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Objective:To analyze the clinical characteristics and prognostic factors of acquired immunodeficiency syndrome (AIDS) patients with cytomega-lovirus retinitis (CMVR).Methods:The basic information, clinical features, fundus manifestations, treatment and prognosis of AIDS patients complicated with CMVR from January 2016 to December 2019 in Chongqing Public Health Medical Center were collected. Logistic single factor regression and multivariate regression analysis were used to analyze the factors affecting the prognosis of patients.Results:A total of 73 AIDS patients with CMVR were enrolled, including 54 males and 19 females. They were (41.3±12.1) years old. The median of CD4 + T lymphocyte counts was 34.0/μL, and there were five cases (6.85%) with CD4 + T lymphocyte counts> 200.0/μL. Forty cases (54.79%) were positive for cytomegalovirus (CMV) DNA in blood. Thirty-five patients (47.95%) were admitted with ocular symptoms, and monocular involvement was common (53.42%, 39/73). The results of ophthalmoscope showed that 41 cases (56.16%) had central lesions, 63 cases (86.30%) had exudative lesions and 52 (71.23%) had bleeding lesions. Sixty-seven patients were treated with anti-CMV therapy, and 46 patients were discharged with improved after treatment, and two patients were improved without treatment during follow-up. The median hospitalization time was 25 days. Logistic single factor regression analysis showed that the prognosis of patients with combination of anti-CMV drugs and dexamethasone was better than that of patients who were treated with anti-CMV drugs (sodium phosphonate or ganciclovir) alone (odds ratio ( OR)=0.308, P=0.038). Compared with patients aged <30 years old, the prognosis of patients aged> 50 years old was worse ( OR=14.667, P=0.009). The multivariate analysis showed that age>50 years old was the independent risk factor influencing the prognosis of CMVR ( OR=18.183, P=0.009). Conclusions:CMVR is frequently found in AIDS patients with low CD4 + T lymphocyte counts, but CMVR may still occur in patients with CD4 + T lymphocyte counts >200.0/μL. However, not all patients have positive CMV DNA results in blood. Therefore, it is necessary for AIDS patients to receive examination of ocular fundus. The overall prognosis of CMVR is good. Age>50 years old is an independent risk factor affecting prognosis. Appropriate use of dexamethasone combined with anti-CMV treatment can improve the prognosis.
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<p><b>OBJECTIVE</b>To observe the effect of pricking blood at Neiyingxiang (EX-HN 9) on the intraocular pressure of patients of primary open angle glaucoma (POAG).</p><p><b>METHODS</b>Ninty-six cases (166 eyes) were randomly divided into an observation group (44 cases) and a control group (52 cases). The observation group was treated with pricking blood at Neiyingxiang (EX-HN 9), and the control group was treated with 0.5% Timolol Maleate drops in eyes. The changes of patients' intraocular pressure in both groups were observed before and after treatment.</p><p><b>RESULTS</b>The intraocular pressure were (29.81 +/- 3.49) mmHg and (23.18 +/- 3.61) mmHg before and after treatment in the observation group, and (29.94 +/- 3.64) mmHg and (23.88 +/- 3.96) mmHg in the control group respectively, there were significant differences after treatment in the two groups (both P<0.01), while there was no significant difference in decreasing the intraocular pressure between the two groups (P>0.05).</p><p><b>CONCLUSION</b>Pricking blood at Neiyingxiang (EX-HN 9) can effectively decrease the intraocular pressure and the effect is equivalent to Timolol Maleate drops.</p>
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Acupuncture Points , Bloodletting , Glaucoma, Open-Angle , Therapeutics , Intraocular PressureABSTRACT
@#ObjectiveTo analyze the clinical characteristics and treatment of severe acute respiratory syndrome (SARS).MethodsDuring epidemic period of SARS,all suspected patients were isolated and treated at very early stage. Clinical symptoms, signs and changes of the chest film were observed carefully to make early diagnosis and begin early intervention. 14 SARS cases with definite diagnosis were treated by Western Medicine combined with Chinese Traditional Medicine.3 cases of them with severe type were treated by timely technical ventilation,which was nasotracheal intubition guided with fibronchoscope,with the principle of low tide volume and high PEEP to improve oxygen combination.ResultsAll patients were cured to discharge. Only two cases of mild pulmonary fibrosis were found after 2 months' follow-up. None of the medical workers taking part in rescuing and treating SARS patients and none of the family members of the patients were infected.ConclusionDuring SARS epidemic period,early isolation,early diagnosis,early combined treatment of Western Medicine and Chinese Traditional Medicine,and prompt technical ventilation intervention on severe cases are important factors to successfully rescue and treat SARS patients.