Polypoidal choroidal vasculopathy (PCV) is a fundus disease characterized by choroidal anomalous branch vascular network and terminal polypoidal dilatation. According to its fundus feature, lesion location, imaging feature and disease progression, PCV can be divided into different types or stages. It can be divided into hemorrhage and exudation PCV according to the fundus features, into macular, peripapillary, periphery and mixed types according to the lesion locations. It can also be divided into type 1 and 2 according to the ICGA (indocyanine green angiography) manifestations, and can be classified as early stage and late stage according to disease progression. There were different correlations between different types of PCV and some risk genetic loci, such as ARMS2 (age-related macular degeneration factor 2)/ HTRA1 (high temperature essential protein A1) , C2, complement factor B, complement factor H, and elastin genes. The response to therapy and prognosis are also different between different types. It is important to further study the clinical classification of PCV, to explore the genetic characteristics, influencing factors and treatment or prognosis features of different types of PCV. The results will improve the differential diagnosis of PCV, and the effectiveness of individualized treatment.
Objective To investigate the therapeutic effects of retinal angiomatosis in different clinical stages. To discuss the indication of vitrectomy for retinal hemangioblastoma. Methods The clinical data of 22 cases (33 eyes) were retrospectively analyzed. The retinal hemangiomas were divided into 5 stages according to their degrees of development from simple angioma without vessel dilation to feeder vessel dilation and intra-retinal exudates, local retinal detachment, massive retinal detachment and co mplication occurrence in proper order. The methods of treatment were laser photo coagulation, trans－scleral cryotherapy and vitrectomy. 13 eyes were treated with laser photocoagulation, 5 eyes with cryotherapy combined with laser and 11 eye s with vitrectomy. Tumor resection and silicone oil tamponade was performed in 3 eyes during vitrectomy. The patients were followed up for 46 months on average. Visual acuity (VA), the condition of the hemangioma and retina was compared pre- and post-operation respectively. Results In all 13 eyes treated with laser photocoagulation the hemangiomas regressed and the retina remained attached. VA improved in 2 eyes, and remained unchanged in 11 eyes. Cryother apy combined with laser photocoagulation was performed on 5 eyes. In this group, 4 eyesprime; hemangiomas regressed and no new hemangiomas occurred, proliferative vitreous retinopathy and vitreous hemorrhage was observed in 1 eye which vitrecto my was performed later. VA improved in 2 eyes, unchanged in 2 eyes and decreased in 1 eye. In the 11 eyes treated with vitreoretinal surgery, new hemangiomas wa s found in 1 eye, exudative retinal detachment was caused by hemangiomas in 2 eyes, proliferative vitreous retinopathy was observed in 2 eyes, and the retina re mained attached in 8 eyes. VA improved in 3 eyes, unimproved in 3 eyes, and decreased in 5 eyes. In the 3 eyes with surgical resection of retinal hemangioma during vitrectomy, 2 eyesprime; retina remained attached, 1 eye had exu dative retinal detachment and no new hemangiomas occurred. VA improved in 2 eyes and decreased in 1 eye. Conclusions Laser photocoagulation or combined with cryotherapy is effective in treating the hemangiomas in early stage. Vitrectomy is advisable for late stage of retinal angiomatosis, especially with vitreous hemorrhage, epiretinal membrane, proliferation and large scale of r etinal detachment. Surgical resection of isolated large retinal hemangioblastoma may be useful for selected patients. (Chin J Ocul Fundus Dis,2008,24:107-110)
ObjectiveTo analyze the clinical character of uveitis in second hospital of Jilin university. MethodsRetrospectively analyze the clinical data of uveitis patients referred to from Second Hospital of Jilin University from September 2009 to September 2014. According to anatomical location, the manifestation of these uveitis patients were divided into anterior uveitis, panuveitis, intermediate uveitis and posterior uveitis. To discuss the possible causes of these patients according to the general information and relevant clinical laboratory examinations results. ResultsThere were 1215 cases in this study, which included 587 male, accounting for 48.31%; and 628 female, accounting for 51.69%. The ratio of male-to-female was 0.93:1. The range of the age of these patients was from 4 to 91 years old. The mean age of these patients at the onset of these disease was (41.43±14.20) years. Of the 1215 cases, 40 male and 43 female were younger than 20 years. The ratio of male-to-female was 0.93:1; 412 male and 396 female were between 21 and 50 years old. The ratio of male-to-female was 1.04:1; 135 male 189 female were older than 50 years. The ratio of male-to-female was 0.71:1. There were 572 cases of anterior uveitis, accounting for 47.08%; 527 cases of panuveitis, accounting for 43.37%; 52 cases of intermediate uveitis, accounting for 4.28%; 64 cases of posterior uveitis, accounting for 5.27%. 703 cases had etiological diagnosis according to the clinical character and the auxiliary results, accounting for 57.68%. Vogt-koyanagi Haradal (VKH) syndrome, ankylosing spondylitis associated with uveitis and Behçet's disease were the common entity, accounting for 30.44%, 19.77% and 14.22% respectively. ConclusionsThe mean age of these patients in this study was older, compared to other reports. Female patients were more than male, especially in these patients older than 50 years. VKH syndrome, ankylosing spondylitis associated with uveitis and Behçet's disease were the common entities.
Objective To study the clinical classification and etiologies of uveitis based on 1214 uveitis patients reffered to Zhongshan Ophthalmic Center. Methods A retrospective analysis was made on the patients with uveitis, coming from all over China between January 1996 and December 2001. All kinds of uveitis were classified according to the anatomical criteria and etiological criteria. The relevant data of these patients, such as the age at uveitis onset and sex were also analyzed. Results The total number of the patients is 1214 (male 698, female 516), with the average age at disease onset being 34.43. Anterior uveitis, the most common type, was seen in 546 cases, accounting for 44.98% of all the patients, followed in descending order by panuveitis (530 cases, 43.66%), intermediate uveitis(78 cases, 6.43%) and posterior uveitis(60 cases, 4.94%). Etiological factors and clinical entities were identified in 703 patients, accounting for 57.91% of all the patients, and the other 511 patients were idiopathic ones. The most common types of anterior uveitis were idiopathic uveitis(316 cases, 57.88%), followed by Fuchs syndrome(85 cases) and ankylosing spondylitis(45 cases). BehCcedil;et disease(218 cases, 41.13%) and Vogt-Koyanagi-Harada syndrome(196 cases, 36.98%) were the most common entities in panuveitis. Neither etiological factors nor clinical entities could be identified in the patients with intermediate uveitis and those with posterior uveitis. Conclusions Uveitis occurs mostly in young and middle-aged adults. In general, a predilection was seen in the male as compared with the female in the development of uveitis. Idiopathic anterior uveitis, BehCcedil;et disease and Vogt-Koyanagi-Harada syndrome are the most common entities of uveitis seen in China. Classification based on etiological and anatomical factors may provide a reasonable system for the study of uveitis. (Chin J Ocul Fundus Dis, 2002, 18: 253-255)
ObjectiveThe current medical questionnaire resources are mainly processed and organized at the document level, which hampers user access and reuse at the questionnaire item level. This study aims to propose a multi-class classification of items in medical questionnaires in low-resource scenarios, and to support fine-grained organization and provision of medical questionnaires resources. MethodsWe introduced a novel, BERT-based, prompt learning approach for multi-class classification of items in medical questionnaires. First, we curated a small corpus of lung cancer medical assessment items by collecting relevant clinical assessment questionnaires, extracting function and domain classifications, and manually annotating the items with "function-domain" combination labels. We then employed prompt learning by feeding the customized template into BERT. The masked positions were predicted and filled, followed by mapping the populated text to labels. This process enables the multi-class classification of item texts in medical questionnaires. ResultsThe constructed corpus comprised 347 clinical assessment items for lung cancer, across nine "function-domain" labels. The experimental results indicated that the proposed method achieved an average accuracy of 93% on our self-constructed dataset, outperforming the runner-up GAN-BERT by approximately 6%. ConclusionThe proposed method can maintain robust performance while minimizing the cost of building medical questionnaire item corpora, illustrating its promotion value of research and practice in medical questionnaire classification.
Objective To investigate the mass casualty triage system and its application, to provide evidence and advice for its future standardized use. Method Based on the principles and methods of systematic reviews, we searched MEDLINE (1950 to 2008), The Cochrane library (Issue 2, 2008) and CBM (from establishment to May 2008) to identify papers written in English of Chinese which described mass casualty triage systems or triage systems specific to the aftermath of earthquakes. We extracted information on name, grades, criteria, main characteristics and application of each triage system from the papers involving mass casualty triage systems. We also extracted information on setting, personnel performing the triage, grades, and characteristics from those papers describing any specific triage system for earthquake. We compared the colour of tags, codes and other materials used in different triage systems. Result We included 38 English and 6 Chinese papers. For mass casualty triage systems, we identified 7 primary triage methods with 4 grades.Three of these had relevant application reports. There were 6 secondary triage methods with 3-5 grades, and none had relevant application reports. Four tag methods were identified. Seven papers, 2 of which were published in China, reported specific secondary triage methods for earthquakes. Conclusion Based on the current evidence, there is no universally accepted mass casualty triage system with documented reliability and validity. No triage system has been developed specifically for the wounded in earthquakes. There are large differences between the triage methods for earthquake and other mass casualty incidents. Future research should focus on the development of a reliable and valid mass casualty triage system, aimed at maximizing the capacity for medical rescue.
Objective To retrospectively analyze and classify 23 open fractures that resulted in severe infection, in order to provide evidence that can be used in future disaster scenarios. Methods Based on medical records of 23 cases of open fracture and subsequent bacterial infection, we analyzed the clinical diagnosis, treatment, laboratory tests, bacterial smear of wound secretion, and the bacterial culture of the wound secretion. We then analyzed which antimicrobial agents were used and how they were applied, and the subsequent effect on controlling the serious infection.? Results All cases were related to seismic injury and belonged to class VI open fracture. Eight cases were male and 15 were female. All cases had similar symptoms such as chills, fever, large scale muscle necrosis, and severe infection. A direct smear of the wound showed that the number of cases with one bacterial infection was 6 (26.09%), the number that had double bacterial infections was 12 (52.18%), and the number with multiple bacterial infections was 5 (21.74%).There were 18 strains of 11 types of bacteria recovered from wound samples. Conclusion Early treatment with the joint application of multiple antibacterial agents, early debridement, and adequate drainage all helped to control the infection and avoid nosocomial infection. Employing these strategies in the future will control infection in disaster situations.
Objective To observe the prognosis of visual acuity (VA) of patients with different classification of polypoidal choroidal vasculopathy (PCV). Methods Sixty-seven PCV patients (68 eyes) diagnosed by fundus photography, fundus fluorescein angiography, indocyanine green angiography (ICGA) and ocular coherence tomography were enrolled in this retrospective study. The patients were classified into static, exudative, small hemorrhage and large hemorrhage according to activity and pathological characteristics of lesions. The patients were classified into aciniform, single or several single, combined branching choroidal vascular network (BVN) according to morphological characteristics and combination with BVN of lesions on ICGA. The patients also were classified into macular, vascular arcade, peripapillary and mixing zone according to distribution of lesions. The VA of all the types were observed. Results There were 16, 19, 19, 14 eyes in the type of static, exudative, small hemorrhage and large hemorrhage PCV, which with logMAR VA of 0.34plusmn;0.52, 0.70plusmn;0.98, 0.60plusmn;0.50, 0.91plusmn;0.75 respectively. The VA of static PCV patients was better than that in exudative, small hemorrhage and large hemorrhage PCV patients (q=4.75, 4.26, 5.13; P＜0.05). There was no significant difference of VA between exudative and small hemorrhage PCV patients (q=0.98, P＞0.05). There were 22, 38 and eight eyes in the type of aciniform, single or several single, combined BVN PCV, which with logMAR VA of 0.52plusmn;0.55, 0.59plusmn;0.43, 0.80plusmn;0.95 respectively. The VA of combined BVN PCV patients was worse than that in aciniform and single or several single PCV patients (q=3.81, 3.02;P＜0.05). There were 34, 13, 8 and 13 eyes in the type of macular, vascular arcade, peripapillary and mixing zone PCV, which with logMAR VA of 0.78plusmn;0.43, 0.57plusmn;0.37, 0.38plusmn;0.27, 0.74plusmn;0.41 respectively. The VA of macular PCV patients was less than that in vascular arcade and peripapillary PCV patients (q=4.61,5.11;P＜0.05). There was no significant difference of VA between macula and mixing zone PCV patients (q=0.73,P＞0.05). Conclusions The VA of PCV patients is variable.It is related to activity and pathological characteristics of lesions, morphological characteristics and combination with BVN of lesions on ICGA, and distribution of lesions.
Objective To explore the influence of two emergency reception and triages workflows between Wenchuan and Lushan earthquakes on the victim’s length of stay in emergency department of the West China Hospital of Sichuan University. Methods A total of 65 victims admitted in the West China Hospital within 12 hours after Lushan earthquake were retrospectively analyzed, and their diagnosis and treatment information and the length of stay in emergency department were collected and compared with those of the victims in Wenchuan earthquake. Then we analyzed the influence of two emergency reception and triage workflows on the length of stay of the batches of earthquake victims. Results For the Lushan earthquake victims, the median length of stay in the emergency reception and triage workflow was 0.51 hour, while that was 2.13 hours for the Wenchuan earthquake victims, with a significant difference (Plt;0.05). Conclusion The emergency reception and triage workflow for Lushan earthquake victims is a summarized experience and improvement based on that for Wenchuan earthquake, which can be used as references for treating batches of victims in the emergency department after a disaster.
Purpose To analyse the maculopathy in 597 eyes of 317 cases with diabetic retinopathy,and to explore the classification and visual prognosis. Methods Using fluorescein angiography to examine the extend of capillary leakage and foveal avascular zone as well as the extent of the capillary closure in macular area. Results ①Diabetic maculopathy was divided into 5 types,among 597 eyes,no leakage type 154 eyes (25.8%),focal edema type 188 eyes(31.5%),diffuse edema type (including cystoid edema)231 eyes(40.0%),ischemic type 12 eyes(2.0%) and proli ferative type was 4 eyes(0.7%).② There is close relationship between the classification and visual prognosis.such as when visual acuity was ge;0.5,no leakage type was 99.4%, focal edema type was 83.0%,diffuse edema type was 28.4%,ischemic type was 8.4%,and proliferative type was 0.5%.the visual acuity of cystoid edema was worse than diffuse edema only 20.3%.③The stage and visual prognosis:The higher the stage the worse the visual prognosis.if visual acuityge;0.5, 1 stage in 96.2% eyes,2 stage in 84.8%,3 stage in 53.2%,4 stage in 37.2%,5 stage in 12.5%. Conclusion Diabetic maculopathy is the main cause of visual impairment in diabetic retinopathy. Different type has different visual prognosis.macular edema and cystoid edema are the main factors to decrease visual acuity and could be treated by focal and grid laser photocoagulation to prevent visual loss. (Chin J Ocul Fundus Dis,2000,16:144-146)