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The comparison between tendency-oriented perimetry and traditional threshold perimetry

Objective To evaluate the application of tendency-oriented perimetry (TOP) in detecting the visual function of glaucoma. Methods The traditional threshold perimetry (Normal/Normal strategy) and TOP (TOP/Normal strategy) carried out by Octopus 101 perimetry were used to examine the visual field of 20 normal subjects (20 eyes), 32 cases (32 eyes) of primary open-angle glaucoma (POAG), and 14 cases (14 eyes) of suspected POAG, respectively. The visual field outcomes, indices, point by point threshold variability and defective points of the two perimetries were compared and analysed. Results The negative rate of TOP was 90% in normal subjects. The positive rate of TOP was 75% in POAG , and 100% in middle and late stage of POAG. The visual field indices of two perimetries were positively correlated, with mean sensitivity (MS) of r=0.9335, mean defect (MD) of r=0.9189, and loss variance (LV) of r=0.9621. The point by point threshold variability and defective points of TOP were higher than those of traditional threshold perimetry, but the difference between the two perimetries was not significant (P=0.2019, P=0.4448). Conclusion The visual field indices of TOP and traditional threshold perimetry are positively correlated. The sensitivity and reproducibility of TOP are high in detecting the visual function of middle and late stage of POAG. (Chin J Ocul Fundus,Dis, 2002, 18: 269-272)

纤维支气管镜代胸腔镜诊断不明原因胸腔积液28例临床分析

目的探讨纤维支气管镜代胸腔镜检查在诊断胸腔积液中的临床应用价值。 方法以我院2013年5月至2014年8月收治的不明原因胸腔积液患者28例为研究对象, 对其行纤维支气管镜代胸腔镜检查, 获取胸腔积液及病变组织行病理学检查。 结果28例患者中, 2例脓胸患者未行病理检查, 其余26例患者均行病理检查并明确诊断, 确诊率为92.86%。其中, 18例为恶性肿瘤病变, 包括腺癌10例, 鳞癌8例; 8例为肉芽肿样改变, 诊断为结核性胸腔积液, 经正规抗结核治疗胸腔积液消失。27例患者的人工气胸在术后1~3 d内完全吸收拔管, 无术中术后大出血、伤口感染以及胸腔积液新发感染等并发症发生。 结论纤维支气管镜代胸腔镜在检查胸腔积液病因中是一种安全有效、检出率高的检查方法, 值得临床大范围应用与推广。

彩色多普勒超声在胆囊小隆起性病变中的诊断价值

目的 评价彩色多普勒超声在胆囊小隆起性病变中的诊断价值。 方法 2003年3月-2008年7月收治56例胆囊小隆起性病变患者，其中胆固醇息肉35例，胆囊炎性息肉8例，腺瘤7例，腺肌增生症4例，胆囊癌2例，观察病灶二维图像及彩血流分布及血流频谱特征，均经手术、病理证实。 结果 胆囊息肉常多发，基底窄或有蒂，CDFI不或很少显示血流信号。腺瘤单发为主，基底较宽或有蒂，CDFI不或很少显示血流信号；腺肌增生症（局限型）单发，基底较宽，CDFI不显示血流信号；胆囊癌基底宽，CDFI显示丰富血流信号，多普勒频谱呈低阻动脉频谱。 结论 彩色多普勒超声结合传统二维声像图对胆囊小隆起性病变有较高的诊断价值。

Ultrasonography on eyes with silicon oil tamponade

Objective To investigate the characteristics of ultrasonogram of eyes with silicon oil tamponade. Methods Forty-seven patients (47 eyes) who had undergone the operation of silicon-oil removing were examined by A-(to determine the length of ocular axis) and B-scan before and after the operation respectively. The length of ocular axis and cubage of vitreous chamber were detected and the characteristics of the ultrasonograms were observed according to the default parameters of ultrasonograph. Results The results of A-scan showed that the preoperative axial length was 1.465 times of the postoperative one in the eyes without lens, and 1.284 times in eyes with lens; after modified the parameter according to the acoustic velocity, the preoperative axial length was (0.78±0.34) mm longer than the postoperative one in the eyes without lens, and (0.56±0.32) mm in eyes with lens. The results of A-scan showed that the cubage of vitreous chamber enlarged obviously in eyes with silicon oil tamponade, and the acoustic features included complete filling and partial filling according to the amount of silicon oil. Several arc echoes at the posterior segment of eye were detected in the silicon-oil-filling eyes with retinal detachment. Conclusion In the silicon-oil-filling eyes with lengthened ocular axis, the characteristics of B-scan images are affected by acoustic velocity through silicon oil, the amount of silicon oil capacity and the emulsification of silicon oil. (Chin J Ocul Fundus Dis，2004，20：349-351)

A study on the short-term fluctuation of macular light threshold in suspected early age-related macular dege-neration

Objective To study the significance of detection the short-term fluctuation (SF) of macular light threshold detected by Octopus-123 automatic perimeter in suspected early age-related macular dege-neration (AMD). Methods SF of macular light sensitivity, Amsler chart and central visual acuity were examined in 51 patients(66 eyes) with suspected early AMD group and in 32 patients (40 eyes) in the control group. Results SF were significantly different in suspected early AMD group and control group. SF was more sensitive than the examination of central visual acuity and Amsler chart. SF was related to the quantity, location and quality of drusen. Conclusion Visual function of some suspected early AMD patients with drusen may be damaged, though the central visual acuity appears normal. (Chin J Ocul Fundus Dis, 2002, 18: 119-120)

视网膜母细胞瘤的彩色多普勒超声诊断分析

Preliminary study on feasibility of breast masses screening by homemade domestic breast palpation imaging instead of clinical breast palpation examination

ObjectiveTo explore the feasibility of homemade domestic breast palpation imaging (BPI) instead of clinical breast palpation examination (CBE) for screening breast masses. MethodsThe patients who received breast ultrasonography (BUS), BPI examinations and CBE in the Sichuan Cancer Hospital from March 2022 to September 2022 were retrospectively collected. The result of BUS examination was used as the criteria to compare the efficiency and difference between the BPI examination and CBE in detecting breast masses. The effects of the patients’ body mass index, breast volume, tumor location, benign and malignant tumor, and maximum tumor diameter on the accuracy of breast tumor detection by BPI system were further analyzed. ResultsA total of 102 patients were included in this study. Among the 90 patients with breast mass detected by BUS, 76 cases were detected by BPI and 51 cases were detected by CBE. In the 12 patients without tumor mass detected by BUS, only 11 cases patients without tumor mass were detected by BPI and CBE. The sensitivity and accuracy of breast tumor mass screening by the BPI were higher than those by the CBE (84.4% vs. 56.7%, 85.2% vs. 60.7%, respectively), and the specificity was similar (91.6%, both). The area under the receiver operating characteristic curve (95% confidence interval, 95%CI) of BPI and CBE for screening breast masses were 0.903 (0.791, 0.970) and 0.799 (0.747, 0.851), respectively. The former was higher than the latter (Z=2.494, P=0.013). The consistencies were moderate (Kappa=0.518, P<0.001), general (Kappa=0.204, P=0.002), moderate (Kappa=0.518, P<0.001) between the BPI and BUS, between CBE and BUS, and between BPI and CBE for screening breast masses, respectively. The results of multivariate analysis of binary logistics regression indicated that the benign tumor mass was not easily detected [OR (95%CI） was 9.600（1.328, 69.400), P=0.025] and the tumor mass with breast volume ＜350 mL was easily detected [OR (95%CI） was 0.157 (0.030, 0.818), P=0.028], the diameter of tumor mass had no obvious influence on breast tumor mass screening by the BPI. ConclusionAccording to the preliminary results of this study, BPI can improve the sensitivity of detecting breast masses and make up for the lack of objective records of CBE, but BPI cannot replace CBE at present.

Analysis of the results of multifocal visual evoked potential examination in patients with anterior ischemic opticneuropathy before and after treatment

Objective 　To observe the results of multifocal visual evoked potential (mfVEP) examination in patients with anterior ischemic optic neuropathy (AION) before and ater treatment, and to probe its clinical significance. Methods A total of 90 patients (90 eyes) with AION were examined by mfVEP; the secondorder reaction of mfVEP was analyzed.The reaction was divided into upper and lower hemi　field of visual field, or 1/4 quadrant visual field (superior nasal, inferior nasal, superior temporal, and inferior temporal). The sum of waves of each response was analyzed and the results in various regions were compared.The features of wave configuration was compared between the AION eyes and the contralateral eye, and between the AION eyes before and after treatment.Results The amplitude and latency of P-wave of mfVEP was 0.198plusmn;0.033 and 100.197plusmn;7.354 respectively in AION eyes before treatment, and was 0.271plusmn;0.024 and 98.567plusmn;6.794 in the contralateral eyes; the difference was significant (t=16.556,18.330; Plt;0.01). The amplitude and latency of P-wave of mfVEP was 0.229plusmn;0.016 and 100.104plusmn;10.603 respectively in AION eyes after treatment, which differed much from that before the treatment (t=13.649, 8.858; Plt;0.01) and also from that of the contralateral eyes (t=13.649，8.858；P＜0.01). ConclusionsThe amplitude and latency of P-wave of mfVEP may accurately reflect the recovery of local optic nerve damage in AION eyes before and after treatment with good repeatability. AION can be used as a new method for AION diagnosis and detection of the prognosis.

Application of Quality Management Cycle Method in Reducing Errors in General Inspection Items of Health Examination

ObjectiveTo explore the plan-do-check-action (PDCA) circulation method in reducing errors in general inspection items of health examination and to improve the quality of examination. MethodsUsing PDCA circulation method, the reasons of errors in general items of health examination for 39 individuals examinied between August and December 2010 were analyzed. Rectification was carried out according to the reasons, and the differences in the incidence rate of errors in general items of health examination before (from August to December, 2010) and after the rectification was (from Auguest to December, 2011) was compared. ResultsAfter the rectification, the incidence of errors in general items of health examination (0.08%) was significantly lower than that before the rectification (0.45%) (P<0.05). ConclusionPDCA circulation method can effectively reduce the incidence of errors in general items of health examination thus may ensure the medical quality.

Antenatal Sonographic Diagnosis of Hypoplastic Left Heart Syndrome

目的 探讨胎儿左心发育不良综合征产前超声诊断方法，提高诊断准确性。 方法 常规产前超声检查方法，应用四腔心切面和三血管气管平面进行胎儿心脏畸形筛查。 结果 2006年1月-2008年12月发现4例左心发育不良综合征，3例并发心内畸形（2例右室双出口及1例室缺），1例并发心外畸形（Dandy-Walker畸形及单脐动脉）。 结论 应用四腔心切面和三血管气管平面筛查心室发育不良简单易行，准确性高。