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1.
International Eye Science ; (12): 1224-1227, 2022.
Article in Chinese | WPRIM | ID: wpr-929512

ABSTRACT

AIM: To provide guidance for more accurate measurement of axial length(AL)of difficult measuring eyes by comparing the differences in the AL of the patient's difficult measuring eye with three methods of the sitting position, supine position A-scan and Lenstar 900(Lenstar, LS900). METHODS: Clinical case-control study. We selected 102 cases(102 eyes)including cataract patients with combined silicone oil filled, vitreous hemorrhage or retinal detachment and patients with dislocation of the lens or IOL in Zhengzhou Second Hospital from May 2019 to September 2020. AL were measured using LS900 and A-scan on sitting position and supine position respectively, and the results of the three methods were statistically analyzed.RESULTS: The detection rates of LS900 and A-scan axial measurement were 83% and 100% respectively. Three methods of A scan in sitting position, supine position and LS900 to measure the overall AL, silicone oil group, lens dislocation group and vitreous hemorrhage group, the differences were statistically significant(P<0.001), The mean values of AL measured by overall A-scan, supine positions of silicone oil group, supine position of lens dislocation group and vitreous hemorrhage group were statistically significant differences with LS900 measurement(all P<0.05), while there was no statistical difference between the results of the overall sitting position and the difficult measuring eye groups' sitting position compared with the LS900 measurement of AL. The three measurements showed good consistency within the 95% consistency range, but the result of A-scan on sitting position was closer to LS900.CONCLUSION: Changing the conventional decubitus position to the sitting position can improve the accuracy of the measurement results and provide clinicians with more reliable guidance for the treatment of patients with difficult measuring eyes of A-scan axial measurement, especially in diseases with altered ocular structure.

2.
International Eye Science ; (12): 1642-1646, 2022.
Article in Chinese | WPRIM | ID: wpr-942833

ABSTRACT

Dry eye(DE)is a multi-factorial ocular surface disease. The mechanisms underlying the pathogenesis of DE is still unclear. Inflammation and immune response are considered to be one of the core mechanisms among the pathogenesis of DE. Neuropeptides are small molecular peptides generated after the sensory nerve endings damaged or stimulated. They play an important role in triggering and regulating inflammatory response. Thus, they are important mediums between the nervous system and immune system. Recent studies have revealed that neuropeptides secreted by ocular surface nerves are considered to be an important factor involved in the pathogenesis of DE. Therefore, this paper summarized the research progress on the roles of neuropeptides underlying the mechanisms of the pathogenesis of DE, analyzed the latest points of view and research hot spots, so as to provide references for the prevention and treatment of DE.

3.
Article in English | WPRIM | ID: wpr-928940

ABSTRACT

Computational medicine is an emerging discipline that uses computer models and complex software to simulate the development and treatment of diseases. Advances in computer hardware and software technology, especially the development of algorithms and graphics processing units (GPUs), have led to the broader application of computers in the medical field. Computer vision based on mathematical biological modelling will revolutionize clinical research and diagnosis, and promote the innovative development of Chinese medicine, some biological models have begun to play a practical role in various types of research. This paper introduces the concepts and characteristics of computational medicine and then reviews the developmental history of the field, including Digital Human in Chinese medicine. Additionally, this study introduces research progress in computational medicine around the world, lists some specific clinical applications of computational medicine, discusses the key problems and limitations of the research and the development and application of computational medicine, and ultimately looks forward to the developmental prospects, especially in the field of computational Chinese medicine.


Subject(s)
Algorithms , Computer Simulation , Humans
4.
Article in Chinese | WPRIM | ID: wpr-928449

ABSTRACT

OBJECTIVE@#To perform gene mutation analysis in a Chinese pedigree with dystrophic epidermolysis bullosa pruriginosa (DEB-Pr), and explore phetotype, genotype, and genotypes-phenotypes relationship of DEB-Pr.@*METHODS@#Potential variants of the COL7A1 gene were detected by skin targeted sequencing panel and verified by Sanger sequencing. The pathogenicity of the variation was analyzed.@*RESULTS@#Compound heterozygous variants, c.4128delT and c.8234G>A, were detected in the COL7A1 gene of the two patients. The c.4128delT(p.Pro1376fs) variant was derived from their mother and unreported previously. According to the American College of Medical Genetics and Genomics Standards and Guidelines, it was suggested to be a pathogenic mutation. The c.8234G>A(p.Arg2745Gln) variant was derived from their father, and possibly is a pathogenic variation.@*CONCLUSION@#In this study, the compound heterozygous variants of c.4128delT(p.Pro1376fs) and c.8234G>A(p.Arg2745Gln) of the COL7A1 gene probably underlies the disease in this patient and his sister. And our study expands the database on mutations of DEB-Pr.


Subject(s)
Collagen Type VII/genetics , Epidermolysis Bullosa Dystrophica/genetics , Female , Humans , Male , Mutation , Pedigree , Phenotype
5.
Article in Chinese | WPRIM | ID: wpr-928000

ABSTRACT

Rich experience of clinical diagnosis and treatment has been accumulated in the developmental history of Chinese medicine, and the efficacy has been increasingly accepted by the public. However, the evaluation of clinical efficacy is currently based more on scientific evidence instead of merely the changes of patient symptoms. In Chinese medicine, the changes of major disease indicators, patient symptoms, and pathogenesis are the major criteria for the evaluation of clinical efficacy. The lack of well-accepted and uniform criteria and the uncertainty of subjective evaluation limit the development of clinical Chinese medicine. Evidence-based medicine combines clinical skills with the current best evidence. Narrative medicine, utilizing people's narratives in clinical practice, emphasizes patient feelings, willingness, and value orientation. The introduction of both evidence-based medicine and narrative medicine into the evaluation of clinical efficacy refers to the construction of the clinical efficacy evaluation system in a paradigm of participatory diagnosis and treatment. It can fully reflect the characteristics of Chinese medicine, respect the values of patients, and achieve universal clinical evidence. Therefore, it helps to improve the diagnosis and treatment, the relationship between doctors and patients, patients' life quality and decision-making awareness, and finally the new evaluation model of clinical efficacy of Chinese medicine.


Subject(s)
Evidence-Based Medicine , Humans , Medicine, Chinese Traditional , Narrative Medicine , Physicians , Treatment Outcome
6.
International Eye Science ; (12): 1408-1411, 2021.
Article in Chinese | WPRIM | ID: wpr-882103

ABSTRACT

@#Graves ophthalmopathy(GO)is an autoimmune disease, mostly accompanied by orbital tissue inflammation. The practical guideline was produced by a research team of members from different scientific disciplines. The article provided a thorough interpretation of the management guidelines in GO and intended to provide direction for diagnosis of GO in daily clinical practice and improved the curative effect and medical service quantity of GO patients.

7.
International Eye Science ; (12): 1000-1003, 2021.
Article in Chinese | WPRIM | ID: wpr-876743

ABSTRACT

@#Hydroxychloroquine and chloroquine play more and more important roles in the treatment of rheumatism, skin diseases and autoimmune diseases. Irreversible macular diseases,retinopathy and even permanent blindness are common side effects of them. High dose per kilogram of body weight, duration of treatment, presence or absence of keratosis and renal or liver dysfunction are all related to this. Therefore, the examination of the two kinds of drug lesions is also relatively complicated. FAF and SD-OCT are required for wide field examination. For patients with complicated retinopathy, multifocal electroretinogram and the like are also required for diagnosis. The specific examination methods need to be determined by clinical ophthalmologists according to the patient's medication and preliminary examination.

8.
International Eye Science ; (12): 111-114, 2021.
Article in Chinese | WPRIM | ID: wpr-837727

ABSTRACT

@#AIM: To investigate the ocular surface changes of diffuse diabetic macular edema(DDME)treated by intravitreal injection of Conbercept. <p>METHODS: Twenty patients(20 eyes, right eyes)diagnosed as DDME and requiring vitreous injection of conbercept in the Department of Ophthalmology, the First Affiliated Hospital of Nanchang University from January 2019 to June 2019, were selected as experiment group. Experiment goup was treated with three vitreous injections of Conbercept. The left eyes of the patients without macular edema were treated as control group without any treatment. Before operation and on the first day after operation, we used corrected visual acuity, superficial punctate epithelial erosion(SPEE), lacrimal river height, intraocular pressure, symptom and sign scores, Schirmer I test(S I t)and corneal fluorescein staining(CSF)to estimate eyes.<p>RESULTS: Before treatment, there was no difference in intraocular pressure, the height of lacrimal river, OSDI score, S I t, CSF score between the two groups(<i>P</i>>0.05), and there was no superficial punctate epithelial erosion in both groups, but the corrected visual acuity of the control group was significantly better than that of the experimental group(0.50±0.20 <i>vs</i> 1.65±0.35, <i>P</i><0.05). After treatment, the corrected visual acuity, lacrimal river height and S I t in the experimental group were significantly lower than those in the control group, OSDI and CSF scores were significantly higher than those in the control group(all <i>P</i><0.05), and the intraocular pressure increased more significantly than that in the control group, but there was no difference between the two groups(<i>P</i>>0.05). Compared with before treatment, the corrected visual acuity of the experimental group was significantly improved, the lacrimal river height and S I t were significantly decreased, OSDI and CSF scores were significantly increased(<i>P</i><0.05), but the intraocular pressure had no significant change(<i>P</i>>0.05); the observation indexes of the control group had no significant changes(<i>P</i>>0.05).<p>CONCLUSION: Intravitreal injection of conbercept in the treatment of diffuse diabetic macular edema can damage the ocular surface.

9.
Article in Chinese | WPRIM | ID: wpr-942266

ABSTRACT

OBJECTIVE@#To explore the stress distribution characteristics of the graft after anterior cruciate ligament (ACL) reconstruction, so as to provide theoretical reference for the surgical plan of ACL reconstruction.@*METHODS@#Based on 3D MRI and CT images, finite element models of the uninjured knee joint and knee joint after ACL reconstruction were established in this study. The uninjured knee model included femur, tibia, fibula, medial collateral ligament, lateral collateral ligament, ACL and posterior cruciate ligament. The ACL reconstruction knee model included femur, tibia, fibula, medial collateral ligament, lateral collateral ligament, ACL graft and posterior cruciate ligament. Linear elastic material properties were used for both the uninjured and ACL reconstruction models. The elastic modulus of bone tissue was set as 17 GPa and Poisson' s ratio was 0.36. The material properties of ligament tissue and graft were set as elastic modulus 390 MPa and Poisson's ratio 0.4. The femur was fixed as the boundary condition, and the tibia anterior tension of 134 N was applied as the loading condition. The stress states of the ACL of the intact joint and the ACL graft after reconstruction were solved and analyzed, including tension, pressure, shear force and von Mises stress.@*RESULTS@#The maximum compressive stress (6.34 MPa), von Mises stress (5.9 MPa) and shear stress (1.83 MPa) of the reconstructed ACL graft were all at the anterior femoral end. It was consistent with the position of maximum compressive stress (8.77 MPa), von Mises stress (8.88 MPa) and shear stress (3.44 MPa) in the ACL of the intact knee joint. The maximum tensile stress of the graft also appeared at the femoral end, but at the posterior side, which was consistent with the position of the maximum tensile stress of ACL of the uninjured knee joint. More-over, the maximum tensile stress of the graft was only 0.88 MPa, which was less than 2.56 MPa of ACL of the uninjured knee joint.@*CONCLUSION@#The maximum compressive stress, von Mises stress and shear stress of the ACL graft are located in the anterior femoral end, and the maximum tensile stress is located in the posterior femoral end, which is consistent with the position of the maximum tensile stress of the ACL of the uninjured knee joint. The anterior part of ACL and the graft bore higher stresses than the posterior part, which is consistent with the biomechanical characteristics of ACL.


Subject(s)
Anterior Cruciate Ligament Injuries/surgery , Anterior Cruciate Ligament Reconstruction , Biomechanical Phenomena , Femur/surgery , Finite Element Analysis , Humans , Knee Joint/surgery , Tibia/surgery
10.
Article in Chinese | WPRIM | ID: wpr-879625

ABSTRACT

OBJECTIVE@#To carry out genetic testing for a Chinese patient with X-linked hypohidrotic ectodermal dysplasia (XLHED) and explore its genotype-phenotype correlation.@*METHODS@#Clinical data of the patient was collected. Peripheral blood samples were taken from the patient, his parents and 100 unrelated healthy controls. Genetic variants were detected by using next-generation sequencing using a skin-disease panel through targeted capture and next generation sequencing. Candidate variant was verified by Sanger sequencing. All literature related to genetic testing of XLHED patients in China was searched in the database, and the genotypes and phenotypes of patients in the literature and the correlation between them were statistically analyzed.@*RESULTS@#A novel splice site variant c.655_689del was detected in the patient but not among his parents and the 100 unrelated healthy controls. So far 61 variants of the EDA gene have been identified among Chinese patients with XLHED, which suggested certain degree of genotype-phenotype correlation.@*CONCLUSION@#A novel c.655_689del variant has been identified in the EDA gene, which has expanded the spectrum of EDA gene variant and facilitated delineation of the genotype-phenotype correlation of XLHED.


Subject(s)
Child , China , Ectodermal Dysplasia 1, Anhidrotic/genetics , Ectodysplasins/genetics , Genetic Testing , Genotype , Humans , Phenotype
11.
Article in Chinese | WPRIM | ID: wpr-879195

ABSTRACT

Network Meta-analysis was used to evaluate the efficacy and safety of different oral Chinese patent medicines combined with transcatheter arterial chemoembolization(TACE) in the treatment of primary liver cancer. Randomized controlled trials of oral Chinese patent medicines for primary liver cancer were retrieved from CNKI, Wanfang, VIP, SinoMed, PubMed, Cochrane Library and EMbase databases from inception to May 2020. According to the Cochrane recommendation standard, the quality of the included articles was evaluated, and the data were analyzed by RevMan, R software and GeMTC software. A total of 10 kinds of oral Chinese patent medicines and 68 RCTs were included. Network Meta-analysis results showed that: as compared with TACE alone, 10 kinds of oral Chinese patent medicines combined with TACE showed advantages in effective rate, 1-year survival rate, 2-year survival rate, KPS score improvement rate and reduced adverse reaction incidence. In the pairwise comparison of oral Chinese patent medicines, the results showed that Cidan Capsules were superior to Jinlong Capsules and Xihuang Pills in 1-year survival rate. According to the probabi-lity ranking results: Shenyi Capsules and Ganfule were more obvious in improving the effective rate; Cidan Capsules and Shenyi Capsules were more effective in improving the 1-year survival rate; Pingxiao Capsules and Shenyi Capsules had better efficacy in improving 2-year survival rate; Huaier Granules and Shenyi Capsules had better efficacy in improving the quality of life; Huisheng Oral Liquid and Ganfule were more effective in reducing the incidence of adverse reactions(such as nausea, vomiting and leukocytosis). The current evidence showed that oral Chinese patent medicine combined with TACE was superior to TACE alone in efficacy and safety. In terms of the effective rate, 1-year survival rate, 2-year survival rate, KPS score improvement rate and reduced adverse reaction incidence, the optimal treatment measures were Shenyi Capsules, Cidan Capsules, Pingxiao Capsules, Huaier Granules and Huisheng Oral Liquid in turn. However, due to the limitations of the research, the current level of evidence is not high, and clear conclusions and evi-dence strength still need to be further verified and improved by high-quality researches.


Subject(s)
Carcinoma, Hepatocellular/drug therapy , Chemoembolization, Therapeutic , China , Drugs, Chinese Herbal , Humans , Liver Neoplasms/drug therapy , Network Meta-Analysis , Nonprescription Drugs , Quality of Life
12.
Article in Chinese | WPRIM | ID: wpr-878996

ABSTRACT

To systematically evaluate the efficacy and safety of Huaier Granules in the adjuvant treatment of primary liver cancer. The databases of CNKI, Wanfang, VIP, CBMdisc, PubMed, Cochrane Library and EMbase were searched by computer to screen out the randomized controlled trial on Huaier Granules combined with Western medicine in the treatment of primary liver cancer from the establishment of the databases to January 2020. Data extraction and quality evaluation were conducted for the included literature. Meta-analysis was conducted with RevMan 5.3 software, and evidence quality evaluation was conducted for the outcomes by GRADE profiler software. A total of 24 articles were included, with a total sample size of 2 664 cases. Meta-analysis showed that as compared with Western medicine alone, Huaier Granules combined with Western medicine could improve the objective remission rate(RR=1.38, 95%CI[1.26, 1.51], P<0.000 01), disease control rate(RR=1.29, 95%CI[1.10, 1.52], P=0.002) and 6-month survival rate(RR=1.20, 95%CI[1.10, 1.32], P<0.000 1), 1-year survival rate(RR=1.39, 95%CI[1.23, 1.58], P<0.000 01), 2-year survival rate(RR=1.95, 95%CI[1.28, 2.96], P=0.002), KPS score(MD=17.15, 95%CI[6.47, 27.83], P=0.002) and the improvement rate of KPS score(RR=2.02, 95%CI[1.47, 2.77], P<0.000 1), AFP decline rate(RR=1.40, 95%CI[1.20, 1.62], P<0.000 1), CD3~+(MD=17.34, 95%CI[9.28, 25.40], P<0.000 1), CD4~+(MD=8.62, 95%CI[1.59, 15.64], P=0.02), CD8~+(MD=1.95, 95%CI[-3.93, 7.82], P=0.52), CD4~+/CD8~+(MD=0.42, 95%CI[-0.33, 1.17], P=0.27); reduce the level of AFP(MD=-71.57, 95%CI[-80.42,-62.72], P<0.000 01), recurrence rate(RR=0.76, 95%CI[0.67, 0.85], P<0.000 01), and incidence of adverse reactions(RR=0.60, 95%CI[0.41, 0.89], P=0.01) in patients with primary liver cancer. According to the GRADE system, the evidence for outcome measures was low to very low. The results show that Huaier Granules have certain efficacy and high safety in adjuvant treatment of primary liver cancer, but its effect in reducing adverse reactions and improve immunity remains to be verified. Due to the poor quality of the included studies and evidences, the conclusions still need to be further verified by multi-center, large sample, and randomized double-blind controlled studies.


Subject(s)
Adjuvants, Pharmaceutic , Complex Mixtures , Drugs, Chinese Herbal , Humans , Liver Neoplasms/drug therapy , Trametes
13.
Article in Chinese | WPRIM | ID: wpr-871790

ABSTRACT

The retinal blood oxygen quantification method is a fast and non-invasive new retinal vascular imaging technology, which is used to reflect the metabolism of retinal blood oxygen and the micro-circulation of whole body by measuring, analyzing and quantifying the blood oxygen saturation of the main arteries and veins of the retina. The circulation state provides a reliable basis for medical diagnosis. Retinal blood oxygen saturation can be used as a biomarker for the diagnosis and evaluation of ophthalmologic and brain diseases such as diabetic retinopathy, central retinal vein occlusion, retinitis pigmentosa, glaucoma and Alzheimer's disease.

14.
Chinese Journal of Dermatology ; (12): 718-720, 2020.
Article in Chinese | WPRIM | ID: wpr-870348

ABSTRACT

Case 1, a 16-year-old male patient, presented with local verrucous hyperplasia and clustered brown follicular keratotic papules on the face, neck and bilateral axillae, some of which merged into plaques; his mother had similar medical history and clinical manifestations. Case 2, a 21-year-old male patient, presented with local verrucous hyperplasia and diffuse follicular keratotic papules on the head, face, neck, trunk, bilateral axillae and buttocks, some of which merged into patchy lesions; none of his family members had similar symptoms. Histopathological examination of the neck skin lesion of the case 2 showed epidermal hyperkeratosis with focal parakeratosis, suprabasal cleft with acantholysis, "villi" , corps ronds and grains in the spinous layer, and inflammatory cells infiltrating the superficial dermis. Genetic testing showed a missense mutation c.2300A>G in exon 15 of the ATP2A2 gene in both the case 1 and his mother, and a splice-region mutation c.2097+5G>A at the junction between exon 15 and intron 15 of the ATP2A2 gene in the case 2. Neither of these mutations were identified in the other family members of the 2 patients.

15.
Chinese Journal of Dermatology ; (12): 366-367, 2020.
Article in Chinese | WPRIM | ID: wpr-870290

ABSTRACT

Objective:To report 7 cases of vitiligo caused by eyebrow tattooing.Methods:Seven cases of vitiligo caused by eyebrow tattooing were collected from Department of Dermatology, Henan Provincial People′s Hospital from December 2017 to May 2019, and their clinical features were retrospectively analyzed.Results:One month to 1 year after eyebrow tattooing, several eyebrows became white in the 7 patients. In the early stage, only several eyebrows became white, and the surrounding skin was normal, but white patches with unclear boundaries gradually appeared around the eyebrows in the later stage. Reflectance confocal scanning microscopy of skin lesions on the eyebrow showed depigmentation in the basal layer and around hair follicles, and highly refractive amorphous substances (colorants) in the superficial and middle dermis. The 7 patients all showed negative patch test reactions to eyebrow colorants but positive reactions to sodium dodecyl sulfate.Conclusion:No depigmentation was observed on the eyebrow skin in the early stage of vitiligo caused by eyebrow tattooing, and reflectance confocal scanning microscopy of eyebrow lesions may be beneficial in reducing its misdiagnosis.

16.
Chinese Journal of Urology ; (12): 282-286, 2020.
Article in Chinese | WPRIM | ID: wpr-869650

ABSTRACT

Objective:To discover the efficacy of the combination of preoperative/2 hours postoperative blood WBC count ratio and qSOFA to predict the urosepsis after flexible ureteroscopic lithotripsy.Methods:Retrospectively analyze the patients’ information from September 2015 to July 2018. In total, 2 364 patients who underwent the flexible ureteroscopic lithotripsy procedure were enrolled in the study. Patients gender (male: 1463, female: 751), age (54.9±14.0)years, BMI (23.9±2.8)kg/m 2, stone size(10.8±6.2)mm, side (left: 1 305, right: 1 018, both sides: 41), preoperative body temperature(36.8±0.4)℃, blood glucose level(5.7±1.5)mmol/L, WBC(7.4±4.6)×10 9/L, neutrophil percentage 0.62±0.11, C reactive protein(20.1±59.3)mg/L, procalcitonin(1.6±11.8)μg/L, interleukin-6(11.3±32.9)pg/ml. Results:The operative time was (39.3±23.0) min. The 2 hours postoperative WBC count was (6.7±2.9) ×10 9/L, neutrophil percentage was 0.70±0.12. qSOFA was positive for 69 cases and negative for 2 295 cases. 15 (0.6%) patients developed urosepsis. qSOFA positive patients were 15 in urosepsis group and 54 in normal group. The preoperative/2 hours postoperative blood WBC count ratio was 2.5±1.6 for urosepsis group and 0.7±0.2 for normal group. Univariate analysis showed that female patients(χ 2=16.20, P<0.001), large size of stones( t=2.14, P=0.050), high preoperative blood WBC( t=2.51, P=0.025), neutrophil percentage( t=2.90, P=0.012), C reactive protein( t=2.58, P=0.028), procalcitonin( t=16.09, P<0.001)and interleukin-6( t=7.88, P=0.032), positive preoperative mid-stream sample of urine culture(χ 2=21.10, P<0.001), preoperative/2 hours postoperative blood WBC count ratio >1( t=4.51, P=0.001)and qSOFA positive(χ 2=502.10, P<0.001) were recognized as statistically significant. Patients whose qSOFA was positive as well as preoperative/2 hours postoperative blood WBC count ratio >1 were diagnosed high-risk urosepsis patients. The efficacy of the combining of qSOFA and preoperative/2 hours postoperative blood WBC ratio >1 were higher than using separately. When using qSOFA alone, the area under the receiver operating characteristic curve was 0.98 but the positive prediction value was 21.7%. When using preoperative/2 hours postoperative blood WBC ratio alone, AUROC was 0.98, specificity was 60.0% and positive prediction value is 38.5%. Both indicate that the false positive rates were high. And for combining model, the area under the receiver operating characteristic curve was 1.00, specificity was 98.3% and the positive prediction value was 93.8%. It had a much higher efficacy which was a 2-hour-quick, sufficient and reliable indicator for diagnosing urosepsis. Conclusions:The combination of qSOFA positive and preoperative/2 hours postoperative blood WBC count ratio>1 could quickly and accurately predict the urosepsis after flexible ureteroscopic lithotripsy.

17.
Chinese Journal of Lung Cancer ; (12): 381-387, 2020.
Article in Chinese | WPRIM | ID: wpr-826971

ABSTRACT

Patients with sensitive epidermal growth factor receptor (EGFR) mutations often respond to tyrosine kinase inhibitors (TKIs), but acquired resistance will eventually develop. The most common mechanisms of acquired resistance include secondary EGFR mutation, MET amplification, and histologic transformation. Besides, gene fusions could also mediate the process of acquired resistance. Various gene fusions including rearranged during transfection (RET), v-raf murine sarcoma viral oncogene homolog B1 (BRAF) and anaplastic lymphoma kinase (ALK) could take place after TKIs resistance, the incidence of which is around 1%. The clinical cases and experiments both in vitro and in vivo have proved the role of gene fusions in EGFR-TKI resistance. The combination of EGFR inhibitors and gene fusion inhibitors might be an effective therapeutic method. The understanding of gene fusions at EGFR-TKI resistance may contribute to the subsequent diagnosis and treatment strategy.

18.
International Eye Science ; (12): 1-3, 2020.
Article in Chinese | WPRIM | ID: wpr-777784

ABSTRACT

@#Diabetic retinal disease(DRD)is a disease with a sharp increase in the proportion of retinal disease(RD). Diabetic macular edema is the leading cause of vision loss. The treatment of diabetic macular edema has always been a hot topic in medicine. The diagnosis and treatment of diabetic macular edema is the latest treatment guideline for diabetic macular edema published by the European Association of Retinal Experts. It is considered to be the most representative guide at present. Detailed interpretation in this article will help the majority of ophthalmologists have a new understanding of the diagnosis and treatment of diabetic macular edema.

19.
Article in Chinese | WPRIM | ID: wpr-941853

ABSTRACT

OBJECTIVE@#To provide new concepts of anterior cruciate ligament (ACL) reconstruction by anatomical gross observation of ACL tibial insertion and finite element analysis of distribution of ACL mechanical insertion.@*METHODS@#In the anatomical study, ten fresh adult cadaveric knees were dissected, including 6 males and 4 females, all knees were generally observed through standard medial parapatellar approaches, paying attention to the close anatomical relationship of tibial insertion and anterior horn of lateral meniscus, and ACL was exposed and gradually removed from the inside. The shape of tibial insertion of ACL was observed and recorded, and anterior-posterior diameters and left-right diameters of tibial insertion were measured with vernier caliper. For the study of finite element analysis, three-dimensional thin-layer magnetic resonance imaging of normal knee joint was used to establish knee joint model. Three-dimensional reconstruction software MIMICS and finite element analysis software ANSYS were used to establish knee joint model, subsequently, clinical physical examination Lachman test and pivot-shift test were simulated to observe the force distribution of ACL tibial insertion and femoral insertion.@*RESULTS@#The ACL tibial mechanical insertion was rather flat and long similar as an arc shape without a clear separation between anterior medial bundle (AMB) and posterolateral bundle (PLB) in gross observation. The dense fibers lies belonged to the medial intercondylar ridge and ended up anterior with the osseous landmark of anterior ridge. Its average anterior-posterior diameter was (13.8±2.0) mm, the average left-right diameter of midsubstance was (5.3±0.6) mm, and the average left-right diameter of anterior margin was (11.5±1.2) mm. The finite element analysis showed that distribution on the femoral side was oval shape mainly below the residents' ridge, while the tibial side was rather flat mainly along the medial intercondylar ridge, which was consistent with the anatomical observation. The biomechanical characteristics of ACL attachments were verified theoretically.@*CONCLUSION@#Anatomical study and finite element analysis have confirmed the flat arc shape of ACL tibial insertion. The ideal reconstruction technique of ACL should be based on its biomechanical insertion. Based on anatomical study and biomechanical analysis, we have proposed the idea of ACL biomechanical insertion reconstruction (BIR) and established a surgical model with oval femoral tunnel and rounded-rectangle tibial tunnel.


Subject(s)
Anterior Cruciate Ligament , Anterior Cruciate Ligament Reconstruction , Biomechanical Phenomena , Cadaver , Female , Finite Element Analysis , Humans , Knee Joint , Male , Tibia
20.
Article in Chinese | WPRIM | ID: wpr-816528

ABSTRACT

OBJECTIVE: To report the application of oncoplastic breast conserving surgery(OBCS) in China.METHODS: The survey was performed by using questionnaire in 110 breast surgery centers in China,whose annual breast cancer surgery volume over 200 in 2017.The surgery application situation and its relevant factors were analyzed.RESULTS: In2017,total 8443 cases of OBCS were performed in sample hospitals.OBCS occupied 9.8% of total breast cancer surgery and 43.4% of total breast conserving surgery(BCS).OBCS application showed extremely uneven among different hospitals.Both the number of hospitals whose OBCS/BCS>50% or <10% were 36(32.7%).Hospital's breast surgery volume had significant relevance with proportion of OBCS in BCS(P=0.006).The application rate of volume displacement was significantly higher than that of volume replacement(60.1% vs.15.2%,P<0.001).Geological distribution,GDP,hospital level or category showed no significant relevance with the OBCS application.CONCLUSION: The present scale of OBCS usage are uneven in China.Breast surgeons should receive more oncoplastic skills training,strengthen the concept of oncoplastic surgery and improve the multidisciplinary cooperation.

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