Application of biomimetic double-layer biofilm stent in arthroscopic rotator cuff repair: A protocol of randomized controlled trial

Background:Rotator cuff injury is the most common cause of shoulder dysfunction. Despite the continuous advancement of surgical techniques, the incidence of re-tearing after rotator cuff repair is still high. The main reason is that it is difficult to reconstruct the normal tendon bone interface and the process is slow, and the application of tissue engineering technology can promote tendon and bone healing. This study will evaluate the effect of the bionic double membrane stent on the rotator cuff healing after arthroscopic rotator cuff repair.Methods:This is a prospective randomized controlled trial to study the effect of biomimetic double-layer biofilm stent on rotator cuff healing. Approved by the clinical research ethics committee of our hospital. The patients were randomly divided into 1 of 2 treatment options: (A) a biomimetic double-layer biofilm stent group and (B) a non-bionic dual-layer biofilm stent group. Observation indicators include: visual analog scale score, University of California Los Angeles score, American Shoulder & Elbow Surgeons score and Constant-Murley score. Data were analyzed using the statistical software package SPSS version 16.0 (Chicago, IL).Discussion:This study will evaluate and evaluate the effect of the bionic double-layer membrane stent on the rotator cuff healing after arthroscopic rotator cuff repair. The results of this experiment will provide new treatment ideas for promoting rotator cuff tendon bone healing.OSF Registration number:DOI 10.17605/OSF.IO/FWKD6     

剥脱综合征患者结膜印迹细胞学的检查特征

目的:研究剥脱综合征对结膜细胞和泪液功能的影响.方法:研究共纳入剥脱综合征患者60例86眼作为试验组,年龄相仿正常人55例89眼作为对照组.所有115例175眼均接受Schirmer泪试验及泪膜破裂时间试验,并对上方和鼻下方睑裂区球结膜进行印迹细胞学检查.印迹细胞学检查结果根据Nelson方法分级.对TBUT,Schirmer泪试验及印迹细胞学结果进行相关性分析.结果:剥脱综合征患者的Schirmer试验、TBUT均较正常组显著降低,结膜细胞也有显著改变.剥脱综合征患者的印迹细胞学分级中位数为3级,而正常人组为0级.在试验组中发现45例样本出现了两种以上分级共存的现象,而对照组仅发现3例.此外,实验组中的45例样本结膜上皮细胞和杯状细胞分级出现明显差异,且均表现出杯状细胞的破坏甚于上皮细胞,而对照组未发现此种现象.结论:剥脱综合征患者的结膜细胞受到破坏,泪液分泌受到影响,极易造成眼表疾病的出现.     

白内障超声乳化术对泪膜功能的影响

目的：观察白内障超声乳化吸除联合人工晶状体植入手术对于患者术后泪膜的影响,探讨其临床意义。
　　方法：随机选取接受超声乳化白内障吸除术治疗的患者106例140眼,观察患者术前;术后1 d;1,2,3 wk;1 mo这六个时间节点的主观干燥异物感,通过角膜荧光素试验(FSC)、基础泪液分泌试验(SⅠt)和泪膜破裂时间(BUT)这三个指标测定患者的泪膜功能变化,并分析泪膜稳定性和角膜知觉之间的相关性。
　　结果：患眼术后1d;1,2wk干眼症状累计得分高于术前( t=8.53, P=0.000;t=6.27, P=0.000;t=9.02, P=0.000),患眼术后3 wk和1 mo干眼症状累计得分与术前相比无差异(t=1.91,P=0.824;t=1.27,P=0.069)。患眼术后1d;1,2wk角膜上皮荧光素染色点与术前相比增多(t=11.64, P=0.000;t=9.61,P=0.000;t=8.87,P=0.001),患眼术后3 wk和1 mo角膜上皮荧光素染色点与术前相比无差异(t=2.52, P=0.746;t=1.16,P=0.094)。患眼术后1d;1,2wk角膜知觉检测数值明显大于术前( t=9.61,P=0.000;t=9.27,P=0.000;t=11.39,P=0.024),术后3wk和1mo角膜知觉检测结果数值与术前相比无差异( t=1.19, P=0.562;t=2.17,P=0.501)。
　　结论：白内障超声乳化吸除联合人工晶状体植入术会在短期内降低术眼泪膜的稳定性,但是在长期休养之后会得到一定程度上的改善。     

Keratograph眼表综合分析仪与传统方法对泪膜功能评价的一致性分析

目的：探讨一种最新的眼表综合分析仪Keratograph对于泪膜稳定性评估的重复性和准确性,将其测量值与传统的检查方法进行比较。

方法：采用Keratograph测量包括首次泪膜破裂时间(the first tear film break-up time, BUT-f)和平均泪膜破裂时间(the average tear film break-up time, BUT-ave)在内的非侵入式泪膜破裂时间(noninvasive tear film break-up time, NI_BUT)结果。测量结果的重复性使用变异系数(coefficient of variation,CV)和组内相关系数(intraclass correlation coefficient,ICC)进行评价, NI-BUT与传统的荧光素泪膜破裂时间(fluorescein tear film break-up time, FBUT)的比较采用Wilcoxon符号秩和检验,确定NI-BUT与FBUT,Schirmer Ⅰ试验结果的相关关系,采用Bland-Altman分析进行一致性评价。

结果：本研究纳入了48个受检者(48眼),平均年龄38.7±15.2岁。BUT-f的CV和ICC分别为12.6%和0.95,BUT-ave的为9.8%和0.96。BUT-f值低于FBUT值,差异有统计学意义(6.16±2.46s vs 7.46±1.92s, P < 0.01)。NI-BUT与FBUT,Schirmer Ⅰ试验结果之间存在显著的正相关关系(P<0.01)。BUT-f与FBUT的95%一致性界限(limits of agreement, LoA)范围为4.46s,BUT-ave与FBUT的LoA范围为3.64s。

结论：Keratograph能够提供具有较好重复性和可靠性的NI-BUT数据,在干眼诊治和角膜屈光性手术等领域有很好的应用前景。     

Validity of subjective assessment as screening tool for dry eye disease and its association with clinical tests

AIM: To determine the role of subjective assessment using McMonnies dry eye questionnaire in diagnosing dry eye disease and its association with clinical tests. METHODS: There were 500 patients screened for dry eye using McMonnies dry eye questionnaire between May to October 2013 at the outpatient Department of Ophthalmology of a medical college hospital. All 500 patients were subjected to clinical tests. Dry eye was defined as having one or more symptoms often or all the time. Positive signs were if one or both eyes revealed tear film breakup time (TBUT) of ≤10s, a Schirmer test score of ≤10 mm, a Rose Bengal staining score of ≥1, a Lissamine green staining score of ≥1 or existence of meibomian gland disease (≥grade 1). Statistical analysis was performed to describe the distribution of symptoms and signs, to assess the correlations between McMonnies score (MS) and variable clinical signs of dry eye, and to explore the association between dry eye symptoms and variable clinical signs. Analysis was performed using software package Epi info. A Probability (P) value using Chi-square test of <0.005 was taken as significant. RESULTS: Dry eye prevalence with symptoms (questionnaire), Schirmer test, TBUT, Rose Bengal staining and Lissamine green staining was 25.6%, 15.20%, 20.80%, 23.60%, and 22.60% respectively. Among those with severe symptoms (MS>20), 75.86% had a low TBUT (<10s), 58.62% had a low Schirmer’s I test (≤10 mm), 86.20% had Rose Bengal staining score of ≥1, 79.31% had Lissamine green staining score of ≥1. We found statistically significant associations between positive Schirmer test and arthritis (P<0.002), dryness elsewhere (P<0.001), contact lens use (P<0.002), systemic medication (P<0.0001), sleeping with eyes partly open (P<0.002), history of dry eyes treatment (P<0.0001), environmental factors (P<0.001), swimming (P<0.001). CONCLUSION: Subjective assessment plays an important role in diagnosing dry eye disease. There is strong correlation between MS and Schirmer test, TBUT, Rose Bengal staining and Lissamine green staining in normal as well as marginal and pathological dry eye.     

经导管介入治疗二尖瓣疾病的研究进展

二尖瓣反流（Mitral valve regurgitation,MR）逐渐成为心脏瓣膜病中最常见的疾病之一。虽然外科手术在治疗MR中起到重要作用,但由于围手术期的风险过大、老年人基础情况较差等原因,许多患者禁忌外科手术。近年来,经导管治疗MR装置的出现,给治疗MR带来了新的选择,但同时也面临着许多挑战。本文综述了经导管治疗MR装置的技术特征及其临床试验的结果。     

奥洛他定治疗过敏性结膜炎的疗效及其对血清、泪液相关指标的影响

目的探讨奥洛他定治疗过敏性结膜炎的疗效及其对血清、泪液相关指标的影响。方法 90例过敏性结膜炎患者随机分为对照组(色甘酸钠滴眼液)和观察组(奥洛他定滴眼液),比较2组患者治疗前及治疗后各项症状体征评分、血清及泪液ECP、HA、LTB4及Ig E水平。结果治疗后,观察组的各项症状体征评分及血清、泪液ECP、HA、LTB4及Ig E水平均显著低于对照组(P0.05)。结论奥洛他定能有效改善过敏性结膜炎患者的症状体征及血清、泪液相关指标。