ABSTRACT
AIM: To analyze the clinical characteristics of acute acquired concomitant esotropia(AACE)in patients among different age groups.METHODS: Retrospective analysis of clinical data. A total of 112 non-Swan type AACE patients who underwent surgery at Peking University People's Hospital from January 2015 to December 2022 were retrospectively analyzed. Clinical data were collected and the characteristics were compared, including gender, age, diopter, duration of disease, daily time spent on near work, angles of deviation before and after surgery, stereopsis, etc. According to age, patients were divided into three groups: <18 years old group(22 cases), 18-45 years old group(67 cases), and >45 years old group(23 cases). The clinical characteristics of patients were compared in each group.RESULTS: A total of 112 patients were included in the study, comprising 56 males and 56 females, with a median age of 29.50(19.25, 41.75)years old. Among them, 97 patients had myopia(86.6%). There were 93 patients(83.0%)who spent more than 8 h on near work. The age group <18 years old had the shortest duration before surgery, with a median time of 1.00(0.50, 1.00)a, the minimum negative diopter, with a median diopter of -0.75(-3.19, -0.56)D in the right eye and the diopter of -1.25(-2.81, -0.75)D in the left eye, and the maximum preoperative near angle of deviation, with a median angle of 30.00(18.50, 80.00)PD, and the maximum preoperative distant angle of deviation, with a median angle of 35.00(23.75, 80.00)PD. All these differences were statistically significant compared with other two groups(both P<0.05). For the age group from 18 to 45 years old, the median near angle of deviation was 20.00(14.00, 30.00)PD, and the median distant angle of deviation was 25.00(20.00, 35.00)PD, both of which were higher than those in the age group >45 years old(both P<0.05). For the age group >45 years old, the median near angle of deviation after surgery was -4.50(-7.50, 0)PD, and the median distant angle of deviation after surgery was 4.50(0, 9.50)PD, which were smaller than those in other two groups(all P<0.05). The age group >45 years old had the hiughest surgical success rate(100%). The preoperative stereopsis was better in age group >45 years old than the group <18 years old(P<0.05). The postoperative stereopsis of the age group of 18 to 45 years old and the age group >45 years old was better than age group <18 years old(both P<0.05).CONCLUSION: Surgical patients with AACE are mainly in the age group from 18 to 45 years old. The characteristic of angle of deviation is that distant angle of deviation is greater than near angle of deviation. The patients <18 years old have larger preoperative angles of deviation than adults, while their stereoacuity is worse than adults in the early postoperative period. It is recommended that augmented-dose surgery should be performed in AACE patients who are in the age group of 18 to 45 years old(5-10 PD). A conservative surgery should be designed for hyperopia young children without established binocular vision.
ABSTRACT
Purpose: This study aimed to investigate the effect of virtual reality (VR) technology in children after surgery for concomitant strabismus. Methods: A total of 200 children with concomitant exotropia or concomitant esotropia were randomly divided into a training group and a control group according to the single even number random method (100 cases in each group). Patients in the training group received VR intervention training within 1 week after surgery. Patients in the control group did not receive any training. Results: Six months after the surgery, the orthophoria (the far or near strabismus degree was ?8?) rate was significantly higher in the training group than in the control group (P = 0.001), while the eye position regression rate (compared to the strabismus degree within 1 week after the surgery, the amount of regression >10?) was significantly lower in the training group than in the control group (P = 0.001). Six months after the surgery, the number of children with simultaneous vision and remote stereovision was significantly higher in the training group than in the control group (P = 0.017 and 0.002, respectively). The differences in the number of patients with peripheral stereopsis, macular stereopsis, and stereopsis in macular fovea centralis at 1, 3, and 6 months after the surgery between the training and the control groups were not statistically significant (P = 0.916, 0.274, and 0.302, respectively). Conclusion: The intervention of VR technology after strabismus correction effectively improved children’s visual function and maintained their eye position
ABSTRACT
Objective:To explore the differences on clinical characteristics, concomitant diseases and treatment status between psoriasis and psoriatic arthritis (PsA), and provide clues for the early diagnosis and treatment of PsA.Methods:Data were collected by in-person interview of 225 patients with psoriasis and 299 patients with PSA who visited the department of rheumatology and Immunology and Department of Dermatology in People′s Hospital of Peking University from November 2020 to May 2021. After informed consent, the questionnaire was completed on site. The differences of clinical characteristics, concomitant diseases, mental health evaluation and treatment status between patients with arthritis (PsA) and patients with psoriasiswere analyzed and compared. Enumeration data were described by frequency. Chi square test was used to compare categorical variables. Multivariate Logistic regression analysis was used to determine the independent risk factors. P value of less than 0.05 was considered statistically significant. Results:Dactylitis [ OR(95% CI)=8.439(4.677,15.226), P<0.001], hip pain [ OR(95% CI)=3.442(1.829,6.480), P<0.001], heel pain [ OR(95% CI)=2.621(1.652,4.157), P<0.001] and low back pain [ OR(95% CI)=1.924(1.156,3.203), P=0.012] may be closely related to the progression of PsA ( P<0.05). The three most common concomitant diseases of patients with PsA and psoriasis both were overweight [43.1%(129/299)、29.3%(66/225)], fatty liver [(28.4%(85/299)、23.1%(52/225)]and hypertension[24.1%(72/299、13.3%(30/225)]. The proportion of osteoporosis in PsA group at the age of 30-39 and 40-49 years old was significantly higher than those in psoriasis group (30-39 years old:12.5%(10/80) vs 1.5%(1/65), χ2=6.14, P=0.013; 40~49 years old: 19.2%(15/78) vs 2.0%(1/51), χ2=8.46, P=0.004]. The proportion of hypertension in PsA group was also higher than that in psoriasis group at the age of 40~49 years old[7.0% (21/78) vs 2.7%(6/51), χ2=4.99, P=0.026)]. And the proportion of fatty liver in PsA group was also higher than that in psoriasis group at the age ≥60 years old [(46.0%(23/50) vs 29.1(7/24), χ2=4.99, P=0.025)]. Among 299 PsA patients, 47.1%(141/299) had anxiety tendency, 45.2%(135/299) had sleep disorder and 41.8%(125/299) had depression tendency. Among 225 psoriasis patients, 44.4%(100/225) had anxiety tendency, 40%(90/225) had sleep disorder and 36.9%(83/225) had depression tendency, there was no significant difference in above-mentioned situations between the PsA and psoriasis patients ( P>0.05). Conclusion:More attention should be paid to the management of concomitant diseases and psychological intervention in patients with PsA. When psoriasis patients occur with heel pain, dactylitis, low back pain and hip pain, the risk of development into PsA should be considered.
ABSTRACT
The prevalence of seasonal allergic rhinitis (hereinafter “hay fever”) is increasing annually. While self-medication with over-the-counter (OTC) drugs is growing, some hay fever patients also use OTC drugs alongside medical visits. Issues arising from co-administration, such as excessive dosing and reduced quality of life (QOL) due to drowsiness, have been highlighted. However, no research has investigated the factors contributing to the concomitant use of prescribed and OTC drugs. Therefore, this study examined the following three patient groups: those using only prescribed drugs, those using only OTC drugs, and those using a combination of both. Initial analyses compared adherence, overuse extent, QOL (as measured by the Japanese Rhino-conjunctivitis Quality of Life Questionnaire [JRQLQ]), treatment satisfaction, lifestyle habits, and health literacy (as measured by the Communicative and Critical Health Literacy Scale [CCHL]) among the groups. Subsequently, a multinomial logistic regression analysis focusing on combination users identified factors associated with co-administration. The results revealed that combination users exhibited lifestyle issues and lower QOL compared to those using prescribed or OTC drugs only, although differences in CCHL were not significant. Furthermore, co-administration was linked to social life-related JRQLQ and excessive usage during symptom onset. In conclusion, patients with hay fever should avoid the concurrent use of prescribed and OTC drugs. Co-administration may not necessarily improve symptoms and might even lead to overuse risks. Thus, patients should be guided to consult medical professionals before purchasing OTC drugs, and lifestyle improvements should be emphasized as well.
ABSTRACT
【Objective】 To explore the clinical characteristics and risk factors of renal function deterioration in children with renal dysplasia and chronic kidney disease (CKD), so as to provide a basis for the diagnosis, treatment, and management. 【Methods】 The clinical data of children with renal dysplasia complicated with CKD treated in the Children’s Hospital of Chongqing Medical University during 2012 and 2022 were retrospectively analyzed, including the gender, age of diagnosis, growth index, concomitant malformation and complications. According to the diagnostic criteria and staging standard of KDIGO2020 guidelines, patients with disease deteriorated to CKD stage 4-5 were enrolled into the regression group. Factors affecting the deterioration of renal function were determined with Cox regression analysis. 【Results】 A total of 122 children were involved, including 66 (54.1%) with CKD stag 4-5. There were more boys than girls. Bilateral and unilateral renal dysplasia occurred in 88 (72.13%) and 34 (27.87%) cases, respectively, and 64 (52.46%) cases were complicated with other urinary diseases. There were significant differences in weight, height and body mass index (BMI) among patients with CKD stage 1-5 (P<0.01). The age of onset of CKD <10 years, BMI lower than the 3rd percentile of the same sex and age, bilateral renal dysplasia, and one or more complications of congenital renal and urinary tract abnormalities (CAKUT) were the risk factors of deterioration of renal function (P<0.05). 【Conclusion】 Renal dysplasia complicated with CKD are more common in boys, with high incidence of bilateral renal dysplasia. Bilateral renal dysplasia, age of onset of CKD <10 years, BMI lower than 3% and complications are important influencing factors of renal dysplasia in children with CKD.
ABSTRACT
@#Objective To investigate the effect of concomitant tricuspid valve repair during mitral valve surgery on the early and mid-term prognosis of the tricuspid valve and right heart function in the patients with moderate or less tricuspid regurgitation. Methods A retrospective study of 461 patients with mitral valve disease requiring cardiac surgery combined with moderate or less tricuspid regurgitation in our hospital from 2011 to 2014 was done. They were 309 males and 152 females with a median age of 53.00 (44.00, 60.00) years. According to whether they received tricuspid valve repair (Kay’s annuloplasty, DeVega’s annuloplasty or annular ring implantation), the patients were divided into a mitral valve surgery only group (a nTAP group, n=289) and a concomitant tricuspid valve repair group (a TAP group, n=172). At the same time, 43 patients whose tricuspid valve annulus diameter was less than 40 mm in the TAP group were analyzed in subgroups. Results The median follow-up duration was 3.00 years (range from 0.10 to 9.30 years). There was no perioperative death. Three months after surgery, the anteroposterior diameter of the right ventricle in the TAP group was significantly improved compared with that in the nTAP group [–1.00 (–3.00, 1.00) mm vs. 0.00 (–0.20, 2.00) mm, P=0.048]. Three years after surgery, the improvement of right ventricular anteroposterior diameter in the TAP group was still significant compared with the nTAP group [–1.00 (–2.75, 2.00) mm vs. 2.00 (–0.75, 4.00) mm, P=0.014], and the patients in the TAP group were less likely to develop moderate or more tricuspid regurgitation (3.64% vs. 35.64%, P<0.001). Annuloplasty ring implantation was more effective in preventing regurgitation progression (P=0.044). For patients with a tricuspid annulus diameter less than 40 mm, concomitant tricuspid valve repair was still effective in improving the anteroposterior diameter of the right ventricle in the early follow-up (P=0.036). Conclusion Concomitant tricuspid valve repair for patients with moderate or less tricuspid regurgitation during mitral valve surgery can effectively improve the tricuspid valve and right heart function in the early and mid-term after surgery. Annuloplasty ring implantation is more effective in preventing regurgitation progression. Patients whose tricuspid annulus diameter is less than 40 mm can also benefit from concomitant tricuspid repair.
ABSTRACT
AIM: To analyze the clinical characteristics and treatment of patients with acute acquired concomitant esotropia(AACE)in different refractive status.METHODS: A retrospective analysis was conducted on 110 patients with non-type I AACE treated from January 2020 to January 2022. The non-myopic group(30 cases, spherical equivalent>-0.5D)and the myopic group(80 cases, spherical equivalent≤-0.5D)were divided according to the refractive status. The degree of deviation, accommodative convergence and accommodation ratio(AC/A), visual function, and surgical methods were observed. RESULTS: The non-myopic group had no difference in the degree of near deviation [(47.13±23.54)△] and the degree of distant deviation [(48.90±22.59)△](P>0.05); near deviation [(40.49±26.09)△] of myopic group was less than distant deviation [(50.09±25.41)△](P<0.001); and there was no difference in the same distance between the two groups(P>0.05). AC/A in the non-myopic group(5.40±2.23)was higher than that in the myopic group(3.14±3.10; P<0.05). Patients in the myopic group had better near stereopsis than the non-myopic group(P<0.05). The non-myopic group had a variety of surgical methods, while the myopic group mostly used lateral rectus resection or/and medial rectus recession.CONCLUSION: AACE can occur in different refractive status. Non-myopic patients have the same degree of distant and near strabismus, high AC/A, and varied surgical methods. However, myopic patients have less degree of near deviation than distant deviation and have normal AC/A and better near stereopsis, and lateral rectus resection or/and medial rectus recession are commonly used.
ABSTRACT
AIM: To investigate the differences in squint angle measured by right angle prism and isosceles angle prism.METHODS: Case control study. A total of 176 cases of concomitant strabismus admitted to our hospital from June 2021 to April 2022 were selected, among which 79 cases were concomitant esotropia and 97 cases were concomitant exotropia. The squint angle of all patients was measured respectively by alternating cover right angle prism and isosceles angle prism.RESULT: For patients with concomitant esotropia, the right angle prism degree was 49.167△±13.573△ and the isosceles angle prism degree was 38.250△±10.756△ (P<0.01), with a difference of 10.917△±3.752△; the measurement of right angle prism converted to circular degree was 19.096°±2.456°, and the isosceles angle prism value was 20.847°±5.364°(P<0.05), with a difference of 2.443°±2.702°. For patients with concomitant exotropia, the right angle prism degree was 51.875△±13.567△, and the isosceles angle prism degree was 40.492△±11.753△ (P<0.01), with a difference of 11.383△±4.783△; the measurement of right angle prism converted to circular degree was 19.589°±2.521°, and the isosceles angle prism value was 21.947°±5.864°(P<0.01), with a difference of 3.200°±3.077°. There was no significant statistical difference in the differences of the two prism degree and the circular degree for concomitant esotropia and concomitant exotropia(P>0.05).CONCLUSIONS: The squint angle measured by different shaped prisms is different. The degree measured by right angle prism is larger than that by isosceles angle prism.
ABSTRACT
AIM: To analyze the strabismus surgery situation of adolescents and children in Yunnan province.METHODS: A retrospective analysis was conducted on medical records data of 3 068 adolescents and children who received strabismus surgery at Affiliated Hospital of Yunnan University from January 2017 to December 2021. The analysis included gender, constituent ratio of age, distribution of strabismus types and combination with other ocular diseases, etc.RESULTS: Among the included patients, 52.12% were males, and 47.88% were females. Preschool patients(1 to 6 years old)accounted for 32.89%, primary pupils(7 to 12 years old)accounted for 45.89% and high school students(13 to 18 years old)accounted for 21.22%. Exotropia accounted for 63.17% of the total strabismus, of which intermittent exotropia was the most common type. Esotropia accounted for 19.69%, and concomitant esotropia was the most common type. The special type of strabismus accounted for 17.14%, and A-V syndrome and dissociative vertical deviation(DVD)were the most common types. Strabismus combined with ametropia accounted for 61.02% and amblyopia accounted for 10.89%. A few patients also combined with other eye diseases.CONCLUSION: In Yunnan province, intermittent exotropia was the most common type of strabismus among adolescents and children. Some patients combined with other ocular diseases.
ABSTRACT
El trauma maxilofacial es un problema de salud pública, comúnmente asociado a traumatismo dentoalveolar. Su prevalencia es alta, siendo más frecuente en poblaciones de riesgo, como personal de Fuerzas Armadas, esto por sus actividades laborales, generando gran impacto en el paciente. Caracterizar, según la literatura, el traumatismo dentoalveolar concomitante a trauma maxilofacial en el personal profesional de Fuerzas Armadas. Se realizó una revisión narrativa en cuatro bases de datos, en octubre del 2020. Se incluyeron publicaciones de máximo 5 años de antigüedad, en inglés o español, con resumen disponible, estudios primarios y revisiones sistemáticas. Se excluyó publicaciones no disponibles en texto completo y reportes de casos. Se incluyeron 15 artículos. Existe un déficit de evidencia sobre la asociación que existe entre traumatismo dentoalveolar y traumatismo maxilofacial en la población estudiada. Encontrándose que solo el 6,7 % de estos incluía en su análisis la concomitancia entre ambos tipos de traumas. Sin embargo, los diagnósticos más prevalentes consistieron en fracturas coronarias y mandibulares, respectivamente, asociadas a actividades de entrenamiento y combate. Se establece que el tipo de trauma maxilofacial más frecuente en la población profesional de Fuerzas Armadas es la fractura mandibular y en relación al traumatismo dentoalveolar, la fractura coronaria. En cuanto a la etiología, destacan las heridas de bala, explosivos y accidentes en vehículos, afectando principalmente a personal del Ejército entre 18 a 30 años. Es importante mencionar que los artículos incluidos en esta revisión que hacen referencia a la concomitancia entre el traumatismo dentoalveolar y maxilofacial son escasos y no se encuentran actualizados, por lo que, se necesita continuar investigando en esta temática.
The maxillofacial injuries are a public health issue commonly associated to dentoalveolar injuries. Its high prevalence in risk population such as the Armed Forces personnel, due to their work activities, generates a great impact on the patient. Characterize, according to the literature, dentoalveolar injuries within the maxillofacial injuries in professional Armed Forces personnel. A narrative research was conducted on October 2020 with four data bases. Only 5-year-old publications were considered both in English and Spanish, including their available summary, primary studies and systematic revisions. Publications without full access or report cases were not included. Fifteen scientific papers were included. There is a deficit of evidence between maxillofacial and dentoalveolar injuries in the target population. Only 6.7 % of the research included a joint analysis between both traumas, however the most prevalent diagnosis consisted in coronaries and mandibular fractures, in that order, associated mainly to training and combat activities. The most frequent maxillofacial injury within the Armed Forces personnel is the mandibular fracture, and in relation with dentoalveolar injuries is the coronary fracture. Regarding the etiology, gunshot wounds, explosives and car accidents are featured affecting mainly between 18 to 30 years old army personnel. It's relevant to highlight that the scientific papers included in this revision about the association between dentoalveolar and maxillofacial injuries are poor and not updated. Further research is needed in this issue.
ABSTRACT
Purpose: To investigate the risk factors and surgical design for type III acute acquired concomitant esotropia (AACE). Methods: In this retrospective, matched, case–control study, 51 patients developed type III AACE between March 2018 and September 2020, and the control group consisted of 60 patients matched by age and refractive power during the same period. A history of the duration of near work per day and the use of glasses were reviewed, and the refractive power of both eyes, deviation angles at both near and far vision, visual function, and treatment options were analyzed. Additionally, the distance from medial rectus insertion to the limbus was measured in surgical patients. The data were analyzed by logistic regression analysis. Results: We found that 99.96% of the patients and 91.67% of the controls had myopia. Of these, 60.8% and 20.0%, respectively, did not wear glasses for near work. Twelve patients were treated with a prism and 39 were treated surgically. The average time devoted to near work per day was 7.24 and 3.7 h by the patients and controls, respectively. Univariate logistic regression analysis showed that increased hours of near work per day and near work without the use of spectacles were associated with the incidence of type III AACE. Multiple logistic regression analysis revealed that increased hours of near work per day and near work without the use of glasses were independent risk factors for AACE. Conclusion: Increased hours of near work per day and uncorrected myopia in near work are independent risk factors for type III AACE
ABSTRACT
Purpose: The aim of this study was to evaluate the outcomes of a simplified, fixed surgical dosage calculation for uncomplicated, horizontal, concomitant strabismus in adults. Methods: Outcomes analysis of a fixed?dose calculation method for uncomplicated, horizontal, concomitant strabismus in adults (?18 years) wherein 1?mm recession/resection equals 2 PD for lateral rectus and 3 PD for medial rectus. This was a retrospective case series. Results: The mean age of the patients was 28.50 � 8.43 years, the mean amount of preoperative deviation was 35.16 � 9.97 PD, the mean expected correction was 36.26 � 9.49 PD, and the mean correction achieved was 35.92 � 10.74 PD. There were 22 monocular exotropias, six monocular esotropias, eight alternate divergent squints, and two alternate convergent squints. There were 20 cases of sensory strabismus (54.28%). There was no statistically significant difference between the expected correction and correction achieved (P = 0.519), meaning that our fixed?dose calculation method was effective. Thirty?five out of 38 patients had successful outcomes as per our criteria of less than 10?PD deviations from straight in primary position. Therefore, the success rate achieved by this procedure was 92.10%. There was no statistically significant correlation between age and the amount of deviation (P = 0.611). Conclusion: Our case series had a high postoperative success rate in terms of motor alignment. It is hoped that this simplified, fixed?dosage calculation method would help the numerous novice strabismus surgeons, make their starting steps easier and give them the confidence to do strabismus surgeries. They can modify the dosages later as per their own experiences
ABSTRACT
Resumen Antecedentes: La hidradenitis supurativa (HS) es una enfermedad inflamatoria crónica de la piel. Se relaciona con diferentes factores que podrían incrementar la severidad, pero algunos son poco conocidos o controvertidos. Dado su alto impacto social, deterioro de la calidad de vida y falta de estudios epidemiológicos en Colombia, decidimos describir las variables relacionadas en pacientes con HS atendidos en un centro dermatológico colombiano. Métodos: Se realizó un estudio descriptivo y retrospectivo en un centro dermatológico de Bogotá. Los datos se obtuvieron de los registros médicos de enero de 2016 a diciembre de 2019. Analizamos edad, sexo, índice de masa corporal (IMC), hipertensión, relación premensual, antecedentes familiares de HS, presencia de acné, severidad y ubicación de las lesiones. Resultados: De 24 pacientes, 18 eran mujeres. La mediana de edad fue de 30 años. La mediana del IMC fue de 22,8 Kg / m². El 25% de los casos eran fumadores, el 12,5% tenía hipertensión arterial, el 25% tenía antecedentes familiares de HS, el 20,8% coexistió con acné. Además, el 38,9% de las mujeres informaron un empeoramiento de la sintomatología de la HS en el período premenstrual. La localización más común fue la axila (58,3%). El estadio I de Hurley fue el más frecuente (41,7%). Conclusiones: Este es el primer estudio epidemiológico en Colombia y uno de los pocos publicados en Latinoamérica. Estamos ante una enfermedad crónica con un diagnóstico frecuentemente retrasado, de difícil tratamiento y que afecta la calidad de vida. Es importante hacer una intervención temprana para mejorar el pronóstico. Finalmente se necesitan más estudios sobre las principales características de la HS.
Abstract Background: Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease. It is related to different factors that could increase the severity, but some are not well known or are controversial. Given its high social impact and quality of life impairment and the lack of epidemiological studies in Colombia, we described disease variables in patients with HS treated at a colombian dermatological center. Methods: A descriptive and retrospective study was carried out in a dermatological center in Bogota. Data were collected from medical records from January 2016 to December 2019. We analyzed age, sex, boy mass index (BMI), hypertension, pre-monthly relationship, family history of HS, acne presence, severity and lesion locations. Results: Of 24 patients, 18 were women. The median age was 30 years . The BMI median was 22,8 Kg/m². The 25% of cases were smoker, 12,5% had arterial hypertension, 25% had family history of HS, 20.8% had coexistence with acne. Also, 38.9% of women reported worsening symptomatology of HS in the premenstrual period. The most common location was the armpit (58.3%). Hurley stage I was the most frequent (41.7%). Conclusions: This is the first epidemiological study in Colombia and one of the few published in Latinamerica. We are facing a chronic disease with a frequently delayed diagnosis, which is difficult to treat and affects quality of life. Is important to do an early intervention to improve the prognosis. Further studies are needed about HS main characteristics.
ABSTRACT
Metabolic-dysfunction associated fatty liver disease (MAFLD) is a common concomitant disease of breast cancer. It is one of the main causes of liver damage during chemotherapy and also an important cause of liver damage during endocrine therapy or follow-up, which seriously affects the quality of life and prognosis of breast cancer patients. Nonalcoholic fatty liver disease was renamed as MAFLD, which changed the original "exclusive diagnosis" to "inclusive diagnosis" and the non-negligible role of metabolic factors in the occurrence and development of fatty liver disease was recognized, but the clinical attention is not enough at present. More attention should be paid to the diagnosis and treatment of MAFLD in breast cancer patients because the proportion and risk of metabolic disorders are higher than that in general people. In this article, we will focus on the clinical significance, prevention and treatment of the new definition of MAFLD in the comprehensive management of concomitant diseases of breast cancer, so as to further improve the quality of life and prognosis of breast cancer patients.
ABSTRACT
AIM: To explore the curative effect of modified Parks incision combined with rectus linear tucking on adults with concomitant strabismus and its influences on postoperative recovery of visual function and ocular aesthetics.METHODS: A total of 160 adults with concomitant strabismus were enrolled as the research subjects between June 2019 and June 2021. They were divided into observation group(modified Parks incision combined with rectus linear tucking, 89 cases)and control group(corneal limbal trapezoid conjunctival flap incision combined with rectus linear tucking, 71 cases)according to different surgical methods. The clinical curative effect and surgical related indexes between the two groups were compared. The changes in scores of corneal fluorescence staining, standard patient of eye dryness(SPEED), visual analogue scale(VAS)and Vancouver scar scale(VSS)before and after surgery in both groups were observed. The occurrence of complications such as poor conjunctival healing and astigmatism was statistically analyzed at 1mo after surgery.RESULTS: The total response rate of surgery in observation group was higher than that in control group, and length of surgical incision was shorter than that in control group(all P<0.05). The scores of postoperative corneal fluorescence staining and dry eye in observation group were lower than those in control group, and VAS scores at 1wk after surgery were lower than that in control group(all P<0.05). Postoperative divergent fusion range, strabismus angles of short-sighted 33cm and far-sighted 5m in observation group were greater than those in control group. Convergent fusion range was smaller than that in control group, and stereopsis of short-sighted 33cm and far-sighted 5m was lower than that in control group(all P<0.05). Postoperative break-up time in observation group was longer than that in control group, lacrimal secretion was more than that in control group, and scores of corneal surface regularity index(SRI)and VSS scores were lower than those in control group(all P<0.05). The total incidence of complications in observation group was lower than that in control group(P<0.05).CONCLUSION: The modified Parks incision combined with rectus linear tucking can not only improve surgical effect and promote the recovery of visual function and tear film function in adults with concomitant strabismus, but also relieve dry eye and postoperative pain, improve ocular aesthetics and reduce the incidence of postoperative complications.
ABSTRACT
@#Reconstruction of chronic boutonniere deformity remains to be a challenging procedure especially when combined with other debilitating injuries in the same extremity. The balance to properly tension the reconstruction with active motion is often prevented by the need to perform the procedure under sedation of block to tolerate the use of tourniquet. We present a case of a young patient who successfully underwent restoration of active proximal interphalangeal (PIP) extension with a Palmaris longus graft while wide awake under local anesthesia and no tourniquet (WALANT) before subsequently having nerve transfers for upper type brachial plexus injury.
ABSTRACT
Aim To explore the cytotoxic and synergistic effects of decitabine and ruxolitinib on HEL cells with TET2 knockdown. Methods Stable TET2 knockdown by shRNA was established in HEL cell line. The change of cell proliferation was measured by CCK-8 assay. The median lethal dose (IC50) and colony formation assay were used to evaluate the cytotoxic effects of decitabine and ruxolitinib, the synergistic effects of which was further analyzed by Chou-Talalay method. Results The inhibition of TET2 increased the proliferative capacity of HEL cells. HEL cell lines became resistant to decitabine following shRNA-media- ted TET2 inactivation. Colony formation assay showed that the drug sensitivity of decitabine and ruxolitinib both decreased in TET2 knockdown HEL cells. The synergistic inhibitory effects of ruxolitinib and decitabine on TET2 knockdown HEL cells were observed. Conclusion The combination of ruxolitinib and decitabine may be an effective therapeutic strategy for accelerated or blast phase MPN patients with JAK2V6m and TET2 mutations.
ABSTRACT
Objective To explore the outcomes in patients who receive the endovascular abdominal aortic aneurysm repair(EVAR)and have concomitant intra-abdominal malignancy.Methods Between January 2014 and December 2019,all the patients who underwent surgery for malignancy and/or EVAR were retrospectively reviewed.Results Twenty-eight abdominal aortic aneurysm(AAA)patients with concomitant intra-abdominal malignancy were included.The patients were treated by two-stage operation and the priority was given for EVAR in 21 patients.There was no perioperative death or major complications.In the follow-up,one patient developed graft thrombosis and one had type Ⅱ endoleak.There was no AAA-associated death.Conclusions It is preferred that EVAR should come first followed by operation for malignancy.Details of treatment strategy still need further investigation.
Subject(s)
Humans , Abdominal Neoplasms/surgery , Aortic Aneurysm, Abdominal/surgery , Blood Vessel Prosthesis Implantation , Endovascular Procedures , Retrospective Studies , Risk Factors , Treatment OutcomeABSTRACT
Context: Better locoregional control and increased overall survival by continuous hyper fractionated accelerated radiotherapy have been shown in unresectable nonsmall cell lung carcinoma (NSCLC). Dose escalation and neoadjuvant chemotherapy (NACT) along with continuous hyperfractionated accelerated radiotherapy week end-less (CHARTWEL) were also tried for improved survival. In this present study, we compared the results of NACT followed by CHARTWEL against NACT followed by conventional concurrent chemo-radiation therapy. Aims: The aim of this study is to compare the locoregional control and toxicities in NSCLC Stage IIIA and B in both arms. Settings and Design: Randomized, prospective single-institutional study with a study population comprising all locally advanced unresectable NSCLC patients enrolled in 2014 at our institute. Subjects and Methods: All enrolled patients were randomized into two arms-CHARTWEL and concomitant chemo-radiotherapy (CCRT), after three weeks of the fourth cycle of NACT. In CHARTWEL arm 30 patients received two-dimensional radiotherapy (RT) 58.5 Gy/39 fr/2.5 weeks while in CCRT arm 30 received 66 Gy/33 fr/6.5 weeks. Disease response was evaluated at 6 months and toxicity assessment during and after treatment completion. Data were analyzed using tools such as percentage, mean, Chi-square test and P value. Chi-square and P value was calculated by statistical online software (http://quantpsy.org). Results: 28% of patients in study arm and 20% in control arm had complete response at 6 months after RT. Locoregional disease control was observed in 44% in study arm and 32% in control arm of patients. There was no statistical difference in grades of toxicities or overall survival (OS)/disease-free survival except persistent esophagitis Grade III seen in two patients of study arm. Conclusions: Study suggests that CHARTWEL in combination with NACT is an effective strategy to treat patients with locally advanced lung cancer with the advantage of a smaller dose and shorter duration. Although large multivariate studies still needed