目的:回顾性分析臀会阴及下肢大面积皮肤软组织撕脱伤的治疗体会。方法:2005年1月至2007年6月,对8例臀会阴及下肢大面积皮肤软组织撕脱伤患者进行综合治疗。男4例,女4例,年龄4～48岁,平均26岁,病程1天～1月,平均2周。皮肤撕脱达体表总面积8%～20%。致伤原因:车祸伤7例,高坠伤1例。其中7例成人均上翻身床治疗,1例小孩床上自行翻身,6例由于创面距肛门较近或脊髓损伤不能控制大便而行结肠造瘘,通过造瘘口排便,创面愈合3月后行造瘘还纳术。所有患者均通过积极创面处理、肉芽新鲜后行刃厚植皮术而痊愈。结果:8例患者经过我们的综合治疗后伤口均愈合,随访6月后皮肤愈合良好。6例行结肠造瘘的患者中3例因骨盆骨折稳定于出院后3月左右行结肠造瘘还纳术,恢复肛门排便,3例伴有脊髓损伤患者而不能自行控制排便的患者在随访期间未行结肠造瘘还纳术。结论:臀会阴及下肢大面积皮肤软组织撕脱伤患者通过上翻身床,必要时行结肠造瘘,积极的创面处理及对症支持治疗能取得较好效果。
Purpose To identify matrix metalloproteinase (MMP) in human vitreous samples of diabetic vitreoretinopathy (DR) and other ocular diseases (non-DR) and to probe the related factors of MMP expression． Methods Thirty-one diabetic and 17 non-diabetic vitreous samples (nine macular hole and eight epiretinal membrane patients) were examined． Samples were concentrated and subjected to substrate zymography to conduct a quantitative analysis of MMP-2,9 activity． The technology of Western blotting against anti-human MMP-2,9 was performed to identify MMP in vitreous samples． Results Vitreous samples both from DR patients and from non-DR patients showed a single band at the position of 72 kDa, correspondin g to MMP-2． Quantitative analysis revealed that diabetic vitreous showed higher MMP-2 activity than non-DR, although the difference was not significant.45.2% of DR patients showed MMP-9, but no expression in non-DR．Among DR samples, the positive ratio of MMP-9 in partial posterior vitreous detachment (PVD)(66．7%) was significantly higher than that of complete PVD (15．4%)． Western blotting study confirmed the expression of MMP-2 and MMP-9． Conclusion There is no obvious difference of MMP-2 activity between DR and non-DR． MMP-9 may be involved in the pathogenesis of diabetic vitreor etinopathy and the deterioration of proliferative change． (Chin J Ocul Fundus Dis, 2001,17:195-197
Objective To detect the difference of the light sensitivity in the central visual field between normal people and type Ⅱ diabetic patients without diabetic retinopathy, and evaluate the effect of perimetric examination in early diagnosis of diabetic retinopathy. Methods The light sensitivity at the 80 locations in the central field was measured by Dicon field analyzer (model TKS-4000) in 76 normal eyes of 44 normal volunteers aged from 45 to 72 years and 75 eyes of 40 type Ⅱ diabetic patients without retinopathy aged from 46 to 71 years. Results For the diabetic patients without diabetic retinopathy, the light sensitivity of locations decreased by 4-8 dB,and there were some decreased light sensitivity areas. The mean light sensitivity of three zones of the central field had significant reduction in the diabetic patients as compared with the control group(Plt;0.001). Conclusion The retinal neurosensory function of diabetic patients is damaged in some degrees before diabetic retinopathy occured, and no relationship is found between the decrease of retinal light sensitivity and localized blood-retinal barrier leakage. It is suggested that examination of central field with computerized perimetry has certain clinical significance in early diagnosis of diabetic retinopathy. (Chin J Ocul Fundus Dis, 2002, 18: 218-220)
PURPOSE:To observe the clinical features of the macular hemorrhage in myopes. METHOD:Twenty-four patients(30 eyes)with myopic macular hemorrhage were examined with slitlamp biomicroscopy,funduscope,A/B ultrasonography,and fundus fluorecein angiography(FFA). The patients were followed up for 3~18 months(average 12 months). RESULTS: Four of 26 eyes with macular hemorrhage examined with FFA were found to be due to choroidal neovaseulature,and they were associated with posterior staphyloma. The other 22 eyes without neovascular change were thought to be simple type,and 19 of them were associated with lacquer cracks. The hemorrhage in simple type cases deminished usually within 1~3 months. CONCLUSION:Myopic macular hemorrhagic eyes of neovascular type resulted usually in recurrent hemorrhage and worse prognosis in visual acuity than those of simple type. （Chin J Ocul Fundus Dis,1996,12: 220-222）
目的：探讨输卵管性不孕妇女生存质量及其影响因素，并为输卵管性不孕症治疗决策的选择提供相应的依据。方法：采用生存质量测评量表SF-36对80名输卵管性不孕妇女及80名已生育或妊娠的健康妇女进行了同期的横断面调查与比较。结果：输卵管性不孕妇女的生存质量较正常健康妇女人群低，除了生理功能及躯体疼痛外，输卵管性不孕妇女有关社会功能、生理问题对功能的限制、心理问题对功能的限制、心理健康、活力、健康的总体评价、健康变化程度等七个方面的主观满意度均较对照组低，差异有显著意义(Plt;0.05)。患者的年龄、文化程度及居住环境对其生存质量有影响。结论：在治疗不孕症时，不应仅针对其病因治疗，而且要重视心理和社会因素的作用，加强心理治疗，重视健康教育，针对性地改善患者在精神、社会、心理等方面的主观体验，以促进不孕症妇女生存质量的提高。
Objective To present stereoscopic image of rhegmatogenous retinal detachment with three-dimentional reconstruction of sonography． Methods Ultrasound data were collected by Hpsonos 1500 and 7.0MHz transducter with the motor controlled by computer．Three-dimentional image were reconstructed with Tomtec echoscan． Results Three-dimentional image were successfully reconstructed in 14 eyes of 13 cases of retinal detachment include 3 eyes of 3 cases with opaque refractive medium showing stereosopic image of retina and some retinal tears． Conclusion Static three-dimentional reconstruction of sonography might enhance the ability to visulize spatial anatomic structure of retina and offer a new method to find retinal tears in patients with opague refractive medium． (Chin J Ocul Fundus Dis,1998,14:24-25)
Objective To evaluate the applic ation of blue-on-yellow(B/Y) perimetry in detecting the early visual field loss of glaucoma． Methods The B/Y perimetry of the G2 strategy in the OCTOPUS 101 perimetry was used to examine the visual field of 16 normal persons (32 eyes), 25 cases (35 eyes) of primary open-angle glau coma (POAG) with abnormal white-on-white (W/W) visual fields, 15 cases (15 eye s) of early POAG with normal W/W visual field, and 11 cases (22 eyes) of suspect ed POAG． Results The mean sensitivity (MS) in the normal cases, suspected POAG, early POAG, middle POAG, and late POAG was ( 23．24plusmn;1．22) dB，(20．97plusmn;3．42) dB，(18．44plusmn;3．57) dB，(11．04plusmn;1．85) dB and (8．55plusmn;2．29) dB, respectively． It was demonstrated that B/Y perimetry was more sensitive than W/W perimetry in detecting the glaucomatous visual fi eld defects,and its sensitivity was 92% and specificity was 90．62%． The averag e number of defective points in central visual field with B/Y perimetry was more than that with W/W perimetry in early and middle POAG． Conclusion B/Y perimetry is a relatively sensitive method for detection of the early visual field loss in POAG． (Chin J Ocul Fundus Dis, 2001,17:125-127)
目的:研究纳米炭淋巴示踪剂在乳腺癌手术淋巴结病理检查中价值。方法:84例乳腺癌患者随机分为普通组和纳米炭组2组,比较2组患者淋巴结检获情况。结果:两组共计检获淋巴结1660枚,其中纳米炭组(24.5±3.2)枚/例,显著高于常规组(13.5±5.3)枚/例,(t=3.475, Plt;0.05)。纳米炭组检获出更多淋巴结,炭着色淋巴结癌转移率更高。结论:纳米炭示踪剂提高了淋巴结检获率,确保了病理活检的准确性,是一值得推广的示踪剂。
By using the different light stimuli, the flash ERG of 32 cases of central retinal vein occlusion(CRVO) (13 of ischemic type,19 of non-ischemic type) during acute phase were examined. The results showed that the a-wave and b-wave latency of CRVO elongated,while the b-wave amplitude of ischemie type decreased and that of non-ischemic type varied in different stimulus: decreased,increased or normal.Therefore,b-wave amplitude and b/a ratio,and selection of suitable ERG condition of stimulus are thought to be important in differetiating ischemic from non-ischemic CRVO. (Chin J Ocul Fundus Dis,1994,10:7-10）