319例352眼眼外伤疗效观察

采用综合治疗，抗炎，散瞳，局部治疗与全身应用免疫抑制疗法，治疗３１９例３５２眼外伤获得了满意的疗效，眼球挫伤１０４例，眼球穿孔伤９３例，化学烧伤７１例，眼炸伤４６例。眼热烧伤５例，治疗包括及时清创胶粘或缝合，清除前房出血合理用皮质类固醇和免疫抑制剂等。眼球挫伤治愈率９７．１２％，穿透伤９３．１８％，热烧伤６６．６７％。３１９例眼外伤治愈率９４．６７％好转５．３３％，并对各种治疗方法进行了讨论。     

Retrorenal colon: implications for percutaneous diskectomy

It has been recommended that computed tomography (CT) with the patient prone be performed in every patient undergoing percutaneous diskectomy; this would enable detection of a retrorenal location of the colon, which could interfere with the percutaneous procedure. In this evaluation of 346 prone CT studies, only one patient (0.29%) was found to have retrorenal or retropsoas bowel that would have been perforated at diskectomy. Because of this extremely low prevalence, the performance of prone CT in every patient undergoing percutaneous lumbar diskectomy is not believed to be necessary.     

Ultrasound biomicroscopic features of spherophakia

Background: Spherophakia is an uncommon diagnosis. This is the first case report of spherophakia evaluated by ultrasound biomicroscopy.
Methods: Ultrasound biomicroscopy is a new diagnostic technique developed by one of the authors and provides images with microscopic resolution of the anterior segment. A patient with spherophakia was evaluated by ultrasound biomicroscopy (Zeiss-Humphrey, 50MHz) before and after YAG laser iridotomy.
Results: Ultrasound biomicroscopic assessment revealed a shallow anterior chamber, a very steep anterior lens curvature, iridolenticular contact, elongated zonules, and an increased distance between the lens equator and the ciliary processes. Angle closure glaucoma was due to a pupil block mechanism. The pupil block was relieved by YAG laser iridotomy.
Conclusions: Ultrasound biomicroscopy is a useful technique to confirm the diagnosis of spherophakia. The pupil block in spherophakia is relieved by YAG laser iridotomy.     

Comparison of polymerase chain reaction and Chlamydiazyme for the detection ofChlamydia trachomatis in clinical specimens

An attempt was made to improve laboratory diagnosis ofChalmydia trachomatis and to validate the Abbott Chlamydiazyme confirmatory test used at present by comparing the polymerase chain reaction (PCR) procedure and the Abbott enzyme immunoassay. A total of 275 routine clinical specimens representing a range of positive and negative findings by Chlamydiazyme were retested by PCR. The procedures demonstrated 99 % concordance for specimens with optical density (OD) readings above the Chlamydiazyme cut-off of 0.1, but PCR was confirmed to be significantly more sensitive (p<0.025) for specimens with OD values between 0.05 and 0.09. Specimens in this range should be retested routinely by PCR.     

Pituitary macroadenomas associated with hyperprolactinaemia: immunocytochemical and in-situ hybridization studies

OBJECTIVE: We have assessed whether in-situ hybridization for prolactin messenger RNA (mRNA) provides additional information for the classification of pituitary macroadenomas associated with hyperprolactinaemia. DESIGN: In-situ hybridization for PRL mRNA was performed on surgical biopsies of pituitary adenomas and the results correlated with serum PRL levels and PRL immunoreactivity. PATIENTS: Twenty-one patients (11 men, 10 women) were included; five had normal serum PRL levels, 11 mild hyperprolactinaemia (less than 3000 mU/l) and five marked hyperprolactinaemia (greater than 3000 mU/l). MEASUREMENTS: Immunocytochemistry for PRL and in-situ hybridization for PRL mRNA were performed on surgical biopsies. RESULTS: Immunoreactivity for PRL was detected in tumours from all patients with serum PRL greater than 3000 mU/l and in one of 11 patients with mild hyperprolactinaemia. Positive signal for PRL mRNA was detected in four of five immunopositive cases studied, in a further two cases with mild hyperprolactinaemia, and in one tumour associated with normal serum PRL level. CONCLUSIONS: In-situ hybridization provides evidence of PRL gene activation in the absence of immunoreactivity for prolactin. This may reflect low levels of hormone storage or defective translation of the mRNA.     

1,6—二磷酸果糖对手术后应激病人应用全肠外营养支持效果的影响

本文在胃癌行全胃或胃大部切除术引起的中等程度应激病人，随机分组对比观察了全肠外营养或ＴＰＮ加用１，６－二磷酸果糖的效果。结果显示，与单纯ＴＰＮ相比，ＴＰＮ加用ＦＤＰ后血清皮质醇和胰高血糖素等应激激素水平有所下降，尿中３－甲基组氨酸排出减少，累积氮平衡增加。     

Platelet function in hairy-cell leukaemia

A quantitative study of various aspects of platelet function was carried out in eight patients with typical hairy-cell leukaemia (HCL). In at least two patients platelet aggregation was convincingly reduced to more than one aggregating agent (ADP, adrenaline, collagen, thrombin, and ristocetin). Granular storage capacity for {(14)C} 5-HT was reduced in five of the six patients tested. The two patients with definitely abnormal aggregation had the greatest reduction in granular storage pool and the longest bleeding times of those tested but, like the other patients, they did not have a clinical haemostatic defect. It was concluded that a granular storage pool defect (SPD) was at least partly responsible for aggregation abnormalities in HCL since the platelet release reaction in response to thrombin appeared to be normal. All our patients ran a chronic course uncomplicated by any of the factors known to predispose to a platelet SPD acquired in the circulation. Although in the one patient tested before and after splenectomy there was some improvement in platelet aggregation after operation, there was no clear general relationship between defective platelet function and either previous splenectomy or platelet count. Since a direct involvement of the megakaryocytic series in the underlying cell proliferation of HCL seems unlikely, it is concluded that the platelet defect can most reasonably be attributed to the production of abnormal platelets as a result of marrow fibrosis and/or infiltration by hairy cells.