One hundred and thirty patients with uveitis in north-western zone of our country were analyzed based on anatomical classification and their causes. It was found that anterior uveitis was the commonest type in uveitis,accounting for 86.15% of total patients. Intermediate uveitis, pan-uveitis and posterior uveitis accounted repectively for 6.92%, 3.85%and3.08% of the total patients. Rheumatic arthritis was the most frequently accompanied systemic disease in patients with uveitis,showing a possibly causative link between them in their pathogenesis. （Chin J Ocul Fundus Dis,1994,10:156-158）
Objective To discuss the treatment of craniocerebral injuries caused by earthquake. Methods Retrospective analysis of clinical information for 256 patients with craniocerebral injury caused by an earthquake. Results The ‘Classification and Treatment’ was applied to the patients, whether or not they were operated on. A total of 146 patients were cured, 68 improved, 24 remained dependent on the care of others, and 8 died. The mortality rate was 3.13%. Conclusion Applying the ‘Classification and Treatment’ to patients with craniocerebral injury following an earthquake supported the use of medical resources and was associated with a low rate of death and disability.
Objective To review the clinical operation methods of abdominal incisional hernia. Methods Classification, operation method and fellow-up of 78 patients with abdominal incisional hernia were retrospectively analyzed. Results The average time of fellow-up was 26 months. Nineteen cases were repaired with simple suture with 3 cases (15.8%) recurrence, 57 cases were repaired with man-made material with 2 case （3.4%） recurrence. Conclusions Individual operation method should be chosen according to body condition, classification of the size of abdominal loss and abdominal hypertension. It is an effective method to repair the hernia of abdominal incision with man-made material.
Objective To discuss the concept of ulnar tunnel at thewrist, the types, causes, traits of compression, diagnosis, and clinical significance of ulnar tunnel syndrome(UTS). Methods Thirty-nine cases diagnosed as having UTS from 1986 were retrospectively reviewed combined with previous relevant literature. Results Ulnar tunnel included Guyon’s canal, pisohamate tunnel and hypothenar segment. There were 8 types andmany causes of UTS. Some patients had compression in more than one zones and might be associated with carpal tunnel syndrome or cubital tunnel syndrome. UTS could be diagnosed through clinical manifestations and electrophysiological examination. Conclusion Defining the concept of ulnar tunnel and the knowledge of the complexity and rarity of UTS can effectively guide diagnosis and treatment.
Objective To review the latest progress in classification system of thoracolumbar fractures and its surgical treatment with posterior approaches. Methods Recent l iterature about classification system of thoracolumbar fractures and its surgical treatment was reviewed. Results For the treatment of thoracolumbar fracture, the surgeon first should decide whether the surgical treatment was necessary. Recently, a new classification system had been developed to help the surgeon make the right decision. The surgical methods included short segment internal fixation and long segment internalfixation with or without fusion, and minimally invasive internal fixation. Conclusion The progress in the surgical treatmentof thoracolumbar fracture will help spinal surgeon decide the necessary surgery beneficial for the patients. The most appropriate and effective surgical method with the minimum damage should be used to treat the fracture. The advantages of non-fusion surgical treatment still need a further study.
Objective To recognize and reevaluate the pathologic anatomic classification of ventricular septal defect （VSD）. Methods From January,2002 to October,2004,119 patients less than 10kg of body weight with simple VSD whose pathologic anatomic classification was determined by preoperative echocardiography and ascertained during surgery were choosed randomly. Results （1） There were fihy-one patients with perimembranous VSD （diameter 0. 6±1.0 cm）, 8 VSD situated in the membranous septum （diameter 0. 5±0.4 cm）, 21 VSD extending to inlet （diameter 0.8±0.5 cm）, 14 extending to outlet （diameter 1.0±0. 6 cm） and 8 extending to trabecula （diameter 0. 8±0.6 cm）. In this group, accessory tricuspid valve tissue was formed in 14 patients（diameter 0. 5±0.3 cm）. （2） Twenty-one patients had conoventricular VSD （diameter 1.2±0. 8 cm）, among them 13 VSD had muscle margins, 8 extending to membranous septum, 14 had septal band hypertrophy, and 5 had subaortic stenosis. （3） Twenty-six patients had subpulmonary VSD（diameter 0.8±0.8 cm）, 18 VSD lay immediately below pulmonary valve, 8 had muscle distant from pulmonary valve, 20 lay completely below pulmonary valve, and 6 lay below pulmonary valve and aortic valve. （4） Ten patients were atrioventricular canal type or inlet VSD （diameter 1.2±0.8 cm）. （5）Eleven patients had muscular VSD, among them 3 were single ,and 8 multiple （diameter 0. 4±0.3 cm）. Conclusion It will be more clinically significant that VSD is classified into perimembranous, conoventricular, atrioventricular canal or inlet, muscular and subpulmonary artery or conical types.
ObjectiveTo investigate the feasibility of modified classification of terrible triad of the elbow and the effectiveness of treatment strategy which was chosen by modified classification results. MethodsBetween March 2007 and November 2013, 12 cases of terrible triad of the elbow were treated by operation. There were 5 males and 7 females with an average age of 37.2 years (range, 26-74 years). The mechanism of injury was falling from height in 8 cases and traffic accident in 4 cases. The time from injury to operation was 4 to 11 days (mean, 6.8 days). According to the radial head, coronoid process, olecranon, and medial and lateral collateral ligament complexes injury situation, and based on Mason classification standard and O'Driscoll criteria, the classification standard of terrible triad of the elbow was improved. According to classification results, the approach was determined. The fracture reduction and fixation were performed and soft tissue was repaired. ResultsDehiscence of incision occurred in 1 case and was cured after dressing change; primary healing was obtained in the other patients. All the cases were followed up 19-35 months (mean, 21.6 months). The X-ray films showed fracture healing at 10-17 weeks (mean 12.8 weeks). At last follow-up, the mean flexion-extension arc of the elbow was 117.9° (range, 95-135°) and the mean forearm pronation and supination were 77.1° (range, 70-85°) and 62.5° (range, 45-75°). According to Mayo elbow performance score (MEPS), the results were excellent in 4 cases, good in 5 cases, and fair in 3 cases. One patient had valgus deformity of elbow who refused radial head replacement, and 5 cases had heterotopic ossification of the elbow on the X-ray films. ConclusionThe modified classification of the terrible triad of the elbow is simple and practical, based on the damage assessment of bony structures (radial head, coronoid process, and olecranon) and the soft tissue (medial and lateral collateral ligament complexes). The modified classification can be used effectively for guiding treatment decisions.
ObjectiveTo sum up staging treatment experiences of hip preservation for avascular necrosis of the femoral head (ANFH) according to China-Japan Friendship Hospital Classification (CJFH Classification).MethodsThe literature about hip preservation of ANFH was extensively reviewed, and a staging treatment method for ANFH was set up base on CJFH Classification and the 28 years of clinical experience in this research group.ResultsAccording to CJFH Classification, the ANFH can be rated as types M, C, and L. And the type L is rated as L1, L2, and L3 subtypes. The staging treatment method for ANFH based on CJFH Classification is set up. Conservative treatment was selected for CJFH-M patients because the necrotic area is small and in the medial non-weight-bearing area. Minimally invasive sequestrum clearance, impacting bone graft, and supporting allogenic fibular graft is selected for CJFH-C patients because the necrotic area is also small and in the lateral non-weight-bearing area. If patients are in CJFH-L1, normal bone area is less than 1/3 on hip abduction radiograph, the sequestrum clearance and impacting bone graft via surgical hip dislocation approach can be selected. If patients are in CJFH-L1, normal bone area is more than 1/3 on hip abduction radiograph, the transtrochanteric curved varus osteotomy can be selected. The rotational osteotomy on the base of femoral neck via surgical hip dislocation approach is for CJFH-L2 patients. Total hip arthroplasty via direct anterior approach is for CJFH-L3 patients.ConclusionThe staging treatment method for ANFH according to CJFH Classification has good short-term effectiveness. But the long-term effectiveness needs further follow-up.
Objective To summary the pathological classification， clinical manifestations， diagnosis， and treatments of gastrointestinal neuroendocrine tumors （GE-NETs）. Methods Domestic and international literatures were collected to summary the status of clinical researches and treatments of GE-NETs. Results GE-NETs derived from enterochromaffin cells throughout the gut which had the function of amine precursor uptake decarboxylase （APUD）. These tumors secreted discrete bioactive substances and produced characteristic immunohistochemical patterns， making patients to manifest endocrine syndrome. But there were no unified standards on the diagnosis， grade， TNM classification， and prognosis of GE-NETs. Early diagnosis rate of GE-NETs was low， and most of tumors were asymptomatic and detected at late stage， with a tendency to metastasize to the liver. Imaging examation was important in early diagnosis of GE-NETs. Surgery was the traditional first-line therapy and the only possible curative approach. Somatostatin analogues， such as long-term-release （LAR） octreotide， could relieve the hormonal symptoms， slow down the tumor growth， and had shown synergistic antiproliferative activity in combination with biological agent everolimus. Conclusions The lack of standardized classification and an incomplete understanding of this disease are some of the impediments to the progress of treatment. Individualized comprehensive therapy is the aim of the future treatment.
ObjectivesTo explore classification management method of evidence-based evidence for medical consumables based on cost multiplication and to conduct empirical test.MethodsFour quadrants was used to explore the classification management of consumables evidence.Results95.22% of the “recommended” items in the consumables department were “recommended” by the group. 100% of group “recommended” items passed the committee resolution. Advice of consumables department and group was highly relevant with decision of commission.ConclusionsOne-dimensional recommendations allow the decision-making of group and committee to be more convenient. Cost calculation is based on all consumables required for medical treatment, which is similar to reality. The classification threshold requires further optimization, and the classification basis requires continual adjustment under different conditions of hospital. The evidence-based evidence evaluation method for medical consumables based on incremental cost ratio is a simple and rapid hospital health technology assessment method suitable for China’s national conditions.