ObjectiveTo investigate the therapeutic effects of vitrectomy for retinal detachment in patients with morning glory syndrome (MGS). MethodThe clinical data of 8 patients (8 eyes) who underwent vitrectomy for retinal detachment and MGS were retrospectively analyzed. Follow-up after treatment was performed for 8 months to 2 years. The visual acuity and retina reattachment were followed up. ResultsRetina was reattached in 5 eyes after vitrectomy. Retina was reattached in 2 eyes after second revision operation. Retina was not reattached in 1 eye after two operations. ConclusionsVitrectomy is effective in treating retinal detachment in patients with MGS.
This study sought to reveal the difference of brain functions at resting-state between subjects with sub-health and normal controls by using the functional magnetic resonance imaging (fMRI) technology. Resting-state fMRI scans were performed on 24 subjects of sub-health and on 24 healthy controls with gender, age and education matched with the sub-health persons. Compared to the healthy controls, the sub-health group showed significantly higher regional homogeneity (ReHo) in the left post-central gyrus and the right post-central gyrus. On the other hand, the sub-health group showed significantly lower ReHo in the left superior frontal gyrus, in the right anterior cingulated cortex and ventra anterior cingulate gyrus, in the left dorsolateral frontal gyrus, and in the right middle temporal gyrus. The Significant difference in ReHo suggests that thebsub-health persons have abnormalities in certain brain regions. It is proved that its specific action and meaning deserves further assessment.
Many meta-analysis studies evaluate rates as parameter to assess the overall estimate of effects. However, none of these studies address systematic approaches for the meta-analysis of rates. This paper outlines the conditions, analysis and software operation procedures for the meta-analysis of rates. It also compares different operation procedures of three types of commonly-used R software (Comprehensive Meta-Analysis, Stata and MetaAnalyst) through real application examples. The biggest challenge for the meta-analysis of rates is to determine whether rates can be pooled, and how to evaluate heterogeneity between studies' outcomes needs further discussion.
ObjectiveTo explore the prevalence, awareness, treatment and control of hypertension in island of China. MethodsLiteratures regarding the prevalence and treatment of hypertension in island of China were retrieved in PubMed, EMbase, The Cochrane Library (Issue 12, 2013), CNKI, WanFang Data and CBM from January 2000 to December 2012. Two reviewers independently screened literature according to the inclusion and exclusion criteria, and extracted data. Then the pooled rates were conducted by Comprehensive Meta-Analysis software using inverse variance method. ResultsNine studies involving 926 836 samples were included. The results of meta-analysis showed the pooled rates of prevalence, awareness, treatment and control were 32.0% (95%CI 18.8% to 48.8%), 47.4% (95%CI 29.7% to 65.8%), 38.0% (95%CI 23.1% to 55.5%) and 10.0% (95%CI 4.3% to 21.7%), respectively. Whether in 60 or 65 as the threshold value, the prevalence of hypertension in old people was higher than that in young people. ConclusionThe prevalence of hypertension is about 32% and much higher in island regions of China, while the awareness, treatment and control rates are so lower in these regions. The relevant public health policy should pay more attention to improve primary health care in these regions.
ObjectiveTo investigate the clinical value of pedicled latissimus dorsi Kiss flap in repairing chest wall large skin defect after tumor operation. MethodsA retrospective analysis was made on the clinical data from 15 cases of chest wall tumors treated between December 2010 and December 2015. There were 2 males and 13 females with an average age of 51.8 years (range, 43-60 years); there were 11 cases of locally advanced breast cancer, 3 cases of fibrosarcoma in chest wall, and 1 case of chest wall radiation ulcer with a median disease duration of 24.1 months (range, 6 months to 8 years). The area of skin defects was 17 cm×12 cm to 20 cm×18 cm after primary tumor resection; the pedicled latissimus dorsi Kiss flap was designed to repair wounds. The flap was a two-lobed flap at a certain angle on the surface of latissimus dorsi based on the thoracodorsal artery, with a size of 17 cm×6 cm to 20 cm×9 cm for each lobe. The donor site was sutured directly. ResultsFourteen flaps survived with primary healing of wound; delayed healing was observed in 1 flap because of distal necrosis; and healing by first intention was obtained at the donor sites. The follow-up time was from 6 months to 3 years (mean, 21.6 months). The flap had good appearance with no bloated pedicle. The shoulder joint activities were normal. No local recurrence occurred, but distant metastasis in 2 cases. No obvious scar was found at donor sites. ConclusionThe application of pedicled latissimus dorsi Kiss flap to repair chest wall skin defects after tumor resection has important clinical value, because of the advatages of simple operation, minor donor site damage and rapid postoperative recovery, especially for late stage cancer patients.
ObjectiveTo explore the effectiveness of pedicled thoracoacromial artery perforator (TAAP) flap for pharyngocutaneous fistula repair after total laryngectomy and radiotherapy. MethodsBetween February 2012 and January 2015, TAAP flap was used to repair pharyngocutaneous fistula after total laryngectomy and radiotherapy in 8 patients. The eight patients were male, aged from 46 to 72 years (mean, 51.8 years). The disease duration was 8-62 months (mean, 27.5 months). Fistula size ranged from 4.0 cm×2.5 cm to 6.0 cm×4.0 cm and the skin defect size ranged from 4.0 cm×3.0 cm to 6.0 cm×4.0 cm. The flap size ranged from 7.0 cm×4.0 cm×0.3 cm to 9.5 cm×6.0 cm×0.5 cm. The length of pedicle was (8.3±0.5)mm. The distance from pivot point of flap to central point of recipient site was (94.5±1.9) mm. ResultsAll 8 flaps survived and all incisions healed smoothly. The hospitalization time was 7-14 days (mean, 9.6 days). The barium meal examination showed no fistula or stenosis. The patients were followed up 8-42 months (mean, 28.5 months). During follow-up, the neck appearance was good, and no fistulas or stenosis occurred. Only linear scars were observed at the donor sites, pectoralis major muscle function was normal in all patients. ConclusionPharyngocutaneous fistula should be repaired as early as possible after total laryngectomy. TAAP flap is suitable for the reconstruction of pharyngocutaneous fistula after total laryngectomy.
Objective To investigate the clinical outcome of free thoracoacromial artery perforator (TAAP) flap in the reconstruction of tongue and mouth floor defects after radical resection of tongue carcinoma. Methods Between May 2010 and February 2015, 11 cases of tongue carcinoma underwent radical resection and reconstruction of tongue and mouth floor defects with free TAAP flaps. The locations of tongue carcinoma were the lingual margin in 7 cases, the ventral tongue in 2 cases, and the mouth floor in 2 cases. According to Union for International Cancer Control (UICC) TNM stage, 3 cases were classified as T4N0M0, 3 cases as T4NlM0, 2 cases as T3N1M0, 2 cases as T3N2M0, and 1 case as T3N0M0. The disease duration ranged from 3 to 28 months, 10.6 months on average. The tumor size ranged from 6.0 cm×3 cm to 10 cm×5 cm. The TAAP flap ranged from 7.0 cm×4.0 cm to 11.0 cm×5.5 cm in size, and 0.6-1.2 cm (0.8 cm on average) in thickness, with a pedicle length of 6.8-9.9 cm (7.2 cm on average). Results All 11 flaps survived, the donor site was closed directly and healed primarily in all cases. The patients were followed up 12-24 months (17.2 months on average). The reconstructed tongue had satisfactory appearance and good functions of swallowing and language. No local recurrence was observed during follow-up. Only linear scar was left at the donor site, and the function of pectoralis major muscle was normal. Conclusion The TAAP flap is an ideal choice in the reconstruction of tongue defect after resection of tongue carcinoma, which has good texture, appearance, and function results.
ObjectiveSeizure-related respiratory or cardiac dysfunction was once thought to be the direct cause of sudden unexpected death in epilepsy (SUDEP), but both may be secondary to postictal cerebral inhibition. An important issue that has not been explored to date is the neural network basis of cerebral inhibition. Our aim was to investigate the features of neural networks in patients at high risk for SUDEP using a blood oxygen level-dependent (BOLD) resting-state functional MRI (Rs-fMRI) technique. MethodsRs-fMRI data were recorded from 13 patients at high risk for SUDEP and 12 patients at low risk for SUDEP. The amplitude of low-frequency fluctuations (ALFF) values were compared between the two groups to decipt the regional brain activities. ResultsCompared with patients at low risk for SUDEP, patients at high risk exhibited significant ALFF reductions in the right superior frontal gyrus, the left superior orbital frontal gyrus, the left insula and the left thalamus; and ALFF increase in the right middle cigulum gyrus, the right supplementary motor area and the left thalamus. ConclusionsThese findings highlight the need to understand the fundamental neural network dysfunction in SUDEP, which may fill the missing link between seizure-related cardiorespiratory dysfunction and SUDEP, and provide a promising neuroimaging biomarker for risk prediction of SUDEP.