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）
To investigate the causes and the cl inical treatment methods of postoperative wound compl ications following total knee arthroplasty (TKA). Methods From June 2005 to August 2008, 486 cases (576 knees, including 314 left knees and 262 right knees) underwent primary TKA using standard midl ine incision and medial parapatellar arthrotomy. There were 146 males (172 knees) and 340 females (404 knees) aged 51-86 years old (average 61.3 years old). The duration of disease was 3-35 years. Primary diseases included: 138 cases (156 knees) of rheumatoid arthritis, 282 cases (348 knees) of osteoarthritis, 46 cases (49 knees) of traumatic arthritis, 20 cases (23 knees) of pigmented villonodular synovitis. The factors of etiology, deformity correction, duration of tourniquet use and wound drainage were analyzed to determine the cause of postoperative wound compl ication. Results Postoperatively, 37 cases (43 knees) had wound compl ications and the rate of incidence was 7.5%, including 13 cases (15 knees) of aseptic exudation, 3 cases (4 knees) of fat l iquefaction, 4 cases (4 knees) of subcutaneous hematoma, 8 cases (9 knees) of flap margin necrosis, 6 cases (7 knees) of superficial infection, 3 cases (4 knees) of red swollen joint with increased skin temperature and deepinfection. All 37 patients recoveried after symptomatic treatment. Among those 37 cases, patients with rheumatoidarthritis had a higher incidence rate of wound compl ication than the patients with other primary diseases (P lt; 0.05). Theincidence rate of patients with deformity correction more than or equal to 20 degree was significantly higher than that ofother patients (P lt; 0.05). The duration of using tourniquet was (86 ± 15) minutes for patients with wound compl ication,and (78 ± 8) minutes for patients without wound compl ication, indicating there was a significant difference (P lt; 0.01).Wound compl ication occurred in 22 knees (5.1%) with autologous blood transfusion absorber, 11 knees (11.5%) withnegative pressure attraction, and 10 knees (19.2%) receiving no drainage. The incidence rate of postoperative woundcompl ication in patients without drainage was obviously higher than that in patients with drainage (P lt; 0.05). ConclusionPatients with rheumatoid arthritis are more l ikely to have wound compl ication after TKA. Postoperative wound drainage and short duration of tourniquet appl ication help decrease the incidence of compl ications. It is necessary to make early definitive diagnosis of postoperative wound compl ication, and provide proactive treatment.
Twenty-one patients(male 18 cases,femal 3 cases)died of primary liver cancer after operation are reviewed.The liver tumors were located in the right lobe(13 cases),left lobe(3 cases),middle position of liver(4 cases)and hepatic hilum(1 cases).The average diameter of the tumors were 9.0cm.All the patients had suffered from liver cirrhosis and were operated on (most of them partial hepatectomy).The times of death were about 7 days,7-14 days later after operation.The data suggest that causes of death were different from the different stage after operation.The relations between partial hepatectomy and hepatic failure,and the liver cirrhosis and liver regeneration are discussed.
Objective To explore the causes and solutions of dissatisfied complaints about frame glasses wearing after medical optometry to improve service quality. Methods Patients with dissatisfied complaints about frame glasses wearing after medical optometry in West China Medical Center of Optometry Glasses between January 2013 and December 2014 were selected. Targeted re-examination and corresponding treatment was performed on them. The causes of their complaints were clustered and analyzed. Result There were 105 cases of complaints out of the 58 278 patients with frame glasses wearing after medical optometry, including complaints about wearing glasses uncomfortable in 58 cases (55.2%), mainly related to abnormal binocular vision, high myopia and progressive glasses lens fitting; quality of glasses in 23 cases (21.9%), in whom 16 were dissatisfied with the frame; quality of service in 10 cases (9.5%); glasses assembly / calibration in 7 cases (6.7%); and other dissatisfaction in 7 cases (6.7%). Conclusions In medical optometry, optometrists and sales staff should establish a good communication with patients according to individual differences, attach importance to the selection of right frame and lens in patients with high myopia or progressive piece of glasses, introduce the right wearing method of progressive piece of glasses, and enhance the follow-up service. For patients with obvious eye fatigue, it is needed to check the binocular visual function, if the visual fatigue is closely related to abnormal binocular visual function, special glasses fitting and functional training should be instructed to the patients.
ObjectiveTo explore the causes and preventive measures of pain after laparoscopic cholecystectomy (LC). MethodsDomestic and international literatures were collected to summary the causes and preventions of pain after LC. ResultsPain after LC had several origins:the irritative effect of carbon dioxide (CO2) gas, residual pockets of CO2 in the abdominal cavity, peritoneal and diaphragmatic stretching and injury, and complications related to the operation. The main measures included:nitrous oxide (N2O) gas insufflation or abdominal wall lift, low-pressure of pneumoperitoneum, shortened the time of pneumoperitoneum, active gas aspiration, intra-abdominal instillation of isotonic saline, the use of local anesthesia as well as Traditional Chinese medicine. ConclusionsThe causes of pain after LC are multifactorial. It is the key to reduce postoperative pain that we should pay more attention to every perioperative aspect.
ObjectiveTo examine the cause of failure of mitral valve repair. MethodWe retrospectively anal-yzed the clinical data of 89 consecutive patients with non-rheumatic mitral valve diseases who underwent reoperation for failure of mitral valve repair in our hospital from January 2009 through January 2016. There were 54 males and 35 females at age of 36.2±17.4 years. ResultsThere were 16 patients with reoperation of mitral valve repairs and 73 patients of mitral valve replacements. The failure reasons of initial mitral valve repair were technique-related in 63 patients (70.8%) and valve-related in 18 patients (20.2%). Technique-related causes of repair failure included leaflet suture dehiscence (20 patients, 22.5%), edge-to-edge procedure (11 patients, 12.4%), leaflet thickening or retraction (11 patients, 12.4%), ring dehiscence (8 patients, 9.0%), inappropriate annuloplasty (6 patients, 6.7%), incomplete repair (4 patients, 4.5%), and chordal elongation or rupture (3 patients, 3.4%). Median interval since previous repair was 4.0 (0.04-18.0) years for the technique-related failure group, and 9.7 (0.21-35.6) years for valve-related failure group (P < 0.05). ConclusionTechnique-related factors are main causes of repair failure, which include leaflet suture dehiscence, edge-to-edge procedure, and leaflet thickening or retraction. Reoperation for technique-related failure needs to be adopted early.
【摘要】 目的 探讨颅脑损伤(BI)死亡的法医病理学特点,以及继发性脑干损伤、并发症的发生与死亡之间的因果关系。方法 从性别、年龄、致伤方式、损伤类型、生存时间、死亡原因等方面,对四川大学华西法医学鉴定中心1998年1月-2008年12月127例BI死亡尸检案例进行回顾性统计研究分析。结果 127例法医病理学检案中,原发性BI死亡51例(402%),继发性脑干损伤死亡61例(480%),并发症死亡15例(118%),其中伤后12 h内死亡者直接死因均为严重原发性脑损伤,存活12 h～1周者直接死因以继发性脑干损伤居多,生存时间超过1周者约半数死于并发症。结论 在BI案例的死亡原因确定时,应在全面系统的病理学检验基础上,结合案情及临床资料进行综合分析。【Abstract】 Objective To explore the characteristics of forensic pathology in traumatic brain injury and the relationships between secondary brainstem damage, complications and the causes of death. Methods 127 cases were reviewed from gender, age, manner of injury, survival time and the direct causes of death from January 1998 to December 2008. Results Of the 127 cases, the key direct cause of death was secondary brainstem damage, followed by severe primarily brain injury and complications. For those who died within 12 hours after injury, the direct cause was severe primarily brain injury; for those who survived between 12 hours to one week, secondary brainstem damage was in the majority of the causes and for those who survive more than one week time, complication was an important cause. Conclusion In the cases of traumatic brain injury, we should take comprehensive and systematic examination of forensic pathology, and refer to clinical data at the same time to determine the direct cause of death.
ObjectiveTo explore the cause of prosthesis dislocation after primary artificial hip replacement (AHR) and propose preventive measures. MethodsA total of 221 patients underwent artificial hip replacement from 2000 to 2012, among whom 8 developed dislocation. These cases were retrospectively analyzed to summarize the causes of dislocation and preventive measures were proposed. ResultsAmong 221 cases of hip replacement, 8 suffered from postoperative dislocation. All of them underwent posterolateral-approach total hip arthroplasty. The causes of dislocation included coexisting decreased muscle strength before operation, improper placement of the prosthesis during operation, inappropriate postural changes after operation, improper nursing and health education. Of the 8 dislocation cases, 2 were cured after reoperation and revision, 6 were cured through close reduction under anesthesia, and 7 were followed up for 1-5 years without relapse. ConclusionPreoperative assessment of the patients' soft tissue tension of affected hip and comorbid conditions, selection of proper design of prostheses and the components, removal of tissues possibly causing joint impact, correct placement of artificial prosthesis and components and instructing the patients for the correct movement mode of the affected hip after operation are all crucial for the prevention of postoperative hip dislocation.
ObjectiveTo explore the common causes and the clinical pathological characteristics of infant death which occurred after vaccination. MethodsThe study retrospectively analyzed the data of 13 cases of infant death occurring after vaccination from January 2009 to September 2014 in West China Medico-legal Expertise Center. ResultsAmong the 13 cases of infant death, 12 were dead from lethal respiratory system and cardiovascular system diseases, 1 from mechanic asphyxia caused by milk intake. All cases were coupling disease death and had no direct correlation with vaccination. ConclusionSystematic and comprehensive forensic pathological examination is helpful to clarify the cause of death, reveal the relationship between vaccination and the cause of death, and contribute to proper processing of such incidents.
Objective To retrospectively analyze the characteristics and death causes among the Wenchuan earthquake victims in The Third People’s Hospital of Chengdu so as to provide information for reducing mortality in future earthquake disasters. Methods The analysis was based on the data provided by the Department of Information, the Medical Record Library, and the Emergency Room of the hospital through July 12. Microsoft EXCEL was used for data input and SPSS 13.0 was used for statistical analyses. Results Through July 12, 9 (1.57%) out of the 575 wounded patients died, comprising 3 males and 6 females. Of those, 5 died in the outpatient department. The death causes were all related to severe cerebral injuries. The other 4 died in the inpatient department and the death causes were related to severe underlying illnesses and infection. Conclusion Screening and early treatment for cerebral injuries is very important in the period directly following the earthquake. Later, more attention should be paid to the treatment of underlying illnesses as well as the prevention and control of infection.