Congenital dysplasia involving both medial and inferior recti: clinical features and surgical outcomes

AIM: To investigate the clinical features and surgical outcomes of congenital dysplasia involving both inferior recti (IR) and medial recti (MR) muscles. METHODS: A retrospective review was conducted including cases of simultaneous congenital dysplasia of IR and MR that were diagnosed and surgically treated at the Zhongshan Ophthalmic Center, Sun Yat-sen University, China, from July 2009 to November 2019. Ocular motility, ocular alignment at distance (6 m) and near (33 cm) by prism alternating cover test and stereoacuity were assessed in all patients before and after surgery. RESULTS: A total of five patients (four males and one female; three with right eye and two with left eye congenital dysplasia) were included in this review. The patients ranged in age from 10 to 42y (21±13.4y). The main clinical findings were hypertropia and exotropia of the affected eye, along with motility limitations in adduction and depression. Lateral rectus (LR) recession/transposition combined with IR resection was performed in one case. Two scheduled surgeries were performed in four cases, with one involving superior rectus recession and IR resection and the others LR recession and MR resection. Mean±SD pre-surgical exotropia of 51.0±31.11 prism diopter (PD) and hypertropia of 29.20±7.12 PD in the primary position were decreased to 3.6±12.90 and 3.2±10.09 PD, respectively, at two years after surgery, with a success rate of 60% and an under-correction rate of 40%. CONCLUSION: The main clinical features associated with simultaneous MR/IR congenital dysplasia are hypertropia and exotropia of the affected eye along with motility limitations in adduction and depression. Scheduled two-stage surgeries achieved a success rate of 60%.     

Inhibitory effect of midkine-binding peptide on tumor proliferation and migration

Background: To investigate the inhibitory effect of midkine-binding peptides on human umbilical vein endothelial cells (HUVECs) proliferation and angiogenesis of xenograft tumor. Methods: The midkine-binding peptides were panned by Ph.D.-7^™ Phage Display Peptide Library Kit, and the specific binding activities of positive clones to target protein were examined by phage ELISA. The effect of midkine-binding peptides on proliferation of HUVECs was confirmed by MTT test. The xenograft tumor model was formed in BALB/c mice with the murine hepatocarcinoma cells H22 (H22). Microvessel density (MVD) was analyzed by immunohistochemistry of factor VIII staining. Results: Midkine-binding peptides have the inhibitory effects on tumor angiogenesis, a proliferation assay using human umbilical vein endothelial cells (HUVECs) indicated that particular midkine-binding peptides significantly inhibited the proliferation of the HUVECs. Midkine-binding peptides were also observed to efficiently suppress angiogenesis induced by murine hepatocarcinoma H22 cells in BALB/c nude mice. Conclusion: The midkine-binding peptides can inhibit solid tumor growth by retarding the formation of new blood vessels. The results indicate that midkine-binding peptides may represent potent anti-angiogenesis agents in vivo.     

老年肱骨远端骨折治疗中垂直与平行双钢板的疗效对比

目的：探讨垂直或平行双钢板在治疗老年骨质疏松性肱骨远端骨折中的优劣。方法回顾性地分析2008年9月至2013年1月解放军总医院收治的老年肱骨远端骨折患者39例,平均年龄64（60-81）岁,其中21例患者采用垂直双钢板内固定,18例患者采用平行双钢板内固定。评价手术时间、术中出血量、骨折愈合时间、肘关节活动度,并按Mayo肘关节功能评分（MEPS）评估疗效。结果所有患者术后均获得随访,时间12-25个月,垂直钢板组平均（17.0±1.5）个月,MEPS平均（82.0±5.6）分,优良率81.0%;平行钢板组随访时间平均（15.0±2.0）个月,MEPS平均（83.1±5.5）分,优良率88.9%。手术时间、出血量、骨折愈合时间、功能评分等组间差异均无统计学意义（P＞0.05）。垂直钢板组中有2例骨折延迟愈合,经二次手术植骨后愈合;1例发生异位骨化,轻度影响术后功能。结论两种内固定方式都可提供初期良好的复位与稳定。与垂直双钢板相比,平行钢板内固定在减少老年人肱骨远端骨折并发症方面可能更有优势。     

头颈直径比与假体安装参数对髋关节活动度影响的计算机模拟研究

观察不同头颈直径比股骨假体全髋置换中,髋关节假体安装参数对髋关节活动度的影响,并探讨杯与颈前倾角优化组合。建立全髋关节假体三维可视化计算机模型,计算满足两组不同髋关节活动度下,髋臼外展角每变化5°时相应的髋臼前倾角安装角度,并在以髋臼外展角为横坐标,髋臼前倾角为纵坐标的坐标系上描点、连线画图,并对数据进行分析。实验显示,颈干角135°,髋关节一般标准和严格标准活动度,髋臼杯前倾角(Y)与股骨颈假体前倾角(X)的关系分别为Y1=-0.728X1+40.916,Y2=-0.7384 X2+46.456;允许的最小髋臼外展角(OImin)和头颈直径比(GR)的关系分别为OImin’1=254.27GR 1-3.172,OImin’2=230.58GR 2-2.519。髋关节活动度和髋臼安装角度安全范围随着头颈直径比增大而增大;髋关节活动度要求越高,髋臼安装角度安全范围越小。可允许的最小髋臼外展角随着头颈直径比的增大而变小。髋臼前倾角与股骨颈前倾角呈负相关。     

Using discrete-event simulation in strategic capacity planning for an outpatient physical therapy service

This study uses a simulation model as a tool for strategic capacity planning for an outpatient physical therapy clinic in Taipei, Taiwan. The clinic provides a wide range of physical treatments, with 6 full-time therapists in each session. We constructed a discrete-event simulation model to study the dynamics of patient mixes with realistic treatment plans, and to estimate the practical capacity of the physical therapy room. The changes in time-related and space-related performance measurements were used to evaluate the impact of various strategies on the capacity of the clinic. The simulation results confirmed that the clinic is extremely patient-oriented, with a bottleneck occurring at the traction units for Intermittent Pelvic Traction (IPT), with usage at 58.9 %. Sensitivity analysis showed that attending to more patients would significantly increase the number of patients staying for overtime sessions. We found that pooling the therapists produced beneficial results. The average waiting time per patient could be reduced by 45 % when we pooled 2 therapists. We found that treating up to 12 new patients per session had no significantly negative impact on returning patients. Moreover, we found that the average waiting time for new patients decreased if they were given priority over returning patients when called by the therapists.     

The NHS Performance Assessment Framework: a "balanced scorecard" approach?

The NHS in the UK has recently adopted a new Performance Assessment Framework (PAF), aiming to provide a broader view of performance within the NHS The PAF is not only a multi-stakeholder approach reflecting various stakeholders' interests across six dimensions, but is also used by the Government as a strategic management tool to ink national strategies with local operation activities. The Government claims that the PAF is a "balanced scorecard" approach This study discusses the concepts of the BSC underlying the NHS PAF.     

核苷酸切除修复基因XPB反义RNA表达质粒的构建及其功能的初步研究

背景与目的：核苷酸切除修复机制是细胞修复损伤DNA的重要途径,肿瘤细胞的耐药常伴随DNA损伤修复基因表达增强,采取反义策略降低细胞的DNA损伤修复能力可以增加肿瘤细胞的药物敏感性。本研究拟构建能在哺乳动物细胞中表达XPB反义RNA的表达质粒pcDNA-XPB/AS(XPB：着色性干皮病B基因),并初步探讨其对肺癌细胞DNA损伤修复能力及抗肿瘤药物耐药性的影响。方法：采用RT-PCR技术扩增的XPB cDNA5′端一段69--520bp的序列被反向插入表达质粒pcDNA3．1／His。将该重组质粒瞬时转染肺癌A549细胞。单细胞凝胶电泳(SCGE)比较阿霉素诱导的转染前后细胞DNA损伤修复情况。MTT法检测转染前后细胞对阿霉素的敏感性。结果：酶切图谱分析和基因测序证实反义表达质粒构建成功。RT-PCR显示转染细胞XPB mRNA表达水平下降。以4．Oμg／ml阿霉素诱导细胞DNA损伤,SCGE显示转染细胞修复DNA损伤能力受到抑制。MTT显示未转染细胞与转染细胞对阿霉素的敏感性存在差别,但无统计学意义。结论：构建的反义表达质粒能下调转染细胞XPB mRNA表达,抑制细胞DNA损伤修复能力,为进一步研究XPB基因功能奠定了基础。     

新型口服活性炭微球对链脲佐菌素诱导的糖尿病模型大鼠治疗作用的研究(英文)

制备并表征了孔径不同的活性炭微球,考察其对糖尿病模型大鼠的治疗作用。通过制备工艺的改良,制得了直径在0.2-0.3mm的活性炭微球。通过对葡萄糖的吸附实验,筛选最优的活性炭微球。采用雄性Sprague-Dawley大鼠腹腔注射链脲佐菌素诱导制得糖尿病大鼠模型。两组大鼠采用每天两次口服灌胃活性炭微球,连续给药30天。通过离体肠段外翻实验法,测定葡萄糖的跨膜透过量。与糖尿病组相比,在服药2周以后,活性炭微球治疗组的血糖水平明显降低,改善血糖耐受量。在肠粘膜侧有活性炭微球存在时,葡萄糖分子的渗透清除率显著增大,尤其是当浆膜侧的葡萄糖浓度较高时(10mg/mL)。筛选得到的活性炭微球BET比表面积为1566m2/g,微孔含量高(0.478cm3/g),球形良好,对葡萄糖吸附率高。作为口服微球制剂,活性炭微球对链脲佐菌素诱导的糖尿病大鼠有治疗作用。