OBJECTIVE To sum up the experience of diagnosis and treatment of intrinsic upper gastro-intestinal membrane, 13 cases in children were studied retrospectively. METHODS There were 10 boys and 3 girls, the major symptoms were vomiting and epigastric distension. Eleven cases were treated by membranectomy with intestinal plasty, and 2 cases were treated by retrocolic side to end duodenojejunostomy. RESULTS All cases had good results without severe complications. CONCLUSION The children who have typical symptom of upper digestive tract should be considered duodental and upper jejunal membrane, and should be proved by contrast radiology. The membranectomy with intestinal plasty is the better operative method.
ObjectiveTo investigate the clinical value of cervical vascular color Doppler ultrasound for dignosis of nonrecurrent laryngeal nerve before thyroid surgery.
MethodsThere were 1931 cases of thyroid patients treated between January 2010 to Jule 2014, group these patients according to the results of preoperative chest radiograph examination, the chest radiograph shows abnormal vessels image were group A (45 cases), no abnormalities were group B (1886 cases). Before operaton, made patients of group A to have routine carotid duplex ultrasound to identify whether the right subclavian artery abnormalities. All patients were exposed to conventional methods of recurrent laryngeal nerve during surgery.
ResultsThe 45 patients of group A, chest angiography showed 17 cases with right subclavian artery abnormalities, they were confirmed that all the 17 patients were nonrecurrent laryngeal nerve by surgery, no damage cases. The other 28 cases showed a normal right subclavian artery and no cases of nonrecurrent laryngeal nerve. The 1886 patients in group B, surgical exploration found four cases with nonrecurrent laryngeal nerve, injury in 1 case. The 21 patients whose nonrecurrent laryngeal nerve were on the right side, there were no left side with nonrecurrent laryngeal nerve and no co-exist cases of nonrecurrent and recurrent laryngeal nerve. The average exposure time of nonrecurrent laryngeal nerve in patients of group A (17 cases) was significantly shorter than that group B[(4.28±1.08) min vs. (15.50±2.08) min, t=-15.978, P=0.000].
ConclusionsThe cervical vascular color Doppler ultrasound examination before thyroid surgery can be adjuvant used, if there is the right subclavian artery abnormalities, it showes that there is the right side nonrecurrent laryngeal nerve. So as to effectively prevent the damage of nonrecurrent laryngeal nerve during thyroid surgery.
ObjectiveTo investigate the successful signs of laser photocoagulation or endolaser combined vitrectomy for congenital optic disc pit (ODP) with serous macular detachment.MethodsA retrospective case analysis. Twelve eyes of 12 patients with congenital ODP complicated with serous macular detachment diagnosed in Zhongshan Ophthalmic Center from 2003 to 2018 were included in this study. There were 2 males (2 eyes) and 8 females (8 eyes). The average age was 30.17 years old. Retinal laser photocoagulation and/or vitrectomy were performed in all the eyes. The optic disc and macular area were scanned using the tracking mode of the Germany Heidelberg Spectralis OCT instrument. The " dam-sign” change was a retinal choroidal scar on the channel between the ODP and the macula on the OCT image after treatment. The eyes were divided into a " dam-sign” change group (group A, 10 eyes) and no " dam-sign” change group (group B, 2 eyes). The BCVA of eyes in group A was 0.03-0.6. In group A, 1 eye was treated with laser photocoagulation alone, 9 eyes were treated with vitrectomy combined with laser photocoagulation. The BCVA of eyes in group B was 0.1. All the eyes in group B underwent vitrectomy combined with laser photocoagulation. The follow-up was ranged from 6 to 174 months. The same equipment and method before treatment were used for 1, 3, 6, 12, 18, and 24 months after treatment. The BCVA, absorption of subretinal fluid (SRF) and the formation of " dam-sign” change were observed.ResultsAt the last follow-up, the BCVA of eyes in group A was 0.4-1.0 (0.4 in 1 eye, 0.5 in 3 eyes, 0.6 in 2 eyes, 0.8 in 3 eyes, 1.0 in 1 eye). In 9 eyes treated with vitrectomy combined with laser photocoagulation, SRF was completely absorbed. In 1 eye treated with laser photocoagulation alone, SRF remained in small amount. The BCVA of the two eyes in group B was 0.03 and 0.3, respectively; and SRF was not absorbed in both of them.ConclusionsThe " dam-sign” change near optic disc after laser photocoagulation can promote SRF absorption and improve BCVA. It can be used as a success indicator after treatment.
Objective
To explore the causes and solutions of dissatisfied complaints about frame glasses wearing after medical optometry to improve service quality.
Methods
Patients with dissatisfied complaints about frame glasses wearing after medical optometry in West China Medical Center of Optometry Glasses between January 2013 and December 2014 were selected. Targeted re-examination and corresponding treatment was performed on them. The causes of their complaints were clustered and analyzed.
Result
There were 105 cases of complaints out of the 58 278 patients with frame glasses wearing after medical optometry, including complaints about wearing glasses uncomfortable in 58 cases (55.2%), mainly related to abnormal binocular vision, high myopia and progressive glasses lens fitting; quality of glasses in 23 cases (21.9%), in whom 16 were dissatisfied with the frame; quality of service in 10 cases (9.5%); glasses assembly / calibration in 7 cases (6.7%); and other dissatisfaction in 7 cases (6.7%).
Conclusions
In medical optometry, optometrists and sales staff should establish a good communication with patients according to individual differences, attach importance to the selection of right frame and lens in patients with high myopia or progressive piece of glasses, introduce the right wearing method of progressive piece of glasses, and enhance the follow-up service. For patients with obvious eye fatigue, it is needed to check the binocular visual function, if the visual fatigue is closely related to abnormal binocular visual function, special glasses fitting and functional training should be instructed to the patients.
On account of the mechanical disturbance of external chest pressing to electrocardiogram (ECG) signal, the ECG rhythm cannot be identified reliably during the cardio-pulmonary resuscitation period. Whereas the possibility of successful resuscitation will be lowered due to interrupted external chest pressing, a new filtering algorithm, enhanced leastmean-square (eLMS) algorithm, was proposed and developed in our laboratory. The algorithm can filter the disturbance of external chest pressing without the support of hardware reference signal and correctly identify ventricular fibrillation (VF) rhythm and normal sinus rhythm in case of uninterrupted external chest pressing. Without other reference signals, this algorithm realizes filtering only through the interrupted electrocardiograma (cECG) signal. It was verified with ECG signal and disturbance signal under different signal to noise ratios and contrasted with other mature algorithms. The verification results showed that the identification effect of eLMS was superior to those of others under different signal to noise ratios. Furthermore, ECG rhythm can be correctly identified only through cECG signal. This algorithm not only reduces the research and development(R & D)costs of automated external defibrillator but also raises the identification accuracy of ECG rhythm and the possibility of successful resuscitation.
ObjectiveTo investigate the method and effectiveness of selectively upward placement of acetabular implants in patients with anatomically abnormal acetabulum during total hip arthroplasty (THA).
MethodsTwenty-six cases (26 hips) of anatomically abnormal acetabulum received THA between January 2005 and December 2010, including 22 cases of developmental dysplasia of the hip, 3 cases of osteonecrosis of the femoral head, and 1 case of post-traumatic arthritis. There were 5 males and 21 females with an average age of 52.3 years (range, 35-67 years). The left hip was involved in 11 cases and the right hip in 15 cases. The preoperative Harris score was 45.85±10.04. The anteroposterior X-ray films and CT scan of the pelvis, anteroposterior and lateral X-ray films of the femur, and TraumaCad analysis were performed routinely before operation. The principles of acetabular implants were that more than 70% of the bone-implant interface was covered, and the upward distance of acetabular implant was less than 15 mm.
ResultsAcetabular implants were placed within 5 mm from the anatomical rotation center in 11 cases. The upward distance of acetabular implant was 5-10 mm in 8 cases and was 10-15 mm in 7 cases. No bone fracture or nerve injury was observed intraoperatively. All incisions healed by first intention, and no infection or lower limb deep venous thrombosis occurred. One case had dislocation at 3 days after operation, and was cured after reduction and conservative treatment. The follow-up time ranged from 15 to 71 months (mean, 34 months). The Harris score was 91.42±3.59, showing significant difference when compared with preoperative score (t=20.099, P=0.000). The Harris scores were 92.09±4.04 in patients having less than 5 mm upward distance, 91.25±2.82 in patients having 5-10 mm upward distance, and 90.57±3.95 in patients having 10-15 mm upward distance, showing no significant difference (F=0.377, P=0.690). No loosening or subsidence of the implant was observed by X-ray film during the follow-up.
ConclusionThe acetabular implants should be placed as close to anatomical rotation center as possible according to the principle. However, appropriate upward distance of the acetabular implants (≤15 mm) could be acceptable to meet 70% coverage of bone-implant interface and the implant stability. A satisfactory mid-term effectiveness can be obtained, but long-term effectiveness should be further investigated.
Objective
To investigate the relationship between a body shape index (ABSI) and abnormal inflammation.
Methods
In May 2007, a cross-sectional study was conducted among 651 individuals by random sampling method in an urban community located in Chenghua district of Chengdu. We mainly assessed the relationship between ABSI and abnormal inflammation, which was defined as high sensitive C-reactive protein equal to 3 mg/L or higher.
Results
Logistic regression analysis showed that body mass index (BMI), waist circumference (WC) and ABSI were independently associated with abnormal inflammation. For identifying abnormal inflammation, WC had the best discriminatory power with the area under the receiver operating characteristic curve (AROC) was 0.627 [95% CI (0.564, 0.689)], followed by BMI (AROC: 0.609) and ABSI (AROC: 0.608). In addition, combination with ABSI could improve the discriminatory power of BMI for abnormal inflammation, and AROC increased from 0.609 to 0.646. Combination with ABSI could also improve the discriminatory power of WC for abnormal inflammation, and AROC only increased from 0.627 to 0.631.
Conclusions
In the general Chinese population, ABSI is independently associated with abnormal inflammation, but the discriminatory power is poor, no better than BMI and WC. Furthermore, combination with ABSI can improve the discriminatory power of BMI and WC for abnormal inflammation, especially for BMI. Further studies about ethnic specificities of ABSI are needed.
Objective To construct and evaluate a screening and diagnostic system based on color fundus images and artificial intelligence (AI)-assisted screening for optic neuritis (ON) and non-arteritic anterior ischemic optic neuropathy (NAION). MethodsA diagnostic test study. From 2016 to 2020, 178 cases 267 eyes of NAION patients (NAION group) and 204 cases 346 eyes of ON patients (ON group) were examined and diagnosed in Zhongshan Ophthalmic Center of Sun Yat-sen University; 513 healthy individuals of 1 160 eyes (the normal control group) with normal fundus by visual acuity, intraocular pressure and optical coherence tomography examination were collected from 2018 to 2020. All 2 909 color fundus images were as the data set of the screening and diagnosis system, including 730, 805, and 1 374 images for the NAION group, ON group, and normal control group, respectively. The correctly labeled color fundus images were used as input data, and the EfficientNet-B0 algorithm was selected for model training and validation. Finally, three systems for screening abnormal optic discs, ON, and NAION were constructed. The subject operating characteristic (ROC) curve, area under the ROC (AUC), accuracy, sensitivity, specificity, and heat map were used as indicators of diagnostic efficacy. ResultsIn the test data set, the AUC for diagnosing the presence of an abnormal optic disc, the presence of ON, and the presence of NAION were 0.967 [95% confidence interval (CI) 0.947-0.980], 0.964 (95%CI 0.938-0.979), and 0.979 (95%CI 0.958-0.989), respectively. The activation area of the systems were mainly located in the optic disc area in the decision-making process. ConclusionAbnormal optic disc, ON and NAION, and screening diagnostic systems based on color fundus images have shown accurate and efficient diagnostic performance.
Objective
To investigate the causes of visual loss and failure of treatment after intraocular silicone oil removal.
Methods
Retrospective clinical analysis of the causes of loss of visual acuity of 15 eyes after silicone oil removal in patients with complicated retinal detachment which were successfully treated with vitreous and retinal microsurgery.
Results
Among the 15 eyes,retina failed to reattach in 11 eyes,secondary glaucoma occurred in 2 eyes and corneal opacity appeared in another two eyes.All of them were resulted in total loss of vision.
Conclusion
Retinal redetachment was the leading cause of final visual loss in the failing 15 cases(15 eyes) after intraocular silicone oil removal,and secondary glaucoma and corneal decompensation may also be the causes of visual loss.
(Chin J Ocul Fundus Dis, 1999, 15: 230-231)
In this work, a new method of heart sound signal preprocessing is presented. First, the heart sound signals are decomposed by using multilayer wavelet transform. And then double parameters as thresholds are used in processing each layer after decomposition for denoising. Next, reconstruction of heart sound signals could be done after processing last layer. Four methods, i.e. wavelet transform, Hilbert-Huang transform (HHT), mathematical morphology, and normalized average Shannon energy, were used to extract the envelop of the heart sound signals respectively after reconstruction of heart sounds. All methods were improved in this study. We finally in our study chose 30 cases of raw heart sound signals, which were selected randomly from a database comed from The Clinical Medicine Institute of Montreal, and processed them by using the improved methods. The results were satisfactory. It showed that the extracted envelope with the original signal has a high degree of matching, whether it is a low frequency portion or high frequency portion. Most of all information of heart sound has been maintained in the envelope.
