发作

Objective To investigate the clinical features, causes of blindness and diagnosis of Vogt Koyanagi Harada syndrome Methods The data of 157 patients with VKH syndrome were reviewed and analyzed Patients were carefully examined with slit lamp, ophthalmoscope, three mirror lens, fundus fluorescein angiography, indocyanine green angiography and HLA typing Results Headache was noted in 73 5% of these patients Simultaneous involvement of both eyes occurred in 80 8% of these patients Chroiditis,papilledema and edema of the retina adjacent to the optic nerve were noted in 100% of these patients in the posterior uveitis stage, whereas recurrent granulomatous anterior uveitis (98 4%),"sunset glow" fundus (95 8%) and Dalen Fuchs nodules (71 2%) were the common ocular findings in the recurrent anterior uveitis stage The common causes of blindness were papillitis, exudative retinal detachment and complicated cataract in the posterior uveitis stage, anterior uveal involvement stage and its recurrent stage Poliosis (36 3%) and alopecia (35 0%) were the most common extraocular findings Early irregular patches of fluorescence, followed by localized hyperfluorescent spots were the typical findings of FFA Dilation of choroidal vessels and leakage of ICG from the choroidal vessels were the common ICGA findings The prevalence of HLA DR4 and HLA DRw53 in patients (54 9% and 71 8% respectively) was significantly higher than that in controls (14 7% and 38 2% respectively) Conclusions VKH syndrome is characterized by chroiditis, papillitis or neuroretinitis in the posterior uveitis stage, followed by a generalized uveitis with a typical recurrent granulomatous anterior uveitis Extraocular findings and relevant examinations including FFA, ICGA and HLA typing are helpful to the diagnosis of VKH syndrome

目的探讨Vogt-Koyanagi-Harada综合征患者的临床特征、盲目原因及诊断等有关问题。方法对在1996年1月至2000年12月间就诊资料完整的157例VKH综合征患者进行回顾性分析，并对裂隙灯、眼底镜、三面镜、荧光素眼底血管造影(fundus fluorescein angiography，FFA)、吲哚青绿血管造影(indocyanine green angiography，ICGA)及人类白细胞抗原分型等检查结果进行分析。结果 VKH综合征最常见的前驱症状为头痛(102例，73.5%)，双眼同时患病118例(80.8%)；后葡萄膜炎期眼部主要表现为脉络膜炎、视乳头及附近视网膜水肿(100.0%)；前葡萄膜炎反复发作期眼部表现为复发性肉芽肿性前葡萄膜炎(128例，98.4%)、晚霞状眼底改变(95.8%)及Dalen-Fuchs结节(71.2%)；后葡萄膜炎期、前葡萄膜受累期及前葡萄膜炎反复发作期导致盲目的主要原因分别为视乳头炎、视网膜脱离及并发性白内障；毛发变白(36.3%)及脱发(35.0%)是最常见的眼外表现；炎症活动期FFA典型表现为斑驳状高荧光，ICGA发现脉络膜血管扩张、通透性增高等改变；VKH综合征患者HLA-DR4及HLA-DRw53的阳性率(54.9%及71.8%)显著高于正常对照组(14.7%及38.2%)。结论 VKH综合征患者在后葡萄膜炎期眼部典型表现为双侧脉络膜炎、视乳头炎或神经视网膜炎，随后出现以反复发作的肉芽肿性前葡萄膜炎为特征的全葡萄膜炎。眼外症状及相关的辅助检查包括FFA、ICGA 及HLA分型等有助于VKH综合征的诊断。

Univariate analysis revealed that a high incidence of early epileptic seizures after intracerebral hemorrhage ocurred in patients with cortical hemorrhage, the medical history of intracerebral hemorrhage, electrolyte disbalance. Logistic regression analysis revealed that the position of hemorrhage and times of hemorrhage and electrolytic states were positively correlated with the incidence of early epileptic seizures after intracerebral hemorrhage. The cortical hemorrhage was the independent risk factor for the early epileptic seizures after intracerebral hemorrhage.

单因素分析显示，皮质出血、再发脑出血、电解质紊乱者易发生脑出血后早发性癫痫发作；Logistic回归分析显示，出血部位、出血次数和电解质情况与脑出血后早发性癫痫发作的发生有关，其中皮质出血为与脑出血后早发性癫痫发作有关的独立危险因素。

Results:Before surgery, 39 patients with paroxysmal pain, after surgery, 84 patients with pain immediately disappeared, reaching 94.4%, 12 patients with mild throat discomfort, 2 patients with cough of short-term drinking water, 1 patient with hoarseness, the follow-up in the 3 months to restore Conclusion:Preoperative care focus on patients with Glossopharyngeal neuralgia are primarily on the preparation and pre-operative pain attack, as much as possible to avoid the attack of the pain, postoperative complications, mainly care, treatment and care through to complications as soon as possible.

结果：39例术前出现发作性疼痛，术后89例患者立即止痛者达94.4%，12例出现轻度咽部不适，2例出现短暂的饮水呛咳，1例出现声音嘶哑，经随访在3个月内恢复。结论：舌咽神经痛术前的护理重点主要是术前准备和疼痛发作，尽量通过治疗和护理的避免疼痛的发作，术后主要是并发症的护理，通过治疗和护理促使并发症的尽快恢复。

The interventions include laser, surgical and medical therapies. Conclusions Laser peripheral iridoplasty as primary treatment to the acute attack of AACG showed a decrease of intraocular pressure more rapidly than conventional medical treatment. Laser peripheral iridotomy was an efficacious intervention to relieve pupillary block, control IOP, and prevent new attacks. LPI was found to be as effective as surgical peripheral iridectomy in the TOP control of affected or contralateral eyes of AACG.

结论目前已有较为有力证据的治疗方法：急性发作时即刻行激光周边虹膜成形术较传统的药物治疗方案降眼压作用起效快；急性发作缓解后行激光周边虹膜切开术以及对侧眼的预防性LPI，具有解除瞳孔阻滞、控制眼压和预防急性发作再发或新发的效果；LPI和周边虹膜切除手术治疗效果相当。

In patients with CPS but without GTS, the focus was mostly located in unilateral temporal lobe, esp, in the medial temporal lobe or the limbic system if the ictal and the interictal EEG was normal, but in those patients with CPS and GTS, the focus was located in the lateral temporal parietal lobe or temporal parietal-occipital areas.

CPS不继发全身性发作的患者，病灶多局限于一侧颞叶，如发作期和发作间期脑电图均正常，更应考虑病灶位于颞叶内侧面，或边缘系统；CPS继发GS的患者病灶多位于颞叶外侧面与顶、枕交界区。

Result: 1、Ethology result:50 rats were injecting convulsive dose kainic acid, showing prodrome such as gaze, wet dog shake in the 0-30 minutes; 1-5 degree epileptic attack in the 30-60minutes; 4-5 degree repteately spontaneous epileptic attack in 60-90 minutes; then status epilepticus,SE-epileptic attack endurance became longer and interval became shorter with bulk salivas and various kinds psychomotor symptoms.

结果：1、行为学结果：SD大鼠(n=50)在注射惊厥剂量(10mg/kg)KA后，0-30min内动物出现凝视，湿狗样抖动(wet dog shake，WDS)等前驱症状；30-60min内动物出现1-5级癫痫发作；60-90min内动物反复自发出现4-5级癫痫发作；其后动物癫痫发作持续时间延长，间隔变短伴有大量唾液分泌，出现各种精神运动症状，呈现SE，SE后10天，用阈下剂量(5mg/kg)KA检测动物对癫痫刺激的敏感性。

Indeed, people with type 2 diabetes are as likely to suffer a heart attack as people without diabetes who have already had a heart attack.

事实上，没有心脏病的II型糖尿病患者心脏病发作的概率竟然接近于那些没有糖尿病但是有心脏病发作历史的患者再次心脏病发作的概率。

Results 20 ictal seizures in 17 cases showed the characteristics of typical frontal lobe origin as follows: postural seizures, gestural automatism, vocalization, adversive seizures and changes in expressions.

结果 额叶癫痫常见的发作形式有：姿势性发作，具有额叶癫痫特点的自动症；复杂部分性发作时伴发声、偏转或表情的变化，有时出现发作性情绪改变或强迫思维等少见症状。

On a per-episode basis, 42% of the episodes in the single-chamber arm and 69% of the episodes in the dual-chamber arm were due to SVT.

根据每个程控间期SVT发作次数，其中单腔检测到的42%发作及双腔检测到的69%发作是SVT的发作。

Results: The time of follow-up study range from 1 to 2.5 years, average (1.5±0.4) months. Among them: 63 recuperations, 10 significant improvements, 12 improvements, 13 inefficacies, 0 aggravations.

结果：术后观察1~2.5年，平均(1.5±0.4)年，癫痫发作消失63例，极少发作10例，仍有癫痫发作但发作减少12例，无效13例，并且综合手术治疗术后副反应发生率并不增加、程度轻且可恢复。

Methods: Five patients with parkinsonism or dystonia were assigned to general anesthesia using an modified endotracheal tube.

本实验依照人体实验之相关规定进行，五位患有帕金森氏症或肌张力异常的病人接受神经立体定位手术。

If you can benefit from this book, it is our honour.

如果您能从本书获益，这将是我们的荣幸。