[The prevention and therapy of corneal ulcers in patients with large-area thermal burns].

Objective: To evaluate the characteristics of ocular injury in patients with severe extensive thermal burns, and to explore the effective methods to prevent and treat corneal ulcers related to severe burns. Methods: A retrospective case series study. Between 2010 and 2019, Sixteen severe thermal burn patients with burn sizes>70% of the total body surface area involving the ocular region were admitted to the Burns and Plastic Surgery Division of Chinese PLA General Hospital, and consult with Ophthalmology Division. There were deep second-degree to fourth-degree burns in the eyelids. In the eleven surviving patients, 22 eyes presented ectropion. Eyelid full-thickness skin grafting (EFTSG) combined with or without tarsorrhaphy was performed in 20 eyes due to severe corneal exposure. Two eyes received partial blepharorrhaphy because of mild ectropion. The ocular manifestations and treatment outcomes were reviewed and assessed. Results: The majority of the patients were youth, and the average age was (36.8±10.4) years. The burn area was 84.0%±9.1% of the body surface area. Corneal ulcers secondary to lagophthalmos occurred at (35.1±15.6) days after burning in 75% (24/32) of eyes. Perforation was found in 18.8% (6/32) of eyes. Among the 22 operated eyes, the corneal ulcer was repaired in all 9 eyes receiving EFTSG with tarsorrhaphy, whereas ectropion recurred in 8 of 11 eyes only receiving EFTSG, and 4 eyes underwent further surgery due to corneal epithelial defects. Conclusions: In patients with severe large-area thermal burns, corneal ulcers are common complications. Prevention of corneal exposure is vital because the treatment of corneal ulceration is difficult due to eyelid deformity, inflammation and the absence of donor skin. Timely full-thickness skin grafting and blepharorrhaphy are effective approaches to preventing exposure keratopathy. To severe ulcers occur, conjunctival flap or Tenon's capsule covering combined with eyelid EFTSG and tarsorrhaphy is useful to rescue visual function.

Cognitive motor interference for gait and balance in stroke: a systematic review and meta-analysis.

BACKGROUND AND PURPOSE: An increasing interest in the potential benefits of cognitive motor interference (CMI) for stroke has recently been observed, but the efficacy of CMI for gait and balance is controversial. A systematic review and meta-analysis of randomized controlled trials was performed to estimate the effect of CMI on gait and balance in patients with stroke. METHODS: Articles in Medline, EMBASE, the Cochrane Library, Web of Science, CINAHL, PEDro and the China Biology Medicine disc were searched from 1970 to July 2014. Only randomized controlled trials examining the effects of CMI for patients with stroke were included, and no language restrictions were applied. Main outcome measures included gait and balance function. RESULTS: A total of 15 studies composed of 395 participants met the inclusion criteria, and 13 studies of 363 participants were used as data sources for the meta-analysis. Pooling revealed that CMI was superior to the control group for gait speed [mean difference (MD) 0.19 m/s, 95% confidence interval (CI) (0.06, 0.31), P = 0.003], stride length [MD 12.53 cm, 95% CI (4.07, 20.99), P = 0.004], cadence [MD 10.44 steps/min, 95% CI (4.17, 16.71), P = 0.001], centre of pressure sway area [MD -1.05, 95% CI (-1.85, -0.26), P = 0.01] and Berg balance scale [MD 2.87, 95% CI (0.54, 5.21), P = 0.02] in the short term. CONCLUSION: Cognitive motor interference is effective for improving gait and balance function for stroke in the short term. However, only little evidence supports assumptions regarding CMI's long-term benefits.

Significance of Bcl10 gene mutations in the clinical diagnosis of MALT-type ocular adnexal lymphoma in the Chinese population.

We investigated the expression of Bcl10 gene mutations in mucosa-associated lymphoid tissue-type ocular adnexal lymphoma (OAL), atypical lymphoid hyperplasia (ALH), and reactive lymphoid hyperplasia (RLH) in the Chinese population and its role in clinical diagnosis and pathogenesis. Forty-three samples were collected during patient surgeries. Pathological diagnosis confirmed OAL in 23 cases, ALH in 10 cases, and RLH in 10 cases. Normal peripheral lymph tissues from 12 cases were used as negative controls. Bcl10 gene expression was examined using molecular biological methods, and DNA sequences and mutations were compared with published data. The protein expression of Bcl10 and nuclear factor kappaB (NF-κB) were detected with immunohistological and immunofluorescence colocalization. Bcl10 gene expression was detected in 15 OAL cases. Novel mutations were found in 11 cases. Notably, 1 mutation, which matched a published mutation, was detected in 1 ALH case; 1 novel mutation was found in 1 RLH case; and no Bcl10 gene mutation was found in controls. Most novel mutations were truncation mutations, resulting in a truncated protein product of 99 amino acids (compared to the full-length 233 amino acids; GenBank accession No. EF189176). Results of tests for abnormal Bcl10 gene expression in nuclei or cytoplasm were consistent with changes in NF-κB translocation. This report is the first of newly discovered mutations in the Bcl10 gene in the Chinese population. The distribution of the mutations is consistent with and more sensitive than that of the pathological diagnosis. These mutations can be used to identify the stage and clinical characteristics even when morphological changes are absent.