梅花针叩刺拔罐治疗配合甲钴胺穴位注射带状疱疹后遗神经痛疗效观察

目的观察梅花针叩刺拔罐治疗配合甲钴胺穴位注射带状疱疹后遗神经痛（PHN）疗效。方法将80例患者随机分为梅花针叩刺拔罐组和梅花针叩刺拔罐配合甲钻胺穴位注射组各40例。2组疗程均为20d。结果梅花针叩刺拔罐配合甲钴胺穴位注射组与梅花针叩刺拔罐组均能有效的治疗PHN,但梅花针叩刺拔罐组的总有效率明显低于梅花针叩刺拔罐配合甲钴胺穴位注射组;经统计学分析,差异具有显著性（P〈0．01）,梅花针叩刺拔罐配合甲钴胺穴位注射组与梅花针叩刺拔罐组治疗前VAS评分比较（P〉0．05）,无显著性差异,二者具有可比性。梅花针叩刺拔罐配合甲钴胺穴位注射组与梅花针叩刺拔罐组治疗前后情况对比均有显著性差异（P〈0．01）治疗后梅花针叩刺拔罐配合甲钴胺穴位注射组与梅花针叩刺拔罐组比较有显著性差异（P〈0．01）。结论说明梅花针叩刺拔罐配合甲钴胺穴位注射组治疗PHN明显优于梅花针叩刺拔罐组。说明二者均可有效的治疗带状疱疹后遗神经痛;说明梅花针叩刺拔罐配合甲钴胺穴位注射组在治疗带状疱疹后遗神经痛的疼痛程度方面明显优于梅花针叩刺拔罐组,可有效消除患者的疼痛。     

Acute retinal necrosis: a case series with clinical features and treatment outcomes

Purpose:  To determine clinical features, viral aetiology and treatment outcomes of eyes with acute retinal necrosis (ARN).
Methods:  Retrospective, interventional, non-comparative case series.
Results:  Twenty-two patients (23 eyes) were identified between 1996 and 2007. Varicella zoster virus was the causative agent in 12 patients (nine confirmed by polymerase chain reaction), herpes simplex virus type 1 in six (five polymerase chain reaction-confirmed) and unknown in three patients. Five patients had documented herpes zoster infection in the month prior to the onset of ARN. Twelve patients (55%) had identifiable (clinical or subclinical) immune dysfunction. At 6 months, 3 out of 15 eyes (20%) maintained vision 6/12 or better and 7 (47%) were 6/60 or worse. Median final VA was 6/60. Nine eyes developed retinal detachment and two-thirds of these had received prior barrier laser. Poor prognostic factors for severe visual loss by univariate analysis were male gender ( P  = 0.019), and the development of retinal detachment ( P  = 0.05). Delay between onset of symptoms and diagnosis was associated with moderate visual loss ( P  = 0.018). Barrier laser did not reduce the risk of retinal detachment.
Conclusions:  Acute retinal necrosis still has poor visual prognosis. Early diagnosis and initiation of treatment may improve outcome.     

穿透性角膜移植术治疗单纯疱疹病毒性角膜炎后复发的危险因素

目的研究单纯疱疹病毒性角膜炎在行穿透性角膜移植术（PKP）治疗后复发的危险因素,临床特征和治疗方式的选择。方法回顾性病例研究。回顾性分析2000年1月至2012年7月在青岛眼科医院因药物治疗无效行穿透性角膜移植术的单纯疱疹病毒性角膜炎患者329例（329眼）。观察分析其术后首次复发的情况,包括复发时间、复发类型、复发的危险因素以及复发后的治疗转归。PKP术后复发的相关危险因素的比较应用卡方检验。在一个回归模型中应用初始单变量分层分析以鉴定和选择复发的重要的相关因素。结果穿透性角膜移植术后有33眼（10％）复发,复发类型主要为上皮型,18例（54％）,复发病灶主要集中于植片与植床交界处（63％）,复发时间从2周到13年不等。复发的相关危险因素包括：免疫排斥（X2=47．09,P〈0．01）、继发性青光眼（X2=26．38,P〈0．05）、并发性白内障行白内障手术（x2=7．31,P〈0．05）、上呼吸道感染（X2=5．60,P〈0．05）、病灶累及角膜缘（x2=8．30,P〈0．05）。复发病例中上皮型有10例经单纯药物治疗有效,其余基质型和内皮型（包括由上皮型转化而来）有5例行结膜瓣覆盖术治疗,12例行单层或双层羊膜覆盖术,6例行二次PKP术。所有复发病例经药物或手术治疗后平均随访（24．6±5．4）个月,植片透明率达46％。结论免疫排斥、继发性青光眼（未行手术）、白内障手术、上呼吸道感染、病灶累及角膜缘,是穿透性角膜移植术后复发的危险因素,基于复发的临床特征和危险因素,选择合适的预防方式和治疗方式可有效控制复发。     

蒲地兰消炎口服液联合利巴韦林气雾剂对小儿疱疹性咽峡炎的治疗效果观察

目的观察蒲地兰消炎口服液联合利巴韦林气雾剂对小儿疱疹性咽峡炎的临床疗效。方法疱疹性咽峡炎患儿100例,随机分为研究组50例和对照组50例,在常规治疗的基础上,对照组患儿给予利巴韦林气雾剂喷咽峡部,研究组在对照组的基础上加服蒲地兰消炎口服液,对两组患儿临床治疗效果进行比较分析。结果研究组50例中痊愈7例,显效22例,有效19例,无效2例,总有效率96.0%;对照组50例中痊愈5例,显效20例,有效17例,无效8例,总有效率84.0%。两组比较,差异有统计学意义（P〈0.05）。研究组治疗效果优于对照组。结论蒲地兰消炎口服液联合利巴韦林气雾剂对小儿疱疹性咽峡炎疗效显著,适于临床应用。     

Cutaneous involvement of pre‐existing Rosai–Dorfman disease via post‐herpetic isotopic response

We report the case of a patient with a long‐standing history of extranodal, sinus histiocytosis with massive lymphadenopathy (Rosai–Dorfman disease) and no evidence of original cutaneous involvement as well as a history of herpes zoster of the left flank with post‐herpetic neuralgia who went on to develop multiple, round‐to‐oval, red‐brown, atrophic macules and thin papules at the sites of herpes zoster scars on the left flank. Histopathology showed a dense nodular infiltrate of lymphocytes with some plasma cells and numerous large pale‐staining histiocytes (S100+/CD68+), consistent with Rosai–Dorfman disease. This case showed exclusively cutaneous involvement, as demonstrated by otherwise normal physical examination, laboratory evaluation and imaging. This is the second reported case of Rosai–Dorfman disease occurring at the site of zoster scars, and to our knowledge this represents the first case report of cutaneous involvement of pre‐existing Rosai–Dorfman disease via post‐herpetic isotopic response (Wolf's isotopic response).     

自制阿昔洛韦地塞米松混合滴眼液治疗61例病毒性角膜基质炎的疗效分析

目的：观察自制阿昔洛韦地塞米松混合滴眼液治疗难治性病毒性角膜基质炎的临床疗效。方法：回顾性分析2013年6月—2015年12月我院确诊和收治的61例难治性病毒性角膜基质炎患者的临床资料。对这些患者，给予自制阿昔洛韦地塞米松混合滴眼液并采用逐渐减量、长期使用的方式治疗，同时给予长期辅助口服抗病毒药治疗。定期随访患者的视力、角膜水肿及浑浊情况、眼压，并进行角膜内皮细胞镜、角膜荧光素染色和眼前节反应等指标检查。结果：治疗前患者的平均视力为（0.15±0.12），角膜中央直径2 mm范围内的平均角膜厚度为（652±116）μm，平均眼压为（17.8±2.5）mmHg。治疗3个月后，患者的眼部症状和体征均明显好转，平均视力为（0.58±0.35），角膜中央直径2 mm范围内的平均角膜厚度为（557±61）μm，平均眼压为（15.4±3.6）mmHg，平均角膜内皮细胞密度为（2453±559）个/mm2，临床总有效率为90.2%。结论：自制阿昔洛韦地塞米松混合滴眼液治疗难治性病毒性角膜基质炎的疗效确切。     

单纯疱疹性角膜炎患者血清可溶性白细胞介素2受体水平的测定

本文应用双体夹心ＥＬＩＳＡ法对４５例纯性疱疹性角膜炎（ＨＳＫ）患者血清可溶性ＩＬ－２受体（ｓＩＬ－２Ｒ）进行了研究，结果显示，活动期ＨＳＫ患者血清ｓＩＬ－２Ｒ水平显著性高于非活动期和正常对照组（Ｐ〈０．００１）；非活动期ＨＳＫ患者血清ｓＩＬ－２Ｒ水平与正常对照组相比无显著性差异（Ｐ〉０．０５）。通过对两种不同类型活动期ＨＳＫ患者血清ＨＳＫ患者血清ｓＩＬ－２Ｒ水平的比较，可见基质型明显高于上皮型（Ｐ     

黄连解毒丸联合利巴韦林治疗小儿疱疹性口炎的临床研究

目的探讨黄连解毒丸联合利巴韦林治疗小儿疱疹性口炎的临床疗效。方法选取2014年2月—2016年2月宝鸡市妇幼保健院收治的小儿疱疹性口炎患儿92例,随机分为对照组和治疗组,每组各46例。对照组超声雾化吸入利巴韦林注射液,10 mg/kg加入到生理盐水10 m L中,2次/d。治疗组在对照组基础上口服黄连解毒丸,6丸/次,2次/d。两组患者均治疗7 d。观察两组的临床疗效,比较两组症状缓解时间、免疫球蛋白(IgG、IgA、IgM)和T细胞亚群(CD3~+、CD4~+、CD8~+)情况。结果治疗后,对照组和治疗组的总有效率分别为87.0%、97.8%,两组比较差异有统计学意义(P0.05)。治疗后,治疗组发热、非正常进食、口腔疱疹和流涎的症状缓解时间均明显短于对照组,两组比较差异有统计学意义(P0.05)。治疗第4、5、6、7天后,对照组IgG、IgA、IgM、CD3~+、CD4~+和CD8~+水平均显著升高,而治疗第1、2、3、4、5、6、7天后,治疗组IgG、IgA、IgM、CD3~+、CD4~+和CD8~+水平均显著升高,同组治疗前后比较差异有统计学意义(P0.05);且治疗组这些观察指标的升高程度明显优于对照组,两组比较差异具有统计学意义(P0.05)。结论黄连解毒丸联合利巴韦林治疗小儿疱疹性口炎具有较好的临床疗效,可改善临床症状,提高患儿免疫力,具有一定的临床推广应用价值。     

A novel flow cytometry based assay for quantification of corneal angiogenesis in the mouse model of herpetic stromal keratitis

In this study a novel flow cytometry based quantitative assay for measuring corneal angiogenesis is demonstrated. Corneas of Balb/c mice were lightly scarified and infected with 5 x 10(5), 5 x 10(4) and 5 x 10(3) pfu Herpes simplex virus 1 (HSV-1) RE virus. Development of corneal angiogenesis was studied on day 15 post infection by direct visualisation of infected cornea with a slit-lamp biomicroscope. Endothelial cells constituting the newly developed blood vessels in cornea were stained with murine anti CD31 antibody on frozen corneal sections and corneal whole mounts at day 15 post infection. Total number of endothelial cells was quantified at day 15 post infection by flow cytometry. Mice infected with different doses of HSV-1 RE developed severe to mild corneal angiogenesis at day 15 post infection. Endothelial cells constituting the newly formed blood vessels expressed CD31 at day 15 post infection. Flow cytometry revealed that, the number of CD31 positive cells isolated from diseased corneas increased with the increase in Neovascularisation index. The flow cytometry analysis used in this present study is a useful, accurate and cost effective method for quantifying corneal angiogenesis.