[目的]比较经皮与开放缝合治疗急性跟腱断裂的临床疗效。[方法]回顾性分析2017年10月—2021年10月本院手术治疗的急性跟腱断裂35例患者的临床资料,根据术前医患沟通结果,16例采用带线锚钉闭合缝合(经皮组),19例采用切开缝合(开放组)。...[目的]比较经皮与开放缝合治疗急性跟腱断裂的临床疗效。[方法]回顾性分析2017年10月—2021年10月本院手术治疗的急性跟腱断裂35例患者的临床资料,根据术前医患沟通结果,16例采用带线锚钉闭合缝合(经皮组),19例采用切开缝合(开放组)。比较两组围手术期、随访结果。[结果]所有患者均顺利完成手术。经皮组手术时间[(56.6±10.4) min vs(81.7±28.7) min, P=0.003]、切口长度[(1.9±0.6) cm vs (7.7±3.5) cm, P<0.001]、术中失血量[(10.6±6.0) ml vs (26.0±15.8) ml, P<0.001]、住院时间[(8.2±1.6) d vs (11.1±3.5) d, P=0.015]均显著优于开放组,而两组下地行走时间及切口愈合情况的差异均无统计学意义(P>0.05)。随访时间平均(21.8±7.1)个月,经皮组术后完全负重活动时间显著早于开放组[(8.4±1.0)周vs (12.8±3.1)周, P=0.005]。术后随时间推移,两组患者VAS、AOFAS和ATRS评分,以及足跖屈-背伸ROM均显著改善(P<0.05)。经皮组术后1个月[(1.6±0.4) vs (2.3±0.7), P=0.001]和术后6个月[(0.9±0.3) vs (1.3±0.4), P=0.004]的VAS均显著优于开放组,相应时间点,两组间AOFAS、ATRS评分和足跖屈-背伸ROM的差异均无统计学意义(P>0.05)。[结论]与切开缝合治疗相比,带线锚钉经皮缝合手术创伤小,更有利于功能恢复。展开更多
Background Neovascular glaucoma （NVG） is a refractory disease which is difficult to manage. This study aimed at evaluating the efficacy and safety of adjunctive intravitreal bevacizumab （IVB） injection in conjunct...Background Neovascular glaucoma （NVG） is a refractory disease which is difficult to manage. This study aimed at evaluating the efficacy and safety of adjunctive intravitreal bevacizumab （IVB） injection in conjunction with Ahmed glaucoma valve implantation （AGVI） in the management of NVG. Methods This was a retrospective study of patients with NVG in whom AGVI was performed between October 2008 and May 2012. The sample was divided into two groups according to the pretreatment： with adjunctive IVB injection （the IVB group, n=25 eyes） and without adjunctive IVB injection （the control group, n=28 eyes）. The surgical success rate, number of antiglaucoma medications used, best-corrected visual acuity （BCVA）, postoperative complications, regression, and recurrence of iris neovascularization （NVI） were analyzed between the groups. Results The surgical outcomes of the two groups were compared. The complete success rates in the IVB and control groups were 84.0% and 64.3% at 12 months and 80.0% and 53.6% at 18 months, respectively. There was a significant difference between the two groups （P=0.041）. Mean postoperative intraocular pressures, mean number of postoperative antiglaucoma medications, and BCVA were not significant between the two groups. The NVI in 22 （88.0%） eyes had completely regressed within 2-8 days after IVB. However, NVI recurred in 10 eyes （40.0%） 2-9 months later after IVB. The IVB group had only 1 case （4.0%） of hyphema out of 25 eyes, while there were 8 （28.6%） cases of hyphema out of 28 eyes in the control group （P=0.026）.Conclusions This study showed that preoperative IVB injection reduced NVI remarkably, decreased hyphema, and led to higher surgical success rates. Pre-operative IVB injection may be an effective adjunct to AGVI in the management of NVG.展开更多
Background The protective effects of magnesium sulfate against ischemia-reperfusion injury of the small intestine in Sprague-Dawley （SD） rats have been confirmed in our previous research. However, its exact mechanis...Background The protective effects of magnesium sulfate against ischemia-reperfusion injury of the small intestine in Sprague-Dawley （SD） rats have been confirmed in our previous research. However, its exact mechanism is unclear. This study was to evaluate the role of PI3K/Akt signal pathway in the protective effect of magnesium sulfate against ischemia-reperfusion injury of the small intestine in SD rats. Methods Rat model of intestinal ischemia-reperfusion injury was used. The SD rats were divided into four groups randomly： sham operation group, ischemia-reperfusion group, magnesium sulfate group and magnesium sulfate plus LY294002 （an inhibitor of PI3K） group. The pathological changes of intestinal mucosa were examined; the activity of diamine oxidase （DAO） in plasma, the plasma contents of malondialdehyde （MDA）, and apoptosis rate of the intestinal mucosal cells were determined and compared. The expression of p-Akt was detected by Western blotting. Results There were more evident pathological changes of the intestinal mucosa （higher Chiu＇s score, P 〈0.05）, enhanced DAO activity （P 〈0.05）, elevated contents of MDA （P 〈0.05）, higher apoptosis rate （P 〈0.05）, and lower level of p-Akt （P 〈0.05） in the ischemia-reperfusion group compared with the sham operation group. There were less evident pathological changes of the intestinal mucosa （lower Chiu＇s score, P 〈0.05）, lower DAO activity （P 〈0.05）, lower contents of MDA （P 〈0.05）, and lower apoptosis rate （P 〈0.05）, but higher level of p-Akt （P 〈0.05） irL the magnesium sulfate group compared with the ischemia-reperfusion group. There were more evident pathological changes of the intes,inal mucosa （higher Chiu＇s score, P 〈0.05）, higher contents of MDA （P 〈0.05）, higher DAO activity （P 〈0.05） and higher apoptosis rate （P 〈0.05）, and lower level of p-Akt （P 〈0.05） in the magnesium sulfate plus LY294002 group compared with the magnesium sulfate group. Conclusions Activation of PI3K/Akt signal pathway results in the reduction of cell apoptosis, which likely accounts for the protective effect of magnesium sulfate against intestinal ischemia-reperfusion injury.展开更多
Background Ahmed Glaucoma Valve implantation （AGVI） is blood-aqueous barrier （BAB） has been noted after some surgica BAB disruption afterAGVl. used to treat refractory glaucoma. Breakdown of the techniques. The cu...Background Ahmed Glaucoma Valve implantation （AGVI） is blood-aqueous barrier （BAB） has been noted after some surgica BAB disruption afterAGVl. used to treat refractory glaucoma. Breakdown of the techniques. The current study was designed to assess Methods Anterior chamber protein content was measured by the laser flare cell photometry in 22 eyes of 22 patients with refractory glaucoma before AGVI and at each postoperative visit up to 1 month. Results Before AGVI the mean aqueous flare values in all eyes were （15.17＋9.84） photon counts/ms. After AGVI, the values significantly increased at day 1, day 3, and week I compared to those before AGVI （all P 〈0.05） with a peak at day 3. They returned to pre-operative levels at week 2, and were lower than preoperative level at month 1. Eyes with previous intraocular surgery history had greater aqueous flare values than those without previous intraocular surgery history, but there were no significant differences at all time points postoperatively （all P 〉0.05）. Furthermore, eyes with shallow anterior chambers had greater aqueous flare values at day 3 and week 1 （all P 〈0.05）. When comparing eyes with other refractory glaucoma conditions, neovascular glaucoma combined with intravitreal bevacizumab injection resulted in lower aqueous flare values after AGVI, but no significant differences were observed at all time points, postoperatively （all P 〉0.05）. Conclusions The BAB was impaired and inflammation was present in the anterior chamber in refractory glaucomatous eyes following AGVI. However, such conditions were resolved within 1 month postoperatively. Intravitreal bevacizumab treatment in neovascular glaucoma eyes before AGVI may prevent BAB breakdown.展开更多
文摘[目的]比较经皮与开放缝合治疗急性跟腱断裂的临床疗效。[方法]回顾性分析2017年10月—2021年10月本院手术治疗的急性跟腱断裂35例患者的临床资料,根据术前医患沟通结果,16例采用带线锚钉闭合缝合(经皮组),19例采用切开缝合(开放组)。比较两组围手术期、随访结果。[结果]所有患者均顺利完成手术。经皮组手术时间[(56.6±10.4) min vs(81.7±28.7) min, P=0.003]、切口长度[(1.9±0.6) cm vs (7.7±3.5) cm, P<0.001]、术中失血量[(10.6±6.0) ml vs (26.0±15.8) ml, P<0.001]、住院时间[(8.2±1.6) d vs (11.1±3.5) d, P=0.015]均显著优于开放组,而两组下地行走时间及切口愈合情况的差异均无统计学意义(P>0.05)。随访时间平均(21.8±7.1)个月,经皮组术后完全负重活动时间显著早于开放组[(8.4±1.0)周vs (12.8±3.1)周, P=0.005]。术后随时间推移,两组患者VAS、AOFAS和ATRS评分,以及足跖屈-背伸ROM均显著改善(P<0.05)。经皮组术后1个月[(1.6±0.4) vs (2.3±0.7), P=0.001]和术后6个月[(0.9±0.3) vs (1.3±0.4), P=0.004]的VAS均显著优于开放组,相应时间点,两组间AOFAS、ATRS评分和足跖屈-背伸ROM的差异均无统计学意义(P>0.05)。[结论]与切开缝合治疗相比,带线锚钉经皮缝合手术创伤小,更有利于功能恢复。
基金ZHOU Min-wen and WANG Wei contributed equallyto this study. This research was supported by grants from the National Natural Science Foundation of China （No. 81170849）, and the Fundamental Research Funds of State Key Laboratory of Ophthalmology （No. 2011 C02）.
文摘Background Neovascular glaucoma （NVG） is a refractory disease which is difficult to manage. This study aimed at evaluating the efficacy and safety of adjunctive intravitreal bevacizumab （IVB） injection in conjunction with Ahmed glaucoma valve implantation （AGVI） in the management of NVG. Methods This was a retrospective study of patients with NVG in whom AGVI was performed between October 2008 and May 2012. The sample was divided into two groups according to the pretreatment： with adjunctive IVB injection （the IVB group, n=25 eyes） and without adjunctive IVB injection （the control group, n=28 eyes）. The surgical success rate, number of antiglaucoma medications used, best-corrected visual acuity （BCVA）, postoperative complications, regression, and recurrence of iris neovascularization （NVI） were analyzed between the groups. Results The surgical outcomes of the two groups were compared. The complete success rates in the IVB and control groups were 84.0% and 64.3% at 12 months and 80.0% and 53.6% at 18 months, respectively. There was a significant difference between the two groups （P=0.041）. Mean postoperative intraocular pressures, mean number of postoperative antiglaucoma medications, and BCVA were not significant between the two groups. The NVI in 22 （88.0%） eyes had completely regressed within 2-8 days after IVB. However, NVI recurred in 10 eyes （40.0%） 2-9 months later after IVB. The IVB group had only 1 case （4.0%） of hyphema out of 25 eyes, while there were 8 （28.6%） cases of hyphema out of 28 eyes in the control group （P=0.026）.Conclusions This study showed that preoperative IVB injection reduced NVI remarkably, decreased hyphema, and led to higher surgical success rates. Pre-operative IVB injection may be an effective adjunct to AGVI in the management of NVG.
文摘Background The protective effects of magnesium sulfate against ischemia-reperfusion injury of the small intestine in Sprague-Dawley （SD） rats have been confirmed in our previous research. However, its exact mechanism is unclear. This study was to evaluate the role of PI3K/Akt signal pathway in the protective effect of magnesium sulfate against ischemia-reperfusion injury of the small intestine in SD rats. Methods Rat model of intestinal ischemia-reperfusion injury was used. The SD rats were divided into four groups randomly： sham operation group, ischemia-reperfusion group, magnesium sulfate group and magnesium sulfate plus LY294002 （an inhibitor of PI3K） group. The pathological changes of intestinal mucosa were examined; the activity of diamine oxidase （DAO） in plasma, the plasma contents of malondialdehyde （MDA）, and apoptosis rate of the intestinal mucosal cells were determined and compared. The expression of p-Akt was detected by Western blotting. Results There were more evident pathological changes of the intestinal mucosa （higher Chiu＇s score, P 〈0.05）, enhanced DAO activity （P 〈0.05）, elevated contents of MDA （P 〈0.05）, higher apoptosis rate （P 〈0.05）, and lower level of p-Akt （P 〈0.05） in the ischemia-reperfusion group compared with the sham operation group. There were less evident pathological changes of the intestinal mucosa （lower Chiu＇s score, P 〈0.05）, lower DAO activity （P 〈0.05）, lower contents of MDA （P 〈0.05）, and lower apoptosis rate （P 〈0.05）, but higher level of p-Akt （P 〈0.05） irL the magnesium sulfate group compared with the ischemia-reperfusion group. There were more evident pathological changes of the intes,inal mucosa （higher Chiu＇s score, P 〈0.05）, higher contents of MDA （P 〈0.05）, higher DAO activity （P 〈0.05） and higher apoptosis rate （P 〈0.05）, and lower level of p-Akt （P 〈0.05） in the magnesium sulfate plus LY294002 group compared with the magnesium sulfate group. Conclusions Activation of PI3K/Akt signal pathway results in the reduction of cell apoptosis, which likely accounts for the protective effect of magnesium sulfate against intestinal ischemia-reperfusion injury.
基金This research was supported by grants from the National Natural Science Foundation of China （No. 81170849）, and the Fundamental Research Funds of State Key Laboratory of Ophthalmology （No. 2011C02）.
文摘Background Ahmed Glaucoma Valve implantation （AGVI） is blood-aqueous barrier （BAB） has been noted after some surgica BAB disruption afterAGVl. used to treat refractory glaucoma. Breakdown of the techniques. The current study was designed to assess Methods Anterior chamber protein content was measured by the laser flare cell photometry in 22 eyes of 22 patients with refractory glaucoma before AGVI and at each postoperative visit up to 1 month. Results Before AGVI the mean aqueous flare values in all eyes were （15.17＋9.84） photon counts/ms. After AGVI, the values significantly increased at day 1, day 3, and week I compared to those before AGVI （all P 〈0.05） with a peak at day 3. They returned to pre-operative levels at week 2, and were lower than preoperative level at month 1. Eyes with previous intraocular surgery history had greater aqueous flare values than those without previous intraocular surgery history, but there were no significant differences at all time points postoperatively （all P 〉0.05）. Furthermore, eyes with shallow anterior chambers had greater aqueous flare values at day 3 and week 1 （all P 〈0.05）. When comparing eyes with other refractory glaucoma conditions, neovascular glaucoma combined with intravitreal bevacizumab injection resulted in lower aqueous flare values after AGVI, but no significant differences were observed at all time points, postoperatively （all P 〉0.05）. Conclusions The BAB was impaired and inflammation was present in the anterior chamber in refractory glaucomatous eyes following AGVI. However, such conditions were resolved within 1 month postoperatively. Intravitreal bevacizumab treatment in neovascular glaucoma eyes before AGVI may prevent BAB breakdown.
