手术治疗眼眶爆裂性骨折26例临床分析

目的 分析评价Medpor植入修复眼眶爆裂性骨折的治疗效果.方法 对行眼眶壁骨折修复的26例住院患者进行回顾性分析.结果 26例中25例(96.2%)眼球内陷得到明显改善,24例复视和眼球运动障碍患者中21例治愈,3例好转.结论 采用手术修复联合Medpor植入治疗眼眶爆裂性骨折安全、有效.     

眼眶爆裂性骨折的临床分析

目的 探讨眼眶爆裂性骨折的临床特点和诊治方法.方法 对89例89眼眼眶爆裂性骨折患者的致伤原因、临床表现及治疗方法进行回顾性分析.结果 经CT扫描证实为眼眶爆裂性骨折的89例患者,致伤原因最常见于拳伤(57.3%),其次为车祸(20.2%)、脚踢伤(11.2%)、钝物撞击伤(9.0%)、坠落伤(2.2%).所有患者均有眼睑肿胀瘀血、视力不同程度下降;骨折面积大可出现眼球内陷;合并外直肌嵌顿可出现眼球运动障碍、复视;前房积血、视网膜震荡、黄斑出血等少见.结论 眼眶爆裂性骨折临床表现多种多样易被误诊,CT扫描对眼眶爆裂性骨折的诊断具有诊断价值.     

Medpor治疗眼眶爆裂性骨折的临床疗效分析

目的探讨应用高密度多孔聚乙烯(Medpor)填充材料治疗眼眶爆裂性骨折的手术方法及临床疗效。方法选取68例眼眶爆裂性骨折患者,均采用Medpor眶壁修补术治疗。观察患者切口愈合情况、眼球内陷矫正情况、眼球运动恢复情况、复视程度及并发症情况。结果68例患者术后均获得Ⅰ期切口愈合,68例术前眼球内陷患者术后均得到不同程度矫正,其中22例完全矫正,40例基本矫正,6例残留1~2 mm眼球内陷。68例患者术后眼球运动均恢复正常,术后均无视力下降或丧失。术前存在不同程度复视的42例患者,均于术后1周~4个月内复视消失。68例患者均无Medpor移位、脱出、感染或排斥反应,无明显下眼睑切口瘢痕及眼睑外翻发生。结论眼眶爆裂性骨折手术中充分松解嵌顿的眼外肌防止再粘连是消除复视的关键。Medpor材料生物相容性好,无致敏反应,疗效可靠,早期采用Medpor眶壁修补术是治疗眼眶爆裂性骨折的有效方法。     

眼眶爆裂性骨折8例的临床治疗

目的探讨眼眶爆裂性骨折的临床表现和治疗.方法经CT确诊爆裂性眶骨折8例,其中内侧壁骨折5例,下壁骨折2例,内侧合并下壁骨折1例,手术治疗3例,非手术治疗5例,临床主要表现为眼球内陷、复视和眼球运动障碍.CT显示眶壁骨折移位,眶腔扩大,眶内软组织嵌顿和副鼻窦损伤.结果非手术治疗和手术治疗病例全部临床治愈.结论眼眶爆裂性骨折引起的眶壁骨组织破坏导致眼眶组织解剖异常,CT可以显示眶壁结构破坏和眶组织及副鼻窦损伤的变化,是否手术治疗取决于骨折的程度和对眶内组织损伤的影响.     

Medpor填充联合自体脂肪移植治疗眼眶爆裂性骨折疗效观察

眼眶爆裂性骨折是眶部挫伤所致的眶壁骨折,是由直径大于眶口的物体钝性打击眼部,使眶内压突然升高,引起眶壁薄弱处爆裂所敛.眼眶爆裂性骨折常伴有软组织如眼外肌、脂肪、韧带和筋膜等结构嵌顿,从而引起复视和眼球内陷.我院自2005年9月-2008年10月,共为65例(65眼)眼眶爆裂性骨折患者行骨折修复,其中15例早期联合自体脂肪移植,取得良好效果,现报告如下.     

眶爆裂性骨折眼球内陷的手术治疗体会

目的探讨眶爆裂性骨折眼球内陷患者的手术治疗方法以及临床效果。方法回顾性分析2010年1月至2014年6月本院收治的46例眶爆裂性骨折眼球内陷患者的临床资料。结果术后3个月33例眼球内陷基本矫正;13例明显改善;第一眼位复视基本消失18例,周边视野复视改善5例,复视不变5例。未发生感染、置入材料排出及移位等并发症。结论眶骨骨折所致后期眼球内陷畸形可通过骨复位及植骨的手段重建眶缘,修复眶骨各壁的缺损,缩小扩大的眶腔而得以有效矫正。     

眼眶爆裂性骨折的诊断治疗体会

<正>随着社会经济的发展,工业外伤和交通事故的发生率增加,眼眶爆裂性骨折的发生率也明显上升。伤者出现眼球运动障碍,复视,眼球内陷及感觉异常等临床表现。以往眼科医师对此类骨折多采取非手术治疗,但随着医疗诊断技术的提高和新的医疗器械、医用材料的应用,眼眶爆裂性骨折及时行手术治疗,可取得良好的临床效果。1资料和方法1.1一般资料笔者所在医院2001-01～2009-10经CT等检查诊断为爆裂性眶壁骨折共38例(38眼),男31例,女7例;年龄19～76岁。均为眼钝挫伤,其中拳击伤13例,车祸伤12例,木棍等钝器伤8例,摔伤5例。右眼20例,左眼18     

眶壁爆裂性骨折276例临床分析及术后功能评估

<正>眶壁爆裂性骨折是指外力作用于眼眶,由于眶内压急剧增高,使眶壁薄弱处发生骨折及移位,而眶缘部并无骨折,它是发生眼球内陷及复视的主要原因。随着交通事故和外伤的增加,眶壁爆裂性骨折的发病率逐年增多,典型病例表现为     

眼眶爆裂性骨折的手术治疗探讨

目的探讨眼眶爆裂性骨折术中应用Medpor填充治疗的手术效果。方法对2004年1月至2010年12月在河南省眼科研究所收治的51例眼眶爆裂性骨折患者的临床表现和治疗方法进行回顾性分析。眶内壁骨折患者采用内眦皮肤切口入路,眼眶下壁骨折及下壁合并内壁骨折书中采用下睑睫毛下皮肤切口入路,充分暴露眼眶骨折部位,将嵌顿于眼眶骨折处的眼外肌及眶脂肪游离至眶内,骨膜下填充塑形后的Medpor材料。结果 51例患者眼球内陷全部矫正,48例术后复视均有好转,42例眼球活动度完全改善,6例部分改善。结论用Medpor材料行眶壁修补术是治疗眶壁爆裂性骨折的有效方法,术中应充分松解嵌顿的眼外肌;术后早期加强眼外肌功能训练,防治再粘连是消除复视的关键。早期手术疗效优于晚期手术。     

MEDPORE植入材料在眼眶爆裂性骨折中的临床应用

目的探讨在眼眶爆裂性骨折手术中应用MEDPORE外科植入体材料的临床疗效。方法回顾性分析我院2010年2月至2013年6月应用MEDPORE植入材料46例(46眼)眼外伤眶骨骨折患者的临床资料。结果 46例患者术后效果满意,双眼突出度基本一致,眼球内陷得到不同程度的矫正,眼球运动恢复正常,43例复视消失,2例复视改善,1例复视无改善。出院随访患者未出现植入物脱出或排斥反应。结论 MEDPORE外科植入体材料组织相容性较好,可塑性强,眼眶爆裂性骨折、尤其眶下壁和眶内侧壁骨折手术,应用MEDPORE外科植入体材料可以有效的防止患者术后发生眼球下陷、回退等并发症,临床应用效果满意。     

老年代谢综合征患者动脉弹性的相关研究

目的探讨老年代谢综合征(MS)与动脉弹性的关系。方法根据2005年国际糖尿病联盟MS诊断标准将256例受试者分为健康对照组(无任何指标异常)、非MS组(不满足MS标准但含有1个以上代谢指标异常)、MS组亚组1(腰围+其他2项指标异常)、亚组2(腰围+其他3项或以上指标异常)。应用全自动脉搏波速度测量系统测定臂—踝动脉脉搏波速度(baPWV)作为反映动脉弹性的指标,并与各临床观察指标进行多元回归分析。结果MS各亚组baPWV均显著高于健康对照组(P<0.01)及非MS组(P<0.01),非MS组与对照组间差异也有统计学意义(P<0.01)。ba PWV与年龄(r=0.543,P<0.001)、收缩压(r=0.562,P<0.001)、舒张压(r=0.387,P<0.001)、平均动脉压(r=0.468,P<0.001)、脉压(r=0.487,P<0.001)、空腹血糖(r=0.519,P<0.001)、甘油三酯(r=0.236,P<0.001)、腰围(r=0.136,P=0.029)和尿酸(r=0.162,P=0.010)呈显著正相关。多元逐步回归分析显示,年龄、收缩压和甘油三酯是影响baPWV的独立因素。结论在老年人群中MS组成成分的聚集可能促进动脉硬化的发生和发展。对老年MS患者进行代谢成分聚集的评估及进行脉搏波速度检测有助于心血管事件的一级预防。     

Predicting the outcome of severe ulcerative colitis: development of a novel risk score to aid early selection of patients for second-line medical therapy or surgery

BACKGROUND: The failure rate of medical therapy in severe ulcerative colitis is high. A risk index, to aid the identification of patients of not responding at an early stage to intravenous corticosteroid therapy, would be useful to facilitate second-line treatment or surgery. METHODS: We recruited 167 consecutive patients with severe ulcerative colitis between January 1995 and March 2002; and employed multiple logistic regression to analyse parameters within the first 3 days of medical therapy. We applied statistical modelling to formulate a risk score according to the likelihood of medical failure. RESULTS: Sixty-seven (40%) patients failed to respond to medical therapy. Multiple logistic regression analysis identified mean stool frequency and colonic dilatation within the first 3 days and hypoalbuminaemia as independent predictors of outcome (P < 0.001, 0.001 and 0.002 respectively). A numerical risk score was formulated based on these variables. Patients with scores of 0-1, 2-3 and > or =4 had a medical therapy failure rate of 11%, 43% and 85% respectively. Receiver-operator characteristic analysis of this score yielded area under curve of 0.88, with a sensitivity of 85% and specificity of 75% using score > or =4 in predicting non-response. CONCLUSION: This risk score allows the early identification of patients with severe ulcerative colitis who would be suitable for second-line medical therapy or surgery.     

Influence of age on the steady state disposition of drugs commonly used for the eradication of Helicobacter pylori

BACKGROUND: The success of eradication therapy for Helicobacter pylori might be affected by the age of patients. AIM: To investigate whether disposition of drugs commonly used for H. pylori eradication is age-dependent. METHODS: Trough steady state serum levels of lansoprazole or ranitidine, amoxycillin, clarithromycin and metronidazole were monitored in 232 patients during the last dosing interval of a 5-day quadruple H. pylori eradication regimen. Detailed pharmacokinetic analysis was performed in 28 patients. RESULTS: Linear correlations between age and trough serum levels were observed with lansoprazole (r=0.25; P=0.002), ranitidine (r=0. 38; P=0.001) and clarithromycin (r=0.36; P < 0.0001). These associations were also inversely dependent of creatinine clearance for ranitidine (r=0.36; P=0.001) and clarithromycin (r=0.30; P < 0. 0001). Multiple linear regression revealed age as an important factor influencing trough serum levels of lansoprazole, clarithromycin and ranitidine. There were significant inverse relationships between creatinine clearance and area under curve of ranitidine (r=0.88; P < 0.0001) and amoxycillin (r=0.56; P=0.002). Multiple linear regression revealed serum creatinine as the most important factor influencing the area under curve of ranitidine, clarithromycin and amoxycillin. CONCLUSIONS: Age per se has little influence on pharmacokinetics of amoxycillin and ranitidine, which depend more on age-dependent decline in renal function. The influence of age, but not renal function was established for lansoprazole. Age and renal function have independent impacts on clarithromycin disposition.     

海洛因依赖者血清细胞因子含量与红细胞免疫功能的变化及其相互关系

目的·· :探讨海洛因依赖者血清细胞因子含量与红细胞免疫功能的变化及其关系。方法·· :采用双抗夹心ELISA法对50例海洛因依赖者血清白细胞介素2(IL -2)、可溶性白细胞介素2受体 (sIL -2R)和干扰素 -γ(IFN -γ)进行测定 ;检测红细胞C3b受体花环 (RBC -C3bRR)、红细胞免疫复合物花环 (RBC -ICR)、粘附增强因子活性(RFER)及抑制因子活性 (RFIR),观察海洛因依赖者红细胞免疫功能的变化。结果·· :海洛因依赖者血清IL -2、IFN -γ水平显著低于正常组 (P<0.01),sIL -2R水平比正常组明显上升 (P<0.01) ;海洛因依赖者RBC -C3bRR、RFER明显下降 (P<0.01)。血清IL -2和IFN -γ含量与RBC -C3bRR、RFER正相关(r=0.86,P<0.01);血清sIL -2R水平与RBC -C3bRR、RFER负相关(r= -0.88,P<0.01)。结论·· :海洛因依赖者细胞因子 (IL -2、IFN -γ)水平及红细胞免疫功能均属低下 ,且二者密切相关。     

Chlorzoxazone: a probe drug the metabolism of which can be used to monitor one-point blood sampling in the carbon tetrachloride-intoxicated rat.

In this study, we have carried out an investigation to determine if chlorzoxazone (CZX) is a suitable probe drug for predicting hepatic injury in carbon tetrachloride (CCl4)-intoxicated rats. The animals received oral doses of CCl4 (0.25, 0.5 and 1 ml/kg) 24 h prior to intraperitoneal administration of CZX. The total CYP and CYP2E1 content, as well as the aniline and CZX hydroxylase activity (Vmax and CLint), was reduced depending on the dose of CCl4 administered. At the highest concentration (128 mM) of diethyldithiocarbamate, a specific inhibitor of CYP2E1, the production of 6-hydroxychlorzoxazone (HCZX) in microsomes from CCl4-treated rats was reduced by about 85%. The IC50 value in microsomes from CCl4-treated rats was between 3 and 5 microM. The production of HCZX and the activity of aniline hydroxylase in CCl4-treated rats correlated with the amount of rat CYP2E1 protein (r=0.881, P<0.001 and r=0.822, P<0.001, respectively). The elimination of CZX by CCl4-treated rats was reduced and the HCXZ production in the CCl4-treated group was less than that in the olive oil-treated control group. The correlations between the intrinsic clearance [CLint: Vmax/Km) in vitro and the total body clearance (CLtot) of CZX hydroxylation and the elimination half-life (t1/2) of CZX in vivo in CCl4-treated rats were high (r=0.839, P<0.001 and r= -0.828, P<0.001, respectively). In addition, the metabolic plasma HCZX/CZX ratio did not require multiple blood sampling and, 2 h after CZX administration in vivo, there was also a high correlation with the CLint (Vmax/Km) in vitro (r= -0.909, P<0.01). In conclusion, these results from this study demonstrate that CZX is a good probe for monitoring the inhibition of metabolism in rats due to CCl4 treatment.     

Using behaviour to predict stroke severity in conscious rats: post-stroke treatment with 3', 4'-dihydroxyflavonol improves recovery

Prognostic models are used to predict outcome in stroke patients and to stratify treatment groups in clinical trials. No one has previously attempted to use such models in stroke recovery studies in animals. We have now shown the predictive value of assigning stroke severity ratings, based on behaviours displayed in conscious rats during infusion of endothelin-1 to constrict the middle cerebral artery, on neurological and histological outcomes. The validity of prior stratification of treatment groups according to stroke ratings was tested by assessment of the protective potential of synthetic flavonol, 3',4'-dihydroxyflavonol (DiOHF). Neurological deficits and performance on the sticky label test were evaluated before and at 24, 48 and 72 h post-stroke. Histopathology was assessed at 72 h. Positive correlations between stroke ratings and neurological deficit scores were found at 24 (r=0.58, P<0.001), 48 (r=0.53, P<0.001) and 72 (r=0.56, P<0.001) h post-stroke, with more severe strokes associated with worse deficit scores. Similar correlations were observed with the sticky label test. Higher stroke ratings also correlated with greater infarct volumes (total infarct volume: r=0.74, P<0.0001). Treatment with DiOHF (10 mg/kg i.v. given 3, 24 and 48 h post-stroke) significantly reduced infarct volume and restored neurological function in rats with modest stroke ratings (P<0.01), but not in rats with high stroke ratings. These results suggest that stroke ratings, based on behavioural assessment as the stroke develops, reliably predict histopathological and functional outcomes and allow stratification of treatment groups. DiOHF given after stroke improves outcomes in moderate strokes, and therefore has cytoprotective potential.     

Genotoxicity of the herbicide 2,4-dichlorophenoxyacetic and a commercial formulation, 2,4-dichlorophenoxyacetic acid dimethylamine salt. I. Evaluation of DNA damage and cytogenetic endpoints in Chinese Hamster ovary (CHO) cells.

Genotoxicity of the 2,4-dichlorophenoxyacetic acid (2,4-D) and a commercially-used derivative, 2,4-D dimethylamine salt (2,4-D DMA), was evaluated in CHO cells using SCE and single cell gel electrophoresis (SCGE) assays. Log-phase cells were treated with 2.0-10.0 microg/ml of herbicides and harvested 24 and 36 h later for SCE analysis. Both agents induced significant dose-dependent increases in SCE, regardless of the harvesting time (2,4-D: r=0.98 and r=0.88, P<0.01, for 24 and 36 h harvesting times; 2,4-D DMA: r=0.97 and r=0.88, P<0.01, for 24 and 36 h harvesting times). Neither test compound altered cell-cycle progression or proliferative replication index (P>0.05), but the higher doses of both compounds reduced the mitotic index of cultures harvested at 24 and 36 h (P<0.05). A 90-min treatment with 2.0-10.0 microg/ml 2,4-D and 2,4-D DMA produced dose-dependent increases in the frequency of DNA-strand breaks detected in the SCGE assay, both in cultures harvested immediately after treatment and in cultures harvested 36 h later. The doses of 2,4-D and 2,4-D DMA were equally genotoxic in all of the assays. The results indicate that 2,4-D induces SCE and DNA damage in mammalian cells, and should be considered as potentially hazardous to humans.     

Co-regulation of phenytoin and tolbutamide metabolism in humans.

1. The disposition of phenytoin and tolbutamide was compared in eighteen healthy young adults separately administered single therapeutic doses (sodium phenytoin 300 mg, tolbutamide 500 mg) of the two drugs. 2. Within the group, ratios of ranges of total and unbound areas under the plasma concentration-time curves were similar for both drugs. 3. There were significant (P < 0.001) correlations between total (r = 0.88) and unbound (r = 0.86) areas under the plasma phenytoin and tolbutamide concentration-time curves. 4. The results are consistent with the involvement of the same cytochrome P-450 isoenzyme(s) in the metabolism of tolbutamide and phenytoin.     

Isoallopregnanolone; an antagonist to the anaesthetic effect of allopregnanolone in male rats

The interaction of isoallopregnanolone (3 beta-OH-5 alpha-pregnan-20-one) on allopregnanolone (3 alpha-OH-5 alpha-pregnan-20-one) induced anaesthesia was studied in male rats using burst suppression of 1 s ("silent second") with an electroencephalographic-threshold method. The i.v. administration of isoallopregnanolone was varied in relation to induction of "silent second". Pre-treatment with isoallopregnanolone (12.5-50 mg/kg iv) 2 min prior to the threshold test gave an increase in the threshold dose of allopregnanolone (ANOVA df(3;36), F=13.61, P<0.001), which was dose dependent (r=0.73, b [slope]=0.08, df=38, P<0.001). After isoallopregnanolone pre-treatment, but not in the controls, anaesthesia time was positively related to the dose of allopregnanolone (r=0.52, b=1.72, df=28, P<0.01). Anaesthesia times were not influenced by a corresponding administration of isoallopregnanolone immediately after induction of "silent second". When allopregnanolone and isoallopregnanolone were infused together at molar ratios of 1:1, 1:1.23, 1:1.43, a linear increase of the threshold doses of allopregnanolone was seen in relation to the dose of isoallopregnanolone (r=0.86, b=0.40, df=8, P<0.01). Thus isoallopregnanolone can antagonise the anaesthetic action of allopregnanolone.