ObjectiveTo observe the features of the manifestations of fundus fluorescein angiography （FFA） in multiple sclerosis （MS） and their value in clinical diagnosis.MethodsThe clinical data of 42 patients (84 eyes) with MS diagnosed by magnetic resonance imaging (MRI) and examination of cerebrospinal fluid (CSF) were retrospectively analyzed. The clinical data included visual acuity, ocular fundus examined by direct ophthalmoscope after mydriasis, FFA, visual field, CSF，visual evoked potential (VEP) and MRI examination.ResultsIn 42 patients (84 eyes),the positive detectable rate of examination of direct ophthalmoscope, CSF, visual field, VEP, and MRI was 36.9%, 21.4%, 71.4%, and 83.3% respectively. Abnormal results of FFA were found in 44 eyes (52.38%), including papillitis in 4 eyes（4.76%）at the early stage with extended physiological scotoma and central scotoma; neuroretinitis in 7 eyes （8.33%）at the medium stage with central or para-central scotoma; optic atrophy in 33 eyes（39.29%） at the late stage with centripetal constriction and even tubular visual field. ConclusionThe main angiographic features of MS are papillitis, neuroretinitis and optic atrophy. The manifestations of FFA combined with the results of examination of CSF，visual field, VEP and MRI is helpful for comprehensive and exact diagnosis of MS.(Chin J Ocul Fundus Dis, 2005,21:300-302)
Objective To introduce a method to repair soft tissue defect in different regions and different areas of hand in one procedure. Methods From May 2002 to May 2005, anterolateral femoral flap or lobulated anterolateral femoralflap(forming irregular anterolateral femoral flap) was designed into different shapes to repair multiple soft tissue defect in different regions in hand, whichwas used clinically in 27 cases. Among 27 cases, there were 16 males and 11 females; the locations were left hand in 9 , right hand in 16 and left foot in 2; including 5 penetrating injury, 9 hotpressing injury, 2 soft tissue defection of instep and planta by milled injury, 6 gearing injury and 5 carding machine injury. All the cases complicated by exposure of tendons, bones or joints. Defect was repaired with H-shape flaps in 5 cases of penetrating palm injuries; with Y-shape or K-shape flaps in 11 cases of dorsals or combined with fingers of hand with skin defect; with shape flaps in 3 cases of dorsals combined with sides of palms or the first web of hands with skin defect and in 2 cases of skin defects of dorsals combinedwith palms of feet;with h-shape flaps in 6 cases of skin defects of dorsal or palms combined with disconnected skin defect of fingers. The sizes of main flaps ranged from 6.5 cm×4.8 cm to 17.0 cm×12.0 cm, the sizes of lobulate flaps ranged from 3.5 cm×2.8 cm to 7.5 cm×4.5 cm. Results Allflaps survived without vascular crisis after operation. Except the fascia flapall recipient sites healed by first intention. The follow-up period ranged from 3 months to 1 year, all cases had satisfactory appearance, the texture of flaps was soft. Except 2 cases of penetrating injury, 3 cases of hotpressing injuryand1 case of carding machine injury whose function was not satisfactory, theremaining cases achieved the function of snap and pinch. More than 1 year after operation, the sense of pain and touch recovered. There was no functional impairment at the donor sites although scar hyperplasia was formed in some cases.Conclusion The application of irregular anterolateral femoralflap is an optimal choice for complex skin defect of hand.
ObjectiveTo explore the value liver resection combined with intraoperative radiofrequency ablation during the same period in the treatment of multiple liver cancer. MethodsWe retrospectively analyzed the clinical data of 33 patients with multiple liver cancer treated between January 2005 and April 2013. All the patients were treated by liver resection combined with intraoperative radiofrequency ablation in the same period. There were 91 tumor foci in 33 patients, among which 39 tumor foci were surgically removed, and 52 tumor foci were radiofrequency ablated. Ultrasonography and enhanced CT/MRI were performed for the patients 1 year, 2 years and 3 years after surgery. ResultsNo bleeding or death occurred during the operation. It was observed that the transient liver function was damaged after surgery, but it quickly returned to A level after treatment. All the patients had no perioperative death or other serious complications. Tumor recurrence rate was 16.1% in the first year, 48.4% in the second year and 93.5% in the third year after surgery. ConclusionLiver resection combined with intraoperative radiofrequency ablation for multiple liver cancer in the same period is feasible and safe, without increasing the average length of hospital stay, operative mortality rate and postoperative tumor recurrence rate.
目的：探讨蛋白酶体抑制剂——硼替佐米对初治多发性骨髓瘤的疗效及对移植造血干细胞采集的影响。方法：对一例初发的中年男性多发性骨髓瘤患者使用硼替佐米+地塞米松+反应停（VTD）的方案进行化疗，获得缓解后采集外周血造血干细胞。结果：应用以硼替佐米为基础的方案治疗3个疗程后，患者即获得完全缓解；完成4个疗程化疗后成功采集足够数量的外周血造血干细胞；完成6个疗程化疗后，进入维持治疗，至今已完全缓解17个月。治疗过程中除恶心、呕吐外无其他明显不良反应。结论：硼替佐米用于初治多发性骨髓瘤有良好的治疗效果，不良反应少，不影响造血干细胞采集。