Objective To summarize the visual outcome of patients with severe ocular trauma treated with vitreous surgery. Methods Clinical data of 188(191 eyes) with severe ocular trauma treated with vitreous surgery in a period from November 1996 to April 1998 were analysed retrospectively. Results The study included penetrating injury in 56 eyes, foreign bodies in the posterior segment in 70 eyes, blunt injury in 41 eyes , and globe rupture in 24 eyes. Main complications included endophthalmitis in 35 eyes, choroidal bleeding in 20 eyes, retinal detachment in 60 eyes, and vitreous hemorrhage in 97 eyes. Post-opera-tively, out of 188 eyes, except for 3 of patients too young to examine, visual acuity improved in 133(70.7%), including 85(45.2%) with visal acuity 0.02-1.0, 46(24.5%) remained unchanged; and 9(4.8%) had worse vision. Among 34 with no-light-perception, 12 had light-perception or over. Conclusion A majority of severe trauma eyes can be salvaged with considerable visual recovery after adequate and timely vitreous surgery. (Chin J Ocul Fundus Dis,1999,15:4-6)
Objective To investigate the diagnosis and treatment of congenital choledochal cysts(CCC) in children. MethodsThe manifestation, auxiliary examination, mode of operation and effect of 42 patients with CCC in children from Jan., 1980 to June, 1999 were analyzed retrospectively.Results The patients with the triad of jaundice, an abdominal mass, and pain was 38.1% among the 42 patients. B-ultrasonic diagnosis was made with a correct diagnostic rate of 95.2%. The effective rate of internal drainage was significantly lower than that of resection of the cyst(χ2=19.36, P＜0.001) while the reoperation rate and incidence of carcinoma of internal drainage were higher than those of resection of the cyst(χ2=11.59, P＜0.001 and χ2=4.97, P＜0.05). Conclusion B-ultrasonic diagnosis is recommended as the first examination method. Internal drainage should be abandoned. Resection of the cyst with Roux-Y hepaticojejunostomy is recommended as the treatment of choice on extrahepatic cholangiectasis. Liver transplantation is a reasonable choice to treat the diffuse intrahepatic cholangiectasis.
Objective To explore the content and scientific evidence of every element of the fast-track programmes in colorectal surgery. Methods The literatures about the applied status and opinion of the modality applied in the surgical treatment of the colorectal cancer and fundament investigation in recent years were collected and reviewed. Results The feasibility of the every fast-track’s element was based on the clinical and fundamental investigaton. Conclusion The advantage of the fast-track programmes in colorectal surgery is confirmed.
Objective To explore the arterial origin and the distribution of the extracranial branches of the facial nerve. Methods Red latex or red chlorinated polyvinyl chloride was injected into the arteries of 15 fresh adult head specimens by both common carotid artery catheterization. The arterial origin and distribution of the extracranial branches of the facial nerve were observed. Results The nutrient arteries of the extracranial branches of the facial nerve originated from stylomastoid artery of the posterior auricular artery, the facial nervous branch of superficial temporal artery, transverse facial artery, superior and inferior facial nervous branches of external carotid artery and the posteriorand anterior facial nervous branches of external carotid artery. The outer diameters of them were (0.8±0.2) mm, (0.9±0.4) mm, (1.9±0.3) mm, (1.0±0.2) mm, (1.1±0.4) mm, (1.0±0.2) mm and (1.1±0.6) mm respectively. The sub-branches ofthe attendant artery of the facial nerve anastomosed each other in addition to supplying their own nerve, and a rich vascular network was formed between the facial nerve and adjacent tissue. Conclusion The study on blood supply of the extracranial segment of the facial nerve can provide anatomic basis for avoiding injury of the nutrient arteries of the facial nerve during operation of the parotidean and masseteric region clinically.
Objective To identify the needs of patients undergoing pulmonary nodule day surgery during the perioperative medical interaction experience under the enhanced recovery after surgery mode based on the patient journey map, and to provide references for optimizing the diagnosis and treatment experience of these patients and the patient-centered medical support. Methods Using the descriptive qualitative research method, 15 patients who underwent thoracoscopic pulmonary nodule resection or pulmonary wedge resection in the day surgery ward of Huadong Hospital, Fudan University between January and June 2024 were selected for semi-structured interviews. The data were analyzed using the content analysis method, and the interactive map of the patient’s medical seeking experience was drawn. Results According to the medical seeking process and perioperative stages, the interactive journey map of the patient’s medical seeking experience was formed. The medical seeking experience and health support needs of patients undergoing pulmonary nodule day surgery were classified and summarized into themes such as medical consultation cues, screening of medical information, multidisciplinary assessment, medical-patient cognitive differences, rehabilitation exercises and sports, nutritional management, doctor-patient communication, social adaptation, and emotional expression from four links: interaction touchpoints, information flow, communication methods, and feedback mechanisms. Conclusions Patients undergoing pulmonary nodule day surgery experience the perioperative medical seeking process under the enhanced recovery after surgery mode, with a shortened hospitalization period but complex postoperative health management needs. The interaction touchpoints generated during the experience are intertwined and changeable, and the health support needs required vary at different stages of intervention points. Optimizing the touchpoints can ensure that patients receive efficient medical support when needed, thereby enhancing the patient experience, improving the medical seeking feeling, and ensuring that high-quality nursing services are implemented throughout all stages.
ObjectiveTo introduce a new method to remove the small foreign body in the hand or foot, and to discuss its feasibility and effectiveness. MethodsBetween May 2007 and March 2012, 78 patients with small foreign bodies embedded in the soft tissue of the hand or foot were treated with the method. There were 51 males and 27 females, aged from 7 to 69 years with an average of 32.5 years. The hand, wrist, and foot were involved in 48, 6, and 24 cases respectively. Foreign body type included fiberglass (57 cases), thorn (11 cases), iron (5 cases), bamboo thorn (2 cases), fishbone (2 cases), and metal needles (1 case). The time between injury and operation was 30 minutes to 16 days (mean, 2.6 days). The position and range of the foreign body were defined using the multipoint centralization method before removal surgery. The skin was cut according multipoint connection for finding small foreign body under a microscope. ResultsAll foreign bodies were successfully removed. The mean operation time was 6 minutes (range, 3-22 minutes). Healing of incision by first intention was obtained in all cases; no blood circulation disorders or infection occurred. All the patients were followed up 3 months-3 years (mean, 9 months). The distal limb had no feeling or movement disorders. ConclusionRemoval of small foreign body in soft-tissue using multipoint centralization method is safe and effective.
目的 探討原發性甲狀腺鱗狀細胞癌的診斷和治療。方法 回顧性分析我院收治的1例原發性甲狀腺鱗狀細胞癌典型病例，并結合相關文獻復習，探討其診斷和治療。結果 該例腫瘤侵及甲狀軟骨、環狀軟骨和喉，行甲狀腺癌聯合喉擴大切除術。術后發生甲狀旁腺功能低下和手足抽搐，術后第15天出院。隨訪1年健康生存，未見復發和遠處轉移。結論 原發性甲狀腺鱗狀細胞癌罕見，早期診斷困難，惡性程度高，積極手術是首選的治療方法。放射治療可延緩腫瘤的生長、轉移。
Objective To study the surgical treatment of tracheal and main bronchial tumors. Methods We retrospectively analyzed the clinical data of 30 patients with tracheal and main bronchial tumors treated in Shengjing Hospital of China Medical University from January 2000 to December 2015. There were 12 males and 18 females with the age ranging from 22 to 80 years. Results Ten patients were treated with enucleation, 12 patients tracheal tumor resection and end-to-end anastomosis, 1 patient window resection, 1 patient wedge resection, 5 patients tumor resection and tracheal reconstruction by using pulmonary tissue flap with alloy stent and 1 patient left pneumonectomy. One patient died of sudden massive hemoptysis 26 d after operation. Intraoperative complications were found in 2 patients. Others had a good recovery after operation. Patients were followed up for 11 months to 14 years. Eight patients were followed up less than 5 years postoperatively, one patient died of sudden massive hemoptysis 14 months after operation, while others survived; 21 patients were followed up more than 5 years and 5 patients were lost to follow-up. Conclusion Surgical resection is recommended for tracheal and main bronchial tumors. Patients with small benign tumor may choose local tracheal resection; tracheal segmental resection and end-to-end anastomosis is the most common surgical treatment. Patients with more than half of the whole length of tracheal defects or in the risk of anastomotic ischemic necrosis may be suggested to receive tracheal reconstruction.