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Objective:To discover the clinical features of nocturnal enuresis (NE) in adults and to detect factors that correlated with the symptom severity.Methods:This cross-sectional study recruited NE subjects from September 2017 through December 2020. All patients had experienced enuresis at least once per week and with a symptom duration of 3 months or longer. Followed by documentation of history and medical records, three-day bladder diary was adopted to assess their voiding pattern, and urodynamic parameters were obtained to evaluate lower urinary tract function.Results:A total of 106 NE patients (43 male and 63 female) were identified. There is no statistical difference regarding the average age (men: 57.8±15.6 vs. women: 56.1±14.0, P>0.05) and BMI (men: 23.9±3.4 vs. women: 23.3±4.3, P>0.05) between men and women. Comorbidities are extremely common in NE patients (n=85, 80.2%), with the incidence rate higher in men compared to women [88.4% (38/43)vs. 74.6% (47/63), P<0.05]. Hypertension (n=58, 54.7%), hyperlipemia (n=41, 38.7%), diabetes mellitus (n=38, 35.8%), coronary heart disease (n=22, 20.8%) were the most frequently reported conditions. On bladder diaries, subjects were frequently manifested nocturnal polyuria (NP, 47/106, 44.3%), reduced nocturnal bladder capacity (NBC, 74/106, 69.8%), or combination of both(33/106, 31.3%). Urodynamic studies suggested that the incidence of reduce bladder compliance, detrusor overactivity (DO), stress incontinence, bladder outlet obstruction(BOO), detrusor underactivity(DU)and detrusor hyperreflexia with impaired contractility(DHIC)was 27.4%(29/106), 39.6%(42/106), 17.9%(19/106), 9.4%(10/106), 25.5%(27/106)and 15.1%(16/106), respectively. Women were more likely to suffer from stress urinary incontinence [2.3%(1/43) men vs. 28.6% (18/63) women, P<0.01], while men were prone to have bladder outlet obstruction [ 23.3%(10/43) men vs. 0 women, P<0.01]. Correlation analysis demonstrated that obesity( r=0.63, P<0.01), systemic comorbidities( r=0.40, P<0.01), presence of NP( r=0.50, P<0.01) and NP+ NBC( r=0.47, P<0.01), post-void residual( r=0.53, P<0.01), reduced compliance( r=0.21, P=0.04), DU( r=0.28, P<0.01), stress incontinence( r=0.42, P<0.01)and DHIC ( r=0.35, P<0.01)are positively correlated with NE severity. Whereas, reduced Q max( r=-0.35, P<0.01), low capacity( r=0.21, P=0.03), and reduced bladder sensation( r=-0.21, P=0.03) correlate negatively with NE severity. Conclusions:The presence of NE is not only a sign of bladder dysfunction, but also an implication of obesity, systematic chronic diseases, urine production malfunctioning. Therefore, a thorough history regarding the lower urinary tract function and systemic comorbidities should be taken carefully, so that, an integrated and personalized treatment can be carried out.
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This article summarized nursing care and management of a child with hypereosinophilic syndrome presenting five foot wounds.Nursing key points included:wound care,pain management and comprehensive interventions.Debriding and selection of dressing were based on the wound bed and acceptance of the patient;medication and psychological intervention were applied to reduce pain;the patient and his family members were encouraged to be involved in the management of wound management.Patient adherence was improved and pain was greatly reduced.After dressing change for 21 times in 93d,five foot wounds were all healed.
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Objective To observe the efficacy of single Nd-YAG laser treatment for the sub-inner limiting membrane(sub-ILM) haemorrhages in the macular region.Methods This is an uncontrolled case series retrospective study.Nd-YAG laser was performed for 6 patients (6 eyes) with premacular sub-ILM haemorrhages.The best corrected visual acuity(BCVA) and optical coherence tomography(OCT) in macular were observed at 1 day,1 week,1 month and 3 months after operation.The conditation of hematopoietic drainage and complications of macular retina were recorded.Results Sub-ILM haemorrhages were clinically confirmed in 6 patients (aged from 23 to 60 years old),including 4 cases of paroxysm associated with cough,1 case of hypertension,and 1 case of diabetic retinopathy.Funduscopic examination showed sub-inner limiting membrane hemorrhage in the macular region,BCVA count finger (CF) was 0.05 (averagely 0.03).The onset time was from 5 hours to 12 days.All the patients were treated with Nd-YAG laser treatment once,and all of them resulted in excellent partial visual recovery immediately.The average hemorrhage absorption time was 2 weeks.OCT examination showed macular retinal inner limiting membrane calm and foveal shape recovery at 3 month after laser treatment.However,the two patients with hypertension and diabetes recieved vitrectomy at 2 weeks and 1 month after laser surgery respectively because of serious vitreous hemorrhage.Conclusion Single Nd-YAG laser is a safe and effective method in the treatment of simplicity sub-ILM haemorrhages.
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Based on the professional characteristics and nature of ophthalmology special examination and combined with teaching requirements for optometry foreign students, we developed a targeted teaching plan and practiced the classification teaching. Using guided trilogy teaching, we guided students to identify and analyze the similarities and differences between the image and the special examination function exami-nation results, emphasizing the cultivation of clinical ophthalmology diagnostic thinking of students, and we obtained good teaching and practice effect.
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Background:Inflammatory bowel disease( IBD)is a group of chronic and non-specific intestinal inflammatory diseases of undetermined origin. Functional impairment of macrophages has been associated with the dysregulation of mucosal immunity in intestinal tract of patients with IBD. Aims:To investigate the correlation of serum levels of macrophage polarization-related cytokines with the development and disease activity of IBD. Methods:A total of 105 IBD patients admitted from May 2013 to May 2014 at Shanghai Ruijin Hospital were recruited,of them 65 were Crohn’s disease (CD)and 40 were ulcerative colitis( UC). Twenty-four patients with colonic polyps were served as controls. Serum samples were obtained and the levels of interleukin-1beta(IL-1β),IL-6,IL-10,IL-13,interferon-gamma(IFN-γ)and inducible nitric oxide synthase(iNOS)were determined by ELISA method. Results:Serum levels of IL-1β,IL-6,IL-10, IL-13 and IFN-γ were significantly higher in CD group than in control group(P 0. 05). Conclusions:Serum levels of macrophage polarization-related cytokines increase to varying degrees in IBD patients,but these cytokines have no obvious correlations with IBD and its disease activity. Presumably,theses cytokines are only involved in but not the triggers in the development of IBD.
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Objective To analyze the clinical characteristics,pathological classification and therapy strategy of rectal carcinoid and its prognostic factors.Methods Forty four patients with rectal carcinoid were diagnosed and treated in Ruijin Hospital Shanghai Jiaotong University from January 2006 to November 2013,among whom 21 patients (19 males and 2 females) were followed-up for 1-7.5 years.The clinical data of these cases were retrospectively analyzed.Results The patients underwent colonoscopy because of changed bowel habits and/or abnormal digital rectal examination,none of them had carcinoid syndrome.Colonoscopy showed that most lesions presented yellowish in color and smooth in surface; the diameter of the tumor was ≤ 1.0 cm in 12 cases (57％) ; the tumors were located at the rectum within 8 cm from anal rim in 17cases (76％); most of them were well differentiated.Immunohistochemistry demonstrated that NSE expression was highly positive.The 1 year-and 3year-survival rate were both 100％.Among 8 cases who were followed up for over 5 year,2 relapsed.Conclusions The digital rectal examination plays a key role in detecting rectal carcinoid.Though prognosis is relatively good,we should keep close following-up to detect the recurrence.The main risk factors influencing the prognosis are tumor size,depth of invasion and clinical stage.The combination measurement of CEA,TSGF,CA19-9 and NSE will either increase the sensitivity or the specificity of early detection.
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Objective To compare the clinical choosing principles of sedated colonoscopy with con-ventional colonoscopy. Methods Outpatients who were willing to accept colonoscopy with or without seda-tion were prospectively recruited,which were assigned to sedated colonoscopy group(n=362)and conven-tional colonoscopy group(n=323). All patients and endoscopists were asked to answer a self-administered questionnaire. The colonoscopy completion,operation time,procedure-related discomfort,and questionnaire results of the two groups were compared and statistically analyzed. Results The completion rate was 98. 9%in the sedated colonoscopy group(358/362)and 89. 8% in the conventional colonoscopy group(290/323) ( P=0. 337 ). The operation time of sedated and conventional group were( 5. 60 ± 3. 25 ) minutes and (7. 71 ± 5. 70)minutes respectively(P<0. 001). And the average cost was CNY 886. 54 per patient in se-dated group and CNY 386. 00 per patient in the conventional group. Patient satisfaction score of conventional group and sedated group were 4(3-4)and 3(2-3)points(P<0. 001),while endoscopist satisfaction score was 4(3-4)and 4(4-4)(P<0. 001). A total of 354 patients(97. 79%)in the sedated group and 225 pa-tients(69. 66%)in the conventional group showed willingness to repeat the identical colonoscopy( P <0. 001). Patients who were male(P=0. 035),having no past abdominal operations(P<0. 001),or no ab-dominal pain during colonoscopy( P =0. 015 )in the conventional group preferred to repeat conventional colonoscopy. Conclusion Although the examination time of conventional colonoscopy is longer than sedated colonoscopy,it could reduce anesthesia risk and the cost. Conventional colonoscopy remains an irreplaceable examination of colorectal diseases in developing countries. Physicians should not only focus on patients'com-fort during endoscopy,but also help patients make a decision based on their actual situation and endoscopic indications to make the best of medical resources.
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0.05).Significant difference was seen in the thickness of RNFL at different scanning diameters(P
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Objective To study the changes of central corneal thickness(CCT) and corneal endothelium morphology in type 2 diabetes mellitus. Methods The CCT and corneal endothelium morphology in 60 diabetic patients(60 eyes) and 60 healthy volunteers(60 eyes) as the age and gender matched control group were examined by pachymetry and non contact specular microscopy. Stepwise regression analysis was performed to assess the effects of systemic factors on CCT and the corneal endothelial cell density of diabetic patients. Results Compared with that in the control group, the endothelial cell density decreased, and the coefficient of variation of cell area increased significantly( P 0 05). Compared to patients with non proliferative diabetic retinopathy(NPDR), the patients with proliferative diabetic retinopathy(PDR) had a significant reduction in cell density( P
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Objective To investigate the changes of the neurosensory retinal thickness in the macula in high myopia eyes by optical coherence tomography (OCT). Methods A total of 47 cases (47 eyes) of high myopia eyes and 42 cases (42 eyes) of normal eyes were divided into high myopia group and control group, respectively. The neurosensory retinal thickness in the center and at the edge of the fovea was measured by OCT. Meanwhile, the mean thickness of the neurosensory retina on OCT macular map was calculated automatically. The neurosensory retinal thickness in high myopia group was compared with that in the control group by t test. Results In high myopia group, the neurosensory retinal thickness in the center and at the edge of the fovea, parafovea, and perifovea was significantly thinner than that in the control group. However, no significant difference in the average thickness of neurosensory retina of the fovea was found between the two groups. Conclusion The thickness of the neurosensory retina in the macula in high myopia eyes is significantly thinner than that in normal eyes. When measurement of the neurosensory retinal thickness by OCT is performed, the thickness of a spot and the thickness of the area in which the spot is located should be considered.
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Objective To observe the characteristics of the choroidal circulation in the macular area in patients with high myopia. Methods Fundus fluorescein angiography (FFA) and indocyanine green angiography (ICGA) were performed in 25 cases (44 eyes) with high myopia, 16 cases (20 eyes) of low to moderate myopia, and 19 cases (24 eyes) of normal eyes using TOPCON50IA fundus fluorescein photographic system. The filling time of fluorescence in the choroid at the earlier stage and the filling time of fluorescence in the choroidal vessels in each group were compared. The relationship of the abnormal fluorescence configuration and the blood perfusion in the choroidal capillary vessels with the corrected visual acuity was analyzed. Results The filling time of fluorescence in the choroid at the earlier stage in eyes with high myopia and the filling time of fluorescence in the choroid in the macular area were significantly different from those of the control ( P