ObjectiveTo compare the results of internal limiting membrane (ILM) peeling with and without ILM transplantation to treat idiopathic macular hole (IMH) with hole form factor (HFF)<0.6. MethodsForty patients (40 eyes) of IMH with HFF<0.6 who underwent pars plana vitrectomy (PPV) were enrolled in this study. 20 eyes was performed PPV combined with ILM peeling (ILM peeling group), the other 20 eyes was performed PPV combined with ILM peeling and ILM transplant (ILM transplant group). The follow-up was ranged from 3 to 6 months with an average of 4 months. The changes of closing rate of hole, best corrected visual acuity (BCVA), photoreceptor inner segment/outer segment (IS/OS) junction defect diameter and amplitude of wave P1 of ring 1 and ring 2 by multifocal electroretinogram (mfERG) were comparatively analyzed for the two groups. ResultsIn 3 months after surgery, the IMH closing rate was 70% (14/20) in the ILM peeling group, and 100% (20/20) in the ILM transplant group, the difference between these two groups was significant (χ2=7.059, P<0.05). Postoperative BCVA was improved obviously in the two groups compared to preoperative BCVA, the difference was significant (t=4.017, 4.430; P<0.05). The rate of BCVA improvement in the ILM peeling group and ILM transplant group were 80% and 85%, the difference was not significant (χ2=0.173, P>0.05). The rate of significantly BCVA improvement in the ILM peeling group and ILM transplant group were 35% and 70%, the difference was significant (χ2=4.912, P<0.05). IS/OS junction defect (t=6.368, 6.635; P<0.05) and amplitude of wave P1 of ring 1 (t=2.833, 4.235) and ring 2 (t=2.459, 4.270) by mfERG in the two groups were improved after operation. The differences of postoperative IS/OS junction defect (t=2.261, P<0.05) and amplitude of wave P1 of ring 2 between the two groups were significant (t=2.282, P<0.05), but the differences of postoperative amplitude of wave P1 of ring 1 between two groups was not different (t=1.800, P>0.05). ConclusionPPV combined with ILM peeling and ILM transplantation can significantly improve the closure rate and vision of IMH with HFF<0.6.
ObjectiveTo explore the effectiveness of posterior unilateral transpedicular debridement, bone graft fusion, and pedicle screw fixation for thoracolumbar tuberculosis. MethodsBetween January 2009 and January 2013, 97 patients with thoracolumbar tuberculosis were treated with posterior unilateral transpedicular debridement, bone graft fusion, and pedicle screw fixation in 53 cases (group A), and with traditional posterior operation in 44 cases (group B). There was no significant difference in age, sex, disease duration, affected segments, Frankel grade, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), sagittal Cobb angle, visual analogue scale (VAS), and Oswestry disability index (ODI) between 2 groups (P>0.05). The surgery and follow-up results were compared between 2 groups. ResultsThe patients were followed up 24-60 months. All patients achieved intervertebral bone fusion after operation. The bone graft fusion time of groups A and B was (6.79±1.68) months and (6.89±2.00) months respectively, showing no significant difference (t=-0.251, P=0.802). There was no significant difference in operation time, intraoperation blood loss, and postoperative hospitalization time between 2 groups (P>0.05); the postoperative drainage volume of group A was significantly less than that of group B (P<0.05). The CRP and ESR at 1 year and the VAS score at last follow-up were significantly decreased when compared with preoperative values in 2 groups (P<0.05), but no significant difference was found between 2 groups (P>0.05). The Cobb angle at 1 week and at last follow-up and ODI at 3 months and at last followup were significantly improved in 2 groups (P<0.05), but there was no significant difference between the time points after operation (P>0.05). At 3 months after operation, the ODI of group A was significantly lower than that of group B (t=-2.185, P=0.027), but no significant difference was found in Cobb angle, Cobb angle loss, and ODI at other time points between 2 groups (P>0.05). At last follow-up, the Frankel classification of nerve function was improved 1-2 grades in 2 groups, showing no significant difference between 2 groups (Z=-0.180, P=0.857). No complication of internal fixation breakage or loosening was observed. ConclusionThe effectiveness of posterior unilateral transpedicular debridement, bone graft fusion, and pedicle screw fixation in the treatment of thoracolumbar tuberculosis is satisfactory, with the advantages of less trauma, strong spinal stability, and fast function recovery.
ObjectiveTo investigate the effect of perioperative allogeneic blood transfusion on the prognosis of patients with non-small cell lung cancer (NSCLC).MethodsThe databases including PubMed, The Cochrane Library, EMbase, CNKI, Wanfang Data, VIP and CBM were searched for literature about the effects of perioperative allogeneic blood transfusion on the prognosis of patients with NSCLC from the inception to May 2020. Two authors independently screened the literature, extracted and cross-checked data, and negotiated to resolve differences in opinions. Review Manager V5.3 (Cochrane Collaboration, Oxford, UK) software was used for data analysis.ResultsA total of 15 articles were included, including 5 897 patients. There were 1 649 patients in the trial group and 4 248 patients in the control group. The results of meta-analysis showed that the overall survival of the control group was significantly higher than that of the trial group (OR=0.58, 95%CI 0.47-0.70, P<0.000 01). The disease-free survival of the control group was significantly higher than that of the trial group (OR=0.43, 95%CI 0.36-0.52, P<0.000 01). The recurrence rate of the control group was significantly lower than that of the trial group (OR=1.85, 95%CI 1.34-2.55, P=0.000 2).ConclusionPerioperative allogeneic blood transfusion has adverse effects on the recurrence and survival of patients with NSCLC.
Abstract: Objective To observe the combined protective effects of U50 488H and hypothermia preservation on isolated rabbit hearts preconditioned. Methods Forty rabbits were randomly divided into five groups, 8 rabbits in each group. The perfusion model of isolated rabbit hearts was established by the Langendorff device. In the control group: the isolated rabbit hearts were preserved with the University of Wissconsin solution (UW ) for six hours; groupI : the isolated rabbit hearts were preconditioned with St. ThomasII cardioplegic solution containing U50 488H (1. 6mmo l/L ) and then preserved with hypothermic preservation for four hours; groupII ; the precondition was the same as group II , hypothermic preservat ion fo r six hours; group III : the precondit ion was the same as group I , hypothermic preservation for eight hours; group IV : the precondit on was the same as group I , hypothermic preservation for ten hours. The cardiac function, myocardial sarcoplasmic reticulum calcium ion adenosine triphosphatase (SRCa2+ -ATPase) act ivity and calcium ion concentrations in mitochondria were determined at thirty minutes after reperfusion. Results As the hypothermic preservation time increased from four to ten hours, the recovery rate of each index of cardiac function, coronary artery flow (Cf) and SRCa2+ -ATPase activity also decreased, but the calcium ion concentrations in the mitochondria increased. Cardiac function index recovery rates in group I and group II w ere higher than those in group III and groupIV respectively (P lt; 0. 05, 0. 01) ,meanwhile recovery rates of cardiac function index in group III were higher than that in group IV (P lt; 0. 05). Recovery rate of Cf in groupII ( 84. 56%±10. 38%)were higher than those in group III (79. 45%±9. 67% ) and group IV (68. 31%±6. 84% , P lt;0.01) , meanwhile the recovery rate of Cf in group III was higher than that in group IV (P lt; 0. 05). SRCa2+ -A Tpase activity in group II (4. 43±0. 41μmo l/m g?h)were higher than those in control group (3. 04±0. 22Lmo l/mg?h ) , group III (3. 26±0. 29Lmo l/m g?h) and group IV (2. 57±0. 63Lmo l/m g?h, P lt; 0. 05) , SRCa2+ -ATPase activity in group III was higher than that in group IV (P lt; 0. 01). The calcium ion concentrations in mitochondria in group II (38176±4. 30μmo l/g ?dw ) and in the control group (40. 23±3. 75μmol/g ?dw )were less than those in group III (43125±5116μmol/g?dw ) and groupIV (45. 78±3. 26μmol/g?dw , P lt; 0. 05, 0. 01) respect ively. Conclusion The hypothermic preservation time for isolated dono r’s hearts p re-treated with St. Thomas II cardioplegic solution containing U 50 488H should the kep tunder 8h. The myocardial protection effects of both UW solution and U50 488H- containing St. Thomas II cardioplegic solution on isolated dono r’s hearts appear to be the same at 6 hours.
ObjectiveTo observe the clinical effect of intravitreal injection of tissue plasminogen activator (t-PA), ranibizumab and C3F8 in the treatment of early submacular hemorrhage (SMH) induce to polypoid choroidal vasculopathy (PCV).MethodsThe clinical data of 20 eyes of 20 patients with early SMH induce to PCV were enrolled in this study. The duration of bleeding in the eye was 7 to 28 days, and the mean duration of bleeding was 14.8±5.6 days. All eyes are measured using the Snellen chart best corrected visual acuity (BCVA), logarithm of the minimum angle of resolution (logMAR) was used to calculate visual acuity. Measure central retinal thickness (CRT) and central retinal pigment epithelial detachment (PED) thickness using frequency-domain optical coherence tomography. The average logMAR BCVA of eyes was 1.73±0.91; the mean CRT was 620.0±275.8 μm; the average central PED thickness was 720.3±261.9 μm. All eyes receive intravitreal injection of t-PA, ranibizumab and C3F8. The intravitreal injection of ranibizumab was administered once a month for 3 consecutive months, followed by an on-demand treatment plan. Mean follow-up time was 9.9±3.6 months. The changes in BCVA, CRT, central PED thickness and clearance degree of SMH at 6 months after treatment were observed.ResultsOn the 6 months after treatment, the average logMAR BCVA, CRT and central PED thickness of the eyes were respectively 0.42±0.37, 290.2±97.4 μm and 41.6±78.1 μm. Compared with baseline, the after treatment BCVA was significantly increased (F=38.14, P=0.000), but the CRT and central PED were significantly decreased (F=7.48, 75.94; P=0.000, 0.000). Among the 20 eyes, 16 eyes of SMH was completely cleared, accounting for 80%;4 eyes was partially cleared, accounting for 20%. No recurrence and systemic or local complications occurred during follow-up of all eyes.ConclusionIntravitreal injection of t-PA, ranibizumab, and C3F8 in the treatment of early SMH induce to PCV can effectively remove SMH, improve vision, reduce CRT and central thickness of PED.