Abstract: Objective To summarize the clinical experiences of onestage hybrid operation for treating typeB aortic dissection and aortic aneurysm involving distal aortic arch, explore the indication for this special technique and analyze shortterm followup results. Methods From October 2008 to May 2010, 16 consecutive patients received onestage hybrid operation in Fu Wai Hospital for aortic dissection or aortic aneurysm involving distal aortic arch. There were 12 males and 4 females. Their age ranged from 38.0 to 67.0 years (54.0±9.2 years). There were 14 patients of typeB aortic dissection, 1 patient of thoracic aortic aneurysm involving the aortic arch, and 1 patient of penetrating aortic ulcer. Among them, 10 were acute ones and 6 were chronic ones. Brachiocephalic artery bypass using neck incision with retrograde endovascular stent graft implantation was used. Four patients received bypass from the left common carotid artery to the left subclavian artery; 11 patients underwent bypass from the right common carotid artery to the left common carotid artery; and 1 patient had both of the bypasses. Intensive care unit(ICU) stay, hospital stay， and incidence of complications were closely monitored after operation. Computed tomography(CT) and general condition of the bypass grafts and its blood flow were followed up at three months and one year after operation. Results No death or severe complications occurred perioperatively. All onestage surgeries were technically successful with stent grafts implanted. Angiography during the operation showed 100% patency of all the bypass grafts and no obvious translocation or endoleakage of the stent grafts. One patient had mild paraplegia and recovered soon after treatment. Ventilation time of these patients was 2.010.0 hours (5.3±2.7 hours). The ICU stay was 0.0-2.0 days (1.1±0.4 days) and hospital stay was 4.0-7.0 days (5.3±0.8 days). The expenditure of blood products was 0.0-1 016.5 RMB (134.5±281.8 RMB). All patients were followed up with a followup period of 3.0 to 26.0 months (130±5.1 months). All patients recovered to normal social life. Enhanced CT scanning at three months and one year after operation showed no endoleakage or translocation of the stent grafts and 100% patency of the bypass grafts. There was no obvious change of the distal part of the dissection except some thrombosis formation in nine patients. Conclusion Onestage hybrid operation is safe and effective in shortening the duration of the operation and hospital stay, reducing the surgical trauma and sufferings of the patients, and lowering the risk of staged operations with satisfactory shortterm results. This special technique may expand the indications of simple endovascular repair. The mid and longterm results still need to be followed up.
OBJCTIVE :To investigate the fundus ocu]i changes in hypnxie isehemic encepbalnpa ally(HIE)of new[x,rns. METHODS:One hundred and two newblt;~rns suffered from HIE were investi- gated to observe lhe pathological neular fundus changes by di~et ophthabnoseopy after mydria~s. RE- SULTS:Seventy seven ca.~s(154 eyes)were found to have ophthalmoscopic changes in the ~ular fundi including papilledema .white retina vaseolar abnormality and hemorrhage. CONCLUSIONS:In clinical view .the severity of HIE depends on the pathological ebanges of the brain .and ftmdus ahnormalby will be very often in middle and .~vere sufforers of HIE.
ObjectiveTo understand the current situation and challenges of basic research on respiratory diseases in China.MethodsTo summarize and analyze the application and projects funded in the field of respiratory medicine (Code: H01 and H1615) from National Natural Science Foundation of China (NSFC) during 2010 to 2017.ResultsA total of 2 191 projects of 11 766 applications were funded by NSFC in the field of respiratory medicine and the total subsidy fund reached ￥981 279 000. A total of 1 130 projects of 5 915 applications were funded in the Research Projects, including 1 021 General Program projects, 14 Key Program projects, 16 Major Research Plan projects, 1 Major Research Program project, 2 Program projects of Joint Funds, 30 International (Regional) Cooperation and Exchange Program projects, and 46 Emergency Management Program projects. A total of 1 061 projects of 5 851 applications were funded in the Talent Projects, including 853 Young Scientists Fund projects, 191 projects of Fund for Less Developed Regions, 4 projects of Distinguished Young Scholars, 4 projects of Excellent Young Scientists Fund, and 9 projects of the Research Fund for International Young Scientists. The projects funded were mainly distributed in the field of respiratory inflammation and infection, asthma, chronic obstructive pulmonary disease, pulmonary circulation and pulmonary vascular disease. The top three research directions were asthma (19.0%), acute lung injury and acute respiratory distress syndrome (15.4%), chronic obstructive pulmonary disease (12.7%), pulmonary circulation and pulmonary vascular disease (12.7%) in sequence. Average funding rate of respiratory tumor (application code: H1615) was 17.2%.ConclusionsSince the Department of Health Science of NSFC was established in 2009, with the increasing of NSFC budget, the basic research in the field of Respiratory Medicine has been developed rapidly. With the efforts of scientific researchers and clinical medical workers, research in the field of respiratory medicine will achieve rapid development in China.
ObjectiveTo compare the consistency of artificial analysis and artificial intelligence analysis in the identification of fundus lesions in diabetic patients.MethodsA retrospective study. From May 2018 to May 2019, 1053 consecutive diabetic patients (2106 eyes) of the endocrinology department of the First Affiliated Hospital of Zhengzhou University were included in the study. Among them, 888 patients were males and 165 were females. They were 20-70 years old, with an average age of 53 years old. All patients were performed fundus imaging on diabetic Inspection by useing Japanese Kowa non-mydriatic fundus cameras. The artificial intelligence analysis of Shanggong's ophthalmology cloud network screening platform automatically detected diabetic retinopathy (DR) such as exudation, bleeding, and microaneurysms, and automatically classifies the image detection results according to the DR international staging standard. Manual analysis was performed by two attending physicians and reviewed by the chief physician to ensure the accuracy of manual analysis. When differences appeared between the analysis results of the two analysis methods, the manual analysis results shall be used as the standard. Consistency rate were calculated and compared. Consistency rate = (number of eyes with the same diagnosis result/total number of effective eyes collected) × 100%. Kappa consistency test was performed on the results of manual analysis and artificial intelligence analysis, 0.0≤κ＜0.2 was a very poor degree of consistency, 0.2≤κ＜0.4 meant poor consistency, 0.4≤κ＜0.6 meant medium consistency, and 0.6≤κ＜1.0 meant good consistency.ResultsAmong the 2106 eyes, 64 eyes were excluded that cannot be identified by artificial intelligence due to serious illness, 2042 eyes were finally included in the analysis. The results of artificial analysis and artificial intelligence analysis were completely consistent with 1835 eyes, accounting for 89.86%. There were differences in analysis of 207 eyes, accounting for 10.14%. The main differences between the two are as follows: (1) Artificial intelligence analysis points Bleeding, oozing, and manual analysis of 96 eyes (96/2042, 4.70%); (2) Artificial intelligence analysis of drusen, and manual analysis of 71 eyes (71/2042, 3.48%); (3) Artificial intelligence analyzes normal or vitreous degeneration, while manual analysis of punctate exudation or hemorrhage or microaneurysms in 40 eyes (40/2042, 1.95%). The diagnostic rates for non-DR were 23.2% and 20.2%, respectively. The diagnostic rates for non-DR were 76.8% and 79.8%, respectively. The accuracy of artificial intelligence interpretation is 87.8%. The results of the Kappa consistency test showed that the diagnostic results of manual analysis and artificial intelligence analysis were moderately consistent (κ=0.576, P＜0.01).ConclusionsManual analysis and artificial intelligence analysis showed moderate consistency in the diagnosis of fundus lesions in diabetic patients. The accuracy of artificial intelligence interpretation is 87.8%.
Purpose To investigate the blood dynamic feature of choroid in normal eyes. Methods Indocyanine green angiography (ICGA) was performed in each of fifty consecutive normal eyes. Results The earliest fundus fluorescence emerged at the mean timiest fundus fluorescence emerged at the mean time of (14.25plusmn;3.59) seconds,it represented the beginning of filling of choroidal arteries located at the posterior pole.The irrigation of choroidal veins appeared at the mean time of (15.03plusmn;3.44) seconds.At the time threre was the overlapping imaging appearance of choroisal arteries and veins.The most hyperfluorescent areas appered at the mean time of(16.75plusmn;3.78) seconds with definite shapes located at the posterior pole,and this stood for the fluorescence stage of choroidal arteries,veins and capillaries.The fluorescence of choroidal vein began to weaken at 11prime;58Prime;15plusmn;2prime;39Prime;86,and revealed the imaging of late stage of choroidal veins.The latest stage of ICGA was at 22prime;13Prime;22plusmn;3prime;30Prime;55,and presented obscure fluorescence. Conclusion The measurement results and fluorescent features of ICGA of normal eyes can offer consulted bases for the clinical diagnosis of the choroidal diseases. (Chin J Ocul Fundus Dis,1998,14:68-71)
Objective Observation on the characteristics of choroidal melanomas with indocyanine green angiography (ICGA) and fundus fluorescsin angiography(FFA). Methods Both ICGA and FFA were used in 16 cases of choroidal melanoma for comparison and analysis. Results 81.2% of tumors showed hypofluorescence all the way or faint fluorescence in later stage．62.6% of tumors had characteristic intrinsic tumor vassels with ICGA,while 12.5% of tumors had intrinsic vessels with FFA．Those tumors that can't be diagnosed owing to whole hyperfluorescence in later stage with FFA may be diagnosed by visibility of intrinsic tumor vessels with ICGA. Conclusion ICGA is helpful in the diagnosis of choroidal melanoma. (Chin J Ocul Fundus Dis, 2000，16：3-5)
ObjectiveTo observe the features of the manifestations of fundus fluorescein angiography （FFA） in multiple sclerosis （MS） and their value in clinical diagnosis.MethodsThe clinical data of 42 patients (84 eyes) with MS diagnosed by magnetic resonance imaging (MRI) and examination of cerebrospinal fluid (CSF) were retrospectively analyzed. The clinical data included visual acuity, ocular fundus examined by direct ophthalmoscope after mydriasis, FFA, visual field, CSF，visual evoked potential (VEP) and MRI examination.ResultsIn 42 patients (84 eyes),the positive detectable rate of examination of direct ophthalmoscope, CSF, visual field, VEP, and MRI was 36.9%, 21.4%, 71.4%, and 83.3% respectively. Abnormal results of FFA were found in 44 eyes (52.38%), including papillitis in 4 eyes（4.76%）at the early stage with extended physiological scotoma and central scotoma; neuroretinitis in 7 eyes （8.33%）at the medium stage with central or para-central scotoma; optic atrophy in 33 eyes（39.29%） at the late stage with centripetal constriction and even tubular visual field. ConclusionThe main angiographic features of MS are papillitis, neuroretinitis and optic atrophy. The manifestations of FFA combined with the results of examination of CSF，visual field, VEP and MRI is helpful for comprehensive and exact diagnosis of MS.(Chin J Ocul Fundus Dis, 2005,21:300-302)
Purpose To investigate the clinical features and pathogenesis of acute posterior multifocal placoid pigment epitheliopathy(APMPPE). Methods To observe the features in 8 eyes of 6 cases of APMPPE with fundus fluorescein angiography(FFA) and indocyanine green angiography(ICGA).One of the cases had been observed continuously for 160 days. Results 1.FFA: at the acute stage of APMPPE,the affected foci showed low fluorescence in the early phase and stained gradually in 3 eyes;the fluorescence of recessive foci were still lower in 4 eyes,and the stale one showed window defect fluorescence due to some RPE fading and fluorescence sheltering due to pigment deposit.2.ICGA:at acuted stage,the fluorescence of choroid lobules was ofen defected untill in late period of pathogenical changes. Conclusion The findings demonstrate the obstruction of choriocapillaries may be the primary pathogenesis of APMPPE. (Chin J Ocul Fundus Dis,1998,14:84-87)
Objectives To analyze the status quo of projects on pension services funded by the National Natural Science Foundation of China (NSFC), with the aim of enlarging the perspective and horizon of related studies, and improving both the quantity and quality of such projects in NSFC. Methods NSFC website was systematically searched to collect information of pension service projects funded by NSFC from 2008 to 2017. SPSS 19.0 software was subsequently applied to analyze the characteristics of the projects in terms of study type, regional distribution, profession and institution, and fund scale, etc. Results A total of 39 projects on pension service were included, among which 12 were focused on related strategies (30.8%), 11 on related models (28.2%), and 6 on the effects of different interventions (15.4%). The 39 projects were unbalanced in terms of geographical distribution, institutions and research types. Conclusions NSFC should facilitate the research of pension service by expanding the related fund scale, increasing the fund support, strengthening the exchange of domestically different regions, and enhancing international cooperation.
Objective To assess the consistency of diagnostic results using optical coherence tomography angiography(OCTA) and fundus fluorescein angiography(FFA) in the central retinal vein occlusion(CRVO). Methods A retrospective case series of 26 eyes of 26 patients with CRVO. Simultaneous OCTA and FFA were performed in all patients by using 7-standard field of ETDRS to evaluate the microaneurysms, nonperfused areas, optical disc/retinal neovascularization and macular edema. The consistency was evaluated using weightedKappa statistic values.Kappa≥0.75, consistency is excellent; 0.60≤Kappa＜0.75, consistency is good; 0.40≤Kappa＜0.60, consistency is general;Kappa＜0.40, consistency is poor. Results Examined by OCTA, microaneurysms were found in 23 eyes, nonperfused areas in 16 eyes, optical disc/retinal neovascularization in 8 eyes and macular edema in 21eyes. Performed with FFA, 23 eyes were diagnosed to have microaneurysms, 16 eyes have nonperfused, 8 eyes have optical disc/retinal neovascularization, 22 eyes have macular edema. The consistency was excellent for microaneurysms(Kappa=0.772，P<0.01) and optical disc/retinal neovascularization(Kappa=0.766，P<0.01), good for nonperfused areas (Kappa=0.703，P<0.01) and macular edema(Kappa=0.60，P<0.01). Conclusion There is high consistency between OCTA and FFA in the diagnosis of CRVO, OCTA is an effective method in the examination of CRVO.