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find Author "范俊" 2 results
  • Establishment and validation of nomogram model for visual prognosis of macular edema secondary to retinal branch vein occlusion treated with ranibizumab

    Objective To explore the influencing factors of visual prognosis of macular edema secondary to branch retinal vein occlusion (BRVO-ME) after treatment with ranibizumab, and construct and verify the nomogram model. MethodsA retrospective study. A total of 130 patients with BRVO-ME diagnosed by ophthalmology examination in the Department of Ophthalmology, Liuzhou Red Cross Hospital from January 2019 to December 2021 were selected in this study. All patients received intravitreal injection of ranibizumab. According to the random number table method, the patients were divided into the training set and the test set with a ratio of 3:1, which were 98 patients (98 eyes) and 32 patients (32 eyes), respectively. According to the difference of logarithm of the minimum angle of resolution (logMAR) best corrected visual acuity (BCVA) at 6 months after treatment and logMAR BCVA before treatment, 98 patients (98 eyes) in the training set were divided into good prognosis group (difference ≤-0.3) and poor prognosis group (difference >-0.3), which were 58 patients (58 eyes) and 40 patients (40 eyes), respectively. The clinical data of patients in the two groups were analyzed, univariate and multivariate logistic regression analysis were carried out for the different indicators, and the visualization regression analysis results were obtained by using R software. The consistency index (C-index), convolutional neural network (CNN), calibration curve and receiver operating characteristic (ROC) curve were used to verify the accuracy of the nomogram model. ResultsUnivariate analysis showed that age, disease course, outer membrane (ELM) integrity, elliptical zone (EZ) integrity, BCVA, center macular thickness (CMT), outer hyperreflective retinal foci (HRF), inner retina HRF, and the blood flow density of retinal deep capillary plexus (DCP) were risk factors affecting the visual prognosis after treatment with ranibizumab in BRVO-ME patients (P<0.05). Multivariate logistic regression analysis showed that course of disease, ELM integrity, BCVA and outer HRF were independent risk factors for visual prognosis after ranibizumab treatment for BRVO-ME patients (P<0.05). The ROC area under the curve of the training set and the test set were 0.846[95% confidence interval (CI) 0.789-0.887) and 0.852 (95%CI 0.794 -0.873)], respectively; C-index were 0.836 (95%CI 0.793-0.865) and 0.845 (95%CI 0.780-0.872), respectively. CNN showed that the error rate gradually stabilized after 300 cycles, with good model accuracy and strong prediction ability. ConclusionsCourse of disease, ELM integrity, BCVA and outer HRF were independent risk factors of visual prognosis after ranibizumab treatment in BRVO-ME patients. The nomogram model based on risk factors has good differentiation and accuracy.

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  • 回盲部结肠癌误诊为阑尾炎30例分析

    【摘要】 目的 分析回盲部结肠癌误诊为阑尾炎的原因及如何避免误诊的方法。 方法 回顾性分析1998年1月-2010年10月误诊为阑尾炎的回盲部结肠癌患者30例的临床资料。其中男24例,女6例;年龄14~78岁,平均56岁。30例患者均行手术治疗,阑尾切除术中发现回盲部结肠癌28例而改行其他术式,其中一期右半结肠癌根治术12例,姑息性右半结肠切除术5例,回肠横结肠短路术6例,二期手术5例;1例于阑尾切除术后15 d发现回盲部结肠癌,行右半结肠癌根治术;1例于阑尾切除术后6个月因肠梗阻明确诊断而再次手术,行右半结肠癌根治术。20例术后行全身静脉联合化学疗法治疗。 结果 术后发生切口感染6例,经局部换药、抗感染及支持等治疗后切口丙级愈合;其余切口均甲级愈合。术后无肠漏发生。住院时间12~68 d,平均18 d,住院期间无死亡者。所有患者术后病理检查均证实为回盲部结肠腺癌,其中合并阑尾炎28例。20例获随访,随访时间3个月~12年,平均5.6年。6例因无法切除病灶而行回肠横结肠吻合短路手术,于术后6~15个月死亡;5例行姑息性右半结肠切除术,于术后9~27个月死亡;余9例随访2~12年无复发。同期收治回盲部结肠癌167例,误诊、漏诊率为18%。 结论 回盲部结肠癌有时易误诊为阑尾炎,或并发阑尾炎时易漏诊;应仔细询问病史,全面了解和掌握患者的病情,完善必要的辅助检查,不要盲目自信是防止误诊、漏诊的关键。

    Release date:2016-09-08 09:26 Export PDF Favorites Scan
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