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A 35-year-old female patient with a history of significant epidemiological exposure firstly visited eye doctor due to acute tarsadenitis in the right eye.Subsequently, she developed subconjunctival hemorrhage, fever and cough and received topical administration of antibiotics and systemic treatment of antiviral drug.Shortly thereafter, both his mother and father, who denied COVID-19 associated epidemiological history, appeared fever, fatigue and other symptoms and diagnosed as COVID-19.This female patient was diagnosed as COVID-19 by CT image of lung and COVID-19 RNA detection 17 days and 24 days after firstly visited eye doctor, respectively, and received specialized isolation treatment.The symptoms of COVID-19 are very varied, eye doctors should keep alert and pay attention to personal protection.
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Objective:To investigate the effect of Demodex palpebralis infestation and meibomian gland dysfunction(MGD) on the incidence of recurrent corneal erosion syndrome (RCES).Methods:A case-control study was performed.Thirty eyes of 30 RCES patients were enrolled from January to June 2018 in Hanyang Hospital of Wuhan Aier Eye Hospital, and served as the RCES group.Thirty-one eyes of 31 simple ametropia patients with matched age and gender were enrolled at the same time and served as the control group.Eyelash microscopic examination was performed for Demodex counting, slit-lamp examination was performed to observe the condition of meibomian gland.Keratograph 5M examination was performed to detect the morphological changes in the meibomian glands.This study was approved by the Ethics Committee of Wuhan Aier Eye Hospital.All subjects were aware of the method and purpose of this study.Results:The average meibomian glands score was 4(3, 4) in the RCES group, which was significantly higher than 2(1, 3) in the control group (Z=-4.55, P=0.00). The average meibomian gland secretion score was 15.5(11.0, 16.8) in the RCES group, which was significantly higher than 8.0(5.5, 10.0) in the control group (Z=-3.97, P=0.00). The average Demodex numbers was 8(4, 9) and 0(0, 2) in the RCES and control groups, respectively, with a significant difference between them (Z=-4.13, P<0.00). The average Demodex infection rate was 83.3% (25/30) and 38.7% (12/31) in the RCES and the control groups, respectively (χ 2=7.60, P<0.01). The recurrence frequency showed a positive correlation with the meibomian glands scores (r s=0.70, P<0.01), meibomian gland secretion scores (r s=0.47, P=0.04) and Demodex numbers (r s=0.73, P<0.01). Conclusions:The infection rate of Demodex palpebralis and the degree of MGD are obviously elevated in RCES patients, and are associated with the relapse frequency of RCES.
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Objective To analyze effects of thoracoscopy in the diagnosis and treatment of suspected diaphragmatic injury after thoracoabdominal stab wound.Methods Sixty-eight patients who received thoracoscopic diagnosis and management of diaphragmatic injuries due to thoracoabdominal stab wounds from April 2000 to October 2011 were retrospectively analyzed.Results Occult diaphragmatic injuries were found in 11 patients.Seven patients underwent thoracoscopic suture,of which five had synchronous laparotomy for inspected abdominal organ injuries.Pulmonary parenchymal lacerations occurred in 15 patients who received thoracoscopic repair or resection.Coagulated hemothorax in 13 patients were removed.Postoperative complications included pleural effusion in one patient,pneumonia in two and pulmonary atelectasis in one.Hospital stay was(7.9±13.5)days,without ICU stay.The length of drainage,operation time and intraoperative blood loss were(3.3±1.5)days,(45.6±78.1)minutes and(57.8±24.3)ml respectively.There was no conversion to thoracotomy.Thoracic CT scan was performed six months postoperatively,without hernias.The accuracy of thoracoscopy in diagnosing diaphragmatic injury was 100％.Conclusion Thoracoscopy should be performed for the thoracoabdominal stab wounds with stable hemodynamics,with definite significance especially for the diagnosis and treatment of wounds at the 7-9th intercostal spaces.
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Objective To evaluate the surgical technique in ventricular septal defect(VSD)associated with aortic valve insufficiency(AI)patients.Methods 115 VSD patients associated with AI were retrospectively analyzed.96 patients belong subarterial to VSD,membranous defect in 19 cases.Moderate hypothermia circulatory arrest in all cases.Direct closure of the VSD was undertaken in 16 cases and other cases repaired with patches.Aortic valvuloplasty in 92 cases.and 5 patients underwent aortic valve replacement.The other 18 cases were directly repaired the VSD with patches.Results The results of surgical treatment is satisfactory.In the 4 months to 2 years follow up,10 patients died,NYHA cardic function 72 cases is Ⅰ,31 is Ⅱ and 2 is Ⅲ.Conclusion Early and concomitant surgical treatment ventricular septal defect associated with aortic valve insufficiency can obtain an ideal results.
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BACKGROUND:Recently,the development of tissue-engineered technique lms broadened the study of artificial esophagus.Some investigators have inoculated esophageal epithelial cells cultured in vitro onto compound polymer material and successfully constructed tissue-engineered esophagus.OBJECTIVE:To investigate the feasibility of tissue-engineered artificial esophagus by combining dog esophageal epithelail cells and an acelhilarized porcine thoracic aorta allogenic matrix.DESIGN:An experimental observation.SETTING:Central Laboratory,Taishan Medical College.MATERIALS:This study was carried out in the Central Laboratory.Talshan Medical College from June to December in 2004.Three hybrid dogs,24-hour-old,were provided by the Laboratory Animal Center,Taishan Medical College.The protocol was performed in accordance with ethical guidelines for the use and care of animals.The experimenhal instruments and reagents were as follows:CO2 incubator(MCO-15AC,SANYO),hypothermal high-speed centrifuge(RC-26,Dupont),trypsin,transferrin,type Ⅱ collagenase(Gibco),dulbecco's modified eagle's medium(DMEM),DispaseⅡ isolated enzyme,and rat monoclonal anti-keratin antibody(Sigma).METHODS:Acellularization of porcine aortas was performed by a method of enzyme-detergent.Esophageal epithelial cells of hybrid dogs were in vitro isolated,cultured and proliferated.Next,they were inoculated onto an acellularized porcine thoracic aortas allogenic matrix seaffold.Three and seven days later,the growth of esophageal epithelial cells on the acellularized matrix was observed under an electron microscope.MAIN OUTCOME MEASURES:Morphology of esophageal epithelial cells cultured in vitro;Biocompatibility of acellular matrix and dog esophageal epithelial cells.RESULTS:The acellularized procedure resulted in an almost complere removal of the cells and the loose three-dimensional matrix.The acellular matrix could be reseeded with expended esophageal epithelial cells in vitro.and esophageal epithelial cells had the potential of spread and proliferation.CONCLUSION:Acellular matrix possesses satisfactory biocompatibility for allogenic esophageal epithelial cells.Tissue-engineered artificial esophagus can be generated in vitro by a combination of esophageal epithelial cells and allogenic aceilularized matrix.