Primary malignant lymphoma of the cranial vault

Summary A 60-year-old woman presented with a subcutaneous mass on her scalp. Computed tomography (CT) showed a homogeneously enhanced mass of the parietal bone with both intra- and extra-calvarial extension and having destroyed the right parietal bone. The mass was hypointense on the T1-weighted magnetic resonance image, slightly hyperintense on the T2-weighted image and homogenously enhanced with Gd-DTPA. Bone scintigraphy showed prominent accumulation of radioisotopes in the scalp lesion. The tumour was removed, including the involved bone and dura mater. Histologic diagnosis was non-Hodgkin’s B-cell lymphoma, and tumour cells had infiltrated into the dura mater. The patient was treated with radiotherapy and chemotherapy. She returned to ordinary daily life and has been well without recurrence for 3 years. Although primary malignant lymphoma of the cranial vault is rare, it should be considered in the differential diagnosis when a mass is encountered in the cranial vault. We have found only fourteen such cases in the literature, and we review these cases.     

电子鼻咽镜评估改良悬雍垂腭咽成形术中软腭切除范围的作用*

目的: 利用电子鼻咽镜测量Ⅱ型阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者上气道解剖结构,以指导在改良悬雍垂腭咽成形术中精准切除软腭范围,提高手术疗效。方法: 自2020年2月至10月,应用电子鼻咽镜,在清醒状态下,经鼻对38例Ⅱ型OSAHS患者腭部的长度及咽后壁派氏嵴的距离进行术前评估测量,采用完整保留悬雍垂及软腭游离缘改良术式,切除过长的软腭组织,平均切除软腭长度(10.3±3.7) mm。术后随访6～12月,复查腭部的长度及派氏嵴的距离,观察术后并发症及临床疗效。结果: 根据术前电子鼻咽镜测量结果,切除过长的软腭组织进行改良悬雍垂腭咽成形术,患者术后临床症状明显改善,无出现术后常见的并发症;PSG检测术前、后明显改善,其疗效有统计学意义(P＜0.05)。结论: 应用电子鼻咽镜对Ⅱ型OSAHS患者的上气道解剖结构进行测量,可以为手术治疗OSAHS患者提供准确的软腭切除范围,有效防止术后并发症的发生,提高手术疗效。     

肾上腺素及地塞米松对白内障患者晶状体上皮细胞增殖的影响

为了观察肾上腺素及地塞米松对白内障患者晶状体上皮细胞 (lensepithelialcell,LEC)增殖的影响并探讨其机制 ,在行白内障超声乳化术中 ,取出中央 5～ 7mm的晶状体前囊 ,将其均分成 3等份 ,用于对照组及两实验组 ,分别培养于 10 -6mol/L的肾上腺素及地塞米松 4 8h,免疫组织化学染色后 ,采用医用多功能图像分析系统测定增殖细胞核抗原 (proliferatingcellnuclearantigen ,PCNA)阳性面积率。结果显示 ,10 -6mol/L的肾上腺素及地塞米松对LEC的增殖有明显的抑制作用 ,PCNA的阳性面积率分别为 (2 6 14± 0 92 2 ) %和(3 338± 0 838) % ,与对照组比较 ,差异有显著性意义 (P <0 0 1)。研究表明 ,肾上腺素及地塞米松对白内障患者LEC有明显的抑制作用 ,从而可用于白内障术后防治后囊膜混浊的发生 ,为临床筛选防治后发性白内障的药物提供了科学依据。     

Collar Badge Lens Dose Equivalent Values among United States Physicians Performing Fluoroscopically Guided Interventional Procedures

PurposeTo describe the range of occupational badge dose readings and annualized dose records among physicians performing fluoroscopically guided interventional (FGI) procedures using job title information provided by the same 3 major medical institutions in 2009, 2012, and 2015.Materials and MethodsThe Radiation Safety Office of selected hospitals was contacted to request assistance with identifying physicians in a large commercial dosimetry database. All entries judged to be uninformative of occupational doses to FGI procedure staff were excluded. Monthly and annualized doses were described with univariate statistics and box-and-whisker plots.ResultsThe dosimetry data set of interventional radiology staff contained 169 annual dose records from 77 different physicians and 698 annual dose records from 455 nonphysicians. The median annualized lens dose equivalent values among physicians (11.9 mSv; interquartile range [IQR], 6.9–20.0 mSv) was nearly 3-fold higher than those among nonphysician medical staff assisting with FGI procedures (4.0 mSv; IQR, 1.8–6.7 mSv) (P < .001). During the study period, without eye protection, 25% (23 of 93) of the physician annualized lens dose equivalent values may have exceeded 20 mSv; for nonphysician medical staff, this value may have been exceeded 3.5% (6 of 173) of the time. However, these values did not account for eye protection.ConclusionsThe findings from this study highlight the importance of mitigating occupational dose to the eyes of medical staff, particularly physicians, performing or assisting with FGI procedures. Training on radiation protection principles, the use of personal protective equipment, and patient radiation dose management can all help ensure that the occupational radiation dose is adequately controlled.     

婴儿先天性白内障术后硬性透气性接触镜与框架眼镜效果对比

目的比较硬性透气性角膜接触镜(RGPCL)与框架眼镜对婴儿先天性白内障术后无晶状体眼的矫正效果。方法本研究为前瞻性研究。收集3~12月龄婴儿先天性白内障术后无晶状体眼46例(72只眼)随机分为两组,A组为佩戴RGPCL者,20例(31只眼);B组为佩戴框架眼镜者,26例(41只眼)。术后进行视功能训练,随访12个月。比较两组效果。结果两组患儿术后12个月视力较术后1个月视力明显提高(A组:Z=-6.791,P=0.000;B组:Z=-7.427,P=0.000),术后12个月视力A组较B组提高更显著,差异具有统计学意义(Z=-3.496,P=0.000)。A组的眼球震颤缓解率为54.55%高于B组的25.00%,但两者之间差异无统计学意义(χ^2=2.135,P=0.144)。A组建立的双眼同时视者占55.56%高于B组的21.43%,但两者之间差异无统计学意义(χ^2=2.807,P=0.094)。术后屈光度和眼轴长度两组之间的差异均无统计学意义(P>0.05)。两组均未见因佩戴而出现与视力相关的眼部并发症。结论RGPCL用于矫正婴儿先天性白内障术后无晶状体眼效果优于框架眼镜,能更好地改善患儿视力,有助于视功能的重建。     

PDR患者二期行硅油取出联合白内障手术的临床观察

目的探讨增殖性糖尿病视网膜病变(PDR)二期患者硅油填充术后行硅油取出联合白内障手术的临床疗效。方法回顾性分析2008—2012年于我院行硅油取出联合白内障超声乳化、人工晶体植入术的PDR患者55例(61眼),术后视力恢复情况。结果术后1个月最佳矫正视力好于术前最佳矫正视力的40眼(74.07%),与术前相同的10眼(18.52%),低于术前最佳矫正视力的4眼(7.41%)。所有患者均无角膜内皮失代偿、人工晶体移位、复发性视网膜脱离等并发症发生。结论 PDR行玻璃体切除术后合并白内障的患者,取出硅油时联合白内障超声乳化、人工晶体植入术是经济、安全、有效的治疗方法。     

蛋白酶体β5亚单位过表达对氧化环境下人晶状体上皮细胞的影响

【目的】探讨蛋白酶体筇亚单位（PSMB5）基因过表达对氧化条件下晶状体上皮细胞的影响。【方法】构建重组质粒pcDNA3．1-PSMB5并将其转染人人晶状体上皮细胞株SRAO1／04中，形成稳定表达，同时设pcDNA3．1空载体为对照组。RT—PCR法及Western blot法分别检测PSMB5基因及蛋白的表达情况。H2O2分别作用PSMB5转染细胞及空载体转染细胞，MTT法检测细胞增殖能力的变化。【结果】转染后用G418筛选3周后，获得PSMB5转染及空载体转染的G418抗性的细胞克隆。转染PSMB5基因的细胞PSMB5 mRNA表达强度明显增高．而空载体转染细胞与未转染细胞无显著差异：转染PSMB5基因的细胞的PSMB5蛋白表达也显著高于空载体转染细胞。低浓度H2O2作用后，转染PSMB5基因的细胞增殖能力高于空载体转染细胞。【结论】低浓度氧化环境下蛋白酶体历亚单位PSMB5过表达能对人晶状体上皮细胞具有保护作用。     

白内障术后不同人工晶状体对比敏感度的研究

目的：研究白内障术后非球面晶状体、单焦晶状体和多焦晶状体功能视力的比较。方法：白内障超声乳化联合人工晶状体（IOL）植入术后患者90例90只眼,随机分为三组,其中非球面晶状体组30例30只眼,单焦晶状体组30例30只眼,多焦晶状体组30例30只眼。与上述三组年龄匹配的门诊患者30例30只眼为对照组。所有患者年龄为50-80岁,矫正视力均≥0.8,且除了白内障之外,无任何影响对比敏感度（CS）的眼疾,亦无其他可能影响CS的全身性疾病。对照组及白内障患者于术后30 d,分别用CSV-1000E对比敏感度测试仪（由VECTORVISION公司提供）进行对CS测定。结果：白内障术后患者的CS大致恢复至正常范围,但较正常组降低。非球面晶状体组在6、12和18周/度（cpd）时,与其他组比较显著提高患者CS（P〈0.05）,且多焦晶状体组明显低于单焦晶状体组（P〈0.01）。结论：非球面晶状体通过其独特的Z-SHARP光学技术抵消了球面像差,从而有效地提高了CS。     

硬核性白内障人工晶状体术的临床应用

目的 探讨硬核性白内障的手术方式及临床效果.方法 采用改良式小切口非超声乳化白内障摘出人工晶状体植人术治疗硬核性白内障48例(54眼).结果 术后最佳矫正视力:0.1～0.2者5眼,0.3～0.4者12眼.0.5～1.0以上者37眼.无严重并发症发生.结论 改良式小切口非超声乳化白内障摘出人工晶状体植入术操作简单、安全有效.