Objective To invesligate the treatment of retinal de tachment(RD) after silicone oil tamponades(SOT)． Methods The records of a consecutive series of 32 eyes with redetachment of retina after SOT surgery between 1998 to 2000 were reviewed retrospectively． The surgical techniques used for these cases included remove of silicon oil,peeling of preretinal membrane, retinotomy, endolaser photocoagutation, secondary vitrectomy and C3 F8 tamponades． Results In 28 of 32 eyes the retina was reattached (87．6%)． The postoperative visual acuity was improved in 12 eyes, redused in 4 eyes and remained no change in 16 eyes． The postop erative complications in 6 eyes included secondary glaucoma(3 eyes), hypotony (1 eye) and hyphema (2 eyes)． Conclusion The techniques of preretinal membrane peeling, retinotomy, endophotocoagulation and C3 F8 tamponades can be effectively used in combination to treat the redetachment of retina after the silicone oil tamponades surgery． (Chin J Ocul Fundus Dis,2001,17:214-215)
睡眠呼吸暫停低通氣綜合征( SAHS) 是一種常見病癥,臨床上以阻塞性睡眠呼吸暫停低通氣綜合征( OSAHS) 最為常見[1] 。1993 年一項基于社區人群的研究中, Young 等[2] 發現年齡介于30 ～60 歲的人群中, 以睡眠呼吸暫停低通氣指數( AHI) ≥5 次/h 定義的OSAHS在女性的患病率為9% ,在男性為24% , 2% 的女性和4% 的男性同時存在嗜睡癥狀。越來越多的證據表明睡眠呼吸暫停可導致許多并發癥, 包括行為和軀體兩方面。行為并發癥包括日間嗜睡、注意力下降和神經心理異常, 而軀體并發癥主要包括心腦血管疾病, 尤其是高血壓[3, 4] 。OSAHS 是全身多個臟器功能損害的獨立危險因素, 其中心血管并發癥是主要死因[5] 。如何評價OSAHS 病情嚴重程度, 對患者的診斷、治療及預后判斷具有非常重要的意義。目前AHI 仍然是診斷OSAHS 的金標準,但其與靶器官損害的相關性存在諸多爭議。
Sensorimotor disorder can be easily caused by stroke, and there are many targeted movement rehabilitation therapies. With the development of rehabilitation robot technology, robot-assisted therapy combined with mechanical perturbations has become a more effective motor rehabilitation therapy. In this paper, the definition of mechanical perturbation and its physiological mechanism in stroke rehabilitation are introduced, the research progress on mechanical perturbation in the field of stroke rehabilitation therapy is mainly discussed, the application of mechanical perturbation in motor control, postural response and sensory evaluation of stroke rehabilitation is summarized, and the future development direction of mechanical perturbation rehabilitation therapy is also prospected.
Objective To investigate the mutations of quinolone resistance determinational region ( QRDR) in fluoroquinolon-resistant Pseudomonas aeruginosa strains isolated from patients with nosocomial pneumonia. Methods Eight-four Pseudomonas aeruginosa strains isolated from patients with nosocomial pneumonia in Xinhua Hospital during January 2006 to December 2007, from whom fluoroquinolon-resistant resisitant ( case) and fluoroquinolon-susceptible ( control ) Pseudomona aeruginosa were identified. The mutation of QRDR was tested by restriction fragment length polymorphism ( RFLP) and gene sequencing.The relationship between QRDR mutations and clinical prescription was analyzed. Results Mutation in QRDR was found in 42 isolates among the 50 fluoroquinlon-resisitant isolates( 84. 0% ) , while no mutation was found in fluoroquinlon-susceptible isolates. The mutation in GyrB Ser464 was found in 34 isolates ( 68. 0% ) . There was statistical difference in the usage of β-lactams between the GyrB-Ser464-mutated group and the non-GyrB-Ser464-mutated group( OR = 11. 3, P = 0. 003 and OR = 3. 5, P = 0. 023) , also in the time of fluoroquinolon usage before isolated ( P = 0. 038) . Conclusions The mutation of QRDR is contributing to fluoroquindor-resisitance of Pseudomona aeruginosa, most of which lies in GyrB Ser464.Abuse of β-lactams and fluoroquinolon may be the risk factors of mutation in GyrB Ser464.
目的 提高臨床醫生對甲狀腺功能減退癥（甲減）并發急性呼吸衰竭的認識，減少誤診，提高救治率。方法 對2002年11月－2011年6月收治的6例甲減并發急性呼吸衰竭患者予以有創機械通氣及早期使用左旋甲狀腺素治療，使病癥得以控制和治愈。 結果 患者使用有創機械通氣治療平均7 d，住院治療14～43 d，平均（28.6 ±14.4）d， 5例治愈，1例死亡。 結論 甲減并發呼吸衰竭早期使用機械通氣及甲狀腺激素替代治療可提高搶救成功率。
目的 觀察獨用內鏡下手術以及聯合等離子低溫射頻治療外耳道乳頭狀瘤的療效。 方法 2006年7月－2010年7月，隨機將收治的45例外耳道乳頭狀瘤患者（150只耳）分組，比較獨用內鏡下手術組（A組）以及聯合等離子低溫射頻組（B組）治療外耳道乳頭狀瘤的療效。 結果 患者均術后成功隨訪1～3年，48只患耳無復發及惡變，2只患耳3個月后復發。 結論 內鏡下手術聯合等離子低溫射頻治療外耳道乳頭狀瘤具有微創，手術徹底有效，防止復發的優點，值得臨床廣泛應用。
Objective To investigate the value of ice test in the diagnosis of ptosis of myasthenia gravis(MG). Methods A total of 32 patients with myasthenic ptosis and 33 with nonmyasthenic ptosis underwent ice and rest test which were performed alternately twice within 1 day on each patient. Besides, neostigmine test was performed on the patients with myasthenic ptosis after ice and rest test . Two observers who didnrsquo;t know the clinical diagnosis were asked to evaluate the improvement of eyelid elevation by measuring the width between the midpoints of upper and lower eyelid with a 20mm steel rule (precision of 0.5 mm). The average of margin of palpebral fissure width after double ice or rest tests subtrac ted from the one before the tests in one patient was the standard of the improve ment of eyelid elevation. Results Ice and rest test improved myasthenic ptosis but not nonmyasthenic ptosis with the specificity of 100% in both of the tests. In addition, ice test improved myasthenic ptosis more effectively with a higher sensitivity of 78%, and it could also improve the palpebral fissure width in pa i tents with complete myasthenic ptosis apparently. Compared with the neostigmine test, ice test had lower sensitivity, cost shorter time, didnt need injection which avoided the discomfort, and had no side effects. Conclusion Ice test is a simple and safe means with high sensitivity and specificity to diagnose myasthenic ptosis, which is valuable in clinical application. (Chin J Ocul Fundus Dis, 2006,22:382-384）
The consolidated framework for implementation research (CFIR) is one of the most commonly used theoretical frameworks for implementation science. The updated CFIR was optimized based on the original version. The background, process and contents of the updated CFIR were introduced, and the domains and constructs of the updated CFIR were interpreted in this article. We analyzed the similarities and differences of the updated CFIR compared with the original CFIR, in order to provide methodological references for Chinese researchers to explore the determinants of implementation.
In recent years, photon-counting computed tomography (PCD-CT) based on photon-counting detectors (PCDs) has become increasingly utilized in clinical practice. Compared with conventional CT, PCD-CT has the potential to achieve micron-level spatial resolution, lower radiation dose, negligible electronic noise, multi-energy imaging, and material identification, etc. This advancement facilitates the promotion of ultra-low dose scans in clinical scenarios, potentially detecting minimal and hidden lesions, thus significantly improving image quality. However, the current state of the art is limited and issues such as charge sharing, pulse pileup, K-escape and count rate drift remain unresolved. These issues could lead to a decrease in image resolution and energy resolution, while an increasing in image noise and ring artifact and so on. This article systematically reviewed the physical principles of PCD-CT, and outlined the structural differences between PCDs and energy integration detectors (EIDs), and the current challenges in the development of PCD-CT. In addition, the advantages and disadvantages of three detector materials were analysed. Then, the clinical benefits of PCD-CT were presented through the clinical application of PCD-CT in the three diseases with the highest mortality rate in China (cardiovascular disease, tumour and respiratory disease). The overall aim of the article is to comprehensively assist medical professionals in understanding the technological innovations and current technical limitations of PCD-CT, while highlighting the urgent problems that PCD-CT needs to address in the coming years.
In this study, we propose an automatic contour outlining method to measure the spatial resolution of homemade automatic tube current modulation (ATCM) phantom by outlining the edge contour of the phantom image, selecting the region of interest (ROI), and measuring the spatial resolution characteristics of computer tomography (CT) phantom image. Specifically, the method obtains a binarized image of the phantom outlined by an automated fast region convolutional neural network (AFRCNN) model, measures the edge spread function (ESF) of the CT phantom with different tube currents and layer thicknesses, and differentiates the ESF to obtain the line spread function (LSF). Finally, the values passing through the zeros are normalized by the Fourier transform to obtain the CT spatial resolution index (RI) for the automatic measurement of the modulation transfer function (MTF). In this study, this algorithm is compared with the algorithm that uses polymethylmethacrylate (PMMA) to measure the MTF of the phantom edges to verify the feasibility of this method, and the results show that the AFRCNN model not only improves the efficiency and accuracy of the phantom contour outlining, but also is able to obtain a more accurate spatial resolution value through automated segmentation. In summary, the algorithm proposed in this study is accurate in spatial resolution measurement of phantom images and has the potential to be widely used in real clinical CT images.