ObjectiveTo observe the clinical features, treatment and prognosis of ciliary body tumors. MethodsA retrospective clinical study. From November 2011 to March 2023, 8 cases (8 eyes) with ciliary body tumours confirmed by pathohistological examination at the Department of Ocular Oncology, Beijing Tongren Hospital were included in the study. Patients' age, gender, involved eyes, symptoms, best corrected visual acuity (BCVA), intraocular pressure, cataract, lens subluxation, and imaging manifestations were collected in detail. All affected eyes were treated surgically. The follow-up time after surgery ranged from 1 to 10 years. The patients' clinical presentation as well as imaging, pathohistological features and treatment and prognosis were analysed retrospectively. ResultsAmong 8 cases (8 eyes), there were 3 males (3 eyes) and 5 females (5 eyes), 3 and 5 eyes in the right and left eyes, respectively. The median age was 44 years. Ciliary body medulloepitheliomas, melanoma, squamous cell carcinoma, leiomyoma, schwannoma, and adenoma of the nonpigmcnted ciliary epithelium were in 2, 2, 1, 1, 1, and 1 eyes, respectively. All reported decreased or loss of vision. Cataract, vitreous opacity, red eye and or (ocular pain), retinal detachment, lens subluxation, and secondary glaucoma were 6, 4, 4, 2, 1, and 1 eyes, respectively. Diagnostic imaging was consistent with pathological findings in 3 eyes. The first surgery was performed for enucleation and orbital implantation in 2 eyes, the patients were 9 and 10 years old with medullary epithelioma; the follow-up time after surgery was 1 and 5 years, respectively. Local tumour resection was performed in 6 eyes. Among them, 3 eyes with benign tumours were followed up for 1 to 9 years after surgery; 2 eyes showed significant improvement in visual acuity, 1 eye with adenoma of the nonpigmcnted ciliary epithelium had a preoperative BCVA of finger count/1 m, and a postoperative BCVA of 0.5, and 1 eye with leiomyoma had a preoperative BCVA of 0.06, and a postoperative BCVA of 0.5; and 1 eye was lost to follow-up. Malignant tumour in 3 eyes, of which 2 eyes recurred after surgery. Re-operation for enucleation and local tumour excision combined with local cryotherapy in 2 eyes of recurrence were 1 eye each, respectively. The follow-up period after surgery was 2 and 4 years, respectively. No recurrence after surgery in 1 eye, but there was no significant improvement in visual acuity during follow-up. No recurrence or metastasis was observed in any of the eyes during the follow-up period or at the final follow-up.ConclusionsCiliary body tumour types and clinical presentations are complex and varied; imaging can detect tumours but is poor at determining the nature of the lesion. Benign tumours do well with local excision surgery; malignant tumours do well with enucleation.
Respiratory viruses are important pathogens responsible for community- and hospital-acquired pneumonia in adults. Outbreaks of highly pathogenic viruses in recent years have made us aware of the difficulty and importance of diagnosis and treatment of viral pneumonia. This review summarized the current status of diagnosis and treatment of viral pneumonia in adults so as to improve our understanding of it.
Objective To analyze the clinical manifestations, diagnosis, treatment and prognosis of bone hydatid disease in China by literature review. Methods We searched the databases of China National Knowledge Infrastructure and Wanfang for case reports of bone hydatid disease published from 2000 to 2015 in China. Data were extracted by using a standardized form and a retrospective clinical analysis was performed. Results A total of 21 relevant literatures published from 2000 to 2015 were included, including 87 cases of bone hydatid disease treated from 1975 to 2015. The regional distribution of bone hydatid disease was mainly concentrated in the animal husbandry areas in China. In terms of diagnosis basis, imaging examination was mentioned in 54 cases (62.1%), laboratory examination was mentioned in 32 cases (36.8%), and pathologic examination was mentioned in 8 cases (9.2%), etc. Surgical treatment was the main treatment, and some treatments were combined with chemotherapy. The outcomes of bone hydatid disease were relatively poor. In the 44 cases whose outcomes were reported, 26 cases (59.1%) had recurrence, 18 cases were cured (40.9%), 10 cases (22.7%) underwent re-operation, and 2 cases (4.5%) died. Conclusions Bone hydatid disease is rare. Surgical treatment is still the main method for treating bone hydatid disease. The rate of recurrence of bone hydatidosis is relatively high, so it is very important to explore new methods for diagnosis and treatment of bone hydatid disease.
To investigate the pathological characteristics, diagnosis and treatment of rectal carcinoid tumors, 26 cases, which had been diagnosed and treated in our hospital from 1987 to 1997, were retrospectively analysed. The rectoscopic examination were taken in all 26 patients and final diagnosis were made by pathological examination, among them, 19 cases were treated with local resection or expensively local resection, 7 cases with radical operation because the diameter of tumor was beyond 2 cm. These patiests were followed up 1-10 years with 5 patients died. The authors consider that rectoscopic examination and biopsy are important method to diagnose rectal carcinoid tumors preoperatively, in addition, for suspicious case, argentation and immunohistochemistry staining should be further made besides routine HE staining. The operative treatment is the best therapy to this kind of disease, the choice of operative mode must be made according to the size, infiltration of the tumor, the condition of infiltrated lymph node and hepatic metastasis.
Objective To assess the benefits and harms of traditional Chinese medicine in the treatment of postmenopausal osteoporosis. Methods We electronically searched MEDLINE (1966-2003), EMBASE (1974-2003), Controlled Trials Register and The National Research Register, The Cochrane Library Issue 4, 2003, CBM disc, VIP, CNKI, and CMCC. We also handsearched some related journals. The search was conducted in Nov., 2003. The quality of included randomized controlled trials was evaluated and meta-analysis was conducted by RevMan 4.2.2. Results We identified 33 studies including 2 337 patients and 27 traditional Chinese medicines. Some traditional Chinese medicines alone or integrated Chinese and Western medicine may be effective for improving patients’ bone mineral density, serum oestradiol and serum calcium. For example, Compared with placebo, Bushen Yigu soft extraction with WMD 0.76, 95% confidence interval 0.65 to 0.87, Bushen Qianggu capsule with WMD 39.94, 95% confidence interval 35.12 to 44.76 were effective for improving the level of serum oestradiol.There were no confirmed results of the other traditional Chinese medicines because of the small number of studies or inconsistent conclusions among studies. We didn’t find obvious side effects. Conclusions Some traditional Chinese medicines may be effective for treating postmenopausal osteoporosis. Due to the limited evidence identified, we can not draw a firm conclusion. More randomised controlled trials of high quality are needed for ber evidence.
To study the changes in diagnosis and treatment of pediatric choledochal cyst in the past 10 years, a retrospective analysis was made in 79 children with choledochal cyst, who were admitted into our hospital from 1982 to 1998. Results show that in the past years, the clinical manifestation of choledochal cyst in children have become less obvious for earlier consultation. B-mode ultrasounscanning should be the first choice since it aids in the diagnosis of choledochal cyst as well as its related and complicated diseases. Choledochectomy is the only radical treatment for choledochal cyst in children.
This paper interprets 2017 European Society of Cardiology (ESC) peripheral arterial disease diagnosis and treatment guidelines on lower extremity arterial disease, and in order to provide reference for clinical practice.
ObjectiveTo evaluate the efficacy of intravenous glutamine on patients with severe acute pancreatitis. MethodsThe Cochrane Library, PubMed, EMbase, CNKI and CBM databases were searched up to January 2013. Randomized controlled trials (RCTs) that compared non-glutamine nutrition with intravenous glutamine supplemented nutrition in patients with severe acute pancreatitis were included. A method recommended by the Cochrane Collaboration was used to perform a meta-analysis of those RCTs. ResultsFour RCTs involving a total of 190 participants were included. Analysis of these RCTs revealed the presence of statistical homogeneity among them. Results showed that glutamine dipeptide had a positive effect on reducing the mortality rate[OR=0.26, 95%CI (0.09, 0.73), P=0.01], length of hospital stay[WMD=-4.85 d, 95%CI (-6.67, -3.03) d, P<0.001], and the rate of complications[OR=0.41, 95%CI (0.22, 0.78), P=0.006]. No serious adverse effects were found. ConclusionCurrent best evidence demonstrates that glutamine is effective for severe acute pancreatitis. Further high quality trials are required and parameters of nutritional condition and hospital cost should be considered in future RCTs with sufficient size and rigorous design.
Objective To share the experience of the diagnosis and treatment of children with hand-foot-mouth disease. Methods We retrospectively analyzed 31 children with hand-foot-mouth disease in our hospital from April 2007 to June 2007 in terms of epidemiology, clinical features, treatment and prognosis. Results The average age of the children was 2.8 years, and 20 out of the 31 cases were from nurseries and kindergartens. Eighteen had clear contact history. Typical signs and symptoms, including oral ulcerative herpes and blister-like rash in extremities, were found in all cases. All the children were cured after timely diagnosis and early treatment with ribavirin, without any severe complications. Conclusion Timely treatment based on early diagnosis and considerate care are important for children with hand-foot-mouth disease. Nurseries, kindergartens and primary schools should attach great importance to relevant prophylaxis and isolation. These are essential for reducing the occurrence and prevalence of this disease.