20 cases of chronic lymphedema of theleg were examined by lymphoscintigraphybefore and after Heating and Bandage Treat-ment. The result showed that lymph flowwere improved in 17 cases, edematous legsafter the treatment, among these, lymphflow were much improved in 4 patients, al-most reaching a normal state. The compari-son of clarity and appearing time of imagesand the comparison of lymph flow rate be-fore and after the treatment also showed sta-tistical significance. It is further proved from this study that Heating and Bandage Treatment can improve lymphatic circulation in lymphedematous limbs.
Objective To explore the correlation between retinal extracellular edema and vitreous contraction in rabbits. Methods Seventeen pigmented rabbit models with retinal vein occlusion (RVO)was set up by laser photocoagulation. Retinal vascularity area was pathologically examined 1 month later.The vitreous gellength under the gravity condition and the percentage of its weight in the rabbits with extraeellular edema was observed. The mechanisms were investigated by Western immunoblotting of type II collagen.Results Extracellular edema was found in 13 experimental eyes 1 month after the formation of RVO (76.5~) with contracted vitreous gel and released watery liquid, and the a component of type II collagen was cross-linked together to form high-molecular-weight components of 1] and 7, which weakened the stability of collagen net structure.Conclusions Vitreous contraction and retinal extracellular edemawere correlated. The main reason may be the cross-links of vitreous collagen that damages the stability of collagen structure. (Chin J Ocul Fundus Dis，2004，20：2-32)
目的:初步评价健身钢球锻炼法治疗乳腺癌根治性手术后上肢水肿的疗效。方法:收集乳腺癌改良根治术后并发上肢水肿患者60例,按照就诊顺序随机配对分为实验组和对照组,每组各30例。实验组术后采用健身钢球锻炼患侧上肢的方法;对照组采用抬高患肢、向心性按摩和热敷的传统方法。结果:两组患侧上肢各部位术后1天均存在不同程度水肿(Plt;0.05),实验组随着时间的推移,其水肿程度不断减轻(Plt;0.05),而对照组则在术后1周内变化不明显(Pgt;0.05),并且其各部位肿胀率均高于实验组,二者差异均有统计学意义(Plt;0.05)。结论:健身钢球锻炼法对乳腺癌根治性手术后上肢水肿具有一定的短期疗效。
Thirteen cases of unilateral lymphedema of lower extremity were treated by the anastomosis between the suporficial and deep lymphaties. The rate of subeidence of edema at 2 weeks and 6 months after operation were 57.1±18.5%and 47.3± 22.9%, respectively, It was believed that this type of oporation had the advantageS of anastomosis on the tissues of same origin, unlikely occurrence of thrombosis at the anastomotic stoma, small incision, less surgical trauma and acceptable by patients.
The prevalence of diabetes mellitus in adults of China has reached 12.8%. Diabetic retinopathy (DR) accounts for approximately 1/4-1/3 of the diabetic population. Several millions of people are estimated suffering the advanced stage of DR, including severe non-proliferative DR (NPDR), proliferative DR (PDR) and diabetic macular edema (DME), which seriously threat to the patients’ vision. On the basis of systematic prevention and control of diabetes and its complications, prevention of the moderate and high-risk NPDR from progressing to the advanced stage is the final efforts to avoid diabetic blindness. The implementation of the DR severity scale is helpful to assess the severity, risk factors for its progression, treatment efficacy and prognosis. In the eyes with vision-threatening DR, early application of biotherapy of anti-vascular endothelial growth factor can improve DR with regression of retinal neovascularization, but whether it is possible to induce capillary re-canalization in the non-perfusion area needs more investigation. Laser photocoagulation remains the mainstay treatment for non-center-involved DME and PDR.
By using biochemical assessment technique and histological examination,a comparative study of the cutaneous tissues in 16 patients with lymphedema of the lower extremity before and after the heating and bandage therapy, and it was noted thatthe heating and bandage therapy might:(1) the content of hydroxyproline in the affected skin would be decreased; (2) the thickness of skin was decreased and the water content was reduced; (3) the microcirculation of local tissues was enhanced, and (4) the activity of the macrophages was increased. In conjunction with the criteria of clinical observation, the action mechanism of heating and bandage therapy might be as follows: (1) improve the local microcirculation and enhance the resorption of tissue fluid and the protein, and (2) increase the activity of the macrophages, and minimize the extent of fibrosis of the affected tissues.
Objective To introduce a modified penile elongation method and observe its postoperative compl ications. Methods From January 1993 to December 2007, 130 patients with congenital short and small penis were divided into 2 groups: the routine group and the modified group, with 65 patients in each group. In the routine group, the patients were 18-55 years old (39.6 on average), and the penile length during erection was (4.9 ± 1.4) cm. In the modified group, the patients were 20-56 years old (35.4 on average), and the penile length during erection was (5.0 ± 1.5) cm. There was no significant difference between the two groups (P gt; 0.05). On the basis of scrotal flap which was transferred to cover the prolonged cavernous body of penis, the “+” shaped incision at the root of the penis was made in the routine group, and theincision was shifted upward by 1.5 cm in the modified group. And V-Y incision was made for the penises with more than 4 cm prolonged length. In order to compare the conditions in the two groups, no physical therapy was appl ied in 30 days after the operation. Results All the 130 patients’ incisions obtainedt heal ing by the firs intention, and all flaps survived successfully. Postoperative hydrophallus appeared differently between both groups. In the routine group, obvious hydrophallus appeared on the 3rd day after the operation and lasted for (15.11 ± 2.71) days, with 3 cases (4.62%) suffering from refractory hydrophallus. In the modified group, hydrophallus appeared on the 3rd day after the operation and lasted for (6.65 ± 0.29) days without any refractory hydrophallus. There was significant difference between the two groups in the duration of hydrophallus (P lt; 0.05). All patients were followed up for 6-8 months. After the operation, the shape and function of the penis were found good. The prolonged length was (4.9 ± 1.4) cm in the routine group and (5.0 ± 1.5) cm in the modified group. There was no significant difference between the two groups (P gt; 0.05). The satisfaction rate (according to the patients’ self-rating) was 95% and 98% in the routine group and the modified group, respectively. Conclusion The method using the scrotal flap transferred to cover the prolonged cavernous body of the penis is safe and of low compl ication rate. The modified method is more effective to abate postoperative hydrophallus.
Macular edema is a common cause of visual loss in patients with retinal vascular diseases represented by diabetic retinopathy and retinal vein occlusion. Laser photocoagulation has been the main treatment for this kind of diseases for decades. With the advent of antagonist of vascular endothelial growth factor and dexamethasone implant, diabetic macular edema and macular edema secondary to retinal vein occlusion have been well controlled; the use of laser therapy is decreasing. However, considering possible risks and complications, lack of extended inspection of efficacy and safety of intravitreal pharmacotherapy, laser therapy cannot be replaced by now. Therefore, the efficacy and safety of laser therapy will improve by sober realization of role of photocoagulation and proper selection of treatment indication.
In recent years, the subthreshold micropulse laser is a kind of laser mode which is characterized by long intermittence. It achieves effective therapeutic effect while minimizes the damage to tissues. At present, it has been used to treat diabetic macular edema. Early studies suggested that the laser selectively acts on retinal pigment epithelial cells to reduce macular edema by regulating the expression of inflammatory biomarkers, growth factors, heat shock proteins and other substances. In recent years, with the development of research, more and more emphasis has been placed on the role of retinal glial cells. Müller cells are also considered as one of the target cells affected by micropulse laser, but there is no evidence of direct or indirect effects of micropulse laser on Müller cells. In the near future, it is expected that we will have more clinical evidence to confirm the target cells of the micropulse laser, which may be further confirmed by in vitro experiments through Müller cells or Müller cells co-cultured with retina pigment epithelium cells, so as to make a more detailed statement on the mechanism of it.