中心性浆液性脉络膜视网膜病变与个性关系探讨

本文采用我国＂Ａ型性格问卷＂对７２例中心性浆液性脉络膜视网膜病变与７０例健康人进行调查发现Ａ型行为比例中浆组为７２．２２％，对照组为６４．２８％，Ｐ＞０．０５，无显著差异；Ａ型行为类型得分明显高于对照组，Ｐ＜０．０１，有显著差异。提示：中浆与Ａ型行为类型有关，对该病应开展心理咨询和心理治疗。     

Central circulatory responses in normotensive and hypertensive pregnancy.

Haemodynamic responses in normotensive pregnancy in the antenatal phase show that cardiac output is elevated by the end of the first trimester, and remains elevated throughout pregnancy, although it may fall very slightly at the end of the third trimester of pregnancy. Heart rate remains virtually static throughout pregnancy, although it may fall very slightly at the end of the third trimester of pregnancy. Arterial blood pressure remains virtually unaltered. During labour in patients with traditional anaesthesia, cardiac output is elevated by 40% overall at the end of the labour, and this rise may be as much as 60% in the immediate post-partum period. Patients with epidural analgesia show no overall rise in cardiac output throughout labour. Following Caesarean section there may be massive rises in cardiac output. In patients who become hypertensive as a result of pregnancy, there are marked individual patterns. These different groups show patients with elevated levels of cardiac output, patients with a pure elevation of systemic vascular resistance, and a third group in which there is elevation of both resistance and output. It seems certain that different syndromes are occurring, the theoretical explanations for which are discussed.     

Successful pregnancy after conservative surgery for ovarian papillary serous cystadenocarcinoma of low malignant potential.

Conservative surgery was performed on a 28-year-old patient with an ovarian serous cystadenocarcinoma of low malignant potential who became pregnant one year later. The good prognosis of these tumours makes conservative surgical management the treatment of choice when preservation of child-bearing potential is deemed appropriate.     

玻璃体腔注射雷珠单抗治疗点状内层脉络膜病变并发的脉络膜新生血管

目的:观察玻璃体腔注射雷珠单抗治疗点状内层脉络膜病变(punctate inner choroidopathy,PIC)并发的脉络膜新生血管(choriodal neovascularization,CNV)的疗效。方法:本实验回顾性分析了8只接受玻璃体腔注射雷珠单抗治疗PIC并发CNV的患眼。所有患者都接受过一系列广泛的眼部检查,包括最佳矫正视力(BCVA)、裂隙灯检查、眼压、眼底检查、SD-OCT、FFA、ICGA。在第1次治疗后,每例患者至少完成6个月的随访检查。评估内容包括BCVA及黄斑中心凹视网膜厚度(central macular thickness,CMT)。结果:87.5%的患眼能维持原有视力或者视力改善,平均提高1.5行。患者的BCVA由治疗前的(0.39±0.11)提高到(0.22±0.19),差异有统计学意义(P=0.028)。患者治疗前CMT平均(275.50±53.53)μm,接受玻璃体腔雷珠单抗注入术后CMT平均(213.63±22.86)μm。患者接受治疗玻璃体腔雷珠单抗注入术后与治疗前对比,CMT值显著下降,差异有统计学意义(P=0.017)。结论:玻璃体腔注射雷珠单抗治疗PIC并发的CNV,疗效安全肯定。     

Perfluorocarbon liquid-assisted external drainage in the management of central serous chorioretinopathy with bullous serous retinal detachment

The differential diagnosis of serous retinal detachment (RD) includes Vogt-Koyanagi-Harada syndrome, severe hypertensive choroidopathy, posterior scleritis, multifocal choroiditis, metastatic tumor, and uveal effusion. Some cases of serous retinal detachment occur as a result of central serous chorioretinopathy (CSCR). Typical CSCR generally affects healthy middle-aged males and is characterized by localized serous RD of the neurosensory retina and retinal pigment epithelium in the macula that often spontaneously improve within 2 to 3 months. On rare occasions, variant CSCR with bullous RD occurs which is frequently misdiagnosed. We report on a case of variant CSCR with severe bullous serous retinal detachment in the left eye that was initially treated at another hospital under the misdiagnosis of rhegmatogenous retinal detachment. Because the retinal detachment developed so fast that a laser could not be applied to all leaking spots, we performed a pars plana vitrectomy, pertluorocarbon liquid-assisted external drainage, and final treatment with an endolaser. The retina was well attached after this management.     

Lactate dehydrogenase isoenzyme patterns in serous effusions

THE levels of LDH isoenzymes were asssayed, following electrophoretic separation, in the serous effusions of 137 patients under hospital investigation for cancer. The levels of M-subunit LDH in serous effusions from patients proven to have cancer by cytological evaluation were significantly higher than in patients in whom cancer is not proven (p>0.001). There was a positive correlation in 123 of 137 specimens of serous effusion between the concentration of M-subunit LDH and the malignant status of the patient. These results suggest that the measurement of LDH isoenzyme levels may be of significant value in the diagnoses of cancer in serous effusions.     

Adolescent pregnancy outcomes at Queen Elizabeth Central Hospital,Malawi: a cross-sectional study

Malawi has a growing population with a high Maternal Mortality Ratio (MMR) of 439 per 100,000 live births to which adolescents contribute 25%. Current data suggests adolescent pregnancies in low resource settings are at an increased risk of both maternal and neonatal morbidity.ObjectivesThis study assessed the pregnancy outcomes amongst adolescents while using women from the early adulthood (20 – 24-year-old) and advanced maternal age (35 years old and above) groups as reference.MethodsThis was a cross-sectional study, carried out at the Chatinkha maternity (labour) and post-natal wards at QECH, and included all adolescents (10 – 19 years old) and women between 20 – 24 years old (early adulthood) and 35 years old or older (advanced maternal age), presenting in labor, at any gestational age ≥ 28 weeks or with a birth weight of 1000 grams or above.ResultsThe study found the prevalence of adolescent pregnancy to be 20.4% (N=5035) out of all the deliveries during the recruitment period. Sexually transmitted infections were proportionally higher in the adolescent group, with 12% testing HIV seroreactive and 10% syphilis seroreactive. Neonatal outcomes of birth asphyxia (3.5%), low birth weight (5%), prematurity (4.3%) and early neonatal death (4.3%) were not statistically different from the outcomes of the older age groups. The major causes of maternal morbidity were determined to be a high caesarean section rate of 31.9% and intrapartum diagnosis of urinary tract infection (7.4%), malaria (7.4%) and hypertensive disorders (14.5%).ConclusionsAdolescents are a significant proportion of the pregnant population in Malawi. These adolescents are at increased risk of some pregnancy and peripartum complications when compared to women of older age groups. However, our study determined that these outcomes appear to be more likely related to the peripartum care received and not solely specific to maternal age.     

Role of transpupillary thermotherapy in central serous chorio-retinopathy

Background: To assess the efficacy of transpupillary thermo therapy (TTT) in cases of chronic central serous chorio- retinopathy (CSCR).     

子宫浆液性癌的临床病理相关因素分析

目的探讨子宫浆液性癌的临床病理特征及其发生的高危因素。方法回顾性分析2013年1月～2018年5月期间于我院住院行手术治疗子宫内膜恶性肿瘤患者的临床资料,经过筛选后分为子宫浆液性癌组(n=30)和子宫内膜样腺癌组(n=171),先将两组的年龄、孕产次、合并糖尿病、组织分化、宫颈间质浸润等基本临床病理资料指标行单因素分析,再将差异有统计学意义的指标行Logistic多因素分析,从而得出子宫浆液性癌的临床病理特征及其发生的独立高危因素。结果与子宫内膜样腺癌组相比,子宫浆液性癌组将年龄[(60.67±9.63) vs (54.26±7.82)]、绝经(80.0%vs 58.5%)、合并糖尿病(30.0%vs 11.7%)、CA125阳性(36.7%vs 19.9%)、FIGO晚期(33.3%vs 9.4%)、宫颈间质浸润(20.0%vs 7.6%)、组织低分化(60.0%vs 18.1%)、深肌层浸润(33.3%vs 10.5%)、淋巴结转移(23.3%vs 6.4%)等9种差异有统计学意义的因素行Logistic多因素分析,结果示年龄[(OR:1.076;95%CI:1.004～1.152),P=0.038]、组织低分化[(OR:4.043;95%CI:1.550-10.546),P=0.004]是发生子宫浆液性癌的独立危险因素。结论高龄、组织低分化是发生子宫浆液性癌的独立高危因素。     

Transgelin基因在卵巢浆液性肿瘤中的表达

目的 探讨Transgelin基因在卵巢浆液性肿瘤发生、发展过程中的作用.方法 采用逆转录-聚合酶链反应(RT-PCR)及Western Blot方法对10例正常卵巢、11例卵巢良性浆液性瘤、14例卵巢交界性浆液性瘤及38例卵巢浆液性癌组织中Transgelin基因mRNA及蛋白进行检测.结果 Transgelin基因mRNA及蛋白在卵巢浆液性癌中阳性表达率及相对含量皆低于卵巢交界性浆液性瘤、良性浆液性瘤及正常卵巢组织,差异均有显著性(P<0.05).Transgelin基因mRNA及蛋白低表达或缺失与卵巢浆液性癌的临床手术病理分期、组织学分级及淋巴结转移有关,与有无腹水无关.结论 Transgelin基因低表达或表达缺失为卵巢浆液性肿瘤发生过程中的早期事件,可能是卵巢浆液性肿瘤发生过程中的抑制因素,与卵巢浆液性癌的发生、发展密切相关.     

卵巢浆液性囊腺瘤的超声诊断价值

目的观察卵巢浆液性囊腺瘤的超声影像特点,评价超声检查对卵巢浆液性囊腺瘤的诊断价值。方法对192例卵巢浆液性囊腺瘤手术患者的超声图像进行观察,并与病理诊断结果进行对比分析。结果超声诊断的192例卵巢浆液性囊腺瘤中,169例与病理诊断一致,诊断符合率为88.02%;有23例(11.98%)与病理诊断不符。结论卵巢浆液性囊腺瘤的超声检查方法无创、简便、经济,准确率高,可作为临床诊断卵浆液性囊腺瘤的首选诊断方法。     

经瞳孔温热疗法治疗中心性浆液性脉络膜视网膜病变

目的 初步观察经瞳孔温热疗法(TTT)治疗中心性浆液性脉络膜视网膜病变(CSC)的疗效.方法 28例28眼CSC行TTT治疗,并定期随访,观察治疗前后视力、眼底、眼底荧光造影(FFA)及光学相干断层扫描(OCT)的变化.结果 28眼CSC经TTT治疗后,患者黄斑水肿减轻或吸收,FFA显示渗漏停止或减少,视力明显提高.结论 TTT治疗CSC有效,但还需要更多的病例来评价治疗效果.     

Short-term efficacy of intravitreal dobesilate in central serous chorioretinopathy

Purpose

To report the anatomic and functional outcome of intravitreal dobesilate to treat recurrent central serous chorioretinopathy (CSC).

Methods

This is an interventional case report in which dobesilate was intravitreally injected in a case of recurrent CSC. Main measures included fundoscopy, Snellen visual acuity (VA) testing, fluorescein angiography and optical coherence tomography (OCT).

Results

We present anatomical and functional evidences, obtained as early as eleven days after the treatment, of the efficacy of intravitreal dobesilate, in the treatment of chronic CSC condition. The effect after intravitreal dobesilate injection for CSC might be related to the normalization of retinal architecture.

Conclusions

Intravitreal dobesilate may be an effective treatment option for recurrent CSC.     

慢性中心性浆液性脉络膜视网膜病变眼底自发荧光特点

目的 观察22例慢性中心性浆液性脉络膜视网膜病变(简称中浆,central serous chorioretinopathy,CSC)患者眼底的自发荧光,探究中浆患者在恢复期眼底自发荧光的特点. 方法 回顾性随访临床病程超过3个月且曾经眼底荧光血管造影确诊为中心性浆液性脉络膜视网膜病变的患者16例22眼,单眼10例,双眼6例,发病后半年22眼均经海德堡共焦激光扫描镜HRA2-cSLO拍摄眼底自发荧光(fundus autofluorescence,FAF),观察其影像学特点. 结果 22眼中仅有2眼表现为正常FAF,其余20眼均表现为异常FAF.异常FAF可分为3类:第一类,原发病灶渗漏点处呈不规则形状的低荧光,周围环绕0.5 -2 DD大小的高荧光区,有8眼占36.3%;第二类,在原发病灶处几乎看不到异常荧光,而在其下方或侧下方可见竖椭圆型,葫芦状或斜条状的高荧光区,中央夹杂有点片状的低荧光有7眼占31.8%;第三类,原发病灶处呈明暗相间的斑驳状的异常荧光有5眼占22.7%.这些不同类型的异常FAF说明自行愈合的中浆患者即使黄斑区视网膜下渗液已经消失但在病灶的原始渗漏部位或病灶周围及下方却出现了RPE细胞功能和代谢的损害. 结论 未经治疗的中浆患者眼底可出现异常FAF,说明RPE细胞出现了永久损害,故对中浆病人应早期进行干预性治疗.