急性原发性闭角型青光眼

Acute primary closed angle glaucoma is fast becoming one of the most important causes of blindness in the 21 st Century. World bhnding statistics show that there are 60 million people suffering from glaucoma. Of these,approximately 6 million are blind and 1.5 million (25%) are due to acute closed angle glaucoma. With the aging population, the number of patients blind from glaucoma will continue to increase.Attacks from acute primary closed angle glaucoma can lead to irreversible blindness to the affected eye.Blindness can be effectively prevented in acute primary closed angle glaucoma because the severity of symptoms will draw the attention of the patient who will then seek for medical care. Therefore, it is essential to educate the public,doctors and healthcare workers about the danger and symptoms of acute glaucoma. With early diagnosis and treatment to the affected eye and laser iridotomy to the fellow eye-bilateral blindness from acute glaucoma can be prevented.This paper highlights important clinical advances in the management of acute primary closed angle glaucoma and also poses several questions for discussion.(1) What evidence is there to suggest that bilateral blindness from acute primary closed angle glaucom is preventable?(2) In what way is Ultrasonic Biomicroscopy (UBM) useful in clinical research in glaucoma?(3) Will UBM be important in clinical diagnosis in primary closed angle glaucoma?(4) What is the scientific basis of treatment in acute primary closed angle glaucoma?(5) What are the essential procedures to preserve vision in chronic primary closed angle glaucoma?(6) What are the reasons for blindness after laser iridotomy?(7) What is the mechanism of laser iridoplasty?(8) What are the reasons why laser iridoplasty should be combined with laser iridotomy?(9) Why there is an intraocular pressure increase in 50% of eyes within 3 months after laser iridoplasty?(10) Can UBM explain the changes in the angle after lens removal in primary closed angle glaucoma?(11) Are there reasons why trabeculectomy is infrequently used in acute glaucoma, yet it is an important procedure in chronic primary closed angle glaucoma?(12) The scientific reasons why laser iridotomy is essential in the fellow eye.     

呼吸道微生态对晚期非小细胞肺癌患者接受PD-1抑制剂单药治疗疗效影响的探索性研究

目的:探讨呼吸道微生态对晚期非小细胞肺癌(non-small cell lung cancer, NSCLC)患者接受PD-1单药治疗的疗效及预后的影响。方法:本研究设计为回顾性分析，从2018年10月到2021年10月纳入后线接受PD-1抑制剂单药治疗且符合入排标准的晚期NSCLC患者58例。PD-1抑制剂包括卡瑞利珠单抗，信迪利单抗和帕博利珠单抗。通过科室的患者病历记录及医院的电子病历系统整理分析患者的基本人口学资料，接受治疗的疗效数据，生存预后情况及接受治疗过程中的不良反应情况。另一方面，收集患者接受PD-1抑制剂治疗前的深部诱导痰标本，通过16S rRNA基因测序方法检测收集的58例样本的呼吸道菌群情况，分析呼吸道菌群α多样性的指标，并和患者的疗效及预后进行关联分析。结果:58例NSCLC患者符合研究的筛选标准并且均可以评价疗效与不良反应。疗效数据提示PD-1抑制剂治疗晚期NSCLC患者的客观缓解率(ORR)为19.0%[95%置信区间(CI):9.9%-31.4%],疾病控制率(DCR)为55.2%(95%CI:41.5%-68.3%)。通过后续的访视获取的预后数据表明58例...     

医院获得性假丝酵母菌菌血症流行病学特征及其药物敏感性

目的分析医院获得性假丝酵母菌菌血症患者的临床特征、病原菌种类及其耐药情况,探讨影响假丝酵母菌菌血症患者预后的危险因素。方法选取南方医科大学南方医院2008年1月1日—2018年12月31日血培养确诊为医院获得性假丝酵母菌菌血症病例,收集人口统计学资料及临床资料,根据患者预后分为生存组与死亡组,进行统计分析。结果共收集240例医院获得性假丝酵母菌菌血症患者资料,其中男性155例,女性85例,平均年龄(50.4±16.6)岁。血培养分离白假丝酵母菌90株(37.5%),近平滑假丝酵母菌63株(26.3%),热带假丝酵母菌53株(22.1%)。白假丝酵母菌和近平滑假丝酵母菌对唑类药物的敏感率90%,克柔假丝酵母菌、光滑假丝酵母菌、热带假丝酵母菌对氟康唑的敏感率较低(分别为40.0%、59.3%、62.3%),热带假丝酵母菌和克柔假丝酵母菌对伊曲康唑的敏感率也偏低(分别为62.3%、60.0%)。多因素分析结果表明,器官衰竭(OR=5.872,P0.001)、脓毒性休克(OR=3.313,P=0.005)为医院获得性假丝酵母菌菌血症患者死亡的独立危险因素。结论白假丝酵母菌是引起假丝酵母菌菌血症最常见的病原菌,且检出了耐氟康唑、氟胞嘧啶、伊曲康唑的假丝酵母菌。假丝酵母菌菌血症患者基础疾病多、病情重、病死率高,器官衰竭、脓毒性休克是其死亡的独立危险因素。     

浅谈中西医结合的临床护理工作

<正> 中医和西医是在不同历史条件下发展起来的两种医学体系,其目的都是为了防治疾病,因此可以取长补短,对防止疾病,保障健康是有益的。在临床实践中不仅在医疗上要中西医结合,且在护理方面亦应中西医结合,这才有利于临床诊治。本人在十几年的临床护理工作中深深体会到,临床工作中,即要西医的医护,也要中医的医护。本文就谈临床工作中中西医结合护理的运用。     

实用眼科显微手术学讲座

第一章 引言 手术显微镜的使用，提高了常规的眼科手术效果，显微镜高倍放大下，使术者能准确的进行手术。显微手术于30年代     

Acute Primary Closed Angle Glaucoma

·Professor and Head of the Department of Ophthalmology, National University of Singapore. ·Medical Director of Singapore National Eye Center. ·Chairman, Singapore Eye Research Institute. ·Secretary General of the Asia-Pacific Academy of Ophthalmology. ·Presidem of the XXVI International Congress of     

CO_2激光治疗宫颈糜烂465例临床疗效观察

６５例宫颈糜烂中,Ⅰ度糜烂１６８例,Ⅱ度糜烂２４３例,Ⅲ度糜烂５４例。常规消毒,充分暴露宫颈,用０１％新洁而灭局部消毒,以功率为２０～４０Ｗ的ＣＯ２激光散焦照射糜烂处,照射范围作者单位：福建省莆田县东峤镇田柄卫生所（３５１１６４）不超过正常表面２ｍ...     

窄谱强脉冲光联合长脉宽1064nm激光治疗皮肤血管性病变的疗效分析

目的:探讨窄谱强脉冲光(500～600nm)联合长脉宽1 064nm激光治疗皮肤血管性病变的疗效。方法:使用窄谱强脉冲光(500～600nm)联合Nd:YAG激光长脉宽1 064nm治疗214例血管性病变患者,根据血管性病变的厚度,先用长脉宽1 064nm Nd:YAG激光,然后用窄谱强脉冲光(500～600nm),照射病变部位,治疗1～6次,治疗间隔1个月,门诊随访3～6个月。结果:治愈87例(40.65%),显著消退115例(53.73%),有效9例(4.20%),总有效率94.38%。治疗后出现水疱13例,紫癜10例,色素沉着6例,色素脱失2例,随时间逐渐恢复。结论:窄谱强脉冲光(500～600nm)联合长脉宽1 064nm激光治疗皮肤血管性病变,发挥了强脉冲光和激光的优点,疗效显著,不良反应轻,值得临床推广应用。     

开展QC活动减少手术室无菌物品返消毒率

目的 探讨QC活动在降低手术室无菌物品返消毒率的效果.方法 成立QC小组,确立"减少手术室无菌物品返消毒率"为活动的课题,进行现状调查,确定目标值,对产生无菌物品返消毒的原因进行分析,确定主要原因,制定并实施相应的对策,最后进行效果检查.结果 开展QC活动后手术室无菌物品返消毒率由原来的4.05%降低到2%.结论 QC活动可有效减少无菌物品的返消毒率.