准分子激光近视矫正术治疗患者10年随诊结果分析

目的分析准分子激光近视矫正术的远期疗效。方法选择2002年10月至2004年3月于荆州市中心医院行准分子激光近视矫正术治疗,且随诊10年、资料完整的近视患者136例(241眼)。将241眼分为中度近视组(近视度-3.00~-6.00D,48眼)、高度近视组(近视度-6.00~-10.00D,134眼)和超高度近视组(近视度-10.00~-16.00D,59眼)。术后随诊10年,观察并记录视力、屈光度、角膜前表面曲率和眼压。结果中度近视组术后10年裸眼视力大于0.5和1.0比例分别为100.00%、84.00%,高度近视组分别为100.00%、83.95%,超高度近视组分别为91.45%、33.33%。各研究组术后10年最佳矫正视力达到或超过术前最佳矫正视力的比例分别是98.21%、98.43%、92.34%。术后第1年屈光度回退明显,超高度近视组回退量最大,中度近视组回退量最小;术后第2~10年,超高度近视组屈光度回退最大,中度和高度近视组回退不明显。术后第1年角膜前表面曲率变化较之后更明显,超高度近视组角膜前表面曲率改变最多,中度近视组改变最少。术后10年随诊时,患者眼压均在正常范围内。结论准分子激光近视矫正术远期效果稳定,是治疗近视有效且安全的方法,但近视程度越大,手术效果的预测性及术后视力稳定性越小。     

Effect of early treatment with transcutaneous electrical diaphragmatic stimulation (TEDS) on pulmonary inflammation induced by bleomycin

Background

Bleomycin (B) is an antineoplastic drug that has pulmonary fibrosis as a side effect. There are few experimental studies about the effects of physical therapy treatment in this case.

Objective

The objective was to study rat lungs treated with B and precocious intervention by transcutaneous electrical diaphragmatic stimulation (TEDS).

Method

Wistar rats were divided into 4 groups (n=5): a control group (C); a stimulated group (TEDS); a group treated with a single dose of B (intratracheally, 2.5 mg/kg) (B); and a group treated with B and electric stimulation (B + TEDS). After the B instillation, the electrical stimulation was applied for 7 days, for a duration of 20 minutes. Lung fragments were histologically processed with hematoxylin and eosin (HE) and 8-isoprostane-PGF2α (8-iso-PGF2α). The density of the alveolar area was determined by planimetry, the inflammatory profile was defined by the number of cells, and the level of oxidative stress in the pulmonary tissue was evaluated by 8-iso-PGF2α. For statistical analysis of the data, the Shapiro-Wilk test was used, followed by a one-way ANOVA with the post-hoc Bonferroni test (p≤0.05).

Results

The B group exhibited a significant reduction in the area density, and the acute treatment with B + TEDS prevented this reduction. There were increased numbers of fibroblasts, leukocytes, and macrophages in the B group, as well as increased lipid peroxidation, which was observed only in this group.

Conclusion

B promoted a reduction in the alveolar density area, thereby inducing the inflammatory process and increasing the production of free radicals. These effects were minimized by the application of TEDS at the initial treatment stage.     

Outbreak of postoperative endophthalmitis caused by Pseudomonas aeruginosa: a case report and brief literature review

Endophthalmitis is the most serious complication of cataract surgery. A cluster of endophthalmitis is a devastating event for surgeons. Pseudomonas aeruginosa is the main causative pathogen of Gram-negative endophthalmitis, which can be suggestive of the occurrence of an outbreak.Ten patients diagnosed with endophthalmitis after cataract surgery performed by one surgeon were analyzed in this study. At presentation, five patients had obvious clinical findings of endophthalmitis with visual acuity of light perception, two patients had poor light perception/no light perception of vision complicated by concomitant keratitis, and three patients had earlier signs of infection (e.g., a lower degree of anterior chamber and vitreous cells, better presenting visual acuity, and greater visibility of the fundus). Investigations revealed that the source of infection was growth of P. aeruginosa on the phaco probe. All of the surgeries had been performed by the same contaminated probe without sterilization between surgeries. This finding emphasizes the importance of strict adherence to sterility protocols during high-risk surgeries such as intraocular surgeries. Additionally, this report aims to emphasize to surgeons that negligence of simple but vital steps of sterility for any reason, such as limitations in time or equipment, can lead to catastrophic events.     

Care models for mental health in a population of patients affected by COVID-19

ObjectiveEmergency psychological interventions are needed in patients with COVID-19. During the pandemic, psychological counseling services have been provided using online platforms to address adverse psychological impacts and symptoms in patients and the general population. We investigated the effects of telepsychotherapy on emotional well-being and psychological distress in patients affected by COVID-19.MethodsForty-five Sicilian patients who had contracted COVID-19 joined “Telecovid Sicilia” from March to June 2020. Participants completed self-assessment questionnaires and psychological testing to measure levels of anxiety, presence of depressive symptoms, and altered circadian rhythm with consequent sleep disorders and psychological distress. Individual telepsychotherapy services were provided for 1 hour, twice a week, for 16 sessions in total.ResultsWe enrolled 45 patients (42.2% women). We found significant changes between baseline and the end of follow-up in all outcome measures, especially depression (χ² (1) = 30.1; effect size [ES] = 0.82), anxiety (χ² (1) = 37.4; ES = 0.91), and paranoid ideation (χ² (1) = 5.6; ES = 0.35). The proportion of participants with sleep disorders decreased to 84.1% after intervention (χ² (1) = 58.6; ES = 1.14).ConclusionA telepsychotherapeutic approach showed promising effects on psychological symptoms, with significantly reduced patient anxiety and depression.     

Study of the physical condition of middle-aged workers by gender

[Purpose] The purpose of this research was to investigate the physical condition of middle-aged workers in Korea by gender. [Subjects] In total, 2,644 middle-aged workers (male, n = 2,175; female, n =469) ≥50 years of age from eight geographical areas were evaluated from 2007 to 2008. [Methods] The subjects’ physical condition, muscular endurance, reaction, flexibility, agility and age of physical strength were evaluated. [Results] The physical condition and exercise status of males were superior to those of female workers. Male workers exhibited a higher rate of smoking than female workers, but had better muscular endurance, reaction, agility and age of physical strength. [Conclusion] Middle-aged female workers in Korea have a poorer overall physical condition than middle-aged male workers. The physical condition of middle-aged and elderly workers must be managed through various health management programs to maintain a productive aging society.Key words: Elderly workers, Physical condition, Gender     

Endovascular treatment of the vertebral artery origin stenosis by using the closed-cell,self-expandable Carotid Wallstent

BackgroundEndovascular treatment has been considered a good alternative to surgery for symptomatic vertebral artery origin stenosis (VAOS) due to the high risk of morbidity associated with surgery. The purpose of this study was to evaluate the feasibility and efficacy of insertion of the closed-cell, self-expandable Carotid Wallstent for the treatment of VAOS.MethodsThe records of 72 patients with VAOS refractory to adequate medication who were treated by endovascular treatment with the Carotid Wallstent from December 2006 to November 2018 were retrospectively evaluated.ResultsOf the 72 patients, 43 presented with transient ischemic attacks. Forty-seven patients (65.3%) manifested other brachiocephalic stenoses; of these, 40 patients had occlusion, hypoplasia, or stenosis of the contralateral vertebral artery. Overall technical success (defined as 20% or less residual stenosis) was 100%. Procedure-related complications (n = 8, 11.1%) included sudden asystole (n = 1), acute in-stent thrombosis (n = 3), minor stroke (n = 3), and stent shortening (n = 1). All complications were resolved without permanent neurological deficit. Angiographic follow-up (mean, 13.0 months) was achieved in 49 patients and revealed in-stent restenosis in 1 patient (2.0%) and stent malposition by shortening in 2 patients (4.1%). Follow-up records were available in 57 patients (mean 15.6 months). Three of the 57 patients (n = 3, 5.3%) had recurrent symptoms of vertebrobasilar ischemia and none was retreated.ConclusionsEndovascular treatment of symptomatic VAOS using the closed-cell, self-expandable Carotid Wallstent is technically feasible and effective in alleviating patient symptoms and for improving vertebrobasilar blood flow.     

Comparison of antibiotic-associated diarrhea caused by cefoperazone/sulbactam or piperacillin/tazobactam in neurosurgery patients

ObjectiveTo compare the occurrence and prognosis of antibiotic-associated diarrhea (AAD) between patients treated with cefoperazone/sulbactam and piperacillin/tazobactam in the neurosurgery department.MethodsThis study retrospectively analyzed patients who received cefoperazone/sulbactam or piperacillin/tazobactam to prevent or treat hospital-acquired infections in the Department of Neurosurgery of The First Medical Center of Chinese PLA General Hospital between October 2019 and October 2020. For patients with AAD, clinical data, antibiotic usage, the incidence of diarrhea, treatment, and prognosis were collected and analyzed.ResultsIn total, 356 patients were enrolled, and 65 (18.6%) experienced AAD, 38 patients in the cefoperazone/sulbactam group and 27 patients in the piperacillin/tazobactam group. The AAD rate did not differ between the treatment arms. Conversely, the dosage, intensity, and duration of antibiotic therapy differed between the groups, whereas no differences were noted in the time to the appearance of diarrhea and prognosis. According to regression analysis, the incidence of AAD did not differ between the groups (odds ratio [OR] = 0.85, 95% confidence interval [CI] = 0.46–1.48).ConclusionCefoperazone/sulbactam or piperacillin/tazobactam can lead to a similar incidence rate of AAD. The combined application of antibiotics and empiric therapy often occurs. The rational use of antibiotics should be improved.     

In situ measurement of the stiffness increase in the posterior sclera after UV-riboflavin crosslinking by optical coherence elastography

Scleral crosslinking may provide a way to prevent or treat myopia by stiffening scleral tissues. The ability to measure the stiffness of scleral tissues in situ pre and post scleral crosslinking would be useful but has not been established. Here, we tested the feasibility of optical coherence elastography (OCE) to measure shear modulus of scleral tissues and evaluate the impact of crosslinking on different posterior scleral regions using ex vivo porcine eyes as a model. From measured elastic wave speeds at 6 - 16 kHz, we obtained out-of-plane shear modulus value of 0.71 ± 0.12 MPa (n = 20) for normal porcine scleral tissues. After riboflavin-assisted UV crosslinking, the shear modulus increased to 1.50 ± 0.39 MPa (n = 20). This 2-fold change was consistent with the increase of static Young’s modulus from 5.5 ± 1.1 MPa to 9.3 ± 1.9 MPa after crosslinking, which we measured using conventional uniaxial extensometry on tissue stripes. OCE revealed regional stiffness differences across the temporal, nasal, and deeper posterior sclera. Our results show the potential of OCE as a noninvasive tool to evaluate the effect of scleral crosslinking.     

Primary squamous cell carcinoma of the ovary accompanied by transition of a mucinous borderline ovarian tumor

This report describes a woman with a rare primary squamous cell carcinoma of the ovary accompanied by transition of a mucinous borderline ovarian tumor. A woman in her late 40s was referred for abdominal discomfort, which worsened during defecation. Pelvic magnetic resonance imaging showed a multiloculated cystic lesion in the left adnexa measuring approximately 7.5 × 9.5 × 7.0 cm. An intraoperatively obtained frozen biopsy sample of the mass in the left ovary was positive for malignancy, resulting in a surgical staging operation. The tumor was composed of squamous cell carcinoma and mucinous borderline tumor. There was no evidence of capsular invasion or invasion of other internal organs, including pelvic and para-aortic lymph nodes (0/41). Immunohistochemistry showed that the tumor was diffusely positive for cytokeratin 7, cytokeratin 20, Ki-67, and P40 but negative for P16. After a debulking operation, the patient has been monitored regularly without adjuvant therapy owing to final surgical staging of the tumor as stage IA.     

The Influence of Short-term Aquatic Training on Obstacle Crossing in Gait by the Elderly

[Purpose] The purpose of this study was to examine the fall-prevention effect of 12 weeks of aquatic training for the elderly using variables representative of the relationship between the trailing foot and an obstacle. [Subjects] Ten healthy elderly participants, who lived in C city, (age: 77.15±5.21 yrs, height: 149.87±3.54 cm, body mass: 57.44 ±6.74, and BMI: 25.58±2.98 kg/m²), participated in this study. [Methods] To determine the effect of 12 weeks’ aquatic training, 3-D motion analysis with 7 infrared cameras and one force plate, was performed. [Results] TC, HC, MVHC, and CV significantly increased after intervention. For the all gait stability parameters, statistically significant training effects were found. [Conclusion] In conclusion, 12 weeks’ aquatic exercise can help the elderly become more stable when crossing a height obstacle, which is the most frequent cause of falls by the elderly.Key words: Obstacle-crossing in gait, The elderly fall, Elderly gait stability     

Preventive Effects of Antioxidants and Exercise on Muscle Atrophy Induced by Ischemic Reperfusion

[Purpose] This study aimed to determine whether muscle atrophy induced by ischemic reperfusion injury in rats can be prevented by the administration of antioxidants and exercise. [Subjects] Rats were randomly divided into five groups: non-treated, ischemic, exercise, ascorbic acid and exercise, and tocopherol and exercise. [Methods] The relative weight ratio of the soleus muscle and the length of the soleus muscle fiber cross-section minor axis were used for the evaluation of muscle atrophy. Pain was assessed as the weight-bearing ratio of the ischemic side. A multiple comparison test and the paired t-test were used for the statistical analyses. [Results] Compared with the non-treated group, the relative weight ratios of the soleus muscle and the lengths of the soleus muscle fiber cross-section minor axis significantly decreased in the other groups. Excluding the non-treated group, the relative weight ratios of the soleus muscle were heaviest in the tocopherol and exercise group. Excluding the non-treated group, the lengths of the soleus muscle fiber cross-section minor axis were longest in the tocopherol and exercise group, followed by the ischemic, exercise, and ascorbic acid and exercise groups. The amount of antioxidant substances did not decrease on the weight-bearing ratio of the ischemic side. [Conclusion] In this study, using an experimental rat model, we confirmed that antioxidants and exercise effect muscle atrophy induced by ischemic reperfusion. The results show that muscle regeneration was facilitated by phagocytosis in the tocopherol and exercise group.Key words: Ischemic reperfusion, Exercise, Antioxidant     

普拉洛芬联合rhEGF滴眼液治疗白内障术后干眼症的效果

目的探讨普拉洛芬联合重组人表皮生长因子(rhEGF)滴眼液治疗白内障术后干眼症的临床效果。方法将白内障术后发生干眼症的患者94例随机分为普拉洛芬组和联合治疗组,每组47例。普拉洛芬组采用普拉洛芬滴眼液治疗,联合治疗组采用普拉洛芬滴眼液联合rhEGF滴眼液治疗。比较两组患者临床疗效、干眼症状评分、泪膜破裂时间(BUT)、泪液分泌长度、角膜荧光素染色(FL)评分和泪液炎性因子水平。结果普拉洛芬组治疗总有效率为83.12%,显著低于联合治疗组的97.47%(P<0.05)。治疗后,两组干眼症状评分均降低,且联合治疗组显著低于普拉洛芬组(P<0.05)。治疗后,联合治疗组BUT、泪液分泌长度显著长于普拉洛芬组,FL评分显著低于普拉洛芬组(P<0.05)。治疗后,两组泪液IL-1β、IL-6、TNF-α水平均较治疗前显著下降,且联合治疗组低于普拉洛芬组(P<0.05)。结论普拉洛芬滴眼液联合rhEGF滴眼液可促进白内障术后干眼症泪膜修复、减轻炎症反应,改善干眼症状。     

High-speed, image-based eye tracking with a scanning laser ophthalmoscope

We demonstrate a high-speed, image-based tracking scanning laser ophthalmoscope (TSLO) that can provide high fidelity structural images, real-time eye tracking and targeted stimulus delivery. The system was designed for diffraction-limited performance over an 8° field of view (FOV) and operates with a flexible field of view of 1°–5.5°. Stabilized videos of the retina were generated showing an amplitude of motion after stabilization of 0.2 arcmin or less across all frequencies. In addition, the imaging laser can be modulated to place a stimulus on a targeted retinal location. We show a stimulus placement accuracy with a standard deviation less than 1 arcmin. With a smaller field size of 2°, individual cone photoreceptors were clearly visible at eccentricities outside of the fovea.OCIS codes : (170.4460) Ophthalmic optics and devices, (330.2210) Vision - eye movements, (330.4460) Ophthalmic optics and devices     

The influence of frontal sinus in brain activation measurements by near-infrared spectroscopy analyzed by realistic head models

Adequate modeling of light propagation in the head is important to predict the sensitivity of NIRS signal and the spatial sensitivity profile of source-detector pairs. The 3D realistic head models of which the geometry is based upon the anatomical images acquired by magnetic resonance imaging and x-ray computed tomography are constructed to investigate the influence of the frontal sinus on the NIRS signal and spatial sensitivity. Light propagation in the head is strongly affected by the presence of the frontal sinus. The light tends to propagate around the frontal sinus. The influence of the frontal sinus on the sensitivity of the NIRS signal to the brain activation is not consistent and depends on the depth of the frontal sinus, the optical properties of the superficial tissues and the relative position between the source-detector pair and the frontal sinus. The frontal sinus located in the shallow region of the skull tends to reduce the sensitivity of the NIRS signal while the deep frontal sinus can increase the sensitivity of the NIRS signal.OCIS codes: (170.3660) Light propagation in tissues, (170.5280) Photon migration, (170.2655) Functional monitoring and imaging     

Management of anxiety in the refractive surgery patient

Refractive surgery has rapidly evolved to become a preferred alternative for the correction of refractive errors. As the quest to obtain faster visual recovery, fewer complications, and early stability continues, there is little in the literature that addresses the anxiety experienced by most refractive surgical patients. Although vision-correction surgery uses highly technical and precise procedures, the need to develop therapeutic caring and communicative techniques for these patients has not been adequately addressed. There has been insufficient research in the literature focusing on the patient's fear. Respecting the patient's fear and concerns and supporting them by developing a humanistic approach to patient care may prove to be beneficial to the patient and the refractive team.     

Reliability of isometric knee extension muscle strength measurements made by a hand-held dynamometer and a belt: a comparison of two types of device

[Purpose] The purpose of the present study was to compare the reliability of 2 hand-held dynamometers (HHD-1, 2) with different designs, by performing isometric knee muscle extension measurements two times each. [Subjects] The subjects were 40 young healthy adults. [Methods] The reliability of the measurements was examined using Bland-Altman analysis. [Results] Bland-Altman analysis found a fixed bias in measurements made by HHD-1 with an average limits of agreement (LOA) value of −2.1 kgf. For HHD-2, only random errors were detected, and the minimal detectable change (MDC) was 11.4 kgf. Fixed biases were observed between the two devices with an average LOA value of 2.2 kgf. When the bodyweight ratio was used, fixed biases were observed in measurements made by both devices, and the average value of LOA was −0.03 kgf/kg. The comparison of the two devices revealed only random errors, and MDC was 0.22 kgf/kg. [Conclusion] For HHD measurements using these two devices, the appropriate number of measurements is two times, and comparison of measurement values between the two devices should be avoided.Key words: Hand-held dynamometer, Muscle strength, Reliability     

眼部整形美容术后采取局部冷敷处理的临床疗效观察

目的观察眼部整形美容术后采取局部冷敷处理的临床疗效。方法选取行眼部整形美容术的患者120例,随机分为实验组和对照组。对照组术后予以常规包扎及止痛处理,实验组在对照组基础上,加用自制冰袋局部冷敷。对比两组患者术后不同时间C-反应蛋白(CRP)水平、手术部位肿胀程度、视觉模拟评分法(VAS评分)、术后24 h内曲马多用量、术后24 h的心理状态评分。结果两组患者术后3 d、7 d的CRP和手术部位肿胀程度均显著低于前一时间节点(P0.01);实验组术后1 d、3 d、7 d的CRP和手术部位肿胀程度均显著低于对照组(P0.01)。实验组术后1 h、2 h、4 h、8 h、12 h及24 h的VAS评分均显著低于对照组,术后24 h内曲马多用量显著低于对照组(P0.01)。实验组术后24 h的SES、SAS和SDS评分显著低于对照组,BDD评分显著高于对照组(P0.01)。结论眼部整形美容术后采取局部冷敷可以有效改善肿胀和疼痛症状,利于患者早日康复。     

One-stop hybrid surgery for treatment of complex Stanford type B aortic dissection

ObjectivesTo compare the efficacy and prognosis of one-stop hybrid surgery using the elephant trunk procedure for treatment of complex Stanford type B aortic dissection.MethodsWe retrospectively analyzed patients who underwent surgical treatment from January 2014 to July 2019. The patients were divided into those who underwent the elephant trunk procedure (n = 10) and those who underwent one-stop hybrid surgery (n = 10). The cardiopulmonary bypass time, mechanical ventilation time, length of hospital stay, and red blood cell usage were compared between the two groups. All patients’ 3-month postoperative aortic computed tomography angiography (CTA) findings were also reviewed.ResultsThe cardiopulmonary bypass time, mechanical ventilation time, and length of hospital stay were significantly shorter and red blood cell usage was significantly lower in the one-stop hybridization group. The aortic cross-clamp time was not significantly different between the two groups. Aortic CTA review after hybrid surgery showed that the true lumen of the descending aorta was almost completely restored at 3 months.ConclusionOne-stop hybrid surgery effectively alleviated the occlusion of the aortic dissection, prevented the need for additional surgery, and expanded the indications for covered-stent endovascular repair.