Objective To evaluate the therapeutic effects of vitrectomy on chronic and refractory Behcet′s diseases. Methods The clinical data of 8 patients (10 eyes) with Behcet′s diseases from 0.5 to 3 years after vitrectomy were retrospectively analyzed. Pre-and post-operative visual acuity, control of inflammation after the surgery, and the recurrence were observed and analyzed. Both of the eyes were involved in all of the patients, including complete Behcet′s diseases in 5 and incomplete in 3. Results Vitreous opacity and liquefaction were found in all of the involved eyes, dark retina and thin retinal vessels were seen in most of the eyes, and vascular obstruction or sheath-like changes in different degrees were detected in some eyes. Improvement of visual acuity was observed in all of the eyes which had undergone the treatment after the operation. There was significant difference between the visual acuity before the surgery and at the 1st and 2nd week and the 1st and 6th month after the surgery. During the follow-up period, recurrence of the inflammation was found in 3 eyes within 1 month and in 6 eyes within 6 months; no recurrence was found in 4 eyes after the operation. No acute recurrence of inflammation was found after operation in the involved eyes. Conclusion Vitrectomy for chronic and refractory Behcet′s diseases may improve the visual acuity of the involved eyes, and the surgery is safe and effective. (Chin J Ocul Fundus Dis, 2005, 21: 357-359)
This article discusses the concret implementation of day surgery in Ophthalmology Center, Beijing Tongren Hospital, Capital Medical University during the coronavirus disease 2019 epidemic and under the regular prevention and control, so as to provide a basis for ensuring the safety and effectiveness of clinical work in the special period. According to the requirements of health administration departments and the hospital for the prevention and control of epidemic, combining with the characteristics of concret work, the Ophthalmology Center carried out and accurately implemented a series of prevention and control management measures, and obtained good results in the clinical work on the basis of comprehensive security protection. From February to October, 2020, there were a total of 16 507 cases who underwent the day surgery in the Ophthalmology Center, with no surgical infection or suspected case of coronavirus disease 2019. The safety and quality management of epidemic prevention and control has played an active and effective role in the active development of day surgery in this center. The safe and optimized diagnosis and treatment process has reassured the patients and their families, and the strict implementation of protective measures by medical staff has ensured the safety of surgery and the work being proceed with smooth progress and high efficacy.
ObjectiveTo systematically review the diagnostic value of FDG-PET, Aβ-PET and tau-PET for Alzheimer ’s disease (AD).MethodsPubMed, EMbase, The Cochrane Library, CNKI, WanFang Data, VIP and CBM databases were electronically searched to collect diagnostic tests of FDG-PET, Aβ-PET and tau-PET for AD from January 2000 to February 2020. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies; then, meta-analysis was performed by Meta-Disc 1.4 and Stata 14.0 software.ResultsA total of 31 studies involving 3 718 subjects were included. The results of meta-analysis showed that, using normal population as control, the sensitivity/specificity of FDG-PET and Aβ-PET in diagnosing AD were 0.853/0.734 and 0.824/0.771, respectively. Only 2 studies were included for tau-PET and meta-analysis was not performed.ConclusionsFDG-PET and Aβ-PET can provide good diagnostic accuracy for AD, and their diagnostic efficacy is similar. Due to limited quality and quantity of the included studies, more high quality studies are required to verify the above conclusions.
Objective To review the progress of perioperative treatments for patients of Parkinson’s disease and hip fractures. Methods The related literature of treatments for patients of Parkinson’s disease and hip fractures were reviewed and analyzed from the aspects such as the perioperative management, selection of operation ways, and prognosis. Results The patients of Parkinson’s disease are more likely to sustain hip fractures because of postural instability and osteoporosis. The perioperative treatments for patients of Parkinson’s disease and hip fractures should be determined by orthopedists, neurologist, anesthesiologist, and physical therapist. There is still controversy about the selection of operation and surgical approach. And the prognosis of patients of Parkinson’s disease and hip fractures are associated with the severity of Parkinson’s disease. Conclusion There are few clinical studies about the patients of Parkinson’s disease and hip fractures. The mid-term and long-term functional outcomes of patients of Parkinson’s disease and hip fractures are unsufficient. And the best treatments of patients of Parkinson’s disease and hip fractures need to be further explored.
Due to the coronavirus disease 2019 pandemic, the traditional outpatient and medical center pulmonary rehabilitation models for chronic obstructive pulmonary disease have been limited, while pulmonary rehabilitation technology has always been the focus of clinical and scientific research in rehabilitation. This article reviews the application status of remote pulmonary rehabilitation for chronic obstructive pulmonary disease under the coronavirus disease 2019 epidemic in recent years. From the selection and method of remote pulmonary rehabilitation equipment before the epidemic, to the development of rehabilitation forms and equipment innovation after the epidemic, the current status and problems of remote pulmonary rehabilitation are clarified. Establishing a remote pulmonary rehabilitation model in line with China’s national conditions is the direction and goal of future development.
Objective To explore the effect of local injection of high concentration of glucose when removing setons of perianal fistulizing in Crohn’s disease (CD). Methods Thirty cases of CD combined with anal fistula admitted to the Affiliated Hospital of Nanjing University of Chinese Medicine from August 2015 to July 2017 were collected prospectively, 12 cases were divided into experimental group and 18 cases were divided into control group. Cases of the experimental group received demolition of drainage seton+IFX+local injection of high concentration of glucose treatment, cases of the control group received the drainage setons removing+IFX only. Before treatment, and at 6, 14, 22, and 30 weeks after IFX treatment, the laboratory indicators of the 2 groups were detected, and BMI, Crohn’s diseaseactivity index (CDAI), perianal disease activity index (PDAI), and clinical efficacy were evaluated. Results Therewas no significant difference on the group effect and interaction of group and time (P>0.05), but time (P<0.05). Both in the experimental group and the control group, compared with before treatment group, the counts of WBC and platelet, levels of C reaction protein (CRP) and erythrocyte sedimentation rate (ESR), CDAI, and PDAI at 6 months after IFX therapy decreased and maintained at the latter period, but the level of hemoglobin (Hb) and BMI increased at 6 weeks after IFX therapy and maintained at the latter period. On the clinical effect, there was no significant difference at the time points of 14, 22, and 30 weeks of IFX therapy (P>0.05). Conclusion The treatment of local injection of high concentration of glucose when removing setons has not shown any positive effect to CD combined with anal fistula, this conclusion needs to be further studied.
During the coronavirus disease 2019 epidemic, West China Hospital, Sichuan University explored a new management model to ensure timely diagnosis and treatment and regular follow-up for breast cancer patients. On the basis of previous internet Breast Cancer Information Management System, patient management WeChat groups were integrated to develop an online and offline interconnect management platform. Regular follow-up of patients was mainly conducted by telephone, with WeChat management group as auxiliary. Coronavirus infections were screened during telephone follow-up. In the meanwhile, patients who needed to be further treated would be identified and recommended to the outpatient follow-up. The new management model can improve the efficiency of follow-up management, on the premise of reducing the risk of coronavirus disease 2019 transmission for both health care providers and patients.
Objective To evaluate the short-term effectiveness of talonavicular arthrodesis for Müller-Weiss disease. Methods Between May 2013 and February 2015, 13 patients with Müller-Weiss disease were treated with talonavicular arthrodesis. There were 11 females and 2 males with an average age of 59 years (range, 42-67 years). The disease duration was 8-20 years (mean, 13 years). According to Maceira stage, there were 7 cases of stage Ⅲ, 6 cases of stage Ⅳ. The foot longitudinal arch height measured on weight-bearing X-ray films was (43.1±1.8) mm; the Meary angle and talocalcaneal angle measured on lateral X-ray films were (–2.8±2.3)° and (5.8±2.4)°, respectively; the calcaneal valgus angle measured on Saltzman position X-ray films was (–2.0±0.7)°. The American Orthopaedic Foot and Ankle Society (AOFAS) score was 43.5±12.4, and visual analogue scale (VAS) score was 7.3±1.5. Results All the patients were followed up 14-39 months (mean, 20 months). The symptoms of foot pain and intermittent claudication disappeared in all patients. All cases achieved bony union, the fusion time was 12-16 weeks (mean, 13 weeks). There was no complications such as wound infection, skin necrosis, or internal fixator broken. At last follow-up, the foot longitudinal arch height, Meary angle, talocalcaneal angle, and calcaneal valgus angle were (52.5±2.2) mm, (1.3±2.2)°, (16.5±3.7)°, and (0.4±0.7)°, respectively; the AOFAS score and VAS score were 83.8±9.1 and 1.0±0.4, respectively; all were significantly improved when compared with preoperative ones (P<0.05). Conclusion If the subtalar and calcaneocuboid joints are relatively healthy, talonavicular arthrodesis may be a reliable and effective surgical option for Müller-Weiss disease that is resistant to conservative treatment.
Objective To explore the feasibility and effect of remote medical education model using online film reading training to improve the ability of ophthalmologists in the Xinjiang Uygur Autonomous Region (hereinafter referred to as “Xinjiang Region”) in diagnosing fundus diseases. MethodsThe three-level film reading training system of Xinjiang Production and Construction Corps system division hospital-Corps Hospital-Peking Union Medical College Hospital was established. From June 2022 to January 2023, 4 159 posterior color fundus images were continuously collected from Department of Ophthalmology of Xinjiang Corps Hospital and 4 divisional hospitals in the Corps medical system. Among them, hypertensive retinopathy, diabetic retinopathy, exudative age-related macular degeneration (AMD), atrophic AMD and retinal vein occlusion were 3 073, 651, 43, 186 and 206 cases, respectively. The images were divided into 3 rounds (first, second and last) according to the proportion of diseases. The doctors who participated in the training (hereinafter referred to as the "training") were 15 ophthalmologists from the Corps Hospital of Xinjiang Region and the division hospital of the Corps system. There were 7 male and 8 female. Age was (38.1±4.0) years. The titles of senior, deputy senior, intermediate and junior are 1, 6, 5 and 3 respectively; Bachelor's degree and master's degree are 13 and 2 respectively. The working time of fundus disease specialty was (9.6±3.3) years. The film reading system training was conducted before the first round of labeling, and after each round of film reading, the doctors of Peking Union Medical College Hospital gave feedback and explanation on the film reading results. The diagnostic consistency, sensitivity and specificity were compared by paired sample t test. Spearman or Pearson correlation analysis was conducted between the improvement of diagnostic level and professional title, education, age and working hours of ocular fundus disease. ResultsAll the participating doctors completed the first, second and last reading. After each round of film reading, the film reading summary was carried out for 2 hours. The average diagnostic agreement rates of participating physicians were 53.0%, 67.0% and 75.0%, respectively. The sensitivity and specificity were 0.38, 0.69, 054 and 0.66, 0.85, 0.96, respectively. There was significant difference between the first and last examination (P＜0.001). The sensitivity of the second reading was significantly higher than that of the first reading, and the sensitivity of the last reading was significantly lower than that of the second reading, with statistical significance (P＜0.05). The specificity of the second reading was significantly higher than that of the first reading, and the last reading was significantly higher than that of the second reading, with statistical significance (P＜0.05). There was no significant correlation (P＞0.05) between the improvement of diagnostic level of participating physicians and educational background (Rho=0.07), professional title (Rho=0.13), age (r=0.20), and working time of ophthalmofundus disease specialty (r=0.26).ConclusionsRelying on the three-level online telemedicine training, it can improve the ability of ophthalmologists in Xinjiang region to diagnose fundus diseases. The preliminary telemedicine education model has demonstrated potential for feasibility and effectiveness in remote areas with inadequate medical resources.
ObjectiveTo investigate the characteristics and prognostic value of cellular immune function in severe patients with coronavirus disease 2019 (COVID-19).MethodsA cohort study was conducted to collect the clinical data of 119 severe patients admitted to the Renmin Hospital of Wuhan University (Eastern District) including 60 males (50.4%) and 59 females (49.6%), with an average age of 60.9±14.2 years. The primary endpoint of follow-up was death in the hospital, and the disease outcome classification was the secondary endpoint of follow-up within 30 days after admission. We analyzed the correlation between cellular immune function and COVID-19 prognosis.Results A total of 22 patients died during this process, and 47 patients were severe/critical during the follow-up period. The counts of CD3+, CD4+, CD8+, and CD19+ in the primary endpoint events were significantly different between the survival group and the death group (all P<0.05). The counts of CD3+, CD4+, CD8+, CD19+ in the secondary endpoint events were significantly different between the normal group and the severe/critical group (all P<0.05). The results of the receiver operating characteristic (ROC) curve showed that the area under the cellular immune function curve of dead patients and severe/critical patients had good predictive value (all P<0.05).ConclusionCell immune function has good clinical and prognostic value for COVID-19.