Quantitative grading evaluation of the therapeutic efficacy of asymmetric bilateral lateral rectus recession in type Ⅲ Duane retraction syndrome / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To quantitatively evaluate the therapeutic efficacy of the asymmetric recession of bilateral lateral rectus in patients with unilateral type III Duane retraction syndrome.METHOD:Retrospective analysis of clinical data. The clinical data of 12 cases of type III Duane retraction syndrome with unilateral lateral rectus recession were analyzed. All subjects had restricted internal rotation, with narrowing of the palpebral fissure and vertical deviation, and restricted external rotation with widening of the palpebral fissure. All patients had abnormal head positions. The degree of strabismus was measured while maintaining the head in a neutral position. Asymmetric recession of bilateral lateral rectus was selected based on the degree of strabismus of affected eye or 1～3mm longer, with a smaller recession and Y-splitting in the affected eye and a larger recession in the healthy eye.RESULT:The difference in the degree of strabismus in the healthy eyes before and after surgery was statistically significant(Z=-4.158, P<0.01), as was the difference in the degree of restricted internal rotation(Z=-2.640, P=0.008). The difference in the degree of restricted external rotation was not statistically significant(Z=-1.732, P=0.083). The difference in abnormal head position was statistically significant(Z=-4.181, P<0.01), while the difference in eyeball recession was not statistically significant(Z=-1.414, P=0.157). The difference in vertical deviation was statistically significant(Z=-3.115, P=0.002). A total of 10 patients(83%)had stereoscopic vision before surgery, and 11 patients(92%)had recovered stereoscopic vision after surgery, with a further improvement in stereoacuity in 50% of patients.CONCLUSION:Asymmetric recession of bilateral lateral rectus combined with Y-splitting of the affected lateral rectus can effectively improve the degree of strabismus, abnormal head position, vertical deviation and stereoacuity without aggravating the degree of restriction of external rotation or eyeball recession.

Discussion on the feasibility of data extraction from patient electronic medical record / 中华医院管理杂志

Patient diagnosis and treatment data are scattered in various clinical systems related to electronic medical records(EMR). The data can be better applied to the emergency prevention and control, medical research and government supervision only through unified integration. The authors analyzed the construction level of the EMR system in medical institutions, and sorted out the problems faced by directly extracting the diagnosis and treatment data of patients through the EMR system, including the lack of patient-centered integration of data, insufficient application depth of the EMR system, insufficient data standardization, lack of data and so on. Public health emergencies posed a severe challenge to the extraction of EMR data.For medical institutions with different information construction levels, the authors gave a feasibility analysis of data extraction by classification and time period, and suggested that medical institutions should fundamentally strengthen the understanding of information, establish data standard system and realize data integration and unified management.

Analysis of Grading Evaluation Standard of Ophiopogonis Radix from Sichuan Province / 中国实验方剂学杂志

Objective::To investigate the correlation between the characteristics and internal quality of Ophiopogonis Radix from Sichuan province through various quality evaluation, and provide reference for the formulation of grading standard of this herb. Method::For 28 batches of Ophiopogonis Radix, the characters, microscopic characteristics, thin-layer chromatography (TLC), the content of moisture, ash content, acid insoluble ash content, residues of sulfur dioxide, heavy metals, hazardous elements and paclobutrazol, water-soluble extract, contents of total saponins and three major components [ophiopogonin D (OPD), methylophiopogonanone A (MPOA) and methylophiopogonanone B (MPOB)] were determined.The relationships between various indicators and the grade of Ophiopogonis Radix were analyzed. Result::Ophiopogonis Radix exhibited specific properties in characters, microscopic characteristics and TLC.The contents of impurity, moisture, total ash, acid-insoluble ash and water-soluble extract existed differences in four grades of Ophiopogonis Radix from Sichuan province.For grade Ⅰ, grain number was 80-120 grains per 50 g, the moisture content was 11.1%-14.9%, total ash content was 1.6%-2.1%, acid-insoluble ash content was 0.03%-0.14%, water-soluble extract content was 77.0%-86.5%.For grade Ⅱ, grain number was 120-160 grains per 50 g, the moisture content was 13.1%-14.2%, total ash content was 1.3%-2.2%, acid-insoluble ash content was 0.06%-0.22%, water-soluble extract content was 75.9%-83.3%.For grade Ⅲ, grain number was 160-300 grains per 50 g, the impurity was 0.2%-8.4%, the moisture content was 12.6%-14.0%, total ash content was 1.2%-1.5%, acid-insoluble ash content was 0.06%-0.22%, water-soluble extract content was 74.0%-86.5%.For grade Ⅳ, grain number was 80-300 grains per 50 g, impurity was 1.2%-22.6%, the moisture content was 13.0%-15.4%, the total ash content was 1.4%-2.0%, acid-insoluble ash content was 0.03%-0.15%, water-soluble extract content was 79.8%-85.2%. Conclusion::It is reasonable and feasible to classify the grade of Ophiopogonis Radix from Sichuan province according to the appearance characteristics such as the grain number per 50 g and internal indexes such as impurity and water-soluble extract, which can be used as a reference for grading standards of Ophiopogonis Radix from Sichuan province.