Objective To probe the clinical character,the histopathological classification and misdiagnoses of intraocular tumors. Methods The clinical and pathological data of 359 patients with intraocular tumor diagnosed clinically between 1980～2000 were retrospectively analyzed. Results There were 300 cases of malignant tumor and 23 cases of benign tumor respectively. Non-oncologic malady and benign tumor misdiagnosed as tumor or malignant tumor were 40 cases. The two leading malignant tumors were retinoblastoma and melanoma. Conclusion The clinical and pathological analysis of intraocular tumor is beneficial to the correct clinical diagnosis and treatment. (Chin J Ocul Fundus Dis,2002,18:28-30)
ObjectiveTo explore the clinical efficacy of the ultrasound-guided intra-articular injection of platelet-rich plasma (PRP) in the treatment of patients with different stages of knee osteoarthritis.MethodsWe retrospectively analyzed the clinical characteristics and X-ray data of patients with knee osteoarthritis who received ultrasound-guided intra-articular injection of PRP in the Department of Rehabilitation Medicine at Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University between May 2018 and June 2019. The patients were grouped according to the Kellgren & Lawrence Classification (K&L 0, Ⅰ, Ⅱ, Ⅲ, and Ⅳ). All the patients received four injections with a one-week interval. The Visual Analogue Scale (VAS) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) were used to evaluate the clinical efficacy before the injection, and 3 and 6 months after the injection. Adverse reactions were recorded.ResultsA total of 102 patients were included without any grade 0 cases. There were 20 patients in K&L Ⅰ group, 37 in Ⅱ group, 31 in Ⅲ group, and 14 in Ⅳ group. No adverse event was reported. Significant differences of VAS scores and WOMAC index were observed in Ⅰ, Ⅱ and Ⅲ groups at the 3rd and 6th month follow-up (P<0.05). VAS and WOMAC scores of the three groups at the 3rd and 6th month after the treatment were significantly improved compared with those before the treatment (P<0.05). There was no significant difference in VAS score at the 3rd or 6th month after the treatment three groups (P>0.05). For K&L Ⅰ group, there was no statistically significant difference in WOMAC score at the 3rd or 6th month after the treatment (P>0.05). However, the WOMAC scores at the 3rd month after the treatment were better than those at the 6th month in K&L Ⅱ and Ⅲ groups (P<0.05). There was no significant time-depended changes in VAS score or WOMAC score in K&L Ⅳ group (P>0.05).ConclusionThe ultrasound-guided intra-articular PRP injection is safe and effective for pain relief and function improvement in patients with knee osteoarthritis at the early and middle stage.
ObjectiveTo explore the influence of sentinel lymph node (SLN) status on the prognosis of elderly breast cancer patients ≥70 years old, and to screen patients who may be exempted from sentinel lymph node biopsy (SLNB), so as to guide clinical individualized treatment for such patients. MethodsA retrospective analysis was made on 270 breast cancer patients aged ≥70 years old who underwent SLNB in the Affiliated Hospital of Southwest Medical University from 2012 to 2021. The clinicopathological characteristics of the total cases were compared according to the status of SLN. Kaplan-Meier method was used to draw the survival curve, and the influence of SLN status on the overall survival (OS) time, local recurrence (LR) and distant metastasis (DM) of patients were analyzed, and used log-rank to compare between groups. At the same time, the patients with hormone receptor (HR) positive were analyzed by subgroup. The differences between groups were compared by single factor χ2 test, and multivariate Cox regression model was used to analyze and determine the factors affecting OS, LR and DM of patients. ResultsThe age of 270 patients ranged from 70 to 95 years, with a median age of 74 years. One hundred and sixty-nine (62.6%) patients’ tumor were T2 stage. Invasive ductal carcinoma accounted for 83.0%, histological gradeⅡ accounted for 74.4%, estrogen receptor positive accounted for 78.1%, progesterone receptor positive accounted for 71.9%, and human epidermal growth factor receptor 2 negative accounted for 83.3%. The number of SLNs obtained by SLNB were 1-9, and the median was 3. SLN was negative in 202 cases (74.8%) and positive in 68 cases (25.2%). Thirty-five patients (13.0%) received axillary lymph node dissection. There was no significant difference in LR between the SLN positive group and the SLN negative group (P>0.05), but the SLN negative group had fewer occurrences of DM (P=0.001) and longer OS time (P=0.009) compared to the SLN positive group. The results of univariate and multivariate analysis suggest that the older the patient, the shorter the OS time and the greater the risk of DM. Analysis of HR positive subgroups showed that SLN status did not affect patient survival and prognosis, but age was still associated with poor OS time and DM. ConclusionsFor patients with invasive ductal carcinoma of breast in T1-T2 stage, HR positive, clinical axillary lymph nodes negative, and age ≥70 years old, SLNB may be exempted. According to the patient’s performance or tumor biological characteristics, patients who need systemic adjuvant chemotherapy may still consider SLNB.
【摘要】 目的 探讨研究静脉滴注丹参注射液发生不良反应的类型及因素，为临床用药提供依据。 方法 对2007年1月-2010年12月82例因静脉滴注丹参注射液发生不良反应的患者资料进行回顾分析，并对其相关因素进行分析。 结果 男性的不良发生率高于女性，不良反应发生年龄多为中、老年患者，并且不良反应多发生在输液30 min内，多为Ⅰ型过敏反应。 结论 对丹参注射液应严格控制生产工艺流程，临床用药要掌握适应证，以避免不良反应的发生。【Abstract】 Objective To investigate the types and factors of adverse reactions caused by intravenous infusion of Danshen injection, in order to provide basis for clinical drug application. Methods We retrospectively analyzed the clinical records of 82 patients with adverse reaction to intravenous infusion of Danshen injection from January 2007 to December 2010. Results Adverse reaction incidence was higher in males than females, and it mainly occurred in patients of middle or old ages. Most of the adverse reactions happened within 30 minutes of the infusion. Type-I allergic reaction was more commonly observed. Conclusion In order to avoid the occurrence of adverse reactions, Danshen injection production process should be strictly controlled, and indications should be considered carefully in clinical medication.
Objective To investigate the clinical features, etiological classification and staging of epiretinal macular membrane(MEM)． Methods Clinical materials of 194 cases of MEM diagnosed by fundus fluorescein angiography in outpatient department of eye clinic in this hospital from 1983 to 2000 were retrospectively analyzed． Results There were typical clinical symptoms and signs of MEM in all of this 222 eyes of 194 patients． Etiological classification revealed that 4 cases were congenital(2．12%), 22 cases were secondary(11．34%), and 168 cases were idio pathic(86．60%)． Staging of course of disease indicated that 119 eyes were in early stage(53．60%), 72 eyes were in middle stage(32．43%), and 31 eyes were in late stage(13．96%)． Conclusion MEM may be classified as congenital, secondary and idiopathic type according to its pathogenesis , as early, middle and late stage according to the clinical course of disease．This can be helpful in treating the disease． (Chin J Ocul Fundus Dis, 2001,17:210-213)
ObjectiveTo investigate the situation of off-label drug use in dose (OLDUD) of ambroxol hydrochloride injection (AHI) in perioperative period among patients for stanford type A aortic dissection in Guangdong General Hospital, so as to provide references for the rational application of AHI in clinical practice. MethodsAll medical orders of AHI for patients had aortic arch replacement for Stanford type A aortic dissection in Guangdong General Hospital between January 2005 and December 2014 were included. The patients were divided into a mild OLDUD ( < 450 mg) group, a moderate OLDUD (450 mg≤OLDUD < 900 mg) group, and a high OLDUD (≥900 mg)group. The preoperative and postoperative features, incidence of PPCs, mortality, incidence of reintubation, time of mechanical ventilation, time stay in ICU, time stay in hospital and the overall costs among three groups were compared by SPSS 22.0 software. Resultsa) A total of 549 patients were included. The incidence of OLDUD was 99.82%. The most common PMDDs were 450 mg (n=358) and 900 mg (n=88). b) The three groups were well matched for perioperative and operative variables. c) The incidence of preoperative drug use was 8.6%. The incidences (5.5% vs. 7.7% vs. 15.7%, P=0.022) and maximum doses (180 mg vs. 300 mg vs. 450 mg, P=0.014) of preoperative drug use were statistically different in mild OLDUD, moderate OLDUD and high OLDUD groups. The days of preoperative drug use were not different (3 d vs. 2.5 d vs. 2 d, P=0.307). The days of postoperative drug use (9.5 d vs. 13 d vs. 19 d, P < 0.001) and postoperative drug use in maximum doses (7 d vs. 8 d vs. 7 d, P=0.005) were different. d) The incidence of PPCs was 100%, and the mortality (8.2% vs. 6.6% vs. 9.0%, P=0.696) was not statistically different among mild OLDUD, moderate OLDUD and high OLDUD groups. However the incidence of reintubation (14.3% vs. 13.8% vs. 27%, P=0.009), time of mechanical ventilation (37 h vs. 50 h vs. 114 h, P < 0.001), time stay in ICU (138 h vs. 178.5 h vs. 316 h, P < 0.001), time stay in hospital (25 d vs. 27 d vs. 34 d, P=0.001) and the overall costs (¥ 0.17 million vs. ¥ 0.19 million vs. ¥ 0.25 million, P < 0.001) were different among three groups. Moreover, they were all increasing along with the dose of AHI. ConclusionAHI cannot improve the prognosis of patients having aortic arch replacement for Stanford Type A Aortic Dissection in a dose-dependent manner. Further well-designed prospective studies should be conducted to verification or falsification.
目的：探讨《医疗事故处理条例》颁布后医疗纠纷法医学鉴定的相关特点，启示医务人员在防范医疗纠纷时应注意的相关问题。方法：对四川华西法医学鉴定中心2002年～2006年受理的356例医疗纠纷法医学鉴定资料进行回顾性研究。结果：(1)《医疗事故处理条例》实施以来，医疗纠纷案例逐年增多，个体诊所和三级医院医疗纠纷比例和过错率降低，二级医院和一级医院医疗纠纷率和医疗过错率增加；(2)误诊误治等医疗技术方面的过失是导致医疗事故的主要原因；骨科、妇产科和普外科等手术科室的医疗风险最大；(3)医疗纠纷死亡的患者尸检主要集中在儿童和中青年。各年龄段常见死因不同。三级医院在医院临床死因诊断与法医尸检诊断上符合率最高；(4)侵犯患者知情同意权的现象比较多见；(5)疾病自然转归是被鉴定为非医疗事故的最常见原因；结论：《医疗事故处理条例》颁布后，医疗纠纷法医学鉴定案例逐年增多；目前医疗纠纷的特点和产生原因有了新的变化，其中尤以侵犯患者知情同意权和医患沟通障碍突出。
ObjectiveTo review the characteristics of patients who underwent atrioventricular septal defects (AVSD) repair with prosthetic valve ring implantation in our hospital, and to analyze the safety and effectiveness of this intervention.MethodsThe clinical data of all patients diagnosed with AVSD who received surgery repair and prosthetic valve ring implantation from January 1, 2018 to July 12, 2020 in Guangdong Provincial People's Hospital were collected and analyzed. There were 22 patients with 9 males and 13 females at a median age of 35.00 (14.10, 53.00) years. There were 9 (40.9%) patients with prosthetic half or full rings placed on the left atrioventricular valve and 18 (81.8%) patients with prosthetic half or full rings placed on the right atrioventricular valve. ResultsThe median postoperative hospital stay was 7.00 (6.00, 8.80) d, and the postoperative mechanically assisted ventilation time was 11.00 (6.25, 19.00) h. There were 2 (9.1%) patients of moderate or higher postoperative atrioventricular valve regurgitation, 1 on the left and 1 on the right. There was one patient (4.5%) of the postoperative residual septal defect. There was no left ventricular inflow or outflow tract obstruction and no postoperative residual atrial septal defect during the follow-up of 152.00 (124.00, 1 030.00) d.ConclusionImplantation of a prosthetic ring is safe and effective in patients with AVSD, and the structural strength of the ring may be improved after the implantation. The physiological development of the AVSD annulus after prosthetic ring implantation and the results of long-term follow-up needs further attention.
OBJECTIVE: To evaluate clinical outcome of bone or osteoarticular allografts. METHODS: From September 1991 to November 1997, large bone or osteoarticular defects secondary to bone tumors resection in 36 patients and severe trauma in 2 patients were repaired by deep frozen or lyophilized allogeneic osteoarticular or diaphysis graft. RESULTS: No obvious immune rejection to the grafts was observed in most of the patients in early stage after operation. The patients were followed up from 1 year and five months to 7 years and five months with an average of 4.2 years. Limb function was satisfactory in 74.19% of the 31 survival patients with large osteoarticular or diaphysis allografts. CONCLUSION: Cryopreserved or lyophilized allogeneic osteoarticular grafts with decreased antigenicity and good biocompatibility are suitable materials for repairing large bone or osteoarticular defects.
Objective To investigate the clinical effectiveness and adverse event of preventive medicine for severe acute respiratory syndrome (SARS), and provide clinical data for designing prospective clinical trial. Method Retrospective study on medical staffs, that were exposed to SARS patients, was conducted in two main SARS designated hospitals to obtain information such as SARS exposure risk and preventive measures (medical and others). According to the type of preventive medicine, they were assigned to earthworm’s nucleases and protease (ENP) group, interferon group and blank control group respectively. Exposure risk, suspected sub-clinical infection rate and adverse event rate were compared between the three groups. Results Non-medical preventive measures used in each group were consistent, but the exposure intensity to risk factors between groups was statistically different, which biased the evaluation of clinical effectiveness of preventive medicine. The rate of suspected sub-clinical infection in earthworm’s nucleases and protease (ENP) group, interferon group and control group were 4.5%, 4.5%, and 9.9% (Pgt;0.05), respectively; and adverse event rate were 19.6%, 13.6% (Pgt;0.05), and 0%, respectively. Conclusions Suspected sub2clinical infection rate in ENP group, interferon (INF) group were lower than that in control group, which indicated that these two medicines might be effective in preventing SARS. Adverse event rate in ENP group was similar to that of interferon group, and the symptoms were mild in both groups, which was in accordance with the result of in vitro experiments. ENP spray is a kind of biological preparation; further purification may reduce its adverse event rate. However, because there had excessive confounding factors, especially because of the unequal of exposure risk between three groups, the results of this study can only provide insights to design prospective clinical trial in the future.