准分子激光原位角膜磨镶术后成人屈光性弱视治疗效果分析

目的 观察准分子激光原位角膜磨镶术后成人弱视的变化情况.方法 对21例( 35只眼)年龄大于18岁、屈光不正伴弱视患者进行准分子激光原位角膜磨镶手术治疗,检查术前裸眼视力、术前最佳矫正视力,以及术后1个月、1年、3年的裸眼视力及最佳矫正视力,观察最佳矫正视力的变化情况.结果 术后1个月最佳矫正视力与术前最佳矫正视力无统计学意义(P=0.50).术后3年最佳矫正视力稳定在1.0者31只眼(88.57 % ),与术前最佳矫正视力比较有统计学意义(P＜0.05).结论 准分子激光原位角膜磨镶术治疗屈光不正伴有弱视患者,术后弱视可有明显的改善.     

小光斑飞点扫描准分子激光原位角膜磨镶术治疗LASIK术后残余近视

目的 评价小光斑飞点扫描准分子激光原位角膜磨镶术治疗LASIK术后残余近视的疗效及安全性.方法 对75例93只眼LASIK术后残余近视的患者行二次LASIK手术,全部采用掀瓣的手术方式,两次手术间隔(7.18±3.56)个月.术后平均随访超过6个月.结果 二次LASIK术后平均裸眼视力较术前显著提高(P＜0.01),术后裸眼视力与术前最佳矫正视力比较,差异无显著意义(P＞0.05);术后6个月时屈光度在±0.5 D以内者为90只眼(96.8%),20只眼(21.5%)术后裸眼视力大于术前最佳矫正视力.无危及视力的并发症出现.结论 小光斑飞点扫描准分子激光原位角膜磨镶术治疗LASIK术后残余近视安全、效果好.     

准分子激光治疗中度近视临床疗效分析

目的　评价准分子激光治疗中度近视的有效性和预测性。方法　分别应用准分子激光屈光性角膜切削术和准分子激光原位角膜磨镶术对中度近视共 10 85眼进行治疗和临床疗效对照分析。结果　术前准分子激光屈光性角膜切削术组和准分子激光原位角膜磨镶术组平均裸眼视力分别为 (0 .11± 0 .0 5 )和 (0 .0 6±0 .0 4 ) (P <0 .0 5 ) ,平均等值球镜屈光度分别为 (- 3.6 3± 1.5 5 )、(- 4 .87± 0 .93)D(P <0 .0 5 ) ;术后 6个月准分子激光屈光性角膜切削术组平均裸眼视力为 (1.12± 0 .2 3) ,等值球镜屈光度为 (- 0 .4 9± 0 .4 3)D ,而准分子激光原位角膜磨镶术组平均裸眼视力为 (1.18± 0 .17) (P >0 .0 5 ) ,等值球镜屈光度为 (- 0 .5 8± 0 .4 0 )D(P >0 .0 5 )。结论　准分子激光屈光性角膜切削术和准分子激光原位角膜磨镶术两种方法治疗中度近视均具有准确性高、预测性良好的特点。     

小光斑飞点式准分子激光原位角膜磨镶术治疗近视眼的疗效观察

目的评价小光斑飞点式准分子激光原位角膜磨镶术治疗近视眼的疗效。方法采用德国Schwind公司生产的Esiris第六代小光斑飞点式准分子激光系统和法国Moria公司生产的气动平推式角膜板层刀,对67例134眼近视患者(-2.00D～-15.00D)行LASIK手术,术后随访6个月,观察分析视力及屈光度的变化。结果术前矫正视力≥1.0的125眼,术后第1天裸眼视力在0.5、0.8、1.0以上的分别为96.8%(121眼)、81.6%(102眼)、78.4%(98眼),术后1、3、6个月裸眼视力>1.0的分别为98.4%(123眼)、97.6%(122眼)、97.6%(122眼);术前矫正视力≤0.8的9眼,术后6个月时裸眼视力较术前矫正视力提高者占55.6%(5眼);所有患者屈光度在术后1～3个月时基本稳定。结论小光斑飞点式准分子激光治疗近视眼术后视力恢复快,稳定快,无偏心切削、中心岛形成及不规则散光。     

飞秒激光联合准分子激光原位角膜磨镶术用于高度近视的疗效探究

目的 探讨飞秒激光联合准分子激光原位角膜磨镶术用于高度近视的疗效.方法 将2019年1月-2020年1月收治的高度近视患者106例,随机分为对照组53例,观察组53例.对照组给予准分子激光原位角膜磨镶术治疗,观察组给予飞秒激光联合准分子激光原位角膜磨镶术治疗.比较两组患者的裸眼视力、屈光度、角膜瓣厚度及角膜后表面高度值...     

准分子激光上皮下角膜磨镶术治疗准分子激光角膜切削术后屈光回退的临床疗效观察

目的探讨准分子激光上皮下角膜磨镶术（LASEK）治疗准分子激光角膜切削术（PRK）术后屈光回退的疗效及安全性。方法对21例36只眼PRK术后屈光回退患者施行LASEK。LASEK术前的平均屈光度为（-1.98±0.65）D,平均角膜厚度为（470.17±18.46）μm,LASEK平均切削深度为（36.58±11.24）μm。结果术后第12个月裸眼视力1.0以上22只眼（占61.1%）,0.8以上31只眼（占86.1%）,0.5以上36只眼（占100%）,平均屈光度为（-0.18±0.53）D,未见最佳矫正视力下降,术后裸眼视力较术前明显提高,差异有显著意义（P〈0.05）。角膜瓣混浊0级29只眼（占80.6%）,0.5级5只眼（占13.9%）,1级2只眼（占5.5%）。结论 LASEK治疗PRK术后屈光回退安全有效,长期效果有待随访观察。     

微型角膜刀板层角膜成形联合准分子激光角膜切削术治疗高度近视65例

 目的:探讨微型角膜刀板层角膜成形联合准分子激光角膜切削术(MLK-E)治疗高度近视的预测性、稳定性及安全性.方法:利用SCMD公司生产的微型角膜刀及Compak-200型准分子激光机对65例(124眼)-6.00 D以上的高度近视施行矫治手术,术后随访3～6个月.结果:Ⅰ组(-15.00 D以下)术后3个月及6个月时裸眼视力分别为0.70±0.26、0.75±0.24,裸眼视力达到及超过最佳矫正视力的比例为50.6%、75.0%,3个月时的欠矫率10.9%.Ⅱ组(-15.00 D以上)术后3个月及6个月时裸眼视力分别为0.36±0.16、0.29±0.16,裸眼视力达到及超过最佳矫正视力的比例为60.6%、50.0%,3个月时欠矫率21.2%.结论:MLK-E对于矫正-6.00D以上的高度近视是有效且安全的,但应注意其潜在并发症.     

准分子激光角膜屈光手术对不同类型屈光不正的矫治效果

目的 评价准分子激光角膜屈光手术对各种类型屈光不正的矫治效果。方法 使用Keratom-F/Schwind准分子激光治疗仪对3221只不同类型的屈光不正眼行角膜光学屈光切削术或角膜原位磨镶术。随访8个月到3年。比较术前术后裸高力变化程度和观察手术并发症种类及发生率。结果 全部3221只眼术后裸眼视力达到术前矫治最佳视力为76％，小于50％最佳矫正视力仅占0.4%。近视组术后裸眼视力达到术前最佳视力为77％，远视组30cm近视力为88.2%，散光组为53.8%。并发症总发生率0.34%，包括角膜雾浊、各种角膜瓣并发症、眼底出血、视网膜脱离。结论 准分子激光手术有效提高屈光不正眼的裸眼视力。绝大多数近视，远视，散光的患者经治疗后可以达到无需眼镜正常生活和工作的目的。准分子激光手术并发症少，是一种低风险屈光矫治手术。     

准分子激光小光斑飞点扫描切削模式与宽光束切削模式治疗复性近视散光的临床效果比较

目的 比较准分子激光的宽光束和小光斑飞点扫描切削模式对复性近视散光矫正效果的影响。方法 回溯研究接受准分子激光原位角膜磨镶术的复性的近视散光共92眼。按照准分子激光切削模式分为A组(小光斑飞点扫描切削模式)51眼；B组(宽光束切削模式)41眼，做两组患者之间年龄、屈光度、术前最佳矫正视力与术后裸眼视力以及两组术后裸眼视力统计学处理。结果A、B两组在年龄、屈光度、术前最佳矫正视力上无统计学差异。A组术后平均裸眼视力达到术前平均最佳矫正视力水平。B组术后平均裸眼视力低于术前平均最佳矫正视力水平。术后平均裸眼视力A组高于B组。结论 小光斑飞点扫描切削模式治疗复性近视散光的效果优于宽光束模式。     

准分子激光原位角膜磨镶术矫治儿童单纯远视性屈光参差

目的评价准分子激光原位角膜磨镶术(LASIK)矫治儿童单纯远视性屈光参差的临床疗效。方法采用Summit公司的SVSApexplus准分子激光系统,对22例远视儿童患者(7~15岁)绝对散光值低于1.25D的22只眼进行LASIK手术,最大预矫值 6.00D。术后1个月开始行弱视治疗。随访时间12个月以上。结果术前,球镜屈光度: 5.50~ 9.00( 6.25±0.43)D,柱镜屈光度:0.00~-1.25(-0.73±0.33)D,两眼等值球镜屈光度差值: 4.25~7.75( 6.13±0.51)D,裸眼远视力:0.05~0.3(0.12±0.10)D,裸眼近视力:0.1~0.5(0.19±0.14)D,矫正远视力:0.05~0.4(0.20±0.13)D,矫正近视力:0.1~0.6(0.27±0.16)D。术后12月,球镜屈光度:-0.50~ 0.75( 1·02±0.51)D,柱镜屈光度:0.00~-1.75(-0.52±0.51)D,两眼等值球镜屈光度差值:0.00~1.75(0.86±0.55)D,平均裸眼远视力:0.1~0.5(0.25±0.13)D,平均裸眼近视力:0.1~1.2(0.53±0.38)D,平均矫正远视力:0.1~0.6(0.29±0·17)D,平均矫正近视力:0.1~1.2(0.56±0.37)D。所有手术眼均未见最佳矫正视力丢失。结论LASIK矫治儿童单纯远视性屈光参差是安全、有效的,可明显减少双眼屈光参差度。术后辅以弱视治疗疗效显著。     

Knee injury and Osteoarthritis Outcome Score (KOOS) - validation of a Swedish version

The Knee injury and Osteoarthritis Outcome Score (KOOS) is a self-administered instrument measuring outcome after knee injury at impairment, disability, and handicap level in five subscales. Reliability, validity, and responsiveness of a Swedish version was assessed in 142 patients who underwent arthroscopy because of injury to the menisci, anterior cruciate ligament, or cartilage of the knee. The clinimetric properties were found to be good and comparable to the American version of the KOOS. Comparison to the Short Form-36 and the Lysholm knee scoring scale revealed expected correlations and construct validity. Item by item, symptoms and functional limitations were compared between diagnostic groups. High responsiveness was found three months after arthroscopic partial meniscectomy for all subscales but Activities of Daily Living.     

The acutely limping child

Acute limping may be the result of multiple pathologies in children. The differential diagnosis varies based on the age of the child. Irrespective of age, the initial imaging work-up includes AP and frog leg radiographs of the pelvis and ultrasound; MRI may sometimes be helpful. In children less than 3 years, infections and trauma are most frequent. MRI is the imaging modality of choice when osteomyelitis is clinically suspected. Between the ages of 3 and 10 years, transient synovitis of the hip and Legg-Calvé-Perthes disease are main considerations but infection, inflammation and focal bony lesions are also considered. In children over 10 years, slipped capital femoral epiphysis also is considered.     

Do Balance Board Training Programs Reduce the Risk of Ankle Sprains in Athletes?

Introduction Ankle sprains are the most common musculo-skeletal injury that occurs in athletes,particularly in sports that require jumping and landing on one foot such as soccer,and basketball(1-4).These injuries often result in significant time loss from participation,long-term disability,and have a major impact on health care costs and resources(5-8).     

High Intensity Interval Training:New Insights

KEY POINTS ·High-intensity interval training(HIT)is characterized by repeated sessions of relatively brief，intermittent exercise.often performed with an“a11 out”effort or at an intensity close to that which elicits peak oxygen uptake(i.e.，≥90%of VO2 peak).     

Endovascular management of carotid-cavernous fistulas

Objective To investigate endovascular treatment of traumatic direct carotid-cavernous fistulas （CCF） and their complications such as pseudoaneurysms. Methods： Over a five-year period, 22 patients with traumatic direct CCFs were treated endovascularly in our institution. Thirteen patients were treated once with the result of CCF occluded, 8 twice and 1 three times. Treatment modalities included balloon occlusion of the CCF, sacrifice of the ipsilateral internal carotid artery with detachable balloon, coll embolization of the cavernous sinus and secondary pseudoaneurysms, and covered-stem management of the pseudoaneurysms. Results All the direct CCFs were successfully managed endovascularly. Four patients developed a pseudoaneurysm after the occlusion of the CCF with an incidence of pseudoaneurysm formation of 18.2% （4/22）. A total number of 8 patients experienced permanent occlusion of the ICA with a rate of ICA occlusion reaching 36.4% （8/22）. Followed up through telephone consultation from 6 months to 5 years, all did well with no recurrence of CCF symptoms and signs. Conclusion Traumatic direct CCFs can be successfully managed with endovascular means. The pseudoaneurysms secondary to the occlusion of the CCFs can be occluded with stent-assisted coiling and implantation of covered stents.     

Developmental validation of the PowerPlex(®) ESI 16 and PowerPlex(®) ESI 17 Systems: STR multiplexes for the new European standard

In response to the ENFSI and EDNAP groups’ call for new STR multiplexes for Europe, Promega^® developed a suite of four new DNA profiling kits. This paper describes the developmental validation study performed on the PowerPlex^® ESI 16 (European Standard Investigator 16) and the PowerPlex^® ESI 17 Systems. The PowerPlex^® ESI 16 System combines the 11 loci compatible with the UK National DNA Database^®, contained within the AmpFlSTR^® SGM Plus^® PCR Amplification Kit, with five additional loci: D2S441, D10S1248, D22S1045, D1S1656 and D12S391. The multiplex was designed to reduce the amplicon size of the loci found in the AmpFlSTR^® SGM Plus^® kit. This design facilitates increased robustness and amplification success for the loci used in the national DNA databases created in many countries, when analyzing degraded DNA samples. The PowerPlex^® ESI 17 System amplifies the same loci as the PowerPlex^® ESI 16 System, but with the addition of a primer pair for the SE33 locus. Tests were designed to address the developmental validation guidelines issued by the Scientific Working Group on DNA Analysis Methods (SWGDAM), and those of the DNA Advisory Board (DAB). Samples processed include DNA mixtures, PCR reactions spiked with inhibitors, a sensitivity series, and 306 United Kingdom donor samples to determine concordance with data generated with the AmpFlSTR^® SGM Plus^® kit. Allele frequencies from 242 white Caucasian samples collected in the United Kingdom are also presented. The PowerPlex^® ESI 16 and ESI 17 Systems are robust and sensitive tools, suitable for the analysis of forensic DNA samples. Full profiles were routinely observed with 62.5 pg of a fully heterozygous single source DNA template. This high level of sensitivity was found to impact on mixture analyses, where 54–86% of unique minor contributor alleles were routinely observed in a 1:19 mixture ratio. Improved sensitivity combined with the robustness afforded by smaller amplicons has substantially improved the quantity of data obtained from degraded samples, and the improved chemistry confers exceptional tolerance to high levels of laboratory prepared inhibitors.     

Prevalence and severity of hip and groin pain in sub‐elite male football: a cross‐sectional cohort study of 695 players

The purpose of this study was twofold: (a) to investigate the prevalence of hip and groin pain in sub‐elite male adult football in Denmark and (b) to explore the association between prevalence and duration of hip and groin pain in the previous season with the Copenhagen Hip and Groin Outcome Score (HAGOS) in the beginning of the new season. In total 695 respondents from 40 teams (Division 1–4) were included. Players completed in the beginning of the new season (July–Sept 2011) a self‐reported paper questionnaire on hip and/or groin pain during the previous season and HAGOS. In total 49% (95% CI: 45–52%) reported hip and/or groin pain during the previous season. Of these, 31% (95% CI: 26–36%) reported pain for >6 weeks. Players with the longest duration of pain during the previous season had the lowest HAGOS scores, when assessed at the beginning of the new season, P < 0.001. This study documents that half of sub‐elite male adult football players report pain in the hip and/or groin during a football season. The football players with the longest duration of pain in previous season displayed the lowest HAGOS scores in the beginning of the new season.     

Bronchial stump fistula :treatment with covered retrievable hinged metallic stents-preliminary clinical experience

Objective To evaluate the preliminaily clinical efficacy and retrievability of a retrievable hinged covered metallic stent in the treatment of the bronchial stump fistula （BSF）. Methods Between April 2003 and March 2005, 8 patients with bronchial stump fistula after pneumonectomy or lobectomy were treated with two types （A and B） of retrievable hinged covered metallic stents. Type A stent was placed in 6 patients and type B in 2 under fluoroscopic guidance. The stent was removed with a retrieval set when BSF was healed or complications occurred. Results Stent placement in the bronchial tree was technically successful in all patients, without procedure-related complications. Immediate closure of the BSF was achieved in all patients after the procedure. Stents were removed from all patients but one. Removal of the stents was difficult in two patients due to tissue hyperplasia. Patients were followed up for 6 - 21 months. Placement of the stents remained stable in all patients except one due to severe cough. Permanent closure of BSF was achieved in 7 （87.5%） of 8 patients. Conclusion Use of a retrievable hinged covered expandable metallic stent is a simple, safe, and effective procedure for closure of the BSF. Retrieval of the stent seems to be feasible. （J Intervent Radiol, 2007, 16： 253-257）