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Femtosecond laser-assisted cataract surgery(FLACS)has been used for more than 10 years, with its safety and precision well-verified. In recent years, FLACS has been gradually applied to patients with glaucoma and cataracts, especially those patients with primary angle closure glaucoma(PACG). The unique anatomical characteristics of PACG increase the difficulty of lens extraction and potential complications in conventional phacoemulsification surgery, highlighting the distinct advantages of FLACS in these patients. Recently, the application of FLACS combined with minimally invasive glaucoma surgery(MIGS)in patients with open angle glaucoma, and goniosynechialysis(GSL)in patients with angle-closure glaucoma, and even in patients with filtering blebs after anti-glaucoma surgery, has been reported. The indications for FLACS are increasingly expanding. FLACS can cause a transient intraoperative increase in intraocular pressure(IOP), and ocular parameters can have a certain impact on IOP. The long-term effects on IOP require further research. More attention should be paid to the impact of FLACS on visual function in glaucoma patients and the related complications that may arise. This article reviews the application of FLACS in different types of glaucoma, its effects on IOP and visual function, specific complications, and application prospects.
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Objective:To investigate the effect of lithium chloride (LiCl) on the gap junctional intercellular communication (GJIC) in human Tenon capsule fibroblasts (HTFs) and its underlying mechanism.Methods:The Tenon capsule tissue of a patient who underwent strabismus surgery in Dezhou People's Hospital in April 2019 was collected and cut into tissue blocks of dimensions 1 mm×1 mm×1 mm.Primary culture and subculture were carried out, and the 4th-generation HTFs were taken for experiment.HTFs were divided into the control group and LiCl treatment group and were cultured with cell medium without or with 80 mmol/L LiCl for another 48 hours according to grouping.The cell scratch and dye labeling technique were used to label the coupling index and evaluate the GJIC function.The expression and localization of Cx43 in HTFs were detected by immunofluorescence staining.The expression levels of Cx43 mRNA and protein were detected by real-time fluorescence quantitative PCR and Western blot, respectively.The study protocol was approved by an Ethics Committee of Dezhou People's Hospital (No.2019-023). Written informed consent was obtained from the subject.Results:The cultured spindle-shaped HTFs grew adhering to the wall showing radial monolayer or vortexlike, and the cytoplasm was vimentin positive.Results of dye tracer experiment of cell scratch showed that the cell coupling index of LiCl treatment group was 9.04±0.53, which was significantly higher than 4.94±0.39 of the control group ( t=-18.79, P<0.01). Immunofluorescence staining showed that the Cx43 fluorescence was dotted in the cell membrane between adjacent cells in the control group, and Cx43 staining was obviously enhanced in the LiCl treatment group.The results of real-time fluorescence quantitative PCR showed that with relative expression level of Cx43 mRNA in the control group set to 1, the relative expression level of Cx43 in the LiCl treatment group was significantly increased to 1.97±0.23, showing a statistical significance between them ( t=-14.426, P<0.01). Western blot showed that the relative expression level of Cx43 protein was 0.871±0.057 in the LiCl treatment group, which was significantly higher than 0.446±0.028 in the control group ( t=-11.682, P<0.01). Conclusions:LiCl can enhance the GJIC function between HTFs by upregulating the expression levels of Cx43 mRNA and protein, suggesting that the enhanced GJIC function by LiCl may be one of the mechanisms of its inhibition on HTFs proliferation.
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Objective:To explore the effect of high-frequency repeated magnetic stimulation on the body-specific attention of healthy adults.Methods:Forty healthy adults were recruited and randomly divided into a repeated stimulation group and a sham stimulation group, each of 20. A " Pathleader" medical device which can produce magnetism was used to stimulate the initial segment of the deep branch of the radial nerve on each subject′s non-dominant side in the repeated stimulation group. The intensity was set within the subject′s tolerable range but sufficient to induce obvious dorsiflexion of the wrist joint. The frequency was 50Hz, the stimulation time was 2s with 1s intervals. The entire stimulation sequence lasted 36min. In the sham stimulation group, the device and parameters were the same but the coil was rotated 90° so there was no actual stimulation. The difference between the reaction time in the body condition and the reaction time in the control condition was defined as body-specific attention. Body-specific attention was quantified before stimulation, right after stimulation and 10 minutes later.Results:Right after stimulation body-specific attention was no different from before stimulation in either group. Ten minutes after real stimulation, body-specific attention had increased significantly, but there was no significant difference in the sham stimulation group.Conclusion:High-frequency repeated magnetic stimulation of a peripheral nerve can improve the body-specific attention of neurologically-intact healthy adults. The effect may arise from initial inhibition followed by enhancement.
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Objective To find a simple, sensitive and effective method to predict the occurrence of cogni-tive impairment in patients after a transient ischemic attack ( TIA) . Methods Thirty-six persons who had survived a first TIA and could walk independently were selected into a TIA group, with another 36 healthy counterparts chosen to form a control group. Those in both groups were given a gait analysis during dual-task walking at the outset and then assessed using the MoCA scale 12 months later. Statistical analyses were conducted to assess the reliability of gait pa-rameters in predicting cognitive dysfunction, and the area under the receiver operating characteristics curve was calcu-lated. Results On the day after enrollment the variation in step length among the TIA patients with an abnormal step length was compared with variation among the normal controls and among the TIA patients with non-abnormal step-size. The differences were significant. The average walking speed of the TIA patients with an abnormal average walking speed was significantly different from that of the control group and that of the TIA patients with non-abnormal average speed. On the day after enrolling, the accuracy rate of the control group in the dual-task walking test was sig-nificantly better than that of any of the TIA patients, and the accuracy rate of the TIA patients with an abnormal gait in the dual-task walking test was significantly lower than that of the patients with a non-abnormal gait. Twelve months later the number of patients whose MoCA scores were less than 26 in the abnormal gait group was compared with that in the normal gait group, and the difference was statistically significant. The area under the receiver operating charac-teristics curve suggests that both the incidence of step length variation and the average stepping speed could signifi-cantly predict the occurrence of cognitive dysfunction 12 months later. Conclusion Quantitative analysis of gait while dual-task walking can effectively predict the occurrence of cognitive impairment in patients with TIA, and can detect abnormalities earlier than the MoCA scale test.
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Objective To compare the efficacy of intra-articular injection of autologous platelet-rich plasma (PRP) with that of sodium hyaluronate for patients with knee osteoarthritis (KOA). Methods Fifty KOA patients were randomly divided into a PRP group ( n=25) and a sodium hyaluronate group ( n=25) . Those in the PRP group were injected intra-articularly with 5 ml of autologous PRP every 2 weeks for 6 consecutive weeks, while the sodium hyaluronate group was given intra-articular injections of 2 ml of sodium hyaluronate once a week for 6 weeks. Both groups performed isokinetic strength training three times a week for 6 weeks. Before as well as 6 weeks, 3 months, 6 months and 12 months after the treatment, both groups were followed and evaluated using the Western Ontario and McMaster University osteoarthritis index ( WOMAC) . A Biodex System 4 isometric muscle strength testing system was used to evaluate the knees' peak torque (PT) in flexion and extension, total power (TW), and average power (AP). Results Before the treatment there were no significant differences in pain, stiffness or average WOMAC score be-tween the two groups. Afterward significant improvement was observed in the pain, stiffness and WOMAC scores of both groups. Compared with the sodium hyaluronate group, significantly greater decreases in the average WOMAC pain score were observed in the PRP group after the different intervals. That was also true of the average stiffness scores and the overall average WOMAC scores after 6 and 12 months. The flexor and extensor PT, TW and AP at the angular velocities of 60°/s and 90°/s also improved significantly in both groups after 6 weeks and 12 months, with the improvement of the PRP group significantly greater than that in the control group at the same time points. Conclu-sion Intra-articular injection of either autologous PRP or sodium hyaluronate can effectively alleviate the clinical symptoms of KOA when combined with isokinetic strength training. However, PRP is the more effective. Its use is worthy of clinical application and promotion.
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Objective@#To compare the efficacy of intra-articular injection of autologous platelet-rich plasma (PRP) with that of sodium hyaluronate for patients with knee osteoarthritis (KOA).@*Methods@#Fifty KOA patients were randomly divided into a PRP group (n=25) and a sodium hyaluronate group (n=25). Those in the PRP group were injected intra-articularly with 5 ml of autologous PRP every 2 weeks for 6 consecutive weeks, while the sodium hyaluronate group was given intra-articular injections of 2 ml of sodium hyaluronate once a week for 6 weeks. Both groups performed isokinetic strength training three times a week for 6 weeks. Before as well as 6 weeks, 3 months, 6 months and 12 months after the treatment, both groups were followed and evaluated using the Western Ontario and McMaster University osteoarthritis index (WOMAC). A Biodex System 4 isometric muscle strength testing system was used to evaluate the knees′ peak torque (PT) in flexion and extension, total power (TW), and average power (AP).@*Results@#Before the treatment there were no significant differences in pain, stiffness or average WOMAC score between the two groups. Afterward significant improvement was observed in the pain, stiffness and WOMAC scores of both groups. Compared with the sodium hyaluronate group, significantly greater decreases in the average WOMAC pain score were observed in the PRP group after the different intervals. That was also true of the average stiffness scores and the overall average WOMAC scores after 6 and 12 months. The flexor and extensor PT, TW and AP at the angular velocities of 60°/s and 90°/s also improved significantly in both groups after 6 weeks and 12 months, with the improvement of the PRP group significantly greater than that in the control group at the same time points.@*Conclusion@#Intra-articular injection of either autologous PRP or sodium hyaluronate can effectively alleviate the clinical symptoms of KOA when combined with isokinetic strength training. However, PRP is the more effective. Its use is worthy of clinical application and promotion.
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Objective To explore the effect of sling exercise therapy (SET) for improving the balance and walking ability of patients with incomplete paraplegia.Methods The 37 patients were randomly divided into two groups:19 patients in the observation group and 18 cases in the control group.Both groups were given conventional rehabilitation training,including bridge training on the mat,kneeling position training,sit-stand training and orthosis walking training.The observation group was additionally provided with sling exercise therapy with multi-point,muhi axis sling suspension supine,prone with a neutral lumbar spine,supine with pelvic elevation and in a lateral position like an arch.Before the treatment and 6 weeks after the treatment,trunk control tests (TCTs) were administered.The Berg balance scale (BBS) and Holden's walking function classification were used to assess the subjects' balance and walking ability.Results There were no significant differences in the two groups' average TCT and BBS scores before the treatment.After 6 weeks of treatment the average scores of both groups had increased significantly,with a significantly bigger increase observed in the observation group.After the treatment,the average Holden classification of the observation group was significantly superior to that of the control group.Conclusion SET in addition to conventional rehabilitation training can significantly improve the balance and walking ability of patients with incomplete paraplegia.It is worthy of application in clinical practice.
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@# Objective To observe the effect of Kinesio taping combining with sling exercise therapy (SET) on the motor function for children with spastic hemiplegia. Methods From October, 2014 to April, 2016, 60 children with spastic hemiplegia of cerebral palsy were randomly divided into control group (n=20), SET group (n=20) and observation group (n=20), who accepted routine rehabilitation, routine rehabilitation+SET and routine rehabilitation+SET+Kinesio taping, respectively. They were assessed with Mallet Score, modified Ashworth Scale (MAS), Peabody Developmental Motor Scale-fine motor (PDMS-2FM) and Gross Motor Function Measure (GMFM)-C zone before and three months after treatment. Results The Mallet Score and the scores of PDMS-2FM and GMFM-C improved in all the groups after treatment (t>2.074, P<0.05), and improved the most in the observation group (F>10.032, P<0.001). The score of MAS decreased in the observation group after treatment (t=4.767, P<0.001), and was the least among these groups (F=4.262, P<0.05). Conclusion Kinesio taping combining with SET can improve the motion in the children with spastic hemiplegia, and promote the development of both fine and gross motor function.
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<p><b>OBJECTIVE</b>To evaluate the clinical efficacy of electroacupuncture (EA) combined with transperineal injection of botulinum toxin-A (BTX-A) on neurogenic bladder caused by spinal cord injury.</p><p><b>METHODS</b>One day af ter surgery, 35 cases of spinal cord injury accompanied with neurogenic bladder were randomly divided into a BTX-A plus EA group (20 cases, group A) and a BTX-A group (15 cases, group B). The two groups were both treated with regular rehabilitation training of bladder function and injection of 200 IU (4 ml) BTX-A through perineum external urethral sphincter; the group A was additionally treated with EA at Zhongji (CV 3), Guanyuan (CV 4), Shenshu (3BL 23), Huiyang (BL 35) and Baliao (Shangliao (BL 31), Ciliao (BL 32), Zhongliao (BL 33), Xialiao (BL 34)), once a day, 40 min per treatment. The treatment was given 6 times per week for 4 weeks. The urination status in two groups before and after treatment was observed, and urodynamics examination and urethral pressure test were also made.</p><p><b>RESULTS</b>After 4-week treatment, mean times of urinary incontinence, mean urethral catheter output, pressure of bladder and volume of urinary incontinence were all improved in two groups (all P<0.05), which were more significant in the group A (all P<0.05). The residual urine, maximum bladder capacity, maximum urethral closure pressure and maximum urine flow rate were all improved in two groups after treatment (all P<0.01); the improvement of residual urine, maximum bladder capacity, maximum urethral closure pressure in the group A was more significant than that in the group B (all P<0.05).</p><p><b>CONCLUSION</b>Electroacupuncture com bined with transperineal injection of BTX-A could effectively improve the urination dysfunction in patients with neurogenic bladder after spinal cord injury.</p>
Sujets)
Adolescent , Adulte , Femelle , Humains , Mâle , Adulte d'âge moyen , Jeune adulte , Toxines botuliniques de type A , Association thérapeutique , Électroacupuncture , Injections , Traumatismes de la moelle épinière , Résultat thérapeutique , Vessie neurologique , Traitement médicamenteux , Thérapeutique , MictionRésumé
Objective To observe the effect of scalp acupuncture plus body weight support treadmill (BWST) training on motor function and ambulation of lower limbs in spastic cerebral palsy. Method Sixty-six eligible subjects with cerebral palsy were divided by using random number table into group A (n=20), group B (n=23), and group C (n=23). Group A was intervened by regular rehabilitation training, group B was by BWST in addition to the treatment given to group A, and group C was intervened by scalp acupuncture in addition to the treatment given to group B. The dimension D and E of Gross Motor Function Measure (GMFM) scale and Activities of Daily Living (ADL) were adopted for evaluation before treatment and after 3-month treatment. Result Before treatment, there were no significant differences in comparing the indexes among the three groups (P>0.05). After 3-month treatment, the D-dimension scores of GMFM were respectively (25.38±4.85), (29.54±5.70), and (32.37±6.58) in the three groups; the E-dimension scores were respectively (55.35±11.64), (60.80±12.47), and (65.74±13.50); the ADL scores were (60.24±14.49), (68.25±13.74), and (76.30±14.58); the scores were significantly increased in all three groups after intervention (P<0.01), and the D-dimension and E-dimension scores of group B and C were significantly higher than those of group A (P<0.05), and the scores of group C were significantly higher than those of group B (P<0.05). Conclusion Scalp acupuncture plus BWST can improve the motor function and walking ability of lower limbs in spastic cerebral palsy, and thus enhance of ADL of the patients.
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Objectives To observe the effect of rehabilitation robots with routine rehabilitation training on walking func -tion after stroke .Methods Sixty patients with stroke were randomly divided into treatment group and control group , 30 ca-ses in each group .The control group received routine rehabilitation training while the treatment group received routine reha -bilitation training by rehabilitation robots .The lower extremity functions ,balance and walking ability were assessed with a simplified Fugl-Meyer Assessment(FMA) and using the Berg Balance Scale (BBS) before treatment and after 12 weeks. Results Before treatment , neither the treatment group nor the control group showed any statistically significant difference in terms of FMA and BBS results (P>0.05).After 12 weeks′training, both groups showed significant improvement in terms of FMA and BBS results(P<0.05).The treatment group showed significantly better improvement in lower extremity function, balance and walking function than the control group (P<0.05).Conclusion Rehabilitation robots can signifi-cantly improve walking function in patients after stroke .