Serum Inflammatory Biomarkers in Patients with Nonarteritic Anterior Ischemic Optic Neuropathy

PurposeTo evaluate the neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), platelet-to-lymphocyte ratio (PLR), and systemic immune-inflammation index (SII) in patients with non-arteritic anterior ischemic optic neuropathy (NAION).MethodsFifty-six patients with NAION and 60 age-sex matched healthy controls were included in the study. Demographic characteristics and laboratory findings of the patients and the controls were obtained from the electronic medical records. NLR, PLR, MLR, and SII were calculated and compared between the groups. Cutoff values were also determined.ResultsNeutrophil, monocyte and platelet counts were higher in the NAION group than in the control group, but the difference was not statistically significant (p > 0.05). The mean NLR and SII were higher in the NAION group than in the control group (p = 0.004 and p = 0.011, respectively). In the receiver operating characteristic curve analysis, the areas under the curve for NLR were 0.67, and NLR >1.79 predicted NAION with a sensitivity of 71% and specificity of 59%. The areas under the curve for SII was 0.66, and SII of >417 predicted NAION with a sensitivity of 71% and specificity of 49%. There was no significant difference in PLR and MLR between the groups (p = 0.105 and p = 0.347, respectively).ConclusionsThe current study demonstrated that NAION patients had increased NLR and SII levels compared with control subjects. Elevated NLR and SII might serve as readily available inflammatory predictors in NAION patients.     

先天性视盘占位病变继发非动脉炎性前部缺血性视神经病变的临床特征分析

目的 探讨先天性视盘占位病变相关的非动脉炎性前部缺血性视神经病变（NAION）的临床特征。设计 回顾性病例系列。研究对象 2010年1月-2019年6月北京同仁医院先天性视盘占位病变继发NAION患者9例（11眼）。方法 回顾及分析患者的眼科及头颅神经影像学资料。所有患者均经半年以上随访。主要指标 性别、年龄、发病眼别、视盘病变特征及与视野改变关系、头颅神经影像学表现。结果 9例继发NAION的先天性视盘占位病变中4例视盘黑色素细胞瘤,3例视盘内玻璃膜疣,2例视盘区残存有髓纤维。年龄26~65岁（中位数39岁）。7例单眼发生NAION,2例视盘内玻璃膜疣患者双眼先后发生NAION。发生NAION时患眼矫正视力0.05~1.0。可行视野检查的4例患者表现为水平下半缺损及向心性缩小。最后随访时均无视功能进行性损伤和病情复发。结论 先天性视盘占位性病变可继发NAION而出现视功能损伤。（眼科, 2020, 29： 141-146）     

Acute changes in ganglion cell layer thickness in ischemic optic neuropathy compared to optic neuritis using optical coherence tomography

AIM:To elucidate the changes of different ganglion cell layer(GCL)thinning patterns between the optic neuritis(ON)and non-arteritic anterior ischemic optic neuropathy(NAION).METHODS:A prospective,observational study was conducted to evaluate the timing of GCL changes between acute ON and NAION using optical coherence tomography.RESULTS:Thinning on optical coherence tomography in the NAION group occurs as early as 11 d after symptomatic onset of vision loss and follows an altitudinal pattern.The mean superior-inferior GCL thickness difference in the NAION cohort was clinically significant at 5.7μm in the NAION cohort compared to controls of 0.8μm(P=0.032),but not significant in the ON group compared to controls with both groups measuring 1.1μm.Global thinning was significant for the ON group compared to controls at 7.2μm(P=0.011)but not the NAION group compared to controls at 1.35μm.CONCLUSION:These findings suggest that future treatments for NAION should be given early,and possibly before 11 d in order to prevent GCL and irreversible vision loss.     

探讨体外冲击波碎石治疗肾结石疗效的影响因素

目的研究分析肾结石体外冲击波碎石术(ESWL)的临床疗效和影响因素。方法对2011年5月至2013年在我院采用ESWL治疗的400例肾结石患者病例资料进行回顾性分析。结果 400例碎石的成功率为78.0%。结石直径<2.0 cm,2.0³.0cm及>3.0 cm的肾结石,肾结石体外冲击波碎石后清石率(4个月后)差异均有统计学意义(P<0.05);两组在肾盂结石与肾盏结石方面比较后成功率差异有统计学意义(P<0.05);单发结石与多发结石两组成功率比较差异有统计学意义(P<0.05),其他因素对成功率影响均无统计学意义(P>0.05)。结论结石位置、大小和数量是影对ESWL治疗肾结石的疗效有重要影响作用。     

骨髓干细胞治疗心脏疾病的临床新进展

骨髓干细胞为多潜能细胞,包括造血干细胞和间充质干细胞两类,以骨髓组织中含量最为丰富,具有自我更新及多向分化能力,在一定的条件下能被诱导分化为包括心肌细胞在内的多种细胞,可作为理想的种子细胞用于衰老和病变引起的组织器官损伤修复,尤其是应用于心肌梗死、缺血性心衰、难治性心绞痛、扩张型心肌病等心脏疾病的临床治疗。本文就临床骨髓干细胞治疗心脏病的研究报道做简要综述。     

NMDAR/PSD-95/nNOs复合体及其解偶联剂在治疗缺血性卒中的应用

缺血性脑卒中是一种高死亡率、高致残率、高复发率的疾病。目前认为,脑卒中是由各种血管性病因引起的急性或局灶性脑功能障碍,且持续时间超过24 h或引起死亡的临床症候群。随着对脑卒中发病机制的深入研究,其治疗药物也日新月异,该文综合国内外文献,根据NMDAR/PSD-95/nNOs复合体结构特点及其如何在缺血性脑卒中产生病理作用,阐明新型解偶联药物在治疗缺血性卒中的应用前景。     

高同型半胱氨酸血症与缺血性脑血管病危险因素的关系及干预治疗

目的探讨高同型半胱氨酸血症（HHcy）与缺血性脑血管病危险因素的关系及干预治疗。方法选择265例急性缺血性脑血管病患者（其中腔隙性脑梗死85例,短暂性脑缺血发作53例,急性脑梗死127例）和140例对照,检测所有受试者空腹血浆同型半胱氨酸（Hcy）水平并与其它缺血性脑血管病危险因素进行比较。分析HHcy伴有传统危险因素时对缺血性脑血管病的影响,并进一步提出干预治疗措施及预后。结果 HHcy合并高血压病、糖尿病危险因素者可促使缺血性脑血管病的发生（P〈0.01）。使用单一维生素治疗6周无效（P〉0.05）,联合使用两种维生素治疗4-6周起效（P〈0.05）,但尚未达标,联合使用三种维生素治疗2周开始起效（P〈0.05）,4-6周达标,且随访观察1.5年,三种维生素治疗组再发缺血性脑血管病明显减少。结论 HHcy可能与缺血性脑血管病其它危险因素如高血压、糖尿病相互作用促进缺血性脑血管病的发生有关。三种维生素干预治疗4-6周,效果及预后明显优于未服维生素治疗组、一种或两种维生素治疗组。     

Preoperative Characteristics of Auditory Brainstem Response in Acoustic Neuroma with Useful Hearing: Importance as a Preliminary Investigation for Intraoperative Monitoring

We classified the results of preoperative auditory brainstem response (ABR) in 121 patients with useful hearing and considered the utility of preoperative ABR as a preliminary assessment for intraoperative monitoring. Wave V was confirmed in 113 patients and was not confirmed in 8 patients. Intraoperative ABR could not detect wave V in these 8 patients. The 8 patients without wave V were classified into two groups (flat and wave I only), and the reason why wave V could not be detected may have differed between the groups. Because high-frequency hearing was impaired in flat patients, an alternative to click stimulation may be more effective. Monitoring cochlear nerve action potential (CNAP) may be useful because CNAP could be detected in 4 of 5 wave I only patients. Useful hearing was preserved after surgery in 1 patient in the flat group and 2 patients in wave I only group. Among patients with wave V, the mean interaural latency difference of wave V was 0.88 ms in Class A (n = 57) and 1.26 ms in Class B (n = 56). Because the latency of wave V is already prolonged before surgery, to estimate delay in wave V latency during surgery probably underestimates cochlear nerve damage. Recording intraoperative ABR is indispensable to avoid cochlear nerve damage and to provide information for surgical decisions. Confirming the condition of ABR before surgery helps to solve certain problems, such as choosing to monitor the interaural latency difference of wave V, CNAP, or alternative sound-evoked ABR.