ObjectiveTo observe the outcomes of 23G pars plana vitrectomy (PPV) and air tamponade for non-inferior rhegmatognous retinal detachment (RRD).MethodsA prospective case series study. From August 2017 to April 2018, 39 consecutive RRD patients (39 eyes) in Department of Ophthalmology of Subei People’s Hospital Affiliated to Yangzhou University were enrolled in this study. There were 20 males (20 eyes) and 19 females (19 eyes), 23 right eyes and 16 left eyes, with the mean age of 55±11 years. There were 30 eyes with lens and 9 eyes without lens or IOL. There were 21, 14 and 4 eyes with 1, 2 and equal or greater than 3 retinal tear respectively. All patients underwent 23G PPV which performed preretinal proliferative membranes and vitreous cortex removal, photocoagulation around the breaks with 3-5 rows, and filtered air tamponade. The follow-up was more than 2 months. The retinal reattachment, visual acuity and complications were observed. Pearson correlation analysis was used to analyze the correlation between BCVA and disease course. Chi-square test was performed for comparison among retinal reattachment rate and different clinical factors before operation.ResultsAt 2 months after the PPV, 35 eyes’ retina reattached, the rate of reattachment was 89.8%. In 2-3 weeks, 4 eyes were re-detached, all of them performed silicone oil tamponade. One eye was secondary to pre-macular membrane. The logMAR BCVA before and after PPV were 1.15±0.78 and 0.41±0.31, respectively (t=6.589, P=0.0001). Correlation analysis results showed that BCVA after surgery was positively correlated with BCVA before surgery (r=0.544, P=0.001). Twelve of 30 eyes with crystalline lens suffered cataract. The rate of reattachment vary in the number of the breaks (χ2=9.181, P=0.010).ConclusionPPV with air tamponade may be an optimal treatment of non-inferior RRD with better success rate and security.
ObjectiveTo observe and explore the feasibility and effectiveness of platelet-rich fibrin (PRF) membrane packing and air filling in the treatment of refractory macular holes. MethodsA retrospective clinical study. From January 2019 to January 2020, 17 patients with refractory macular hole (17 eyes) who diagnosed in Renmin Hospital of Wuhan University were included in the study. Among them, there were 7 males (7 eyes) and 10 females (10 eyes), with the age of 55.18±7.91 years. All eyes underwent 23G minimally invasive vitrectomy combined with internal limiting membrane stripping and PRF packing, and air filling was performed at the end of the operation. The best corrected visual acuity (BCVA) and optical coherence tomography angiography were performed in all eyes before surgery and at 1 week and 1, 3 months after surgery. The BCVA examination was performed using a international standard logarithmic visual acuity chart, which was converted into logarithm of the minimum angle of resolution visual acuity during statistics. Taking 3 months after surgery was as the time point to judge the efficacy, the changes of BCVA, superficial retinal vascular density (SVD), foveal avascular zone (FAZ) area and central foveal thickness (CFT) before and after surgery were compared. Paired t-test was used to compare the indicators before and after surgery. ResultsAmong the 17 eyes, there were 6, 7, and 4 eyes with giant macular hole, high myopia macular hole, and recurrent macular hole, respectively; the hole diameter was 723.94±38.30 μm. Three months after surgery, all holes were closed. Compared with before surgery, the BCVA (t=4.458) and SVD (t=2.675) increased, and the CFT (t=6.329) and FAZ area (t=4.258) decreased at 3 months after surgery, and the differences were statistically significant (P<0.05). At the last follow-up, there was no complications such as intraocular hypertension and retinal detachment in all eyes.ConclusionMinimally invasive vitrectomy combined with internal limiting membrane stripping and PRF tamponade in the treatment of refractory macular holes can increase the closure rate, improve visual acuity and retinal blood perfusion.
ObjectiveTo analyze the effect of different nebulization methods in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) requiring non-invasive ventilators (NIV). MethodsOne hundred and two patients with AECOPD were selected according to the standard, and randomly divided into a control group, a trial group I, and a trial group II according to the random number table. The patients in the control group received NIV intermittent oxygen-driven nebulization; the patients in the trial group I received NIV simultaneous oxygen-driven nebulization; and the patients in the trial group II received NIV simultaneous air-driven nebulization. The dynamic fluctuations of transcutaneous partial pressure of carbon dioxide (PtCO2), arterial blood gas indexes (PaCO2, PaO2, pH), vital signs and pulse oxygen saturation (SpO2) fluctuations were compared. ResultsPtCO2 at 15min of nebulization in the trial group II were lower than the other groups (P<0.05). PtCO2 at 15min of nebulization was higher than the other time points in the control group (P<0.05); there was no statistical difference of PtCO2 at different time points in the trial group I (P>0.05); PtCO2 gradually decreased with time in the trial group II (P<0.05). The difference before and after nebulization of PtCO2 (dPtCO2) was larger in trial group II than the other groups (P<0.05). PtCO2 at 0min and 5min after the end of nebulization in trial group II were lower than the other groups (P<0.05); there were no statistical differences of PtCO2 at 10min and 15min after the end of nebulization among three groups (P>0.05). There were statistical differences of the PtCO2 at each time point in the control group except for the PtCO2 at 10 min and 15min after the end of nebulization, all of which decreased with time; PtCO2 at each time points of nebulization decreased with time in the trial group I (P<0.05). PtCO2 only at 5min after the end of nebulization was lower than that at 0min after the end of nebulization in trial group II (P< 0.05), there were no statistical differences in other times (P>0.05). PaCO2, pH at the 4th day of treatment was lower than the pre-treatment in the control group (P<0.01); there were statistical differences of PaCO2 between the pre-treatment and the rest time points in the trial group I and group II (P<0.05). The number of abnormal fluctuations in vital signs and SpO2 during nebulization in three groups was not statistically different (P>0.05). ConclusionsThree groups can achieve good therapeutic effects. NIV intermittent oxygen-driven nebulization can make PtCO2 rise during nebulization; NIV simultaneous oxygen-driven nebulization can make PtCO2 remain stable during nebulization; NIV simultaneous air-driven nebulization can make PtCO2 fall during nebulization.
ObjectiveTo evaluate the surgical outcomes of 25G+ vitrectomy with air tamponade and 1-day prone positioning for idiopathic macular hole (IMH).MethodsA prospective analysis was performed on 39 patients (39 eyes) underwent 25G+ pars plana vitrectomy (PPV) combined with the internal limiting membrane (ILM) removal and fluid-air exchange for IMH from July 2012 to December 2013. After vitrectomy, patients were instructed to keep prone positioning for only 1 day (the air group). These patients were compared to 30 consecutive patients from July 2010 to July 2012, who were conducted 25G+ PPV with 25% SF6 tamponade. They remained in the same face-down position for 3 days postoperatively (SF6 group). Age, gender, logMAR BCVA, macular thickness, macular hole diameter, axial length, macular hole stages and pseudophakic status were collected as baseline characteristics in both groups. The initial hole-closure rate, visual outcome and intra-operative & post-operative complications were evaluated for 6 months. Group comparisons of numeric variables were made by using two sample t -test. Group difference of categorical variables was determined by using standard chi-square test or rank sum test.ResultsThirty nine patients (39 eyes) and 30 patients (30 eyes) were respectively enrolled in air group and SF6 group. The distribution of age (t=－1.63), gender (χ2=0.03), logMAR BCVA (t=0.39), macular thickness (t=－0.93), macular hole diameter (t=－0.70), axial length (t=－0.56), macular hole stages (Z=－0.47) and pseudophakic status (χ2=0.13) was similar in both groups. Anatomical closure of macular holes was achieved in 35 (89.7%) of the 39 eyes in the air group and in 27 eyes (90.0%) in the SF6 group. There was no significant difference of closure rate between the two groups (χ2=0.001, P=0.970). The postoperative visual acuity of gaining, stability and decreasing 2 or more 2 lines was achieved in 23 eyes,10 eyes and 6 eyes in air group and 18 eyes, 6 eyes and 6 eyes in SF6 group. The proportion of visual acuity improvement in air group was lower than that in SF6 group without the statistical significance (Z=－0.08, P=0.93). The gas bubble was absorbed sooner in the air group (mean 8.54±1.74 days) than in the SF6 group (mean 31.10±3.20 days). No retinal break, retinal detachment or endophthalmitis occurred in either group. Postoperatively intraocular pressure was elevated temporarily in 2 eyes of the air group and 3 eyes in the SF6 group. All returned to normal limit after local medication.ConclusionCompared to SF6 group, air group has similar anatomical macular hole closure rate and visual acuity rehabilitation.
【摘要】目的探讨喉癌手术后患者对两种不同雾化方式的耐受性,为选择最佳雾化方式提供参考。方法将49例喉癌手术后患者随机分为观察组(25例)和对照组(24例),观察组采用氧气雾化吸入,对照组采用空气压缩泵雾化吸入。分别记录两组患者雾化吸入前及吸入15 min时脉搏血氧饱和度(SpO2)及心率;雾化过程中患者有无心慌、气紧等不适以及雾化后痰液的性质及量。采用SPSS 13.0软件进行统计分析。结果两组患者雾化吸入15 min时的SpO2差异有统计学意义(Plt;001),观察组高于对照组;而两组患者雾化吸入前SpO2、心率、不适主诉及雾化后痰液的性质差异均无统计学意义(Pgt;005)。结论氧气雾化吸入可以提高喉癌手术后患者雾化过程中的SpO2,使患者感觉更加舒适。【Abstract】Objective To investigate postoperative patients with laryngeal carcinoma atomization of two different forms of tolerance, in order to choose the best means of atomization. Methods Fifty postoperative patients with laryngeal carcinoma were divided into observation group using oxygen inhalation and control group using the air compression pump inhalation. Two groups of patients were recorded the value of SpO2 and heart rate before 15 minutes after the inhalation,as well as the discomforts such as flustered,gas tight during the atomization process and the nature and olume of sputum. Results The results of two groups of patients at the time of 15 minutes inhalation SpO2 statistically significant difference (Plt;001), the observation group than in the control group average SpO2 high; and two groups of patients with preinhalation SpO2 average, average heart rate, Discomfort chief complaint and the nature of sputum after aerosol compared no significant difference (Pgt;005). Conclusion Oxygen inhalation in patients with laryngeal cancer can improve the atomization process SpO2 value, so that patients feel more comfortable.
Xuanwei district in Yunnan Province of China has pretty high incidence of lung cancer in China, even around the world. Studies have shown that there exists a close relationship between lung cancer and local indoor air pollution caused by Bituminous coal. Considering that the indoor air pollution in Xuanwei District is caused by "open fireplace", an indoor air pollution simulation system was designed, and an F344 rats lung damage model was established for this indoor air pollution fireplace. The model is based on indoor air pollution simulation system with signal multiplexer control and multichannel acquisition, and mining PID algorithm was used for polynomial fitting to each test point, and a relatively constant PM2.5 air pollution status was simulated. The results showed that the system could simulate a variety of states of air pollution, provide a new test method for evaluation of human injury caused by indoor air pollution and a new idea for the study of the incidence of lung cancer in Xuanwei district and other places.
ObjectiveTo observe the changes of macular visual function after myopic foveoschisis (MF) and pars plana vitrectomy (PPV) combined with internal limiting membrane peeling and air filling. MethodsA single-center, retrospective study. From October 2018 to October 2019, 29 MF inpatients (32 eyes) in Tianjin Eye Hospital were included in this study. There were 3 males (4 eyes) and 26 females (28 eyes). The age was 63.00±3.45 years old. Equivalent spherical lens degree was －14.16±2.54 D, and axial length was 29.14±1.04 mm. Among them, 3 patients (3 eyes) had lamellar macular holes. All eyes underwent standard pars plana three-channel 25G PPV combined with internal limiting membrane peeling and air filling. Before surgery and at 1, 3, and 6 months after surgery, macular microperimetry was performed with a macular integrity assessment instrument, and the mean retinal sensitivitie (MS) within 10° of the macula, fovea 2° and 4° fixation rates (P1, P2), 63% and 95% bivariate contour ellipse area (BCEA) were recorded. The comparison of MS, P1, P2, 63%BCEA and 95%BCEA at different times before and after surgery was performed by paired t test; the comparison of fixation stability rate was performed by χ2 test. ResultsCompared with before surgery, there were significant differences in the improvement of MS in affected eyes at 1, 3 and 6 months after surgery (t=－2.208, －3.435,－4.919; P=0.038, 0.002, 0.000). In the pairwise comparison at different times after surgery, only 6 months after surgery and 1 month after surgery were significantly different (P=0.036). Compared with the preoperative P1, P2, 63%BCEA and 95%BCEA, the P1 and P2 of the eyes gradually increased after surgery, while the 63%BCEA and 95%BCEA gradually decreased, however, the difference was not statistically significant (P1: t=－1.595,－1.698,－1.966; P=0.125, 0.104, 0.062. P2: t=－1.622,－1.654,－1.707; P=0.119, 0.112, 0.102. 63%BCEA: t=1.410, 1.409, 1.553; P=0.172, 0.173, 0.135. 95%BCEA: t=1.412, 1.408, 1.564; P=0.172, 0.173, 0.132). Six months after surgery, all the eyes underwent anatomical repositioning of the macular area, and no serious complications such as full-thickness macular hole and macular hole retinal detachment were found. ConclusionsPPV with internal limiting membrane peeling and air filling is an effective and safe method for MF, and the macular function improved significantly within 6 months postoperatively.
The current issue of air pollution has pushed the development of the corresponding observational air pollution studies. The World Health Organization has developed a new risk of bias (RoB) assessment instrument and a related guideline for assessing the risk of potential bias in observational air pollution studies. This study introduced the background, methods, uses, advantages and disadvantages, precautions, and usage scenarios of the RoB instrument. It is expected to provide researchers with corresponding quality evaluation tools when writing related systematic review and meta-analysis, which will also help provide reporting standards for observational air pollution studies, thereby improving the quality of studies.