Purpose To observe the clinical features and visual acuity of the eyes with idiopathic macular holes. Methods We reviewed the clinical materials of 23eyes of 18 patients with idiopathic macular holes and the follow up results from 6 to 120 months. Results In the initial examinations of 22 eyes,the numbers of eyes with stagesⅠ-Ⅳ macular holes were5,4,10,3 eyes respectively,and funds fluorescein angiography showed there were focal transmission of choroidal fluorescein in 17 eyes (stagesⅡ～Ⅳ).Macular hole ocurred in one eyes during follow up.At the final examination of 23 eyes,the numbers of eyes with stages Ⅰ～Ⅳ macular holes were 2,2,9,8 eyes respectively .Full-thickness macular hole of 2 eyes closed naturally after posterior vitreous detachment.The time interval of the subjective visual loss on stage Ⅰ was 5-8 months,stageⅡ8-20 months,stageⅢ12-126 months ,and the average visual acuity on stageⅠwas 0.7,stage 0.55,stageⅢ0.08,and stage Ⅳ0.08 Conclusion Approximately 60% of impending (stage Ⅰ) hole progress to full thickness holes, the full thickness holes were usually enlarged and the visual acuity of affected eyes decreased as the natural course was prolonged . (Chin J Ocul Fundus Dis,1998,14:222-223)
Objective To investigate the risk factors, clinical characteristics and prognostic factors of venous thrombosis (and pulmonary embolism) in patients with idiopathic hypereosinophilia (IHE) so as to provide a theoretical basis for clinical prevention of venous thrombosis and improve prognosis.Methods Thirty-nine patients with IHE admitted to West China Hospital of Sichuan University from January 2010 to January 2022 were collected in this retrospective case-control study to explore the risk factors of venous thrombosis (including pulmonary embolism) and thrombosis recurrence after treatment. Results There were 17 (43.5%) patients combined with venous thrombosis of 39 patients with IHE. In the patients with vascular involvement, pulmonary embolism was the initial expression of IHE accounted for 29% (5/17). patients of IHE with pulmonary embolism were younger [44 (24.5 - 51.0) vs. 56 (46.3 - 67.8) year, P=0.035] and had higher peak absolute eosinophil counts [11.7 (7.2 - 26.5)×109/L vs. 3.8 (2.9 - 6.7)×109/L, P=0.020] than those without pulmonary embolism. After a mean follow-up of 13 months (2 - 21 months), thrombosis recurred in 35.3% (6/17) of patients. Persistent increasing in eosinophils (>0.5×109/L) was an independent risk factor for thrombus recurrence (odds ratio 13.33, 95% confidential interval 1.069 - 166.374). Conclusions Thrombosis is a common vascular impaired complication in IHE , and increased eosinophilia is a risk factor for thrombosis and thrombus recurrence after therapy. Controlling and monitoring the eosinophilic cell levels in patients with IHE may avoid severe comorbidities.
目的 探讨腹腔镜下脾切除术（LS）治疗特发性血小板减少性紫癜(ITP)的临床效果。方法 我院2003年1月至2008年8月期间行LS治疗ITP患者20例，将术前与术后1、2、7、14、30、90及180 d的血小板计数进行比较。结果 20例ITP患者均顺利完成LS，平均手术时间为156 min，术中出血平均50 ml，平均住院时间为9 d。完全停用药物14例； 4例患者术后需继续服用激素治疗，但激素用量较前明显减少； 无效2例。总有效率为90%。术后1、2、7、14、30、90及180 d的血小板数量分别为(251.6±91.4)×109/L、(312.6±90.1)×109/L、(343.2±103.7)×109/L、(300.0±98.2)×109/L、(175.6±42.6)×109/L、(151.8±42.1)×109/L及(207.0±53.4)×109/L,分别与术前〔(38.3±19.4)×109/L〕比较，经t检验，差异均有统计学意义（P＜0.001）。结论 LS治疗ITP是可行和安全的，手术效果满意。
目的 总结在三维标测系统Carto 3指导下射频消融治疗特发性室速患者的护理方法。 方法 对2010年11月－2011年10月收治的62例特发性室速患者，采用Carto 3系统进行心室标测和消融治疗，并予以周全细致的护理。 结果 本组61例患者顺利完成射频消融术，1例因诱发室颤后停止手术。术后随访6个月，3例出现既往相同形态室速，其余58例症状较前均有不同程度的缓解，未发生明显心动过速，手术成功率为93.55%。 结论 Carto 3系统指导下的特发性室速射频治疗安全、高效，可减少射线透视量，恰当细致的护理配合是手术获得成功的基础与保障。
ObjectiveTo investigate key differentially expressed genes (DEGs) in peripheral blood of idiopathic epilepsy patients, as well as their biological functions, cellular localization, involved signaling pathways, through bioinformatics analysis. So to provide new insights for the pathogenesis and prevention of idiopathic epilepsy.MethodsFirstly, we screened and downloaded microarray data including 6 peripheral blood samples of drug-naive patients with idiopathic epilepsy, 8 peripheral blood samples of responders of idiopathic epilepsy treated with Valproate (VPA), and 10 peripheral blood samples of non-responders of idiopathic epilepsy treated with VPA from Gene Expression Omnibus (GEO) data series GSE143272, which Public in January 2020. Secondly, we identified DEGs via the limma package and others in R software. Then we had gotten 74 DEGs, and subsequently conducted gene ontology and pathway enrichment analysis, PPI network analysis and hub gene analysis, using multiple methods containing DAVID, STRING, and Cytohubba in Cytoscape.ResultsWe had identified significant hub DEGs, including TREML3P, KCNJ15, ORM1, RNA28S5, ELANE, RETN, ARG1, LCN2, SLPI, HP, PGLYRP1, BPI, DEFA4, TCN1, MPO, MMP9, CTSG, CXCL8, RNASE3, RNASE2, S100A12, DEFA1B, DEFA1, DEFA3, CEACAM8, MS4A3, PTGS2, PI3, CCL3. The biological processes involved in these DEGs include immune response, inflammatory response, chemotaxis, etc. While, the molecular function is focused on peroxidase activity, chemokine activity, etc. Moreover, KEGG pathway enrichment analysis shows that DEGs were mainly involved in cytokine-cytokine receptor interaction, Toll-like receptor signaling pathway, chemokine signaling pathway and so on.ConclusionThese important key DEGs may be involved in the onset and development of idiopathic epilepsy through a variety of signaling pathways and complex mechanisms.
Objective To improve the awareness of acute exacerbation of idiopathic pulmonary fibrosis ( AEIPF) and discuss its clinical characteristics, diagnosis, treatment and outcome. Methods The clinical data of patients with AEIPF from June 2006 to June 2011 in 11 hospitals in Jiangsu were collected and analyzed. Resluts There were 18 males and 3 females in the AEIPF patients with mean age of ( 67.4 ± 8.1) years. The duration from IPF diagnosis was ( 7.4 ±8.2) months. The duration of acute symptom before admission was ( 7.0 ±5.3) days. The distribution pattern of new groud-glass opacity was peripheral in 3 patients,multifocal in 5 patients, and diffuse in13 patients. All patients were treated with corticosteroid pulse therapy. Nine patients survived and 12 patients died. The mortality rate was 57.1% . Conclusions AEIPF progresses quickly and the mortality rate is very high. Corticosteroid pulse therapy is the mainstay of therapy in AEIPF patients.
Objective To review the King-types Ⅲ and Ⅳ patients treated by the CD hybrid technique and evaluate clinical results on the shorter fusion levels. Methods Fifty-eight patients with idiopathic scoliosis were treated by the CD hybrid method from March 2000 to January 2003, among whom 40 were grouped as Kingtype Ⅲ and 18 as Kingtype Ⅳ; 41 were female and 17 were male. The Cobb angle of the thoracic curve was averaged 64°(range 50-83°), and the curve flexibility was 62%. The compensative lumbarcurve was averaged 37°（range 16-48°）, and the curve flexibility was 105%. With the neutral rotational vertebrae as a basis to select the low instrumentation vertebrae, the neutral rotational vertebrae or the vertebrae at 1 or 2 levelsproximal to the neutral rotational vertebrae were selected as the low instrumentation vertebrae in all the patients. Standing AP and lateral radiographs were taken respectively at the discharge, during the follow-up after discharge, and at the final follow-up. Results The patients were followed up for an average of 2.4 years (range 1.8-3.2). The corrected curves lost an average of 3.1°（range -1-5°）and the correction rate of the thoracic curve was 68% at the final follow-up.The plumbline from C7 was parallel to the sacral midline in 56 patients. The lumbar curves were corrected to an average of 8°（2-13°）automatically. The lumbosacral angle was corrected automatically by 53% and the low instrumentation vertebrae in 48 patients turned into stable vertebrae. The low instrumentation vertebrae lost 1.4 segments on average compared with the Harrington principle. No spinal imbalance was clinically observed in all the patients. Conclusion The choice of the low instrumentation vertebrae as the neutral rotational vertebrae can have a good result in the clinical practice. It can be applied in the CD hybrid technique in treatment of idiopathicthoracic curves.
Objective To analyze the clinical symptoms, imaging, laboratory tests, efficacy and other indicators of patients diagnosed as diffuse parenchymal lung disease ( DPLD) , in order to provide a reference for differential diagnosis of secondary DPLD and idiopathic interstitial pneumonia ( IIP) .Methods Sixtytwo patients diagnosed as DPLD were retrospectively analyzed. Results In 62 patients with DPLD, 19 patients ( 30. 6% ) were diagnosed as secondary DPLD, 42 cases ( 67. 7% ) as IIP, 1 case ( 1. 6% ) as Langerhans cell histiocytosis. The smoking rate of the DPLD patient was 33. 8% , which was higher than general population ( 29. 7% ) . 94. 7% of the secondary DPLD patients had cough, which was higher than the IIP patients ( 71. 4%) . The average age of onset of the secondary DPLD and IIP was ( 45. 9 ±16. 8) years and ( 60. 5 ±7. 7) years respectively, without significant difference ( P gt; 0. 05) . Etiological factors of secondary DPLD were dust, pets, drugs, pesticides, decoration material, etc. The secondary DPLD patients had higher response rate to steroid therapy, but had no statistical difference compared with the IIP patients ( 46. 2% vs. 37. 5% , P gt;0. 05) . Conclusions As a group of diseases of known causes, history taking is very important for DPLD diagnosis and differential diagnosis. Clinical symptoms, imaging, and laboratory tests may provide reference for differential diagnosis of secondary DPLD and IIP.
Objective This study aims to analyze the clinical characteristics of idiopathic inflammatory myopathy (IIM) associated interstitial lung disease (ILD) with positive anti melanoma differentiation-associated gene 5 (MDA5) antibody. Methods The clinical data of 91 patients with IIM in Shanxi Bethune Hospital from Jan 2019 to Mar 2022 were collected. Then various comparisons and analyzed retrospectively in the clinical symptoms, laboratory indicators and imaging characteristics between the negative MDA5-IIM and the positive anti-MDA5-IIM. ResultsCompared with the negative anti-MDA5-IIM patients, the significantly higher incidences of Gottron sign (71.0% vs. 38.3%), ulcerative rash (45.2% vs.16.7%), dyspnea (64.5% vs. 36.7%), and ILD (71.0% vs. 43.3%), in the positive anti-MDA5-IIM patients (P<0.05). Compared with the negative anti-MDA5-IIM patients, the more ground-glass opacification (GGO) in the positive anti-MDA5-IIM patients on high resolution computed tomography (81.8% vs.53.8%, P<0.05). Compared with the positive anti-MDA5-IIM patients without ILD, the positive anti-MDA5-IIM patients with ILD had significantly higher incidence of Gottron sign (77.3% vs. 33.3%), the increased levels of lactate dehydrogenase [(525.20±203.09) IU/L vs. (321.73±188.88) IU/L], Krebs von den Lungen-6 [(1399.55±869.64) U/mL vs. (371.56±128.92) U/mL], and D-dimer [(1226.65±902.31) U/L vs. (703.73±160.11) U/L], as well as higher positive rate of anti-Ro-52 antibody (68.2% vs. 22.2%) and the higher case fatality rate (54.5% vs. 0.0%), with all P<0.05. The triple treatment of high-dose glucocorticoid (GC) combined with intravenous cyclophosphamide (IVCY) and another immunosuppressive agent (tacrolimus or tofacitinib) was found to be effective in the MDA5-IIM associated ILD group, with a lower case fatality rate (28.6%) than high-dose GC combined with IVCY group (47.1%). Conclusions The positive anti-MDA5-IIM with ILD of patients have the higher incidence of rash and dyspnea, with GGO as the most common imaging manifestation. When rapidly progressive interstitial lung disease (RPILD) is combined, the case fatality rate higher. Meanwhile, early intensive immunosuppressive therapy may improve the survival rate of RPILD patients with positive anti-MDA5 antibody.