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Advances in the management of the surgical complications for congenital cataract

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《医学前沿（英文）》 2012年第6卷第4期页码 360-365 doi: 10.1007/s11684-012-0235-1

摘要：

The greatest concern in children with cataracts is irreversible visual loss. The timing of congenital cataract surgery is critical for the visual rehabilitation. Cataract surgery in children remains complex and challenging. The incidence of complications during or after operation is higher in children than adults. Some complications could be avoided by meticulous attention to surgical technique and postoperative care, and others were caused by more exuberant inflammatory response associated with surgery on an immature eye or the intrinsic eyes abnormalities. Utilizing of advanced techniques and timely applying topical corticosteroids and cycloplegic agents can reduce the occurrence of visual axis opacification. Operation on children with strabismus or nystagmus, and applying occlusion therapy on amblyopic eyes can balance the visual inputs to the two eyes. Diagnosis of glaucoma following congenital cataract surgery requires lifelong surveillance and continuous assessment of the problem. So cataract surgeries in children are not the end of journey, but one step on the long road to visual rehabilitation. This paper describes recent evidence from the literature regarding the advance of management after congenital cataract surgery.

关键词： cataract/congenital surgery cataract/complication

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Retrospective study of the efficacy and complication of thoracoabdominal incision for nephrectomy: a

Minggen YANG, Xiaokun ZHAO

《医学前沿（英文）》 2009年第3卷第2期页码 191-196 doi: 10.1007/s11684-009-0026-5

摘要： This retrospective study was performed to compare the outcome of thoracoabdominal incision flank incision for radical nephrectomy in the patients with large renal tumors. A questionnaire assessing postoperative pain, administration of pain medications and the return to activities and work was sent to the patients who undergoing radical nephrectomy through the 11th rib (group 1: underwent flank incision, including 96 patients) or the 9th to 10th rib (group 2: undergoing thoracoabdominal incision, including 98 patients) from 2003 to 2007 in our hospital. A case retrospective analysis assessing operation time, perioperative hemorrhage volume, size of tumor, success in the treatment of tumor thrombus in renal vein or vena cava, time length of presence of drainage tube, postoperative analgesia usage and length of stay was conducted in patients whose questionnaires were returned. A total of 56 patients (58%) in group 1 and 60 (61%) in group 2 responded to the questionnaire. Time lengths of operation and presence of abdominal drainage tube were shorter in group 2 than those in group 1. Perioperative hemorrhage volume in group 2 was obviously less than that in group 1. The mean size of tumors in group 1 was significantly smaller than that in group 2 ( < 0.0005). The success rate of treating thrombus in renal vein or vena cava in group 2 was significantly higher than that in group 1 ( <0.05). Lengths of off-bed time and stay were the same in both groups. There were no differences between groups in terms of pain severity on postoperative day 1, on day of discharge and 1 month postoperatively ( >0.05). There were no significant differences between groups in the time following surgery when pain completely disappeared, when pain medications were discontinued, and when the patient returned to daily activities and work ( >0.05). The thoracoabdominal incision provides excellent exposure and allows for early vascular control. Efficacy and complication was comparable for thoracoabdominal and flank incisions in terms of incisional pain, analgesic requirements after discharge and return to normal activities.

关键词： surgery renal tumors nephrectomy

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Effectiveness of quality of care for patients with type 2 diabetes in China: findings from the Shanghai Integration Model (SIM)

《医学前沿（英文）》 2022年第16卷第1期页码 126-138 doi: 10.1007/s11684-021-0897-7

摘要： This cross-sectional study aimed to investigate the quality of care of diabetes in Shanghai, China. A total of 173 235 patients with type 2 diabetes in 2017 were included in the analysis. Profiles of risk factors and intermediate outcomes were determined. The patients had a mean age of 66.43±8.12 (standard deviation (SD)) years and a mean diabetes duration of 7.95±5.53 (SD) years. The percentage of patients who achieved the target level for HbA_1c (<7.0%) was 48.6%. Patients who achieved the target levels for blood pressure (BP)<130/80 mmHg and low-density lipoprotein-cholesterol (LDL-c)<2.6 mmol/L reached 17.5% and 34.0%, respectively. A total of 3.8% achieved all three target levels, and the value increased to 6.8% with an adaptation of the BP target level (<140/90 mmHg) for those over 65 years. Multivariable analysis identified the factors associated with a great likelihood of achieving all three target levels: male, young age, short diabetes duration, low body mass index, macrovascular complications, no microvascular complications, prescribed with lipid-lowering medication, and no prescription of antihypertensive medication. In conclusion, nearly 50% and one-third of the patients with diabetes met the target levels for HbA_1c and LDL-c, respectively, with a low percentage achieving the BP target level. The percentage of patients who achieved all three target levels needs significant improvement.

关键词： type 2 diabetes quality of care macrovascular complication microvascular complication treatment pattern epidemiology

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重庆市男性绝育术后并发症市级鉴定情况分析

李川海,马明福,杨皓,周署平

《中国工程科学》 2014年第16卷第5期页码 110-112

摘要：

2012—2013年根据国家卫生和计划生育委员会发布的《计划生育手术并发症鉴定管理办法（试行）》和《计划生育手术并发症鉴定分级标准（试行）》，通过填写重庆市统一的计划生育手术并发症鉴定申请表，对重庆市部分区（县）进行了计划生育手术并发症鉴定，并对市级鉴定情况进行了探讨。结果表明：2012—2013 年申请男性绝育术后并发症市级鉴定的56 例中，符合男性绝育术后并发症的有10 例，占申请人数的25.2 %；自述症状中有25 例与男性绝育术后并发症无关，占44.64 %；符合男性绝育术后并发症的都是20 世纪90 年代以前进行的绝育术。因此，男性绝育术后并发症鉴定应严格执行鉴定标准，做到公平、公开、公正，应做好男性绝育术相关知识的宣传，加强对老年病科普知识的宣传，并加强计划生育技术服务队伍的建设。

关键词：男性绝育术并发症市级鉴定技术服务

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Diagnosis and management against the complications of human cystic echinococcosis

Hao WEN, Tuerganaili AJI, Ying-Mei SHAO,

《医学前沿（英文）》 2010年第4卷第4期页码 394-398 doi: 10.1007/s11684-010-0180-9

摘要： Cystic echinococcosis (CE) (hydatidosis, hydatid disease) is a zoonosis caused by the larval stage of , typically affecting the liver. Hepatic cystic echinococcosis (HCE) is often asymptomatic, and symptoms occur largely when complications develop. Up to one-third of HCE can be shown their complications such as rupture of the cyst, secondary infection, and anaphylactic reaction. Clinically, patients present with pain, obstructive jaundice, cholangitis, anaphylactic reaction, and shock. Early diagnosis and treatment of complications of CE must be very important, since mortality is high when obstruction of the biliary ducts occurs, leading to ascending cholangitis and septicemia, anaphylactic shock, or even life-threatening conditions.

关键词： cystic echinococcosis complication diagnosis treatment

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人流不全的临床特点分析及生育情况调查

罗岚蓉,李坚

《中国工程科学》 2015年第17卷第6期页码 70-76

摘要：

目的：分析人流不全的临床特点，探讨其发生的高危因素，同时调查患者术后的生育及避孕情况。方法：对首都医科大学附属北京妇产医院2007年10月—2012年10月收治的55例人流不全病历进行回顾性病例分析以及电话随访了解其生育情况及避孕情况。结果：人流不全的主要临床表现为人流术后的异常阴道出血42例（42/55，76.4 %）以及月经异常13例（13/55，23.6 %），超声检查可以发现人流不全造成的宫腔内异常，但需要结合人绒毛膜促性腺激素（HCG）水平的测定以及术后的病理来诊断人流不全。B超下的清宫手术能有效地清除残留的妊娠组织，术后均未再发现宫腔残留。人流不全的高危因素中主要的客观因素为子宫过度屈曲，占23.6 %（13/55），主要的主观因素为宫颈扩张不够，占25.5 %（14/55）。二次清宫术后主要并发症为宫腔粘连，发生率为5.5 %（3/55）。55例患者术后共随访到29例患者，有17例再次妊娠，其中11例妊娠分娩，6例选择人工流产终止妊娠，未发现人流不全二次清宫对生育的明显不良影响。无生育要求的妇女均有意识采取避孕方法来避免意外妊娠。结论：人流不全的主要临床表现为手术后异常的阴道出血，通过结合尿或血的HCG检查以及B超检查，可以及时地发现人流不全。超声指导下清宫是治疗的有效办法。人流不全发生的高危因素，主要客观因素为子宫过度屈曲，主要主观因素为宫颈扩张不够。对于存在高危因素的手术采取超声指示下手术，能够有效地降低人流不全的发生率。人流不全二次清宫术后主要手术并发症为宫腔粘连，无手术并发症发生的患者，未发现明显生育能力的受损。但是对于避孕方法的选择，还需要更多的计划生育服务来帮助她们采取高效的避孕方法。

关键词：人流不全并发症宫腔粘连生育避孕

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Comparing the effects of Bassini versus tension-free hernioplasty: 3 years’ follow-up

Yulong SHI, Zhongxue SU, Leping LI, Hongjun LIU, Changqing JING,

《医学前沿（英文）》 2010年第4卷第4期页码 463-468 doi: 10.1007/s11684-010-0050-5

摘要： In order to compare the effects of Bassini and tension-free mesh hernioplasty, a total of 552 patients with inguinal hernia who were subjected to surgical treatment in our hospital were randomly divided into the following two groups: the Bassini group (=269) and the tension-free mesh group (=283). The recurrence rates, pain, discomfort, and other complications were recorded, and the causes of the complications were explored. The recurrence rate in the Bassini group was 8.9% (24/269), significantly higher than that in the tension-free repair group (2.8%, 8/283). In addition, the recurrence rates in the Bassini and tension-free groups before 2004 were 12.6% and 5.6%, respectively, which were markedly higher than the rates after 2004 (5.3% and 0.7%, respectively). The rate of post-operative discomfort and pain within the first three months was higher in the Bassini group compared to the tension-free group (25.7% 18.5%, respectively). However, there was no difference after three months in the rate of post-operative discomfort and pain, incidence of infection, or scrotal edema between the two groups. The average hospital stay in the Bassini group was longer than that in the tension-free repair group (7.6€±€1.2 4.5€±€2.2 days, respectively), but the cost was lower (4518.0€±€510 6221.3€±€578 yuan, respectively). Thus, tension-free mesh hernioplasty is indicated for most inguinal hernia patients due to the low recurrence rate, rapid recovery time, and treatment success, but the traditional Bassini procedure has lower cost and other beneficial effects and is still suitable for some patients.

关键词： hernioplasty Bassini repair tension-free repair complication

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Role of stair-climbing test in predicting postoperative cardiopulmonary complications in elderly patients with biliary diseases

Pei-Tu REN BM, Bao-Chun LU MM, Zhi-Liang CHEN MM, Hong FU MM,

《医学前沿（英文）》 2010年第4卷第1期页码 77-81 doi: 10.1007/s11684-010-0005-x

摘要： One hundred and twenty-six patients above 80 years old with biliary diseases undergoing operations in Shaoxing People’s Hospital from Jan. 2002 to Jan. 2007 were analyzed retrospectively. All patients performed a preoperative stair-climbing test, and the risks for cardiopulmonary €complications were evaluated with pair-matching and linear correlations analysis between stair-climbing height (h) and left ventricular ejective factor (EF), forced vital capacity (FVC) and forced expiratory volume in one second (FEV). There was a significant difference in the incidence of cardiopulmonary complications among different stair-climbing heights. Stair-climbing heights were positively related with EF, FVC and FEV. This suggests that the stair-climbing test is an effective and simple method for predicting cardiopulmonary complications in elderly patients with biliary diseases.

关键词： biliary disease cardiopulmonary complication stair-climbing test