Technical Note: Method for estimating volume of subretinal fluid in cases of localized retinal detachment by OCT ophthalmoscopy

The volume of the subretinal fluid can be used to assess the condition of different types of retinal and macular disorders. The purpose of this report is to introduce a method to measure the volume of the subretinal fluid with the images of the optical coherence tomography (OCT) Ophthalmoscope in three cases of central serous chorioretinopathy and one case of retinal pigment epithelial detachment. We used the topography-mode program of the OCT Ophthalmoscope and measured the average height of the retinal detachment. By multiplying the size of the area of the retinal detachment and the average height of the retinal detachment, the volume of subretinal fluid could be determined. Examples are given to show the results of volume measurement of subretinal fluid in cases of localized retinal detachments.     

星点设计效应面法在药学试验设计中的应用

目的介绍星点设计基本原理,在大量文献的基础上对星点设计效应面法进行综述,指出该设计的优点和缺点。方法通过查阅国内外近年来的有关资料和文献,对星点设计效应面法在药学试验设计中的应用进行了分析。结果与结论星点设计效应面法具有试验次数少,精确度高,应用方便的特点,该设计方法可以很好地应用于药学领域。     

OCE对体外培养的视网膜组织保护作用的观察

目的:观察不同成分的培养液进行成年犬视网膜组织体外培养前后的组织形态学及SOD、MDA变化,旨在为视网膜移植提供抗氧化能力的保护性方法.方法:健康成年家犬37只(74眼).动物随机分成6组,即Ⅰ:新鲜视网膜组;Ⅱ:常规培养液组;Ⅲ:高浓度OCE组;Ⅳ:低浓度OCE组;Ⅴ:高浓度全脑组织提取液组;Ⅵ:低浓度全脑组织提取液组,各组均培养1周后进行组织形态学观察以及SOD、MDA生化指标的测定.结果:Ⅱ组视网膜大量细胞坏死.Ⅲ、Ⅴ、Ⅵ组Ⅲ组显示各层比Ⅱ组略好.Ⅳ组视网膜各层排列紧密,其中内核层及外核层细胞数量明显增多,且未见坏死细胞;高倍镜下显示结构完整.Ⅰ～Ⅵ组视网膜组织SOD值、MDA含量差异有显著性,与Ⅰ组比较Ⅱ组SOD值显著下降,Ⅱ组MDA显著增高.Ⅳ组SOD值显著增高,且明显高于新鲜视网膜组,MDA值显著降低,与Ⅰ组无统计学差异.结论:成年犬OCE中含有清除自由基、增强抗氧化能力的特殊物质.并且低浓度OCE较高浓度OCE对体外培养的视网膜组织抗氧化作用显著.     

针刺治疗假性球麻痹吞咽困难89例

假性球麻痹属于上运动神经元延髓麻痹,常见于两侧半球血管病变,如脑梗死、多发性腔隙性梗塞、脑出血等疾病。临床表现为构音障碍,吞咽困难,饮水呛咳,患者不能进食、进水,出现营养不良。笔者运用针刺治疗假性球麻痹89例,疗效显著,现报道如下。     

大型医院人才建设路径的探索和实践

就大型医院人才建设的内涵、重要性进行了探讨、分析，结合实际就其建设路径进行了阐述，并提出了要把握的几个方面问题。     

原发性眼内淋巴瘤

原发性眼内淋巴瘤是一种少见的眼部恶性肿瘤，其淋巴瘤病理分类为结节外型弥漫型大细胞B细胞淋巴瘤，属于原发性中枢系统淋巴瘤（PCNSL）的一种。近年来发病率逐渐上升，在过去的20a里，美国PCNSL的发病率增长了3倍。该病临床表现无特异性，往往表现为假性葡萄膜炎，玻璃体或病变组织细胞病理学检查是诊断的金标准；但由于玻璃体活检手术，标本保存和病理诊断方法要求较高，所以诊断困难。治疗上主要应用大剂量甲氨蝶呤治疗。由于往往有神经系统受累，预后不佳，随着治疗方法的改进PIOL的平均存活率已经从1～1．5a提高到3a以上。     

Central serous chorioretinopathy

Central serous chorioretinopathy (CSC) is a disease of the retina characterized by serous detachment of the neurosensory retina secondary to one or more focal lesions of the retinal pigment epithelium (RPE). CSC occurs most frequently in mid‐life and more often in men than in women. Major symptoms are blurred vision, usually in one eye only and perceived typically by the patient as a dark spot in the centre of the visual field with associated micropsia and metamorphopsia. Normal vision often recurs spontaneously within a few months. The condition can be precipitated by psychosocial stress and hypercortisolism. Ophthalmoscopic signs of CSC range from mono‐ or paucifocal RPE lesions with prominent elevation of the neurosensory retina by clear fluid – typical of cases of recent onset – to shallow detachments overlying large patches of irregularly depigmented RPE. The spectrum of lesions includes RPE detachments. Granular or fibrinous material may accumulate in the subretinal cavity. Serous detachment often resolves spontaneously. From first contact, counselling about the potential relation to stress and glucocorticoid medication is warranted. After 3 months without resolution of acute CSC or in chronic CSC, treatment should be considered. Resolution of detachment can usually be achieved in acute CSC by focal photocoagulation of leaking RPE lesions or, in chronic CSC, by photodynamic therapy. The effect of therapy on long‐term visual outcome is insufficiently documented. Reattachment within 4 months of onset is considered a relevant therapeutic target because prolonged detachment is associated with photoreceptor atrophy. This suggests that the value of treatment depends upon proper selection of cases that will not resolve without therapy. Chronic CSC may be difficult to differentiate from occult choroidal neovascularization secondary to CSC. Patients with chronic CSC who receive glucocorticoid treatment for systemic disease can often be managed without having to discontinue this medication.     

复方丹参滴丸治疗Bell’s面瘫的随机对照研究

目的评价复方丹参滴丸治疗Bell’s面瘫的疗效与安全性。方法将60例Bell’s面瘫患者随机分为两组，治疗组30例，对照组30例。治疗组采用复方丹参滴丸为主，辅以药物治疗和物理治疗；对照组只应用药物治疗和物理治疗。两组均治疗30d后观察疗效。结果治疗组总有效率为90．00％，对照组总有效率为80．00％，两组间差异有统计学意义。临床观察中未发现治疗组有不良反应发生。结论复方丹参滴丸治疗Bell’s面瘫安全有效，值得在临床上应用。     

A longitudinal study of autoantibodies against central nervous system tissue and gangliosides in connective tissue diseases

Our objective was to investigate longitudinally, antibodies against central nervous tissue (anti-CNS) derived from bovine brain and gangliosides GM 1, GD1a, GD1b, and GT1b in 91 patients with connective tissue diseases (systemic lupus erythematosus, n = 38; mixed connective tissue disease, n = 16; primary Sjogren's syndrome, n = 7; progressive systemic sclerosis, n= 13; polymyositis/dermatomyositis, n=4; overlap syndrome, n = 5; undifferentiated connective tissue disease, n = 8). Anti-CNS and anti-ganglioside antibodies, measured by enzyme-linked immunosorbent assay, were found in 73% and 63% of patients, respectively. Anti-CNS positive sera were also reactive in Western blotting in 74% of cases and recognized up to 14 different polypeptides from 29 to 130 kDa. Anti-CNS and anti-ganglioside antibodies reflected only in a limited extent the disease activity. In 27 of 58 patients, anti-CNS antibodies remained positive independently of disease activity and antibody levels did not correlate with the phases of exacerbations. A total of 36 of 60 anti-CNS-positive patients, in contrast to two of 22 anti-CNS-negative patients, had major neuropsychiatric manifestations (P < 0.001). Anti-ganglioside antibodies were not significantly associated with neuropsychiatric manifestations. In conclusion, our longitudinal data suggest that anti-CNS antibodies may be an important marker for the diagnosis of cerebral involvement in connective tissue diseases, but the pathogenic role of these autoantibodies remains to be determined.     

中枢神经系统感染患儿脑脊液和血清补体C3,C4及C-反应蛋白检测的临床意义

目的探讨脑脊液补体C3,C4及C-反应蛋白(C-reactive protein,CRP)检测,对中枢神经系统感染患者病因的鉴别诊断意义及脑脊液补体C3,C4与血清补体C3,C4的关系。方法采用速率散射比浊法测定38例病毒性脑炎(A组)、10例化脓性脑膜炎(B组)、18例结核性脑膜炎(C组)及22例非中枢神经系统感染(对照组)患者脑脊液及血清补体C3,C4及C-反应蛋白含量,并进行对比分析。结果1B组、C组、A组、对照组脑脊液C3阳性率分别为100.00%,88.88%,5.20%,0;脑脊液C4阳性率分别为80.00%,44.44%,0,0。B组、C组与A组及对照组脑脊液C3,C4比较,差异有显著意义(P<0.01);C组与B组、A组及对照组脑脊液C3,C4比较,差异无显著意义(P>0.05);2血清C3,C4检测结果显示,各组均在正常参考范围内,组间比较,差异无显著意义(P>0.05),与同组脑脊液C3,C4无正相关。3B组、C组脑脊液CRP值和血清CRP值与A组及对照组比较,显著增高(P<0.01);B组与C组比较,差异无显著意义(P>0.05);A组与对照组比较,差异无显著意义(P>0.05)。结论脑脊液补体C3,C4,CRP及血清CRP值,对细菌性脑膜炎与病毒性脑炎的鉴别诊断有很高的参考价值。脑脊液补体C3,C4与血清中补体C3,C4无明显相关性。