Endoscopic dacryocystorhinostomy with bicanalicular silicone tube intubation for treating chronic dacryocystitis secondary to nasolacrimal duct stent incarceration

AIM:To investigate the feasibility of endoscopic dacryocystorhinostomy(En-DCR)with bicanalicular silicone tube intubation for treating chronic dacryocystitis secondary to nasolacrimal duct stent(NDS)incarceration.METHODS:En-DCRs were performed on 44 chronic dacryocystitis patients(46 eyes)secondary to NDS incarceration from April 2016 to October 2022.The granuloma and scar tissues were separated,and the removal of NDS incarceration was achieved during the surgery;the flap of the lacrimal sac was trimmed and anastomosed with nasal mucosal,a bicanalicular silicone tube was implanted,and lacrimal size and condition were assessed.The tube was removed 3mo after surgery.During the final follow-up of 12mo when the surgery was completed,the complications and the rates of surgical success were assessed.RESULTS:This study covered 40 patients(42 eyes).Intraoperatively,it was found that the lacrimal sac became small,and the sac wall had granulation and scar tissue attached to the incarcerated NDS in all eyes.At 12mo after surgery completed,the rates of the functional and anatomical success reached 80.95%(34/42)and 83.33%(35/42),respectively.Under the effect of intranasal ostial closure,seven eyes failed to achieve anatomical success.No serious complications(e.g.,visual impairment,sinusitis,and orbital fat prolapse)was observed.CONCLUSION:With the success rate over 80%and no serious complications,En-DCR with bicanalicular silicone tube implantation is effective in treating chronic dacryocystitis secondary to NDS incarceration.

Surgical outcomes in acute dacryocystitis patients undergoing endonasal endoscopic dacryocystorhinostomy with or without silicone tube intubation

AIM:To establish the necessity of silicone tube intubation in acute dacryocystitis(AD)patients undergoing endonasal endoscopic dacryocystorhinostomy(En-DCR).METHODS:Patients presenting with unilateral AD were randomly assigned to two treatment groups.En-DCR procedures were performed following lacrimal abscess formation,with the operation being performed with silicone intubation for patients in group B but not group A.Functional success was defined by an absence of additional AD episodes,no epiphora,and ostium patency as established via endoscopic evaluation or fluorescein irrigation.Operative success rates and demographic variables were compared between treatment groups.RESULTS:In total,66 patients were analyzed in the present study(33 per group),with complete postoperative data having been successfully collected from 27 and 22 patients in group A and group B,respectively.All patients exhibited complete resolution of acute inflammation.Upon follow-up,granulation tissue was detected around the ostium at higher rates in group B(9/22,40.9%)relative to group A(4/27,14.8%).At the 12-month follow-up time point,patients in group A exhibited higher success rates(25/27,92.6%)relative to patients in group B(20/22,90.9%),but this difference was not significant.Cases of lacrimal passage reconstruction failure in both groups were attributed to excessive fibrous and/or granulation tissue formation proximal to the intranasal ostium.CONCLUSION:Given that these two operative approaches are associated with similar rates of operative success and in light of differences in granulation tissue formation,cost,and operative duration,these data do not support the routine silicone intubation of AD patients following En-DCR surgery.

Use of Silicone Tubes to Repair Canalicular Lacerations via a Novel Method

Purpose:To develop a novel method to repair canalicular lacerations using silicone tubes.Methods:A total of 47 adult patients(47 eyes)with canalicular lacerations were collected from the outpatient department from November 2010 to December 2012.The age ranged from16 to 53 years.Among the 47 eyes,37 had lower canalicular lacerations,6 had upper canalicular lacerations,and 4 had bicanalicular lacerations..A soft probe was made using a stainless steel acupuncture needle,which was inserted into the lumen of the proximal part of the catheter to increase its rigidity.The probe was then inserted into the lacrimal sac and nasolacrimal duct.After retrieval of the catheters,the two ends of the silicone tube were securely tied.(end to end).to the catheters..The silicon tube outside the nostril formed a Ushape.The catheters were then pulled upward until the silicone tube was completely located in the canalicular system.The catheters were cut off of the silicone tube near the site of the connection.The two ends of the silicone tube were cut short,~2mm out of the lacrimal punctum,and tied securely,end to end.The length of the tube between the upper and lower punctum was adjusted to ensure that no tension was present in the medial cathus,and the suture was removed through the nostril.The silicone tube was removed 3-10 months after this novel canalicular intubation procedure (NCI).Results:.All cases were anatomically rehabilitated after surgery..The silicone tube was removed after implanted in 3-10months (mean 4.5±1.3 months),the average follow-up time was 11.8 months after removal.In total,45 eyes in all 47eyes (95.74%)were free from obstruction.Among them,41eyes (91.11%) achieved complete success(completely disap-pearance of epiphora after tube removal),.4 eyes.(8.89%)achieved partial success.(irritation occurs under stimulation conditions,such as wind or cold conditions),4 eyes showed postoperative tearing,with three eyes having inferior lacrimal duct laceration,and one eye with superior canalicular laceration.Apart from two cases (4.26%) suffering inferior punctum splitting,no other associated issues occurred with the silicone tube or iatrogenic injury and lacrimal complications.Conclusion:For adult patients with canalicular laceration,the NCI was an effective,atraumatic surgery,which has fewer complications than traditional canalicular suture.

Fascial pedicle artificial nerve tissue compared with silicone tube bridging to repair sciatic nerve defects in rats

BACKGROUND： Silicone tube bridging for peripheral nerve defects has been shown to be successful in guiding neural regeneration. However, this method is accompanied by complications. Because materials for bridging nerve fibers should exhibit biocompatibility, the development of novel artificial tissues to bridge nerve grafts has become important in the field of nerve tissue engineering for the repair of peripheral nerve defects. OBJECTIVE： To investigate effectiveness and feasibility of fascial pedicle artificial nerve tissue to repair peripheral nerve defects, and to compare to autologous nerve grafts and silicone tube bridging methods. DESIGN, TIME AND SETTING： Randomized, controlled, neural tissue engineering-based, animal experiments were performed at the Laboratory of Human Anatomy in Qingdao University Medical College from March 2006 to March 2007. MATERIALS： Medical absorbable collagen sponge was purchased from Henan Province Tiangong BJo-Material, China. Cantata 2-track 4-trace EMG-evoked potential instrument was purchased from Dantec, Denmark. Medical silicone tube was purchased from Shenzhen Legend Technology, China. METHODS： Forty healthy, adult, male, Sprague Dawley rats were randomly assigned to four groups fascial pedicle nerve, autologous nerve, silicone tube, and normal, with 10 rats in each group. A 10-mm defective sciatic nerve section was produced in rats following the removal of the fascial pedicle. The fascial flap surrounding the defect was harvested; one side of the nerve pedicle was maintained and then sutured into a tube with the fascia surface as the pipe inner wail. The tube was filled with a medical absorbable collagen （Bodyin） to construct a bridge between the artificial tissue nerve graft and the damaged sciatic nerve. The sciatic nerve defects in the autologous nerve and silicone tube groups were bridged using autologous nerve grafts and a medical silicone tube with matched specifications. MAIN OUTCOME MEASURES： At 4 months after transplantation, electromyogram was used to detect sciatic nerve conduction velocity and action potential amplitude. Hematoxylin-eosin and Nissl staining were used to determine the number of spinal cord anterior horn motor neurons and neurites Osmium tetroxide staining of the sciatic nerve bridge section was performed to detect the number and diameter of nerve fibers. RESULTS： There were no differences in sciatic nerve conduction velocity, action potential amplitude, the number of spinal cord anterior horn motor neurons and neurites, sciatic nerve fiber number, and diameter between the autologous nerve graft and normal groups （P 〉 0.05）. However, these values were significantly greater than in the silicone tube group （P 〈 0.05）. CONCLUSION： Quantitative results suggested that artificial nerve tissue, with an autologous tissue fascia flap as a nerve conduit, could be used to repair peripheral nerve defects. The regenerated fascial pedicle artificial nerve tissue was similar to an autologous nerve graft in terms of morphology and functional recovery and was superior to results from silicone tube bridging transplants.

Outcomes of revision external dacryocystorhinostomy and nasal intubation by bicanalicular silicone tubing under endonasal endoscopic guidance

AIM: To evaluate the long-term treatment outcomes in patients who underwent revision of external dacryocysto- rhinostomy (DCR) and nasal intubation by bicanalicular silicone tubing (BSTI) under endonasal endoscopic guidance. · METHODS: Data from 28 patients with recurrent dacryocystitis were retrospectively reviewed. Revision external DCR and bicanalicular nasal intubation by silicone tubing under endonasal endoscopic guidance was performed in 28 eyes of 28 patients. The patients were evaluated with respect to the reason of recurrence, time to recurrence, time to revision, duration of follow-up and surgical success. · RESULTS: Endoscopic endonasal examination detected an osteotomy-side obstruction by the excessive granulation tissue in 24 patients (86%), nasal septal deviation in three patients (10%) and nasal polyp in one patient (4%). Recurrence occurred after a mean duration of 5.3±3.7 months following the first operation. The mean time between the first DCR operation and the revision DCR was 11.5 ± 9.3 months. After a mean follow-up of 14.9±7.8 months, the rate of anatomic success alone was 85% (24/28); the rate of subjective success was 78% (22/28). · CONCLUSION: Revision external DCR and bicanalicular nasal intubation by silicone tubing under endonasal endoscopic guidance can be recommended in patients with recurrent dacryocystitis as a surgical approach that achieves satisfactory objective and subjective success rates.

Repositioning of the complete prolapsed silicone tube with modified suture-probe and silk thread traction method

The whole lacrimal passage intubation is widely used in lacrimal surgery.However,one of the most typical complications is the prolapse of the silicone tube from the medial canthus.In case,the bicanalicular silicone tube after whole lacrimal duct intubation has completely prolapsed from the medial canthus before extubation,then cannot be found in the opening of the nasolacrimal duct,and it would be a challenge to reposition or removal.A novel approach to employ a modified suture-probe and silk thread traction technique has been developed,and it is not only safe and effective,but also cost-effective.

气相色谱法测定注射用雷替曲塞中甲基环硅氧烷

目的 建立液液萃取法测定注射用雷替曲塞中六甲基环三硅氧烷(D3)、八甲基环四硅氧烷(D4)、十甲基环五硅氧烷(D5)、十二甲基环六硅氧烷(D6)含量的气相色谱法。方法 采用Agilent CP-Sil 8 CB for Amines毛细管色谱柱(30 m×0.25 mm, 0.5μm),氢火焰离子化检测器(FID),进样口温度为260℃,检测器温度为260℃,载气为氮气,流速1.0 mL·min^(-1),程序升温,直接进样,进样量为1.0μL,分流比30∶1。结果 4种环硅氧烷类化合物在40~1000μg·mL^(-1)范围内呈现良好的线性关系,相关系数r为0.9998~0.9999,D3~D6平均加样回收率(n=9)分别为98.45%、96.18%、98.60%、95.14%,RSD分别为1.99%、1.56%、2.72%、0.98%。结论 本文建立注射用雷替曲塞中甲基环硅氧烷的检测方法,本法简便,准确、专属性强,适用于注射用雷替曲塞中环硅氧烷类的检测。

工作场所空气中乙醇胺的测定方法

文章以硅胶管采集,甲醇溶剂解吸,苯甲醛衍生后衍生物为2-苯亚甲基氨基乙醇,氢火焰离子化检测器检测,以保留时间定性,峰面积定量建立了一套工作场所空气中乙醇胺的气相色谱分析方法。结果显示:乙醇胺在12.43~248.6μg/mL范围内线性关系良好,相关系数0.999 7,检出限0.23μg/mL,定量下限0.93μg/mL。按采样体积1.5 L计算,最低检出浓度0.15 mg/m^(3),最低定量浓度0.62 mg/m^(3),精密度1.0%~4.0%,解吸效率92.7%~101.0%,采样效率97.4%,常温下样品保存>7d。该分析方法各项指标均满足国家相关标准要求、高效便捷、对设备损伤小、推广性强。

管式PECVD工艺对“SE+PERC”晶体硅太阳电池镀膜均匀性的影响及改善研究

针对在“SE+PERC”晶体硅太阳电池制备过程中,采用管式等离子体增强化学气相沉积(PECVD)工艺沉积正面钝化介质膜后,硅片正面会出现角部发红色差,即镀膜均匀性异常的问题,通过实验,对硅片厚度、工器具状态、背面膜层结构、正面钝化介质膜沉积工艺等影响因素对硅片正面角部发红色差的影响分别进行分析和讨论,并提出解决方案。研究结果表明:硅片正面角部发红色差的产生与硅片自身厚度、工器具状态、背面膜层结构、正面钝化介质膜沉积工艺均存在一定关系。通过采用最具优势的管式PECVD工艺条件,即优化自动化装片技术、控制石墨舟形变量、采用合适的背面膜层结构,以及正面钝化介质膜沉积工艺采用高射频功率叠加高腔体压力,可将正面角部发红色差硅片的占比降低至0%,从而可有效提升“SE+PERC”晶体硅太阳电池的成品率,提升生产线的经济效益。

Effect of intubation in patients with functional epiphora after endoscopic dacryocystorhinostomy

AIM:To investigate the effect of bicanalicular silicone tube intubation(BSTI)in the treatment of functional epiphora after endoscopic dacryocystorhinostomy(En-DCR).METHODS:Clinical data of 84 patients(95 eyes)with functional epiphora after En-DCR were retrospectively analyzed.Functional epiphora was confirmed as persistent or recurrent epiphora by fluorescein dye disappearance test(FDDT),lacrimal irrigation test,as well as endoscopic examination.Secondary BSTIs were recommended for patients with functional epiphora.These tubes were removed 1mo after surgery.Functional success and associated complications were assessed after 2y of follow-up.RESULTS:Seven patients(9 eyes)refused intervention,5 patients(6 eyes)did not complete postoperative followup,and 1 patient(1 eye)developed tube prolapse within 1mo after surgery.Seventy-one patients(79 eyes)were included at last.Functional success ratios at six months,one year,as well as two years post-operation were 94.9%(75/79),92.4%(73/79),and 91.1%(72/79),respectively.Three eyes presented with punctal slitting(2 eyes without epiphora),1 eye with proximal canaliculus slitting,1 eye with canaliculus stenosis and 4 eyes with still present functional epiphora without detectable abnormal at the last follow-up.CONCLUSION:Secondary intubation is an effective procedure with low recurrence probability for functional epiphora after En-DCR.Punctal and canaliculus injury are the main tube-associated complications after secondary intubation.

闪烁光纤中宇宙线缪子的荧光光子计数测量

开展基于塑料闪烁光纤的宇宙线缪子测量研究时,对闪烁光纤输出光脉冲的光子数定量分析,是读出电子学设计的前提。在无单光子源等弱光标定时,对缪子入射事件在光纤中产生光脉冲的光子数进行定量分析是本文的主要目标。首先利用硅光电倍增管(Silicon Photomultiplier Tube,SiPM)固有的非光生载流子特性标定光脉冲的测量值,获得缪子在直径1 mm和2 mm光纤中产生微弱光脉冲包含的光子数;然后结合Geant4软件模拟计算缪子在光纤中理论光子产额,并与实验结果对比验证。结果显示,在直径1 mm和2 mm光纤中光脉冲光子期望值分别为44个和85个,与模拟结果偏差分别为4.55%和10.59%,表明该低光子数测量方法可以在无额外标定设备时,实现对缪子入射光纤产生光子数的准确测量,并可以应用在其他弱光脉冲光子数测量场景中。

全自动辐射热传导测试仪的研发

为了研发出操作更方便、测试更准确的辐射热传导测试仪,以辐射热源单元、数据采集单元、运动控制单元、冷却系统单元、安全保护单元为核心,采用以逐次逼近法为基础运算配以数据统计法的专用操作软件,设计了一种全自动辐射热传导测试仪。实现了测试数据自动处理、测试报告自动生成、辐射热源自动校准、辐射热功率智能调节等多项人性化功能。认为:研发的全自动辐射热传导测试仪达到了国外同类仪器水平,减少了人员的劳动量,保证了人员的安全。

自制可调节硅胶气管套管固定带在面颈部烧伤气管切开患者中的应用研究

目的探讨自制可调节硅胶气管套管固定带在面颈部烧伤气管切开患者中的应用效果。方法选取我科2019年10月-2023年2月收治的面颈部烧伤行气管切开的患者40例,按随机数字表法分为2组,每组各20例;对照组采用传统气管套管固定带,观察组采用自行设计的可调节硅胶气管套管固定带。(1)比较2组患者面颈部新增皮肤损伤情况。(2)比较2组患者更换气管套管固定带的操作时间,气管切开第1周更换气管套管带次数、更换纱布及敷料的次数。(3)比较2组患者刺激性呛咳时间、气管套管移位的情况。(4)比较2组患者气管套管固定舒适度。结果观察组患者颈部新增皮肤损伤低于对照组(P<0.001),更换气管套管固定带的操作时间、气管切开第1周更换气管套管带次数、气管切开第1周更换纱布及敷料的次数均少于对照组,差异有统计学意义(P<0.001)。观察组患者发生刺激性呛咳时间、气管套管移位例数均低于对照组,差异有统计学意义(P<0.001)。观察组患者气管套管固定舒适度高于对照组,差异有统计学意义(P<0.001)。结论本研究自制可调节硅胶气管套管固定带可保护面颈部烧伤气管切开患者皮肤免受损伤,减少固定带更换操作时间、更换次数,提升患者佩戴舒适度,可减轻医护人员的工作量,值得临床推广。

不同管径闭式引流管用于气胸患者胸腔闭式引流术治疗的效果探讨

目的 探究不同管径闭式引流管用于气胸患者胸腔闭式引流术治疗的效果。方法 选取2020年6月—2022年4月在漳浦县医院行胸腔闭式引流术的100例气胸患者,采用随机数字表法分成各50例的2组。观察组采用中心静脉导管进行术后引流,对照组采用传统硅胶胸管用于术后引流。观察2组患者气胸治疗总有效率、围术期指标、术后生活活动能力指数评分(Barthe指数)、疼痛评分(VAS评分)、并发症发生情况。结果 2组患者治疗总有效率、肺复张时间比较,差异无统计学意义(P>0.05);观察组伤口愈合时间、住院时间短于对照组(P<0.05);术后2周,观察组Barthel指数评分高于对照组,视觉模拟疼痛评分(VAS)低于对照组(P<0.05);观察组胸膜反应、皮下气肿、感染总发生率为4.00%,远低于对照组的20.00%(P<0.05)。结论 中心静脉导管引流用于气胸患者胸腔闭式引流术治疗可有效缩短伤口愈合时间、住院时间,术后生活活动能力较好,患者疼痛程度及创伤性较小,值得临床应用和推广。

TMA杂质元素对二合一管式PECVD影响分析

二合一管式PECVD是晶硅太阳能电池生产环节中用于制备氧化铝+氮化硅钝化减反射薄膜的常用机台,是提升电池光电转换效率不可或缺的工序,同时也是影响良率的重要工序。TMA(三甲基铝)作为氧化铝制备时的反应气体,其纯度以及杂质含量严重影响电池的光电转化效率、良率。经研究发现,TMA中Cl元素杂质含量过高,可能导致机台尾排粉末量大、喷气嘴堵塞等现象,最终影响电池效率。

无鼻内窥镜下RS置管术治疗泪小管断裂的临床疗效

目的:探讨无鼻内窥镜下RS置管术治疗泪小管断裂的临床疗效。方法:回顾性分析我院2017-09/2018-03收治的泪小管断裂患者52例52眼。根据入院时间顺序分为两组,RS管组32例32眼,环形泪道置管组20例20眼。对比分析两组患者的术中鼻出血、临床疗效和术后并发症情况。结果:RS管组术中无鼻出血发生,环形泪道置管组鼻黏膜出血15眼,两组差异有统计学意义(P<0. 001)。RS管组治愈26眼,好转3眼,无效3眼,治疗有效率为91%;环形泪道置管组治愈15眼,好转3眼,无效2眼,治疗有效率为90%,两组临床疗效差异无统计学意义(P=0. 877)。术后2wk～2mo,RS管组脱管2眼,有1眼在留置未满2wk时从泪小点脱出,给予再次吻合;另有1眼在术后1～2mo内从泪点抽出,未再次手术,随访时泪道冲洗好转。环形泪道置管组脱管3眼,未再次手术,在以后的随访过程中泪道冲洗好转。两组患者术后并发症差异无统计学意义(P=0. 361)。结论:泪小管断裂需及时手术治疗,采用RS管能提高手术成功率,降低并发症的概率,并且具有操作方法简单、组织相容性好、不影响患者外观等优点。

新型硅胶管治疗泪小管断裂的临床疗效(英文)

目的:评价新型硅胶管(RS一次性使用泪道引流管)治疗泪小管断裂的临床效果。方法:回顾性研究。收集2013-01/2015-10来我院就诊的47例47眼泪小管断裂患者完整的临床资料。在泪小管断裂吻合术中,新型硅胶管从上、下泪小点"U"形置入,在泪道中保留3mo。拔管后,观察泪道通畅率、是否伴有泪溢和其他并发症发生情况。结果:所有患者,泪小管吻合成功,新型硅胶管顺利植入。未发生硅胶管相关的并发症,如眼部刺激、泪小点外翻和撕裂、过早脱落等。治愈41例(87%),泪道冲洗通畅,无泪溢。部分治愈4例(9%),患眼轻微泪溢,但泪道冲洗通畅。失败2例(4%),患眼泪溢,泪道冲洗不畅。结论:在泪小管断裂吻合术中,新型硅胶管是一种安全、有效、无创的置入物,其操作过程简单,易于掌握,术者学习曲线短。

硅胶管置入在手术治疗喉气管狭窄中的应用

目的探讨硅胶管置入在喉气管狭窄手术治疗中的应用。方法回顾根据喉气管狭窄的范围和程度,选用气管镜扩张、激光切除、喉气管切开成形和支撑器扩张等方式,对36例后天性喉气管狭窄的患者进行治疗。结果 32例患者拔管治愈,成功率为88.8%。结论喉气管狭窄病情复杂多变,术中应根据病变的范围和程度,选择适当的治疗方法,方能获得满意的治疗效果。

两种不同硅胶引流管治疗慢性泪囊炎的临床观察

目的比较两种不同硅胶引流管在逆行置管术治疗慢性泪囊炎中的临床效果。方法选取2009年1月至2011年6月在我科治疗的80例单眼单纯性慢性泪囊炎患者，根据放置引流管的不同，将患者随机分成球头硅胶管逆行置管术（A）组和泪道扩张引流管逆行置管术（B）组，术后3～6个月拔管，随访18个月，评价两组患者手术成功率，并比较两组患者术后拔管操作难易度及复发率。结果完成随访者75例纳入疗效分析，A组39例，B组36例，两组患者年龄、性别、眼别、病程差异均无统计学意义（均为P〉0．05）。A组手术成功率为94．9％（37／39），B组为88．9％（32／36），两组比较差异无统计学意义（P〉0．05）。拔管时，A组有1例、B组5例拔管困难。随访期间，A组有2例、B组有4例复发。结论两种不同硅胶引流管在逆行置管术治疗慢性泪囊炎中都具有操作简单、安全、适应证广等优点，且疗效显著；而在拔管过程中球头硅胶管拔管较泪道扩张引流管相对容易。