Adaptive optics (AO) is a technique to improve the performance of optical systems by reducing the influence of optical aberrations. Combined with scanning laser ophthalmoscope (AOSLO), the aberration of human refractive system can be corrected. Thus, the resolution and quality of imaging can be greatly improved to the cellular level in vivo retina (such as photoreceptor, nerve fibers, vascular parietal cell), therefore the earlier changes of the diseases can be detected. At the same time, microstructure changes of retinal can also be observed during the follow-up of the disease. Due to inherent technical defects of AOSLO, its wide application in clinical practice is limited. With the continuous progress of AO technology and the further improvement of related software functions, the function of the system will become more stronger and will play a more and more important role in scientific research and clinic.
目的评价三排钉倾碟头吻合器在食管癌、贲门癌根治术中的临床应用价值，评价其吻合口成形后的效果。 方法回顾性研究分析江苏大学附属武进医院及河北省邯郸市中心医院2012年10月至2014年5月使用新型三排钉吻合器行食管胃吻合术260例患者的临床资料。其中男185例、女75例，年龄48～75（63±8）岁，均在全身麻醉下行食管癌切除+食管胃吻合术。统计其术后吻合口狭窄、吻合口瘘、吻合口出血的发生率并分析总结其临床意义。 结果全组260例患者均吻合成功，无机械故障，无术后死亡。术后发生吻合口狭窄3例，发生率10%，均为早期吻合口加固缝合的30例，后期未加固缝合的病例无狭窄发生。吻合口瘘8例，发生率3.1%，均发生于食管胃颈部吻合病例。无吻合口出血发生。 结论三排钉倾碟头吻合器使用安全、方便，吻合后不需外层加固，尤其适用于难以暴露的吻合部位。
Objective To investigate the effectiveness of compression screw combined with Buttress plate through direct axillary approach for Ideberg typeⅡ scapular glenoid fractures. MethodsA retrospective analysis was conducted on 11 patients with Ideberg type Ⅱ scapular glenoid fractures treated with compression screws combined with Buttress plate fixation through the direct axillary approach between January 2014 and June 2022. There were 7 males and 4 females, aged from 34 to 75 years, with an average of 56.0 years. The causes of injury included 4 cases of falling from height injury, 4 cases of heavy object injury, and 3 cases of traffic accident injury. The time from injury to operation was 2-5 days, with an average of 3.8 days. The operation time, intraoperative blood loss, hospital stay, complications, and fracture healing time were recorded. The Constant-Murley score, American Society of Shoulder and Elbow Surgeons (ASES) score, and shoulder joint flexion, abduction, external rotation (neutral position), and internal rotation (neutral position) range of motion were used to evaluate shoulder joint pain and function. ResultsThe operation time was 45-105 minutes, with an average of 79.0 minutes; the intraoperative blood loss was 80-200 mL, with an average of 99.2 mL; the hospital stay was 3-8 days, with an average of 5.8 days. One patient had poor wound healing after operation, and the wound healed after strengthening dressing change; the rest wounds had primary healing, and no axillary nerve paralysis occurred. Except for 1 patient lost follow-up, the remaining 10 patients were followed up 10-54 months, with an average of 26.4 months. The postoperative X-ray film examination showed that the fractures healed well within 8-15 weeks, with an average of 11.0 weeks. There was no complication such as fracture displacement, internal fixator failure or fracture during follow-up. At last follow-up, the patient’s shoulder joint flexion, abduction, external rotation (neutral position), and internal rotation (neutral position) range of motion, Constant-Murley score, and ASES score significantly improved when compared with those before operation (P<0.05). ConclusionCompression screw combined with Buttress plate through direct axillary approach is an effective way to treat Ideberg typeⅡ scapular glenoid fracture, with advantages of small trauma, concealed incision, and good effectiveness.