Objective To evaluate the application of tendency-oriented perimetry (TOP) in detecting the visual function of glaucoma. Methods The traditional threshold perimetry (Normal/Normal strategy) and TOP (TOP/Normal strategy) carried out by Octopus 101 perimetry were used to examine the visual field of 20 normal subjects (20 eyes), 32 cases (32 eyes) of primary open-angle glaucoma (POAG), and 14 cases (14 eyes) of suspected POAG, respectively. The visual field outcomes, indices, point by point threshold variability and defective points of the two perimetries were compared and analysed. Results The negative rate of TOP was 90% in normal subjects. The positive rate of TOP was 75% in POAG , and 100% in middle and late stage of POAG. The visual field indices of two perimetries were positively correlated, with mean sensitivity (MS) of r=0.9335, mean defect (MD) of r=0.9189, and loss variance (LV) of r=0.9621. The point by point threshold variability and defective points of TOP were higher than those of traditional threshold perimetry, but the difference between the two perimetries was not significant (P=0.2019, P=0.4448). Conclusion The visual field indices of TOP and traditional threshold perimetry are positively correlated. The sensitivity and reproducibility of TOP are high in detecting the visual function of middle and late stage of POAG. (Chin J Ocul Fundus,Dis, 2002, 18: 269-272)
中药临床试验是中医药研究中发展较快的一个领域，临床研究协调员（CRC）在中药临床试验中有重要作用，其工作范围涉及到中药临床试验的各个方面。由于中药临床试验有着不同于西药临床试验的特点，CRC在中药临床试验中的作用也有其特殊性，对提高临床试验的安全性、科学性及试验数据的可信度方面起重要作用。
Abstract In order to find a new method to repair large bone defect, the free periosteum autograft was investigated in experiment, and then the method was used clinically. In the experiment, a 6mm×18mm×5mm bone defect was made at upper end of both tibiae of 42 rabbites. The periosteum of each rabbit was cut into 1mm cubes, and implanted randomly into the tbial bone defect on one side and the other side was used as control. After 2, 4, 8 weeks, the bone defects of each group were examined for bone formation by roentgenography, radionuclide and histology. The results showed that the defects treated by free periosteum autografts healed twice as fast as the controls (its natural healing). The reason probably was that the periosteum provided with many osteogenic cells. On thebasis of these results, 21 cases of bone defects (the largest was 10.5cm×4cm×4cm, the smallest was 2cm×2cm×2cm) including 17 cases of benign bone tumor and4 cases of chronic osteomyelitis, were treated by free periosteum autografts. The defects were all healed, and the function of the joints was restored.
In this experiment ,the sciatic nerves or twen-ty-eight rats were cut and then anastomosed withbiological adhesive agent or by suture in randonand the latter as control. The biological adhesive a-gent from human plasma was composed of fibrino-gen coagulase and medullary sheath of the nervetaken at the anasomosis region were studied histol-gically. The results of the experimental group wsasignificantly superior to the control.
OBJECTIVE: To compare the clinical results of repairing bone defect of limbs with tissue engineering technique and with autogeneic iliac bone graft. METHODS: From July 1999 to September 2001, 52 cases of bone fracture were randomly divided into two groups (group A and B). Open reduction and internal fixation were performed in all cases as routine operation technique. Autogeneic iliac bone was implanted in group A, while tissue engineered bone was implanted in group B. Routine postoperative treatment in orthopedic surgery was taken. The operation time, bleeding volume, wound healing and drainage volume were compared. The bone union was observed by the X-ray 1, 2, 3, and 5 months after operation. RESULTS: The sex, age and disease type had no obvious difference between groups A and B. all the wounds healed with first intention. The swelling degree of wound and drainage volume had no obvious difference. The operation time in group A was longer than that in group B (25 minutes on average) and bleeding volume in group A was larger than that in group B (150 ml on average). Bone union completed within 3 to 7 months in both groups. But there were 2 cases of delayed union in group A and 1 case in group B. CONCLUSION: Repair of bone defect with tissue engineered bone has as good clinical results as that with autogeneic iliac bone graft. In aspect of operation time and bleeding volume, tissue engineered bone graft is superior to autogeneic iliac bone.
Objective To compare the outcomes and safety of 23G and 20G vitrectomy for treatment of infectious endophthalmitis. Methods This was a retrospective case study. Sixtyseven eyes of 67 eyes suffering from infectious endophthalmitis with a history of trauma or intraocular operation history were enrolled in this study. They were diagnosed by the examinations of best corrected visual acuity, intraocular pressures, slit lamp microscope, indirect ophthalmoscopy, B-scan ultrasound and CT. There were 49 males (49 eyes) and 18 females (18 eyes). The patients aged from 18 to 72 years with a mean age of (43plusmn;13) years. There were 60 patients (60 eyes) with a history of trauma, 7 patients (7 eyes) with intraocular operation history. The patients were enrolled into 20G vitrectomy group (35 patients, 35 eyes) before December, 2009 and 23G vitrectomy group (32 patients, 32 eyes) after January, 2010 when 23G vitrectomy system was imported in this hospital. Vitreous purulence was taken in all patients at the beginning of the surgery for bacteria and fungal culture and drug sensitivity test. A standard vitrectomy with artificial posterior vitreous detachment followed by internal limiting membrane peeling, and (or) intraocular laser photocoagulation, cryocoagulation, fluidair exchange with intraocular silicone oil or gas tamponade were performed in all cases. Broadspectrum antibiotics and glucocorticoids were used systematically for one week after surgery, but glucocorticoids were not used for fungal infections. The followup was ranged from two to nine months with a mean of (7plusmn;1) months. The surgical time, inflammation situation, visual acuity, intraocular pressure, retinal reattachment rate, iatrogenic retinal hole rate, bulbar conjunctiva scar formation rate, reoperation rate and eye retention situation before and after surgery were comparatively analyzed. Results The mean surgical times were (126plusmn;12) and (89plusmn;12) minutes in 20G and 23G group, which was significantly different (t=3.125, P＜0.05). The major surgery complications were ora serrata dialysis and other iatrogenic retinal breaks, and were occurred in 34 eyes, including 30 eyes (85.71%) in 20G group and 4 eyes (12.50%) in 23G group (chi;2=35.85,P＜0.05). These 4 eyes in 23G group received foreign body removal surgery previously. The inflammation was controlled in 65 eyes (97.01%) including 34 eyes (97.14%) and 31 eyes (96.88%) in 20G and 23G group respectively, which was not significantly different (chi;2=0.004,P＞0.05). At last follow-up, There was no statistical difference of visual acuity between the two groups (t=3.12, P＞0.05). Fourteen eyes underwent silicone oil tamponade including 13 eyes (37.14%) and 1 eye (3.13%) in 20G and 23G group respectively, which was significantly different (chi;2=11.703, P＜0.05). Nine eyes underwent reoperation (13.43%), including 8 eyes (22.86%) and 1 eye (3.13%) in 20G and 23G group respectively, which was significantly different (chi;2=5.597,P＜0.05). The 8 re-operated eyes in 20G group included 1 eye of recurrent endophthalmitis and 7 eyes with retinal detachment, the 1 re-operated eye in 23G group was of recurrent endophthalmitis. There was significantly different (chi;2=7.147,P＜0.05) for the rate of retinal detachment between the 2 groups. There were 40 eyes with bulbar conjunctiva scar including 35 eyes (100.00%) and five eyes (15.63%) in 20G and 23G group. Conclusion 23G vitrectomy is an effective treatment for infectious endophthalmitis with shorter surgery time, lower reoperation rate, lower retinal reattachment rate and fewer bulbar conjunctiva scar.
Objective To investigate the effect of different degrees of wound eversion on scar formation at the donor site of anterolateral thigh flaps by a prospective clinical randomized controlled study. MethodsAccording to the degree of wound eversion, the clinical trial was designed with groups of non-eversion (group A), eversion of 0.5 cm (group B), and eversion of 1.0 cm (group C). Patients who underwent anterolateral femoral flap transplantation between September 2021 and March 2023 were collected as study subjects, and a total of 36 patients were included according to the selection criteria. After resected the anterolateral thigh flaps during operation, the wound at donor site of each patient was divided into two equal incisions, and the random number table method was used to group them (n=24) and perform corresponding treatments. Thirty of these patients completed follow-up and were included in the final study (group A n=18, group B n=23, and group C n=29). There were 26 males and 4 females with a median age of 53 years (range, 35-62 years). The body mass index was 17.88-29.18 kg/m2 (mean, 23.09 kg/m2). There was no significant difference in the age and body mass index between groups (P>0.05). The incision healing and scar quality of three groups were compared, as well as the Patient and Observer Scar Assessment Scale (POSAS) score [including the observer component of the POSAS (OSAS) and the patient component of the POSAS (PSAS)], Vancouver Scar Scale (VSS) score, scar width, and patient satisfaction score [visual analogue scale (VAS) score]. Results In group C, 1 case had poor healing of the incision after operation, which healed after debridement and dressing change; 1 case had incision necrosis at 3 months after operation, which healed by second intention after active dressing change and suturing again. The other incisions in all groups healed by first intention. At 6 months after operation, the PSAS, OSAS, and patient satisfaction scores were the lowest in group B, followed by group A, and the highest in group C. The differences between the groups were significant (P<0.05). There was no significant difference between the groups in the VSS scores and scar widths (P>0.05). ConclusionModerate everted closure may reduce the formation of hypertrophic scars at the incision site of the anterior lateral thigh flap to a certain extent.
Objective To sort out the policies related to rare diseases in China, analyze and summarize the focus and potential problems of relevant policy texts, and provide decision-making references for the subsequent formulation and improvement of policies in the field of rare diseases in China. Methods We searched for relevant policy documents in the field of rare diseases at the national level from 2018 to 2023, constructed a three-dimensional analysis framework based on content analysis of “policy tool-stakeholder-policy strength” in the field of rare diseases in China, and conducted cross-analysis between policy tools, stakeholders, and policy strength. Results Finally, 39 policy texts were included. There were 112 policy tool dimension codes, with environment-based, supply-based, and demand-based tools accounting for 62.5%, 30.36%, and 7.14%, respectively. There were 229 stakeholder dimension codes, including 42.79% for government departments, 19.65% for medical institutions, 19.65% for corporate units, and 17.90% for patients and their families. The average score for policy strength was 2.2 points. Cross-analysis showed that government departments had the highest proportion in the dimensions of supply-based, environment-based and demand-based tools (45.76%, 43.45%, 32.00%, respectively). The policy strength of environmental tools was the strongest (124 points). The policy strength of government departments was the strongest (78 points). Conclusions There is a certain imbalance in the design and configuration of rare disease policy tools in China, and there is uneven distribution of rare disease policies among stakeholders. Although the overall effectiveness of policies in the field of rare diseases is showing a positive growth trend, there may be a mismatch between policy tools, stakeholders, and policy strength.