Lacerated Research Articles

Treatment of open fracture of the distal phalanx with syringe needle and nail template

Objective To report the feasibility and efficacy of the treatment of open fracture of the distal phalanx with nail bed injury. Methods From June 2016 to August 2018, 28 patients with open fracture of the distal phalanx of 34 fingers with nail bed injury admitted to the emergency department of our hospital were treated. After thorough debridement, one or two No.7 syringe needles were used to screw from the bottom or side of nail bed through the fingertip, and the fracture end was fixed by intramedullary fixation under direct vision. After nail bed reduction in situ without suture, nail template was made with 5 ml syringe barrel (if the original nail was intact, it could be trimmed and replanted) and covered the surface of the nail bed. The nail template was removed 3 weeks after operation, and the syringe needle was removed 4 to 6 weeks after operation to observe fracture healing and nail growth. Results All the patients were follow-up for 3 to 18 months, and all wounds achieved primary healing. No infection or nonunion occurred. The nail regeneration was evaluated as excellent in 25 fingers, good in 6 fingers, fair in 2 fingers, and poor in 1 finger, with the excellent and good rate being 91.2%. The finger flexion and extension function was rated as excellent in 26 fingers, good in 4 fingers, fair in 3 fingers, and poor in 1 finger, with the excellent and good rate being 88.2%. Conclusion The method of fixing the fracture of the distal phalanx with syringe needle is reliable. The nail template made by syringe needle barrel covering the lacerated nail bed is simple and effective in preventing nail deformity after operation. Key words: Finger phalanges; Fractures,bone; Nail bed; Syringe needle; Nail template

Analysis of one-stage surgical repair for the full-thickness eyelid multiple injuries

Objective To analyze the one-stage surgical repair method and clinical efficacy for the treatment of full thickness injuries multiple of eyelid. Methods The data of 92 eyes of 92 cases with multiple injuries of eyelid full thickness from Jan.2015 to Dec.2015 were analyzed retrospectively. The lacerated wound of eyelid full thickness was repaired with three stitch suture, horizontal and vertical mattress suture. Patients who were accompanied with lacrimal canalicular rupture, musculus levator palpebrae superioris fracture and ligament fracture were separately adopted lacrimal canalicular anastomosis, eyelid defect repair and ligament reduction. Results All cases successfully performed emergency surgery repair, no demonstrated wound infection occurred. All the wound of patients healed after one-stage surgical repair. After 6 months of follow-up, eyelid appearance, closure and motor function recovered well in 96.7%(89/92). Conclusion A correct, timely and delicate surgery can make most eyelid lacerations repaired well after one-stage operation. According to the condition of the patient of multiple eyelid injuries and choose the appropriate surgical methods for repair. Key words: Trauma, eyelid, multiple; Repair, surgical; One-stage

Suicide Attempt Following Pacemaker Implantation in an Eighty-Three-Year-Old Male: A Case Report

As the global population ages, cardiac pacing procedures are rising exponentially to keep pace with the increasing incidence of bradyarrhythmias. The efficacy of pacemakers is well established, but recipients may have poor psychosocial adaptation leading to development or exacerbation of mental disorders, that may manifest with anxiety, depressive symptoms or rarely suicidal tendencies. An 83-year-old male of African descent was referred to us for evaluation and expert management. He came with chief complaints of general body malaise, light-headedness, chest pain and fainting spells for about 6 months. He was diagnosed with hypertension 4 years prior, and there was no history of mental illness in the patient or his family. Echocardiography (ECHO) revealed features of hypertensive heart disease while electrocardiogram (ECG) showed features of third-degree heart block. He underwent successful pacing with a resultant ventricular paced rhythm. The patient was stable and symptom free post pacing, but on the fourth day he jumped off the window of the ward in the hospital’s second floor. Post suicide attempt examination revealed epistaxis, right periorbital hematoma with a temporal lacerated wound and deformed ankles bilaterally. ECG showed a ventricular paced rhythm and the chest radiograph showed an intact pacemaker. Ophthalmological review was evident for right sided blepharospasm with massive chemosis and bilateral constricted reactive pupils. Radiological investigations showed right orbital fracture, stable C5 and C6 fractures, and bilateral bimalleolar fractures with ankle dislocation. Neurosurgical review was unremarkable and psychiatric review could not be performed. The patient died 18 h after the suicide attempt incidence. Emotional disturbances post pacing impairs the quality of life and in the worst case scenario could lead to unanticipated cessation of life. In view of this, thorough evaluation and monitoring of the patient’s psychological well-being both pre and post pacing is paramount. J Med Cases. 2019;10(12):345-347 doi: https://doi.org/10.14740/jmc3383

Histopathological study of Corydoras micracanthus (Siluriformes: Callichthyidae) parasitized by the nematode Procamallanus (Spirocamallanus) pintoi (Camallanidae) from Lesser River, northwestern Argentina, South America

The nematode parasites can cause mechanical injuries such as irritation or atrophy of tissue and occlusions of the digestive tract, blood vessels or other ducts in their hosts. Some species belonging to the family Camallanidae have been the focus of histopathological studies because they lacerate the host´s intestinal wall with their buccal capsule. In this study, we describe the histopathological effects produced by Procamallanus (Spirocamallanus) pintoi in the small fish Corydoras micracanthus from Lesser River, in the northwest of Argentina, South America. The samples were processed with routine histology techniques. At light microscopy, specimens of P. (S.) pintoi were observed occupying the lumen of the gut. The histopathological sections revealed damage to the host intestine with the total destruction of the mucosa and submucosa, observed mainly in the region which is surrounding the buccal capsule of parasites. Moreover, an inflammatory reaction was observed with lymphatic accumulations in the affected tissue. This kind of degenerative and necrotic changes in the mucosa could affect negatively the absorption function of the host intestine, which may have adverse effects of the health status of fish. The present study provides the firs data about the histopathological effects of P. (S.) pintoi in C. micracanthus.

Comparison on the efficacy between two kinds of stent in the anastomosis of lacrimal canaliculus

Objective To compare the application efficacy between RS-type lacrimal intubation and tear duct drainage stent in the anastomosis of lacerated lacrimal canaliculus. Methods The data of 78 eyes of 78 cases with lacrimal canalicular laceration were collected.All cases were randomly divided into 2 groups. Group A, 38 cases were treated with RS-type lacrimal stent and 40 cases were treated with drainage stent in group B. All patients were removed the stent 3 months after surgery. The differences of operative time, intraoperative comfort, efficacy and the rate of complications between the two groups were compared. Results The operation time of group A was (61.71±8.79) min, and group B was (68.25±7.56) min. The difference was statistically significant (t=3.527, P=0.001). The intraoperative pain score of group A was 3.58±0.83 and 4.20±0.97 of group B (t=3.044, P=0.003). The total rate of complications was 20.0% in group B and 15.8% in group A (χ2=0.235, P=0.656). The postoperative evaluation was made when removed the stent 3 months after operation. The total effective rate of group A was 92.1%, while that of group B was 90.0%(χ2=0.106, P=0.752). Conclusion Applications of two stent in surgery are effective, which are ideal supporting materials. However, RS-type lacrimal stent is superior to lacrimal duct drainage stent with short operation time and good intraoperative comfort. Key words: Laceration, canalicular; Stent, lacrimal, RS-type, tear duct drainage stent; Efficacy

A comparison on different route of intubation in anastomosis for traumatic laceration of canaliculus

Objective To compare clinical efficacy of canalicular laceration anastomosis combineded with two routes intubation with silicone stent for traumatic canalicular lacerations. Methods Seventy-eight eyes of 78 patients with traumatic canalicular lacerations were divided into two groups, group A including 30 cases received single route intubation, and the group B including 48 cases underwent double route intubation. The followed up time was 6-12 months. The efficacy and the rate of punctal ectropion or tear were observed after operation. Results In group A, 21 cases were cured, 6 cases were improved, 3 cases wasn’t cured, and 6 cases occurred punctal ectropion, 4 cases occurred punctal tear. In group B, 43 cases were cured, 4 cases were improved, 1 case was not cured, and 1 case occurred punctal ectropion, no case happened punctual tear. The difference in cure rate, punctal ectropion or tear occurrence between group A and group B were statistically significant (χ2=4.808, 5.227, 4.284; P=0.028, 0.022, 0.039). Conclusion The rate of curation of lacerated canalicular anastomosis through double route with silicone sent is higher than single route, and with lower rate of punctal ectropion and tear. Key words: Canalicular lacerations, traumatic; Anastomosis; Silicone stent; Intubation, single route, double route

Lacerated Girls' Uniforms and What the Cuts May Engender

Lacerated Girls' Uniforms and What the Cuts May Engender

Effect of pig tail probe and double-passage annular canalicular stent implantation for the treatmeat of obsolete canalicular laceration

Objective To observe the efficacy of the pig tail probe and double-passage annular canalicular stent implantion for the treatmeat of obsolete canalicular laceration. Methods A total of 15 eyes of 15 patients with obsolete canalicular laceration underwent the secondary operation to repair the canalicular laceration. During the surgery, the pig tail probe was used to found the nasal end of the lacerated canaliculus, then the annular silicone stent was placed and kept for 6 months.The clinical efficacy was observed. Results All patients recovered anatomical position and function. Epiphora symptom disappeared in 14 patients, while 1 patient had a mild epiphora because of slight ectropion of inferior lacrimal punctum, irrigation of lacrimal duct was unobstructed. Conclusion The use of pig tail probe during the operation can save the time of founding the nasal end of the lacerated canaliculus. It is a reliable and satisfactory method for the treatmeat of obsolete canalicular laceration when combined with the double-passage annular canalicular stent intubation. Key words: Canalicular laceration, obsolete; Probe, pig tail; Annular canalicular stent, silicone, double-passage

Calcific degeneration and rupture of the aortic valve and ascending aorta: from cardiac auscultation to multimodality imaging.

Calcific degeneration and rupture of the aortic valve and ascending aorta: from cardiac auscultation to multimodality imaging.

Application of enteral nutrition in pediatric surgery

To explore the value and safety of the application of enteral nutrition in pediatric surgery. Clinical data of 56 children patients who could not undertake oral feeding or those who required enteral nutrition by nasojejunal tube over 7 days in our ward from June 2007 to May 2013 were retrospectively analyzed. Children younger than one year old received enteral nutritional formulation Ai Er Shu mainly composed of short peptides or amino acids, and children over one year received Small peptide or Nengquansu mainly composed of short peptide. Among these 56 children patients, primary disease was pancreatitis in 20 cases, lacerated wound in 10, duodenal perforation in 6, duodenal septum-shape stenosis in 9, annular pancreas in 6, and hepatoblastoma in 5. All the patients successfully completed the enteral nutrition therapy within 7-37 (18±9.9) days with good recovery. During the treatment, 5 cases (8.9%) developed diarrhea, 3 cases (5.4%) nausea and vomiting, 2 cases (3.6%) mild abdominal distension, 5 cases(8.9%) mild abdominal pain, and the symptoms were relieved after adjustment of nutrient solution concentration and infusion rate. After enteral nutrition for 10 days, the nutritional status of children was improved, and weight, blood red cell count, hemoglobin, serum albumin, prealbumin increased significantly (P<0.05). Application of enteral nutrition in pediatric surgery is safe and effective, which can improve the nutritional status of children and promote the recovery.

Diagnosis and treatment of skipping amphi-laceration of disco-ligamentous complex combined with hyperextension injury to the cervical spinal cord

Objective To explore the diagnosis and treatment of skipping amphi-laceration of disco-ligamentous complex (DLC) combined with hyperextension injury to the cervical spinal cord. Methods From January 2008 to December 2012, 17 cases of skipping amphi-laceration of DLC combined with hyperextension injury to the cervical spinal cord were surgically treated at our department. They were 15 men and 2 women, 21 to 57 years of age (average, 36. 3 years). Cervical spine MRI and dynamic flexion-extension lateral radiographs were performed in all patients preoperatively. Injured spinal cord segments were determined according to the plane of spinal cord injury and high signal changes in spinal cord on MRI. Segments of DLC laceration were evaluated according to cervical spine MRI and subaxial cervical stability on radiographs preoperatively. The neurological functions were graded according to the American Spinal Injury Association (ASIA) scale (version 2000) at preoperation, 3, 6 and 12 months postoperatively. The ASIA motor scores (AMS) and sensory scores (ASS) were analyzed statistically. Instrument failure and bony fusion were observed by follow-up radiographs. Results The 17 cases were followed up for an average of 28 months (from 12 to 42 months). The AMS and ASS at all postoperative time points were significantly better than those at preoperation in all patients ( P < 0. 05). Moreover, the AMS and ASS significantly improved as the follow-up time increased, with a significant difference between postoperative time points ( P < 0. 05). There was no failure of instrumentation and bony fusion was observed in all cases of bone grafting. Conclusions The skipping amphi-laceration of DLC combined with hyperextension injury to the cervical spinal cord is likely to be missed in diagnosis. The surgical procedures include decompression of the main spinal cord segment with hyperextension injury and DLC laceration and stability reconstruction of the lacerated DLC segment at the other end. Key words: Cervical vertebrae; Spinal cord; Injury; Disco-ligamentous complex

Improved intubation with double-passage silicone stent for lacrimal canalicular laceration

Objective To evaluate the clinical efficacy of improved silicone stent double-passage intubation for the treatment of lacrimal canalicular laceration.Methods Fifty-two eyes of 52 patients with lacrimal canalicular laceration were divided into two groups.25 patients of group A were treated by using traditional epidural anesthetic tube as stent and underwent the lacrimal canalicular anastomosis surgery after single nasolacrimal duct intubation.27 cases of group B were treated by improved surgical method wihch was double-passage intubation with silicone tube as support.After follow-up of 3 ～ 18 months,the differences of two groups in operation duration,operative cure rate and percentage of lacrimal punctum and lacrimal canaliculus lacerated were compared.Results In group A,the average operation duration was (71.80 ± 36.22) min,13 cases were completely cured,and the lacrimal punctum and lacrimal canaliculus of 8 cases were lacerated.In group B,the average surgery time was (108.78 ± 57.01) min,the number of cases completely healed was 23,and the number of torn lacrimal point and ductule was 2.Compared with group A,the operation time of group B was extended,but the cure rate was higher and the probability of lacrimal punctum and canaliculus torn was lower,and the differences were statistically significant.Conclusion In the treatment of lacrimal canalicular laceration,the method of improved silicone stent double-passage intubation is simple,practical,effective and has less complications. Key words: Intubation, silicone stent, double-passage; Laceration, canalicular; Anastomosis, improved ; Efficacy ; Complication

The comparison of three different methods to localize nasal broken end of lacerated inferior lacrimal canaliculus

Objective To compare the clinical efficacy of three different methods to localize nasal broken end of lacerated inferior lacrimal canaliculus.Methods 24 cases of lacerated inferior lacrimal canaliculus due to trauma were treated by three different methods (pushing water into the superior punctum,finding directly under operating microscope,probing needle)to localize nasal breakage.The clinical effects were analyzed.Results The searching method of pushing water into the superior punctum was performed in 24 cases and only 7 nasal breakages were localized successfully accounting for 29.17％.The searching method of finding directly under microscope was performed in 24 cases and the nasal breakages were found in all cases and the success rate was 100％.The searching method of probing needle was performed in 24 cases.The nasal broken ends were localized in 12 cases,but 4 cases were not successful because of iatrogenic false passage.The success rate was 50％.Conclusion For the patients with lacerated inferior lacrimal canaliculus due to trauma,searching nasal broken ends directly under microscope is the preferred method.If the searching time is more than 30 minutes,pushing water into the superior punctum can be tried.Using probing needle is the last choice,but not be performed when the trauma tissue is edema. Key words: Laceration,canalicular, lacrimal; Ends, broken, nasal

Surgery for obsolete inferior lacrimal canaliculi laceration

Objective To observe the clinical efficacy of two surgical procedures in the management of obsolete inferior canaliculi laceration.Methods 36 cases of obsolete inferior canaliculi laceration were retrospectively reviewed.The nasal breakages of lacerated canaliculus were found through the upper lacrimal punctum or by cutting the lacrimal sac.The effects of two different methods were compared.Results The nasal breakages of lacerated canalicula in 6 cases were found through the upper lacrimal puncta.Other 30 cases' nasal breakages were found by cutting the lacrimal sac.The bicanalicular silicon tubes were implanted successfully in all cases.The tubes were removed after 3 months.All patients were followed for over 6 months.29 cases (80.6％) were cured and 5 cases (13.9％) were improved significantly.Surgeries failed in 2 cases(5.5％).Conclusion The nasal breakages of lacerated canalicula can be found through the upper lacrimal puncta or by cutting the lacrimal sac.The bicanalicular intubation procedure is an effective method for the management of obsolete inferior canalicular laceration. Key words: Laceration, canalicular, inferior, obsolete; Implantation, retrograde; Tube, silicone,bicanalicular

Solution for the difficuties in the anastomosis of lacerated canaliculus

Objective To explore the difficulties and its solutions in treatment of canalicular laceration.Methods Fifty four eyes of 54 cases were enrolled in this retrospective study.The steps of surgery included searching the broken end of the canaliculus under operating microscope,deep fixation of the canaliculus,safe suturing of stent and preventing the contraction of scar on the lower lid.Results The follow up of these cases were from 6 months to 2 years.The result of surgeries was successful in 46 cases (85.2％),improved in 4 cases (7.4％) and failure in 4 cases (7.4％).Conclusion The key points of the success are the search and inosculation of the broken end of the lacrimal canaliculus,the fixation of the stent,prevention of the contraction of scar on the lower eyelid. Key words: Laceration, lacrimal canaliculus; Surgery; Key points

Influence of manual enlarging pupil to different diameters on clinical outcome of pupil atresia complicated cataract

Background Pupil atresia increases the difficulty of cataract surgery.The improper enlarging pupil will lead to many complications.The appropriate method of pupil dilation is very important to improve the postoperative effect.Objective This study was to evaluate the pupillary function after manually enlarged pupil to different sizes for pupil atresia complicated cataract.Methods A retrospective case-controlled study was designed.Thirty-eight eyes of 30 cases suffered from pupil atresia complicated cataract induced by chronic uveitis were enrolled in Shandong Eye Institute from May 2006 to May 2012.The eyes underwent pupil forming and phacoemulsification and assigned to the pupil enlarged to ≥6.0 mm group (15 eyes) and 4.5-5.5 mm group (23 eyes).The fibrosis membrane at pupil zone was removed,and the fibrosis strip at pupil collar was cut evenly by 23G intraocular microscissors as zigzag shape.Then the pupil was enlarged in multipoint by a pair of left and right iris hook from the main and lateral incisions.The pupils of 15 eyes in the pupil enlarged to ≥6.0 mm group were dilated above 6.0 mm and 23 pupils in the 4.5-5.5 mm group were dilated to 4.5-5.5 mm and followed by routine phacoemulsification and foldable intraocular lens implantation.Topical and systemic corticosteroids and nonsteroidal anti-inflammatory drugs combined topical mydriatic were applied before and after operation.The pupil diameter,light reflex and photophobia symptom in postoperation were compared between the two groups.The visual acuity before and after operation and intra-and post-operative complications were recorded.This study was approved by Ethic Committee of Shandong Eye Hospital,and written informed consent was obtined from each patient before operation.Results The pupil diameter in the pupil enlarged to ≥6.0 mm group was dilated to (6.9±0.4) mm and that of the 4.5-5.5 mm was dilated to (5.1 ±0.3) mm intraoperatively,with a statistical significance between them (t =16.100,P =0.000).Three months later,the pupil diameter in the pupil enlarged to ≥ 6.0 mm group was (4.9 ±0.4)mm,with different degrees of lacerated pupillary margins,and that in the pupil enlarged to 4.5-5.5 mm group was (3.5 ±0.5) mm,with rare lacerated pupillary margins,showing a statistically significant difference (t =9.820,P =0.000).The unresponsive or obtuse light reflex in the pupil enlarged to ≥6.0 mm group was significantly higher than in the pupil enlarged to 4.5-5.5 mm group(11 eyes vs.6 eyes) (x2 =8.200,P =0.005).The subjective photophobia symptom of 2-3 grades in the pupil enlarged to ≥6.0 mm group was in 12 eyes,which was higher than that in the pupil enlarged to 4.5-5.5 mm group (2 eyes) (H=19.840,P=0.000).The iris haemorrhage were seen in 3 eyes in the pupil enlarged to 4.5-5.5 mm group and 7 eyes in the pupil enlarged to ≥6.0 mm group (x2 =5.290,P=0.030).The visual acuities of the operated eyes in the two groups improved at different degrees.Conclusions Approximate physiological pupil and good visual quality can been obtained by manual releasing and enlarging pupil to less than 5.5 mm evenly during the surgery for pupil atresia complicated cataract induced by chronic uveitis. Key words: Pupil atresia; Complicated cataract; Pupil diameter; Uveitis

Bi-step retrograde intubation procedure in the treatment of traumatic inferior canalicular laceration

Objective To investigate the clinical effects of bi-step retrograde intubation procedure in the treatment of traumatic inferior canalicular laceration.Methods Fifty-eight consecutive traumatic interior canalicular laceration cases (58 eyes) were randomly separated into two groups.Group A contenting 28 cases was bi-step group:initially the medial cut end of the lacerated canaliculus was located under slitlamp microscope in the out-patient department,and followed by a probing through the cut end into the nasal lacrimal duct,then the patient take a supine position and a drainage silicon tube with a lateral canalicular tube was retrograded placed.The canalicular anastomosis of the separated cut ends was performed under the surgical microscope in the operating room.Group B contenting 30 cases was single-step group:all the surgical procedures were performed in the operating room after several hours queuing waiting for the arrangement.Results The medial cut ends of the lacerated canaliculus were located in all the cases,but (7.5 ± 4.3)min was needed in group A and (24.4± 13.5) min were needed in group B (P ＜ 0.01).The retrograded placed tubes were pulled out 3 months later,and whereafter with a (14.2 ± 3.7) months follow up period.Twenty-six cases (92.86％) were cured and 1 case (3.57％) was re-obstructed 1 week after tube removing in group A; Twenty-six cases (86.7％) were cured and 2 cases (6.67％)was re-obstructed 1 week after tube removing in group B.Conclusions Bi-stepretrograde intubation procedure in the treatment of traumatic inferior canalicular laceration has properties of quick,less tissue injury and light paining. Key words: Canaliculus laceration; Canalicular anastomosis; Lacrimal duct intubation

One-stitch anastomosis through the skin with bicanalicular silicone tube intubation for treatment of superior and inferior canalicular lacerations

Objective To evaluate the efficacy of one-stitch anastomosis through the skin with bicanalicular silicone tube intubation to treat the bicanalicular lacerations.Methods Retrospectively,11 consecutive patients with both superior and inferior canalicular lacerations in one eye who underwent surgical repair using one-stitch anastomosis through the skin and bicanalicular stent were included.All the operations were performed under surgical microscope,5-0 silk sutures were used and bicanalicular silicone tubes (the diameter was 0.8 mm) were intubated,with one lacerated canalicula one-stich anastomosis through the skin.The stents were left in the place for 3 months postoperatively and then were removed.The follow-up period was 3 ～36 months(average 14 months).Results In 11 patients,9 patients were cured entirely,1 patient were meliorated,1 patient had no effects.All the patients had got good recovery of eyelid laceration without traumatic deformity in eyelid or canthus.There was no early tube protrusion or punctal slits in the patients.Conclusion One-stitch anastomosis through the skin with bicanalicular silicone tube intubation is a good method in repair of bicanalicular laceration in one eye.The cut ends could be anastomosed directly.No suture remained in the wound permanently.There was no suture-related granuloma which might cause obstruction or stenosis of canaliculi. Key words: Laceration, canalicular, superior and inferior; Repair; Anastomosis, through the skin, one stitch; Intubation, bicanalicular

Treatment outcomes of 130 patients underwent an endoscopic discectomy

Background and Objective: Endoscopic discectomy method is a novel technique that is increasingly used in spine surgery. Previous studies have reported that some common complications like dural adhesions are lower in this technique compared with the other techniques. Furthermore, treatment outcomes are reportedly higher because of minimal invasion. Thepresent study aims to determine the outcome of percutaneous endoscopic discectomy. Material and Method: A total of 130 patients underwent the lumbar disc prolapse operations during 2008 to 2012 in all of them the entire procedure was performed endoscopically. All procedures were carried out from a posterior approach using a 4-mm Hopkins 0 degrees-telescope placed in the working insert equipped with channels for suction tube, operative instruments and nerve root retractor (ENDOSPINE instrumentation (Karl STORZ GmbH and Co. KG). The preand post-operation pain was assessed using a Visual Analog Scale (VAS). Furthermore, the treatment outcome was assessed using modified MacNab criteria before operation, 24 hours, one month, 2 months, 6 months, one year, and two years after operation . Results: Good to excellent outcome was achieved in 89% of patients, which is comparable with the results of classic microdiscectomy. The mean age of patients was 35.6 years old and the mean length of follow-up was 3.4 years. There was significant reduction in the severity of back pain and lower limb symptoms at 6 months and 2 years postoperation. There was significant improvement in all aspects of the Quality of Life scores at 6 months and 2 years post-operation. In 3 patients the dural sac was lacerated but none of the tears was exceed a few mm in length with not association with neural injury. Conclusion: Findings of this study showed that percutaneous endoscopic lumbar discectomy is associated with improvement in back pain and lower limb symptoms. It has the advantage that it can be performed on a day case basis with short length of hospitalization and early return to work thus improving quality of life earlier.

The application of ocular anterior segment optical coherence tomography after operation of ocular penetraing injury

Objective To evaluat the application of anterior segment optical coherence tomography (ASOCT) in the imaging of postoperative ocular penetrating injuries. Methods Thirty-six successive cases (36 eyes) with ocular penetrating injury in our hospital were examined by ASOCT after surgery to observe and analyze stuctural changes of cornea and anterior chamber angle by anterior segment biomicroscopy. Results The results of ASOCT showed that swollen and cloudy corneas with disordered stroma and irregular surfaces in 21 eyes, lacerated chamber angles in 5 eyes, synechial and closed chamber angles in 12 eyes, iris adhered to the wounds in 8 eyes, broken anterior lens capsules and overflowed cortices in 12 eyes and shallow cyclodialyses in 3 eyes. Conclusion ASOCT has good clinical value in evaluating injury degree in postoperative penetrating injury eyeballs and predicating the prognosis for recovery. Key words: anterior segment optical coherence tomography; ocular penetrating injury