[A multi-center, randomized controlled study on the effect of Saccharomyces boulardii combined with triple therapy for the initial eradication of Helicobacter pylori infection].

Objective: To assess the efficacy and safety of Saccharomyces boulardii (S. boulardii) in combination with triple therapy as a first-line regimen for the eradication of Helicobacter pylori (H. pylori) in non-ulcer dyspepsia (NUD) patients. Methods: A total of 497 Helicobacter pylori-positive patients who underwent gastroscopy and diagnosed with NUD were enrolled from June 2018 to January 2020 in 9 medical centers across China. Participants were segmentedly randomly divided into 3 groups. Patients in group A received S. boulardii for 14 days and triple therapy for 10 days, while patients in group B received bismuth quadruple group for 10 days, and patients in group C received triple therapy for 10 days. The H. pylori status was determined by the 13C-urea breath test on the 44th day of the treatment. Symptom improvement and adverse reactions were assessed on the 14th and 44th day. Results: There were 229 males and 268 females in all 497 patients enrolled. They were aged 18-69 (46.1±11.8) years and 472 of them (158 cases in group A, 159 cases in group B, and 155 cases in group C) completed the trial. The intention-to-treat (ITT) eradication rates in patients in patients A, B and C were 77.8% (126/162), 80.1% (137/171) and 65.2% (107/164) respectively, and per protocol-based (PP) eradication rates were 79.7% (126/158), 86.2% (137/159) and 69.0% (107/155) respectively. The differences were statistically significant in ITT and PP analysis among 3 groups (ITT: χ²=11.14, P<0.01; PP: χ²=13.86, P<0.01). There was no significant difference between eradication rates of two quadruple therapys(all P>0.05), but both of them were significantly higher than that of standard triple therapy (both P<0.05). Statistics revealed that both quadruple therapys led to significantly higher symptom improvement of belching compared with that of standard triple therapy in day 14 (P<0.05). The relief of abdominal distension and belching symptom scores of group A were significantly higher than those of group C in day 44(all P<0.05). There was no serious adverse event reported. The incidence of diarrhea in group A was significantly lower than those in the other two groups (both P<0.05). Conclusions: The combination of S. boulardii and triple therapy can achieve a better eradication effect on H. pylori infection with NUD, and has advantages in symptom relief and safety.

[The influence of patellofemoral joint degeneration on outcome of Oxford medial unicompartmental knee arthroplasty].

Objective: To explore the influence of lateral patellofemoral joint degeneration on the treatment of anteromedial osteoarthritis of knee joint by Oxford medial unicompartmental knee arthroplasty. Methods: The clinical data of 73 patients (73 knees) with knee osteoarthritis underwent unicompartmental knee arthroplasty at Department of Orthopaedic Surgery, Xuanwu Hospital, Capital Medical University from March 2016 to December 2017 were analysed respectively.There were 18 males and 55 females, aged (68.6±7.5) years(range: 53 to 89 years).The lateral patellofemoral joints of patients were evaluated by Ahlback grading system. Patients with Ahlback 0 andⅠ were in the non degenerative group (37 cases), and those with Ahlback Ⅱ and above were in the degenerative group (36 cases). Hospital for special surgery knee score(HSS) and the Western Ontario and McMaster Universities(WOMAC) osteoarthritis index, as well as the condition of kneeling, sit to stand movement, up stair and down stair were recorded. The data before and after operation were compared by paired sample t test, and the data between groups were compared by independent sample t test. χ(2) test was used for counting data. Pearson correlation analysis was used to compare the correlation between ahlback score, HSS and WOMAC osteoarthritis index. Results: The follow-up time was (35.1±6.6) months (range: 25 to 47 months).The knee function of the patients improved significantly after operation.The HSS score increased from 57.7±11.8 preoperative to 81.8±7.8 postoperative (t=16.64, P=0.00) and WOMAC osteoarthritis index decreased from 48.9±13.4 preoperative to 15.6±8.8 postoperative (t=20.48, P=0.00). There was no statistical difference in the change of HSS between the degenerative group and the non-degenerative group before and after surgery(27.5±12.2 vs. 22.5±12.3, t=-1.65, P=0.10) as well as the change of WOMAC osteoarthritis index(31.8±14.0 vs. 36.4±13.7, t=-1.35, P=0.18), but the lateral patellofemoral joint degeneration was related to inability to complete squats (χ(2)=5.17, P=0.04) and sitting up (χ(2)=7.22, P=0.01). Conclusion: The degeneration of lateral patellofemoral joint has no effect on the early functional recovery of patients with anteromedial knee osteoarthritis after Oxford medial unicompartmental knee arthroplasty.

Rehabilitation of oral function with removable dentures--still an option?

Tooth loss is a chronic disability, which makes it difficult for patients to perform essential tasks such as eating, communicating with others and socialising. Numerous studies have revealed and addressed the recent rapid development of various prosthodontic materials and treatment patterns. Oral rehabilitation with dentures exerts a great influence on people's daily life and has tremendous social implications. Dentures help to restore an individual's sense of normality and ability to interact normally. With the introduction and progression of implant technology, many troublesome issues can now be solved simply. Nowadays, more and more attention has been paid to new trends (implant-assisted restoration and fixed prostheses). However, removable dentures may be a more appropriate solution under some circumstances, such as if they are a patient's preferred option, if remaining oral tissues are in poor condition, or if they provide the most cost-effective form of treatment. Thus, removable dentures are still an option for the rehabilitation of oral function. The purpose of this article was to retrospectively review the applications of removable dentures and to emphasise their indispensable status.

[Optimized pathway to schistosomiasis elimination in China: a scrutiny using a marginal benefit approach].

Following concerted efforts for over 7 decades, great achievements have been gained in the national schistosomiasis control program of China. Currently, China is moving towards the stage of schistosomiasis elimination, when the major task is to make full use of available resources to improve schistosomiasis surveillance and response to sustainably consolidate gained schistosomiasis control achievements and prevent re-emerging schistosomiasis. There is therefore an urgent need for optimization of interventions for schistosomiasis elimination. Based on analysis of socioeconomic features at different stages of the national schistosomiasis control program in China, this review discusses the relationship between the needs of assessment of schistosomiasis elimination interventions and the optimized strategy of schistosomiasis elimination at different stages of the national schistosomiasis control program using a marginal benefit approach and proposes the optimized schistosomiasis elimination strategy that allows the highest marginal benefit with currently available schistosomiasis elimination costs, so as to provide the optimal strategic pathway to schistosomiasis elimination and facilitate the achievement of the targets set in Healthy China 2030.

Hybrid Exercise Program Enhances Physical Fitness and Reverses Frailty in Older Adults: Insights and Predictions from Machine Learning.

PURPOSE: The declining physical condition of the older adults is a pressing issue. Wu Qin Xi exercise, despite being low-intensity, is highly effective among older adults. Inspired by its characteristics, we designed a new exercise program for frail older adults, combining strength, endurance, and Wu Qin Xi. Furthermore, we employed machine learning to predict whether frailty can be reversed in older adults after the intervention. METHODS: A total of 181 community-dwelling frail older adults aged 65 years or older participated in this single-center, randomized controlled study, with 54.7% (n=99) being female. The study assessed the effectiveness of several exercise modalities in reversing frailty. The Fried's frailty criterion was used to assess the degree of frailty of the subjects. Participants were assigned a three-digit code 001-163 and randomly assigned (1:1:1) by computer to three different groups based on the study participant number: the Wu Qin Xi group (WQX), the strength exercise mixed with endurance exercise training group (SE), and the WQXSE hybrid exercise group incorporated the above two. Body composition and frailty-related physical fitness factors were measured before and after a 24-week intervention. The measurements included Body height, Body mass, Timed Up and Go Test (TUGT), grip strength assessment (GS), 6min walk test (6 min WT), and 10 m maximum walk speed (10 m MWS). Data were analyzed using repeated measures ANOVA to determine group and time interaction effects and machine learning models were used to predict program effectiveness. RESULTS: A total of 163 participants completed the study, with 53.9% (n=88) of them being female. The two items, 10 m maximum walking speed (10 m MWS) and grip strength, were significantly affected by the interaction of group and time. Compared to the other two groups, the WQXSE group showed the most improvement in the item 10 m MWS. In addition, following 24 weeks of training, 68 (41.7%) of the initially frail older adults had reversed their frailty status. Among them, 19 (36.5%) were in the WQX group, 24 (44.4%) were in the WQXSE group, and 25 (43.9%) were in the SE group. The stacking model exhibited superior performance when compared to other algorithms. CONCLUSION: A hybrid exercise regimen comprising the Wu Qin Xi routine and exercises focused on both strength and endurance holds the potential to yield greater improvements in the physical fitness of older adults, as well as reducing frailty. Leveraging a stacking model, it is possible to forecast the likelihood of older adults successfully reversing their frailty status following participation in a prevention exercise program.

Endovascular treatment for the spontaneous rupture of a non-aneurysmal subdiaphragmatic aorta.

The case of a patient who underwent an endovascular aortic repair for a spontaneous rupture of a non-aneurysmal subdiaphragmatic aorta without trauma, infection, or inflammation is reported. The patient is a 51-year-old male diagnosed with subdiaphragmatic aortic rupture and was in a state of hemorrhagic shock upon admission to the hospital. Intraoperative aortography revealed the abdominal aortic rupture site located above the celiac artery. A coated thoracic stent graft was used. Completion angiography showed a total exclusion with no endoleaks. After six months of follow-up, computed tomographic scans confirmed the absence of endoleaks or graft displacements.

[Clinical effects of free hallux-nail flap combined with the second toe composite tissue flap in the reconstruction of damaged thumb after electrical burns].

Objective: To explore the clinical effects of free hallux-nail flap combined with the second toe composite tissue flap in the reconstruction of damaged thumb after electrical burns. Methods: A retrospective observational study was conducted. From May 2018 to April 2021, 12 male patients with thumb destructive defects caused by electrical burns who met the inclusion criteria were admitted to Zhengzhou First People's Hospital, aged 27 to 58 years, including 10 cases with degree Ⅲ thumb defect and 2 cases with degree Ⅳ thumb defect after thorough debridement. The thumb was reconstructed with free hallux-nail flap combined with composite tissue flap of the second phalangeal bone, joint, and tendon with skin island. The donor site of hallux-nail flap was covered with artificial dermis in the first stage and performed with continuous vacuum sealing drainage, and covered with medium-thickness skin graft from the groin site in the second stage. The donor site in the second toe was filled and fixed with iliac bone strips. The survival of reconstructed thumb was observed 1 week after the reconstruction surgery, the survival of skin graft in the donor site of hallux-nail flap was observed 2 weeks after skin grafting, and the callus formation of the reconstructed thumb phalanx and the second toe of the donor foot was observed by X-ray 6 weeks after the reconstruction surgery. During the follow-up, the shape of reconstructed thumb was observed and the sensory function was evaluated; the function of reconstructed thumb was evaluated with trial standard for the evaluation of the functions of the upper limbs of the Hand Surgery Society of the Chinese Medical Association; whether the interphalangeal joints of the hallux and the second toe were stiff, the scar hyperplasia of the foot donor site, and whether the walking and standing functions of the donor feet were limited were observed. Results: One week after the reconstruction surgery, all the reconstructed thumbs of the patients survived. Two weeks after skin grafting, the skin grafts in the donor site of hallux-nail flap of 11 patients survived, while the skin graft in the donor site of hallux-nail flap of 1 patient was partially necrotic, which was healed completely after 10 days' dressing change. Six weeks after the reconstruction surgery, callus formation was observed in the reconstructed thumb and the second toe of the donor foot of 10 patients, the Kirschner wires were removed; while callus formation of the reconstructed thumb was poor in 2 patients, and the Kirschner wires were removed after 2 weeks of delay. During the follow-up of 6 to 24 months, the shape of reconstructed thumb was similar to that of the healthy thumb, the discrimination distance between the two points of the reconstructed thumb was 7 to 11 mm, and the functional evaluation results were excellent in 4 cases, good in 6 cases, and fair in 2 cases. The interphalangeal joints of the hallux and the second toe of the donor foot were stiff, mild scar hyperplasia was left in the donor site of foot, and the standing and walking functions of the donor foot were not significantly limited. Conclusions: The application of free hallux-nail flap combined with the second toe composite tissue flap in the reconstruction of damaged thumb after electrical burns adopts the concept of reconstruction instead of repair to close the wound. It can restore the shape and function of the damaged thumb without causing great damage to the donor foot.

The role of robotic assisted laparoscopy for oesophagogastric oncological resection; an appraisal of the literature.

The introduction of surgical robotics to the field of surgical oncology brings with it an expectation not only of improved vision, instrumentation, and precision but also as a result, a potential for improved oncological outcomes. The current interest in the field of oesophagogastric oncology is explored in this review together with the benefits, real and potential, that robotic assistance offers surgical cancer resection as well as some of the limiting factors which may be hampering its uptake into current surgical practice. A systematic review of all the published literature up until April 2010 was examined across the field of esophageal and gastric cancer resection. A quantitative assessment of the oncological, operative, and functional outcomes was determined from each procedure. The level of evidence behind the results was determined using the Oxford Centre for Evidence-based Medicine Levels of Evidence; Therapy and Prevention. Three hundred and five cases from 19 independent studies were included for review. Nine studies explored the outcomes from robotic-assisted esophagectomy and eight, the robotic-assisted gastrectomy. Two articles included small case series of both procedures. The level of evidence was predominantly based on case series or expert opinion (Level 4 or 5) with only three unmatched or poorly matched comparative trials (Level 4) with no randomized trials evident. Improved operative outcomes and hospital stays were demonstrated with a reduction of 2 days when the robotic-assisted gastrectomy technique was employed compared with the open. No improvement in oncological outcomes could be identified with the use of the robot for either oesophageal or gastric cancer resection; however, in terms of short-term oncological outcomes, these were at least equivalent to the open approach for oesophageal cancer and early stage gastric cancer. Robotic-assisted laparoscopic surgery is a feasible technique to use to perform a safe and oncologically sound resection for oesophageal and early gastric cancer. Operative benefits appear to be encouragingly similar to the laparoscopic approach with some demonstration of improvement over the open technique despite a prolonged operative time. However, the level of evidence is suboptimal and more randomized controlled trials and long-term survival studies within a framework of measured and comparable outcomes is required.

[Effect of imatinib on the height of children with chronic myeloid leukemia in the chronic phase].

Objective: To evaluate the effect of imatinib on growth impairment in children with chronic myeloid leukemia (CML-CP) in the chronic phase. Methods: From July 2018 to July 2019, questionnaires were distributed to CML children aged <18 years at the time of diagnosis who were receiving imatinib for at least 3 months or to their parents in China. The height-for-age standard deviation score (HtSDS) and the difference of standard deviation integral (△HtSDS) were used to explore the change in height with imatinib therapy. Results: The data of 238 respondents were included; 138 (58.0% ) respondents were men. The median age at the first diagnosis of CML was 11.0 years (range, 1.4-17.9 years) , and 93 (39.0% ) respondents were at the prepuberty stage. At the time of completing the questionnaires, the median age was 15.0 years (range, 2.0-34.0 years) . The median duration of imatinib therapy was 28 months (range, 3-213 months) . Among all the respondents, the mean HtSDS when completing the questionnaires (-0.063±1.361) was significantly lower than that at the time of starting imatinib treatment (0.391±1.244) (P<0.001) . Total 71.0% respondents showed growth impairment that was more common in those starting imatinib therapy at prepubertal age than in those starting at pubertal age. Multivariate analysis showed that younger at the start of imatinib therapy (P<0.001) and longer duration of imatinib therapy (P<0.001) were significantly associated with severe growth impairment on imatinib therapy. Conclusions: Imatinib induced growth impairment in children with CML-CP. Younger the age of initiation and longer the duration of imatinib therapy, more obvious the effect of imatinib on growth impairment.

Thromboprophylaxis rates in US medical centers: success or failure?

BACKGROUND: As hospitalized medical patients may be at risk of venous thromboembolism (VTE), evidence-based guidelines are available to help physicians assess patients' risk for VTE, and to recommend prophylaxis options. The rate of appropriate thromboprophylaxis use in at-risk medical inpatients was assessed in accordance with the 6th American College of Chest Physicians (ACCP) guidelines. METHODS: Hospital discharge information from the Premier Perspective(trade mark) inpatient data base from January 2002 to September 2005 was used. Included patients were 40 years old or more, with a length of hospital stay of 6 days or more, and had no contraindications for anticoagulation. The appropriateness of VTE thromboprophylaxis was determined in seven groups with acute medical conditions by comparing the daily thromboprophylaxis usage, including type of thromboprophylaxis, dosage of anticoagulant and duration of thromboprophylaxis, with the ACCP recommendations. RESULTS: A total of 196 104 discharges from 227 hospitals met the inclusion criteria. The overall VTE thromboprophylaxis rate was 61.8%, although the appropriate thromboprophylaxis rate was only 33.9%. Of the 66.1% discharged patients who did not receive appropriate thromboprophylaxis, 38.4% received no prophylaxis, 4.7% received mechanical prophylaxis only, 6.3% received an inappropriate dosage, and 16.7% received an inappropriate prophylaxis duration based on ACCP recommendations. CONCLUSIONS: This study highlights the low rates of appropriate thromboprophylaxis in US acute-care hospitals, with two-thirds of discharged patients not receiving prophylaxis in accordance with the 6th ACCP guidelines. More effort is required to improve the use of appropriate thromboprophylaxis in accordance with the ACCP recommendations.

[The radiologic study of the nasolacrimal duct decompression surgery for treatment of chronic].

Objective:To explore the possibility of endoscopic nasolacrimal duct decompression surgery for the treatment of chronic dacryocystitis.Method:①Twenty-two eyes with chronic dacryocystitis were treated with 30% iohexol injection for lacrimal sac lithography. Contrast agents were taken from the lacrimal canal reflux to stop the injection. The CT scan for the lacrimal passage was performed immediately. ②Three-dimensional reconstruction of lacrimal duct and its surrounding structures was performed with Sinuses Trachea Ⅰ software. ③The lacrimal sac and nasolacrimal canal were cut and depressed using this software simulation.Result:①The incidence of lacrimal duct obstruction were 4.5% (1/22, in lacrimal duct), 22.7%(5/22, in lacrimal sac), 13.6%(3/22, transition section), 36.4%(8/22, in nasocrimal duct), and 22.7%(5/22, in Hasner valve) separately. The transitional section, nasolacrimal duct, Hasner valve section 72.7%(16/22) totally. ②The lateral wall of the nasolacrimal duct in 3D visual model is constructed of maxillary lacrimal process. The interior wall of the nasolacrimal duct is made of drop process of lacrimal bone and ascending lacimal process of the inferior turbinate. ③Observed from the inferior meatus, hard nasolacrimal duct is surrounded by inferior turbinate bone, and forms the inside wall of openings of the lacrimal duct. ④The removal of the front parts of the inferior turbinate attached to the lateral nasal can lead to the deperession of the membranous nasolacrimal duct sufficiently, and create the efficient space to eliminate nasolacrimal duct obstruction. Conclusion:Endoscopic nasolacrimal duct decompression surgery is efficacy for the treatment of chronic dacryocystitis. The integrity of the membranous lacrimal duct was reserved, and the complication such as lacrimal sac granulation hyperplasia, lacrimal duct obstruction again caused by scar formation was avoided.

Evaluating the dynamical characteristics of particle matter emissions in an open ore yard with industrial operation activities.

A study to investigate the dynamical characteristics of particle matter emissions in a working open yard is conducted in Caofeidian Port of Hebei Province, China. The average diurnal concentrations of the total suspended particulate (TSP) matter and respirable particulate matter (PM10 and PM5) are monitored during the field measurement campaign. Sampling is performed at a regular interval at 8 monitoring stations in the yard with normal industrial activities. The average TSP, PM10 and PM5 concentrations range from 285 to 568, 198 to 423 and 189 to 330 µg.m-3 in the yard, respectively. The linear regression correlation coefficient of TSP/PM10 and TSP/PM5 is 0.95±0.01 and 0.88±0.02, respectively.By using the Spearman correlation method, the wind speed and relative humidity are both weakly correlated with the PM10 and PM5 concentrations according to the measurements. In addition, industrial operation activities, such as vehicular traffic in the yard and the loading time of stackers, are significantly positively correlated with the PM concentration. Using the multivariate regression method, the main parameters influencing the TSP concentration variations are integratedly analysed. The traffic volume is found to be a significant predictor of TSP concentration variation, with the smallest P value (P<0.05).To understand the dynamical characteristics of particle emissions in the yard, the emissions from the truck transports, that is, from unpaved haul roads and from the loading process, are established. Then, the dynamical emission factor (EFD) based on the industrial activities in the yard is proposed. The dynamical emissions average 5.25x105 kg.year-1 and EFD is evaluated to be 0.29 kg.(ton.day)-1 during the measurement period. These outcomes have meaningful implications not only for understanding the dynamical characteristics of particle emissions in the working stockyard but also for implementing effective control measures at appropriate sites in the harbour area.

Polyphenols as inhibitors of carcinogenesis.

Many polyphenolic compounds have demonstrated anticarcinogenic activities in animal models. These compounds include flavanone, flavonols, isoflavone, and catechins. In this article, tea catechins will be used as an example to illustrate current research in this area. Many laboratory studies have demonstrated the inhibition of tumorigenesis in animal models by different tea preparations. The animal models include tumorigenesis in the mouse lung, rat and mouse esophagi, mouse forestomach, mouse skin, mouse duodenum, rat small intestine, rat and mouse livers, and rat colon. In most of the studies, the inhibitory activity of tea could be demonstrated when tea preparations were given either during or after the carcinogen treatment period. Black tea was also effective, although the activity was weaker than green tea in some experiments. Decaffeinated tea preparations were also active in many model systems. The molecular mechanisms for these broad inhibitory actions are not fully understood. They are most likely related to the biochemical actions of the tea polyphenols, which include antioxidative activities and inhibition of cell proliferation and of tumor promotion-related activities. The effect of tea consumption on human cancers is not clear in spite of numerous investigations. The bioavailability and pharmacokinetics of tea polyphenols are being studied in animals and humans to provide a basis for more quantitative analyses on the effect of tea on carcinogenesis. More mechanistic and dose-response studies will help us to understand the effects of tea consumption on human carcinogenesis.

Studies on human dietary requirements and safe range of dietary intakes of selenium in China and their application in the prevention of related endemic diseases.

The human dietary selenium requirement in China has been estimated by various methods. The minimum dietary selenium requirement for the prevention of Keshan disease (KD) was found to be around 17 micrograms/d. On the other hand, an intake of 40 micrograms/d is required to maintain the plasma glutathione peroxidase (GPx) activity at plateau. Hence 40 micrograms/d is considered as the adequate dietary selenium requirement. Studies conducted in a chronic selenosis area indicate that the toxic dietary selenium intake (adverse effect level), which would maintain the characteristic fingernail changes, was approximately 1600 micrograms/d. The mean value of dietary selenium intakes, which enabled the five patients to recover from fingernail lesions, was found to be 819 +/- 126 micrograms/d. At a 95% confidence limit, the lower limit is around 600 micrograms/d. Therefore, 600 and 400 micrograms/d were suggested as the individual daily maximum safe selenium intake and the safe dietary selenium intake, respectively. The results were used in the prevention of Se-related endemic KD and Kashin-Beck disease (KBD).

[The renal function protection of prostaglandin E1 from hemolysis caused by cardiopulmonary bypass].

OBJECTIVE: To observe the renal function protection of PGE1 from hemolysis caused by CPB during and after CPB. METHOD: F-Hb in blood, NAG & beta 2-MG in urine were measured in twenty patients who underwent valvular replacement operation. The patients were divided into two groups at random. The PGE1 group was administered of PGE1 with the dose of 100 ng/kg.min for 30' before CPB, 30 ng/kg.min during CPB intravenation and 100 ng/ml before CPB in CPB mechanical equipment. The control group was administered of N. S. RESULTS: After termination of CPB, F-Hb rose continuously, showing that the damaging RBC factors did not stop working at once after CPB. F-Hb and beta 2-MG were positively correlated and F-Hb and NAG/Cr were positively correlated, demonstrating that increased F-Hb is an important factor for renal function damage. At 60 minutes after CPB and 120 minutes after CPB, F-Hb values of PGE1 group were significantly lower than those of the control group. beta 2-MG and NAG/Cr of the PGE1 group also showed the same trend. The peak of the control group F-Hb was later than that of the PGE1 group. CONCLUSIONS: The results demonstrate that PGE1 can protect renal function by decreasing F-Hb level during CPB and shortening the time of hemolysis after CPB.

[Selection of treatment modality for developmental glaucoma].

53 cases of developmental glaucoma were analyzed with regard to results of treatment and factors involved. Poor compliance was found a major problem, and a number of patients did not respond well to medical treatment. Surgical intervention was indicated for patients with (1) unsatisfactory medical control of IOP, (2) inadequate recognition of the severity of their case, (3) inaccessibility to prompt treatment when needed, (4) occurrence of progressive visual field defects and optic disk damages, and (5) the other eye already in the terminal stage of glaucoma.

[Analysis, prospect and treatment of causes of phacoemulsification complications].

OBJECTIVE: To analyse the causes of different complications of phacoemulsification and to investigate their principles of treatment and prevention. METHOD: The causes of different complications in 187 (180 cases) of 2,250 eyes having undergone phacoemulsification were analyzed. RESULTS: Intraoperatively, the common complications of phacoemulsification were posterior capsular rupture in 70 eyes (3.1%), iris damage in 16 eyes (0.7%), iris prolapse in 6 eyes (0.3%), drop of lens fragments into vitreous in 3 eyes (0.1%) and tear of Descernent's membrane in 4 eyes (0.2%). The common complications after the operation were corneal endothelial edema in 89 eyes (4.0%), corneal decompensation in 2 eyes (0.1%), temporary intraocular hypertension in 28 eyes (1.2%), pupillary dilatation in 7 eyes (0.3%), retinal detachment in 8 eyes (0.4%), cystoid macular edema in 24 eyes (1.1%) and displacement of intraocular lens in 8 eyes (0.4%). CONCLUSIONS: The different complications can be diminished following the popularization and development of phacoemulsification. It should be properly managed once the complication has occurred, and good operative effects can be obtained.

Efficacy of endoscopic stapled transanal rectal resection for the treatment of rectocele.

OBJECTIVE: The objective of the study was to determine the efficacy of endoscopic stapled transanal rectal resection for the treatment of rectocele. PATIENTS AND METHODS: For this purpose, the data were collected from 61 patients with severe rectocele that underwent endoscopic stapled transanal rectal resection within the time period from April 2010 to April 2012. The pre- and post-operative Longo's obstructed defecation syndrome (ODS) were compared. The reduction of the rectocele was assessed by defecography on visit and from patients' satisfaction obtained through following up. RESULTS: We found that the postoperative Longo's ODS was significantly lower than the preoperative value (p < 0.01); and defecography showed that the rectocele was significantly reduced or disappeared. Furthermore, 57 of the 61 (93.4%) patients expressed their satisfaction at follow up. CONCLUSIONS: The endoscopic stapled transanal rectal resection can be recommended as the treatment of choice for rectocele since it is an easy-to-perform procedure that has satisfactory short and mid to long-term therapeutic efficacy.

The rhPTH (1-34), but not elcatonin, increases bone anabolic efficacy in postmenopausal women with osteoporosis.

PURPOSE: Intermittent administration of recombinant human PTH [rhPTH (1-34)] exerts an osteoanabolic effect characterized by direct effects on bone formation, increases bone density, and reduces fracture risk. This study was to investigate the anabolic effects of rhPTH(1-34) on postmenopausal osteoporosis in an Asian population and compare the time course and alteration in bone turnover marker (BTM) during rhPTH(1-34) and elcatonin treatment. METHODS: 124 women with postmenopausal osteoporosis were enrolled in this prospective, open-label, active-controlled trial. The patients randomized to subcutaneous rhPTH(1-34) (20 ug, once daily) or elcatonin (200U, once week) injections for 12 months. Biochemical markers of bone formation (bone specific alkaline phosphatase [BSAP]), and bone resorption maker (serum C-telopeptide of type I collagen [CTX-I] were measured at baseline and at 0, 6, and 12 months. RESULTS: At 12 months, rhPTH (1-34) significantly increased lumbar spine BMD significantly compared with baseline, whereas elcatonin was ineffective. BSAP levels were gradually increased in almost all rhPTH(1-34)-treated subjects and at the end of the study, the percentage of subjects with BSAP above the postmenopausal reference interval was gradually increased as high as 91.5% at month 12. Opposite trends in percentages for CTX-I was observed in rhPTH(1-34). With rhPTH(1-34), but not elcatonin, there were significant positive correlations between ratio of BSAP and CTX-I and bone mineral density (BMD) (r=0.318) at the end of month 12. Both treatments were well tolerated and there were no significant differences detected between the 2 groups in the proportion of any adverse events and any serious adverse events. CONCLUSIONS: rhPTH (1-34) has more positive effects on bone formation than elcatonin for postmenopausal women with osteoporosis and was proved to be safe and well tolerated. The ratio of BSAP and CTX-I may be a useful indicator for positive bone formation.