Intravitreal aflibercept for submacular hemorrhage secondary to neovascular age-related macular degeneration and polypoidal choroidal vasculopathy

Graefe's Archive for Clinical and Experimental Ophthalmology - To evaluate the efficacy of intravitreal aflibercept monotherapy for submacular hemorrhage secondary to neovascular age-related...     

In vitro degradation and controlled release behavior of D,L-PLGA50 and PCL-b-D,L-PLGA50 copolymer microspheres.

Blank and bovine serum albumin (BSA)-loaded microspheres based on poly(lactic-acid-alt-glycolic acid) (D,L-PLGA50) and poly(epsilon-caprolactone)-b-poly(lactic-acid-alt-glycolic acid) (PCL-b-D,L-PLGA50) were successfully fabricated using water-in-oil-in-water (w/o/w) double-emulsion extraction/evaporation technique. In vitro degradation of the blank microspheres was characterized by techniques including nuclear magnetic resonance (1H NMR), gel permeation chromatography (GPC), differential scanning calorimetry (DSC) and scanning electron microscopy (SEM). The PCL-b-D,L-PLGA50 copolymer (Mn: number-average molecular weight, Mw: weight-average molecular weight, Mn=44800, Mw/Mn=MWD=1.24, epsilon-caprolactone (CL) %=20.4% in molar ratio) had similar rate of molecular weight reduction compared with the D,L-PLGA50 copolymer before 5 weeks of in vitro degradation. The BSA % loading efficiency of microspheres was mainly controlled by both block copolymer composition and macromolecular architecture, while the sequence structure and the molecular weight of copolymer had no apparent effect on it. Significantly, The PCL-b-D,L-PLGA50 copolymer microspheres showed good release profiles with a nearly constant release during 20-110 days.     

应用计步器测量日常体力活动的研究

背景:计步器作为一种简便实用的体力活动测量工具,在研究和干预人群体力活动方面具有广泛的应用价值,国外学者已对其开展大量研究.目的:验证计步器测量中国大学生人群体力活动的有效性.时间及地点:试验于2007-04、06在南京体育学院运动人体科学实验室完成.对象:随机选取南京体育学院运动人体科学专业、社会体育专业大学生各15名,共计30名,其中男生15名,女生15名,平均年龄(20±1)岁.方法:受试者佩带Digi-Walker200型计步器1周,记录每日计步器计数:每日填写Bouchard体力活动日记,回忆每日24h活动情况,并据此计算一天总能量消耗;1周后填写国际体力活动问卷,内容包括1周大强度活动、中等强度活动、步行和静坐情况.主要观察指标:每日步数与每日能量消耗、每日静坐时间、每日步行时间、每日运动时间及1周活动水平的关系.结果:步数与日记法记录的一天总能量消耗、步行时间、步行时间呈现中度正相关,与静坐时间呈现中度负相关;不同体力活动水平受试者其步数差异有显著性意义,步数越多,越能真实地反映体力活动水平,运动或连续步行(超过15 min)可以显著增加步数,一人若包含30min的中等强度体力活动基本能够达到或超过10000步/d的日标步数.结论:计步器可以相对客观地反映体力活动总体水平,但其难以提供活动强度、活动时间方面的具体信息.     

彩超诊断老年人三尖瓣脱垂的临床意义

目的探讨老年人三尖瓣脱垂的原因及临床意义。方法应用彩色多普勒观察分析7例老年人三尖瓣脱垂的超声表现和血流动力学改变。结果7例三尖瓣脱垂为轻度一中度，以前瓣脱垂多见，部分伴有偏心性三尖瓣返流及轻度肺动脉高压。结论老年人三尖瓣脱垂多由退行性变和右室心肌缺血引起。     

急性心肌梗死自溶现象分析--附31例报告

目的:分析急性心肌梗死(acute myocardial infarction,AMI)梗死相关动脉(infarct related artery,IRA)的自溶现象,探讨自溶现象的影响因素和预后意义.方法:155例未予静脉溶栓的首次AMI患者,均在发病12小时内行直接经皮冠状动脉介入治疗(percutaneous coronary intervention,PCI).所有患者按照有无自溶现象分为两组:自溶组(31例)和无自溶组(124例).用放射性核素测定心功能,观察两组心力衰竭、再发心肌梗死的发生率和住院病死率.结果:①自溶组梗死前心绞痛的发生率显著高于无自溶组(P＜0.01);CK-MB、心肌肌钙蛋白I峰值均低于无自溶组(P＜0.01,P＜0.01),侧支循环发生率亦低于无自溶组(P＜0.05);②自溶组心肌梗死面积小于无自溶组(P＜0.05);左心室射血分数显著高于无自溶组;③多元Logistic回归分析结果显示,梗死前心绞痛和缺乏侧支循环是发生自溶现象的独立预测因素(P＜0.01,P＜0.05).结论:梗死前心绞痛和缺乏侧支循环是发生自溶现象的独立预测因素,而自溶现象可缩小心肌梗死面积,保护心功能,改善预后.     

硬皮病的超声诊断—附12例观察

采用高频探头(7.5MHz)对12例限局性硬度病皮损超声观察并与正常皮肤比较,前者皮肤全层平均厚3.6±0.4mm,真皮层2.9±0.4mm;后者全层厚2.0±0.4mm,真皮层1.4±0.4mm。两组有显著性差异(P<0.001)。4例硬皮病皮损还进行了显微镜下测量并与超声测量结果比较。认为超声检查硬度病具有实用价值。     

电视辅助胸腔镜手术早期治疗首次发作原发性自发性气胸的研究——附273例报告

目的:探讨电视辅助胸腔镜手术(video-assisted thoracoscopic surgery,VATS)在早期干预治疗首次发作原发性自发性气胸(primary spontaneous pneumothorax,PSP)的临床价值.方法:按手术前接受保守治疗方法的不同将273例首次发作PSP患者分为3组,其中,直接行VATS治疗的104例为A组、行胸腔穿刺术抽气治疗后再行VATS治疗的113例为B组、行胸腔闭式引流术治疗后再行VATS治疗的56例为C组.对3组的手术时间、胸腔引流时间、术后持续发热时间、白细胞恢复正常时间、住院时间、气胸复发率、复张后肺水肿发生率、术后漏气发生率、镜视肺大疱检出率、病理肺大疱检出率、胸腔感染率、伤口感染率、中转开胸率及治疗费等指标进行回顾性对比分析.结果:与B组、C组比较,A组的手术时间、胸腔引流时间、术后持续发热时间、白细胞恢复正常时间、住院时间均较短(均为P＜0.05);气胸复发率、复张后肺水肿的发生率、术后漏气发生率、胸腔感染率、伤口感染率及治疗费用均较低(均为P＜0.05);而镜视肺大疱检出率、病理肺大疱检出率和中转开胸率差异无统计学意义.结论:应用VATS早期干预治疗首次发作PSP可明显缩短病人治疗时间,减轻病人痛苦,减少并发症的发生率及降低病人的治疗费用,值得临床推广使用.     

关节镜单隧道悬吊固定治疗前交叉韧带胫骨止点撕脱骨折

目的探讨关节镜下单隧道悬吊固定治疗前交叉韧带胫骨止点撕脱骨折的方法和临床疗效。 方法回顾性分析2015年3月至2018年1月间27例膝关节前交叉韧带胫骨止点撕脱骨折患者,男19例,女8例,年龄平均(28±8)岁,排除骨质疏松、病理性骨折等。骨折按Meyers-Mckeever分型,Ⅱ型9例,Ⅲ型14例,Ⅳ型4例。本组患者均采用关节镜下单隧道缝线环绕固定方法治疗。定期复查X片观察骨折愈合情况,Lysholm评分系统评价膝关节功能,疼痛采用视觉模拟法(VAS)进行评定;主观因素包括肿胀、关节稳定性及参加工作满意度;记录并发症。术前术后评分比较采用配对样本t检验。 结果术后随访平均(18±6)个月。骨折均在3个月内愈合,无感染、内固定松动等并发症。27例患者膝关节功能恢复正常,26例患者末次随访Lachman试验及前抽屉试验均阴性,1例患者随访体检时膝关节Ⅱ°松弛,自诉无腿软不稳现象。视觉模拟VAS评分平均为(1.0±0.6)分。术前膝关节Lysholm评分(42±9),末次随访膝关节Lysholm评分(90±6),差异有统计学意义(t ＝22.365,P <0.01)。主观评价所有患者日常生活无明显影响。 结论关节镜下单隧道悬吊固定缝线技术治疗前交叉韧带止点撕脱骨折,手术操作创伤小,简单方便,骨折复位固定牢靠,术后功能恢复快,是一种较理想的手术方法。     

The value of magnetic resonance imaging geometric parameters in pre-assessing the surgical approaches of pelvic fracture urethral injury

BackgroundTo investigate the correlation between the magnetic resonance urethrography and the surgical approach and complexity for the patients with pelvic fracture urethral injury (PFUI) by combining the geometry with magnetic resonance imaging (MRI).MethodsForty-three male patients with PFUI (part of the patients complicated with rectal injury) from January 2016 to December 2018 were analyzed in this retrospective research. All the patients underwent a delayed anastomotic urethroplasty and were divided into 2 groups according to the approaches (simple perineal approach or inferior pubectomy). For magnetic resonance urethrography, we measured and calculated the geometric parameters such as the gap distance between two urethral ends, the pubourethral vertical distance (PUVD), and the rectourethral median distance (RUMD).ResultsOf the 43 patients, 16 underwent inferior pubectomy and 27 underwent simple perineal approach. The numbers of patients with and without rectal injury history were 17 and 26, respectively. The operation time and intraoperative blood loss was significantly higher in the inferior pubectomy group. Multivariate logistic analysis revealed that gap distance and PUVD were independent factors of the surgical approaches. The accuracies were 83.7% and 67.4% respectively in the ROC curve analysis. In addition, the RUMD was significantly shorter in the patients with rectal injury history (1.4, 1.8 cm).ConclusionsLonger gap distance and shorter PUVD were the two independent factors of the inferior pubectomy approach. Furthermore, among the patients with rectal injury history, the tissue posterior to the urethra was often weaker and should be carefully handled during the surgery.Trial registrationThis research has been registered on the Chinese Clinical Trial Registry. The registration number is ChiCTR2000030573.     

The risk of intracranial infection in adults with hydrocephalus after ventriculoperitoneal shunt surgery: A retrospective study

Infection remains the most significant complication of ventriculoperitoneal shunt (VPS) surgery. The objective of this study was to investigate intracranial infections complicating VPS surgery in adults with hydrocephalus. Patients who underwent VPS surgery for hydrocephalus between 2000 and 2016 were included. Clinical data and follow‐up evaluations were examined and analysed retrospectively. A total of 502 patients with hydrocephalus who underwent VPS surgery were included. They were followed up for at least 2 years. Twelve patients with incomplete data were excluded. Four hundred and ninety patients were included in the final analysis. Twenty‐five cases of intracranial infection occurred, accounting for 5.1% of patients with VPS surgery. The mean age of the patients was 57.1 ± 10.1 years (range, 39–72 years). The incidence of intracranial infection in patients over 60 years of age was higher than that in patients under 60 years of age (P = .007). Age (P = .007), diabetes (P = .026), skin infection (P = .028), bed‐ridden (P = .007), and modified operation (P = .011) were highly correlated with the incidence of intracranial infection. The findings of this retrospective study show that age, diabetes, skin infection, bed‐ridden, and modified operation of hydrocephalus significantly and independently correlated with the incidence of infection. Prospective studies are needed to assess the relationship between the incidence of infection and risk factors in patients with hydrocephalus after VPS.