Objective To determine the trend in the causes of admission among diabetic patients in West China Hospital from 1996 to 2005. Methods The medical records of diabetic inpatients from January 1996 to December 2005 were retrieved, and half of them were randomly selected. A questionnaire was completed and SPSS13.0 software was used for statistical analyses. Results The most common causes of admission for diabetic patients were diabetic chronic complications (20.2%), infection (19.5%), hyperglycemic symptoms (11.7%), malignant tumor (8.9%) and diabetic acute complications (5.8%). The constituent ratios of diabetic macrovascular disease and malignant tumor as the admission causes tended to increase, while the constituent ratios of diabetic microvascular disease, hyperglycemic symptoms and diabetic acute complications tended to decrease. Infection remained as one of the main causes of admission among diabetic patients. Conclusion The main cause of admission to West China Hospital for diabetic patients from 1996 to 2005 was diabetic chronic complications.
Objective To explore the causes and solutions of dissatisfied complaints about frame glasses wearing after medical optometry to improve service quality. Methods Patients with dissatisfied complaints about frame glasses wearing after medical optometry in West China Medical Center of Optometry Glasses between January 2013 and December 2014 were selected. Targeted re-examination and corresponding treatment was performed on them. The causes of their complaints were clustered and analyzed. Result There were 105 cases of complaints out of the 58 278 patients with frame glasses wearing after medical optometry, including complaints about wearing glasses uncomfortable in 58 cases (55.2%), mainly related to abnormal binocular vision, high myopia and progressive glasses lens fitting; quality of glasses in 23 cases (21.9%), in whom 16 were dissatisfied with the frame; quality of service in 10 cases (9.5%); glasses assembly / calibration in 7 cases (6.7%); and other dissatisfaction in 7 cases (6.7%). Conclusions In medical optometry, optometrists and sales staff should establish a good communication with patients according to individual differences, attach importance to the selection of right frame and lens in patients with high myopia or progressive piece of glasses, introduce the right wearing method of progressive piece of glasses, and enhance the follow-up service. For patients with obvious eye fatigue, it is needed to check the binocular visual function, if the visual fatigue is closely related to abnormal binocular visual function, special glasses fitting and functional training should be instructed to the patients.
ObjectiveTo investigate revision reasons and prosthesis selection of Crowe Ⅳ developmental dysplasia of the hip (DDH) after total hip arthroplasty (THA). MethodsA clinical data of 14 patients (15 hips) with Crowe Ⅳ DDH, who underwent a revision hip arthroplasty between January 2008 and May 2018, was retrospectively reviewed. There were 1 male (1 hip) and 13 females (14 hips). The age ranged from 27 to 63 years (mean, 45.0 years). There were 7 cases of left hip, 6 cases of right hip, and 1 case of bilateral hips. The prosthetic interfaces of primary THA were metal-on-polyethylene (MOP) in 9 hips, ceramic-on-ceramic (COC) in 4 hips, ceramic-on-polyethylene (COP) in 1 hip, and ceramic-on-metal in 1 hip. The time from primary THA to revision was 3-204 months (mean, 65.0 months). The causes of revision included aseptic loosening in 7 hips, dislocation in 3 hips, periprosthetic joint infection in 2 hips, osteolysis in 1 hip, nonunion of osteotomy in 1 hip, and a small-angle of femoral anteversion in 1 hip. Preoperative Harris score was 54.1±17.8 and the range of motion (ROM) of flexion was (92.7±20.2)°. Preoperative X-ray films showed the acetabular bone defect in 11 hips and osteolysis of femoral side in 4 hips. During the revision, the prostheses with COP and COC interfaces were used in 5 hips and 10 hips, respectively. Both acetabular and femoral revisions were performed in 11 hips and only femoral revision was performed in 4 hips.ResultsThe mean operation time was 3.7 hours (range, 1.5-6.0 hours). The mean intraoperative blood loss was 940.0 mL (range, 200-2 000 mL). All patients were followed up 16-142 months (mean, 73.9 months). Postoperative X-ray films showed no difference in inclination and anteversion between primary THA and revision (P>0.05). The height of rotation center and offset after revision were higher than those after primary THA, and the difference in offset was significant (P<0.05). At last follow-up, the Harris score and ROM of flexion were 85.0±7.3 and (115.0±17.0)°, respectively, which were significantly higher when compared with those before revision (t=8.909, P=0.000; t=4.911, P=0.000). Three hips underwent a re-revision operation. All protheses were fixed well and no radiolucent line, loosening, or subsidence was observed at last follow-up.ConclusionThe most common reason for revision in patients with Crowe Ⅳ DDH after THA was aseptic loosening. Due to high activity demand of this population, the prosthesis with MOP interface should be prevented and the prosthesis with COC interface could be alternative. Metal block, cup-cage, and reinforcement ring were reasonable solutions for reconstruction of acetabulum with severe bone defects and have satisfactory effectiveness. S-ROM prosthesis should be the preferred stem for neither primary THA or revision.
ObjectiveTo explore the causes and prevention measures of the cracking of skin tissue expander applied for ear deformity surgery. MethodsWe retrospectively analyzed the clinical data of the patients who underwent ear reconstruction surgery with skin tissue expander which cracked during water injection after surgery between January 2013 and March 2015. And then we analyzed the causes and summarized the preventive measures, such as strengthening health education, protective ear cap application, and correct water injection. ResultsWe collected a total of 149 patients including 153 deformity ears, and 151 skin tissue expanders were used. Skin tissue expander cracking occurred in 7 ears during water injection after surgery with an incidence of 4.64%. Among the seven cases, 5 cases of cracking occurred in the late water injection period when the skin flap size was almost close to expectations; these 5 patients underwent stage-two surgery after the expanders were taken out, and the results were satisfactory. The other 2 ears had expander cracking in the early water injection period, so we took out the skin tissue expander and implanted it again, and the second phase surgery was also satisfactory. The third-stage surgery for the seven cases was all successful. After the third-stage surgery, all patients were followed up for 3 to 6 months, and the outcomes were satisfying without any complications. ConclusionTo reduce or avoid skin tissue expander cracking, we should master strict terms of water injection and take effective health education and preventive measures.
ObjectiveTo observe and analyze the clinical characteristics of children who died of intraocular retinoblastoma (RB). MethodsA retrospective clinical study. Fourteen children (23 eyes) with intraocular RB who died after receiving treatment in Beijing Children's Hospital from 2009 to 2017 were included in the study. Among the children, there were 7 males (10 eyes) and 7 females (13 eyes); 5 had unilateral and 9 had bilateral tumor. Age were 17.2±15.5 months. All children underwent RetCam examination. RB was staged according to the international intraocular RB classify. Among the 23 eyes, 1 eye was in stage B, 2 eyes were in stage C, 12 eyes in stage D, and 8 eyes in stage E. Treatment methods included a systemic (vincristine, etoposide and carboplatin) chemotherapy (VEC chemotherapy), enucleation surgery, and vitrectomy. The basic conditions including age, time of diagnosis, pathological diagnosis, treatment and main causes of death were retrospectively analyzed. ResultsAmong the 14 cases, the first symptom was leukemia in 12 cases, red eye in 1 case, and squintin in 1 case. Systemic VEC chemotherapy was used for 1-6 courses of treatment; 5 cases were enucleated, 3 cases underwent histopathological examination; 3 cases were treated with vitrectomy. Among the 3 cases who underwent histopathological examination, the sclera and optic nerve, optic nerve and optic disc were invasted respectively. Seven patients died of tumor metastasis and/or intracranial lesions (50.0%, 7/14); the median survival time was 19 months. Four patients died of treatment (28.6%, 4/14), including 3 patients died of chemotherapy-related side effects, and 1 died of organ failure after enucleation surgery (7.1%); the median survival time was 3.5 months. Early abandonment of treatment died in 3 cases (21.4%, 3/14); the median survival time was 15 months. ConclusionIntracranial metastasis is the main cause of death in children with intraocular RB.