Directed sampling for electrolyte analysis and water content of micro-punch samples shows large differences between normal and ischemic rat brain cortex

Changes in sodium, potassium, and water content in brain tissue are important in the progression of pathology that follows ischemic stroke. Determining these parameters regionally in rodent models of experimental ischemia has been limited because typical tissue weights of more than 35 mg are too large. Identifying ischemic tissue to direct tissue sampling towards ischemic cortex is also represents a difficult generally unresolved area. We suggest that larger differences between normal and ischemic cortex of sodium, potassium, and water content than previously observed can be obtained from directed sampling of 2-mg brain tissue in a model of focal cerebral ischemia. In five rats, the middle cerebral artery and both common carotid arteries were occluded for 4.9+/-0.13 h (mean+/-SEM). Punch-sampling of 1-mm diameter tissue cores for water content (H(2)O%) by the wet-dry method, and [Na(+)] and [K(+)] by flame photometry, was guided by the observation of a subtle change in the surface reflectivity of ischemic cortex of quickly dried, 20-microm frozen brain sections, that was confirmed by MAP2 immunohistochemistry. The ratio of the lesion areas as determined by the reflective change and MAP2 immunoreactivity was 0.96+/-0.03 (n=5). In ischemic cortex H(2)O% was 79.9%+/-0.8%, [Na(+)] was 550+/-25 mEq/kg dry-weight, and [K(+)] 94.2+/-19.2 mEq/kg dry-weight (n=5), all significantly different from the values in border zone cortex, and in cortex contralateral to ischemic cortex and border zone (for all samples n=60, mean wet weight 2.037+/-0.046 mg). Differences between ischemic and normal cortex were 5.4+/-1.1%, 317+/-21 mEq/kg dry-weight, -304+/-27 mEq/kg dry-weight (n=5) for H(2)O%, [Na(+)], and [K(+)]. These differences between ischemic and normal cortex are 1.4-2.5, 1-3.11, and 1.4-3.5 times greater, respectively, than previous results obtained using samples weighing 35 mg or more. These results extend the association of sodium and potassium with ischemic brain edema in the rodent model, and show that these classical measurements can keep pace with the regionality of histochemical and morphological methods.     

增生性糖尿病视网膜病变弥漫性黄斑水肿的激光治疗

目的　评价全视网膜光凝联合黄斑格栅样光凝治疗伴有弥漫性黄斑水肿的增生性糖尿病视网膜病变的疗效。方法　 4 0例 5 0眼伴有弥漫性黄斑水肿的增生性糖尿病视网膜病变患者 ,采用氩绿激光进行黄斑格栅样光凝联合全视网膜光凝。分析视力、黄斑水肿和新生血管的变化。结果　激光治疗后随访 6～ 30个月 ,5 0眼中 36眼治疗有效 ;76 %患眼的视力稳定 ,视力进步者占 12 % ;6 2 %患眼黄斑水肿明显减少 ,黄斑水肿完全消退者占 10 % ;视网膜新生血管或视盘新生血管完全消退者为 12 % ,部分消退者为 5 6 % ,余 14眼 (2 8% )治疗无效。结论　全视网膜光凝联合黄斑格栅样光凝是治疗伴有弥漫性黄斑水肿的增生性糖尿病视网膜病变的有效措施。     

益肾补气活血法对脑缺血及再灌注大鼠脑水肿、自由基的影响

[目的]从缺血再灌注损伤的主要病理过程出发,研究了益肾补气活血法对脑缺血再灌注损伤的保护作用。[方法]用日龄62d的Wistar大鼠采用Warner方法做成脑缺血再灌注模型,平行观察假手术、盐水对照、益肾补气活血法对照3个组脑组织自由基和脑含水量的变化。[结果]益肾补气活血法中药组脑组织自由基和脑含水量明显低于盐水组。[结论]益肾补气活血法在一定程度上可以抑制自由基的产生及连锁反应的发生,促进神经细胞结构及功能的恢复,延缓神经细胞的坏死,具有治疗的多向性及疗效的准确性。     

大鼠脑出血后体感诱发电位的改变与脑水肿的形成

目的:使用体感诱发电位(SEP)对脑出血(ICH)模型进行评价,并观察ICH后不同时期脑水肿的形成过程。方法:采用脑立体定向术制备大鼠脑内囊出血的模型。观察大鼠在手术前及手术后不同时期内神经系统功能、SEP、脑组织形态学及脑组织含水量的改变。结果:与假手术组相比,实验组(6h、12h、1d、5d)、各波潜伏期延长(P<0.05),脑组织含水量增多(P<0.05);实验组(2d、3d)各波潜伏期明显延长(P<0.01),脑组织含水量明显增多(P<0.01);实验组(7d)各波潜伏期缩短(P>0.05),脑组织含水量减少(P>0.05)。脑组织形态学与神经系统功能呈现相应的改变。结论:SEP是评价脑立体定向术制备大鼠脑内囊出血模型的最客观指标,脑出血后脑水肿的形成是一个动态过程,SEP的改变与脑水肿的形成有直接的关系     

微量激光治疗糖尿病性黄斑病变的临床疗效

目的探讨微量激光治疗糖尿病性黄斑病变的临床疗效。方法将180例210眼临床确诊为轻至中度的背景型糖尿病性黄斑病变患者随机分为传统激光治疗组(90例108眼)和微量激光治疗组(90例102眼)。随访12个月,以三面镜裂隙灯显微镜、光学相干断层扫描仪(OCT)评估两组光凝前、后黄斑水肿严重程度、渗漏范围和硬性渗出的数量变化,同期进行视力、中心10°静态视野检查。结果术后12个月,传统激光治疗组中48例54 眼(50％)、微量激光治疗组中42例49眼(48％)OCT黄斑区厚度变薄。术后12个月在硬性渗出数量和程度上,传统激光治疗组好转54眼(50％),微量激光治疗组好转48眼(47％)。两组在OCT视网膜厚度、视力、视敏度等方面的改变均无明显差异(P>0．05)。结论微量激光与传统激光在治疗背景型糖尿病性黄斑病变方面的疗效相似。     

Massive ovarian edema associated with ovarian serous cystadenoma: a case report and review of the literature

Abstract.   Khalbuss WE, Dipasquale B. Massive ovarian edema associated with ovarian serous cystadenoma: a case report and review of the literature. Int J Gynecol Cancer 2006; 16(Suppl. 1): 326–330.
Massive ovarian edema is a rare entity that can be confused with an ovarian neoplasm. A few ovarian lesions have been reported that are associated with massive ovarian edema. This article describes the first case of an ovarian serous cystadenoma associated with a massive ovarian edema. The patient was a 17-year-old female who was referred to the emergency room because of lower abdominal pain. Subsequent ultrasound and computed tomography scanning studies revealed an abdominopelvic cystic mass suggestive of an ovarian neoplasm. She underwent an exploratory laparoscopy, and a left salpingo-oophorectomy was performed. The specimen weighed 1610 g and consisted of a cystic mass measuring 17 × 15 × 8 cm attached to a solid mass measuring 13 × 11 × 4 cm. Microscopy revealed a cystic and a solid lesion. The cystic structure was composed of a flat or cuboidal single-layer lining showing ciliated epithelium and focal areas of papillary structures compatible with a diagnosis of ovarian serous cystadenoma. The solid mass had an intact capsule and diffuse interstitial edema, preserving the overall structure of the ovary and sparing the outer cortex. These findings are compatible with the diagnosis of ovarian massive edema. This report of an association of serous cystadenoma with massive ovarian edema broadens the histologic spectrum in which a massive ovarian edema may be encountered.     

968例重型颅脑损伤临床分析

目的 :探讨重型颅脑损伤 (GCS≤8分 )的诊断和治疗。总结重型颅脑损伤救治的经验教训 ,提高重型颅脑损伤的治愈率和降低致残率、死亡率。方法 :对我院1989年6月～2004年6月收治重型颅脑损伤 (GCS≤8分 )968例进行回顾性分析。结果 :968例患者中 ,GCS评分 :6～8分762例中 ,恢复良好472例 ,占61 .94 %,中残216例 ,占28 .34 %,重残41例 ,占5 38 %,植物生存6例 ,占0 .78 %,死亡27例 ,占3 .54 %。GCS评分 :3～5分206例中 ,恢复良好33例 ,占16. 01 %,中残50例 ,占24. 27 %,重残33例 ,占16 .01 %,植物生存9例 ,占4 36 %,死亡81例 ,占39. 32 %。总死亡人数108例 ,占11 .16 %。结论 :重型颅脑损伤后早期发生血管源性脑水肿 ,继而发生细胞毒性脑水肿 ,亚低温对预防重型颅脑损伤患者的脑水肿 ,降低死亡率和改善预后是有效的。重型颅脑损伤应尽早明确诊断、选择恰当的治疗方法 ,是降低致残率、死亡率和提高生存率、改善预后的关键。     

感冒、水肿、便秘证治体会

结合多年的临床实践，总结了对感冒、水肿和便秘等中医内科疾病的独特认识，并附病案佐证。     

玻璃体腔注射康柏西普对不同OCT分型糖尿病黄斑水肿的疗效观察

目的：观察玻璃体腔注射康柏西普对不同OCT分型糖尿病黄斑水肿(DME)的疗效差异。

方法：DME患者96例96眼根据OCT形态特征将DME分为弥漫性黄斑水肿(DRT,35眼)、囊性黄斑水肿(CME,33眼)、浆液性视网膜脱离(SRD,28眼),所有患者行玻璃体腔注射0.5mg(0.05mL)康柏西普治疗。治疗后1、3、6mo,比较三组BCVA(LogMAR)、黄斑中心凹视网膜厚度(CFT)、注射次数及视力提高眼数的差异。

结果：随访6mo,三组患眼BCVA呈明显下降趋势(F_时间=205.880,P_时间<0.01),三组间比较有差异(F_组间=3.472,P_组间=0.042),其中DRT组治疗后BCVA改善最佳; 三组患眼CFT呈明显降低趋势(F_时间=392.994,P_时间<0.01),三组间比较有差异(F_组间=5.046,P_组间=0.012),DRT组和CME组的CFT降低程度优于SRD组。随访6mo DRT组的注射次数最少,视力提高眼数比例最高。

结论：玻璃体腔注射康柏西普可显著改善不同OCT分型DME患眼的视力,降低CFT,其中DRT疗效最佳,注射次数最少。     

玻璃体腔注射康柏西普治疗BRVO-ME的疗效及治疗后BCVA的影响因素分析

目的：分析玻璃体腔注射康柏西普治疗视网膜分支静脉阻塞(BRVO)伴黄斑水肿(ME)的疗效及治疗后BCVA的影响因素。

方法：评价2016-01/2018-01在本院接受玻璃体腔注射康柏西普治疗的194例194眼BRVO-ME患者的临床疗效,多因素Logistic回归分析探究治疗后BCVA的影响因素。

结果：患者BCVA(LogMAR)、CMT较治疗前显著下降,其中CMT虽在部分时间节点有回升趋势,但任意时间点的BCVA、CMT均显著低于治疗前(P<0.05); 多因素Logistic回归分析显示,BRVO-ME分型-缺血型、ME类型-混合型、ELM完整性-缺失、IS/OS缺失均是影响BRVO-ME患者经玻璃体腔内注射康柏西普疗效的独立危险因素,且病程及眼轴长度越长、治疗前 BCVA值越高,经玻璃体腔内注射康柏西普治疗无效的风险越高。

结论：玻璃体腔注射康柏西普治疗BRVO-ME疗效显著且安全性良好,部分患者术后BCVA恢复不佳或受病程、术前BCVA、BRVO-ME分型、ELM及IS/OS完整性等因素影响,治疗前或应充分评估上述影响因素并积极应对,优化疗效。