Progress in imaging and functional assessment of myopic fundus tessellation changes / 国际眼科杂志(Guoji Yanke Zazhi)

Myopia has become a serious global burden of visual impairment and blindness, and the World Health Organization has included the prevention and treatment of myopia in its global blindness prevention program. Many ocular pathological alterations that follow from advanced myopia could cause visual impairment and even blindness in severe situations. Myopia is becoming more prevalent and has a greater impact on young people. Myopia's social repercussions are becoming more widely known. One of the several fundus alterations linked to myopia is tessellated fundus, which is the earliest lesion in the natural course of myopic fundus lesions and an important clinical marker for the development of retinopathy. Currently, there are several different methods of grading fundus tessellation, all of which are graded subjectively by fundus color photography. One can investigate the morphological characteristics and functional status of the tessellated fundus with ophthalmoscope, fundus photography, optical coherence tomography, electroretinogram, microperimetry and other modal images. In this study, the imaging properties and common applications of the tessellated fundus are reviewed to provide appropriate resources for clinical ophthalmology.

Effectiveness of health education interventions targeting taeniasis and cysticercosis among primary school students in disease-elimination pilot areas of Henan Province / 中国血吸虫病防治杂志

Objective To compare the changes of knowledge, attitude and practice (KAP) related to taeniasis and cysticercosis among primary school students before and after health education interventions in disease-elimination pilot areas of Henan Province, so as to evaluate the effectiveness of health education interventions. Methods A primary school was selected from each of Dushu, Bowang and Yangji townships, Fangcheng County, Henan Province from 2017 to 2019; then, 2 to 3 classes were randomly selected from grade 4 to 6 in each primary school, and finally, all students in these classes were enrolled as study subjects. A thematic health education lecture pertaining to taeniasis and cysticercosis was given once each year by means of “health education in class”. The KAP towards taeniasis and cysticercosis was investigated among primary school students using selffilled structured questionnaires, and the changes of awareness of taeniasis and cysticercosis control knowledge and percentage of healthy behaviors formation were compared in primary school students among years and following various frequencies of health education interventions. Results More than 10 thousand person-time primary school students received health education interventions during the period from 2017 to 2019, and a total of 1 223 person-time primary school students were investigated during the 3-year study period, including 633 person-time men and 590 person-time women and 88.55% of primary school students at ages of 10 to 12 years. The proportion of households raising pigs and using dry toiliets decreased from 5.30% (24/453) and 18.10% (82/453) in 2017 to 3.60% (13/361) and 11.08% (40/361) in 2019, respectively. The awareness rate of taeniasis and cysticercosis control knowledge increased significantly from 0.22% (1/453) in 2017 to 62.59% (256/409) in 2018 and 76.73% (277/361) in 2019 (χ2 = 567.60, P < 0.001), and the awareness rate was 85.25% (104/122) among primary school students attending the thematic special health education courses for successive three times. The awareness rates of taeniasis and cysticercosis control knowledge were 0.44% (1/225), 58.00% (116/200) and 71.63% (149/208) among male students and 0 (0/338), 66.99% (140/209) and 83.66% (128/153) among female students from 2017 to 2019, and there was a significant difference in the awareness of taeniasis and cysticercosis control knowledge between male and female students in 2019 (χ2 = 7.14, P = 0.01). On-site teaching by doctors was the students’ favorite way to receive health education interventions (70.07%, 857/1 223), followed by watching health education videos (58.63%, 717/1 223) and seeing parasite specimens (48.9%, 598/1 223). The proportion of students’ families who used cutting boards for raw and cooked food separately increased from 7.28% (33/453) in 2017 to 47.37% (171/361) in 2019, was 67.21% (82/122) among students attending the health education courses for successive three times. The proportion of students who frequently washed their hands before meals and after using toilet increased from 71.96% (324/453) in 2017 to 89.47% (319/361) in 2019 and was 95.90% (117/122) among students attending the health education courses for successive three times. In addition, the percentage of students washing hands frequently in families using dry toilets was significantly lower in those who did not use dry toilets (χ2 = 9.21, P = 0.002), and the proportion of students with a habit of eating raw or undercooked meat decreased significantly from 35.76% (162/453) in 2017 to 6.65% (24/361) in 2019 (χ2 = 69.11, P < 0.01). Conclusion The thematic health education activity of “health education in class” contributes greatly to the increase in the awareness of taeniasis and cysticercosis control knowledge and the rate of healthy behaviors formation among primary school students in diseaseelimination pilot areas of Henan Province.

Susceptibility of Anopheles sinensis to insecticides in Puyang City, Henan Province / 中国血吸虫病防治杂志

Objective To investigate the susceptibility of Anopheles sinensis to malathion, deltamethrin and lambda-cyhalothrin in Puyang City, Henan Province, so as to provide the scientific basis for local malaria vector control. Methods An. sinensis was captured from Puyang County, Puyang City of Henan Province in September 2018 and July 2020, and the susceptibility of field captured An. sinensis to malathion, deltamethrin and lambda-cyhalothrin was tested using the filter-paper bioassay recommended by WHO. The insecticide resistance level was assessed based on the WHO criteria. Results In 2018 and 2010, the half knock-down times (KT50) of malathion were 91.08 min and 40.95 min for An. sinensis, with knock-down rates of 37.50% and 60.87% 60 min post-exposure to malathion and 24-hour mortality rates of 90.91% and 100%, respectively, and the insecticide resistance levels were moderately resistant (M) and susceptible (S). The KT50 of deltamethrin were 415.56 min and 341.19 min for An. sinensis in 2018 and 2020, with knock-down rates of 22.92% and 16.98% 60 min post-exposure to malathion and 24-hour mortality rates of 22.92% and 16.98%, and the insecticide resistance levels were all resistant (R). The KT50 of lambda-cyhalothrin were 164.22 min and 236.22 min for An. sinensis in 2018 and 2020, with knock-down rates of 30.39% and 38.30% 60 min postexposure to malathion and 24 h mortality rates of 19.60% and 21.28%, respectively, and the insecticide resistance levels were all R. Conclusion An. sinensis is relatively susceptible to malathion but has developed high-level resistance to deltamethrin and lambda-cyhalothrin in Puyang City, Henan Province..

Systematic review of efficacy and safety of Angong Niuhuang Pills in adjuvant treatment of cerebral hemorrhage / 中国中药杂志

To systematically review the efficacy and safety of Angong Niuhuang Pills in adjuvant treatment of cerebral hemorrhage. CNKI, VIP, Wanfang, CBM, PubMed, EMbase, Cochrane Library were retrieved to collect the randomized controlled trial(RCT) from the time of database establishment to November 2020. Two researchers screened out the literatures and extracted the data according to the inclusion and exclusion criteria. RevMan 5.3 software was used for Meta-analysis. A total of 13 RCTs were included, involving 1 196 patients with cerebral hemorrhage, with 599 in the treatment group and 597 in the control group, and all of them were treated with internal medicine. The results of Meta-analysis showed that compared with conventional therapy, the combined administration with Angong Niuhuang Pills could improve the effective rate in patients with cerebral hemorrhage(RR=1.25, 95%CI[1.18, 1.34], P<0.000 01), the National Institutes of Health stroke scale(NIHSS)score(MD=-5.18, 95%CI[-8.12,-2.23], P=0.000 6) and Glasgow coma scale(GCS) score(MD=1.12, 95%CI[0.46, 1.78], P=0.000 9), activity of daily living(ADL)(MD=15.70, 95%CI[14.05, 17.36 ], P<0.000 01), reduce the malondialdehyde(MDA)(MD=-1.73,95%CI[-2.81,-0.64],P=0.002), but with no statistically significant difference in hematoma volume changes between the two groups. In terms of safety, the combined administration with Angong Niuhuang Pills reduced the incidence of adverse reactions compared with the single administration of conventional therapy(RR=0.40, 95%CI[0.28, 0.57], P<0.000 01), with no serious adverse events. The existing clinical study evidences show that Angong Niuhuang Pills had a good effect in adjuvant treatment of cerebral hemorrhage, and can improve the treatment efficacy, activity of daily living and symptoms of neurological deficits, and reduce oxidative stress, with a higher safety. However, the methodological quality of the included studies is not high, so the above conclusions still need to be verified with more high-quality studies.

Open pulling reduction and bone graft by overstretched wrist traction and internal fixation for the treatment of distal radius type Fernandez Ⅲ fractures / 中国骨伤

OBJECTIVE@#To explore the clinical effect of the treatment of Fernandez type Ⅲ fracture of the distal radius with hyperextension traction prying, volar reduction, bone grafting and internal fixation.@*METHODS@#From February 2017 to March 2018, 11 cases of Fernandez type Ⅲ fracture of the distal radius were treated with intraoperative hyperextension traction and volar prying reduction and bone grafting and internal fixation, including 6 males and 5 females, aged 55 to 67 years. Preoperative X-ray and CT evaluated the distal radius fracture dorsal angulation with articular surface compression, collapse. According to Fernandez, all of them were type Ⅲ. After operation, the reduction of articular surface and fracture healing were evaluated. VAS score and Cooney wrist score were used to evaluate the curative effect.@*RESULTS@#All the patients were followed up for 12 to 14 months. All the fractures healed. Cooney wrist score scale was used to evaluate the curative effect, 9 cases were excellent, 1 case was good and 1 case was fair.@*CONCLUSION@#In the operation of Fernandez type Ⅲ fracture of the distal radius, hyperextension traction was used to enlarge the angle, and through the volar fracture end prying reduction and internal fixation with bone graft, the collapsed articular surface could be effectively reduced and fixed. The early functional exercise after the operation had satisfactory clinical effect.

Effect of breastfeeding on the development of infection-related diseases during hospitalization in late preterm infants in 25 hospitals in Beijing, China / 中国当代儿科杂志

OBJECTIVE@#To investigate the incidence rate of infectious diseases during hospitalization in late preterm infants in Beijing, China, as well as the risk factors for infectious diseases and the effect of breastfeeding on the development of infectious diseases.@*METHODS@#Related data were collected from the late preterm infants who were hospitalized in the neonatal wards of 25 hospitals in Beijing, China, from October 23, 2015 to October 30, 2017. According to the feeding pattern, they were divided into a breastfeeding group and a formula feeding group. The two groups were compared in terms of general status and incidence rate of infectious diseases. A multivariate logistic regression analysis was used to investigate the risk factors for infectious diseases.@*RESULTS@#A total of 1 576 late preterm infants were enrolled, with 153 infants in the breastfeeding group and 1 423 in the formula feeding group. Of all infants, 484 (30.71%) experienced infectious diseases. The breastfeeding group had a significantly lower incidence rate of infectious diseases than the formula feeding group (22.88% vs 31.55%, @*CONCLUSIONS@#Breastfeeding can significantly reduce the incidence of infectious diseases and is a protective factor against infectious diseases in late preterm infants. Breastfeeding should therefore be actively promoted for late preterm infants during hospitalization.

A calcium-sensing receptor polymorphism at E942K promotes the proliferation of gastric cancer cells via Ca and ERK1/2 pathways / 生理学报

The study was designed to investigate the effects and mechanism of a calcium-sensing receptor (CaSR) polymorphism at E942K on the proliferation of gastric cancer cells. Single nucleotide polymorphisms (SNPs) were detected between gastric cancers group and normal controls group by DNA sequence analysis. The cell model was constructed by transfection of E942K mutant plasmid and wild-type (WT) plasmid into SGC-7901 and HEK-293 cells. The effect of E942K mutation on cell proliferation ability was detected by CCK8 and cell clone formation experiments. The effect of E942K mutation on calcium signaling was detected by calcium imaging. Western blot experiments were used to detect changes in phosphorylation levels of key proteins ERK1/2 and β-catenin in downstream signaling pathways after E942K mutation. The results showed that the mutation rate of E942K in gastric cancer group was significantly higher than that in normal control group (P < 0.05). CCK8 and cell clone formation experiments showed that E942K mutation significantly improved the proliferation ability of SGC-7901 gastric cancer cells and HEK-293 cells. E942K mutation enhanced calcium signaling in SGC-7901 and HEK-293 cells. E942K mutation enhanced ERK1/2 phosphorylation without affecting β-catenin phosphorylation. The results suggest that E942K mutation in CaSR may ultimately promote the proliferation of gastric cancer cells by enhancing intracellular calcium signaling and ERK1/2 phosphorylation. These results have potential clinical implications for the diagnosis and targeted therapy of gastric cancer.

Wrist arthroscopy assisted open reduction and bone graft through bone window internal fixation for the treatment of distal radius Die-punch fractures / 中国骨伤

OBJECTIVE@#To explore clinical effect of wrist arthroscopy assisted open reduction and bone graft through bone window internal fixation in treating distal radius Die-punch fractures.@*METHODS@#From March 2016 to March 2017, 12 patients with distal radius Die-punch fractures were treated by wrist arthroscopy assisted open reduction and bone graft through bone window internal fixation, including 8 males and 4 females aged from 20 to 42 years old. Preopeative X-ray and CT were used to diagnosed as compress and collapse Die-punch fractures. Joint activity was observed, postoperative VAS score and Cooney wrist score were used to evaluate pain and wrist function at 12 months.@*RESULTS@#No surgical complications occurred. All patients were followed up from 10 to 13 months with an average of 12.1 months. VAS score was for 0 to 3 points at 12 months after operation. Palmer tilt angle was for 5° to 15°, ulnar drift angle was for 14° to 23°, wrist flexion motion ranged from 123° to 168°, and forearm rotation motion ranged from 115° to 170°. Postoperative Cooney wrist score at 12 months ranged from 70 to 95 points, 10 patients got excellent results, 1 good, and 1 moderate.@*CONCLUSIONS@#Wrist arthroscopy assisted open reduction and bone graft through bone window internal fixation in treating distal radius Die-punch fractures has advantages of good recovery of wrist function, reduce pain symptom, and could receive satisfied clinical effects.

Postoperative local incision analgesia for acute pain treatment in patients with hepatocellular carcinoma

Summary Objective: The present study aimed to investigate the analgesic effect and safety of using local incision analgesia to treat acute postoperative pain in patients with hepatocellular carcinoma (HCC). Method: A cohort of 60 patients undergoing liver cancer resection was randomly divided into three groups (n=20 per group): local incision analgesia (LIA) group, which received local infiltration with ropivacaine combined with a postoperative analgesia pump; intravenous patient-controlled analgesia (PCA) group, which received fentanyl intravenous analgesia postoperatively; and the control group, which received tramadol hydrochloride injection postoperatively according to the NRS scoring system. The postoperative analgesic effect in each group was compared and tumor recurrence (survival) was analyzed using the Kaplan-Meier method. Results: NRS scores, rate of analgesic usage, ambulation time (h) and intestinal function recovery time (h) were significantly reduced in LIA group compared with the control group at each postoperative time point (6, 12, 24 and 48 hours; p<0.05). Additionally, the NRS scores of LIA patients at 12 hours post-surgery was significantly reduced compared with PCA group (p<0.05), and the occurrence of postoperative adverse events in LIA group was significantly lower than that in PCA group (p<0.05). Survival analysis demonstrated that the mean survival time (tumor recurrence) was significantly increased in LIA group compared with the control group (χ2=4.749; p=0.029). Conclusion: Local incision analgesia improves the analgesic effect, causes fewer adverse reactions and increases postoperative survival time. Our study demonstrated that local incision analgesia is a safe and effective method of postoperative pain management following hepatectomy.

Effect of Conbercept injection and macular grid pattern photocoagulation in treating macular edema after non-ischemic branch retinal vein occlusion / 国际眼科杂志(Guoji Yanke Zazhi)

· AIM:To investigate the effects and safety of intravitreal injection of Conbercept combined with macular grid pattern photocoagulation for macular edema secondary to non-ischemic branch retinal vein occlusion (BRVO).· METHODS:A total of 38 patients (38 eyes) with macular edema following non-ischemic BRVO were retrospectively analyzed.All patients were given best corrected visual acuity(BCVA),intraocular pressure,slit lamp with preset lens,optic coherent tomography(OCT) and fluorescence fundus angiography (FFA) examination.The BCVA and central macular thickness (CMT) were observed before and 1wk,1,2,3,6,9 and 12mo after treatment.The change in pre-treatment and post-treatment were compared,and the related complications were recorded.· RESULTS:BCVA before treatment and 1wk,1,2,3,6,9 and 12mo after treatment were 0.89±0.62,0.64±0.59,0.55±0.62,0.46±0.43,0.53±0.67,0.43±0.38,0.42±0.29,0.40 ± 0.30,the difference was statistically significant between that before and after treatment (P＜0.001),while the BCVA after treatment showed no significant difference with each other (P＞ 0.05).CMT were 683.25 ± 236.47,298.65±116.12,276.89±107.28,281.55±99.62,251.41 ± 119.47,240.58±88.62,231.74±75.36,209.51±84.68pm,the difference was statistically significant between that before and after treatment (P＜ 0.001),while the those after treatment showed no significant difference with each other (P＞ 0.05).There were 11 eyes received one injection,18 eyes with two injections,2 eyes with 3,3 eyes with 4,and 4 eyes more than 4,the average injection was 2.01±1.42.The CMT decreased after every injection.The intraocular hypertension and other complications were not seen after treatment.· CONCLUSION:Intravitreal injection of conbercept combined with macular grid pattern photocoagulation for macular edema to non-ischemic BRVO can reduce the macular edema and improve BCVA,which is effective and safety.

Open reduction and bone graft with internal fixation through bone window for the treatment of type B4 distal radius fractures / 中国骨伤

<p><b>OBJECTIVE</b>To explore clinical effect of open reduction and bone graft with internal fixation through bone window for the treatment of type B4 distal radius fractures.</p><p><b>METHODS</b>From January 2015 to June 2016, 13 patients with type B4 distal radius fractures treated with bone graft with internal fixation through bone window, including 9 males and 4 females aged from 18 to 36 years old with an average of 26.3 years old. Fractures were classified to type B4 according to AO/OTA classification. Fracture healing and postoperative complication were observed, VAS score was used to evaluate pain, and Cooney wrist scoring was applied to evaluate recovery of function.</p><p><b>RESULTS</b>All patients were followed up from 10 to 14 months with an average of 12.4 months. Fracture healed from 4 to 6months with an average of 5.2 months. According to Cooney wrist scoring, 10 got excellent results, 2 good and 1 moderate. VAS score was 1.0±1.1, grip strength of contralateral ratio was (88.2±2.7)%, palmer tilt angle was (12.2±3.8)°, ulnar drift angle was (19.3±5.4)°, wrist flexion mobility was (118.1±2.3)°, forearm rotation motion was (158.0±13.0)°. No osteoarthritis occurred and symptoms occurred during follow-up.</p><p><b>CONCLUSIONS</b>Open reduction and bone graft with internal fixation through bone window for the treatment of type B4 distal radius fractures, which has advantages of satisfied clinical effects, less complications, is one of the effective method for type B4 distal radius fractures.</p>

A review on neonatal acute respiratory distress syndrome / 中国当代儿科杂志

Acute respiratory distress syndrome (ARDS) is a common clinical critical disease and is one of the main causes of death and disability in neonates. The etiology and pathogenesis of neonatal ARDS are complicated. It is an acute pulmonary inflammatory disease caused by the lack of pulmonary surfactant (PS) related to various pathological factors. It is difficult to distinguish neonatal ARDS from other diseases. At present, there is no specific treatment method for this disease. Respiratory support, PS replacement, extracorporeal membrane oxygenation, nutrition support and liquid management are main treatment strategies. This paper reviews the research advance in etiology, clinical characteristics, diagnosis and treatment strategies of neonatal ARDS.

Wrist arthroscopy assisted reduction and Herbert screw fixation for the treatment of type B distal radius fractures / 中国骨伤

<p><b>OBJECTIVE</b>To explore the clinical efficacy of internal fixation with arthroscope assistance in type B fractures of distal radius.</p><p><b>METHODS</b>From June 2013 to July 2015, 28 cases of type B distal radius fracture patients were enrolled into the study, including 15 males and 13 females with an average age of 45.3 years old ranging from 17 to 69 years old. These patients were treated with manipulative and poking reduction wrist arthroscopy, internal fixation with Herbert screws and repair of articular soft tissue, and the course of disease was 4 to 7 days after injury. Injured patients had the typical signs of distal radius fracture with confirming of X ray and CT imaging. Finally, no other fractures, no neurovascular injury, no other severe diseases and no surgical cortraindications were identified. According to the classification of AO/OTA, there were 8 cases of type B1, 7 cases of type B2, 13 cases of type B3. Patients were followed up for fracture healing, wrist joint function recovery, and curative effect.</p><p><b>RESULTS</b>The 28 cases of type B distal radius fractures were followed up with an average of(12.1±1.4) months, all fractures were healed, palmer tilt angle was(15.2±3.4)°, ulnar drift angles was(20.4±6.4)°. Wrist functions were evaluated according to Cooney system and rated as excellent in 21 cases, good in 5 cases and fair in 2 cases. Intraoperative arthroscopy showed the tear of scapholunate ligaments in 3 cases, tear of in lunotriguetal ligaments in 1 case, and TFCC tear in 16 cases.</p><p><b>CONCLUSIONS</b>Wrist arthroscopy assisted treatment of distal radius fracture type B can make the recovery of joint surface roughness to a great extent. The application of Herbert screw brings in the small trauma, and the postoperative recovery time is short, reducing the incidence of traumatic arthritis and preventing the chronic pain or inastbility of the wrist in the future.</p>

Analysis of the plantar pressure in children with unilateral developmental dysplasia of the hip following Pemberton’s pericapsular osteotomy at an early age / 医用生物力学

Objective To investigate the changes of plantar pressure distributions in children with the unilateral developmental dysplasia of the hip (DDH) who underwent the Pemberton’s pericapsular osteotomy (PPO) at early age, so as to provide valuable references for clinical therapy and rehabilitation of such patients. Methods Eighteen child patients who underwent PPO before 4 year old were selected as the PPO group, while 18 healthy children at the same age with normal feet were selected as the control group. Footscan system was used to measure the plantar pressure of these subjects during walking. The parameters, i.e. contact area percentage of the total foot contact area (CA%), pressure-time integral (PTI) and contact time percentage of the stance time (CT%) in both PPO group and control group were compared to evaluate changes of the plantar pressures during walking. Results Compared with the sound limb in control group and the unaffected limb in PPO group, the affected limb in PPO group showed higher PTI in the 2nd to 5th toe zone and lower PTI in the medial heel zone. The affected limb in PPO group had a higher CA% in the 4th and 5th metatarsals than the unaffected limb in PPO group and the sound limb in control group, and a lower CA% in the 1st and 2nd metatarsals than the unaffected limb. Compared with the unaffected limb in PPO group and the sound limb in control group, CT% of the affected limb in PPO group increased in the forefoot push-off phase and decreased in the initial contact phase, and the total contact time of the affected limb was shorter than that of the unaffected limb in PPO group and the sound limb in control group. Conclusions There exist residual plantar pressure deviations during walking in DDH patients following PPO at early age, thus a longer period of intensive rehabilitation may be required to change the residual abnormality.

Finite element analysis of a bone healing model: 1-year follow-up after internal fixation surgery for femoral fracture

Finite element analysis was used to compare preoperative and postoperative stress distribution of a bone healing model of femur fracture, to identify whether broken ends of fractured bone would break or not after fixation dislodgement one year after intramedullary nailing. Using fast, personalized imaging, bone healing models of femur fracture were constructed based on data from multi-slice spiral computed tomography using Mimics, Geomagic Studio, and Abaqus software packages. The intramedullary pin was removed by Boolean operations before fixation was dislodged. Loads were applied on each model to simulate a person standing on one leg. The von Mises stress distribution, maximum stress, and its location was observed. According to 10 kinds of display groups based on material assignment, the nodes of maximum and minimum von Mises stress were the same before and after dislodgement, and all nodes of maximum von Mises stress were outside the fracture line. The maximum von Mises stress node was situated at the bottom quarter of the femur. The von Mises stress distribution was identical before and after surgery. Fast, personalized model establishment can simulate fixation dislodgement before operation, and personalized finite element analysis was performed to successfully predict whether nail dislodgement would disrupt femur fracture or not

3D finite analysis on injury mechanism of spinal cord compression / 医用生物力学

Objective To construct 3D finite element model of the thoracolumbar spinal cord, and study the mechanism of spinal cord injury caused by burst fracture through biomechanical experiments. Methods The compression simulation on burst fracture was performed using finite element technology, and the results were verified by comparing the tested models with the in vivo and in vitro experimental results. Results The strain distribution in white matter of the spinal cord was higher than that in grey matter at the initial stage of burst fracture. As the displacement of bony fragments increased, the strain distribution in grey matter increased subsequently. But when the displacement of bony fragments finally reached the maximum, the strain in white matter was higher than that in grey matter. Conclusions Traumatic severity of the spinal cord during burst fracture is dependent on the posterior encroachment, and the traumatic procedure order for ventral horn (motor function) or dorsal horn (sensory function) of cord tissue also plays an important role in the evaluation. In clinical practice, the patient’s condition can be evaluated more accurately by assessing severity of the spinal motor and sensory functions. Further understanding on strain distribution in the spinal cord during the injury may inspire new strategies for treating or preventing spinal cord injury.

Clinical study on the association of ocular dominance with accommodation in myopia adult / 中华实验眼科杂志

Background Dominant eye is one of the functional asymmetric organ,and the dfference between dominant eye and undominant eye is a researching hotspot.But the study about accommodation in adult myopia is less.Objective This study was to determine the association between ocular dominances and accommodative factors in the subjects with adult myopia.Methods This study used prospective descriptive research method.Thirty-five subjects aged from 18 to 35 years with the myopia ranged from-2.00 D to-10.00 D and anisometropia less than 1.5 D,BCVA≥ 1.0 were recruited consecutively in this study.Ocular dominance was determined using the hole-inthe-card test and thumb test.Refractive error was measured with objective and subjective optometry,and amplitude of accommodation was measured by push-up test.Fusion cross cylinder(FCC) was used to measure the accommodative lag,and flipper test was applied to determine the accommodative facility.Oral informed consent was obtained from each subject before any relevant examination.Results No significant differences were found in the amplitude of accommodation (D),accommodative facility (cpm) and accommodative lag (D) between the dominant eye and undominant eye (accommodative amplitude:9.69 D±2.30 D vs.9.60 D±2.37 D,P =0.294 ;accommodative facility: 11.08 D±4.20 D vs.10.63 D± 4.60 D,P=0.260;accommodative lag:P=0.141).In the patients with the right eyes as dominance eyes,the accommodative amplitude of both eyes were (9.48±2.29) cpm and (9.33 ± 2.49) cpm,and accommodative facility were (10.50 ± 4.70) cpm and (9.99 ± 4.90) cpm.There were no significant differences between the right and left eyes in the accommodative amplitude,accommodative facility and accommodative lag (P =0.319,0.116,0.590).In the patients with the left eyes as dominant eyes,the accommodative amplitude of both eyes were (9.91±2.35)D and (9.88±2.26) D,and accommodative facility were (10.70±3.77)cpm and (11.25 ±4.27) cpm.No significant differences were seen between the right eyes and left eyes in the accommodative amplitude,accommodative facility and accommodative lag (P =0.749,0.295,0.238).Conclusions The amplitude of accommodation of the dominant eye is not significantly enhanced,and less accommodative lag and better accommodative facility also are found in the demonstrate eye in myopia adults with low anisometropia.

Correlation analysis between plasma D-dimer levels and orthopedic trauma severity / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>The correlation between the plasma D-dimer level and deep vein thrombosis has not been conclusive in various studies. The aim of this research was to study the relationship between plasma D-dimer levels and the severity of orthopedic trauma by retrospective examination of orthopedic trauma cases.</p><p><b>METHODS</b>Clinically acute trauma and non-acute trauma patients were selected and their plasma D-dimer levels were measured. Plasma D-dimer levels in patients of these two groups were compared. The relationship between the plasma D-dimer level and the severity of the trauma was also studied.</p><p><b>RESULTS</b>There were 548 cases in the acute trauma group and 501 cases in the non-acute trauma group. The levels of plasma D-dimer were significantly higher in the acute trauma group than in the non-acute trauma group (P < 0.01). In the acute trauma group, the correlation between the D-dimer level and the number of fractures was a positive linear correlation (r = 0.9532).</p><p><b>CONCLUSIONS</b>Elevated plasma D-dimer is common in trauma patients. The D-dimer level and the number of fractures in the trauma patients are closely correlated. D-dimer is not only an indicator for the diagnosis of deep vein thrombosis and pulmonary embolus, but also an indicator of the severity of trauma in acute trauma patients.</p>

Clinical evaluation of laser in situ keratomileusis operation with three different ablative patterns / 浙江大学学报·医学版

<p><b>OBJECTIVE</b>To evaluate the clinical outcome among three different laser in situ keratomileusis (LASIK) ablations: Q-factor customized ablation (aberration smart ablation, ASA), wave-front guided ablation (WASCA) and ablation under wave-front guiding plus iris recognition system (IR+WASCA).</p><p><b>METHODS</b>This prospective study comprised 96 eyes of 96 patients, and they were randomly divided into three groups: 30 patients in ASA group, 32 in WASCA group, and 34 in IR+WASCA group. There were no any statistical differences in spherical equivalent (SE), age, sex, pupil diameter, higher-order aberrations (HOA) among three groups preoperatively. Wave-front analysis was performed before and 1, 3 months after operation.</p><p><b>RESULT</b>All patients got an uncorrected visual acuity (UCVA) ≥ 0.8 1 and 3 months after operation. The residual SE was in ± 0.50D both at 1 and 3 months after surgery. There was no statistical difference in SE value, HOA, change of HOA, and coma aberration postoperatively among three groups. Horizontal coma (Z3¹) aberration took the majority of coma. HOA, total coma aberrations and spherical aberration increased postoperatively (P = 0.000), but without significant difference between 1 month and 3 months after surgery.</p><p><b>CONCLUSION</b>That three customized LASIK are all effective, safe, accurate and stable; meanwhile WASCA may have better UCVA than the other two groups postoperatively.</p>

Three dimensional finite element analysis of stress distribution on continuously varying of length of pedicle screw / 医用生物力学

Objective To study the stress distribution on different length of pedicle screws under the physiological load by using the three dimensional finite element analysis. Method A three dimension model of the pedicle screw and L1 vertebral body were constructed with the model meshed on the basis of the finite element method. The feature dimension of pedicle screw in the model was set in a specified varied range. Under the physiological load, the stress on every model with different diameter sizes of pedicle screw was analyzed. ResultsThe stress on every bone model decreased with the increase of stress on screw under the axially pullout force as the length of screw ranged from 30mm to 50mm. And the maximum Equivalent Stress (EQV Stress) in the pedicle screw appeared in the central area of the pedicle screw, the maximum Equivalent Stress (EQV Stress) in the cortical bone appeared in both sides of contact surface, the maximum Equivalent Stress (EQV Stress) of the cancellous bone appeared in both sides of contact surface of the top of pedicle screw and cancellous bone. In a certain external load, with the 50mm length of screw, the load that transfers to the cortical bone and cancellous bone is reduced by 43.1% and 42.3%, respectively, while the maximum Equivalent Stress (EQV Stress) of screw was increased 38%. When L≥45mm, the variable stress on all models become stable. Conclusions While the length of screw is in range of 4.0　mm to 6.5　mm, 30～50 mm ,the increase of pedicle screw length could improve the distribution of axial pullout stress on the screws, cortical bone and cancellous bone. As long as the bone mass allowed, the length of pedicle screws should be not less than 45mm in clinical choice.