激光治疗瞳孔闭锁继发青光眼

瞳孔闭锁继发青光眼,是葡萄膜炎的严重并发症之一。可以引起眼压升高的葡萄膜炎有急性虹膜睫状体炎、慢性复发性虹膜睫状体炎、周边部葡萄膜炎、Fuchs氏异色性睫状体炎及 Still 氏病等。上述葡萄膜炎如得不到及时地治疗或治疗不恰当,就会引起虹膜后粘连、瞳孔膜闭或闭锁,造成瞳孔阻滞,阻断了房水自后房流向前房的通道,引起眼压升高;后房     

Fuchs综合征误诊为青光眼睫状体综合征的临床分析

Fuchs综合征(FHI)是一种少见的原因和性质不明的前部虹膜睫状体病,又称Fuchs异色性睫状体炎综合征,是一种特殊的慢性轻型葡萄膜炎,约占葡萄膜炎的2%～3%[1],当它继发青光眼时,易被误诊为青光眼睫状体炎综合征(简称青睫综合症),现将近年来误诊的3例(3眼)报告如下.     

急性前葡萄膜炎虹膜及睫状体形态变化观察

目的观察急性前葡萄膜炎患者治疗前后虹膜及睫状体的变化特点。方法选取2017年6月至2018年6月在我院进行治疗的25例急性前葡萄膜炎患者为研究对象,均为首次或反复性单眼发病,对照组为患者对侧健康眼(25例25只)。患者采取激素治疗法,治疗前及治疗一周后复查使用前节OCT(anterior segment optical coherence tomography,AS-OCT)、超声生物显微镜(ultrasound biomicroscopy,UBM)采集患者双眼图像,并测量房水闪辉计数、瞳孔直径、鼻侧虹膜厚度、颞侧虹膜厚度、鼻侧UBM睫状体厚度、颞侧UBM睫状体厚度,观察虹膜、睫状体的变化情况。结果 AAU患者治疗一周后复查房水闪辉计数(24.89±2.787)较治疗前(138.71±21.95)明显降低,差异具有统计学意义(P0.05),与AAU对侧眼组相比,治疗后AAU组瞳孔直径变大,差异无统计学意义(P 0.05);鼻侧虹膜厚度,治疗前AAU组明显增厚(P0.05);鼻侧、颞侧的虹膜厚度,治疗前后无明显变化;治疗前AAU组患者鼻侧、颞侧UBM睫状体厚度大于对照组,治疗一周后,睫状体厚度变低但不具有统计学意义(P 0.05)。结论急性前葡萄膜炎鼻侧虹膜明显增厚,睫状体非显著性变厚,治疗后虹膜及睫状体厚度均有所改善。     

中间葡萄膜炎18例误诊分析

葡萄膜炎属常见眼病 ,虹膜睫状体炎和后葡萄膜炎具有典型的临床特征 ,容易诊断。中间葡萄膜炎又称睫状体平坦部炎或周边部葡萄膜炎 ,为累及周边视网膜、睫状体平坦和玻璃体基底部等的渗出性炎症或增殖性病变 ,病因不明 ,早期无明显的视功能障碍 ,眼前节炎症轻微或无 ,误诊率达 5 8%～ 6 7% [1] 。本文报告 18例中间葡萄膜炎误诊病例。1　临床资料1 1　一般资料　本文 18例 32眼为我院门诊 1988年 2月～1998年 2月诊治的 2 7例中间葡萄膜炎中被我院或外院误诊的患者。男性 10例 ,女性 8例 ;双眼发病 14例 ,单眼发病 4例 ;年龄最小 16岁 ,最大…     

葡萄膜炎性青光眼的诊治进展

<正> 慢性高眼压是眼内炎症最严重的并发症,可与任何型葡萄膜炎同时发生。葡萄膜炎性青光眼属难治性,是葡萄膜炎致盲的主要原因之一。葡萄膜炎性青光眼的诊断和治疗目的在于对葡萄膜炎和青光眼进行合适的处理,以挽救视力。本文就葡萄膜炎性青光眼的临床诊治进展综述如下。 1病理生理 葡萄膜炎时眼内压的变化取决于炎症时睫状体房水产生与房水通过炎症性小梁网排出之间的平衡。在疾病的不同阶段,眼内压可以是正常、升高或降低。当睫状体分泌正常时,房水流出减少,则眼内压升高;睫状体分泌减少,而房水流出正常,眼内压降低;若房水流出减少,     

青光眼睫状体炎综合征误诊的分析

目的分析青光眼睫状体综合征误诊原因及鉴别诊断要点。方法选择临床资料及长期随访记录完整的青光眼睫状体炎综合征被误诊的患者40例（42只眼）为研究对象,进行归类统计、分析及长期随访观察。结果青光眼睫状体炎综合征被误诊为：1.急性闭眼角型青光眼20例（20只眼）,占47.62%;2.急性虹膜睫状体炎继发性青光眼8例（8只眼）占19.05%;3.虹膜睫状体炎5例（5只眼）,占11.90%;4.中间葡萄膜炎5例（7只眼）,占16.67%;5.Fuchs综合征2例（2只眼）占4.76%。长期观察表明：此综合征每年发作次数不等,差别较大,因人而异,每次发作无明确诱因,多次反复发作,视功能不受影响。有1例（1只眼）10年后合并原发性开角型青光眼发生。结论青光眼睫状体炎征综合症的误诊较为常见,必须掌握其诊断与鉴别诊断的要点,还需要长期观察,少数病例可合并原发性开角型青光眼发生。     

外伤性Ⅱ期人工晶状体植入术后眼部炎症及血-房水屏障功能研究

[目的] 研究外伤性无晶状体眼在Ⅱ期人工晶状体植入手术前、后眼部炎症、血房水屏障功能改变及其影响因素.[方法] 前期手术后 1～ 5个月、无眼后段病变、矫正视力≥ 0.3的外伤性无晶状体眼患者.根据囊膜情况采取残余囊膜支撑或缝线固定的方式植入人工晶状体.术前、术后行超声生物显微镜( UBM)、黄斑区光学相干断层成像( OCT)、激光蛋白细胞检测仪( LFCM)及常规检查.共 39例,平均随访 6个月.[结果] 外伤性无晶状体眼房水细胞( 4.70± 6.06) /mm3高于健眼( 1.08± 1.46) /mm3( P< 0.05);房水蛋白光子计数 (8.55± 5.48)ms- 1,高于健眼 (3.78± 1.25 )ms- 1( P< 0.05);挫伤、 PPV手术及年龄小者房水蛋白高.Ⅱ期人工晶状体植入术后 3个月患眼房水细胞( 6.02± 8.26) /mm3,等同于术前,术后持续性葡萄膜炎房水细胞数量明显增加;房水蛋白光子计数( 10.78± 8.39) ms- 1,较术前升高( P< 0.05).挫伤、襻位于睫状体冠部或扁平部、术前房水蛋白含量与术后房水蛋白含量呈正相关.[结论] 外伤性无晶状体眼存在一定程度的炎症及血房水屏障功能障碍并持续一定时间,Ⅱ期人工晶状体植入致血房水屏障进一步破坏,准确地将襻植入睫状沟是减少血房水屏障破坏的重要手段.     

青光眼睫状体炎综合征临床治疗体会

目的:探索青光眼睫状体炎综合征的临床治疗方法与效果。方法:以我院接治的60例青光眼睫状体炎综合征患者作为本次研究对象,统计分析患者的临床治疗效果。结果:经临床统计发现,60例患者经治疗后共计47例痊愈,8例好转,另有5例患者治疗无效,其总的有效率为91.7%(55/60)。在治疗时间方面,21例患者小于7d,占35%,26例患者为8-14d,占43.3%,7例患者为15-21d,占11.7%,另有6例患者治疗时间超过22d,占10%。结论:清关眼睫状体炎综合征通常伴随有眼压升高的症状,多以单眼为主,在治疗中与开角型清关眼、闭角型、前葡萄膜炎等相区别,借助抗炎与降眼压等治疗处理,能够取得理想的治疗效果。     

角膜后沉着物的活体共焦显微镜检查

目的:通过活体共焦显微镜(IVCM)检查,评估不同亚型葡萄膜炎患者其角膜后沉着物(KP)的多样性。方法:通过扫描共焦显微镜观察33例患者的K P。这些患者均来自一个治疗免疫相关性和感染性葡萄膜炎的专业机构,该机构中接诊的患者包括H LA-B27相关性葡萄膜炎、类肉瘤病、Vogt-小柳-原田综合征、青少年慢性关节炎、Fuchs异色性虹膜睫状体炎、巨细胞病毒性视网膜炎、带状疱疹病毒性眼炎、眼部弓形体病及特发性葡萄膜炎。图像摄取后行实时数字化分析。结果:研究中检查33例患者的42只眼。年龄为22～84岁,珔x=49.4岁,女性17例(占52%),男性16例(占…     

单疱病毒性角膜炎伴发青光眼

目的探讨单疱病毒性角膜炎伴发青光眼的临床特点,发病机制与治疗方法。方法对21例患者的临床资料及实验室检查结果进行分析。结果21例患者中,盘状角膜基质炎15例,角膜色素膜炎4例,拟青光眼睫状体炎2例。共同的临床表现特点是:在原角膜病变的基础上出现眼胀痛,结膜充血加重,角膜上皮弥漫性水肿及不同程度的色素膜眼体征,眼压升高多在6.65 kPa以上。PCR检测外周血单疱病毒Ⅰ型DNA阳性4例(19.05%)。21例患者经过抗病毒及抗炎治疗均获临床治愈。结论本组病例多系单疱病毒通过内生性感染导致小梁炎与色素膜炎引起眼压升高,通过积极的抗病毒与抗炎治疗能迅速控制炎症与眼压。     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

Dr.Zhang Ren''''s Experience in the Acupuncture Treatment of Different Diseases with the Same Therapeutic Principle

Dr.Zhang Ren,the chief physician,is the chairman of Shanghai Acupuncture and Moxibustion Association.Having been engaged in medicine for about 40 years,he is experienced in treating various intractable diseases.In his long years of clinical practice,he advocates taking the TCM differentiation as the basis to seek for the acupuncture method for treatment of modern intractable diseases.The author of this essay had the fortune to follow Dr.Zhang in study.The following is a summary of Dr.Zhang's experience in the acupuncture treatment for different intractable diseases with the same therapeutic principle.     

Luo Lingjie''''s Experience in Treating Chronic Nephropathy

In treating chronic nephropathy,Luo Lingjie,a chief physician,pays attention to regulating the balance between yin and yang,treating infection if present,and removing pathogenic factors.He prescribes gentle drugs and uses carefully strongly warming-tonifying ones,emphasizes the importance of persuading the patient to persist in treatment with medication and nurse one's health for recuperation,and is good at combined use of TCM and western medicine therapy and brings the merits of various therapies into full play,with obvious theraoeutic effects.     

Acupuncture Combined with Spinal Tui Na for Treatment of Primary Dysmenorrhea in 30 Cases

Objective: To observe the therapeutic effects in acupunture treatment of primary dysmenorrhea combined with spinal Tui Na, and study its mechanism. Methods: Thirty cases of the treatment group were treated by acupuncture combined with spinal Tui Na, and thirty cases in the control group were treated by routine acupuncture. Results: The total effective rate was 93.3% in the treatment group, and 73.3% in the control group, with a significant difference between the two groups (P<0.05). Conclusions: Acupuncture combined with spinal Tui Na has good prospects for treatment of primary dysmenorrhea.     

猪肺磷脂注射液联合经鼻持续气道正压通气对呼吸衰竭早产儿的临床疗效及肌酸激酶同工酶活性的影响

目的 探讨猪肺磷脂注射液联合经鼻持续气道正压通气(NCPAP)对呼吸衰竭早产儿的临床疗效及肌酸激酶同工酶活性(CK-MB)的影响.方法 选取呼吸衰竭早产儿80例,分为观察组和对照组各40例.对照组采用NCPAP给氧治疗,观察组给予NCPAP给氧联合猪肺磷脂气管内给药.观察两组患儿治疗前及治疗12h、24 h后PaO2、PaCO2、血氧饱和度(SaO2)、pH的变化情况,检测治疗前及治疗5d后血清CK-MB水平;评估两组患儿的临床治疗效果.结果 两组患儿PaO2、PaCO2、SaO2、pH比较,差异均有统计学意义(P＜0.05),其中观察组治疗后的PaO2、SaO2、pH均高于对照组,PaCO2则低于对照组.两组的PaO2、SaO2、pH均随观察时间延长而升高(P＜0.05),PaCO2均随观察时间的延长而降低(P＜0.05).观察组治疗有效率为87.5％,显著高于对照组的70.0％ (P ＜0.05).治疗5d后两组患儿血清CK-MB水平均较前降低(P＜0.05),且观察组明显低于对照组(P＜0.05).结论 猪肺磷脂注射液气管内给药联合NCPAP可以显著降低呼吸衰竭早产儿CK-MB的含量,提高治疗有效率,起到很好的呼吸循环支持作用.     

Survey and practice of reporting quality of randomized controlled clinical trials on traditional Chinese medicine

Evidence obtained from randomized controlled trials （RCTs） has been generally accepted as the gold standard in the evaluation of clinical effectiveness. Readers need to understand the trial design, implementation, results, analysis and interpretation, so as to fully Jnderstand the results of RCTs. Thus, the investigators of RCTs have to report these items in a complete, accurate and clear manner. Since 1998, we have conducted several evaluations on the reporting quality of RCTs published in Chinese journals on traditional Chinese medicine （TCM） and results have shown that there is an urgent need for higher quality RCTs on TCM.     

TCM Treatment of Ankylosing Spondylitis by Tonifying the Kidney and Strengthening the Governor Vessel

Ankylosing spondylitis is a chronic and progressive disorder with inflammation mainly involving the central axis joints. It mainly affects the cervical spine and the lumbosacral area, with the pathogenesis closely related to the kidney and the Governor Vessel (GV). TCM holds that the syndrome is deficiency in origin and excess in superficiality, which is due to insufficiency of the kidney, deficiency of GV, and blocking of the channels with the invasion of exogenous evil, leading to poor circulation of qi and blood and malnutrition of the bones, muscles and joints. The TCM method of tonifying the kidney and strengthening GV to regulate circulation of qi and blood and check the arthralgia pain should be adopted, with the Kidney-Tonifying and GV Strengthening Decoction (益肾强督汤) prescribed.     

IMPROVING P-gp EXPRESSION IN HUMAN MONONUCLEAR CELLS IN VITRO TRANSFECTED BY MULTIDRUG RESISTANCE-1 mRNA

CHEMOTHERAPY playsa greatrolein the treat- ment of malignanttumors,especiallyingynecolo- gicalones.But inanticancerchemotherapy,leuko-cytopeniaisfrequentlytheprimarydose-limitingsideeffect factor.Moreover,cancersarefrequentlychemoresistantbe-causeof overexpressionof P-glycoprotein(P-gp), which isencodedby multidrugresistancegene (MDR1 ) and detectableinup to50% ofhuman cancersand renderscellsresistancetoanticancerdrugs.The safetyand potentialtherapeuticbenefitof mdr1 gene transferredto h…