Objective To summarize the visual outcome of patients with severe ocular trauma treated with vitreous surgery. Methods Clinical data of 188(191 eyes) with severe ocular trauma treated with vitreous surgery in a period from November 1996 to April 1998 were analysed retrospectively. Results The study included penetrating injury in 56 eyes, foreign bodies in the posterior segment in 70 eyes, blunt injury in 41 eyes , and globe rupture in 24 eyes. Main complications included endophthalmitis in 35 eyes, choroidal bleeding in 20 eyes, retinal detachment in 60 eyes, and vitreous hemorrhage in 97 eyes. Post-opera-tively, out of 188 eyes, except for 3 of patients too young to examine, visual acuity improved in 133(70.7%), including 85(45.2%) with visal acuity 0.02-1.0, 46(24.5%) remained unchanged; and 9(4.8%) had worse vision. Among 34 with no-light-perception, 12 had light-perception or over. Conclusion A majority of severe trauma eyes can be salvaged with considerable visual recovery after adequate and timely vitreous surgery. (Chin J Ocul Fundus Dis,1999,15:4-6)
Objective To summarize the experience of emergency coronary artery bypass grafting （CABG） after failed percutaneous coronary intervention. Methods From January 1998 to December 2002, 9 patients underwent emergency CABG after failed percutaneous coronary intervention. The indications of emergency CABG were coronary artery dissection （5 cases）or perforation （2 cases） and acute arterial occlusion （2 cases）. The time averaged 2 hours from onset of ischernia to revascularization. The CABG was performed under off-pump bypass in 3 cases and under CPB in 6 cases. The mean graft number was 3. Results There were no hospital death. The mean follow-up was 17 months. No death and angina occurred. The function of New York Heart Association class Ⅰ-Ⅱ were in 8 patients, class Ⅲ in 1 patient. Conclusion Emergency CABG is an effective management for failed percutaneous coronary intervention if the indication is right.
中國的膽道疾病有自己的特點，也是東亞地區的特點。它嚴重危害人民的生命和健康，損害勞動力，比西方的膽道病更重。中國膽道外科應有自己的特色。自成都發現膽道蛔蟲病開始，積累膽道感染和肝內結石病臨床資料60年來，全國各地廣泛深入的臨床和實驗研究已取得重大成績。許多成績不是單純引進或照搬外國經驗，而是針對自己面臨的特殊實際情況，運用現代西方醫學或與祖國傳統醫學相結合，獨立自主研究取得的。我們已經解決或基本上解決了很多臨床實際問題，但還有一些重大問題沒有解決，或沒有完全解決，有些問題還沒有提上議事日程，它與西方的膽道外科自然有基本的共性，所以，我們的研究課題，既是中國的，也是世界的。自從改革開放以來，隨著人們物質生活的改善，膽道病譜也有了明顯改變，原發性膽管結石癥在城市明顯減少，農村鄉鎮所見也緩慢地趨向減少，膽囊結石病則趨向增多。但是，還不能說以原發性膽管結石病為主要對象的中國膽道外科正走向沒落，沒有多少研究課題了。應當著重提出，當今對膽管病研究的，實際上是整個膽道問題，包括全膽道若干艱深問題。我們的研究除深入膽管病外，也應加強膽囊病的研究力度。