Clinical efficacy and safety of modified proceedure for prolapse and hemorrhoids combined with partial internal anal sphincterotomy in the treatment of annular mixed hemorrhoids / 临床外科杂志

Objective To explore the clinical efficacy and safety of modified PPH combined with partial internal anal sphincterotomy in the treatment of circular mixed hemorrhoids.Methods Patients with annular mixed hemorrhoids were divided into two groups by a completely randomized controlled method.54 patients in the experimental group were treated with modified PPH combined with partial internal anal sphincterotomy,while 51 patients in the control group were treated with conventional PPH.The postoperative indicators,perioperative and long-term complication rates of the two groups were compared,and the clinical efficacy and safety were observed.Results The operation time in the experimental group was(48.35±4.37)minutes,which was higher than that in the control group(36.42 ±6.21)minutes(P＜0.05).The incidence of postoperative anastomotic stenosis in the experimental group was 1.9％,lower than 15.6％ in the control group(P＜0.05).Anal pain,urinary retention,first defecation time,long-term anal distention,the experimental group was significantly better than the control group,the difference was statistically significant(P＜0.05);The hospitalization time in the experimental group(4.8±0.62)days was not significantly different from that in the control group(5.1±0.54)days(P＞0.05).The amount of intraoperative bleeding and anastomotic bleeding in the experimental group[(17.28±2.22)ml,3.7％]were not significantly different from those in the control group[(16.75± 2.13)ml,3.9％](P＞0.05).Conclusion Compared with conventional PPH,the modified PPH combined with partial internal anal sphincterotomy slightly increases the operation time,but does not increase the risk of anastomotic bleeding,the incidence of rectal fistula,the amount of surgical bleeding,and the length of hospital stay.It can significantly improve postoperative anal pain,urinary retention,long-term distention symptoms,shorten the time of first defecation,ease the difficulty of defecation,and significantly reduce postoperative anastomotic stenosis,The long-term efficacy and safety are good.

Curative Effect of Bifid Triple Viable Capsules in Patients after Laparoscopic Cholecystectomy / 中国药师

Objective:To discuss the curative effect of bifid triple viable capsules in the patients after laparoscopic cholecystecto-my ( LC) . Methods:Totally 100 cases of patients with LC were selected and divided into the observation group and the control group at random. The patients in the two groups underwent LC under the general anesthesia, and were given routine medical treatment after the operation. The patients in the observation group were additionally given bifid triple viable capsules, 630mg per time, twice a day for 1 week as the treatment course. The changes in the occurrence of diarrhea, alteration of intestinal flora and plasma D-lactic acid of the patients and drug adverse reactions in the two groups were observed and compared after the medical treatment. Results:One week after the operation, the occurrence of diarrhea and alteration of intestinal flora of the patients in the observation group were lower than those in the control group (P0. 05). Conclusion: The application of bifid triple viable capsules in the pa-tients after LC can effectively reduce the plasma D-lactic acid levels, occurrence of diarrhea and alteration of intestinal flora with prom-ising security, which is good for the postoperative recovery of the patients.

Influence of octreotide on serum LPS and high sensitive C-reactive pro-tein (hs-CRP) levels for patients with early postoperative inflammatory intestinal obstruction / 中国现代医生

Objective To discuss curative effect of Octreotide on early inflammatory intestinal obstruction after abdomi-nal operation and its influence on serum LPS and High sensitive C-reactive protein (hs-CRP) levels. Methods All 64 cases of patients with early inflammatory intestinal obstruction after abdominal operation were selected and divided into observation group (n=32) and control group (n=32) at random. The patients in two groups were given routine medical treatment, such like fasting, instant gastrointestinal decompression, anti-infection, intravenous nutrition,maintenance of water-electrolyte and acid-base balance and etc. The patients in observation group were additionally given 0.1mg Octreotide by hypodermic injection,q8h,while the patients in control group were given the same medical treatment as that in observation group except for Octreotide. The changes of serum LPS and hs-CRP levels of patients in two groups before and 6 days after the medical treatment,and the curative effect and untoward effect was compared as well. Results After 6 days' medical treatment, serum LPS and hs-CRP levels of patients in two groups were obvi-ously declined than before(P<0.05 or P<0.01),and the declining rate of patients in observation group was much higher than that in control group (P<0.05), and the total clinical efficiency in observation group (93.75%) was much higher than that in control group (75.00%)(χ2=4.27,P<0.05). 1 and 3 cases of untoward effect were appeared on patients in control group and observation group during treatment with light symptom, and after comparing the occurrence rates of untoward effect of patients in two groups,no differences were appeared(χ2=0.27,P>0.05). Conclusion Octreotide has reliable curative effect on early inflammatory intestinal obstruction after abdominal operation with high security, whose mechanism of action has close effect on obvious reducing serum LPS and hs-CRP levels of patients.

The relationship between the genotype and clinical factors of filamentous fungus causing-keratitis / 眼科研究

Background The study on the classification of fungi is very important for the diagnosis and treatment of fungal keratitis.Identifying the different species of filamentous fungi is a critical factor for the application of anti-fungal drug in treating keratitis.ObjectiveThis report studies the relationship between the genotype of filamentous fungi and the clinical factors.MethodsFifty-two patients with filamentous fungal keratitis determined by clinical and laboratory examination were recruited in Tongren Hospital from January 2006-December 2006.The lesions were graded on the severity of the corneal ulcer and the presence of hypopyon.The filamentous fungal keratitis was treated with topical and systemic administration of anti-fungal drugs or corneal transplantation.The isolates were cultured in potato culture and identified by morphological characteristics based on the Nelson criterion and genotyped by the rDNA ITS method.The clinical data was retrospectively analyzed.ResultsForty-eight species (eubacteria are bacteria,not fungi)of fungus were identified by morphological characteristics,and the filamentous fungi were divided into 4 types based on the phylogenetic relationships within the rDNA ITS of the 52 filamentous fungi.The morphological characteristics and genotype were confirmed in 48 strains of eubacteria and 31 strains of 52 filamentous fungi (90.3%).The 4 groups of fungi were classified by genotype as follows:group 1 represents 22 strains including 20 strains of Fusarium solani and 2 strains of Fusarium oxysporum;group 2 represents 12 strains including 8 strains of Fusarium moniliformis,3 strains of Fusarium proliferatum and 1 strain of Fusarium incarnatum;group 3 represents 5 strains including 1 strain of Fusarium moniliformis and 4 unknown strains;group 4 represents 13 strains including 10 strains of Aspergillus spp.and 3 strains of Alternaria spp.Significant differences were found in the disease duration (P=0.00),inducing cause (P=0.03),ulcer grade (P=0.01)and outcome of the anti-fungal treatment (P=0.035)when compared between group 1 and 2 with group 3 and 4.Conclusion Filamentous fungi that cause keratitis could be correctly identified by sequencing the internal tanscribed spacer of rDNA.There are significant clinical differences among the groups classified by genotype.

Ocular fungal isolates and antifungal susceptibility in northern China.

PURPOSE: To analyze the distribution characteristics of ocular fungal isolates and antifungal susceptibility in vitro. DESIGN: A retrospective case-series descriptive study. METHODS: Two thousand one hundred and seventy-nine specimens collected from Tongren Hospital during 2001 to 2004 were identified at the Beijing Institute of Ophthalmology. Fungal culture-positive rate, antifungal susceptibility in vitro, and genus distribution of positive cultures were analyzed retrospectively. For the fungal culture-positive samples, the gender and age of the patients, the location of ocular involvement, and the season of the onset of mycotic ocular diseases were studied. The fungal positive isolates were subjected to antifungal susceptibility testing. RESULTS: Out of 2,179 specimens, 681 specimens were positive cultures. The culture-positive rate was 31.25%. Out of 681 specimens of positive cultures, 591 specimens were from the cornea, 29 from the aqueous humor, 22 from the conjunctiva, 22 from the vitreous body, one from the lacrimal sac, and 16 from the other sites. Fusarium species was the most common pathogen identified in 394 (57.86% of positive cultures), followed by Aspergillus species in 116 (17.03% of positive cultures). Out of 681 positive cultures, the sensitivity in vitro to natamycin, terbinafine, itraconazole, and fluconazole were 608/681 (89.28%), 467/681 (68.58%), 260/681 (38.18%), and 101/681 (14.83%), respectively. Three hundred and sixty-eight (93.4%) of Fusarium species were sensitive to natamycin, 107 (92.2%) of Aspergillus species were sensitive to itraconazole. CONCLUSIONS: Fusarium species was the predominant pathogen, which resulted in mycotic ocular diseases in northern China, followed by Aspergillus species. Most of the Fusarium species were sensitive to natamycin, and most of the Aspergillus species were sensitive to itraconazole.

Pharmacokinetics of chlorhexidine gluconate 0.02% in the rabbit cornea.

PURPOSE: The aim of this study was to determine the pharmacokinetic parameters of chlorhexidine gluconate (CHG) in the rabbit cornea. METHODS: Each eye of 16 New Zealand white rabbits were topically instilled with 50 microL of CHG 0.02% eye drops twice with a 5-min interval. Four (4) corneas of 2 rabbits were harvested at each time point. The concentration of CHG in the cornea was determined with high-performance liquid chromatography (HPLC) and 387 software to simulate the pharmacokinetic parameters. RESULTS: The concentration of CHG in the cornea displayed an open two-compartment model. Tmax was 13.75 min, Cmax 0.713 microg.g1, clearance rate 1.64 microg.g-1.min-1, and t1/2alpha, t1/2beta, and t1/2ka was 2.65, 48.72, and 2.67 min, respectively. CONCLUSIONS: The concentration of CHG in the rabbit cornea could be determined by means of HPLC. The maximum concentration of CHG in the corneal tissue was much higher than the trophozoite minimum amoebicidal concentration (TMAC) in vitro.

Acanthamoeba keratitis as a complication of orthokeratology.

PURPOSE: To present four cases of Acanthamoeba keratitis as a complication of orthokeratology. DESIGN: Observational case report. METHODS: Four patients with Acanthamoeba keratitis had histories of overnight orthokeratology lens wear of 6 months to 2 years. RESULTS: Three cases were diagnosed with Acanthamoeba keratitis by corneal scraping and one by confocal microscopy examination. The patients were treated with chlorhexidine, metronidazole, and neomycin sulfate, resulting in a rapid resolution of ocular inflammation. CONCLUSION: Overnight wear of orthokeratology lenses may induce Acanthamoeba keratitis.

Etiological analysis on bacterial ocular disease in northern China (1989-1998) / 中华医学杂志(英文版)

<p><b>OBJECTIVE</b>To review the distribution and trends of bacterial culture specimens in Beijing Institute of Ophthalmology.</p><p><b>METHODS</b>A retrospective analysis of the bacterial culture-positive rate, the distribution of gram' s stain, and the distribution and change of isolates was performed on 4705 specimens during a 10-year period (1989- 1998).</p><p><b>RESULTS</b>Positive cultures numbered 1339 of the 4705 specimens, with a positive rate of 28.6%. Gram-positive cocci constituted 55.6% of the total isolates, followed by gram-positive bacilli 13.1% . Gram-negative cocci accounted for 2.8%, and gram-negative bacilli 28.5% . In the positive bacteria cultures, coagulase-negative Staphylococcus (mainly Staphylococcous epidermidis) was the most common isolate (25.3%), and followed by Pseudomonas 18.8%, Micrococcus 11.7%, Cotynbaccterium 10.1%, and Staphylococcus aureus 8.2% . During the 10-year period, the overall frequency of gram-positive cocci appeared to increase with time while the frequency of gram-negative bacilli decreased.</p><p><b>CONCLUSIONS</b>Gram-positive cocci and gram-negative bacilli are still the predominant pathogens of ocular infection in northern China. The frequency of the former increases annually whereas that of the latter decreases. It is important to comprehend the distribution and trends of ocular pathogenic bacteria for the diagnosis, prevention and treatment of bacterial infectious ocular disease.</p>

Study on the clinic and laboratory diagnosis of patients with trachoma / 眼科

Objective To investigate the clinical manifestation of trachoma,and to select the appropriate laboratory test for clini- cal diagnosis.Design Retrospective case series.Participants Retrospective analysis of medical records from 61 patients with trachoma from Jan 2003 to Aug 2006 in Bejing Tongren Eye Center.Methods Grades of trachoma diagnosis were according to the criteria de- signed by Chinese Ophthalmological Society (1979).The general state of health,case history,and the laboratory investigations of pa- tients were recorded.Laboratory tests included the conjunctiva scraping for inclusions,C.trachomatis immune antigen test and PCR test.Main Outcome Measures Manifestation of corneal and conjunctiva,the results of laboratory tests of C.trachomatis.Results Out of sixty-one patients including 28 males and 33 females,the average old was (29.05?19.99) years.88.5% cases were inⅠstage of tra- choma,8.2% were inⅡstage,and 3.3% were inⅢstage.The C.trachomatis inclusions were found in 7 (11.5%) scraping smears.42 (68.9%) cases were positive in C.trachomatis antigen test.46 (75.4%) cases were positive in PCR tests.The positive rates of antigen and PCR test were significantly higher than that of scraping (P=0.00).Conclusions A majority of clinical patients were inⅠstage of trachoma.The degree of their distress was minimal.It is necessary to apply C.trachomatis,antigen test or PCR test to improve the clin- ical diagnosis.