利培酮联合齐拉西酮治疗精神分裂症后抑郁的疗效及对患者认知功能、生活质量的影响研究

目的 分析利培酮联合齐拉西酮治疗精神分裂症后抑郁的效果及对患者认知功能和生活质量的影响.方法 300例精神分裂症后抑郁患者,依据平行对照法分为对照组和观察组,各150例.对照组采用利培酮治疗,观察组采用利培酮联合齐拉西酮治疗.对比两组患者的治疗效果、认知功能评分、生活质量评分及不良反应发生情况.结果 观察组治疗总有效率...     

老年甲状腺功能亢进性心脏病63例临床分析

我院自１９９０年１月～１９９９年２月收治合并心房颤动（房颤）的老年甲状腺功能亢进性心脏病（甲亢心）共６３例,首诊误诊４５例,误诊率７１．４３％。现将其临床特点分析如下。１　临床资料１．１　一般资料　本组６３例中,男５１例,女１２例;年龄７１．３０±１０．６５岁。病程０．５～４年。合并冠心病６例（经选择性冠状动脉造影证实）、高血压病１３例、老年退行性心脏瓣膜病７例。１．２　临床表现　以阵发性快速房颤为主要表现５６例（８８．８９％）,以慢性房颤为特点７例（１１．１１％）;心脏明显扩大２７例（４２．８…     

梅毒性全葡萄膜炎一例

梅毒是由梅毒螺旋体引起的慢性传染病,病程缓慢,可侵及全身任何器官和组织,产生各种症状[1].眼部表现以葡萄膜炎最常见,当发生脉络膜视网膜炎时,视网膜血管常受累,表现为视网膜动脉炎或动脉周围炎,通常还可并发视神经炎、继发视神经萎缩等[2].2007年2月中国医学科学院北京协和医院眼科诊治了1例以梅毒相关性眼病为全身惟一表现的病例.     

1例甲泼尼龙琥珀酸钠致精神兴奋、失眠的病例分析

甲泼尼龙为中效糖皮质激素,具有较强的抗炎、抗休克、抗毒素及免疫抑制作用,是临床广泛使用的药物之一。但与此同时,激素相关的药物不良反应越来越多,越来越受到关注,国外有报道称[1],精神异常是糖皮质激素较为常见的不良反应,有近20%的患者出现躁狂、抑郁、精神异常、兴奋、失眠等。国内张雪玲等[2]对甲泼尼龙琥珀酸钠不良反应文献分析发现,约有16.56%（23/151）的患者出现精神异常（其中失眠1例）。     

特发性黄斑裂孔的黄斑裂孔直径、被破坏的光感受器细胞内外节直径及其与视力的相关性研究

Objective To observe the diameters of macular hole and destroyed boundary line between inner and outer segment (IS/OS) of the photoreceptors and the correlation with the visual acuity in patients with idiopathic macular hole(IMH). Methods The clinical data of 39 eyes (37 patients) with IMH were retrospective analyzed. All the patients had undergone the examinations of visual acuity (Snellen chart), intra-acular pressure, ocular fundus (indirect ophthalmoscope), and Fourier-domain optical coherence tomography (FD-OCT) whose speed was 27 000 A scan/s, area was 6.0 mm×6.0 mm, and the mode was 512×128. The diametres of macular hole and destroyed IS/OS, and the correlations with visual acuity were detected. Results The mean IogMAR was 0.99±0. 44 (ranged from 0. 15 to 2.00), the mean diameter of macular holes was (942.0± 348. 4)μm(ranged from 171 to 1491 μm), and the mean diameter of IS/OS disruption was (1870. 35±673.2) μm(range from 463 to 3176 μm). There was a significant correlation among the diameter of the macular hole, the diameter of the IS/OS disruption, and IogMAR in IMH (P= 0. 038, 0. 002, 0. 000). In eyes with closed macular hole after surgery, the IogMAR and the diameter of the IS/OS disruption had a significant decrease. Conclusion Using FD-OCT the photoreceptor changes can be visualized in vivo. The abnormality in the IS-OS boundary line appears to be involved for a much larger area beyond the macular hole itself, and persists there with small size even after the maeular hole closure surgery.     

新型脑保护剂依达拉奉治疗放射性脑病的临床研究

目的探讨新型脑保护剂依达拉奉治疗放射性脑病的疗效。方法将42例鼻咽癌放疗后放射性脑病患者随机分为试验组(传统常规治疗方法合用依达拉奉)和对照组(传统常规治疗方法)。观察两组治疗前后的临床评分、凝血功能指标、头颅磁共振以及世界卫生组织生存质量测定量表简表(WHOQOL-BREF)评分的变化。结果试验组临床治疗的显效率(50．0%)和总有效率(88．9%)明显高于对照组(14．3%和42．9%)；头颅MRI显示治疗后实验组病灶体积较对照组明显缩小；WHOQOL-BREF评分显示在生理、心理、社会环境、总的生活评分方面试验组均较对照组有明显的改善：且两组在凝血功能方面无明显差异。结论依达拉奉对放射性脑病的治疗具有明显的效果。     

特发性黄斑裂孔的黄斑裂孔直径、被破坏的光感受器细胞内外节直径及其与视力的相关性研究

Objective To observe the diameters of macular hole and destroyed boundary line between inner and outer segment (IS/OS) of the photoreceptors and the correlation with the visual acuity in patients with idiopathic macular hole(IMH). Methods The clinical data of 39 eyes (37 patients) with IMH were retrospective analyzed. All the patients had undergone the examinations of visual acuity (Snellen chart), intra-acular pressure, ocular fundus (indirect ophthalmoscope), and Fourier-domain optical coherence tomography (FD-OCT) whose speed was 27 000 A scan/s, area was 6.0 mm×6.0 mm, and the mode was 512×128. The diametres of macular hole and destroyed IS/OS, and the correlations with visual acuity were detected. Results The mean IogMAR was 0.99±0. 44 (ranged from 0. 15 to 2.00), the mean diameter of macular holes was (942.0± 348. 4)μm(ranged from 171 to 1491 μm), and the mean diameter of IS/OS disruption was (1870. 35±673.2) μm(range from 463 to 3176 μm). There was a significant correlation among the diameter of the macular hole, the diameter of the IS/OS disruption, and IogMAR in IMH (P= 0. 038, 0. 002, 0. 000). In eyes with closed macular hole after surgery, the IogMAR and the diameter of the IS/OS disruption had a significant decrease. Conclusion Using FD-OCT the photoreceptor changes can be visualized in vivo. The abnormality in the IS-OS boundary line appears to be involved for a much larger area beyond the macular hole itself, and persists there with small size even after the maeular hole closure surgery.     

视乳头埋藏玻璃疣合并前部缺血性视神经病变一例

玻璃样钙化物质出现在视乳头部位称为视乳头玻璃疣（drusen of the optic disc），大多数患者为双眼发病，因所在的位置不同而有不同的临床表现。深埋在视神经组织内者称为埋藏视乳头玻璃疣（buried optic disc drusen）。位于筛板前的埋藏玻璃疣可压迫视神经或血管引起前部缺血性视神经病变（anterior ischaemic optic neuropathy,AION）.     

脉络膜转移癌的眼底与眼底血管造影表现

随着公共卫生事业的发展和临床医师诊断水平的提高,脉络膜转移癌的确诊率明显提高.脉络膜转移癌能够提供原发癌转移的早期诊断依据,及时发现、诊断对治疗脉络膜转移癌十分重要.本研究总结脉络膜转移癌的诊疗情况.