Nanomaterial-based Therapeutics for Biofilm-generated Bacterial Infections / 生物化学与生物物理进展

Bacterial biofilms gave rise to persistent infections and multi-organ failure, thereby posing a serious threat to human health. Biofilms were formed by cross-linking of hydrophobic extracellular polymeric substances (EPS), such as proteins, polysaccharides, and eDNA, which were synthesized by bacteria themselves after adhesion and colonization on biological surfaces. They had the characteristics of dense structure, high adhesiveness and low drug permeability, and had been found in many human organs or tissues, such as the brain, heart, liver, spleen, lungs, kidneys, gastrointestinal tract, and skeleton. By releasing pro-inflammatory bacterial metabolites including endotoxins, exotoxins and interleukin, biofilms stimulated the body’s immune system to secrete inflammatory factors. These factors triggered local inflammation and chronic infections. Those were the key reason for the failure of traditional clinical drug therapy for infectious diseases.In order to cope with the increasingly severe drug-resistant infections, it was urgent to develop new therapeutic strategies for bacterial-biofilm eradication and anti-bacterial infections. Based on the nanoscale structure and biocompatible activity, nanobiomaterials had the advantages of specific targeting, intelligent delivery, high drug loading and low toxicity, which could realize efficient intervention and precise treatment of drug-resistant bacterial biofilms. This paper highlighted multiple strategies of biofilms eradication based on nanobiomaterials. For example, nanobiomaterials combined with EPS degrading enzymes could be used for targeted hydrolysis of bacterial biofilms, and effectively increased the drug enrichment within biofilms. By loading quorum sensing inhibitors, nanotechnology was also an effective strategy for eradicating bacterial biofilms and recovering the infectious symptoms. Nanobiomaterials could intervene the bacterial metabolism and break the bacterial survival homeostasis by blocking the uptake of nutrients. Moreover, energy-driven micro-nano robotics had shown excellent performance in active delivery and biofilm eradication. Micro-nano robots could penetrate physiological barriers by exogenous or endogenous driving modes such as by biological or chemical methods, ultrasound, and magnetic field, and deliver drugs to the infection sites accurately. Achieving this using conventional drugs was difficult. Overall, the paper described the biological properties and drug-resistant molecular mechanisms of bacterial biofilms, and highlighted therapeutic strategies from different perspectives by nanobiomaterials, such as dispersing bacterial mature biofilms, blocking quorum sensing, inhibiting bacterial metabolism, and energy driving penetration. In addition, we presented the key challenges still faced by nanobiomaterials in combating bacterial biofilm infections. Firstly, the dense structure of EPS caused biofilms spatial heterogeneity and metabolic heterogeneity, which created exacting requirements for the design, construction and preparation process of nanobiomaterials. Secondly, biofilm disruption carried the risk of spread and infection the pathogenic bacteria, which might lead to other infections. Finally, we emphasized the role of nanobiomaterials in the development trends and translational prospects in biofilm treatment.

Long non-coding RNA LOC101927476 inhibits invasion, migration, and proliferation of ovarian cancer cell lines / 中华肿瘤杂志

Objective: To investigate the expression of long non-coding RNA LOC101927476 (LncRNA LOC101927476) in ovarian cancer and its effect on the biological characteristics of ovarian cancer. Methods: Patients with ovarian cancer who underwent surgery in Cancer Hospital of Chinese Academy of Medical Sciences from 2018 to 2019 were selected. The expressions of LOC101927476 in ovarian cancer cells 3AO, OVCA429, TOV21G, A2780, SKOV3, as well as 22 primary tumor tissues and their matched metastatic tumor tissues were detected by real-time quantitative polymerase chain reaction (RT-PCR). Ovarian cancer transcriptome sequencing data from the TCGA database was used to verify the expressions of LOC101927476 and GATA4. 3AO and OVCA429 cells were infected with lentivirus plasmid containing OE-LOC101927476 and single guide RNA (sg-RNA) targeting LOC101927476, respectively. The effects of LOC101927476 on migration and invasion were detected by Transwell and wound healing assay. The effect of LOC101927476 on cell proliferation was detected by cell counting kit-8 (CCK-8) assay. Results: RT-PCR assay showed that 20 out of 22 patients had significantly lower expression of LOC101927476 in their metastatic tumors compared with primary tumors. Transwell assay showed that overexpression of LOC101927476 significantly inhibited the invasion and migration capacities of 3AO cells. The numbers of invading and migrating 3AO cells infected with OE-LOC101927476 lentivirus were (357±63) and (699±65), respectively, lower than (661±95) and (1 024±76) in OE-EV group (P<0.050). In contrast, the numbers of invading and migrating OVCA429 cells with LOC101927476 knockdown were (512±72) and (472±40), respectively, higher than (309±13) and (363±27) in sg-Control group (P<0.050). Wound healing assay results showed that after 48 hours, the percentage of scratch healing of 3AO cells in OE-LOC101927476 group was (10.86±0.63)%, significantly lower than (57.38±4.42)% of OE-EV group (P=0.009). After 24 hours, the percentage of scratch healing of OCVA429 cells in sg-LOC101927476 group was (59.98±1.34)%, significantly higher than (23.15±2.03)% of sg-Control group (P=0.004). CCK-8 assays showed that the OD value of 3AO cells in OE-LOC101927476 group was (2.07±0.08), significantly lower than (2.29±0.04) of OE-EV group (P=0.009). The OD value of OVCA429 cells in sg-LOC101927476 group was (2.13±0.03), significantly higher than (1.93±0.03) of sg-Control group (P=0.001). The relative expression of GATA4 in OE-LOC101927476 group was (1.86±0.25), significantly higher than 1.00 of OE-EV group (P=0.001). In patients with high expression of LncRNA LOC101927476, the expression level of GATA4 was (2.93±0.35), which was higher than (0.29±0.06) of LOC101927476 low expression group (P=0.001). Conclusion: LncRNA LOC101927476 can inhibit the invasion, migration and proliferation of ovarian cancer cells.

Clinical management strategies of pulsatile tinnitus with transverse sinus stenosis / 中华耳鼻咽喉头颈外科杂志

Objective: To study the clinical diagnosis and treatment strategies for vein-related pulsatile tinnitus patients with transverse sinus stenosis. Methods: The clinical data of patients with vein-related pulsatile tinnitus, from January 2015 to August 2019, were collected,whose digital subtraction angiography showing transverse sinus stenosis. Taking December 2019 as the last follow-up time, we analyzed the clinical characteristics, CT angiography and digital subtraction angiography results, lumbar puncture pressure and cerebrospinal fluid composition, and other auxiliary examination results (pure tone audiometry, fundus examination of papilledema, carotid ultrasonography, bone density screening, endocrinous test), as well as tinnitus handicap inventory, treatment options and follow-up results. Results: 83 patients were enrolled with female of 89.2% (74/83) and male of 10.8%(9/83); 65.1% (54/83) with right tinnitus, 31.3% (26/83) with left tinnitus, and 3.6% (3/83) with bilateral tinnitus; 67.5% (56/83) with right dominant sinus, 19.3% (16/83) with left dominant sinus, 13.3% (11/83) with bilateral equalization; Bilateral and ipsilateral stenosis accounted for 55.4% and 44.6% respectively; BMI was overweight or obese in 41 cases (49.4%, 41/83). Patients with tinnitus handicap inventory level three or above accounted for 79.5% (66/83). Eventually, 33 patients chose conservative observation (39.8%, 33/83), 40 patients (48.2%), 8 patients (9.6%) and 2 patients (2.4%) received sigmoid sinus-related surgery, interventional surgery, or emissary vein occlusion respectively. The mean follow-up time of 74 patients was 26.2 months. The data of 48 surgery patients showed that the pressure differences of venous sinus among the recurrent patients were more obvious; Interventional surgery with simultaneous stenting placement was effective. Tinnitus did not decrease in two patients with emissary vein occlusion. Analysis of 26 patients with lumbar puncture revealed eight cases of normal cranial pressure and 18 cases of high cranial pressure. The sinus pressure difference between the two groups was different (P=0.025), but the difference of age of onset, concomitant symptoms, BMI, proportion of empty sella or papilledema was not statistically significant (P>0.05). Conclusions: The evaluation of patients with vein-related pulsatile tinnitus requires a standardized procedure. Papilledema cannot be used as a sensitive indicator in patients with early intracranial hypertension. Venous sinus pressure difference may be one of the indicators of intracranial hypertension, and the lumbar puncture is the gold standard for the diagnosis. Weight loss can be used as a conservative treatment during the observation period. Significant sinus stenosis is a risk factor for recurrence in patients undergoing sigmoid sinus surgery. Interventional stenting is an effective treatment for tinnitus secondary to transverse sinus stenosis.

Effect of malleostapedotomy procedure on 17 cases of congenital middle ear malformation / 中华耳鼻咽喉头颈外科杂志

Objective: To conclude the clinical features and the postoperative efficacy of congenital middle ear malformation treated with Malleostapedotomy (MS), and to explore the security and effectiveness of MS surgery. Methods: The clinical data of 17 patients (18 ears) with congenital middle ear malformation undergoing MS procedure were analyzed. There were 10 males (11 ears) and 7 females (7 ears), aged from 7 to 48 years. The imaging examination, pure-tone audiometry, intraoperative findings and postoperative hearing improvement of these patients were analyzed and summarized, and software SPSS23.0 was used for statistical analysis. Rusults All the 17 patients (18 ears) presented with hearing loss since childhood on the affected sides. Preoperative high resolution CT (HRCT) of the temporal bone revealed definite malformations in 9 ears (6 ears with incus long process dysplasia and 3 ears with anterior and posterior crus dysplasia). Before surgery, the mean bone conductive hearing threshold at 500, 1 000, 2 000 and 4 000 Hz was (15.6±10.2) dB HL, the mean air conductive hearing threshold was (60.6±9.7) dB HL, and the mean air-bone gap was (45.0±8.9) dB. During the surgery, all 18 ears were found to be accompanied by absence or hypoplasia of incus long process. 12 ears had stapes fixation, 6 ears had oval window atresia. All patients were treated with MS procedure by using Piston. The patients were followed up for 3 months to 1 year. The mean bone conductive hearing threshold was (14.7±8.8) dB HL. The mean air conductive hearing threshold was (37.7±11.6) dB HL, and the mean air-bone gap was (23.0±8.0) dB. There were statistically significant differences in the mean air conductive hearing threshold and mean air-bone gap before and after surgery (P<0.05). While there were no statistically significant differences in the mean bone conductive hearing threshold before and after surgery (P=0.550). Conclusions: MS procedure is safe and reliable in patients with congenital middle ear malformation of incus long process dysplasia, stapes fixation or oval window atresia. HRCT is useful in evaluating the major deformity of ossicular chain and facial nerve deformity. However, it is not enough to evaluate the joint of incus-stapes and oval window atresia. MS surgery in middle ear malformation requires advanced surgical experience and skills. The hearing improvement can be significant, even though some air-bone gap after surgery exist.

Curative Effect of Simiaosan Combined with Radiofrequency Ablation in Treatment of Acute Traumatic Gonarthromeningitis Under Arthroscopy / 中国实验方剂学杂志

Objective:To investigate the clinical efficacy of Simiaosan combined with arthroscopic radiofrequency ablation in the treatment of acute traumatic knee synovitis and its effects on inflammatory markers and knee joint function. Method:A total of 92 patients with acute traumatic knee synovitis who were treated in our hospital from February 2017 to November 2018 were randomly divided into observation group and control group, with 46 cases in each group. The patients in observation group were treated with Simiaosan combined with arthroscopic radiofrequency ablation, while the patients in control group were treated radiofrequency ablation combined with Gubi tablet, synovitis granule and imrecoxib tablets. The efficacy in the two groups was observed one month after operation. The degree of pain and the swelling of knee joint were evaluated before and one month after operation, and the function of knee joint was evaluated by lysholm knee score system (LKSS) before and one month after operation. And at the same time, the knee joint activity was measured, erythrocyte sedimentation rate (ESR) was analyzed by Wechsler's method, and hypersensitivity C-reactive protein (hs-CRP) was detected by immunoturbidimetry. The adverse reactions and complications of the two groups were observed. Result:Compared with control group after treatment, the total effective rate in observation group was significantly higher than that in control group, with statistically significant differences (P<0.05). The visual analogue scale (VAS) scores of knee pain in both groups after treatment were significantly lower than those before treatment (P<0.05), while the joint swelling scores were significantly higher (P<0.05). After treatment, the VAS score of knee pain in observation group was significantly lower than that of control group at the same time (P<0.05), while the joint swelling score was significantly higher (P<0.05). After treatment, the LKSS score and the range of motion of the affected knee joints in both groups were significantly increased compared with those before treatment (P<0.05), but with more significant improvement in observation group (P<0.05). The levels of ESR in peripheral blood and hs-CRP in serum of the two groups were significantly lower than those before treatment (P<0.05), especially in observation group (P<0.05). No obvious side effects were observed in observation group during the treatment with Simiaosan. There was no significant difference in the incidence of complications between the two groups. Conclusion:The treatment of Simiaosan combined with radiofrequency ablation under arthroscope has a significant efficacy in the treatment of acute traumatic gonarthromeningitis. The knee joint function of the patients was significantly improved, and the mechanism may be related to the inhibition of inflammatory reaction in vivo.

Exploring an Integrative Therapy for Treating COVID-19: A Randomized Controlled Trial / 中国结合医学杂志

OBJECTIVES@#To develop a new Chinese medicine (CM)-based drug and to evaluate its safety and effect for suppressing acute respiratory distress syndrome (ARDS) in COVID-19 patients.@*METHODS@#A putative ARDS-suppressing drug Keguan-1 was first developed and then evaluated by a randomized, controlled two-arm trial. The two arms of the trial consist of a control therapy (alpha interferon inhalation, 50 µg twice daily; and lopinavir/ritonavir, 400 and 100 mg twice daily, respectively) and a testing therapy (control therapy plus Keguan-1 19.4 g twice daily) by random number table at 1:1 ratio with 24 cases each group. After 2-week treatment, adverse events, time to fever resolution, ARDS development, and lung injury on newly diagnosed COVID-19 patients were assessed.@*RESULTS@#An analysis of the data from the first 30 participants showed that the control arm and the testing arm did not exhibit any significant differences in terms of adverse events. Based on this result, the study was expanded to include a total of 48 participants (24 cases each arm). The results show that compared with the control arm, the testing arm exhibited a significant improvement in time to fever resolution (P=0.035), and a significant reduction in the development of ARDS (P=0.048).@*CONCLUSIONS@#Keguan-1-based integrative therapy was safe and superior to the standard therapy in suppressing the development of ARDS in COVID-19 patients. (Trial registration No. NCT04251871 at www.clinicaltrials.gov ).

Exploring an Integrative Therapy for Treating COVID-19: A Randomized Controlled Trial / 中国结合医学杂志

OBJECTIVES@#To develop a new Chinese medicine (CM)-based drug and to evaluate its safety and effect for suppressing acute respiratory distress syndrome (ARDS) in COVID-19 patients.@*METHODS@#A putative ARDS-suppressing drug Keguan-1 was first developed and then evaluated by a randomized, controlled two-arm trial. The two arms of the trial consist of a control therapy (alpha interferon inhalation, 50 µg twice daily; and lopinavir/ritonavir, 400 and 100 mg twice daily, respectively) and a testing therapy (control therapy plus Keguan-1 19.4 g twice daily) by random number table at 1:1 ratio with 24 cases each group. After 2-week treatment, adverse events, time to fever resolution, ARDS development, and lung injury on newly diagnosed COVID-19 patients were assessed.@*RESULTS@#An analysis of the data from the first 30 participants showed that the control arm and the testing arm did not exhibit any significant differences in terms of adverse events. Based on this result, the study was expanded to include a total of 48 participants (24 cases each arm). The results show that compared with the control arm, the testing arm exhibited a significant improvement in time to fever resolution (P=0.035), and a significant reduction in the development of ARDS (P=0.048).@*CONCLUSIONS@#Keguan-1-based integrative therapy was safe and superior to the standard therapy in suppressing the development of ARDS in COVID-19 patients. (Trial registration No. NCT04251871 at www.clinicaltrials.gov ).

Analysis of Macular and Retinal Nerve Fiber Layer Thickness in Children with Refractory Amblyopia after Femtosecond Laser-assisted LaserKeratomileusis: A Retrospective Study / 中华医学杂志(英文版)

<p><b>Background:</b>Localized macular edema and retinal nerve fiber layer (RNFL) thinning have been reported shortly after laser in situ keratomileusis (LASIK) in adults. However, it is still unclear how LASIK affects the retina of children. This study aimed to investigate the macular retina and RNFL thickness in children with refractive amblyopia who underwent femtosecond laser-assisted LASIK (FS-LASIK).</p><p><b>Methods:</b>In this study, we included 56 eyes of 32 patients with refractive amblyopia who underwent FS-LASIK in our hospital from January 2012 to December 2016. Foveal (foveal center retinal, parafoveal retinal, and perifoveal), macular inner retinal (superior and inferior), and peripapillary RNFL thicknesses (superior, inferior, temporal, and nasal) were measured using Fourier-domain optical coherence tomography before surgery and 1 day, 3 days, and 1 week after surgery. We divided these patients into three groups based on their refractive error: High myopic group with 22 eyes (equivalent sphere, >6.00 D), mild myopic group with 19 eyes (equivalent sphere, 0-6.00 D), and hyperopic group with 15 eyes (equivalent sphere, >+0.50 D). We compared the macular retina and RNFL thickness before and after LASIK. A paired simple t-test was used for data analysis.</p><p><b>Results:</b>One week after surgery, the visual acuity for all 56 eyes of the 32 patients reached their preoperative best-corrected vision. Visual acuity improved two lines or better for 31% of the patients. The residual refractive errors in 89% of the patients were within ±0.5 D. In the high myopic group, the foveal center retinal and parafoveal retinal thicknesses were thicker 1 day and 3 days after surgery than before surgery (t = 2.689, P = 0.012; t = 2.383, P = 0.018, respectively); no significant difference was found 1 week after surgery (P > 0.05). The foveal center retinal and parafoveal retinal thicknesses were greater 1 day after surgery than they were before surgery (P = 0.000 and P = 0.005, respectively) in the mild myopic and hyperopic groups. No significant difference was found 3 days or 1 week after surgery (P > 0.05). In all three groups, no significant difference was found in the macular inner retinal or peripapillary RNFL thickness 1 day, 3 days, or 1 week after surgery (P > 0.05).</p><p><b>Conclusions:</b>The foveal center retinal edema after FS-LASIK is mild and reversible in children, that mostly occurred in the high myopic group with no effect on the visual acuity, and is always relieved within 1 week.</p>

Clinical observation on Yaotongning Capsule in treatment of lumbar hyperplasia (cold-dampness stagnation syndrome) / 中草药

Objective: To observe the therapeutic effect and safety of Yaotongning Capsule in the treatment of lumbar hyperplasia. Methods: A random, double-blind, placebo controlled, multicenter clinical research method was used. The lumbar hyperplasia patients (144 cases) were selected, divided into Yaotongning Capsule group (treatment group) with 72 cases, 72 cases completed; and placebo group (control group) with 72 cases, 70 cases completed. The treatment lasted for 2 weeks. After treatment, the symptom of traditional Chinese medicine and pain relief situation were observed in the two groups. Results: The curative effects of Yaotongning Capsule in the treatment of lumbar hyperplasia disease (cold-dampness stagnation syndrome) were as follows: The control rate in treatment group was 41.5%, and that in the control group was 0.0%, superiority test (P<0.001) was established. Pain relief: the relieve rate in treatment group was 86.1%, and that in the control group was reduced to 45.7%, there was significant difference between the groups (P<0.001). Conclusion: Yaotongning Capsule in the treatment of lumbar hyperplasia (cold-dampness stagnation syndrome) has obviously curative effect, and can effectively reduce the pain caused by lumbar hyperplasia.

Incidence of vascular anomalies and variants associated with unilateral venous pulsatile tinnitus in 242 patients based on dual-phase contrast-enhanced computed tomography / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>A comprehensive assessment of various vascular anomalies and variants associated with venous pulsatile tinnitus (PT) by radiography is essential for therapeutic planning and improving the clinical outcome. This study evaluated the incidence of various vascular anomalies and variants on the PT side and determined whether these lesions occurred as multiple or single entities.</p><p><b>METHODS</b>The dual-phase contrast-enhanced computed tomography images of 242 patients with unilateral venous PT were retrospectively reviewed. The vascular anomalies and variants on the symptomatic and asymptomatic sides were analyzed, and the incidences of anomalies or variants on each side were compared. The number of anomalies and variants on the symptomatic side in each patient was calculated.</p><p><b>RESULTS</b>(1) A total 170 patients (170/242) had more than one anomaly or variant on the symptomatic side, and 58 patients (58/242) had a single lesion on tomography. (2) There was a statistically significant difference in the incidence of dehiscent sigmoid plate (P = 0.000), lateral sinus stenosis (P = 0.014), high jugular bulb (P = 0.000), sigmoid sinus diverticulum (P = 0.000), jugular bulb diverticulum (P = 0.000), dehiscent jugular bulb (P = 0.000), and a large emissary vein (P = 0.006) between the symptomatic and asymptomatic sides. (3) Dehiscent sigmoid plate (86.4%) was the most frequent lesion on the symptomatic side, followed by lateral sinus stenosis (55.8%), high jugular bulb (47.1%), sigmoid sinus diverticulum (34.3%), jugular bulb diverticulum (13.6%), dehiscent jugular bulb (13.6%), large emissary vein (4.1%), sinus thrombosis (1.2%), and petrosquamosal sinus (0.8%).</p><p><b>CONCLUSIONS</b>Various vascular anomalies and variants occur more frequently on the venous PT side. Preliminary findings suggest that venous PT patients may have multiple vascular anomalies or variants on the symptomatic side.</p>

Analysis of the electromyographic characteristics on shoulder fatigue caused by lifting load / 中华劳动卫生职业病杂志

<p><b>OBJECTIVE</b>To analyze and evaluate the fatigue of shoulder skeletal muscle caused by different lifting loads with surface electromyography (sEMG).</p><p><b>METHODS</b>According to the loading standard of1 Repetition Maximum (1RM), ten male volunteers performed 3 tasks of upper limb flexion, i.e. 10%, 50% and 90%-1RM. During action process, the signals of Upper Trapezius (UT), Lower Trapezius (LT), Serratus Anterior (SA) and Anterior Deltoid (AD) were recorded by sEMG. The Mean Amplitude (MA) served as an index to evaluate the changes in skeletal muscle fatigue.</p><p><b>RESULTS</b>The scores of Borg were 15.6, 15.9 and 15.2 for 3 loads of 10%-1RM, 50%-1RM and 90%-1RM, respectively (P > 0.05). The mean amplitudes (MAs) of Upper Trapezius, Lower Trapezius, Anterior Deltoid and Serratus Anterior in shoulders increased obviously. Under the load intensity of 10%-1RM, the MAs of Upper Trapezius and Anterior Deltoid increased significantly (P < 0.05), which were 0.898 and 0.736, respectively. After the exhaustion, the contribution of mean amplitude in shoulder muscle did not change significantly (P > 0.05).</p><p><b>CONCLUSION</b>The low-load action for long time can induce easily the fatigue of upper trapezius and anterior deltoid.</p>

Study of the wavefront aberrations in children with amblyopia / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Amblyopia is a common ophthalmological condition and the wavefront aberrometer is a relatively new diagnostic tool used globally to measure optical characteristics of human eyes as well as to study refractive errors in amblyopic eyes. We studied the wavefront aberration of the amblyopic children's eyes and analyzed the mechanism of the wavefront aberration in the formation of the amblyopia, try to investigate the new evidence of the treatment of the amblyopia, especially in the refractory amblyopia.</p><p><b>METHODS</b>The WaveScan Wavefront System (VISX, USA) aberrometer was used to investigate four groups of children under dark accommodation and cilliary muscle paralysis. There were 45 cases in the metropic group, 87 in the amblyopic group, 92 in the corrected-amblyopic group and 38 in the refractory amblyopic group. One-way analysis of variance (ANOVA), t-test and multivariate linear regression were used to analyze all the data.</p><p><b>RESULTS</b>Third order to 6th order aberrations showed a decreasing trend whereas in the higher order aberrations the main ones were 3rd order coma (Z(3)(-1)-Z(3)(1)), trefoil (Z(3)(-3)-Z(3)(3)) and 4th order aberration (Z(4)(0)); and 3rd order coma represented the highest percentage of all three main aberrations. Within 3rd order coma, vertical coma (Z(3)(-1)) accounted for a greater percentage than horizontal coma (Z(3)(1)). Significant differences of vertical coma were found among all clinical groups of children: vertical coma in the amblyopic group (0.17 +/- 0.15) was significantly higher than in the metropic group (0.11 +/- 0.13, P < 0.05). In addition, the vertical coma in the refractory amblyopic group (0.19 +/- 0.15) was higher compared with the metropic group (P < 0.05), the 5th order aberration (0.11 +/- 0.08) was also significantly higher than in the metropic group (0.07 +/- 0.04, P < 0.05). No significant difference was found in vertical coma and 5th order aberration between the corrected-amblyopic group (0.13 +/- 0.11) and metropic group (0.07 +/- 0.04) (P > 0.05).</p><p><b>CONCLUSIONS</b>Although lower order aberrations such as defocus (myopia and hyperopia) and astigmatism are major factors determining the quality of the retinal image, higher order aberrations also need to be considered in amblyopic eyes as their effects are significant.</p>

Treatment of osteoporotic distal femur fractures with less invasive stabilizing system (LISS) and high strength injectable graft / 中国骨伤

<p><b>OBJECTIVE</b>To evaluate the clinical results of less invasive stabilizing system (LISS) and high strength injectable graft in the treatment of osteoporotic distal femur fractures.</p><p><b>METHODS</b>From Feb. 2005 to Feb. 2008, 26 cases (15 males, 11 females) of osteoporotic distal femur fractures were treated with less invasive stabilizing system (LISS) and high strength injectable graft. The mean age of the patients was 68.5 years (ranging from 59 to 81 years). According to AO classification,there were 9 cases type A3, 6 cases type C1, 7 cases type C2, 4 cases type C3.</p><p><b>RESULTS</b>The mean operation time was (110 +/- 15) min (ranging from 90 to 135 min). The patients were followed-up for from 12 to 28 months (averaged 18 months). The mean healing time was 20.5 weeks(ranging from 16.5 to 28 weeks). No deep infection, fixation loosening, breakage or failure of implants were observed after the operations. According to Rasmussen radiological evaluation,the results showed 19 cases for "excellent", 7 cases for "good". One year postoperatively, the mean ROM of the knees was 2 degrees to 125 degrees, the HSS knee score was from 59 to 99 points with average of (86.5 +/- 8.2) points. According to HSS scoring system, the results showed 22 cases for "excellent", 2 cases for "good", 1 for "fair" and 1 for "poor".</p><p><b>CONCLUSION</b>The less invasive stabilizing system (LISS) and high strength injectable graft is an effective way for the treatment of osteoporotic distal femur fractures.</p>