ECG signal conditioning by morphological filtering

Clinically obtained electrocardiographic (ECG) signals are often contaminated with different types of noise and baseline drifting commonly occurs. In order to facilitate automated ECG analysis, signal conditioning is undoubtedly a necessity. In this paper, a modified morphological filtering (MMF) technique is used for signal conditioning in order to accomplish baseline correction and noise suppression with minimum signal distortion. Compared with existing methods for ECG signal conditioning, MMF performs well in terms of the filtering characteristics, low signal distortion ratio, low computational burden as well as good noise suppression ratio and baseline correction ratio.     

Two therapeutic concepts in intermittent divergent squint

Several therapeutic concepts are in favour of the treatment of intermittent exotropia. The presented paper will try to answer the question, whether this leads to different results, by the review of the 1989 and 1990 cases of two centres. In the Munich Right Isar Eye Hospital (Centre II) during this period 72 patients (already published data) were treated by recession and resection eye muscle surgery against intermittent exotropia or decompensating exophoria. The 111 compared patients of the Department of Orthoptics and Pleoptics at the University Eye Hospital Kiel (Centre I), were mostly treated with bimedial resection procedures. Another difference: diagnostic occlusion and prism correction were done in the Munich patients. There is major evidence that there are two widely different clinical pictures incorporated in the diagnostic frame of the so-called Intermittent Exotropia. In a third prospective group of patients (10/91 – 3/92), therefore, the prism-acceptance was evaluated.Abreviations APC alternating prism and covertest - APC F alternating at 5 m distance - APC N alternating at near fixation - EP exophoria - R and R resection-recession procedure - XT exotropia     

Banding of nipples as an augmentation of the suction correction of flat or inverted nipples

Summary Banding the nipples with a split and stretched rubber band or by the use of plaster is supplementary to the suction method for correction of flat or inverted nipples and effectively reduces the number and durations of such suction sessions, substantially improving the results. These procedures are an ideal solution for this condition.     

气管壁镜面伪像对甲状腺结节微波消融治疗的不利影响

目的 探讨甲状腺结节微波消融围手术期气管壁镜面伪像对消融术的不利影响及其成因。方法 对2018年1月至2018年10月在上海国际医学中心接受甲状腺结节微波消融治疗的304例患者的围手术期超声影像资料进行系统性研究。就出现气管壁镜面伪像的病例数、伪像来源、伪像特点,以及伪像对消融术的影响进行总结。分析发生气管壁镜面反射伪像的影响因素。结果 消融术前、术中、术后各期超声影像中共169（55.59%）例出现气管壁镜面反射伪像,包括甲状腺结节伪像20例（11.83%）、隔离液注射针伪像133例（78.70%）、微波消融针伪像16例（9.47%）、液体隔离带伪像137例（81.07%）、甲状腺消融区伪像8例（4.73%）。各期中,以消融术中出现伪像者最多,达88.17%（149/169）。结论 气管壁镜面反射引起的镜面伪像在甲状腺结节微波消融围手术期具有较高的发生率,结节位置邻近气管、气管壁扁平化、平坦界面线度大于结节实像是形成气管壁镜面反射伪像的主要因素。结节、消融区、液体隔离带的直接压迫是气管壁扁平化的直接原因。     

乳头内陷的外科治疗进展

乳头内陷是一种女性常见疾病,可由先天因素导致,也可由后天因素导致,按照严重程度不同将其分为3级。乳头内陷除影响女性乳房的形态和功能外,还容易诱发浆细胞性乳腺炎。国内外学者为矫治乳头内陷进行了大量的基础和临床研究,目前其主要治疗方法分为外科手术治疗和非手术治疗两大类,由于乳头内陷患者的个体化差异,以及不同术者的手术习惯,虽然经报道的乳头内陷治疗方法很多,但目前还没有任何一种单一手术方式可以矫正所有类型的乳头内陷。本文总结概括了国内外乳头内陷外科治疗方法的研究进展,对真皮瓣法、牵引法和微创及内镜下纤维组织松解法3类外科手术治疗方法及其主要优缺点进行了介绍。     

Hybrid Lateral Closed-Wedge High Tibial Osteotomy Showed Similar Accuracy in Angular Correction and Reduction of Posterior Tibial Slope Compared to Opening-Wedge High Tibial Osteotomy: A Correction Angle Matched Cohort Study

BackgroundWe aimed to compare the accuracy of applied correction angle between hybrid lateral closed wedge high tibial osteotomy (hybrid HTO) and medial open wedge high tibial osteotomy (OWHTO), and verify previous reports on hybrid HTO by matching correction angle between groups. Change in various radiological parameters including union rate were also compared.MethodsA total of 50 OWHTO patients were selected for 2:1 propensity matching with 25 hybrid HTO patients. Rate of correction error was calculated by dividing the difference between the change in medial proximal tibial angle and preoperatively planned correction angle (PRD) by planned correction angle. Accuracy of angular correction was assessed using PRD and correction error rates. Hip-knee-ankle axis, mechanical lateral distal femoral angle, medial proximal tibial angle, joint line convergence angle, and length of the entire lower limb and tibia were measured. The Caton-Deschamps index (CDI) was used to assess change in patellar height. Serial postoperative radiographic analysis was performed to assess the union rate.ResultsThe discrepancy between planned correction angle and real correction angle was 0.8 ± 2.3° in hybrid HTO and 1.1 ± 3.4° in OWHTO (P > .05), and the rate of error in osteotomy was similar between the groups approximately 6%. Postoperatively, posterior tibial slope (PTS) (P < .001), tibia length, and CDI (P < .001) were significantly different between groups. The amount of change in PTS (P < .001), tibia length in hybrid HTO (P < .001), and CDI (P < .001) were significantly different between groups. Union rate of osteotomy site was significantly faster in hybrid HTO than in OWHTO (P < .001).ConclusionHybrid HTO showed similar accuracy in angular correction compared to correction angle-matched OWHTO. Reduction in PTS, tibial shortening, maintained patellar height relative to the proximal tibia, and faster osteotomy site union were also confirmed in hybrid HTO.     

地西泮辅助局部麻醉在共同性斜视矫正术中的镇静效果分析

分析地西泮辅助局部麻醉在共同性斜视矫正术中的镇静效果,为临床治疗提供参考。回顾性分析本院2015年6月至2017年6月期间诊治的行共同性斜视矫正术80例患者的临床资料,分析地西泮辅助盐酸罗哌卡因注射液(观察组,n=40)局部麻醉镇静效果的Ramsay评分、面部表情分级评分和焦虑评分,并分析手术时间和不良反应发生率。盐酸罗哌卡因注射液局部麻醉手术患者为对照组(n=40)。结果显示观察组患者的镇静效果评分明显高于对照组(P<0.05),术中和术后焦虑评分、面部表情分级明显低于对照组患者(P<0.05);观察组患者的手术时间明显短于对照组,不良反应发生率低于对照组患者(P<0.05),且术后随访观察组病情恢复效果优于对照组患者。因此,地西泮辅助局部麻醉在共同性斜视矫正术中的镇静效果明显,且能有效缓解患者的焦虑情绪。     

鼻中隔缝合和鼻腔填塞在鼻内镜下鼻中隔矫正术后治疗中的应用比较

目的比较分析鼻中隔缝合与鼻腔填塞在鼻内镜下鼻中隔矫正术后治疗中的应用效果。方法选取2015年1月～2018年1月于我院就诊并行鼻内镜下鼻中隔矫正术的患者80例将其随机均分为A组与B组,A组予以鼻中隔缝合治疗,B组予以鼻腔填塞治疗,采用Lund-Mackay评分系统评估鼻内镜、鼻窦CT情况;采用视觉模拟评分量表(VAS)评估患者的临床症状改善程度,比较两组治疗效果。结果 A组患者临床症状的VAS评分低于B组(P0.05)。A组治疗后的鼻内镜评分、鼻窦CT评分显著低于对照组(P0.05)。A组总有效率87.5%显著高于B组的67.5%,差异具有统计学意义(P0.05)。根据VAS量表得分,A组患者的鼻塞得分(0.92±0.25)分、头痛(1.75±0.47)分、鼻部疼痛(1.36±0.28)分、流泪(0.44±0.11)分、耳鸣/耳闷(0.52±0.17)分、吞咽困难(0.61±0.20)分、睡眠困难(0.98±0.25)分、术后清理鼻腔时疼痛不适感(1.72±0.39)分,各项VAS评分均低于B组(P0.05)。两组鼻腔渗血量、术后鼻中隔血肿、鼻粘连比较差异无统计学意义(P0.05)。结论鼻内镜下鼻中隔矫正术后应用鼻中隔缝合治疗可有效减轻患者的临床症状,减少患者的痛苦,较鼻腔填塞更有优势,值得在临床推广使用。