简介：患者女性，51岁。2008年3月在我科接受全身麻醉下左颈部肿物摘除术。术中病理检查证实为左颈部乳头状腺癌淋巴结转移，后行左颈部淋巴结清扫术和甲状腺结节探查术，病理检查未见癌组织。术中分离颈内静脉下段时，可见少量清亮透明液体，但未发现明确漏出点，未予特殊处理。第2天，患者出现轻度呼吸困难，左胸壁肿胀，术区可见少量乳白色液体漏出（见附2页图①）。纤维喉镜检查：左下咽部膨隆，会厌向右侧隆起、肿胀，呈乳白色塑料皮样外观，咽喉部黏膜光滑。喉部及肺部CT扫描：喉旁、颌下、左颈部及左前胸壁弥漫性肿胀，伴左颈部软组织积液，

简介：<正>先天性第一鳃沟发育异常形成的瘘管在临床上很少见,误诊率很高。笔者收治二例,现报道如下:例1,患者男,21岁,因右耳后反复红肿、流脓8年于1996年5月9日入院。患者8年前无诱因出现右耳后红肿、疼痛,皮肤破溃后流出粘稠黄绿色脓液,排脓后症状消失。此后每年反复出现右耳

简介：资料病例1男性,65岁。因右侧鼻腔流臭脓涕8个月,门诊以＂右全组鼻窦炎＂收入院。2年前因鼻咽癌（T3N1M0）行60Co放射治疗（以下简称放疗）,剂量为70Gy。CT扫描显示：右侧鼻腔、上颌窦、筛窦密度增高,上颌窦内侧壁骨质吸收（图1）。根据病史、症状、体征,结合影像学检查,诊断为右侧全组鼻窦炎,拟行鼻内镜手术。手术在全身麻醉下进行。

简介：Mostoftheoculartumorshavepoorprognosis,andtheyremainadifficultproblemintheareaofophthalmology.Withtherapiddevelopmentofmolecularbiologyandimmunologictechniquesandthedeepresearchonoculartumorrelatedgenes,itbecomespossibletodiagnoseandtreatmalignanttumorsfromthemolecularlevel.Thetumornecrosisfactorrelatedapoptosis-inducingligand(TRAIL),amemberofthetumornecrosisfactor(TNF)superfamily,isapromisingcandidate,eitheraloneorincombinationwithestablishedcancertherapies,sinceitcaninitiateapoptosisthroughtheactivationoftheirdeathreceptors.TheabilityofTRAILtoselectivelyinduceapoptosisoftransformed,virus-infectedortumorcellsbutnotnormalcellspromotesthedevelopmentofTRAIL-basedcancertherapy.Here,wewillreviewTRAILanditsreceptors’structure,function,mechanismofactionandapplicationinoculartumorstherapy.

简介：<正>康宁克通—A系合成皮质类固醇类药物,对治疗变应性鼻炎,具有良好的疗效。我科自1993年以来,用此药作下鼻甲和迎香穴注射治疗变应性鼻炎458例,其中男性211例,治疗后出现性功能障碍者4例,现报告如下。

简介：<正>扩瞳查眼底,是眼科临床检查眼底和玻璃体疾病的常用方法。我科近2年来,遇到2例因滴0.25%"双星明"眼水扩瞳查眼底,而引起青光眼急性发作。病例报告例一,男,65岁。因右眼视物模糊2天,于1995年3月4日上午10时来我院门诊初诊。体检发

简介：AIM:ToinvestigatethesideeffectsofthecommonlyusedlasertreatmentalongwithtestingtheneuroprotectiveeffectofbFGFonapotentialretinalimpairment.METHODS:Todothis,30chinchillapigmentedadultmalerabbitsweredividedintothecontrolandexperimentalgroups.ThecontrolandexperimentalgroupsunderwentbothlaserapplicationandbFGFtreatment.Theretinaltissueimpairmentanditsrenewalrateweretestedunderthelightandelectronmicroscopicallevels.RESULTS:Thefocallaserapplicationonrabbiteyescausedmorphologicalalterationsbothintheapplicationregionandintheneighbouringareas.Inthedamagedareas,theouternuclearlayeroftheneuralretinawasalmostdisappeared,retinapigmentepitheliumwasinterrupted,theretinapigmentepitheliummigratedintraretinally,andthedamagedregionalongwithneighbouringareasseemedtobenotseparated.bFGFapplicationjustafterthelaserphotocoagulation,revealedbetterresultsinapplicationareas.CONCLUSION:ItcouldbesuggestedthatthebFGFapplicationfollowinglaserphotocoagulationmighthaveprotective,repairingandwoundhealingeffectsontheretina.

简介：AIM:ToinvestigatetheregulationofEaf2proteininmouselenscellsapoptosisinducedbyultraviolet(UV)radiation.METHODS:AneyeofEaf2geneknockoutmiceornormalcontrolmicewasexposedtoUVradiation,andtheotheronewasnon-exposed.AlloflenseswereanalyzedbyTUNELandcaspase3activityassaystodeterminethedifferenceoftheapoptosisinducedbyUVradiation.Inaddition,exposedandnon-exposedlenseswereanalyzedbyquantifiedp53expressionandreal-timereversetranscription-polymerasechainreaction(RT-PCR)ofBax,Bid,Apaf-1,PumaandNoxa,tocompareEaf2geneknockoutmiceandnormalcontrolmice.RESULTS:UVradiationcausedapoptosisoflenscellsinnormalcontrolmiceandEaf2knockoutmice.Activityofcaspase3wassignificantlyhigherinnormalcontrolmicethanEaf2knockoutmice.Expressionofp53proteinwassignificantlyhigherinlensesexposedtoUVradiationthannonexposedlenses,butwassimilarbetweenEaf2geneknockoutmiceandnormalcontrolmiceinthesameUVcondition.AfterexposingtoUVradiation,theanalysisofreal-timeRT-PCRdemonstratedthatmRNAlevelsofPumaandNoxaweresignificantlyhigherinlensesofnormalcontrolmicethanEaf2geneknockoutmice,andthatmRNAlevelsofBax,BidandApaf-1werenotsignificantlydifferentbetweengeneknockoutmiceandnormalcontrolmice.CONCLUSION:Eaf2increaseslenscellsapoptosisinducedbyultravioletradiation.AndEaf2up-regulatesexpressionofthePumaandtheNoxatoactonlenscellsapoptosisafterUVradiation.

简介：AIM:ToevaluatetheefficacyofSeprafilmtransplantationfollowingadhesiolysisforpreventingpostoperativereadhesionandimprovingsurgicaloutcomes.METHODS:Primaryblepharoplastywascarriedoutonbotheyelidsof18albinorabbits.After2weeks,anewskinincisionwasmade,andadhesiolysiswasperformedonbotheyelids.Therabbitswerecategorizedintotwogroups,onewithadhesiolysisaloneinthelefteyelid(controlgroup),andtheotherwithadhesiolysiswithaSeprafilmgraftintherighteyelid(Seprafilmgroup).Thedegreesofinflammationandfibrosiswereexaminedwithhematoxylin-eosin(HE)andMasson’strichromestains.Expressionofα-smoothmuscleactin(α-SMA)wasalsoimmunohistochemicallyexamined.RESULTS:Eyelidexaminationimmediatelyaftertheoperationrevealedmildswellingandhemorrhageinbothgroups,butthesesymptomsresolvedafter1week-2weeks,andeyelidshapehadrecoveredcompletelyinbothgroups.MicroscopicassessmentsdemonstratedthattheSeprafilmgroupshowedlessinflammationandfibrosisthanthecontrolgroup.TheSeprafilmgroupalsoexhibitedfewerα-SMA-positivecellsthanthecontrolgroup.CONCLUSION:Basedonthesefindings,weconcludethatSeprafilmgraftwithadhesiolysisisaneffectivemethodforpreventingpostoperativereadhesionsaftereyelidsurgery.

简介：AIM:Toexploretheeffectofsaturatedhydrogensalineonbluelight-inducedretinaldamageinrats.·METHODS:Theretinaldamageofratswasinducedbybluelightexposurefor6hoursandexamined8hours,16hoursand24hoursaftertheexposure.OnehundredfemaleSprague-Dawleyratswererandomlydividedintofourgroups.Group1included30ratsreceivedlightexposurewithoutanyothertreatment.Group2included30ratsreceivedlightexposurewithintraperitonealinjectionofnormalsaline.Group3included30ratsreceivedlightexposurewithintraperitonealinjectionofsaturatedhydrogensaline.AndGroup4includedtheother10ratswhichdidnotreceiveanytreatment.Theamountofintraperitonealinjectionofsaturatedhydrogensalineandnormalsalinewascalculatedintheratioof1ml/100gofratweight.SpecimenswerecollectedandprocessedbyH-Estaining,ultrastructureobservation,biochemicalmeasurement.Morphologicalchangeswereobservedbylightmicroscopeandtransmissionelectronmicroscope(TEM)andtheretinalouternuclearlayer(ONL)thicknesswasmeasuredbyIPP6.0,whilethemalondialdehyde(MDA)wasmeasuredbycolorimetricdeterminationat532nm.·RESULTS:AlthoughthestructureofretinainGroup1andGroup2wasinjuredheavily,theinjuryinGroup3wasmild.ThedifferencesbetweenGroup1andGroup2werenotsignificant.ComparedwiththeratsinGroup1andGroup2,theonesinGroup3hadmoreclearlydemarcatedretinastructureandmoreorderedcellsbylightmicroscopeandTEMobservation.TheONLthicknesses(400times)offourgroupsateachtimepointexceptbetweenGroup1andGroup2weresignificantlydifferent(P<0.05).ThethicknessesoftheONLinGroup1atthreetimepointswere30.41±4.04μm,26.11±2.82μmand20.63±1.06μm,inGroup2were31.62±4.54μm,25.08±3.63μmand19.07±3.86μm,inGroup3were29.75±3.62μm,28.83±1.97μmand27.61±1.83μm.InGroup4themeanofthethicknesswas37.35±1.37μm.Astimewentby,thedamageg

简介：AIM:Toinvestigatewhether15-Lipoxygenase-1(15-LOX-1)playsanimportantroleintheregulationofangiogenesis,inhibitinghypoxia-inducedproliferationofretinalmicrovascularendothelialcells(RMVECs)andtheunderlyingmechanism.METHODS:PrimaryRMVECswereisolatedfromtheretinasofC57/BL6JmiceandidentifiedbyanevaluationforFITC-markedCD31.ThehypoxiamodelswereestablishedwiththeBio-bagandevaluatedwithablood-gasanalyzer.ExperimentswereperformedusingRMVECstreatedwithandwithouttransferAd-15-LOX-1orAd-vectorbothunderhypoxiaandnormoxiaconditionat12,24,48,72hours.Theefficacyofthegenetransferwasassessedbyimmunofluorescencestaining.CellsproliferationwasevaluatedbytheCCK-8method.RNAandproteinexpressionsof15-LOX-1,VEGF-A,VEGFR-2,eNOsandPPAR-rwereanalyzedbyreal-timereversetranscriptionpolymerasechainreaction(RT-PCR)andWesternblot.RESULTS:RoutineevaluationforFITC-markedCD31showedthatcellswerepure.Theresultsofblood-gasanalysisshowedthatwhenthecultureswereexposedtohypoxiaformorethan2hours,thePo2was4.5to5.4Kpa.WeverifiedRMVECscouldbeinfectedwithAd-15-LOX-1orAd-vectorviaFluorescencemicroscopy.CCK-8analysisrevealedthattheproliferativecapacitiesofRMVECsinhypoxicgroupweresignificantlyhigherateachtimepointthantheywereinnormoxicgroup(P<0.05).Inahypoxiccondition,theproliferativecapacitiesofRMVECsin15-LOX-1groupweresignificantlyinhibited(P<0.05).Real-timeRT-PCRanalysisrevealedthattheexpressionsofVEGF-A,VEGF-R2andeNOsmRNAincreasedinhypoxiagroupcomparedwithnormoxiagroup(P<0.01).However,theexpressionsof15-LOX-1,PPAR-rmRNAdecreasedinhypoxiagroupcomparedwithnormoxiagroup(P<0.01).Italsoshowedthatinahypoxiccondition,theexpressionsofVEGF-A,VEGF-R2andeNOsmRNAdecreasedsignificantlyin15-LOX-1groupcomparedwithhypoxiagroup(P<0.01).However,15-LOX-1andPPAR-rmRNAincreasedsigni

简介：AIM:ToinvestigatetheroleofRho-associatedproteinkinase(ROCK)inhibitor,Y27632,inmediatingtheproductionofextracellularmatrix(ECM)componentsincludingfibronectin,matrixmetallo-proteinase-2(MMP-2)andtypeIcollagenasinducedbyconnectivetissuegrowthfactor(CTGF)ortransforminggrowthfactor-β(TGF-β)inahumanretinalpigmentepithelialcellline,ARPE-19.METHODS:TheeffectofY27632ontheCTGForTGF-βinducedphenotypeinARPE-19cellswasmeasuredwithimmunocytochemistryasthechangeinF-actin.ARPE-19cellsweretreatedwithCTGF(1,10,100ng/mL)andTGF-β(10ng/mL)inserumfreemedia,andanalyzedforfibronectin,laminin,andMMP-2andtypeIcollagenbyRT-qPCRandimmunocytochemistry.CellswerealsopretreatedwithanROCKinhibitor,Y27632,toanalyzethesignalingcontributingtoECMproduction.·RESULTS:TreatmentofARPE-19cellsinculturewithTGF-βorCTGFinducedanECMchangefromacobblestonemorphologytoamoreelongatedswirlpatternindicatingamesenchymalphenotype.RT-qPCRanalysisanddifferentgeneexpressionanalysisdemonstratedanupregulationinexpressionofgenesassociatedwithcytoskeletalstructureandmotility.CTGForTGF-βsignificantlyincreasedexpressionoffibronectinmRNA(P=0.006,P=0.003respectively),lamininmRNA(P=0.006,P=0.005),MMP-2mRNA(P=0.006,P=0.001),COL1A1mRNA(P=0.001,P=0.001),COL1A2mRNA(P=0.001,P=0.001).PreincubationofARPE-19withY27632(10mmol/L)significantlypreventedCTGForTGF-βinducedfibronectin(P=0.005,P=0.003respectively),MMP-2(P=0.003,P=0.002),COL1A1(P=0.006,P=0.003),andCOL1A2(P=0.006,P=0.004)geneexpression,butnotlaminin(P=0.375,P=0.516).CONCLUSION:OurstudydemonstratedthatbothTGF-βandCTGFupregulatetheexpressionofECMcomponentsincludingfibronectin,laminin,MMP-2andtypeIcollagenbyactivatingtheRhoA/ROCKsignalingpathway.Duringthisprocess,ARPE-19cellswereshowntochangefromanepithelialtoamesenchymalphenotypeinvi

简介：目的明确前列腺素E1等药物对神经性耳鸣的疗效及观察其不良反应.方法对381例神经性耳鸣患者分别使用前列腺素E1、盐酸培他啶、尼莫地平,静脉给药后对其疗效进行观察、分析.结果前列腺素E1、盐酸培他啶、尼莫地平静脉给药后的总有效率分别是82.5%、71.8%、71.3%.疗效与病程有关.结论大多数神经性耳鸣患者对上述药物治疗是有效的.其中前列腺素E1具有疗程价格低廉、疗效高、安全、使用方便等相对优点.

简介：随着建立在医学科学研究基础上认识的不断深入,血管内皮生长因子（vascularendothelialgrowthfactor,VEGF）被确认是脉络膜新生血管（choroidalneovascularization,CNV）发展过程中介导血管生成和血管通透性的主要原因[1-2]。目前所知的VEGF家族包括5个成员：VEGF-A、VEGF-B、VEGF-C、VEGF-D和胎盘生长因子，其中以VEGF-A最为活跃，并与血管生成、新生血管化和血管通透性增强密切相关。

简介：AIM:Tofindouttheoutcomeoflaserphotocoagulationinclinicallysignificantmacularedema(CSME)byopticalcoherencetomography(OCT).·METHODS:Itwasaprospective,non-controlled,caseseriesstudyenrolling81eyesof64patientswithCSMEbetweenAugust2008andJanuary2010.AllpatientsreceivedmodifiedgridphotocoagulationwithfrequencydoubledNd:YAGlaser.Eachpatientwasevaluatedintermsofbest-correctedvisualacuity(BCVA)andregressionorprogressionofmaculopathyafterlasertherapyat1,3and6months.Spearman’scorrelationtestwasusedtoshowthecorrelationbetweenBCVAandtotalmacularvolume(TMV).Analysisofvariance(ANOVA)wasusedtocompareamonggroupsandindependentt-testwasusedtocompareineachgroup.·RESULTS:ThereishighcorrelationbetweenBCVAandTMV(P≤0.001).BCVAimprovedin50.6%,remainedstaticin39.5%anddeterioratedin9.9%patientsafter6monthoftreatment.TheBaselineTMV(meanandSD)were9.26±1.83,10.4±2.38,11.5±3.05,8.89±0.75and9.47±1.98mm3fordifferentOCTpatterns,ST(spongelikethickening),CMO(cystoidmacularedema),SFD(subfovealdetachment),VMIA(Vitreomacularinterfaceabnormality)andaverageTMVrespectively(P=0.04).After6monthsoflasertreatment,themeanTMVdecreasedfrom9.47±1.98mm3to8.77±1.31mm3(P=0.01).InSTtherewassignificantdecreaseinTMV,P=0.01,Furtherwithinthesegroupsat6months,theyweresignificantlydifferent,P=0.01.·CONCLUSION:OCTshowedthedifferentmorphologicalvariantofCSMEwhiletheresponseoftreatmentisdifferent.TMVdecreasedthemostandhenceshowedtheimprovementinvisionafter6monthsoflasertreatment.IntheeraofAntivascularendothelialgrowthfactors(VEGFs),efficacyoflaserseemstobeinshadowbutitisstillfirstlineoftreatmentindevelopingnationlikeNepalwhereantiVEGFsmaynotbeeasilyavailableandaffordable.

简介：AIM:Topresenttheoutcomeofmodifiedgridlaserphotocoagulation(GLP)indiffusediabeticmacularedema(DDME)ineyeswithoutextrafovealand/orvitreofovealtraction.METHODS:InclusioncriteriafortheretrospectivestudywereDDMEeyesofpatientswithtypeⅡdiabetesmellitusthathad≥4monthsoffollow-upfollowingGLP.Onlyoneeyeperpatientwasanalyzed.Using3-Dspectral-domainopticalcoherencetomography(3-DSDOCT),eyesthathadeitherextrafovealorvitreofovealtraction,orhadbeenpreviouslytreatedbyanintravitrealmedication(s)wereexcluded.TreatedDDMEeyesweredividedinto4groups:A)'Classic'DDMEthatinvolvedthecentralmacula;B)edemadidnotinvolvethemacularcenter;C)eyesassociatedwithcentralepiretinalmembrane(ERM);D)DDMEthatwasassociatedwithmacularcapillarydropout≥2disc-diameter(DD).RESULTS:GLPoutcomein35DDMEeyesafter4-24(mean,13.1±6.9)monthswasasfollows:GroupA)18eyeswith'classic'DDME.Followingoneor2(mean,1.2)GLPtreatments,best-correctedvisualacuity(BCVA)improvedby1-2Snellenlinesin44.4%(8/18)ofeyes,andworsenedby1linein11.1%(2/18).Centralmacularthickness(CMT)improvedby7%-49%(mean,26.6%)in77.8%(14/18)ofeyes.CausesofCMTworsening(n=4)werecommonlyexplainable,predominantly(n=3)associatedwithemergenceofextrafovealtraction,5-9monthspost-GLP.GroupB)GLP(s)inDDMEthatdidnotinvolvethemacularcenter(n=6)resultedinimprovedBCVAby1-2linesin2eyes.However,thecentralmaculabecameinvolvedintheedemaprocessaftertheGLPin3(50%)eyes,associatedwithanemergenceofextrafovealtractioninoneoftheseeyes4monthsfollowingtheGLP.GroupC)GLPfailedinall5eyesassociatedwithcentralERM.GroupD)GLPwasofpartialbenefitin2of6treatedeyeswithmacularcapillarydropout≥2DD.CONCLUSION:EyeswithDDMEthatinvolvedthemacularcenterwerefoundtoachievefavourableoutcomesafterGLP(s)duringmid-termfollow-up,unlesscomplicatedpre-GLPorpost-GLPbyvltreoretinalinterfaceabnormalities,oftenextrafovealtra