超声乳化术联合巩膜隧道内显微小梁切除45例

临床资料青光眼45例。男24例24眼，女21例21眼，年龄59～80岁．闭角型青光眼20眼。其中急性闭角型青光眼6眼，慢性闭角型青光眼14眼；开角型青光眼12眼，白内障膨胀期继发青光眼9眼。虹睫炎继发青光眼4眼．术前最佳矫正视力从光感到0．5不等．既往行周边虹膜切除6眼，小梁切除2眼．术前查视力、光定位，眼压、房角、视野、角膜曲率及A／B超．术前药物降眼压致正常36眼。不能降到正常而手术2眼，     

医学显微图像的自动拼接方法

1特征提取 所谓双梯度: 就是计算离散函数一点与其邻近的左边两点及右边两点的差的绝对值.当其4个差值同号时,就能保证该点在5点中取得最大或最小值,即该点取得最大梯度.如图所示:     

The monoacylglycerol lipase inhibitor JZL184 attenuates LPS-induced increases in cytokine expression in the rat frontal cortex and plasma: differential mechanisms of action

Background and purpose

JZL184 is a selective inhibitor of monoacylglycerol lipase (MAGL), the enzyme that preferentially catabolizes the endocannabinoid 2-arachidonoyl glycerol (2-AG). Here, we have studied the effects of JZL184 on inflammatory cytokines in the brain and plasma following an acute immune challenge and the underlying receptor and molecular mechanisms involved.

Experimental approach

JZL184 and/or the CB₁ receptor antagonist, AM251 or the CB₂receptor antagonist, AM630 were administered to rats 30 min before lipopolysaccharide (LPS). 2 h later cytokine expression and levels, MAGL activity, 2-AG, arachidonic acid and prostaglandin levels were measured in the frontal cortex, plasma and spleen.

Key results

JZL184 attenuated LPS-induced increases in IL-1β, IL-6, TNF-α and IL-10 but not the expression of the inhibitor of NFkB (IκBα) in rat frontal cortex. AM251 attenuated JZL184-induced decreases in frontal cortical IL-1β expression. Although arachidonic acid levels in the frontal cortex were reduced in JZL184-treated rats, MAGL activity, 2-AG, PGE₂ and PGD₂ were unchanged. In comparison, MAGL activity was inhibited and 2-AG levels enhanced in the spleen following JZL184. In plasma, LPS-induced increases in TNF-α and IL-10 levels were attenuated by JZL184, an effect partially blocked by AM251. In addition, AM630 blocked LPS-induced increases in plasma IL-1β in the presence, but not absence, of JZL184.

Conclusion and implications

Inhibition of peripheral MAGL in rats by JZL184 suppressed LPS-induced circulating cytokines that in turn may modulate central cytokine expression. The data provide further evidence for the endocannabinoid system as a therapeutic target in treatment of central and peripheral inflammatory disorders.

Linked Articles

This article is part of a themed section on Cannabinoids. To view the other articles in this section visit http://dx.doi.org/10.1111/bph.2013.169.issue-4 & http://dx.doi.org/10.1111/bph.2012.167.issue-8     

Surgical options for Ebstein’s anomaly for optimal functional outcome

Background Ebstein’s anomaly of the tricuspid valve is a complex malformation. Historically, because valve replacement yielded poor results, surgical treatment has focused on valvuloplasties with or without associated procedures. An individualised combination of surgical procedures was practised over three years and forms the subject of this presentation. Method Between November 1995 and September 1999, 7 patients with Ebstein’s anomaly underwent surgical repair (age 3.5 to 40 years). Cyanosis with severe tricuspid regurgitation was present in all. Surgical repair, individualised according to the morphology of the tricuspid valve and right ventricle to provide maximum possible symptom free survival, included, (1) Tricuspid valve: Replacement (n=1); Repair (Carpentier type n=1, Unicuspid repair n=5), (2) Atrial septal defect: left open (n=1), closed partially (n=1), closed compeletely (n=5), and (3) Bidirectional Cavopulmonary Shunt (BCPS)-4 Results There was no hospital death. Intraoperative transoesophageal echocardiography showed only mild tricuspid regurgitation in all, following repair. There were no late deaths at a mean follow up of 29 months. All but one patient were in functional Class 1 New York Heart Association(NYHA). Complications included a thrombus in the right ventricular cavity six months postoperatively in one patient. Conclusion Individualisation of surgical management in Ebstein’s anomaly provides optimal results.     

Acute epiphyseal osteomyelitis in children

Nine children over 20 months of age had acute osteomyelitis of the epiphysis of a long bone. The clinical features varied, but all of the patients had pain at the infected site and an elevated erythrocyte sedimentation rate. The distal femur was involved in seven cases, the proximal tibia in two, and the proximal humerus in one. In two patients there was a contiguous metaphyseal lesion, while the other seven patients (eight sites) had lesions limited to the epiphysis. Bone scintigraphy clearly identified the infected sites in all seven patients in whom it was performed, and allowed an early diagnosis in four cases. Radiographs showed a lytic lesion of the epiphysis that corresponded to the scintigraphic findings in all cases. The vascular supply to the epiphysis and the microscopic structure of the epiphyseal venous sinusoids provide locations that favor lodgement of blood-borne organisms. The epiphysis of the child should be recognized as another site of hematogenous osteomyelitis.