ARDS 是引起重症患者呼吸衰竭的主要原因, 尽管医疗技术有了很大的进步, 但对ARDS 的治疗只局限在器官支持层面, 其病死率仍高达40% [ 1] 。ARDS的主要病理改变为肺泡上皮细胞和毛细血管内皮细胞受损, 通透性增加, 富含蛋白质的液体渗出积聚于肺间质和肺泡。因此促进损伤肺毛细血管内皮细胞和肺泡上皮细胞的有效修复可能是ARDS治疗的关键所在。随着干细胞工程学的发展, 间充质干细胞( MSC) 作为一种理想的组织修复来源, 在ARDS 治疗中的应用受到越来越多的关注, 这可能为ARDS 的治疗开辟一条新的途径。
Objective To investigate the characteristics of images of angiography in uveal effusion syndrome (UES). Methods The clinical data of fundus fluorescein angiography (FFA) and indocyanine green angiography (ICGA) in 11 patients (17 eyes) with UES were retrospectively analyzed, and 4 patients (7 eyes) underwent angiography again 1 month to 28 months after segmental sclerectomy. Result The results of FFA and ICGA showed papilledema and venous tortuosity and dilation in 12 eyes, leakage spots at the post pole of ocular fundus in 2 eyes, leopard spots in 14 eyes, linear or meshy pigment stripes in 8 eyes. The results of ICGA showed uneven flecked hyperfluorescence lasted to later stage in 4 patients (5 eyes), a triangle hypofluorescence area at the inferior fundus in 1 eye, and a geographic pattern hypofluorescence at the posterior pole in 1 eye. Segmental sclerectomy was performed on 5 patients (8 eyes), and after surgery, cilia-choroidal detachment was gradually alleviated and even disappeared, the status of choroidal hyperpermeability was alleviated, and the leakage spots disappeared. The subretinal fluid increased in only 1 eye 2 years after the surgery. Conclusion The characteristics of aniography for UES are venous tortuosity and dilation, papilledema, leopard spots, and linear or meshy pigmentary stripes, which may deepen our understanding about the disease and help to diagnose it. (Chin J Ocul Fundus Dis, 2007, 23: 189-192)
Objective To observe the clinical characteristics of idiopathic retinal vasculitis, aneurysms, and neuroretinitis (IRVAN) syndrome. Methods The clinical data of 3 patients with IRVAN syndrome which were diagnosed by systemic examination, fundus photography and fundus fluorescein angiography (FFA) were retrospectively analyzed. Results Idiopathic retinal vasculitis, which was induced by retinal arterial inflammation, multiple macroaneurysms of optic disc and retinal vessels, edema of optic disc, and exudation around the optic disc, was found in all of the 3 patients, multiple arteriolar aneurysms of optic disc and retinal vascular and exudative neuroretinitis. Two patients had peripheral retinal vascular nonperfusion area, which belonged to typical IRVAN syndrome. Conclusions The clinical characteristics of IRVAN syndrome include idiopathic retinal vasculitis which only involved in artery, multiple retinal macroaneurysms which located on the dissepiment of optic disc and retinal artery, and the neuroretinitis induced by exudation of retina and optic disc because of vasculitis and aneurysms. (Chin J Ocul Fundus Dis, 2007, 23: 180-183)
Objective To detect the clinical manifestations, diagnos is and treatment of painful ophthalmoplegia syndrome. Methods The data of onset, clinical m anifestations, laboratory examination, imaging and treatment from 12 patients with painful ophthalmoplegia, hospitalized from Mar, 2000 to Aug. 2005, were retro spectively analyzed. Results Multiple characters and extents of the headache were found in these 12 patients. The involved cranial nerves included the Ⅲ,Ⅳ, V1-2 and Ⅵ, especially the cranial nerve Ⅲ(83.3%). Several simultaneously in volved cranial nerves were frequently found (75%). Diseases which could cause hea dache along with ophthalmoplegia must be excluded before the diagnosis of the painful ophthalmoplegia syndrome was established. The examination of imaging was important for the diagnosis of painful ophthalmoplegia syndrome. Patients were sensitively responsive to cortico-steoid therapy. The cure rate was 75%. Conclusion The features of clinical manifestations, imaging results and the patients response to cortico-steoid therapy accorded with the etiology of nonspecific inflammation granuloma. Cortico-steoid therapy is effective after the definitude of the disease. (Chin J Ocul Fundus Dis, 2006,22:385-386)
Objective To investigate the clinical manifestations and possible reasons of the missed and inaccurate diagnosis of Fuchs syndrome. Methods The clinical data of 85 patients with Fuchs syndrome who were diagnosed and treated from June 1999 to December 2003 were retrospectively analyzed. The disease history of each patient was carefully recorded. Slit-lamp microscopy was performed on the patients. The character and distribution of keratic precipitates (KP), color of the iris, depigmentation, and complications were noted in detail. The data recorded in other hospitals were analyzed and the reasons of missed and inaccurate diagnosis were statistically analyzed. Results The age of the patients ranged from 13 to 72 years, and binocular involvement was noted in 76 patients. None of the patients showed ciliary congestion and iris synechiae. Middle-sized or stellated KP was found. Triangle-distributed KP was seen in 13 patients, and diffuse distribution behind the corneal or in the pupil area was in 72. Anterior-chamber flare was observed in all of the patients, while anterior-chamber cells were only noted in 42 patients. The iris with different degrees of depigmentation was found in all the patients. Complicated cataract and increased intraocular pressure occured in 44 and 19 patients, respectively. The diagnosis in other hospitals mainly included uveitis, anterior uveitis and complicated cataract. Conclusions Fuchs syndrome is characterized by depigmented iris and typical KP. Missed and inaccurate diagnosis is mainly due to the unawareness of its clinical features. (Chin J Ocul Fundus Dis, 2005, 21: 360-362)
Acquired Immunodeficiency Syndrome (AIDS) is a severe infectious disease induced by human immuno deficiency virus (HIV). Laboratory testing plays an important role in the diagnosis of HIV/AIDS. In general, laboratory testing includes detection of virus antibodies and antigens, virus RNA, immune cells (CD4+, CD8+) and anti-HIV drug resistance. During the past twenty years, great progress has been made in laboratory testing. As research on HIV/AIDS has advanced and biotechnology has developed rapidly, different methods of testing have been discovered. In recent years, the application of molecular biotechnology and immunology has led to important advances for epidemiological surveys, clinical diagnosis and treatment of HIV. The existence of a testing method with high sensitivity and specificity is not only helpful for early diagnosis and prediction, monitoring and evaluation of therapeutic efficacy, but can also reduce the risk of false-negative results. HIV laboratory testing is now developing towards a simple, rapid, sensitive, accurate and automatic way of diagnosing this condition.
由于高血压的高患病率与高致残致死率, 已经成为我国重点防治的心血管疾病和社会普遍关注的重大公共卫生问题之一。大量流行病学、临床和基础研究已证实睡眠呼吸暂停低通气综合征( sleep apnea-hypopnea syndrome, SAHS) 与高血压发病和疗效关系密切[ 1-8 ] , 是高血压发生的主要病因之一, 由此“睡眠呼吸暂停相关性高血压”一词便应运而生[ 9-1 0] , 它是指由SAHS 引发和加重的高血压。本期刊载的“阻塞性睡眠呼吸暂停相关性高血压临床诊断和治疗专家共识”( 以下简称共识) , 为睡眠呼吸暂停相关性高血压的诊治提供了规范性的指导意见, 对推动我国该领域的防治水平有重要作用。我们期望“共识”能为读者认识和防治睡眠呼吸暂停相关性高血压提供必要的指导和帮助, 使我国为数众多的睡眠呼吸暂停相关性高血压患者得到规范的诊治。
高血压是我国重点防治的心血管疾病, 血压的控制率备受关注。在一些血压控制不良的患者中睡眠呼吸暂停是导致顽固性高血压的重要原因。以睡眠过程中反复、频繁出现呼吸暂停和低通气为特点的睡眠呼吸暂停低通气综合征( sleep apneahypopnea syndrome, SAHS) 自20 世纪80 年代以来也受到广泛关注, 临床和基础研究取得了迅速发展。目前, 多项临床、流行病学和基础研究证实SAHS可以导致和/ 或加重高血压, 与高血压的发生发展密切相关。
Objective?To investigate the relationship between syndromes of traditional Chinese medicine (TCM) and lung function in patients with chronic obstructive pulmonary disease (COPD) at stable phase. MethodsBased on diagnostic criterion of TCM, five groups of symptoms of TCM about stable COPD were established including lung Qi deficiency, lung and spleen Qi deficiency, lung and kidney Qi deficiency, lung Spleen Kidney Qi deficiency, and deficiency of both Qi and Yin. A total of 300 cases which were up to the standard were differentiated into 5 groups by the symptoms. Some basic details and lung function of the patients were recorded, and then statistical analysis was performed to analyze the differences of lung function among groups. ResultsForced expiratory volume in the first second in descending order was lung Qi deficiency group, lung and spleen Qi deficiency group, lung and kidney Qi deficiency group, and lung spleen kidney Qi deficiency group (P<0.05). ConclusionThese findings suggest that with the progressing of COPD, the symptom type of TCM for COPD patients at stable phase may vary from lung Qi deficiency to lung and spleen Qi deficiency, or to lung and kidney Qi deficiency, and even lung, spleen and kidney Qi deficiency. Lung function tests help reveal substance and pathogenesis of TCM syndromes of patients with stable COPD, and provide evidence for the clinical syndrome.
ObjectiveTo analyze the association between the acute exacerbation of chronic obstructive pulmonary disease (AECOPD) (syndrome of phlegm-heat obstructing lung) and clinical indicators related to COPD. MethodAECOPD in-patients and out-patients were enrolled from the Third People's Hospital of Chengdu from January 2013 to January 2014. The patients were grouped to Tanre Syndrome and non-Tanre Syndrome according to their clinical symptoms, signs and tongue, pulse. All patients underwent the following tests including routine blood test, erythrocyte sedimentation rate, lung function, blood gas analysis, C-reaction protein (CRP), procalcitonin (PCT) and other clinically relevant indicators. The association between AECOPD and clinically relevant indicators were analyzed by using SPSS 19.0 software. ResultsA total of 194 AECOPD patients were included, of which 88 patients were syndrome of phlegm-heat obstructing lung and 106 were non syndrome of phlegm-heat obstructing lung according to the traditional Chinese medicine (TCM) classifications. The results of single factor analysis showed that age (Z=-4.848, P=0.000) and course of disease (Z=-2.455, P=0.014) were associated with syndrome of phlegm-heat obstructing lung. While further logistic regression analysis showed that age (r=0.090, P=0.000) and the level of CRP (r=-0.008, P=0.000) were associated with syndrome of phlegm-heat obstructing lung. ConclusionSyndrome of phlegm-heat obstructing lung is the major clinical TCM syndrome of AECOPD. Syndrome of phlegm-heat obstructing lung is associated with age and level of CRP.