A comparable study of clinical and optical outcomes after 1,8, 2,0 mm microcoaxial and 3,0 mm coaxial cataract surgery

AIM： To evaluate the clinical pnd optical outcomes after clear corneal incision cataract surgery （ClCS） with three different incision sizes （1.8, 2.0 and 3.0 mm）. METHODS： Eyes of 150 patients with age-related cataract scheduled for coaxial cataract surgery were randomized to three groups： 1.8, 2.0, or 3.0 mm CICS. Intraoperative data and postoperative outcomes including surgically induced astigmatism （SIA）, the corneal incision thickness, wavefront aberrations and modulation transfer function （MTF） of cornea were obtained. RESULTS： There were no significant differences among the three groups in demographic characteristics and intraoperative outcome. The 1.8 and 2.0 mm microincisions showed more satisfactory clinical outcomes than the 3.0 mm incision. The 1.8 mm incision showed significantly less SIA than the 2.0 mm incision until postoperative lmo （P〈0.05）, but the difference was only 0.14-0.18 D. Combined with less increased incision thickness only at postoperative ld （P=0.013）, the 1.8 mm incision presented better uncorrected distance visual acuity （UCDVA） than the 2.0 mm incision only at Id postoperatively （P=0.008）. For higher-order aberrations and other Zernike coefficients, there were no significant differences between the 1.8 mm group and 2.0 mm group （P 〉0.05）. CONCLUSION： Converting from 3.0 mm CICS to 1.8 or 2.0 mm CICS result in better clinical and optical outcomes. However, when incision is 1.8 mm, the benefits from further reduction in size compared with2.0 mm are limited. The necessity to reduce the incision size is to be deliberated.

Effect of Lixujieyu recipe in combination with Five Elements music therapy on chronic fatigue syndrome

OBJECTIVE: To observe the clinical effects of the Lixujieyu recipe combined with Five Elements music therapy on chronic fatigue syndrome(CFS) identified as the symptom patterns of liver stagnation and spleen deficiency in terms of Traditional Chinese Medicine.METHODS: Patients with CFS were randomly divided into treatment group 1(Lixujieyu recipe combined with Gong-Tune, n = 15); treatment group 2(Lixujieyu recipe combined with Jiao-Tune, n = 15);treatment group 3(Lixujieyu recipe combined with Yu-Tune, n = 15); treatment group 4(Lixujieyu recipe combined with Shang-Tune, n = 15); treatment group 5(Lixujieyu recipe combined with Zhi-Tune,n = 15); and the control group(Lixujieyu recipe alone, n = 15). Chinese medicine was given twice daily, and music was listened to for 45 minutes daily, 5 days a week. All patients were treated for4 weeks. Patients were assessed via the Fatigue Scale, the Hamilton Depression Rating Scale, and the Hamilton Anxiety Rating Scale before and after treatment.RESULTS: Treatment groups 1 and 2 had better effects on relieving the symptoms of physical fatigue related to anxiety and depression than the control group(P < 0.05).CONCLUSION: Lixujieyu recipe combined with Gong-Tune or Jiao-Tune significantly relieved the symptoms of CFS.

Dose,Plasma Level,and Treatment Outcome Among Methadone Patients in Shanghai,China

Abstract The purpose of this study was to investigate the blood levels of methadone in participants receiving methadone for the treatment of opioid dependence. After stabilization on methadone for four weeks, blood samples from 95 participants were collected between treatment weeks 4 and 12, before and after receiving doses of methadone, and its blood levels were measured. A multiple linear regression model was used to examine the associa- tion between methadone blood levels and the outcomes of methadone maintenance treatment （MMT）. Outcome dif- ferences between participants who had high （≥2） or low （〈2） peak-to-trough ratios were also compared using an independent sample t-test. The blood level of methadone was not correlated with the clinical outcome of MMT with the moderate range of doses given. However, the retention of patients who had a free peak-to-trough ratio 〉2 was significantly poorer than those whose ratio was 〈2. Thus, monitoring plasma methadone levels is unlikely to be effective for guiding dosing decisions in situations where compliance with MMT is already very high or when themethadone dose is no longer the dominant factor in determining the clinical outcome. However, monitoring plasma methadone levels is still helpful for guiding the dosage for patients with a rapid metabolism.

Predictors of early outcome in unstable pelvic fractures

Objective： To define the preoperative and intraoperative variables which may affect the immediate postoperative outcome in surgically managed patients with unstable pelvic fractures. Methods： This study was performed prospectively from January 2009 to June 2011 on 36 consecutive patients admitted to the trauma ward of Postgraduate Institute of Medical Education and Research, Chandigarh, with unstable pelvic injuries. Results： In the present study of 36 patients, 29 were managed surgically. Surgical duration was 2 hours in pa- tients operated on within 1 week and 3.4 hours in those operated on after 1 week. The blood loss was 550 ml when surgery was done after a week, but when done within a week it was 350 ml. The average blood loss through Pfanenstial approach was 360 ml, through posterior approach was 408 ml and through combined approach was 660 ml which was significantly high. Conclusion： Anterior approach to the pelvis would cause significantly more amount of blood loss than poste- rior approach and extemal fixation. Surgical approaches do not have any influence on the surgical duration or the infec- tion rate. The blood loss significantly increases when the surgical time is more than 1 h. The infection rate is not influ- enced by the duration of surgery. Presence or absence of associated injuries to the head, chest or abdomen is the main determinants of patient＇s survival and it greatly influ- ences the duration of hospital stay.