[Ophthalmic surgical robot-assisted retinal puncture and injection for submacular hemorrhage caused by polypoid choroidal vasculopathy: a case report].

A 65-year-old man presented with decreased visual acuity in the left eye for 1 month. The diagnosis of hemorrhagic retinal detachment (submacular hemorrhage), which was caused by idiopathic polypoid choroidal vasculopathy, was confirmed by the ultra-wide-angle fundus examination, optical coherence tomography, and B-ultrasound. A vitrectomy combined with an ophthalmic surgical robot-assisted retinal puncture and injection was performed. The recombinant tissue plasminogen activator was injected accurately by the ophthalmic surgical robot between the retinal nerve epithelium and retinal pigment epithelium through a micro-injection needle. During the 2-month follow-up, the subretinal hemorrhage was significantly regressive, the visual acuity of the left eye was improved from hand movement to 0.1, and no other complications were observed.

[Percutaneous full-endoscopic removalof lumbar dumbbell tumors viatransforaminal approach].

Objective: To investigate the novel application and effectof Percutaneous Full-Endoscopic transforaminal approach for lumbar dumbbell tumors. Methods: A retrospective analysis of 12 cases of lumbar dumbbell tumors was conducted by Percutaneous full-endoscopic transforaminal approach in the Department of Neurosurgery, Fujian Medical University Union Hospital from Feb, 2018 to Jul, 2019. According to Eden classification, 5 cases in type Ⅲ and 7 cases in type Ⅳ. The Japanese Orthopaedic Association (JOA) score and Pain Visual analogue Scale (VAS) were used to compare the recovery of neurological function before and after surgery. Results: All the 12 tumors were completely removed in one stage. The pathological reports were all schwannomas (WHO grade Ⅰ). The VAS scores were significantly decreased compared with preoperative ones (P<0.001). The JOA scores were significantly improved without obvious complications and spinal instability. Median length of follow-up was 14 months with a range of 4 months to 20 months, there is no tumor recurrence and spinal instability. Conclusion: In the treatment of lumbar dumbbell spinal tumor, the full endoscopic transforaminal approach is a novel, safe and effective surgical procedure which removes the tumors intra-foramen and extra-foramen with less damage of spine, smaller possibility of instability and faster recovery.

[Ventricular arrhythmias in patients with cor pulmonale].

This paper reported the results of 24 hours continuous ECG, day time and overnight arterial blood gas/pH and serum electrolytes in 20 patients with cor pulmonale, in order to investigate the rule of changes of ventricular arrhythmias (VA). The results were as follows: (1) Incidence of VA in 24 hours Holter Monitoring was 100%. (2) Frequent VPBs were increased significantly in period of acute attack (40%, P less than 0.05). (3) Non-sustained VT in the nocturnal (40%) was more than the day time in period of attack (P less than 0.05). (4) Relationship between VA and variables in period of attack: PaCO2 (r = 0.90) greater than arterial blood pH (r = -0.87) greater than PaO2 (r = -0.63); in relieved period VA were only related to serum potassium (r = -0.86). The authors speculated the severity of VA in period of attack was related with worse of arterial blood gas/pH, cardiac dysfunction and compensated enhance of sympathetic activity. It seems that the view accorded with theory of Yin-Yang in TCM.