Reconstruction of eyelid defects using the diplene adhesive membrane

Background The abundance of closely packed vital structures in the periocular and palpebral regions makes resection and subsequent reconstructive interventions extremely difficult.Methods In this novel article,we described a method for closing lower eyelid defects after tumor excision using a skin-muscle flap from the upper eyelid along with the use of an adhesive diplene biodegradable membrane.The membrane was used for seamless fixation of the flap and to prevent the development of lower eyelid deformity.Results The case presented herein demonstrated that using diplene adhesive biodegradable membranes has excellent functional and aesthetic results.Conclusion Our findings suggest that an adhesive biodegradable diplene membrane can be used for the reconstruction of the lower eyelid to prevent the occurrence of retraction,for the surgical treatment of ectropion including recurrent cases,and for seamless fixation of flaps to wound surfaces in patients with a tendency to form keloids and hypertrophic scars.

Repair of Full-Thickness Defects of the Lower Eyelid

The defect after an enlarged resection of lower eyelid tumor was reconstructed by transplantation of a mucosaCartilage composite graft from the nasal septum and a mucosa graft from the oral cavity for inner part of the eyelid. A pedicled skin flap from the adjacent region was rotated to cover the defect. The results in 4 patients were all satisfactory. The keypoint of the operation is the selection and design of an ideal pedicled skin flap.

A systematic review of the treatment of lower eyelid retraction and our attempt of a dermal-orbicularis oculi suspension flap

Lower eyelid retraction describes the inferior displacement of the lower eyelid with or without inversion or ectropion.Based on the causes of lower eyelid retraction,we divided the forming factors of lower eyelid retraction into three categories:(1)change in the balance of forces associated with the lower eyelid margin;(2)excessive loss of lower eyelid volume;(3)changes in the relative position of the eyeball and lower lid margin.In this review,the corresponding treatment methods are elaborated on individually for the above three forming factors.We also reported,for the first time,a new treatment for lower eyelid retraction.We created a dermal-orbicularis oculi suspension flap on the lateral side of the canthus and suspended it upward and inward on the dense connective tissue over the lateral bony surface of the orbital rim.The longest follow-up time was one year,and the results were satisfactory.

Main controlling factors and enrichment area evaluation of shale gas of the Lower Paleozoic marine strata in south China

The Lower Paleozoic shale in south China has a very high maturity and experienced strong tectonic defor- mation. This character is quite different from the North America shale and has inhibited the shale gas evaluation and exploration in this area. The present paper reports a com- prehensive investigation of maturity, reservoir properties, fluid pressure, gas content, preservation conditions, and other relevant aspects of the Lower Paleozoic shale from the Sichuan Basin and its surrounding areas. It is found that within the main maturity range （2.5 % 〈 EqRo 〈 3.5 %） of the shale, its porosity develops well, having a positive cor- relation with the TOC content, and its gas content is con- trolled mainly by the preservation conditions related to the tectonic deformation, but shale with a super high maturity （EqRo 〉 3.5 %） is considered a high risk for shale gas exploration. Taking the southern area of the Sichuan Basin and the southeastern area of Chongqing as examples of uplifted/folded and faulted/folded areas, respectively, geo- logical models of shale gas content and loss were proposed. For the uplifted/folded area with a simple tectonic defor- mation, the shale system （with a depth 〉 2000 m） has lar- gely retained overpressure during uplifting without a great loss of gas, and an industrial shale gas potential is generally possible. However, for the faulted/folded area with a strong tectonic deformation, the sealing condition of the shale system was usually destroyed to a certain degree with a great loss of free gas, which decreased the pressure coefficient and resulted in a low production capacity. It is predicted that the deeply buried shale （〉3000 m） has a greater gas potential and will become the focus for further exploration and development in most of the south China region （outside the Sichuan Basin）.

Coronal plane deformity around the knee in the skeletally immature population:A review of principles of evaluation and treatment

Coronal plane deformity around the knee,also known as genu varum or genu valgum,is a common finding in clinical practice for pediatricians and orthopedists.These deformities can be physiological or pathological.If untreated,pathological deformities can lead to abnormal joint loading and a consequent risk of premature osteoarthritis.The aim of this review is to provide a framework for the diagnosis and management of genu varum and genu valgum in skeletally immature patients.

Eyelid Fissure Narrowing after Recession of the Medial Rectus Muscle

A 67-year-old male had suffered from eye movement disturbance from Graves’ orbitopathy. His right eye was fixed in an esotropic position. Examination by synoptophore showed that his right eye deviation was 22 degrees medially. The upper eyelid margin reflex distance (MRD) was 3.5 mm OD and 5.6 mm OS, and the lower eyelid MRD was 5.1 mm OU. Six mm medial rectus muscle recession with tenotomy was performed in the patient. The next day after the surgery, his eye position did not change and the right eyelid fissure demonstrated narrowing with upper eyelid lowering and lower eyelid elevation. The right upper eyelid MRD was decreased to 1.9 mm and the right lower eyelid MRD was similarly decreased to 4.3 mm. On the same day, 4 mm resection of the ipsilateral lateral rectus muscle was performed, but the same MRDs were ob-served postoperatively. Patients undergoing medial rectus muscle recession in Graves’ orbitopathy need to be informed of this potential complication.

Assessing the deformation response of double-track overlapped tunnels using numerical simulation and field monitoring

The unprecedented rate of metro construction has led to a highly complex network of metro lines.Tunnels are being overlapped to an ever-increasing degree.This paper investigates the deformation response of double-track overlapped tunnels in Tianjin,China using finite element analysis(FEA)and field monitoring,considering the attributes of different tunneling forms.With respect to the upper tunneling,the results of the FEA and field monitoring showed that the maximum vertical displacements of the ground surface during the tail passage were 2.06 mm,2.25 mm and 2.39 mm obtained by the FEA,field monitoring and Peck calculation,respectively;the heaves on the vertical displacement curve were observed at 8 m(1.25D,where D is the diameter of the tunnel)away from the center of the tunnel and the curve at both sides was asymmetrical.Furthermore,the crown and bottom produce approximately0.38 mm and 1.26 mm of contraction,respectively.The results of the FEA of the upper and lower sections demonstrated that the tunneling form has an obvious influence on the deformation response of the double-track overlapped tunnel.Compared with the upper tunneling,the lower tunneling exerted significantly less influence on the deformation response,which manifested as a smaller displacement of the strata and deformation of the existing tunnel.The results of this study on overlapped tunnels can provide a reference for similar projects in the future.

The Variscan Deformation Front (VDF) in Northwest Germany and Its Relation to a Network of Geological Features Including the Ore-Rich Harz Mountains and the European Alpine Belt

The crustal basement of Northwest Germany can be interpreted as an “Avalonian Terrane Assemblage” subdivided by a roughly NW-SE (Hercynian) and SW-NE (Rhenish) running horst and graben system. In Late Devonian and Early Carboniferous times, this assemblage was flooded by the sea and mainly marine carbonates were deposited on the horsts and Stillwater shales in the grabens, as interpretable through magnetotelluric measurements. During the Late Carboniferous Variscan Orogeny, this terrain became the coal-rich foreland of the colliding Rhenohercynian belt. The shale-filled grabens reacted through folding and thrusting with different anticlinal patterns, the main carbonate covered horst in a still unknown way. This horst was the location of the Late Carboniferous basin center and of the inverted oil-rich Mesozoic Lower Saxony Basin (southwestern sector), respectively, with the so-called Bramsche Massif therein. It probably acted as an indenter for the evolution of the Variscan ore-rich Harz Mountains and forced the approaching Rhenohercynian orogen to stack the appropriate tectonic nappes by horizontal shortening to very high altitudes and the root into large depths. Based on seismic evidence this root is still an uncompleted crust/mantle transition zone with a deep reflection seismic and petrological Moho and a shallower hardly reflecting refraction seismic velocity Moho. The alternative, partly unsolved location of the Variscan Deformation Front in Northwest Germany may represent the new findings. The results may be supported by a comparison with features of the northern Alpine deformation belt.

Progress of laser and light treatments for lower eyelid rejuvenation

Laser and light treatments have recently become popular owing to its efficacy in treating laxity,rhytids,hyperpigmentation of the lower eyelids,and drooping of septum fat.For several decades,our department has explored the application of laser and light treatment for eye rejuvenation.This paper summarizes common treatment methods and analyzes the published literature on the indications and outcomes of multiple laser and light treatments for lower eyelid rejuvenation.An extensive survey of peer-reviewed literature was performed using PubMed,with the search terms“noninvasive treatment”,“infraorbital”,“palpebral bags”,“lower eyelid”,“radiofrequency(RF)”,“laser”,“nonsurgical skin tightening”,and“noninvasive fat reduction”.The results showed that the use of lasers,intense pulsed light(IPL),monopolar RF,bipolar RF,AdipoLASER rejuvenation(ALJ),and fractional RF microneedling are safe and effective treatments for palpebral bags.We conclude that using Qswitched lasers,IPL,RF,ALJ,and fractional RF microneedling is safe and effective for lower eyelid rejuvenation,with minimal complications and quick recovery.Further research and development of optoelectronic therapy may encourage breakthroughs in lower eyelid treatment,such as simplified complex surgery and noninvasive methods.

Microscopic characteristics of the inferior tarsal muscle and its surroundings in Korean

AIM: To investigate the detailed microscopic anatomic structures of the lower eyelid in Korean cadavers. METHODS: Eight lower eyelids of 4 formalin-fixed Asian cadavers (4 males; age range, 48-69 years; mean age, 60.2 years) were examined. Three perpendicular dissected sections with a 2mm thickness were obtained from each eyelid to investigate anatomic shapes, size and relationship with surrounding structures. One section was obtained from the midline and 2 the other sections were obtained from a 3mm apart from the lateral and medial tarsus margins. RESULTS: The inferior tarsal muscle fibers were not directly attached to the tarsus but were only linked to the tarsus with enclosed fibrous fascia. The inferior tarsal muscles connected loosely with the capsulopalpebral fascia anteriorly and the conjunctiva posteriorly. The inferior tarsal muscle runs horizontally to the tarsus according to the shape of muscle fibers. The capsulopalpebral fascia consisted of an anterior and posterior layer. The anterior layer reached the orbital septum and subcutaneous fat but the posterior layer forwarded into the tarsus. Lockwood’s ligament was separated from the inferior tarsal muscle and capsulopalpebral fascia or fused into the capsulopalpebral fascia.CONCLUSION: This study suggests that the inferior tarsal muscle which runs horizontally and doesn’t insert directly into the tarsus, plays an important role in the movement and localization of the lower eyelid.

Ultrasonographic visualization of lower eyelid structures and dynamic motion analysis

AIMTo define the ultrasonographic structure of normal lower eyelid anatomic compartments and their spacial relationship in dynamic motion.

Brittle deformation in the Afikpo Basin (Southeast Nigeria): Evidence for a terminal Cretaceous extensional regime in the Lower Benue Trough, Nigeria

This paper deals with the regional and structural framework of the Cretaceous rocks in the Afikpo Basin located in the southeastern part of the Lower Benue Trough. Results from regional tectonics are presented together with those of the microtectonic analysis of microfaults in the Owutu-Afikpo-Adadama area in the basin. The Owutu-Afikpo-Adadama ridge at the north-central part of the basin marks the boundary between the Late Cenomanian-Turonian-Conianian sediments and the Campanian-Maastrichtian sandstones. This ridge trends N45oE on average and is faulted in three main directions, namely: (1) N-S normal faults; (2) NE-SW strike-slip faults; and (3) NW-SE strike-slip faults. The faulted rocks along these brittle discontinuities are mainly cataclastics with internal fracture cleavage and sigmoidal quartz mosaics that are reminiscent of extensional deformation. The cataclasites often bear slickenside striations. The NE-SW and NW-SE strike-slip faults are the results of the youngest brittle events on the Owutu-Afikpo-Adadama ridge. These faults were reactivated after deposition of the Campanian-Maastrichtain sediments (post-depositional faults) and, therefore, are post-Maastrichtain. Microfault analysis of these fault trends suggests an extensional regime that prevailed in the Lower Benue Trough. These results are of significance because this event is least poorly understood and less documented in contrast to the Cenomanian and Santonian events that affected the older Cretaceous strata in this region.

A modified 3D stereophotogrammetry-based distraction test for assessing lower eyelid tension

AIM: To investigate the reliability of a modified threedimensional distraction test(3D-DT) and three-dimensional pinch test(3D-PT) for assessing lower eyelid tension(LET).METHODS: A cross-sectional study was conducted among 97 volunteer s including 97 eyelids with no history of trauma, tumor, or reconstructive surgeries. Six three-dimensional photographs were acquired for each par ticipant, including two photographs obtained in a neutral position(NP), two using a modified 3D-DT with a 15.9-grammes stainless steel eyelid hook performed, and two using 3D-PT.RESULTS: The mean absolute differences between NP, 3D-DT, and 3D-PT measurements varied between 0.07 and 7.42, 0.10 and 13.10, and 0.07 and 15.97, respectively;technical error of measurement varied between 0.05 and 7.81, 0.09 and 10.19, and 0.07 and 12.47, respectively;and relative error measurements varied between 0.10% and 11.50%, 0.16% and 30.51%, and 0.11% and 38.75%, respectively. For intra-rater reliability, the intraclass correlation coefficients(ICCs) were more than 0.80 in seven out of eight measurements obtained in the NP and 3D-DT, whereas those obtained in the 3D-PT were as low as less than 0.30 by rater 1;the ICCs of all the measurements obtained in all the positions(NP, 3D-DT, and 3D-PT) were more than 0.80 by rater 2. For inter-rater reliability six out of eight NP and 3D-DT measurements had an ICC greater than 0.80, whereas those of 3D-PT measurements were less than 0.30. For intra-method reliability, the ICCs of all the NP measurements were more than 0.87, whereas those of the six 3D-DT measurements and four 3D-PT measurements were more than 0.80.CONCLUSION: Our study results prove that the modified 3D-DT, which involves the use of an eyelid hook, can be a highly reliable method for evaluating LET. Furthermore, this novel and simple method may be utilized as the basis for further investigation and routine pre-and postoperative clinical evaluation.

不同术式治疗退行性下睑内翻的临床效果分析

目的分析2种不同术式治疗退行性下睑内翻的临床疗效。方法选取2017年3月—2020年9月在首都医科大学宣武医院诊治的退行性下睑内翻患者84例(86只眼)。按照随机数字表法分为加固组41例(42只眼)和前徙组43例(44只眼)。加固组予下睑缩肌加固联合睑板前轮匝肌缩短术;前徙组予下睑缩肌前徙联合外侧睑板条固定术。比较2组的手术时间、术后眼睑瘀血持续时长、复发率和临床疗效。结果(1)2组术前下睑前方牵拉试验、下睑侧方牵拉试验和下睑缩肌松弛试验阳性率比较,差异均无统计学意义(P>0.05)。(2)手术时间:加固组手术时间低于前徙组,差异有统计学意义(t=32.444,P=0.000)。(3)术后眼睑瘀血持续时长:加固组术后眼睑瘀血持续时长低于前徙组,差异有统计学意义(t=5.544,P=0.000)。(4)复发率和临床疗效:2组复发率和临床疗效比较,差异均无统计学意义(P>0.05),且术后均未出现严重并发症。结论下睑缩肌加固联合睑板前轮匝肌缩短术和下睑缩肌前徙联合外侧睑板条固定术均是治疗退行性下睑内翻的有效方法。但下睑缩肌加固联合睑板前轮匝肌缩短术具有手术步骤简单、手术用时短、术后眼睑瘀血轻等优点。

下睑皮肤眼轮匝肌切除术治疗儿童先天性睑内翻合并倒睫的临床及美学效果评价

目的:探究下睑皮肤眼轮匝肌切除术治疗儿童先天性睑内翻合并倒睫的临床及美学效果。方法:选取笔者医院2017年2月-2021年10月收治的80例先天性睑内翻合并倒睫患儿,按照入院顺序将患儿随机分为观察组和对照组,每组40例。对照组采用单纯下睑皮肤眼轮匝肌双层缝合术矫治,观察组采用下睑皮肤眼轮匝肌切除术矫治。比较两组患者术后1个月临床疗效、术前和术后6个月角膜散光值(Cornea cylinder,CC)、总散光值(Retinography cylinder,RC)、最佳矫正视力(Best corrected visual acuity,BCVA)以及美学评分,回访记录并比较两组患儿术后并发症发生率及复发率。结果:观察组术后1个月临床总有效率显著高于对照组(P<0.05);术后6个月,观察组患儿CC值、RC值、BCVA均显著低于对照组(P<0.05),美学评分显著高于对照组(P<0.05);观察组术后并发症发生率、复发率显著低于对照组(P<0.05)。结论:下睑皮肤眼轮匝肌切除术可有效提高先天性睑内翻合并倒睫临床疗效,改善患儿视力,降低并发症发生率及复发率,提高眼睑美观度。

改良式眼轮匝肌折叠术治疗老年复发性下睑内翻的临床效果

目的:探讨改良式眼轮匝肌折叠术治疗老年复发性下睑内翻的临床效果。方法:回顾性选取2020年9月—2022年9月于厦门市中医院治疗的102例老年复发性下睑内翻患者作为研究对象,依据不同术式分为改良组(行改良式眼轮匝肌折叠术,n=52)与常规组(行常规折叠术,n=50)。比较两组临床疗效,手术前后眼部症状评分、眼表功能,并发症。结果:改良组总有效率为98.08%,高于常规组的86.00%,差异有统计学意义(P<0.05);与常规组比较,改良组术后3个月眼部症状评分较低,泪膜破裂时间较长,泪河高度较高,差异有统计学意义(P<0.05);两组并发症发生率比较,差异无统计学意义(P>0.05)。结论:改良式眼轮匝肌折叠术能提高老年复发性下睑内翻患者临床效果,降低眼部症状评分,维持泪膜稳定性,且未增加并发症风险。

微粒脂肪注射对下睑成形术后就医者泪槽宽度和美观度的影响分析

目的:分析微粒脂肪注射对下睑成形术后就医者泪槽宽度和美观度的影响。方法:选取2022年1月-2022月11月于笔者医院接受治疗的80例泪槽畸形就医者作为研究对象,根据随机数字表法将其分为对照组40例(62眼)与研究组40例(59眼)。对照组就医者接受标准的下睑成形术,研究组就医者在手术期间收集眶下隔脂肪,下睑成形术后经皮微粒脂肪注射入眶下沟。对比两组就医者的术后情况、美观满意度以及术后并发症发生情况。结果:两组就医者的愈合情况以及随访时间比较差异无统计学意义(P>0.05);研究组就医者瞳孔到眼睑的距离、瞳孔到泪沟的距离以及泪槽宽度较对照组改善明显,且泪槽沟畸形等级量表(Tear trough rating scale,TTRS)评分低于对照组(P<0.05);1个月后研究组的美观满意度明显高于对照组(P<0.05);1个月后两组就医者出现血肿、睑外翻、肿胀等并发症的总发生率差异无统计学意义(P>0.05)。结论:在下睑成形术中进行微粒脂肪注射可安全有效地改善泪槽畸形,提高颜面部美观度。

黔南地区下石炭统打屋坝组页岩气储层孔隙结构特征及含气性评价

通过场发射扫描电镜观察、全岩X射线衍射分析、N2与CO_(2)等温吸附实验等,对黔南地区下石炭统打屋坝组页岩孔隙结构特征及含气性进行系统研究。研究结果表明:①黔南地区下石炭统打屋坝组页岩岩相类型主要为灰质页岩相和灰/泥混合质页岩相,含硅泥质页岩相少量发育;页岩有机质丰度偏低,成熟度较高。②研究区打屋坝组页岩孔隙类型可分为无机质孔隙、有机质孔隙和微裂缝,其中无机质孔隙占主导;页岩孔径分布呈多峰态,以小于1nm的微孔及2.0~2.4nm和6.0~8.0nm的低值介孔为主;页岩孔体积主要由介孔和宏孔提供,可控制游离气的赋存;页岩比表面积主要由微孔和介孔提供,可控制吸附气的赋存。③研究区打屋坝组页岩含气性主要受孔隙结构和保存条件的控制,其中孔隙结构的主要影响因素为有机质和矿物组分,有机质和黏土矿物含量对孔隙的发育具有积极作用,而脆性矿物含量在一定程度上抑制了孔隙的发育;强烈的构造变形是导致研究区页岩气保存条件较差的主要原因,可利用保存指数定性-定量评价打屋坝组页岩气的保存条件并进行有效分级。

手术治疗眼球摘除术后结膜囊畸形的下睑外翻

目的:回顾分析治疗眼球摘除术后结膜囊畸形的下睑外翻这类手术的关键技术。方法:回顾性分析2015年3月-2017年12月在笔者医院接受手术治疗的眼球摘除术后结膜囊畸形的下睑外翻患者8例(8只眼),所有患者仅行针对结膜囊畸形的手术矫正,而未采取针对下睑外翻常用的下睑全层楔形切除、外侧睑板条锚定、皮瓣法等术式。结果:8例患者均单纯行二期义眼台植入+结膜囊成形术并穹窿部弧形压管获得了深在、稳定的结膜囊,佩戴义眼片后,下睑缘位置满意,无内外翻。在无需接受任何下睑外翻矫正措施的情况下获得了满意的下睑形态及功能。结论:眼球摘除术后结膜囊畸形的下睑外翻手术关键点在于矫正眼眶凹陷,恢复结膜囊正常形态,尤其是加深下穹窿。

A型肉毒毒素联合眶隔膜张力重建术整复松弛型下睑袋

目的:探讨A型肉毒毒素(Botulinum toxin type A,BTX-A)联合眶隔膜张力重建术整复松弛型下睑袋临床效果。方法:选取2020年12月-2022年12月在笔者医院治疗的松弛型下睑袋就医者为研究对象,共87例。根据治疗方法分为实验组(n=47)和对照组(n=40),实验组行BTX-A联合眶隔膜张力重建术,对照组行眶隔膜张力重建术,术后对就医者进行随访,比较下睑袋术后效果、泪沟畸形(Barton分级)、术后外观满意度、手术并发症。结果:治疗后,实验组瘢痕宽度、VSS低于对照组(P<0.05),手术时间及切口恢复时间与对照组比较,差异无统计学意义(P>0.05);两组就医者Barton分级均有所改善,且实验组0级和1级(95.74%)高于对照组(82.50%)(P<0.05);治疗后,实验组满意度(95.74%)高于对照组(80.00%)(P<0.05);治疗后,实验组与对照组并发症发生率比较,差异无统计学意义(P>0.05)。结论:BTX-A联合眶隔膜张力重建术整复松弛型下睑袋,能够有效消除下睑袋,减少瘢痕增生,改善Barton分级构成,就医者外观满意度较高。