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化脓性心包炎并发左心室假性室壁瘤一例

先天性心脏病心脏不停跳心内直视手术

摘要 目的　介绍体外循环心脏不停跳下心内直视手术治疗先天性心脏病心内畸形的应用体会。　方法　327例先天性心脏病心内畸形行浅低温体外循环心脏不停跳心内直视手术。常规建立体外循环，置左心房引流管，降温至32±1℃并维持，仅阻断上、下腔静脉，不阻断升主动脉，维持灌注压在60mmHg左右，在心脏不停跳下施行心脏畸形矫正术，方法同心脏停搏手术。　结果　死亡7例，死亡率2.1%，其余均痊愈出院，随访1～13个月，恢复良好。　结论　心脏不停跳下心内直视手术有较好的心肌保护作用，能减少并发症的发生，并简化操作，缩短体外循环时间。

Clinical analysis of lamotrigine-related embryo damage and abortion

ObjectiveTo discuss the risk of abortion related to lamotrigine (LTG) and its safety profile during pregnancy. MethodsRetrospectively studied pregnant women in our epilepsy clinics who took LTG from 2011 to 2015 as monotherapy and experienced embryo damage or abortion. Here, we present an extensive review of related literatures regarding possible mechanisms, clinical features and safty of LTG during pregnancy. ResultsIn our study, fourty-five pregnancies were administered monotherapy LTG, and three of these patients suffered embryo damage. ConclusionsAlthough LTG is considered safe for pregnant women and the embryo or fetus,it also has risk of embryo damage or abortion, which should be carefully considered before prescription. Using monotherapy and the lowest effective drug dose, monitoring LTG serum concentrations during pregnancy, supplementing folate administration before and after conception and conducting regular prenatal diagnostic tests might reduce the risk of abortion.

成年起病的Rasmussen脑炎一例

Spectral-domain optical coherence tomography characteristics of acute central serous chorioretinopathy

Objective To observe the characteristics of spectral-domain optical coherence tomography (SD-OCT) for leakage point in acute central serous chorioretinopathy (CSC). Methods A total of 21 acute CSC patients (21 eyes) were enrolled in this retrospective study, including 17 men (17 eyes) and 4 women (5 eyes). The mean age was (47.3±8.8) years (range 35 - 66 years). The mean duration was (1.6±0.8) months (range 0.5 - 3.0 months). All patients were underwent mydriatic fundus photography, SD-OCT examination and fluorescein fundus angiography (FFA). SD-OCT and FFA images were carefully compared to observe the SD-OCT examination characteristics of fluorescence leakage point. Results 21/21 eyes had one fluorescein leakage point. In addition to serous retinal detachment, leakage point in the SD-OCT examination showed retinal pigment epithelium (RPE) protrusion in 10 eyes (47.6％), RPE detachment in 7 eyes (33.3％), highly reflective areas suggesting fibrinous exudate in the subretinal space in 3 eyes (14.3％), and RPE defect in 1 eye (4.8％). Conclusion The SD-OCT characteristics of acute CSC include RPE protrusion, RPE detachment, highly reflective areas suggesting fibrinous exudate in the subretinal space and RPE defect.