ 3692.9). The significant differences (χ(2) = 32.21, P < 0.05) between B1 and B2 were found.

CONCLUSIONTo ensure the protective effects, the self-inhalation air-purifying dust respirators were designed according to Chinese facial features. The respirator fit test must be conducted when workers choose respirators.

Equipment Design ; Female ; Humans ; Inhalation Exposure ; prevention & control ; Male ; Materials Testing ; Occupational Exposure ; prevention & control ; Respiratory Protective Devices

Objective To compare the clinical efficacy betweenLing Gui Ba Fa (eight magic turtle techniques) time-based points selection method and ordinary acupuncture in treating diarrhea-predominant irritable bowel syndrome (IBS-D) due to spleen-stomach deficiency.Method Sixty patients were randomized intoLing Gui Ba Fa group and ordinary acupuncture group, 30 cases each. InLing Gui Ba Fa group, Gongsun (SP4) was selected as the host point, Neiguan (PC6) as the guest point, and Dachangshu (BL25), Tianshu (ST25), Shangjuxu (ST37), Sanyinjiao (SP6), Pishu (BL20) and Zusanli (ST36) as the adjunctive points; in the ordinary acupuncture group, Gongsun and Neiguan were selected as the major points, and Dachangshu, Tianshu, Shangjuxu, Sanyinjiao, Pishu and Zusanli were selected as the adjunctive points. The acupuncture treatments were conducted 3 times a week (the practitioner would make appointment with patient at a convenient time if Gongsun had multiple activation time points according toLing Gui Ba Fa), 10 sessions as a course of treatment. Before and after the intervention, the two groups of patients were evaluated by using the traditional Chinese medicine symptoms and syndromes scale and irritable bowel syndrome quality of life questionnaire (IBS-QOL), and clinical efficacy was also observed.Result The control rate was 86.7% inLing Gui Ba Fa group versus 73.3% in the ordinary acupuncture group, and the therapeutic efficacy ofLing Gui Ba Fa group was significantly better than that of the ordinary acupuncture group (P<0.01); after the treatment, the scores in rating symptoms such as diarrhea, abdominal bloating and abdominal pain were significantly lower than those before the treatment in both groups (P<0.01), and the declines of scores inLing Gui Ba Fa group were more significant than those in the ordinary acupuncture group (P<0.01).ConclusionLing Gui Ba Fa time-based points selection method can produce a more significant efficacy than ordinary acupuncture in treating irritable bowel syndrome.

OBJECTIVEThe indication, surgical techniques and results had been discussed through clinical analysis of percutaneous pinning for the treatment of proximal humerus fractures.

METHODSForty-nine patients with 49 shoulders treated with percutaneous pinning had been reviewed with a mean follow-up period of 16.9 months. All were acute fractures, with a mean age of 40.4 years. There were 39 2-part surgical neck fractures, 6 impacted 2-part greater tuberosity fractures and 4 valgus-impaction 4-part fractures. SST (Simple Shoulder Test) questionnaire, ASES (American Shoulder & Elbow Surgeon) score, Constant-Murley score and UCLA score had been adopted for final evaluation at the latest follow-up.

RESULTSThe mean ASES score was 91.4, the mean VAS score was 1.7, the mean forward flexion was 146.7 degrees, external rotation 39.6 degrees, internal rotation at T(8)-T(9) level; the mean Constant-Murley score was 88.2; the mean UCLA score was 31.2; the mean number of questions for "yes" in SST questionnaire was 10.1. All fractures healed with a mean period of 8.8 weeks. No patient had been found for any evidence of humeral head necrosis at the latest follow-up The total satisfaction rate for pain relieve was 95.9% (47/49), and for functional recovery was 91.8% (45/49).

CONCLUSIONSMost 2-part surgical neck fractures, impacted 2-part greater tuberosity fractures and 4-part valgus-impaction fractures are good indications for percutaneous pinning. With appropriate and intense rehabilitation, satisfactory results can be expected in percutaneous pinning for the treatment of certain types of proximal humerus fractures.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Female ; Follow-Up Studies ; Fracture Fixation, Intramedullary ; methods ; Humans ; Male ; Middle Aged ; Shoulder Fractures ; surgery ; Treatment Outcome

OBJECTIVETo investigate indication, technical key during surgery and early results of humeral head replacement for the treatment of complicated proximal humerus fractures.

METHODSSixteen patients who received humeral head replacement were reviewed with a mean follow-up period of 6.8 months. Of the 16 patients, 15 suffered acute fractures with the mean interval between injury and surgery being 8 days. 1 case was a malunion after ORIF 1 year ago. The mean age for these patients were 58.9 years. Trauma series X-rays were taken at post-operation 2-week, 6-week, 10-week, 16-week 6-month and the latest follow-up. SST (Simple Shoulder Test) questionnaire, ASES (American Shoulder & Elbow Surgeon) score, Constant-Murley score and UCLA score had been adopted for evaluation at the latest follow-up.

RESULTSThe mean ASES score was 89.1 (64 - 94); the mean VAS score was 2.7 (0 - 5); the mean forward flexion was 128.1 degrees (90 degrees - 150 degrees ), external rotation 35 degrees (30 degrees - 40 degrees ), internal rotation at T8-T9 level (L1-T6); the mean Constant-Murley score was 85.7 (53 - 95); the mean UCLA score was 30.4 (21 - 33); the mean number of questions for "yes" in SST questionnaire was 9.3 (7 - 11). The total satisfaction rate for pain relief was 93.8% (15/16), and functional recovery was 87.5% (14/16).

CONCLUSIONSThrough strict indication control, appropriate timing, meticulous surgical techniques and long intense rehabilitation, satisfactory results can be obtained in humeral head replacement for the treatment of complicated proximal humerus fractures. Our report is only a preliminary one on early results, and a long-term follow-up data is needed for further evaluation.

Adult ; Aged ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Range of Motion, Articular ; Shoulder Fractures ; physiopathology ; rehabilitation ; surgery

OBJECTIVETo study the effect of close needling in the treatment of calcifying tendonitis.

METHODSSeventeen patients with calcifying tendonitis who had received close needling treatment were followed-up for 9.3 months on average. An 18-gauge or 16-gauge needle was used during needling. X-ray examination was given 4, 6, 8 and every 4 weeks after needling. SST (simple shoulder test) questionnaire, ASES (American Shoulder & Elbow Surgeon) score, constant-Murley score and UCLA score were adopted for evaluation before and after treatment.

RESULTSCalcium deposition disappeared within 4 - 20 weeks mean 9.4 weeks in 15 of the 17 patients after needling for 1 - 3 times. Average ASES score before treatment was 47.7 (34 - 59), forward elevation was 90 degrees (70 degrees - 100 degrees ), external rotation was 15 degrees (0 degrees - 30 degrees ), and internal rotation was L3-4 (L1-buttock). Average constant-Murley score before treatment was 44.6 (34 - 54), UCLA score was 11.6 (8 - 15), and numbers of questions for "yes" in SST questionnaire was 3.4 (2 - 5). After needling the average ASES score was 87.1 (72 - 91), forward elevation was 143.5 degrees (120 degrees - 160 degrees ), external rotation was 40 degrees (30 degrees - 50 degrees ), internal rotation was T(8)-T(9), constant-Murley score was 87.8 (64 - 94), UCLA score was 29.5 (19 - 33), and numbers of questions for "yes" in SST questionnaire was 9.1 (6 - 12). Significant difference was found between before and after needling (ASES: P < 0.01, forward elevation, external rotation and internal rotation: P < 0.01, constant-Murley: P < 0.01, UCLA: P < 0.01, SST: P < 0.01).

CONCLUSIONSClose needling is an effective method for the treatment of calcifying tendonitis. Symptoms and disability are greatly relieved non-surgically in most of patients. Care should be taken in differential diagnosis of degenerative calcification in chronic rotator cuff disease.

Adult ; Aged ; Calcinosis ; pathology ; surgery ; Female ; Humans ; Male ; Middle Aged ; Nerve Block ; methods ; Rotator Cuff ; innervation ; Tendinopathy ; pathology ; surgery ; Treatment Outcome

OBJECTIVETo discuss and evaluate the surgical techniques of arthroscopic rotator cuff repair and its clinical results.

METHODSFrom March 2002 to May 2005, 44 out of 68 patients treated by arthroscopic rotator cuff repair had been reviewed with a mean post-operation time of 12 months. Of the 44 patients, 40 were available for follow-up, with a mean period of 20.6 (12 - 40) months. The mean age was 56 (30 - 81) years. According to Gerber classification, there were 8 partial tears, 27 small tears and 5 massive tears. No irreparable tear was included in this series. All tears were repaired under the scope, and metal suture anchor (Super-Revo, Linvatec) had been used in all patients. ASES score (American shoulder & elbow surgeons' score), Constant-Murley score and SST (simple shoulder test) questionnaire were adopted before operation and at the latest follow-up.

RESULTSThe pre-operation and post-operation mean ASES score was 72.6 vs. 92.3 (P < 0.001), with the mean VAS score for pain 6.2 vs. 1.8 (P < 0.001), the mean forward flexion 74.5 degrees vs. 146.0 degrees (P < 0.001), and the mean external rotation 27.8 degrees vs. 38.3 degrees (P < 0.01). The excellent and good rate for post-operation ASES was 92.5%. The pre-operation and post-operation mean Constant-Murley score was 69.6 vs. 90.4 (P < 0.001), with an excellent and good rate of 90.0%.

CONCLUSIONSArthroscopic rotator cuff repair is a successful treatment for rotator cuff tear. By the use of suture anchors, scope surgery shares the advantages of minimal morbidity, quick functional recovery and protection of deltoid muscle. With appropriate indication control, descent surgical skill and intense postoperative rehab, gratifying outcome can usually be anticipated.

Adult ; Aged ; Aged, 80 and over ; Arthroscopy ; methods ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Rotator Cuff ; surgery ; Rotator Cuff Injuries ; Tendon Injuries ; surgery ; Treatment Outcome