早产儿视网膜病变(ROP)是儿童盲的重要致盲原因之一,随着ROP防治指南的颁布以及ROP筛查工作的开展,我国ROP发病率和致盲率有所下降。正确认识和理解ROP分类、筛查标准和治疗指南;建立完善的ROP筛查体系,提高筛查水平;加强ROP临床和基础研究,将有助于进一步降低我国ROP发病率和致盲率
PURPOSE:To observe the effect of laser/photocoagulation on prevention of recurrence of retinal datachment following removal of intraocular silicone oil. METHODS:Laser photocoagulation was performed in a series of 24 cases (24 eyes)which had been formerly operated on with vitreoretinal surgery and intraocular silicone oil tamponade for retinal datachment,2 weeks to 3 months before intraocular silicone oil removal. Argon green or krypton red laser photocoagulation were done in whole or half cycle scattered laser burns behind the sclera! ridge. RESULT:Among the 24 eyes ,after the intraocular silicone oil had been removed, 22 (91.7%)eyes had their retinas retained in normal position. CONCLUSION :Laser photocoagulation before removal of intraocular silicone oil might be helpful in avoiding the recurrence of retinal detachment. (Chin J Ocul Fundus Dis,1997,13: 197-198)
目的探讨肝癌手术切除后的序贯综合治疗,以达到有效防治肿瘤复发的目的。方法从我科收治的肝癌患者中挑选3例手术治疗后进行序贯综合治疗并取得良好效果病例,对其临床资料进行分析,从中获取有关肝癌术后治疗的经验。结果3例肝癌患者在我科手术后接受了积极的预防复发措施,虽最终均出现复发,但对待复发的肿瘤均采取积极的应对措施,获得了长期生存。结论对于肝癌手术切除后的患者进行积极的序贯性综合治疗有较好的临床意义,鼓励对术后复发病例进行积极序贯综合治疗。
Objective To investigate the effect of prophylactic 360°laser retinopexy on retinal redetachment after silicone oil removal. Methods The clinical data of 181 vitreoretinal patients after silicone oil removal were retrospectively analyzed. In 88 patients (photocoagulation group) was taken prophylactic 360-degree laser retinopexy before silicone oil removal; in 93 patients (control group) without prophylactic laser retinopexy. The incidence, time, the cause of retinal redetachment and the complications of laser retinopexy after silicone oil removal in two groups were observed. Results The duration of silicone oil tamponade is 4~72 weeks, averaging 13.7±2.4 weeks. 20 cases of retinal redetachment were recorded after silicone oil removal, including 5 cases (5.7%) in photocoagulation group and 15 cases (16.1%) in control group. The difference between two groups is statistically significant (Plt;0.05). Among these 20 patients with retinal redetachment, 10 occured during the first 3 days after the operation, 6 during 4~7 days, 3 during 8~14 days. 1 case occured 2 months after the operation. 11 cases of redetachment result from the omission of small retinal breaks located in ora serrata or behind the photocoagulation zone, or the reopening of primary retinal breaks because of insufficient photocoagulation and freezing during the operation. 1 case result from the hole that come from laser photocoagulation scar tracted by nearby proliferative tissue. 7 cases result from the formation of new breaks from the proliferative vitreoretinopathy(PVR) or proliferation of residual vitreous. There are 52 cases of burning of pupillary border, with the incidence of 59%. Conclusions Prophylactic 360-degree laser retinopexy is associated with a decrease of the incidence of retinal redetachment after removal of silicone oil. (Chin J Ocul Fundus Dis,2008,24:283-285)
Objective To investigate the inhibitory effects of fms-like typrosine kinase receptor sFlt-1 on retinal neovascularization (RNV).Methods Recombinant lentivirus sFlt-1(2-3)and sFlt-1(2-4)expressing the sFlt-1 (2-3) and (2-4) immunoglobulinlike regions of sFlt-1 were constructed. 96 seven-day-old C57/6J mice were randomly divided into 4 groups with 24 mice in each group. Group 1: normal control; group 2: experimental control; group 3: sFlt-1(2-3); group 4: sFlt-1(2-4).The mice in group 2-4 were exposed to hyperoxia with (75plusmn;2)% O2 for 5 days and then returned to normoxia with 21% O2;the mice received an intravitreal injection with 1 mu;l virus of empty vector, sFlt-1(2-3),or sFlt-1(2-4),respectively. Five days later, all mice underwent perfusion fluorecein angiography and retinal wholemont was made to observe the changes of retinal vessels; retinal sections were stained by hematoxylin and eosin and RNV endothelium cell nucleus were counted; vascular endothelial growth factor(VEGF) and VEGF receptor-2 (KDR/Flk-1) protein were measured by Western blot.Results Seventeen days after birth, the retinal area of fluorescein leakage and RNV, RNV nucleus which breaking through inner limiting membrane in group 3 and 4 were smaller or less than that in group 2(P<0.01); while VEGF protein didnprime;t changed much (P>0.05)the expression of KDR/Flk-1 decreased significantly (P<0.01). Conclusion sFlt-1(2-3)and sFlt-1(2-4)can inhibit the formation of oxygen-induced RNV,the former virus has a better effect.
Complications of proliferative diabetic retinopathy have become the major indications of vitrectomy. The surgery, however, is not basically a causative therapy. The visual function after operation depends on the degree of retinal ischemia and damage induced. The surgery itself has a potential for severe complications. Therefore it is important to better understand the pathology and to master surgical strategy and techniques in order to improve surgical outcomes and reduce the surgical complications. (Chin J Ocul Fundus Dis,2007,23:234-237)
Objective To systematically review the efficacy and adverse events of alendronate on bone mineral density and fractures in men with osteoporosis. Methods We electronically searched MEDLINE (1990 to 2005), EMBASE (1990 to 2005), The Cochrane Library (Issue 3, 2005), Controlled Trials Register and The National Research Register, CBM disc, VIP, and CNKI. We also handsearched some related journals. The search was conducted in Nov., 2005. The quality of included randomized controlled trials (RCTs) was evaluated and meta-analysis was conducted by RevMan 4.2.8. Results We identified 7 studies including 817 patients. Sufficient evidence showed that alendronate plus calcium was superior as preventive treatment to calcium in increasing the bone mineral density (SMD 0.59, 95% CI 0.15 to 1.03, P=0.009) of the lumbar spine. The incidence of withdrawal and lost to follow-up due to adverse events of the alendronate plus calcium was lower than that of calcium (RR 0.32, 95% CI 0.11 to 0.87). Two studies showed that alendronate was superior to placebo in increasing the bone mineral density in men with osteoporosis but with no significantly statistical difference in reducing fractures. Two studies showed alendronate was superior to alfacalcidol in increasing the bone mineral density and reducing the vertebral fractures in men with osteoporosis. One study showed alendronate was not superior to calcitonin or alfacalcidol in increasing the bone mineral density in men at high risk of osteoporosis. One study comparing anledronate or parathyroid hormone with combination of these drugs in men with osteoporosis suggested that anledronate wasn’t superior to parathyroid hormone in increasing the bone mineral density, and the combination did not show any difference compared to parathyroid hormone alone. Conclusions Alendronate is more effective in prevention and treatment of men with osteoporosis compared to placebo. Alendronate is more effective than alfacalcidol in increasing bone mineral density and reducingvertebral fractures in men with osteoporosis. Alendronate is not superior to alfacalcidol or calcitonin in increasing the bone mineral density in preventing men osteoporosis. Alendronate compared to combination of parathyroid hormone does not show more effectiveness in increasing the bone mineral density in men with osteoporosis. More RCTs of high quality, especially multiple center trials are needed to generate ber evidence.
目的:分析脊柱外科患者术后并发谵妄综合征的原因,总结其诊断、预防、治疗。方法:回顾性分析我科2008年10月至2009年4月脊柱手术167例,其中11例患者术后发生谵妄综合征。结果:11例患者均给予氟哌啶醇5mg im bid治疗,平均使用5.6天,症状缓解;并获3~6月随访,无一例复发谵妄综合征。结论:谵妄综合征是脊柱外科患者术后常见并发症,其发生与年龄,性别,低血糖等有关,目前治疗首选氟哌啶醇。