【摘要】 目的 探讨基因重组人生长激素（recombinant human growth hormone，rhGH）及雌/孕激素（estrogen/progestogem，E/P）治疗对Turner综合征（Turner syndrome，TS）患儿身高及性征发育的影响。 方法 2005年1月—2009年6月四川大学华西第二医院门诊就诊TS患儿22例，12例患儿接受rhGH治疗，年龄（13.58±2.23）岁，剂量0.15 U/（kg•d），睡前皮下注射，疗程4~24个月。16例年龄≥13岁、骨龄≥11岁的患儿接受E/P治疗，疗程3~30个月。 结果 rhGH治疗后患儿身高、身高的标准差积分提高，生长速率达（9.33±2.39）cm/年；E/P治疗可促进患儿乳房发育及规律月经出现。 结论 rhGH和E/P治疗对TS患儿身高增长及性征发育有明显疗效。【Abstract】 Objective To explore the therapeutic effects of recombinant human growth hormone (rhGH) and sex hormone on the stature and sex feature of children with Turner syndrome (TS). Methods A total of 22 children with TS were selected in the outpatients department of West China Second Hospital between January 2005 and June 2009. Twelve children with TS the average age of (13.58±2.23) years received rhGH [0.15 U/(kg•d)] every night before sleep for 4-24 months . Sixteen children with TS (age≥14 years old, bone age≥11 years old) underwent estrogen and progestogen (E/P) treatment for 3-30 months. Results The height and height standard deviation score increased significantly in children with rhGH therapy (Plt;0.01). The height velocity was (9.33±2.39) cm/year after the treatment. The treatment of estrogen and progestogen could promote the development of breast and establish menstrual cycle in children with TS. Conclusion rhGH and E/P can play a significant role in treatment of TS in children.
Objective To explore a better method in obtaining iris pigment epithelium(IPE) specimen for autologous transplantation in rabbits． Methods IPE was obtained from 20 black rabbits with method A，i.e.surgical peripheral iridectomy at 12:00 position obtaining a triangle iris tissue with the hemline of 4-5 mm in left eyes，and method B,i.e.surgical peripheral iridectomy at 11:00 and 1:00 positions obtaining two triangle iris tissues with the hemlines of 2-2.5 mm in right eyes . The IP E cells were isolated precisely with enzyme microdissection-enzyme isolation method, cultured in vitro, observed with light and electronic microscope, and ident ified with immunocytochemical staining.ResultsThe success ra te of cells culture were 65% for method A and 95% for method B. After 3-4 generations of culturing，the amount of IPE cells was enough for transplantation, and most of the functions of primary clutured IPE cells were kept still. Viability of IPE cells was 85%-93%. Conclusion The success rate of cells culture for method B is higher than that for method A. The third generation of cultured cells is available for autologous transplantation.(Chin J Ocul Fundus Dis，2003，19：201-268)
Ojective To evaluate the therapeutic efficacy of surgical and nonsurgical treatment and the clinical factors affecting the efficacy in traumatic optic neuropathy. Methods To analyse retr ospectively the efficacy of recovery of visual acuity in 40 cases of traumatic optic neuropathy after treatment with transnasal endoscopic sphenoethmoidal optic canal decompression (28 cases) and drug therapy (12 cases). Results No significant difference existed between the therapeutic efficacy of surgery and that of drug therapy in patients with the visual acuity of LP～ 0.02. In surgery group,the therapeutic efficacy of the patients with visual acuity of LP～0.02 was better than that of the patients with no LP.The therapeu tic efficacy of patients with duration shorter than seven days before sutgery is better than that of patients with duration longer than seven days. Conclusions The patients with serious traumatic comperssive optic neuropathy should not be treated with decompressive surgery and should not delay to at most seven days after injury.With or without the visual acuity of light perception of the affected eye surgery is usually an important factor affecting the therapeutic efficacy. (Chin J Ocul Fundus Dis, 2001,17:204-206)
摘要:目的: 探讨儿童慢性淋巴细胞性甲状腺炎的临床特点、诊断方法、治疗及预后。 方法 : 对77例CLT患儿的临床资料进行回顾性分析。 结果 : 77例CLT患儿男女比例1:67,平均年龄1021±233岁(5～15岁)。86％患儿有甲状腺肿大;初诊时表现甲亢患儿51例,甲低20例,甲功正常6例; TGAb阳性率的94％,TPOAb阳性率96％;1例甲状腺细针吸取细胞学检查诊断合并甲状腺乳头状癌。治疗随访1～39月,77例患儿中出现甲低37例。 结论 : 儿童CLT多见于青春期女性,儿童和青春期患者病初表现甲亢较成人多见,TGAb 和TPOAb是CLT诊断的重要指标,随着病程延长,表现甲低患儿比例逐渐增高。Abstract: Objective: To study the clinical feature, diagnosis, treatment and prognosis of Chronic lymphocytic thyroiditis in children. Methods : Analyze the clinical data of 77 children with Chronic lymphocytic thyroiditis. Results : The proportion of men to women was 1:67 in all 77 children, and the mean age at diagnosis was 1021±233(age range 5~15 years). The percentage of positive TGAb and TPOAb were 94% and 96%, respectively in all the 77 children. One children was diagnosed Chronic lymphocytic thyroiditis coexistent with thyroid papillary carcinoma by FNAB. There were 37 children had hypothyrodism in all the 77 after 1～39 months. Conclusion : CLT is more frequent in females, and at the time of diagnosis more children and adolescents had hypethyrodism than adults. TGAb and TPOAb are important markers for the diagnosis of CLT. The percentage of children had hypothyrodism is increasing along with the course of disease.
目的通过漂浮导管（Swan-Ganz导管）监测外周血管阻力指数（SVRI）作为优化的心功能不全状态下感染性休克早期目标导向治疗（EGDT）的临床意义。 方法2012年1月至2014年1月第四军医大学附属西京医院心血管外科ICU收治体外循环心脏术后感染性休克患者8例，其中男7例、女1例，年龄（50.9±11.1）岁。以中心静脉压（CVP）为复苏目标行经验性容量复苏治疗，循环未见改善，则实施漂浮（Swan-Ganz）导管监测血流动力学指标，以外周血管阻力指数（SVRI）为优化目标复苏，观察Swan-Ganz导管复苏前及复苏6 h、24 h后的血流动力学及氧代谢指标，分析复苏达标所需时间。 结果8例患者平均住ICU时间（16.87±3.35）d，发生肺部并发症8例，急性肾功能衰竭5例，急性肝功能衰竭1例，消化道出血1例。6例28 d后病情好转存活，死亡2例。8例感染性休克患者经Swan-Ganz导管目标导向治疗6 h和24 h后平均动脉压（MAP）分别为（65.8±2.76）mm Hg、（67.8±3.79）mm Hg，中心静脉压（CVP）分别为（12.75±3.37）cm H2O、（9.75±2.86）cm H2O，心排血量指数（CI）分别为（2.36±0.12）L·min-1·m-2、（2.41±0.39）L·min-1·m-2，外周血管阻力指数（SVRI）分别为（1 892.60±2 294.62）dyn·s·m2·cm-5、（2 053.90±205.54）dyn·s·m2·cm-5，各项指标均较治疗前升高；治疗6 h和24 h后动脉血乳酸分别为（11.83±1.16）mmol/L、（6.47±2.59）mmol/L，较治疗前[（14.98±0.45）mmol/L]下降。 结论采用Swan-Ganz导管监测SVRI作为优化目标导向治疗心功能不全状态下感染性休克可以提高6 h复苏成功率，改善患者预后。