Objective To investigate the clinical features, etiological classification and staging of epiretinal macular membrane(MEM)． Methods Clinical materials of 194 cases of MEM diagnosed by fundus fluorescein angiography in outpatient department of eye clinic in this hospital from 1983 to 2000 were retrospectively analyzed． Results There were typical clinical symptoms and signs of MEM in all of this 222 eyes of 194 patients． Etiological classification revealed that 4 cases were congenital(2．12%), 22 cases were secondary(11．34%), and 168 cases were idio pathic(86．60%)． Staging of course of disease indicated that 119 eyes were in early stage(53．60%), 72 eyes were in middle stage(32．43%), and 31 eyes were in late stage(13．96%)． Conclusion MEM may be classified as congenital, secondary and idiopathic type according to its pathogenesis , as early, middle and late stage according to the clinical course of disease．This can be helpful in treating the disease． (Chin J Ocul Fundus Dis, 2001,17:210-213)
摘要:目的: 通过分析地市级急救中心院前急救资料,探讨ICD10疾病分类方法在院前急救中的实用性。 方法 :回顾性分析2007年1~12月份自贡市急救中心出诊的全部有效急救患者的急诊诊断以及随访诊断,使用ICD10编码进行归类,比较疾病性别构成比。 结果 :全年院前急救4109例,排5位的疾病分别为损伤、中毒和外因的某些其他后果(484%)、循环系统疾病(170%)、消化系统疾病(81%)、呼吸系统疾病(64%)、精神和行为障碍(52%),损伤、中毒和外因的某些其他后果、循环系统疾病以及消化系统疾病出诊量男性多于女性(P＜005),耳和乳突疾病以及妊娠、分娩和产褥期疾病出诊量女性多于男性(P＜005)。 结论 :采用ICD10标准对院前急救病谱分类有进一步探讨的价值。Abstract: Objective: To investigate the value of ICD10 in prehospital care by the analysis of cases in Zigong Urgent Rescue Center. Methods : All cases of prehospital care during the year of 2007 were studied, whose emergency Diagnoses and followup diagnoses were recorded, and they were classified by international classification of diseases 10th revision (ICD10). The gender composition ratio of diseases was analyzed. Results : Four thousand one hundred and nine cases of prehospital care in 2007 were included. Topfive diseases were injury, poisoning and certain other consequences of external causes (484%), diseases of the circulatory system (170%), diseases of the digestive system (81%), diseases of the respiratory system (64%), and mental and behavioral disorders (52%) respectively. The amout of the male prehospital cases was more that of than the female’s in the diseases of injury, poisoning and certain other consequences of external causes, diseases of the circulatory system, diseases of the digestive system (P＜005); the amount of the female prehospital cases was more than that of the male’s in the diseases of the ear and mastoid process, pregnancy, childbirth and the puerperium (P＜005). Conclusion : Further research on the spectrum of diseases classified by ICD10 is valuable.
目的:通过分析2007年自贡市急救中心院前急救反应能力，探讨其影响制约因素及解决方法。方法：回顾性分析2007年1～12月份自贡市急救中心院前出诊的全部有效病例呼救时间、出车时间、到达现场时间及出诊距离，计算出车准备时间、车辆行驶速度、应急反应时间、急救半径。结果：全年院前出诊共3336例，出车准备时间（2.06±0.93） min，车辆平均行驶速度32.17 km/h，应急反应时间（12.51±10.87） min，急救半径（5.60±5.35） km。结论：我市急救中心目前取得一定成绩，需采取多种措施进一步提高急救反应能力。
Objective To probe the clinical character,the histopathological classification and misdiagnoses of intraocular tumors. Methods The clinical and pathological data of 359 patients with intraocular tumor diagnosed clinically between 1980～2000 were retrospectively analyzed. Results There were 300 cases of malignant tumor and 23 cases of benign tumor respectively. Non-oncologic malady and benign tumor misdiagnosed as tumor or malignant tumor were 40 cases. The two leading malignant tumors were retinoblastoma and melanoma. Conclusion The clinical and pathological analysis of intraocular tumor is beneficial to the correct clinical diagnosis and treatment. (Chin J Ocul Fundus Dis,2002,18:28-30)
ObjectiveTo summarize regional and body distributions, diagnosis, treatment, and prognosis of echinococcosis outside liver in China. MethodsThe published literatures about echinococcosis outside liver in China (not including Hong Kong, Macao and Taiwan regions) from 2000 to 2015 were searched in the databases of CNKI and Wanfang. Data were extracted by using a standardized form and a retrospective clinical analysis was performed. ResultsA total of 66 published literatures about echinococcosis outside liver and data of 884 cases reported were collected. The regional proportions of cases reported were different, five high regions were Xinjiang (68.73%), Tibet (8.77%), Ningxia (6.75%), Qinghai (6.41%), Gansu (5.62%). The organ distributions of cases reported were also different, five high organs were lung (61.09%), bone (9.95%), brain (9.73%), spleen (8.60%), and kidney (6.22%). The main clinical symptoms of patients with echinococcosis outside liver included general asymptoms and organ dysfunction, and the most common examinations were X-ray (30.77%), B ultrasound (7.47%),CT(17.43%), MR (1.59%), and laboratory (36.31%). The main therapy choice was operation (73.30%), and some patients were performed operation combined with drug therapy. ConclusionRegional distribution of echinococcosis outside liver is almost the same as total echinococcosis, and distributed more in organs rich in blood supply, its clinical diagnosis mainly depends on imaging and immunology examination, and operation is still the main therapy choice.
Objective To explore the effects of various kinds of internal fixations on unstable intertrochanteric femoral fractures. Methods From January 2000 to December 2004,88 cases of unstable intertrochanteric femoral fractures were treated. There were 52 males and 36 females (aged 19-86 years). Twenty-two cases were caused by fall from height, 36 by motor vehicle accident and 20 by fall and 10 by tumble. They were divided into 4 groups according to 4 kinds of internal fixations: dynamic hip screw(DHS,group A, n=42), anatomical proximal femur bone plate (group B, n=23), proximal femoral nail（PFN，group C, n=8）and dynamic condylar screw (DCS, group D, n=15). According to the modified Evan’s classification, fractures were all unstable type and were classified as follow types: group A (15 type Ⅲ, 8 type Ⅳ and 19 type Ⅴ); group B (12 type Ⅲ, 5 type Ⅳ and 6 type Ⅴ); group C (3 type Ⅲ,2 type Ⅳ and 3 type Ⅴ); and group D (10 type Ⅲ,3 type Ⅳ and 2 type Ⅴ). The data of operative time, intra-operative blood loss, intraoperative complications, fluoroscopy exposures, clinical healing time of fracture, post-operative restored function and postoperative complications were recorded and analyzed statistically using the SPSS 12.0 software package.Results All patients were followed up for 12-48 month (18 months on average). All patients achieved clinical healing. Coxa varus occurred in 3 cases of group A, in 1 case ofgroup C and in 3 cases of group D . The differences were of no statistical significance in operative time and postoperative complications between 4 groups (P＞0.05). The difference was of statistical significance in the blood loss between groups A,B and groups C,D (P＜0.05) but no statistical significance between group C and group D (P＞0.05). The difference was of statistical significance in the fluoroscopy exposures, clinical healing time of fracture and postoperative complications between group B and the other groups (P＜0.05). The difference was of statistical significance in the postoperative restored functions between group D and theother groups (P＜0.05). Conclusion The anatomical proximal femur bone plate is a useful device in the treatment of unstable intertrochanteric femoral fracture. The operative manipulation is simple and the hip functions recover well.
ObjectiveTo explore the clinical effect of LuX-Valve implantation in patients with severe tricuspid regurgitation (TR) and review articles about similar devices.MethodsWe reported the data of a 58-year-old male patient with severe TR, who was hospitalized on March 17th, 2020 because of “abdominal distention and edema for 5 years”, and then received LuX-Valve implantation in the Department of Cardiovascular Surgery of Changhai Hospital, Naval Medical University. Articles about transcatheter tricuspid valve replacement were reviewed in PubMed according to the key words including “transcatheter tricuspid valve replacement” “TTVR” and “transcatheter tricuspid valve intervention”.ResultsThe patient with severe TR received LuX-Valve implantation under general anesthesia and the guidance of digital subtraction angiography and transesophageal echocardiography. The patient’s TR was totally corrected after implantation and postoperative one-month follow-up showed well clinical effects. The result of literature review showed that there were two similar devices and both had been implanted in TR patients.ConclusionLuX-Valve is an effective and reliable transcatheter tricuspid valve replacement device.
Objective To explore the effect of aortic valve neo-cuspidization (AVNeo) for patients with severe aortic valve lesions simultaneously. Methods Patients who underwent AVNeo combined valve repair surgery for multiple valve diseases were included in Beijing Anzhen Hospital from May 2016 to September 2023. Results We included 11 patients with 7 males and 4 females at a median age of 38 (36, 49) years. Rheumatic heart disease was found in 5 (45.5%) patients and non-rheumatic heart disease in 6 (54.5%) patients. The median EuroSCORE Ⅱ score was 1.62 (1.18, 1.75) points. Eight patients underwent AVNeo plus mitral and tricuspid valve repair, and 3 patients underwent AVNeo plus mitral valve repair. The median operative time was 356 (315, 415) min, and the median cardiopulmonary bypass time and aortic clamping time were 203 (174, 231) min and 168 (131, 188) min, respectively. In the early stage, 2 patients underwent combined valve repair surgery, and 1 patient underwent in-hospital reoperation for aortic valve replacement because of severe aortic regurgitation. There were 9 patients in the mature stage of AVNeo, and no perioperative adverse events or moderate or above residual valvular disease occurred. All patients recovered and were discharged from the hospital. The follow-up period was 3-99 months, and no reoperation, severe valve disease, bleeding, cerebral infarction, or other adverse events occurred in all patients. Conclusion For non-elderly patients whose mitral and tricuspid valves can be repaired successfully with severe aortic valve lesions, AVNeo can be attempted after proficiency. But the operation time and cardiopulmonary bypass time will inevitably be prolonged, and the patient's basic situation should be carefully evaluated before surgery.
ObjectiveTo explore the influence of sentinel lymph node (SLN) status on the prognosis of elderly breast cancer patients ≥70 years old, and to screen patients who may be exempted from sentinel lymph node biopsy (SLNB), so as to guide clinical individualized treatment for such patients. MethodsA retrospective analysis was made on 270 breast cancer patients aged ≥70 years old who underwent SLNB in the Affiliated Hospital of Southwest Medical University from 2012 to 2021. The clinicopathological characteristics of the total cases were compared according to the status of SLN. Kaplan-Meier method was used to draw the survival curve, and the influence of SLN status on the overall survival (OS) time, local recurrence (LR) and distant metastasis (DM) of patients were analyzed, and used log-rank to compare between groups. At the same time, the patients with hormone receptor (HR) positive were analyzed by subgroup. The differences between groups were compared by single factor χ2 test, and multivariate Cox regression model was used to analyze and determine the factors affecting OS, LR and DM of patients. ResultsThe age of 270 patients ranged from 70 to 95 years, with a median age of 74 years. One hundred and sixty-nine (62.6%) patients’ tumor were T2 stage. Invasive ductal carcinoma accounted for 83.0%, histological gradeⅡ accounted for 74.4%, estrogen receptor positive accounted for 78.1%, progesterone receptor positive accounted for 71.9%, and human epidermal growth factor receptor 2 negative accounted for 83.3%. The number of SLNs obtained by SLNB were 1-9, and the median was 3. SLN was negative in 202 cases (74.8%) and positive in 68 cases (25.2%). Thirty-five patients (13.0%) received axillary lymph node dissection. There was no significant difference in LR between the SLN positive group and the SLN negative group (P>0.05), but the SLN negative group had fewer occurrences of DM (P=0.001) and longer OS time (P=0.009) compared to the SLN positive group. The results of univariate and multivariate analysis suggest that the older the patient, the shorter the OS time and the greater the risk of DM. Analysis of HR positive subgroups showed that SLN status did not affect patient survival and prognosis, but age was still associated with poor OS time and DM. ConclusionsFor patients with invasive ductal carcinoma of breast in T1-T2 stage, HR positive, clinical axillary lymph nodes negative, and age ≥70 years old, SLNB may be exempted. According to the patient’s performance or tumor biological characteristics, patients who need systemic adjuvant chemotherapy may still consider SLNB.
Objective To improve the knowledge of epidemiology, diagnosis and treatment of aspirin induced asthma ( AIA) in China. Methods Thirty-six cases with AIA who were reported in 30 papers in recent 10 years were analyzed retrospectively. Results The drugs which induced AIA in China mainly included acetylsalicylic acid ( aspirin) , ibuprofen ( Fenbid, ibuprofen) , while acetaminophen ( paracetamol,Bufferin, Tylenol ) , phenylpropanoid thiazide ( Piroxicam) , methoxy-naphthalene C acid ( naproxen) ,diclofenac in rare cases. 28. 6% ( 8 /28) of AIA patients were complicated with nasal disease . AIA could occur at all ages, especially for those over 40 years ( 72. 2% , 26 /36) . No significant difference of prevalencein male and female. The onset time of AIA was less than 60min in 71. 4% and gt;120min in 38. 6% . Most patients took the medications by oral ( 83. 3% ,30/36) , but the AIA onset time was not different by different administration route. Conclusions The incidence of AIA increases in recent years because of widely use of NSAIDs. However, no awareness of NSAIDs induced asthma is common in patients and physicians. For asthma patients it must be caution to take antipyretic analgesic anti-inflammatory drugs. If necessary,methoxy-naphthalene C acid ( naproxen) and diclofenac could be better choice.