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。     

半规管阻塞术与迷路切除术治疗70例晚期顽固性梅尼埃病的疗效

目的 比较半规管阻塞术与迷路切除术治疗晚期顽固性梅尼埃病的远期疗效。 方法 回顾性分析2015年3月至2016年3月接受半规管阻塞术(n=56)和迷路切除术(n=14)治疗的70例晚期顽固性梅尼埃病患者的临床资料,比较半规管阻塞术(半规管阻塞术组)和迷路切除术(迷路切除术组)两种手术方式的治疗效果。 结果 半规管阻塞术组眩晕总控制率为96.4%(54/56),其中A级控晕率为80.4%(45/56)、B级控晕率为16.1%(9/56);迷路切除组眩晕总控制率为100%(14/14),所有患者均为A级控制;两组眩晕控制有效率差异无统计学意义(P>0.05)。半规管阻塞术组听力下降率为28.6%(16/56),迷路切除组听力损失率为100%(14/14),半规管阻塞术组听力损失率低于迷路切除组(P<0.001)。半规管手术组手术前、后颈源性/眼源性前庭肌源性电位(c/oVEMP)的异常率差异无统计学意义(P均>0.05)。迷路切除术组手术前、后颈源性/眼源性前庭肌源性电位的异常率差异有统计学意义(P=0.014;P=0.006)。半规管阻塞术组、迷路切除组的平衡恢复时间分别为(16.5±5.19)d、(25.07±7.87)d,差异有统计学意义(P<0.001)。 结论 半规管阻塞术治疗晚期顽固性梅尼埃病的疗效优于迷路切除术。     

可逆性脑血管收缩综合征2例的临床及影像学特点

目的 探讨可逆性脑血管收缩综合征(reversible cerebral vasoconstriction syndrome,RCVS)的临床及影像学特点.方法 回顾性分析2例RCVS患者的临床资料.结果 2例患者的触发因素分别为子痫和吉兰巴雷综合征.临床表现包括癫痫、意识障碍和视觉缺失.影像学表现包括凸面蛛网膜下腔出...     

镇眩汤对梅尼埃病大鼠血管加压素的影响

目的探讨中药复方镇眩汤治疗梅尼埃病的机制。方法采用阻塞前庭导水管的方法复制梅尼埃病模型,观察大鼠用药前后听觉诱发电位听阈的变化及大鼠血浆中血管加压素的含量。结果与假手术组比较,模型组大鼠听觉诱发电位听阈和血浆血管加压素水平显著升高;与模型组比较,镇眩汤高、中剂量组大鼠听阈和血管加压管水平显著降低(P<0.05)。结论镇眩汤治疗梅尼埃病的机制与其调节血浆血管加压素有关。     

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、...