First experiences with HLA-matched corneal grafts in high risk cases

In highly vascularized corneas the number of graft failures caused by irreversible rejections is higher than in non- or slightly vascularized corneas. The importance of antigen compatibility is demonstrated, especially in these high risk cases.Ten highly vascularized corneas were grafted with HLA-matched donor material; only one reversible rejection was seen in this group.Nine non- or slightly vascularized corneas were grafted with donor material chosen at random. Retrospective HLA matching was performed. Three irreversible rejections were seen in this group. The number of HLA incompatibilities was high.     

胸腰椎单节段压缩骨折PKP与传统手术治疗对比分析

目的：探讨经皮穿刺球囊扩张椎体后凸成形术(percutaneous kyphoplasty,PKP)治疗胸腰椎单节段压缩骨折中的临床效果及应用价值。方法选择单节段胸腰椎压缩骨折患者56例进行回顾性研究分析,根据患者手术方式不同分为观察组（n=18）和对照组（n=38）。观察组采用闭合复位经皮穿刺球囊扩张椎体后凸成形术,对照组采用切开复位椎弓根螺钉钉棒系统内固定治疗,记录2组治疗及随访情况。结果（1）观察组手术时间、术中出血量、术后患者下地时间、住院天数、并发症发生率优于对照组,组间对比差异有统计学意义（P＜0.05）。（2）观察组术后疼痛评分、术后2个月时生活能力评分优于对照组,组间对比差异有统计学意义（P＜0.05）。(3)观察组、对照组术前测量Cobb角较术后Cobb角均有明显改善（P＜0.05）;术前Cobb角组间对比无统计学差异,术后Cobb角组间对比观察组优于对照组（P<0.05）。结论采用经皮穿刺球囊扩张椎体后凸成形术应用在单节段胸腰椎压缩骨折患者中能够有效减轻患者疼痛感,提高患者活动能力,有效恢复伤锥高度,矫正后凸畸形,缩短手术时间、患者术后下床时间及住院时间,减少并发症发生,值得在临床大力推广使用。     

Detection of genomic deletions of PKP2 in arrhythmogenic right ventricular cardiomyopathy

Arrhythmogenic right ventricular cardiomyopathy (ARVC) is an inherited myocardial disease that predominantly affects the right ventricle and is associated with ventricular arrhythmias that may lead to sudden cardiac death. Mutations within at least seven separate genes have been identified to cause ARVC, however a genetic culprit remains elusive in approximately 50% of cases. Although negative genetic testing may be secondary to pathogenic mutations within undiscovered genes, an alternative explanation may be the presence of large deletions or duplications involving known genes. These large copy number variants may not be detected with standard clinical genetic testing which is presently limited to direct DNA sequencing. We describe two cases of ARVC possessing large deletions involving plakophilin‐2 (PKP2) identified with microarray analysis and/or multiplex ligation‐dependent probe amplification (MLPA) that would have been classified as genotype negative with standard clinical genetic testing. A deletion of the entire coding region of PKP2 excluding exon 1 was identified in patient 1 and his son. In patient 2, MLPA analysis of PKP2 revealed deletion of the entire gene with subsequent microarray analysis demonstrating a de novo 7.9 Mb deletion of chromosome 12p12.1p11.1. These findings support screening for large copy number variants in clinically suspected ARVC cases without clear disease causing mutations following initial sequencing analysis.     

护理干预对骨质疏松性椎体压缩骨折术后患者心理和并发症的影响

目的探讨护理干预对骨质疏松性椎体压缩骨折患者术后并发症和心理的影响。方法将250例骨质疏松性椎体压缩骨折行皮椎体后凸成形术（Percutancous kyphoplasty,PKP）患者随机分为观察组和对照组各125例,观察组采取护理干预措施,对照组采用常规护理,比较两组患者的术后并发症发生情况和SAS、SDS评分变化情况。结果护理后,观察组患者的并发症发生率为6.4%,明显低于对照组（χ2=8.285,P〈0.05）;护理后,观察组患者的SAS、SDS评分分别为（24.9±4.5）分、（14.8±5.6）分,与对照组患者比较均明显改善（均P〈0.05）。结论护理干预措施有利于预防和降低PKP术后并发症发生,有利于缓解患者的不良情绪。     

Clinical Efficacy Analysis of Percutaneous Kyphoplasty Combined with Zoledronic Acid in the Treatment and Prevention of Osteoporotic Vertebral Compression Fractures

ABSTRACT

Objective: The aim of this study is to investigate the clinical efficacy of percutaneous kyphoplasty (PKP) combined with zoledronic acid (aclasta) in the treatment and prevention of osteoporotic vertebral compression fractures (OVCF). Method: A total of 104 patients with OVCF were treated with PKP from February 15, 2014 to January 17, 2016. All patients were randomly assigned to control and experimental groups, each group having 52 patients. All patients in the control group were treated with PKP. On the other hand, all patients in the experimental group were treated with PKP combined with aclasta. To evaluate the clinical efficacy, Visual Analogue Scale (VAS), Oswestry disability index (ODI), bone mineral density (BMD), and bone metabolism (N-MID and β-CTX) were evaluated during the follow-up period. Result: One week after operation, the value of VAS and ODI improved in both groups. One year after operation, these worsened rapidly in the control group but not in the experimental group. Six months and one year after operation, the BMD improved significantly but the bone metabolism decreased significantly in the experimental group. In contrast, the BMD and bone metabolism did not change in the control group. Moreover, four patients again suffered from OVCF in the control group, and three patients had fever symptoms in the experimental group during the follow-up period. Conclusions: Results of this study indicate that the clinical efficacy of PKP combined with aclasta in the treatment and prevention of OVCF is significant.     

穿透性角膜移植术128例临床分析

目的评价穿透性角膜移植术治疗角膜疾病的疗效。方法对128例(128眼)角膜混浊病人行穿透性角膜移植术,于术后1月、3月、6月、12月、24月观察角膜的透明情况以及并发症。结果穿透性角膜移植术后1月128眼中82眼透明(64.1%),术后6月90眼中69眼透明(76.7%),术后12月84眼中53眼透明(63.1%),术后24月43眼中27眼透明(62.8%)。以此同时,患者的视力均有不同程度的增加,术后1月角膜透明82眼中有67眼矫正视力大于0.1(82%),术后3月63眼中有59眼矫正视力大于0.1(94%)同,术后6月69眼中有66眼矫正视力大于0.1(96%)。结论穿透性角膜移植术是治疗因角膜病致盲患者的重要手段,排斥反应是术后主要并发症,三联手术安全有效。     

急性创伤性胸腰椎骨折的经皮后凸成形术治疗

目的:评价经皮椎体后凸成形术治疗急性创伤性胸腰椎骨折的初步临床疗效。方法:采用经皮椎体后凸成形术治疗19例急性创伤性椎体骨折患者,均为单椎体骨折,其中楔形压缩型骨折11例,稳定爆裂型骨折8例,术后对患者的疼痛、日常功能以及影像学结果进行分析。结果:随访10~24月,所有患者腰背疼痛明显缓解或消失,椎体高度较术前明显改善,无1例出现并发症,并于1周内出院。结论:对于急性创伤性胸腰椎骨折,只要病例选择合适,经皮椎体后凸成形术可有效缓解疼痛、恢复创伤椎体高度及患者劳动能力,是一种安全、高效的治疗方法。     

患者经皮椎体后凸成形术后康复方法及效果比较

目的探讨飞燕式腰背肌功能训练法在经皮椎体后凸成形术患者术后康复中的作用。方法选择某院骨科椎体骨折患者115例,分为对照组和观察组。对照组57例患者术后采取常规药物治疗,观察组58例在药物治疗的基础上利用飞燕式腰背肌功能训练法进行康复训练。利用VAS法对患者的疗效进行评价,并对组间数据进行统计学分析。结果两组患者在术后3～6个月期间疼痛度最低,术后1年有上升趋势。组间1个月内患者VAS评分无明显差异,3个月、6个月时观察组VAS评分降低,术后1年观察组VAS评分明显低于对照组(P﹤0.05)。结论在药物治疗基础上进行飞燕式腰背肌功能训练对经皮椎体后凸成形术后腰椎的康复具有积极的作用。     

椎体后凸成形术治疗骨质疏松性压缩骨折的临床研究

目的：探讨椎体后凸成形术（PKP）治疗骨质疏松性椎体压缩性骨折（OVCFs）的临床效果及安全性。方法：回顾分析我院收治的OVCFs患者43例,共43个椎体,26例行椎体成形术（PVP）治疗,17例行椎体后凸成形术（PKP）治疗。观察两组手术前后疼痛采取视觉疼痛模拟评分（VAS）、活动能力评分改善情况,及椎体高度、Cobb＇s角矫正情况。结果：两组术后第3天VAs评分、活动能力评分均较治疗前改善,治疗前后比较差异有统计学意义（P〈0．05）,组间比较无统计学差异（P〉O．05）;PKP组后椎体高度及Cobb＇s角矫正度优于PVP组,组间比较差异有统计学意义（P〈0．05）。结论：PKP治疗OVCFs在矫正恢复椎体高度及Cobb’S角效果优于PVP组,且安全有效,是治疗骨质疏松性椎体压缩性骨折的首选治疗方法