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.
ObjectiveTo systematically review the predictive factors of new-onset conduction abnormalities(NOCAs) after transcatheter aortic valve replacement (TAVR) in bicuspid aortic valve (BAV) patients. MethodsThe CNKI, VIP, WanFang Data, PubMed, Cochrane Library and EMbase databases were electronically searched to collect the relevant studies on NOCAs after TAVR in patients with BAV from inception to December 5, 2022. Two researchers independently screened the literature, extracted data, and assessed the risk of bias of the included studies. Meta-analysis was then performed by using RevMan 5.4 software. ResultsSix studies involving 758 patients with BAV were included. The results of the meta-analysis showed that age (MD=−1.48, 95%CI −2.73 to −0.23, P=0.02), chronic kidney disease (OR=0.14, 95%CI 0.06 to 0.34, P<0.01), preoperative left bundle branch block (LBBB) (OR=2.84, 95%CI 1.11 to 7.23, P=0.03), membranous septum length (MSL) (MD=0.93, 95%CI 0.05 to 1.80, P=0.04), implantation depth (ID) (MD=−2.06, 95%CI −2.96 to −1.16, P<0.01), the difference between MSL and ID (MD=3.05, 95%CI 1.92 to 4.18, P<0.01), and ID>MSL (OR=0.27, 95%CI 0.15 to 0.49, P<0.01) could be used as predictors of NOCAs. ConclusionCurrent evidence shows that age, chronic kidney disease, LBBB, MS, ID, the difference between MSL and ID, and ID>MSL could be used as predictors of NOCAs. Due to the limited quantity and quality of included studies, more high-quality studies are required to verify the above conclusion.
Objective To establish amedical reference for adult pulmonary function parameters and a normal FEV1 /FVC% pred in population of Shanghai. Methods Subjects who underwent routine physical examination were initially screened and those who met enrollment criteria with age over 18 years old were required to underwent pulmonary function tests in Zhongshan Hospital from June 2009 to February 2010. After screening of 450 subjects, a total of 240 subjects with normal pulmonary function and 120 subjects with mild small airway abnormalities were enrolled in this study according to the prediction equations established in1988. All subjects were assigned into 6 groups according to their age with30 males amd 30 females in each group. Pulmonary function parameters including VC, FVC, FEV1 , FEV1 /FVC, PEF, FEF25% , FEF50% , FEF75% , RV, FRC, TLC, RV /TLC, DLCO, and KCO were collected for analysis. New prediction equations for the above 14 parameters were established by parameters of anthropometry. The medical reference ranges of 14 parameters were calculated according to the newprediction equations. The normal FEV1 /FVC%pred was also calculated. Results New prediction equations for normal adult pulmonary function parameters in Shanghai were established. DLCO =5.206 +4. 314 ×gender ( “male”= 1, “female”=0) - 0. 144 ×age( y) +0. 098 × height( cm) +0. 082 ×weight( kg) , KCO =9. 346 - 0. 026 ×age( y) - 0. 031 ×height( cm) +0. 025 ×weight( kg) .The LLN( P5) of VC, FVC, FEV1 , FEV1 /FVC, the LLN( P2. 5 ) and the upper limit of normal value ( P97. 5) of FRC, TLC, RV, RV/TLC were calculated. The LLN( P5) of FEV1 /FVC = 101. 924 - 0. 144 × age ( y) - 0. 118 ×high( cm) . The lower normal limit of FEV1 /FVC% pred was 92% . Conclusions This is the first time to have the medical reference of FEV1 /FVC% pred in China, and new prediction equations for DLCO in Shanghai. The LLN of FEV1 /FVC or FEV1 /FVC% pred lt;92% can be used as diagnostic criteria for obstructive ventilation disorder. Instead of using FEV1% pred lt; 80% , FEV1 lt; LLN can be used as diagnostic criteria for mild ventilation disorder.
Abstract： Objective To explore the clinical correction of Ebstein’s anomaly using a modified Carpentier’s method and summarize the clinical experience . Methods We retrospectively analyzed data for 13 consecutive patients（ 6 males and 7 females, with an age of 26.8±13.5 years） with Ebstein’s anomaly who underwent operation in the First Affiliated Hospital of Anhui Medical University between June 2006 and August 2010. All patients underwent correction using a modified Carpentier’s method. Operative techniques included excising and suturing the right atrialized chamber; puckering and shortening the tricuspid annulus；detaching the septal and posterior leaflet and/or part of the anterior leaflet from the displaced annulus; broadening and enlarging the area of the posterior/septal valve leaflet using autologous pericardium, and reattaching them to the true tricuspid annulus；transecting and reimplanting the papillary muscle and chordae; and simultaneously correcting any other congenital malformations. Results All patients survived and recovered well. The cardiac functional grading ranged from Ⅰ to Ⅱ (New York Heart Association ). All patients were followed up for 3 to 15 months (average 8 months). Postoperative echocardiograpy showed disappearance of tricuspid incompetence in 10 patients and mild or moderate tricuspid incompetence in 3 patients. The patients’ tricuspid valve leaflets were all at the normal level. At three months and at one year postoperation, rechecked echocardiograpy showed opening and closing of the tricuspid and right ventricular function recovering well, with no obvious incompetence in 12 patients, and moderate tricuspid incompetence lightened to mild in 1 patient. All patients returned to normal work and life. Conclusion Our technique for correcting Ebstein’s anomaly using a modified Carpentier’s method had satisfactory early results. The patients’ right ventricles were effectively reshaped and recovered function through excising and suturing the right atrialized chamber, and favorable tricuspid valvuloplasty effect was achieved by reattaching the enlarged leaflets using autologous pericardium to the true tricuspid annulus, and by transecting and reimplantating the papillary muscle and chordae.
In order to fully explore the neural oscillatory coupling characteristics of patients with mild cognitive impairment (MCI), this paper analyzed and compared the strength of the coupling characteristics for 28 MCI patients and 21 normal subjects under six different-frequency combinations. The results showed that the difference in the global phase synchronization index of cross-frequency coupling under δ-θ rhythm combination was statistically significant in the MCI group compared with the normal control group (P = 0.025, d = 0.398). To further validate this coupling feature, this paper proposed an optimized convolutional neural network model that incorporated a time-frequency data enhancement module and batch normalization layers to prevent overfitting while enhancing the robustness of the model. Based on this optimized model, with the phase locking value matrix of δ-θ rhythm combination as the single input feature, the diagnostic accuracy of MCI patients was (95.49 ± 4.15)%, sensitivity and specificity were (93.71 ± 7.21)% and (97.50 ± 5.34)%, respectively. The results showed that the characteristics of the phase locking value matrix under the combination of δ-θ rhythms can adequately reflect the cognitive status of MCI patients, which is helpful to assist the diagnosis of MCI.
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.
Objective To systematically review the clinical presentations and gene types of oculo-facio-cardio-dental (OFCD) syndrome and to provide a theoretical basis for future diagnosis, prevention, and treatment of the disease. Methods The PubMed, EMbase, The Cochrane Library, Web of Science, CBM, WanFang Data, and CNKI databases were electronically searched to collect studies on OFCD syndrome published from inception to March 1st, 2022. Two reviewers independently screened the literature, extracted data, and assessed the risk of bias of the included studies. A systematic review was then performed. Results A total of 19 studies involving 83 patients with OFCD syndrome were included. The patients had an average age of 15.95±16.03 years, including 5 males and 78 females. The clinical presentations mainly included ocular disorders, facial abnormalities, cardiac disorders, dental abnormalities, physical anomalies, and dysfunctions of other body systems. BCOR gene mutations were detected in 71 patients with OFCD syndrome (overall detection rate: 86%, 95%CI 78% to 93%), of whom five were males (detection rate: 6%, 95%CI 1% to 11%) and 66 were females (detection rate: 80%, 95%CI 71% to 88%). Patients were mostly treated using multidisciplinary symptomatic treatment approaches based on clinical presentations and imaging findings. Conclusion In addition to the typical clinical presentations, BCOR gene testing results should also be taken into consideration for the differential diagnosis of OFCD syndrome. Although symptomatic therapies in clinical practice are relatively mature, they do not address the underlying cause of the disease, i.e., BCOR gene mutations. In future research, greater attention should be diverted to gene therapy.
Objective To analyze the causes of cardiac myxoma recurrence and discuss its clinical classification. Methods We reviewed the data of two female patients, aged thirty three and forty two, with recurrent cardiac myxoma, who were admitted into our hospital separately in December 2004 and October 2005. We searched articles with “cardiac myxoma” as the key words at www.cqvip.com, and reviewed literature of big case groups having undergone surgical operations, case reports of recurrence and literature with a followup time longer than 4 years between January 1994 and December 2008. Results We reviewed a total of 1 969 cases of cardiac myxoma, in which there were 60 recurrent cases with a recurrence rate of 3.0%, and there were 15 recurrence case reports. Data analysis showed that single pedicle recurrence rate was 3.0% (3/99) and multiple pedicle recurrence rate was 35.7% (5/14); In two reports on cardiac myxoma distributed in multiple chambers, the recurrence rate was 41.7% (5/12) and 33.3% (3/9) respectively;Average interval of recurrence was 4.1 years; Repeated recurrence happened to 9 cases (12.0%) with the most repetition times of 4 in one case; Malignancy on recurrence was found in one case; Reoperation rate was 64.0% (32/50); Six cases (8.0%) were familial myxoma. Accordingly, we advocate a clinical classification of “typical” and “atypical” cardiac myxoma. The typical myxoma refers to the tumors located at left atrium with single pedicle, rooted at or around fossa ovalis, and without abnormal DNA, while the atypical myxoma are familial tumors and tumors stemming from multiple points or multiple chambers, rooted in abnormal position of the left atrium, arising from clear gene mutation, or with malignant tendency. Conclusion Myxomas with multiple pedicles, distributed in more than one chamber, and rooted in abnormal position of the left atrium have a much higher recurrence rate. Close follow-up is needed for abovementioned patients to achieve an optimal treatment results.
ObjectiveTo summarize the cardiac-vascular abnormalities and clinical results in patients with Fontan operation for heterotaxy syndrome. MethodWe retrospectively analyzed the medical records of 81 patients who underwent the Fontan operation with heterotaxy syndrome between September 2008 and September 2013. There were 49 male and 32 female patients at age of 3.79 (range 2.07-13.02) years with preoperative room air saturation of 81% (range 63%-97%) and weight of 14.8 (10.0-36.0) kg. ResultsThere were 70 patients in the right atrial isomerism group and left in 11 patients. Dextrocardia was seen in 16 patients, and single atrium in 50 patients. Single ventricle was found in 44 patients, conotruncal defects in 40 patients, pulmonary stenosis in 72 patients, pulmonray atresia in 8 patients, common atrioventricular valve in 61 patients, and bilateral superior vena cava in 54 patients. The staged Fontan procedure was applied in 57 patients and one stage in 24 patients. Operation strategies were included intra/extracardiac conduit (n=17), extracardiac conduit (n=48), lateral tunnel (n=14) and direct cavopulmonray connection (n=2).There were 15 early deaths. Postoperative complications included low cardiac output in 15 patients, hepatic insufficiency in 35 patients, renal insufficiency in 55 patients required peritoneal dialysis and arrhythmia in 28 patients. The room air saturation was 89% (range 78%-98%) before discharge and time of follow-up was from 2 months to 6 years in 64 patients. Thromboembolic events were found in 2 patients who had accomplished conduit replacement operation. ConclusionCompared with reported literatures in western countries, heteraotaxia patients are mostly with right atrial isomerism. Fontan palliation is still the main treatment option and strict indication was needed for satisfactory clinical results.
Objective To investigate the vaccination rate of Coronavirus Disease 2019 (COVID-19) vaccine in patients undergoing cardiac mechanical valve replacement and to evaluate its effect on international normalized ratio (INR) value. MethodsWe investigated 132 patients who had received cardiac mechanical valve replacement and followed up in the Department of Cardiovascular Surgery, West China Hospital of Sichuan University from May to October 2021. There were 51 males and 81 females aged 26-72 (53.01±9.51) years. ResultsThe vaccination coverage rate was 53.8%. Among the 61 unvaccinated patients, concerns about heart side-effects were the main reason. The average INR of the first review after vaccination was higher than that of the last review before vaccination, with a difference of 0.40±0.72 (P<0.001). ConclusionThe vaccination rate of patients after cardiac mechanical valve replacement is low. At the same time, COVID-19 vaccine may increase INR value, and it is suggested that patients should increase the frequency of review and adjust warfarin dosage after vaccination.