目的:通过病例复查,找出前牙桩冠修复工作中的问题及不足,使前牙桩冠修复技术更加完善。方法:收集临床病例进行有关项目复查。结果:成品桩钉和铸造桩核固位效果无差异,烤瓷冠满意度100％。塑料冠外观差,对龈组织刺激性大,远期效果不理想。结论: 桩核的类型不影响桩冠的固位,金属烤瓷冠是前牙桩冠理想的修复材料。
ObjectiveTo evaluate the prognostic significance of metastatic lymph nodes ratio (MLNR) in patients with node-positive breast cancer. MethodsThe clinical data of 94 patients with nodepositive breast cancer underwent modified radical mastectomy were retrospectively analyzed. The survival rate and prognosis factors of patients with complete follow-up data were assessed by log-rank test and multivariate regression analysis. Results The survival time of 94 patients ranged from 12-75 months, with median 64 months. The 5-year overall survival rate was 72.34% (68/94). The total MLNR was 0.31 (486/1 553). Univariate analysis demonstrated that the survival was influenced significantly by tumor size, number of lymph node metastasis, MLNR, ER status, and radiotherapy or not (Plt;0.05), but not by patient’s age, menopause or not, PR status, endocrine therapy or not, and histological type (Pgt;0.05). Multivariate analysis showed that MLNR (OR=2.565, 95%CI=1.043-6.309， P=0.040) and tumor size (OR=2.220, 95%CI=1.045-4.716， P=0.038) were independent prognostic factors for the patients with node-positive breast cancer. Conclusion MLNR is a major independent prognostic factor for the patients with node-positive breast cancer, which is more accurate than the number of metastatic lymph nodes in predicting the survival of patients with node-positive breast cancer.
ObjectiveTo study related factors for urinary and fecal incontinence in post-stroke patients, in order to present targeted treatment and effective care. MethodsWith continuous sampling methods, we prospectively evaluated 257 stroke patients admitted to our hospital from August 2010 to October 2012, and had the clinical features form completely filled. All statistical analysis was performed using SPSS 19.0. ResultsUrinary and fecal incontinence rate was 16.7%. Univariate analysis showed that the related factors for the incidence of urinary and fecal incontinence in post-stroke patients included the onset of disturbance of consciousness, disability to sit up or stand two hours after the onset, being complicated with pulmonary infection or ventricular dysfunction, complications, and constipation. A multivariate analysis identified three factors to be independently associated with urinary and fecal incontinence in post-stroke patients, including disturbance of consciousness[OR=4.186, 95%CI (2.010, 8.715), P<0.001], being complicated with pulmonary infection[OR=3.490, 95%CI (1.616, 7.539), P=0.001] and age[OR=1.036, 95%CI (1.004, 1.069), P=0.029]. ConclusionPost-stroke patients are most likely to develop urinary and fecal incontinence, and disturbance of consciousness, being complicated with pulmonary infection and age are three independent factors.
ObjectiveTo observe the prevalence of fundus tessellation in college students with high myopia and analyze the relationship of fundus tessellation and ocular biological parameters.MethodsA cross-sectional study. A total of 202 eyes of 161 individuals were included in the study. Among them, there were 49 males and 112 females with the average age of 19.73 ± 1.12 years old, and the average spherical equivalent of －7.39 ± 1.12 D. All participants underwent computer optometry, non-mydriatic fundus photography, OCT, OCT angiography (OCTA) examination and axial length (AL) measurement. The non-mydriatic fundus camera was used to take the photo of fundus. Fundus tessellation was differentiated to no leopard eye fundus (grade 0), mild leopard eye fundus (grade 1) and middle leopard eye fundus (grade 2) and for severe leopard eye fundus (grade 3). The lenstar was used for eye axis measurement. The choroid, retinal thickness and microvessel density of the macular fovea at the posterior pole of the fundus were measured using a swept-frequency source optical coherence tomography scanner. According to the ETDRS, the choroid within 6 mm of the fovea was divided into 3 concentric circles centered on the macula, which were the central area with a diameter of 1 mm, the inner ring area of 1-3 mm and the outer ring area of 3-6 mm. The outer ring area of 3-6 mm included a total of 9 zones. The inner ring and outer ring 4 regions were superior, inferior, nasal and temporal, respectively. The distribution characteristics of choroid and retinal thickness in different regions and the density of superficial microvessels in the macular area of the retina were observed. Bivariate correlation analysis was used to analyze the relationship of fundus tessellation and ocular biological parameters.ResultsAmong 202 eyes, 37 eyes with leopard pattern fundus with 0 grade (18.32%, 37/202), 165 eyes with grade 1 to 3 (81.68%, 165/202), of which grade 1, 2 and 3 were respectively 125 (61.88%, 125/202), 28 (13.86%, 28/202), 12 (5.94%, 12/202) eyes. The thickness of the retina, both horizontally and vertically, increased first and then decreased from the nasal side to the central area, was lowest in the central area, then increased and then decreased; the overall thickness of the temporal side was slightly lower than that of the nasal side, and the overall thickness of the lower part was slightly lower than the upper part. The choroidal thickness gradually thickened from the nasal side to the temporal side in the horizontal direction; it gradually decreased in the vertical direction from the top to the central area, then increased and then decreased. The SCP blood flow density in the central area in the horizontal and vertical directions was lower than that in other areas. In multivariate regression analysis, Leopard-like fundus classification and AL (β=0.291, OR=1.338, 95%CI 1.064-1.682, P=0.013), SCP blood flow density in the central area of the macula (β=0.080, OR=1.084, 95% CI 1.006-1.167, P=0.034) and choroidal thickness (β=－0.033, OR=0.968, 95%CI 0.960-0.975, P＜0.001) were related.ConclusionsPatients with high myopia have a higher prevalence of tessellation. The deepening of tessellation is related to the thinning of the choroid thickness, the growth of the eye axis, and the larger density of the superficial microvessels in the fovea.
Objective To observe the effectiveness and safety of subretinal dexamethasone injection in treating refractory diabetic macular edema (DME). MethodsA prospective case study. From January 2024 to March 2024, 9 refractory DME patients with 10 eyes diagnosed in Tianjin Eye Hospital were included. All eyes had a central macular thickness (CMT) of more than 275 μm despite undergoing anti-vascular endothelial growth factor therapy at least 5 times. 25G pars plana vitrectomy was performed for the patients combined with internal limiting membrane peeling and subretinal injection of dexamethasone sodium phosphate. Patients underwent ophthalmic evaluation, including best-corrected visual acuity (BCVA), microperimetry and optical coherence tomography testing before surgery and 1 month and 3 months postoperatively. The international standard visual acuity chart was used for BCVA examination, which was statistically converted into logMAR visual acuity. The BCVA, the mean sensitivity (MS) and the CMT before and after surgery were compared using paired t test. The intraoperative and postoperative complications were recorded. ResultsNine cases had 10 eyes, 4 males had 5 eyes and 5 females had 5 eyes. Age 43-79 (65.3±10.8) years old. logMAR BCVA was 0.84±0.25, 0.72±0.31 and 0.63±0.22 before and 1 and 3 months after surgery, respectively. MS was (16.48±5.03), (16.6±6.31), (18.0±5.33) dB, respectively. CMT was (437.5±90.4), (306.9±87.4), (288.7±87.3) μm, respectively. Compared with before surgery, BCVA: 1 month after surgery had no statistically significant difference (t=2.025, P=0.074), 3 months after surgery had statistically significant difference (t=5.161, P=0.001); MS: 1 and 3 months after surgery, there was no significant difference (t=－0.078, －1.022; P=0.940, 0.334); CMT: the difference was statistically significant 1 and 3 months after surgery (t=2.892, 3.175; P=0.018, 0.011), and the difference was statistically significant 1 and 3 months after surgery (t=2.427, P=0.038). There were no complications such as macular hiatus, vitreous hematoma and retinal detachment during and after surgery in all patients. During the follow-up period, there was no increase in intraocular pressure and cataract. ConclusionThe combined treatment strategy involved pars plana vitrectomy, internal limiting membrane peeling and subretinal injection of dexamethasone can effectively reduce CMT in refractory DME patients, improve visual acuity and have good safety.
目的 研究美国国立卫生院脑卒中量表（NIHSS）评分、格拉斯哥昏迷评分（GCS）及指数记分法（BI）量表，预测脑梗死患者发病3个月后二便障碍预后的有效性。 方法 采取队列研究，登记2010年9月－2011年10月入院的脑梗死患者性别、年龄、婚姻、民族、职业，由脑卒中护士全面评定NIHSS评分、GCS评分、BI量表等指标。3个月后回访患者二便障碍恢复情况。 结果 分析显示NIHSS评分、GCS评分分值与脑梗死发病后3个月二便障碍恢复相关，BI量表评分分值与脑梗死发病后3个月二便障碍恢复无关。 结论 NIHSS评分、GCS评分分值可以预测脑梗死患者二便障碍恢复情况及预后情况，具有预测有效性。