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Background/aimsThis study investigated the risk factors for epiretinal membrane (ERM) in eyes with primary rhegmatogenous retinal detachment (RRD) that received silicone oil (SO) tamponade.MethodsThis retrospective analysis included 1140 patients (1140 eyes) with RRD who underwent primary vitrectomy and SO tamponade. The prevalence of ERM was estimated and possible risk factors (eg, type 2 diabetes, proliferative vitreoretinopathy (PVR), SO tamponade time (SOTT), photocoagulation, vitreous haemorrhage, choroidal detachment, cryotherapy and retinal tear size) were analysed via multiple logistic regression.ResultsThe prevalence of ERM was 12.3% (140/1140), and the accuracy of preoperative ERM diagnosis was 40.5%. Multivariate logistic regression analysis showed that risk factors for ERM in eyes with SO tamponade included preoperative PVR (OR=4.336, 95% CI 2.533 to 7.424, pConclusionIn eyes with RRD that received SO tamponade, the prevalence of ERM was 12.3%, while the accuracy of preoperative ERM diagnosis was low. Preoperative PVR, type 2 diabetes, photocoagulation energy and SOTT were the main risk factors for ERM.

A series of comb-shaped fluorene-based poly (arylene ether sulfone nitrile) (CFPESN–x) was synthesized as anion exchange membranes (AEMs). The well-designed architecture of fluorene-based main chains and comb-shaped C8 long alkyl side chains containing quaternary ammonium groups was responsible for the clear microphase-separated morphologies, as confirmed by small angle X-ray scattering and atomic force microscopy. Moreover, nitrile groups on main chains also showed a profound influence on membrane morphology and properties. CFPESN–x exhibited more interconnected ionic domains with increasing the nitrile group content resulting in higher conductivities and anti-swelling property. Then CFPESN–x exhibited high ionic conductivities in the range of 27.1–91.5 mS cm−1 from 30 to 80 °C and superior ratios of conductivity to swelling ratio at 80 °C at moderate IECs. Moreover, CFPESN–x also showed good mechanical properties and thermal stability, and optimizable alkaline stability and single cell performance.

A series of novel fluorene-containing poly(arylene ether sulfone nitrile)s (FPESN-m/n) multiblock copolymers bearing 1,2-dimethylimidazole groups (ImFPESN-m/n) were synthesized for preparing anion exchange membranes (AEMs). Bromination rather than chloromethylation was used in this work. The bulky and rigid fluorene groups were introduced to force each chain apart to create large interchain spacing. Strong polar nitrile groups were introduced into the hydrophobic segments with the intention of enhancing the anti-swelling property of the AEMs. The length of fluorene–containing hydrophobic segment was varied to study the structure–property of the AEMs. With the ion groups anchored selectively and densely on the hydrophilic segments, all the AEMs exhibited well-defined hydrophilic/hydrophobic microphase-separated structures. As a result, the AEMs showed high hydroxide conductivities in the range of 35.2–118.3 mS cm−1 from 30 to 80 °C and superb ratios of ionic conductivity to swelling at 80 °C. Furthermore, the AEMs also exhibited good mechanical properties, thermal and alkaline stabilities.

STUDY DESIGN This was a longitudinal cohort study. OBJECTIVE The main objective of this study was to investigate the outcomes of surgery with or without radiotherapy during treatment of patients with chondrosarcoma of the osseous spine. SUMMARY OF BACKGROUND DATA Chondrosarcoma is a primary spinal malignant tumor; chemotherapy and radiotherapy (RT) are generally unsuccessful, and thus, the main treatment of choice is complete en bloc resection. However, even with complete resection, these patients still have a significant rate of recurrence, morbidity, and mortality. Although there have been reports that the addition of RT to surgery may lead to increased survival and better cancer control, the evidence of the efficacy of RT remains controversial. MATERIALS AND METHODS Patients diagnosed with chondrosarcoma who are then treated by surgery alone or surgery+RT were identified and extracted from the SEER (Surveillance, Epidemiology, and End Results) database (1973-2013). Propensity score matched (PSM) analysis was performed to balance patient characteristics between surgery alone and surgery+RT groups. Patients with a different grade and stage were stratified and analyzed. RESULTS A total of 778 patients with chondrosarcoma of the osseous spine treated by surgery alone or surgery+RT were extracted from the SEER database. Before PSM, the unadjusted Kaplan-Meier curve and bivariable Cox proportional hazard regression models showed that the surgery alone group had higher chondrosarcoma cancer-specific survival and overall survival than the surgery+RT group (both P

Background: There has been no standardized questionnaire and objective criterion for assessing and diagnosing asthenopia so far. This study aimed to design a valid and reliable questionnaire to determine the various causes of asthenopia for use by clinicians and researchers. Methods: We developed a 19-item asthenopia questionnaire (AQ-19) in two phases. In the Design phase, 17 experts, 98 patients with asthenopia and 20 controls participated to generate the item list. We generated a comprehensive 52-item list to create our 1st version. The list included selected items based on a literature review, patient interviews and the Delphi experts method. In the Validation phase, we conducted a pilot test (127 patients and 25 controls) and retest (154 patients and 24 controls) for item reduction and a questionnaire validity assessment. Results: Our initial questionnaire contained 52 symptoms and 2 self-evaluation questions. After item reduction and assessment, we generated a 19-item questionnaire. It included 19 symptom items that were classified into three domains through factor analysis. Cronbach's α for the three subscales of this version were between 0.79 and 0.85, while for the complete questionnaire Cronbach's α was 0.90, with a split-half reliability of 0.80. Factor analysis showed the three components have eigenvalues > 3 and these explained 54.3% of the variance. Conclusions: The AQ-19 has acceptable psychometric properties, making it a valid and reliable tool for ophthalmologists and optometrists to evaluate asthenopia as well as to provide clues to find its causes. It provides three levels of information: (1) Identifies the presence of asthenopia. (2) Differentiates three major causal classifications (ocular-surface, systemic, and vision symptoms). (3) Focuses in on a specific cause. The clinician must still use his or her skills to determine the exact cause. The AQ-19 questionnaire has the potential to be used in clinical trials and outcome research, and most importantly to help clinicians efficiently and effectively diagnose the cause of a patient’s asthenopia. Trial registration: KYK [2016]8. Registered at 25 February 2016. Retrospectively registered. Keywords: Asthenopia, Reliability, Validity, Questionnaire, Delphi Method

Metal complexes of anthranilic acid derivatives that constitute a novel class of non-sugar-type α -glucosidase inhibitors were synthesized and assessed in vitro for inhibitory activity. All of the Ag(I) complexes ( 9 – 16 ) inhibited α-glucosidase at the nanomolar scale, while 3,5-dichloroanthranilic acid silver(I) ( 9 ) was the most potent (IC 50 = 3.21 nmol/L). Analysis of the kinetics of enzyme inhibition indicated that the mechanism of the newly prepared silver complexes was noncompetitive. The structure-activity relationships were also analyzed, and they are discussed in this report.

To report and discuss the postoperative complications in patients after Densiron 68 intraocular tamponade in the management of complicated retinal detachment with proliferative vitreoretinopathy (PVR).We presented a prospective interventional non-comparative case series of 27 eyes of 27 consecutive patients. Inclusion criteria were PVR, posterior or inferior retinal breaks, and the patient's inability to posture. Vitreoretinal surgery with Densiron 68 intraocular tamponade was performed in all patients. Complications were recorded at 1 week and 1, 2, and 3 months after Densiron 68 intraocular tamponade and after removal of Densiron 68 endotamponade at same periods.The most common complication was posterior capsule opacification and cataract development in seven eyes (25.9%) and in two eyes (25%, 2/8), respectively, the second complication was intraocular inflammation in six eyes (22.2%), the third complication was emulsification and dispersion and raised intraocular pressure in five eyes (18.5%), respectively. The success rate with one operation using Densiron 68 was 85.2% and with further surgery 92.5%. Visual acuity improved from mean logMAR of 2.12 (SD= 0.68) to 1.16 (SD=0.84), P=0.0001.According to the results of this study, postoperative complications did not increase significantly in the vitreoretinal surgery with temporary Densiron 68 intraocular tamponade. Densiron 68 intraocular tamponade is safe and effective in treating complicated retinal detachment.

To evaluate the visual acuity and subjective satisfaction of different aged monocular cataract patients who were implanted with ReSTOR multifocal intraocular lens (MIOL).Prospective comparative study: the objects are 24 cases of monocular cataract patients who consecutively received phacoemulsification and implantation of ReSTOR MIOL. The patients were divided into two groups by age: the presbyopic group has 17 cases with age ≥ 45 years, the non-presbyopic group has 7 cases with ages45 years. Research parameters: uncorrected and corrected distance (4 m), intermediate (80 cm, 60 cm), and near visual acuity; contrast sensitivity (CS); and questionnaire survey. All data were statistically analyzed with rank sum test.Among presbyopia patients, the near vision of the eyes implanted with ReSTOR MIOL is better than that of the contralateral eyes with clear lens (Z = 2.864, Z = 2.911;P = 0.004), whereas the distance and intermediate vision and the CS results show no significant differences compared to that of contralateral eyes with clear lens (Z = 0.183 - 1.417, P = 0.855 - 0.156); the subjective satisfactions are 7 to 10 points with 70.6% (12/17) patients scoring higher than 9 points; and the spectacle-independent rate among presbyopia patients is 58.8% (10/17). In non-presbyopic group, the near and intermediate visions of ReSTOR MIOL implanted eyes are lower than that of the contralateral eyes with clear lens (Z = 2.197 - 2.371;P = 0.028 - 0.018); CS results of MIOL implanted eyes are also generally lower than that of the contralateral eyes, and the difference between CSs of bilateral eyes under night glare mode (3 cd/m(2)+28 Lux) with low spatial frequency (1.5 c/d) is statistically significant (Z = 1.997, P = 0.046); the subjective satisfactions are 6 to 9 points with 14.3% (1/7) patients scoring higher than 9 points; the spectacle-independent rate of both eyes is 85.7% (6/7).The monocular cataract patients with presbyopia are suitable for implantation of ReSTOR MIOL, because their near visual acuity of ReSTOR MIOL implanted eyes is better than that of the contralateral clear lens eyes with higher subjective satisfaction and without decrease in distance and intermediate visions and CS. For non-presbyopic young patients with monocular cataracts, the near and intermediate visions of MIOL implanted eyes are lower than that of the contralateral clear lens eyes and with lower subjective satisfaction (compared to that of presbyopic patients), though the distance visions are similar. Therefore, although ReSTOR MIOL can be implanted in non-presbyopic group, a more detailed preoperative communication with these patients is needed.

To evaluate the results of Toric intraocular lens (IOL) for correction of preoperative astigmatism in patients having cataract phacoemulsification.It was a prospective case series study. Seventy-one eyes (60 patients) had implantation of Acrysof Toric IOL. logMAR uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), preexisting corneal astigmatism, residual refractive sphere and cylinder, and toric IOL axis were measured. Four residual astigmatism models were compared according to their axis postoperatively: neutral, against-the-rule (ATR, 180 ± 15 degrees), with-the-rule (WTR, 90 ± 15 degrees) and oblique (OB, 45/135 ± 30 degrees). Rank sum test and Friedman test was used to analyze these data.Three months postoperatively, the median distant UCVA increased significantly from 0.80 to 0.20, residual refractive astigmatism decreased significantly from 2.02 D to 0.67 D. The mean Toric IOL axis rotation was 1.63 ± 1.83 degrees, with rotation less than 5.00 degrees in 96% of eyes. For uncorrected near visual acuity, group ATR fared the best results and the difference between group ATR and groups WTR, neutral and OB was statistically significant. For UCVA, there was no statistically significant difference between group ATR and groups neutral and OB.Acrysof Toric IOL implantation is a predictable, safe and effective method to correct preexisting corneal astigmatism in patients having cataract phacoemulsification. A pseudophakic eye after Acrysof Toric IOL implantation with low residual ATR myopic astigmatism is beneficial for obtaining a better uncorrected near and distant visual acuities.

To study the feasibility of applying expanded forehead axial flaps with fascia pedicles carrying bilateral frontal branches of superficial temporal artery and vein (expanded forehead axial flap with double pedicles in brief, EFAF-DP) in repairing scars in submaxillary region.Sixteen patients with mandibular scars hospitalized in Department of Burns and Plastic Surgery of the First Hospital Affiliated to Fuzhou General Hospital in Nanjing Military Area Command from July 2005 to December 2009 were repaired with EFAF-DP. The operation consisted of 3 stages. Before operation, the location and course of superficial temporal arteries and veins (STAV) and their frontal and parietal branches were identified with Ultrasonic Doppler blood flow detector. In stage I, STAV were dissected from the frontalis muscle as a pedicle to form a skin soft tissue space to hold the dilator of a proper size. In stage II, after gradual dilation by repeated filling with saline, the dilator was removed. EFAF-DP was dissected to repair mandibular scar. Donor site was closed with sutures. In stage III, flap pedicles were divided and pruned.Flap sizes ranged from 25 cm × 6 cm to 33 cm × 16 cm. The duration of dilation was 3-5 months, with 3.6 months in average. Ten patients underwent the operation of EFAF-DP transplantation and cervical skin dilatation. All flaps survived with healing of wounds. Disorder of venous return at the distal end of one flap was seen after second stage surgery, and it was corrected after comprehensive treatment including relieving spasm and improving venous return. Donor site wounds healed with normally grown hair without cicatricial alopecia along the hairline. Few hairs grew around mandible in one female patient out of the three (no hair grew on flaps of other two patients). This female patient and two male patients requesting for beard plasty received laser depilation treatment 1 to 3 months after discharge, with good result. Other male patients received no special treatment for their beard, and they shaped their beard with shaver. Sixteen patients were followed up for 6 to 24 months, and the shape of the flaps and beard (excluding female patients) were satisfactory with good appearance, satisfactory skin color and texture. The mobility of neck was obviously improved.EFAF-DP provides bigger areas of a thin flap besides promoting vascularization of new vessels of flap. Extra expanded skin can be directly sutured at the fringe of hairline, which makes skin grafting unnecessary, and decreases the incidence of secondary deformity in donor sites. Some hair carried by the flaps can be directly used for beard reconstruction after rotation to help the male patients have a better appearance.

To explore the clinical efficacy of using forehead expansive skin flap double-pedicled with superficial temporal vessels for repairing male cervicofacial scar.From July 2005 to June 2009, 13 male patients with an average age of 27 years old (range: 21 - 38) were operated by the above method. The scar-repairing area was from 14 cm × 5 cm to 32 cm × 15 cm. The procedure was carried out in three stages. Firstly, ultrasound Doppler was used to detect and mark the location and orientation of superficial temporal artery. A proper cavity was created under the forehead muscle and then the appropriate expander embedded through the scalp incision. The expander was expanded first by injecting normal saline at 1 or 2 weeks post-operation. After that, the injection was repeated by 3 or 5 days. The volume ratio of injection to expander was (1.5-3.5):1. Secondly the forehead expansive skin flap was designed with proper hair follicle scalp pedicled by bilateral superficial temporal artery when the expansion was completed. After removal of the expander, the rectangle expansive skin flap with hair follicle scalp was transferred through the double pedicle. The cervicofacial scar was excised according to the size of the transferred expansive skin flap (25 cm × 6 cm to 32 cm × 9 cm). And the flap was adjusted with hair follicle scalp to the middle of the chin area in order to obtain the normal beard appearance. Donor site were closed directly. Thirdly, the pedicle skin flap were cut and restored after one month.The volume expanded for each expander ranged from 420 to 800 ml (mean: 660). The average expansion time was 4 months (range: 3 - 5). All flaps survived well. Donor site were closed directly. Both chin and beard looked normal.Repairing hypertrophic scar and reconstructing beard in cervicofacial area with forehead expansive skin flap pedicled by bilateral superficial temporal artery is a valuable and safe method. The donor site is scarless. And the reconstructed chin and beard are normal both functionally and aesthetically.

To observe the early change in plasma brain natriuretic peptide (BNP) level in burn patients with long delayed fluid resuscitation of burn shock and its clinical significance.Thirty-six burn patients with second and third degree of burn covering 32%-92% total body surface area were enrolled for the study, among them 10 patients were complicated with serious heart failure (heart failure group), and 26 patients rallied from shock after delayed fluid resuscitation without heart failure (stable group). The level of plasma BNP, lactate dehydrogenase (LDH), MB isoenzyme of creatine kinase (CK-MB), and left ventricle ejection fraction (LVEF) were determined at admission and 3 hours after hospitalization, and 24, 48, 72, 168 hours after the injury in both groups with electrochemiluminescence (ECL).Compared with stable group, the plasma BNP level (ng/L) of heart failure group at 3 hours after hospitalization, and 24, 48, 72 hours after the burn injury increased significantly (3 hours after hospitalization: 1 521.38+/-121.11 vs. 391.36+/-63.27, 24 hours after burn: 2 516.86+/-193.25 vs. 360.79+/-146.56, 48 hours after burn: 1 587.76+/-169.23 vs. 398.92+/-77.46, 72 hours after burn: 974.45+/-166.33 vs. 283.43+/-68.15, all P0.01), the level of LVEF lowered significantly (3 hours after hospitalization : 0.33+/-0.03 vs. 0.58+/-0.09, 24 hours after burn: 0.36+/-0.09 vs. 0.60+/-0.10, 48 hours after burn: 0.35+/-0.08 vs. 0.62+/-0.11, 72 hours after burn: 0.39+/-0.10 vs. 0.64+/-0.10, all P0.05). The levels of LDH (micromolxs(-1) xL(-1)) in stable group were 2.87+/-0.50 at admission, 3.02+/-0.43 3 hours after hospitalization, 4.02+/-0.87 24 hours after burn, 6.90+/-0.87 48 hours after burn, 3.64+/-0.75 72 hours after burn, 2.67+/-0.45 168 hours after burn while in heart failure group, they were 2.97+/-1.40, 3.84+/-0.37, 4.29+/-0.45, 8.50+/-0.38, 3.84+/-0.62, 2.30+/-0.38, respectively; and CK-MB (U/L) in stable group were 59.12+/-13.75 at admission, 70.39+/-10.72 3 hours after hospitalization, 79.29+/-17.27 24 hours after burn, 67.44+/-12.77 48 hours after burn, 30.28+/-7.13 72 hours after burn, 21.44+/-3.15 168 hours after burn while in heart failure group, they were 65.76+/-16.38, 81.46+/-7.92, 86.43+/-14.19, 72.53+/-11.27, 36.39+/-6.18, 22.85+/-7.26, respectively. No statistically significant difference was found in changes in both LDH and CK-MB between two groups (all P0.05).Determination of the plasma BNP is a simple and useful method in detecting heart failure during resuscitation of shock after a serious burn injury.

To investigate the incidence and related factors of retinal detachment (RD) after phacoemulsification cataract extraction and intraocular lens (IOL) implantation in an unselected patient group.This retrospective review was comprised of 10 076 cataract patients (13 625 eyes) who had phacoemulsification cataract extraction and IOL implantation from December 1, 1998 to September 30, 2008. The patients were of different ages, gender, left or right eye and different type of cataracts. The incidence of postoperative RD was assessed and the relative risk factors were estimated using the Kaplan-Meier method.The average age was 67.22 +/- 15.10 years old with 4439 males and 5637 females. The difference between the numbers of men and women was statistically significant (chi(2) = 142.44, P0.01). A total of 6701 left eyes and 6924 right eyes showed no significant difference (chi(2) = 3.65, P = 0.056). And 65.91% of these eyes were age-related cataract. During the post-operation observation period, 32 eyes of RD in 32 patients were observed from 10 days to 74 months post-operation. The ratio was 0.32% with an estimated risk (Kaplan-Meier) of 0.47% at 74 months. These results confirmed that myopia and increased axial length were significantly associated with RD (chi(2) = 14.55, P0.001) and recognized risk factors for RD such as high myopia, posterior capsular bag rupture and Nd: YAG capsulotomy. Among these 32 eyes, 31 eyes had one successful retina re-attaching operation (90.32%) and two eyes were given up because of post-operative relapse.The incidence of RD increases after phacoemulsification cataract extraction and IOL implantation in an unselected patient group. Hypermyopia, posterior capsular bag rupture and Nd: YAG capsulotomy are possible risk factors of the RD.