Nd:YAG激光泪道成形术联合丝裂霉素C治疗泪道阻塞疗效评价

目的评价Nd:YAG激光泪道成形术联合丝裂霉素C治疗泪道阻塞的效果。方法 Nd:YAG泪道激光成形术联合丝裂霉素C治疗192例218只眼,丝裂霉素C浓度为0.4mg/ml、泪道内浸润时间2min。术后随访观察3～36个月泪道引流的恢复情况和有无丝裂霉素C的不良反应。结果总治愈193只眼(88.5%),3只眼出现下泪点撕裂,随访对导泪无影响,无丝裂霉素C不良反应和并发症发生。结论 Nd:YAG激光泪道成形术联合丝裂霉素C治疗泪道阻塞安全有效,MMC局部发挥抗增殖抗瘢痕作用,可有效提高手术成功率。     

KTP激光泪道成形术中一次性使用丝裂霉素．典必殊眼膏治疗泪道阻塞

激光泪道成形术后再次出现泪道阻塞较常见,其复发病例主要为鼻泪管黏膜创口修复后过度纤维化而形成瘢痕或肉芽组织增生阻塞鼻泪管所致,抗代谢药丝裂霉素C(MMC)已广泛用于眼科手术,笔者从1999年11月至2001年3月对泪道阻塞患者在KTP泪道激光成形术中应用低浓度的MMC联合典必殊眼膏,对其疗效进行观察,现报告如下.     

泪道激光成形联合泪道置管术治疗泪道阻塞的疗效观察

目的:探讨应用泪道激光成形联合泪道置管术治疗泪道阻塞的临床疗效和安全性。方法:2016年1月至2016年12月,泪道阻塞患者50例67只眼,随机分成观察组25例35只眼和对照组25例32只眼。观察组行泪道激光成形联合泪道置管术,对照组行泪道置管术。置管3个月后拔管并随访6个月,观察两组患者的临床疗效和术后并发症,并对数据进行统计学分析。结果:观察组患者的术后治愈率85.7%,好转率8.6%,对照组患者的术后治愈率68.8%,好转率12.5%。观察组疗效明显优于对照组,差异具有统计意义(P0.05)。观察组和对照组患者术后发生并发症各1只眼,两组患者并发症发生率比较无统计学差异(P0.05)。结论:泪道激光成形联合泪道置管术对泪道阻塞有安全有效的治疗作用,操作简便、并发症少、安全性高,值得在临床推广应用。     

壳聚糖在激光泪道成形术中的应用

目的 探讨激光泪道成形术联合泪道内注入药物治疗慢性泪囊炎的临床疗效。方法 采用Nd：YAG泪道激光联合泪道内注和壳聚糖、0．85％生理盐水，治疗慢性泪囊炎患者116例136眼，随记3－6个月，进行疗效观察。结果 壳聚糖组6个月冲洗通畅率最高为95．6％，生理盐水组为64．1％。两组比较差异有非常显著意义（P＜0．005）。结论 采用Nd：LAG泪道激光联合泪道内注入聚糖是有效且成功率较高的治疗慢性泪囊炎的方法。     

Nd:YAG激光联合抗代谢药物治疗阻塞性泪道疾病

目的探讨Nd YAG激光联合丝裂霉素C浸润阻塞部位治疗阻塞性泪道疾病的临床疗效.方法泪道阻塞患者128例(143眼)随机分为2组治疗组66例74眼采用Nd YAG激光照射阻塞部位,阻塞解除后以0.2 mg/ml丝裂霉素C浸润阻塞部位5 min;对照组62例69眼仅用激光照射阻塞部位.2组患者阻塞解除后用庆大霉素、地塞米松和生理盐水冲洗泪道,术后泪道内注入科恒滴眼液.结果泪小点、泪小管、泪总管及鼻泪管阻塞治愈率治疗组分别是100%(8/8)、100%(9/9)、91.7%(11/12)及66.7%(30/45),总治愈率为78.38%(58/74);对照组分别是85.7%(6/7)、75.5%(6/8)、60%(6/10)及54.5%(24/44),总治愈率为60.86%(42/69).2组总治愈率存在差异有显著意义(P<0.01).结论 Nd YAG激光联合丝裂霉素C浸润阻塞部位是治疗阻塞性泪道疾病的有效方法.     

激光泪道成形术治疗滩治性先天性鼻泪管阻塞

目的 评价激光泪道成形术治疗难治性先天性鼻泪管阻塞的效果。方法 采用KTP激光泪道成形术对15例（15眼）难治性先天性鼻泪管阻塞患儿进行治疗，观察其临床效果。结果 术后随访6～24个月，治愈率为93.3%，无并发症发生。结论 激光泪道成形术能够安全、有效治疗难治性先天性鼻泪管阻塞。     

125I粒子泪道探针治疗泪道狭窄的实验研究

目的 探讨^131I粒子泪道探针治疗兔泪道狭窄的作用。方法 制备兔双侧泪道狭窄模型，随机分成狭窄对照组、探通术治疗组和放射性探针（^131I粒子）治疗组，每组10只。不作任何处理的5只新西兰纯种白兔作为空白对照组。探通术治疗组与放射性探针治疗组分别于治疗后10min、30d及处死前60min行泪道数字减影（DSA）检查，所有动物处死后立刻进行泪道标本取材，HE染色并用计算机图像分析仪测量泪道管腔面积。结果 探通术治疗组与放射性探针治疗组治疗后10min，狭窄治愈率均为100％；2组治疗后10min与30d对比，再狭窄率分别为40％，10％。空白对照组、狭窄对照组、探通术治疗组、放射性探针治疗组泪道管腔面积分别为（0．84±0．28），（0．26±0．13），（0．55±0．31）和（0．80±0．36）mm。结论^131I粒子泪道探针具有治疗泪道狭窄兼预防其发生再狭窄的作用。     

Nd∶YAG激光联合抗代谢药物治疗阻塞性泪道疾病

目的　探讨Nd∶YAG激光联合丝裂霉素C浸润阻塞部位治疗阻塞性泪道疾病的临床疗效。方法　泪道阻塞患者 1 2 8例 (1 4 3眼 )随机分为 2组 :治疗组 6 6例 74眼采用Nd∶YAG激光照射阻塞部位 ,阻塞解除后以 0 2mg/ml丝裂霉素C浸润阻塞部位 5min ;对照组 6 2例 6 9眼仅用激光照射阻塞部位。 2组患者阻塞解除后用庆大霉素、地塞米松和生理盐水冲洗泪道 ,术后泪道内注入科恒滴眼液。结果　泪小点、泪小管、泪总管及鼻泪管阻塞治愈率治疗组分别是 1 0 0 %(8/8)、1 0 0 %(9/9)、91 7%(1 1 /1 2 )及 6 6 7%(30 /45 ) ,总治愈率为 78 38%(5 8/74 ) ;对照组分别是 85 7%(6 /7)、75 5 %(6 /8)、6 0 %(6 /1 0 )及 5 4 5 %(2 4 /44 ) ,总治愈率为6 0 86 %(42 /6 9)。 2组总治愈率存在差异有显著意义 (P <0 0 1 )。结论　Nd∶YAG激光联合丝裂霉素C浸润阻塞部位是治疗阻塞性泪道疾病的有效方法。     

激光泪道成形术联合支架植入治疗慢性泪囊炎

目的：观察激光泪道成形术联合鼻泪管支架植入对慢性泪囊炎的治疗效果。方法：慢性泪囊炎患者61例（69眼），男性5例（5眼），女性56例（64眼）；病程6个月至20年。将特制的空心泪道探针插至泪道阻塞处，从空心插入光导纤维，以功率为8－14W的KTP激光击射阻塞处1－3次。待泪道通畅后从鼻腔逆行置入带有小孔蘑茹头和引流管的鼻泪管支架。术后追踪9－33个月。结果：56眼溢泪完全消失，9眼溢泪减轻，总有效率为94．2％。无并发症发生。结论：激光泪道成形术联合鼻泪管支架植入是治疗慢性泪囊炎安全、有效的方法。     

丝裂霉素C辅助鼻腔泪囊吻合术治疗泪道阻塞疗效分析

目的评价丝裂霉素C（mitomycin C,MMC）辅助鼻腔泪囊吻合术治疗泪道阻塞性疾病的有效性及安全性。方法计算机检索Cochrane Library、EMbase、PubMed、中国生物医学文献数据库（CBM）、中国知网（CNKI）及维普文献数据库（VIP）。全面收集MMC辅助鼻腔泪囊吻合术治疗泪道阻塞性疾病的临床随机对照试验（RCT）,评价纳入研究质量,提取有效数据,采用RevMan 5.1软件进行Meta分析。结果共纳入18个RCT,共1139眼,MMC组574眼,对照组565眼。按测量指标和干预措施进行亚组分析,结果显示：在传统鼻腔泪囊吻合术中用MMC在改善症状、保持泪道畅通及维持骨窗面积方面两组比较差异均有统计学意义;在鼻内鼻腔泪囊吻合术中用MMC在改善症状及保持泪道畅通方面两组比较差异无统计学意义但在维持骨窗面积方面两组差异有统计学意义。现有资料未提示严重不良术后并发症。结论在传统或鼻内鼻腔泪囊吻合术中应用MMC对提高手术疗效有一定的帮助。     

The role of interventional radiology in trauma

Introduction Interventional Radiology has evolved into a specialty having enormous input into the care of the traumatized patient.In all hospitals,regardless of size,the Interventional Radiologist must consider their relationships with the trauma service in order to     

Diagnóstico ecográfico del neumotórax

The ultrasonographic diagnosis of pneumothorax is based on the analysis of artifacts. It is possible to confirm or rule out pneumothorax by combining the following signs: lung sliding, the A and B lines, and the lung point. One fundamental advantage of lung ultrasonography is its easy access in any critical situation, especially in patients in the intensive care unit. For this reason, chest ultrasonography can be used as an alternative to plain-film X-rays and computed tomography in critical patients and in patients with normal plain films in whom pneumothorax is strongly suspected, as well as to evaluate the extent of the pneumothorax and monitor its evolution.     

Carbohydrate Supplementation during Exercise: Does It Help? How Much is Too Much?

KEY POINTS· Carbohydrate intake during exercise can delay the onset of fatigue and improve performance of prolonged exercise as well as exercise of shorter duration and greater intensity (e.g., continuous exercise lasting about 1h and intermittent high-intensity exercise), but the mechanisms by which performance is improved are different.     

The acutely limping child

Acute limping may be the result of multiple pathologies in children. The differential diagnosis varies based on the age of the child. Irrespective of age, the initial imaging work-up includes AP and frog leg radiographs of the pelvis and ultrasound; MRI may sometimes be helpful. In children less than 3 years, infections and trauma are most frequent. MRI is the imaging modality of choice when osteomyelitis is clinically suspected. Between the ages of 3 and 10 years, transient synovitis of the hip and Legg-Calvé-Perthes disease are main considerations but infection, inflammation and focal bony lesions are also considered. In children over 10 years, slipped capital femoral epiphysis also is considered.     

磁共振DWI和动态增强鉴别颅底脊索瘤和侵袭性垂体瘤的应用

目的 探讨磁共振扩散加权成像(DWI)和动态增强在颅底脊索瘤和侵袭性垂体瘤(IPA)鉴别诊断中的应用价值.方法 搜集经手术病理证实且影像学有鞍区破坏的颅底脊索瘤患者15例、向鼻咽部侵犯的IPA患者20例.测量二者的表观扩散系数(ADC)值,绘制受试者工作特征曲线(ROC),分析动态增强曲线的类型,统计达峰时间(TTP)、增强峰值(EP)和最大对比增强率(MCER),分析各个参数在鉴别诊断中的价值.结果 颅底脊索瘤的ADC值为(1.274±0.07)×10-3mm2/s,高于IPA ADC值(0.672±0.03) ×10-3 mm2/s(P ＜0.001),ADC阈值为0.964×10-3mm2/s时,ROC曲线下面积为0.997,敏感度为93.3％,特异度为100％.颅底脊索瘤时间-信号强度曲线(TIC)Ⅰ型14例,TICⅢ型1例,此例TICⅢ型者TTP约40 s;IPA TIC Ⅰ型7例,TICⅢ型13例.颅底脊索瘤和IPA的EP、MCER差异均有统计学意义(P ＜0.001).结论 ADC值和TIC的类型及其相关参数(EP,MCER)有助于颅底脊索瘤和IPA之间的鉴别.     

Do Balance Board Training Programs Reduce the Risk of Ankle Sprains in Athletes?

Introduction Ankle sprains are the most common musculo-skeletal injury that occurs in athletes,particularly in sports that require jumping and landing on one foot such as soccer,and basketball(1-4).These injuries often result in significant time loss from participation,long-term disability,and have a major impact on health care costs and resources(5-8).     

Treatment of intrahepatic arteriovenous fistula in hepatocellular carcinoma with N-butyl-2-cyanoacrylate

Primary hepatocellular carcinoma (HCC) continues to be one of the most common malignancies with an incidence of approximately one million cases per year and a dismal prognosis; some authors have reported a median survival of 1 ～ 2 months after diagnosis. Although surgery remains the only hope for cure, few patients are candidates[1,2].     

U50,488H对正常及缺氧心肌细胞L型钙电流的作用

目的 探讨心脏阿片受体和β-受体相互作用的机制。方法 采用全细胞膜片钳技术,观察U50,488H(β-阿片受体选择性激动剂)对正常和缺氧心肌细胞L型钙电流的作用。结果 U50,488H剂量依赖性(0．1～100μmol／L)抑制正常心肌细胞的L型钙电流及异丙肾上腺素(0．1μmol／L)激动的钙电流,而细胞缺氧后,这一抑制作用减弱;U50,488H对Forskolin(10μmol／L)激动的L型钙电流无明显影响。结论 β-阿片受体对β-受体信号的负性调节作用在细胞缺氧后减弱,其作用位点可能发生于β-受体与腺苷酸环化酶环节之间。