ABSTRACT
Objective:To observe the long-term efficacy and safety of macular buckling (MB) in the treatment of high myopia traction maculopathy.Methods:A retrospective clinical study. From January 2014 to December 2017, 57 eyes of 57 patients with high myopia traction maculopathy who underwent MB treatment at Zhongshan Ophthalmic Center of Sun Yat-sen University were included in the study. Among them, there were 15 males with 15 eyes, average age was 51.80±10.72 years; there were 42 females with 42 eyes, average age was 59.14±11.51 years. There were 21 eyes of 21 cases with highly myopic macular hole with macular detachment (MHMD), and 36 eyes in 36 cases with highly myopic foveoschisis with macular detachment (FSMD), and they were grouped accordingly. All patients underwent best corrected visual acuity (BCVA), optical coherence tomography (OCT), and axial length (AL) measurements. The standard logarithmic visual acuity chart was used for BCVA examination, which was converted into logarithm of the minimum angle of resolution (logMAR) visual acuity during statistics. All patients underwent MB, either on its own or combined with vitrectomy. Patients with significant vitreous macular traction on OCT were treated with combined surgery. One, 3, 6 months and 1, 2, 3, and 4 years after the operation, the same equipment and methods before the operation were used to conduct related examinations, and the long-term efficacy and safety of the two groups of eyes were observed.Results:Before surgery, the logMAR BCVA of eyes in MHMD group and FSMD group were 1.35±0.47 and 1.17±0.59, respectively; 4 years after surgery, they were 1.02±0.49 and 0.73±0.55, respectively. The BCVA improved significantly at postoperative 4 years than preoperative in both groups ( P=0.039, 0.001). In the eyes with MHMD, the BCVA was found to be significant improved 3 years after surgery ( P=0.042). Whereas, in the eyes with FSMD, the BCVA was found to be significantly improved 3 months after surgery ( P=0.013). Macular reattachment was achieved in 100% of cases, while macular hole closure rate was achieved in 66.7% in the MHMD group. In the FSMD group, either macular reattachment rate or the foveoschisis resolution rate was 97.2%. After surgery, choroidal neovascularization was observed in 2 eyes, and 3 eyes with intraretinal cyst. Conclusion:MB may represent a safe and effective surgical option for the treatment of high myopia maculopathy.
ABSTRACT
Objective To explore the risk factors of twin preeclampsia,so as to provide evidence for early identification,early warning and prognosis,and better guide clinical work.Methods The clinical data of 236 cases of twin pregnancy with preeclampsia and 200 cases of preeclampsia in the same period in Beijing Haidian District maternal and child health care hospital were analyzed retrospectively.The clinical epidemiology of patients in two groups was conducted in a cohort study to analyze the risk of disease,and to explore the risk factors for twin pregnancy and preeclampsia.Results The preeclampsia incidence of multipara (OR =2.275,95％ CI:1.404-3.686) increased compared with the primipara.The risk of preeclampsia increased in elderly patients (≥35 years old) (OR =1.412,95％ CI:0.917-2.174).The preeclampsia incidence of double chorionic twins was 1.946 times that of monochorial twins (OR =1.946,95％ CI:1.321-2.868).The preeclampsia incidence of assisted reproductive technology pregnancy was 2.063 times that of natural pregnant women (OR =1.946,95％ CI:1.321-2.868).Overweight and obesity were closely related to preeclampsia (OR =3.482,95％ CI:2.064-5.874;x2 =23.498,P ＜ 0.001) and excessive weight gain during pregnancy increased the risk of preeclampsia.Conclusions Primipara,advanced age,double chorionic twins,assisted reproductive technology pregnancy,overweight or obesity and excessive weight gain during pregnancy were all risk factors of preeclampsia in twin pregnancy women.Age,chorionicity and assisted reproductive technology were independent risk factors for preeclampsia.In order to reduce the incidence of preeclampsia and improve the prognosis in twin pregnant women,high risk factors should be identified as early as possible and more perinatal health care should be taken in clinical work.
ABSTRACT
Objective To investigate the effect of comprehensive nursing intervention on lung function and depressive mood of patients with chronic obstructive pulmonary disease and depression,and summarize the effective care of the disease,in order to achieve better efficacy in clinical care and treatment in the future.Methods 58 cases of patients with chronic obstructive pulmonary disease and depression in our hospital were chosen as the research object.They were randomly divided into the routine care group and the integrated care intervention group with 29 patients in each group.The routine care group received conventional care,and the integrated care intervention group was given comprehensive care according to the patients'individualized condition and psychological intervention on the basis of conventional care.The patients' lung function and severity of depression 6 months and 12 months after treatment were compared.Results In the integrated care intervention group,the lung function 6 months and 12 months after treatment were significantlybetter than the routine care group,the degree of depression was significantly slighter than routine care group.The effective rote of treatment was higher than the routine care group.Conclusions The efficacy of integrated care intervention for patients with chronic obstructive pulmonary disease and depression was significant,it can improve the lung function and depression state of patients,which is worthy of clinical application.