目的研究先天性眼外肌纤维化（congenital fibrosis of the extraocular muscles，CFEOM）家系发病者眼外肌及眼运动神经的影像学特征，探讨先天性眼外肌纤维化的发病机制。方法收集2个CFEOM家系，家系一临床表现符合CFEOM1，家系二临...目的研究先天性眼外肌纤维化（congenital fibrosis of the extraocular muscles，CFEOM）家系发病者眼外肌及眼运动神经的影像学特征，探讨先天性眼外肌纤维化的发病机制。方法收集2个CFEOM家系，家系一临床表现符合CFEOM1，家系二临床表现符合CFEOM3。对两家系共17名患者（家系－3名患者，家系二14名患者，其中男性5名，女性12名，年龄范围8—62岁，平均年龄34．4岁，34只眼）进行高分辨率MRI扫描，随机抽取18个正常成人（男女各9人，年龄范围10—59岁，平均年龄35．1岁，36只眼）作为对照。扫描方法：眼眶部行3mm层厚、T1加权MRI扫描；颅内行1mm层厚、3DFIESTA扫描；比较2组眼外肌、眼运动神经、上睑提肌和视神经的变化。对数据进行正态性检验并用t检验对数据进行统计学分析。结果MRI扫描显示发病者外直肌（LR）、内直肌（MR）、上直肌（SR）、下直肌（IR）及上斜肌（10）体积较正常对照组小，尤以上直肌明显，差异有统计学意义（LR：t=－5．535，P=0．003；MR：t=－7．187，P=0．001；SR：t=－23．749，P=0．001；IR：t=－6．907，P=0．001；IO：t=－5．057，P=0．004）；眼运动神经（动眼神经、展神经）的颅内段截面积较正常对照组小，差异有统计学意义（t=－23．749，－11．721，P〈0．05）；视神经较细（t=2．292，P=0．025），且均向鼻上方移位；上睑提肌发育不良。结论由眼运动神经异常支配继发眼外肌组织被致密纤维组织代替所致，可能与动眼神经核和滑车神经核发育缺陷有关。CFEOM的病因为神经源性。展开更多
Diabetic abducens nerve palsy main symptoms include ocular motility disorders and diplopia.This disease is mainly caused by severe vascular degeneration.It is a serious impact on patient＇s quality of life and mental ...Diabetic abducens nerve palsy main symptoms include ocular motility disorders and diplopia.This disease is mainly caused by severe vascular degeneration.It is a serious impact on patient＇s quality of life and mental health.Currently,there is no effective means of intervention for eye movement disorders and diplopia,the patients could only expect for neural self-repair.[1] Our team invented intraorbital electroacupuncture （IEA） therapy to repair abducens nerve affected by diabetes.In the meantime,we applied it into clinical practice and achieved great success.展开更多
Objective and accurate assessment of the degree of ocular motor nerve palsy is helpful not only in the evaluation of prognosis, but also for the screening of treatment methods. However, there is currently no comprehen...Objective and accurate assessment of the degree of ocular motor nerve palsy is helpful not only in the evaluation of prognosis, but also for the screening of treatment methods. However, there is currently no comprehensive measure of its severity. In this study, we designed the Ocular Motor Nerve Palsy Scale and investigated its validity and reliability. Six experts were invited to grade and evaluate the scale. The study recruited 106 patients with a definite diagnosis of unilateral isolated ocular motor nerve palsy. Three physicians evaluated the patients using the scale. One of the three physicians evaluated the patients again after 24 hours. The content validity index（CVI） and factor analysis were used to analyze the scale＇s construct validity. The intraclass correlation coefficient and Cronbach＇s alpha were used to evaluate the inter-rater and test-retest reliability and the internal consistency. The CVI results（I-CVI = 1.0, S-CVI = 0.9, Pc = 0.016, K＊ = 1） indicated good content validity. Factor analysis extracted two common factors that accounted for 85.2% of the variance. Furthermore, the load value of each component was above 0.8, indicating good construct validity. The Ocular Motor Nerve Palsy Scale was found to be highly reliable, with an inter-rater reliability intraclass correlation coefficient of 0.965（P 0.01）, a test-retest reliability intraclass correlation coefficient of 0.976（P 0.01）, and Cronbach＇s alpha values of 0.63–0.70. In conclusion, the Ocular Motor Nerve Palsy Scale with good validity and reliability can be used to quantify the severity of ocular motor nerve palsy. This study was registered at Chinese Clinical Trial Registry（registration number： Chi CTR-OOC-17010702）.展开更多
文摘目的研究先天性眼外肌纤维化（congenital fibrosis of the extraocular muscles，CFEOM）家系发病者眼外肌及眼运动神经的影像学特征，探讨先天性眼外肌纤维化的发病机制。方法收集2个CFEOM家系，家系一临床表现符合CFEOM1，家系二临床表现符合CFEOM3。对两家系共17名患者（家系－3名患者，家系二14名患者，其中男性5名，女性12名，年龄范围8—62岁，平均年龄34．4岁，34只眼）进行高分辨率MRI扫描，随机抽取18个正常成人（男女各9人，年龄范围10—59岁，平均年龄35．1岁，36只眼）作为对照。扫描方法：眼眶部行3mm层厚、T1加权MRI扫描；颅内行1mm层厚、3DFIESTA扫描；比较2组眼外肌、眼运动神经、上睑提肌和视神经的变化。对数据进行正态性检验并用t检验对数据进行统计学分析。结果MRI扫描显示发病者外直肌（LR）、内直肌（MR）、上直肌（SR）、下直肌（IR）及上斜肌（10）体积较正常对照组小，尤以上直肌明显，差异有统计学意义（LR：t=－5．535，P=0．003；MR：t=－7．187，P=0．001；SR：t=－23．749，P=0．001；IR：t=－6．907，P=0．001；IO：t=－5．057，P=0．004）；眼运动神经（动眼神经、展神经）的颅内段截面积较正常对照组小，差异有统计学意义（t=－23．749，－11．721，P〈0．05）；视神经较细（t=2．292，P=0．025），且均向鼻上方移位；上睑提肌发育不良。结论由眼运动神经异常支配继发眼外肌组织被致密纤维组织代替所致，可能与动眼神经核和滑车神经核发育缺陷有关。CFEOM的病因为神经源性。
文摘患者男性,41岁.因摔伤后头痛、头晕2h,于2011年3月21日入院.患者于入院当日晚饭后骑摩托车时不慎摔倒,头部着地,当即意识丧失,约30 min清醒后自觉头痛,恶心、呕吐2次,呕吐物为胃内容物.被他人送入我院.
诊断与治疗经过入院时查体：体温37.1 ℃,脉搏84次/min,呼吸21次/min,血压151/87 mm Hg（1 mm Hg：0.133 kPa）.头皮散在擦伤。
基金This work was supported by a grant from the National Natural Science Foundation of China （No. 81674052）.
文摘Diabetic abducens nerve palsy main symptoms include ocular motility disorders and diplopia.This disease is mainly caused by severe vascular degeneration.It is a serious impact on patient＇s quality of life and mental health.Currently,there is no effective means of intervention for eye movement disorders and diplopia,the patients could only expect for neural self-repair.[1] Our team invented intraorbital electroacupuncture （IEA） therapy to repair abducens nerve affected by diabetes.In the meantime,we applied it into clinical practice and achieved great success.
基金supported by the National Natural Science Foundation of China,No.81674052
文摘Objective and accurate assessment of the degree of ocular motor nerve palsy is helpful not only in the evaluation of prognosis, but also for the screening of treatment methods. However, there is currently no comprehensive measure of its severity. In this study, we designed the Ocular Motor Nerve Palsy Scale and investigated its validity and reliability. Six experts were invited to grade and evaluate the scale. The study recruited 106 patients with a definite diagnosis of unilateral isolated ocular motor nerve palsy. Three physicians evaluated the patients using the scale. One of the three physicians evaluated the patients again after 24 hours. The content validity index（CVI） and factor analysis were used to analyze the scale＇s construct validity. The intraclass correlation coefficient and Cronbach＇s alpha were used to evaluate the inter-rater and test-retest reliability and the internal consistency. The CVI results（I-CVI = 1.0, S-CVI = 0.9, Pc = 0.016, K＊ = 1） indicated good content validity. Factor analysis extracted two common factors that accounted for 85.2% of the variance. Furthermore, the load value of each component was above 0.8, indicating good construct validity. The Ocular Motor Nerve Palsy Scale was found to be highly reliable, with an inter-rater reliability intraclass correlation coefficient of 0.965（P 0.01）, a test-retest reliability intraclass correlation coefficient of 0.976（P 0.01）, and Cronbach＇s alpha values of 0.63–0.70. In conclusion, the Ocular Motor Nerve Palsy Scale with good validity and reliability can be used to quantify the severity of ocular motor nerve palsy. This study was registered at Chinese Clinical Trial Registry（registration number： Chi CTR-OOC-17010702）.
