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Objective:To evaluate and compare the clinical efficacy and safety of three different medicated eye patches in the treatment of Demodex blepharitis. Methods:A multicenter, randomized, double-blind, parallel-controlled clinical trial was conducted.A total of 140 patients (280 eyes) with Demodex blepharitis were recruited in Shanghai Jing'an District Shibei Hospital, Xi'an Fourth Hospital and Kunming First People's Hospital from July 2021 to December 2022.The affected eyes were randomly divided into tea tree oil group, okra oil group, basal fluid control group and metronidazole group by the random number table method.Eye patches containing 20% tea tree oil, 1% okra oil, prepared base solution and 2% metronidazole were applied to the eyes for 28 days by the double-blind method.The count of Demodex was evaluated before treatment and on days 14 and 28 of treatment.Ocular surface symptoms were scored according to Ocular Surface Disease Index (OSDI). The degree of congestion at the eyelid margin and cylindrical dandruff at the root of eyelashes were scored under a slit lamp microscope.The effective rate was calculated according to the comprehensive scores above, and the adverse reactions of the subjects were observed.This study adhered to the Declaration of Helsinki.The study protocol was approved by the Ethics Committee of Shanghai Jing'an District Shibei Hospital (No.YL-20200320-05). All the subjects were informed of the significance, purpose and method of the study.Written informed consent was obtained from each subject before any medical examination. Results:All subjects completed the treatment and follow-up, and the loss to follow-up rate was 0%.After 14 and 28 days of treatment, the Demodex count was significantly decreased in all groups compared with before treatment (all at P<0.05). After 28 days of treatment, the number of Demodex in tea tree oil group, okra oil group and metronidazole group were significantly lower than that in basal fluid control group, with statistically significant differences (all at P<0.05). The OSDI score, palpebral margin congestion score and cylindrical dandruff score on 14 and 28 days after treatment in tea tree oil group, okra oil group and metronidazole group were significantly lower than before treatment, showing statistically significant differences (all at P<0.05). After 28 days of treatment, the effective rates of tea tree oil group, okra oil group and metronidazole group were 71.4%, 71.4% and 62.9%, respectively, which were significantly higher than 25.7% in basal solution control group.No serious local or systemic adverse reactions were found during the treatment and follow-up. Conclusions:Eye patches containing tea tree oil, okra oil and metronidazole have significant effects on the treatment of Demodex blepharitis, which can improve the biological environment of the palpebral margin and eliminate the inflammation related to blepharitis.
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Background The measurement of retinal nerve fiber layer (RNFL) by Cirrus optical coherence tomography (OCT) has been applied widely in ophthalmology.However,previous assessment of RNFL is based on spatial measurement,while the evaluation based on optical characteristics of OCT can offset the shortcomings of spatial measurement in some eye diseases.Objective This study was to analyze the optical characters of RNFL measured by OCT and its correlation with age in healthy Chinese individuals.Methods Four hundred and six normal healthy subjects were collected in Shanghai Shibei Hospital from June 2011 to June 2012,with the age of 40-83 years old.Macular RNFL was unilateral imaged using a Cirrus OCT device with 5 line raster macular scan mode under the approval of Ethic Committee of Shanghai Shibei Hospital and informed consent of subjects.A customized software was used to measure RNFL optical characters,including absorbance (A value) and attenuate coefficient.The difference of the measured parameters in different genders was compared.The correlations between RNFL optical characters and age were analyzed by linear regression analysis.Results The data of 353 eyes were included in the final outcomes.The RNFL thickness,A value and attenuate coefficient were (35.1 ±4.4) μm,121.6 ±5.3 and 2.06 ±0.25,respectively.RNFL thickness and A value showed significantly negative correlations with age (r=-0.487,-0.571,both at P＜0.01) with the regression equation Y=-0.17 X+45.23 and Y=-0.24 X+ 135.82,while a positive correlation was found between the attenuate coefficient and age (r=0.368,P＜0.01) with the regression equation Y=0.01 X+1.63.RNFL thickness and A value showed weaker positive correlations with OCT signal intensity (rs =0.128,P =0.016;rs =0.284,P＜0.01),but no remarked correlation was seen between the attenuate coefficient and OCT signal intensity (rs =-0.053,P=0.319).Conclusions Age of subjects affects the parameters of OCT optical characteristics in normal populaition.Age-related RNFL change in optical characters of OCT should be considered before concluding optical parameters.
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Objective To understand the current situation of smoking and quitting smoking in patients with cardiovascular disease. Methods 184 cases of inpatients or outpatients with cardiovascular disease treated in the First People's Hospital of Kunming were surveyed about quitting smoking, and the smoking and smoking cessation-related clinical features of patients with cardiovascular disease were analyzed. Results ( 1) Cardiovascular diseases in smokers was male-dominated (100%), mainly hypertension and/or coronary heart disease (179, 97.3%) . (2) Average age of starting smoking was 21.5, 97.8%of patients had smoked more than 10 years, with an average of 35.1 ±13.4 years, 69.6% of patients smoked ≥10 cigarettes/day, with an average of 16.3 ± 10.1 cigarettes/day, 65.8%of patients were in the low level of nicotine dependence, 81.5%of the patients thought that quitting smoking was important, 76.1% had quitting smoking ideas, 67.4% had confidence in the success of quitting smoking, 50.5%thought that it was difficult to quit smoking, 127 (69%) patients had seriously quit smoking. (3) 65 cases (51.2%) who seriously quit smoking had succeeded, 54 patients (83.1%) received varying degrees of medical staff advised to quit smoking, 62 cases (48.8%) in relapse, only 34 patients (54.8%) accepted medical personnel advised to quit. Two sets of chi-square test, p=0.000, prompted difference was statistically significant. Relapse reasons were pressure, craving and around other smokers. Conclusions Smoking patients with cardiovascular disease are mainly constituted by male patients with hypertension and/or coronary heart disease. Most of the patients recognize that quitting smoking is important, and have idea and seriously quit smoking. However, lack of confidence and smoking which has also become a lifestyle significantly affect the success of smoking cessation. The medical staffs' recommending smoking cessation persuasion can largely improve the success of smoking cessation for patients.
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Objective To apply 12-leads HOLTER monitoring and analysis to observe paroxysmal atrial fibrillation (PAF) and its related atrial arrhythmias so as to explore the triggering factors of PAF. Methods 47 patients with PAF, including 20 male patients and 27 female patients, were given 12-HOLTER monitoring and analysis. Their average age was 64.89 ±12.70 years-old.PAF patients were subdivided into 2 subgroups: the triggered PAF subgroup and the untriggered PAF subgroup. Patients with atrial premature beats but without PAF were selected into the control group. The PAF and its related atrial arrhythmias were detected and analyzed by 12-HOLTER.Results (1) 9 events of PAF were found in 47 patients by 12-HOLTER monitoring and analysis, among them 72 events of PAF were triggered by atrial premature (AP) (91.1%, 72/79), 6 events of PAF occurred automatically and suddenly (7.6%, 6/79);and only 1 events of PAF was triggered by atrial flutter (1.3%,1/79) . (2) The coupling interval of AP in the triggered PAF subgroup was significantly shorter than that of the untriggered PAF subgroup and control group (490 ±90ms vs. 590 ±140 ms and 630 ±90ms, <0.05);The index of AP was smaller significantly in the PAF group than that of the untriggered PAF subgroup and controll group (0.52±0.12 vs. 0.62±0.09 and 0.71±0.06, <0.05);TheP' on Tof AP was significantly higher in the PAF group than that of the untriggered PAF subgroup and control group (84.72%vs. 26.73%and 2.78%, <0.017);The interval before the AP in PAF group was prolonged more significantly than that of controlled group (990±280 ms vs. 940±210 ms, <0.05) . (3) During 2 min~30 s before the PAF occurrence control as total times,the AP appeared more frequently (from 0.43 beats/min to 3.5~6.00 beats/min, <0.017) . (4) Most of the AP which triggered PAF was originated from the upper part of the left atrium (61/72,84.7%) .Conclusions Most events of PAF are triggered by AP, the AP which can trigger PAF may be of some of the features such as a shorter coupling interval,a smaller AP index,P' on Tand a longer interval before the AP,PAF more occurrence while the AP may take place more frequently.Most of the AP which triggered PAF are originated from the upper part of left atrium.
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Objective To explore the clinical features of acute retroperitoneal colon perforation. Methods A retrospective analysis and summary were made on the clinical data of 20 cases of various retroperitoneal colon perforation. Results All of the 20 cases had been misdiagnosed preoperatively. Eighteen cases received surgical treatment, of which 5 cases underwent one-stage tumor resection, 5 cases had two-stage tumor resection and anastomosis;of 8 cases with traumatic perforation,7 were treated by simple suture, 1 case underwent two-stage colonic anastomosis; 2 cases died,all the 2 cases were treated conservatively.Conclusions There are many differences between retroperitoneal colon perforation and intra-abdominal perforation in clinical symptoms, signs and supplementary examinations. Diagnosis of retroperitoneal colon perforation is difficult and the rate of misdiagnosis is high, so this condition must be highly regarded.Surgery is the best option to treat this disease.