从“脾肾两虚兼湿热瘀毒”论治少弱精子症

少弱精子症为本虚标实之证,以脾肾两虚为本,以湿热瘀毒为标,临证时宜补虚泻实,补脾肾之不足,泻湿热瘀毒,方能取效。     

Specificities of Ophthalmic Tumors: Usefulness of A National Network<br/>Spécificités des Tumeurs de la Sphère Ophtalmique: Utilité d’un Réseau National

We describe the most frequent malignant intraocular tumors, conjunctival tumors and some lids and orbital tumors. Primary intraocular malignant tumors are retinoblastoma in children and uveal melanoma in adults. For uveal melanoma, the liver is the most frequent site of metastasis and this is why it is justified to prescribe liver ultrasonography every 6 months to these patients. Metastatic tumors can occur in the uvea and more frequently in the posterior part called the choroid. They are more frequent after breast cancer and lung cancer. Conjunctival tumors can be epithelial (benign papillomas and epidermoid carcinomas) or melanocytic (benign naevi and melanomas) and sometimes from sebaceous gland origin (sebaceous carcinomas). Conjunctival malignancies can metastasize to the regional lymph nodes and other organs. All these tumors are rare tumors and need to be managed in expert centers. We describe the psychological consequences and the French national network organization for treatment of uveal malignant melanoma.

Résumé:
Nous décrivons les principales tumeurs malignes intraoculaires, les tumeurs conjonctivales et citons également quelques tumeurs orbitopalpébrales. Les tumeurs malignes primitives intraoculaires sont le rétinoblastome chez l’enfant et le mélanome uvéal chez l’adulte. Le mélanome uvéal métastase essentiellement au niveau du foie ce qui justifie une surveillance hépatique régulière. Les métastases peuvent survenir dans l’uvée également le plus souvent l’uvée postérieure ou choroïde et sont plus fréquentes après cancer du sein ou du poumon. Les tumeurs conjonctivales peuvent être épithéliales (papillome bénins et carcinome épidermoïdes malins in situ ou invasifs) ou mélanocytaires (nævi bénins et mélanome malins) voire parfois sébacées. Les tumeurs malignes invasives peuvent envahir les aires ganglionnaires et métastaser. Toutes ces tumeurs sont des tumeurs rares qui doivent être pris e en charge dans des centres experts. Nous décrivons leur retentissement psychologique et le réseau national de prise en charge du mélanome uvéal.     

Removal of biofilm is essential for long-term ventilation tube retention

BACKGROUND Although long-term retention of a ventilation tube is required in many ear diseases,spontaneous removal of conventional ventilation tube is observed in patients within 3 to 12 mo.To address this issue,we aimed to determine a new method for long-term retention of the ventilation tube.AIM To explore the value of removing the biofilm for long-term retention of tympanostomy ventilation tubes.METHODS A case-control study design was used to evaluate the safety and effectiveness of long-term tube retention by directly removing the biofilm(via surgical exfoliation)in patients who underwent myringotomy with ventilation tube placement.The patients were randomly divided into two groups:Control group and treatment group.Patients in the treatment group underwent regular biofilm exfoliation surgery in the clinic,whereas those in the control group did not have their biofilm removed.Only conventional ventilation tubes were placed in this study.Outcome measures were tube position and patency.Tube retention time and any complications were documented.RESULTS Eight patients with biofilm removal and eight patients without biofilm removal as a control group were enrolled in the study.The tympanostomy tube retention time was significantly longer in the treatment group(43.5±26.4 mo)than in the control group(9.5±6.9 mo)(P=0.003).More tympanostomy tubes were found to be patent and in correct position in the treatment group during the follow-up intervals than in the control group(P=0.01).CONCLUSION Despite the use of short-term ventilation tubes,direct biofilm removal can be a well-tolerated and effective treatment for long-term tube retention of tympanostomy ventilation tubes in patients who underwent myringotomy.     

肿瘤坏死因子β基因多态性与吉兰-巴雷综合征不同亚型的关联研究

目的研究肿瘤坏死因子βTNFβ基因多态性与吉兰-巴雷综合征(GBS)的两种主要亚型-急性炎症性脱髓鞘性多发性神经病(AIDP)和急性运动性轴索型神经病(AMAN)的易感性和预后的关系。方法对我院在2008至2011年收治的吉兰-巴雷综合征患者进行电生理标准分型,在疾病高峰期和发病1年后随访时进行Hughes神经功能评分;采用聚合酶链式反应-限制性片段长度多态性(PCR-RFLP)技术对41例AIDP患者、52例AMAN患者和98名健康人进行TNFβ基因多态性分析。结果 AIDP组TNFβ基因型分布与对照组没有差别,TNFβG等位基因频率明显高于对照组(37.8%,25%);AMAN组TNFβ基因型分布与对照组相比有差别,TNFβG等位基因频率明显高于对照组(40.4%,25%),P<0.05;GBS重症型患者(Hughes评分4⁶分)TNFβG等位基因频率明显高于对照组(40.6%,25%),P<0.05。GBS预后较差患者(Hughes评分>2分)TNFβG等位基因频率明显高于对照组(47.5%,25%),P<0.05。结论 TNFβG等位基因与GBS两种亚型的易患性有关,携带有TNFβG等位基因患者更倾向有较严重的疾病病程且预后较差。     

青川县野生重楼资源的分布概况

目的 调查青川县野生重楼的种类、分布区域及资源现状.方法 通过走访调查、野外考察、样本采集、标本鉴定和资料查阅相结合的方法,调查了青川县的重楼资源.结果 在调查的青川县21个乡镇35个样品地区中,5个乡镇6个样地有野生重楼分布,主要分布在海拔1000～2200 m的阔叶林和针叶林下,主要为华重楼、黑籽重楼、多叶重楼、平伐重楼等4种,以华重楼的数量最多.初步估算,总蕴藏量为51.72吨.结论 青川县野生重楼的资源分布广泛,是平伐重楼的已知最北端的分布地,重楼野生资源蕴藏量正在急剧下降,有效保护和合理利用势在必行.     

外周血流式细胞仪分析在淋巴瘤性红皮病诊断中的作用研究

目的:探讨外周血流式细胞仪检测在红皮病诊断中的应用价值。方法:收集2017年9月至2020年12月在中国医学科学院皮肤病医院就诊的29例红皮病患者,包括6例红皮病型蕈样肉芽肿（EMF）、5例Sézary综合征（SS）及18例不同病因的炎症性红皮病（IE）,4例健康志愿者为健康对照。采用流式细胞仪检测外周血淋巴细胞亚群、...     

泽泻汤组分不同配比对豚鼠膜迷路积水影响的比较

目的:观察泽泻汤中泽泻与白术不同剂量配比对膜迷路积水豚鼠的影响。方法:采用腹腔注射醋酸去氨加压素法复制膜迷路积水动物模型。观察各组豚鼠的行为学变化及蜗管组织病理学改变,计算各组豚鼠蜗管横截面积与蜗管加前庭面积之和(总面积)的比值,以评价膜迷路积水的程度。结果:与空白组比较,模型组豚鼠蜗管横截面积与总面积的比值明显升高(P<0.05);与模型组比较,3组实验组豚鼠蜗管横截面积与总面积的比值均下降,但实验1组与模型组比较差异有统计学意义(P<0.05)。结论:3组实验组中,以原方剂量配比(泽泻∶白术为5∶2)的实验1组缓解豚鼠膜迷路积水作用最佳,证实了仲景方剂配伍的科学合理性。     

Morel-Lavallée损伤的临床病理特点及治疗现状

Morel-Lavallée损伤是一类严重的闭合性软组织脱套伤,常见于高能量剪切暴力损伤,可发生在身体不同部位,经常伴随骨盆、髋臼等各类骨折的发生。尽管该损伤发生率不高,但这类损伤十分特殊,早期隐蔽性较强。临床外科医师对此类损伤缺乏足够的重视,往往处理不及时或处理不当,导致皮肤软组织坏死、感染等诸多并发症。目前,Morel-Lavallée损伤没有标准的分类系统,主要基于MRI影像学表现,但对于指导临床治疗及预后无实际意义。其治疗方案多样,如局部加压包扎、经皮穿刺抽吸、有限切开清创冲洗、负压吸引、置管引流等,效果不一。就Morel-Lavallée损伤的研究现状予以综述。