ABSTRACT
Objective To explore the influence of dialect-based communication obstacle on the safety of ophthalmic operation room and to provide the basis for improving the safety of ophthalmic operation room. Methods An in-depth interview was taken on 10 medical staff by qualitative research. The information was arranged and analyzed by phenomenology method. Results The interview with the surgical doctors on the communication barriers were extracted to three themes, including lower surgical efficiency, decreased patient satisfaction, increased risk of surgical complications, the interview with the surgical nurses on the dialects leading to communication barriers were extracted three themes, including surgical verification difficult to carry out, affect the perioperative care, hinder the postoperative mission to carry out, the extracted themes about the impact on patients include increased stress and anxiety affect the surgical outcome, poor intraoperative experience reduced satisfaction, the extracted themes about solution include the organization of medical staff to learn the dialect of the common language, recruit staff diversification, to provide professional translation, standardized body language to instruct the patient. Conclusions In this study, the experience of communication disorder caused by doctors and nurses in the ophthalmic operating room reflects the shortcomings of the safety management of the ophthalmic operating room. These deficiencies can be reduced by the independent study of the medical staff.
ABSTRACT
Objective To investigate the clinical and imaging characteristics of phosphaturic mesenchymal tumor and improve the clinical diagnosis. Methods From November 2014 to September 2017, 22 patients with pathologically confirmed diagnosis as phosphaturic mesenchymal tumor (PMT) were retrospectively analyzed, including 12 males and 10 females, age ranged from 30-72 years, mean (47 ± 11) years old. The clinical data, laboratory tests [serum calcium, phosphorus, alkaline phosphatase, parathyroid hormone and 1, 25- (OH) 2 D] and imaging examinations (X-ray, CT, MRI, nuclide) were collected and explored. Sixteen patients underwent SPECT scan and seven underwent PET/CT scan. Twenty patients had X-ray, eighteen patients had CT and 12 patients had MRI with enhancement. Results All patients suffered from diffuse pain for one to fifteen years, especially in lower back and lower extremities. All patients were found with low serum phosphorus, normal serum calcium. Twenty-one patients were found with elevated alkaline phosphatase, 16 with increased parathyroid hormone and 15 with decreased 1, 25 - (OH) 2 D. Thirteen lesions were located in the medullary cavity, seven in the soft tissue and two in the sinuses. Nineteen cases showed varying degrees of trabecular bone sparse, osteoporosis and osteomalacia on X-ray;There were 15 cases of multiple pseudo-fractures, including four cases of pelvic fracture complicated with femoral fracture, six cases of single fracture of pelvis, four cases of femur and one case of fibula. And seven cases showed multiple vertebral compression fractures. Thirteen lesions showed soft-tissue density and four in the medullary cavity showed high density on CT scan. The lesions presented low signal intensity on T1WI,high or low signal intensity on T2WI FLAIR and obviously enhanced in 12 patients who underwent MRI enhancement. Conclusion For patients with decreased serum phosphorus, elevated alkaline phosphatase, bone softening and fracture, octreotide or other nuclides should be primary imaging modality for confirming the location of the lesion. CT and MRI can further evaluate the nature of the lesion and improve diagnostic accuracy.
ABSTRACT
Objective To compare subjective refraction based on power vectors and conventional subjective refraction in different degrees of astigmatism.Methods A total of 143 subjects (143 right eyes) were divided into two groups according to astigmatism degree:low astigmatism group (0-1.50 D) and high astigmatism group (1.50 -3.00 D).Subjects were then examined by both methods to fetch refraction data,and then the equivalent spherical M component,J0 component,J45 component and the duration of refraction procedures were compared and analyzed.Results There was no statistically difference in age,gender,M component,J45 component and time consuming of subjective refraction between the high and low astigmatism groups (all P ＞ 0.05),but intergroup comparison of J0 component from subjective refraction based on power vectors and conventional subjective refraction was significantly different (all P =0.00).In the low astigmatism group,the agreement of M,J0 and J45 measured by the two methods was tmified,and the mean absolute value of M,J0 and J45 difference was 0.04 D,0.02 D and 0.02 D,respectively;moreover,within the limits of consistency,the maximum absolute value of the difference was 0.37 D,0.13 D and 0.17 D,respectively,and there was no statistically difference in time consuming of the two methods (P =0.72).In the high astigmatism group,the agreement of M,J0 and J45 measured by the two methods was poor,and the mean absolute value of M,J0 and J45 difference was 0.43 D,0.21 D and 0.00 D,respectively;moreover,within the limits of consistency,the maximum absolute value of the difference was 0.75 D,0.50 D and 0.30 D,respectively,and the difference in time consuming of the two methods approached statistical significance (P =0.00),suggesting time consuming of subjective refraction based on power vectors was longer.Conclusion Subjective refraction based on power vectors has good effect on low astigmatism,and it needs to be further improved for clinical practices.