The diagnosis and treatment of uveitis

Date of publication:2009-3   Press: People's health   Author:Yang Peizeng   Pages:1274  
Preface

Illustration: (three) or a temporary strategy in patients with uveitis was completely caused by iris adhesion after intraocular pressure rise suddenly, inflammation is not the principal contradiction, sharply increased intraocular pressure increased as the most prominent contradictions, if cannot get seasonable and effective control, it will cause serious damage to the visual function in the short term, at this point should be as soon as possible to the real water before and after the real, to drain, intraocular pressure can decrease quickly, otherwise you will lose the chance to save the patients vision, namely the so-called emergency stopgap strategy. Acute inflammation of the retina of serious or optic neuritis, short-term inside can cause severe damage to retina or optic nerve, also should be used for emergency stopgap strategy, namely high-dose glucocorticoid (high dose here emphasizes the high dose, reasonable and high dose not bigger is better, to "fight") inflammation, reduce inflammation, injury, win rescue the visual function of time, to take the long view, given the individual drug standard, thus fundamentally cure uveitis. (four) combination strategyTypes of uveitis, with an immunosuppressive therapy, may require dose can control inflammation greatly, but patients can not bear such a high dose of the drug, the combination of two or more drugs therapy; some types of uveitis, inhibitor treatment is not enough to control inflammation with an immune, it should be combined with two or immunosuppressant therapy; in addition, patients need to use a drug (such as glucocorticoid treatment, but because) basic diseases (such as diabetes) exist, this combination can reduce the influence of original disease. Generally speaking, combined medication doses than single use when the dose is small, so it can reduce the side effects of drugs, and also easily tolerated by patients, combination therapy can change the patients to certain drugs are not sensitive, so that patients become sensitive to the non sensitive drugs. Therefore, combination therapy is a treatment for chronic, intractable uveitis, especially a sensible strategy types like Vogt Liu Yuantian syndrome, Behcet disease, sympathetic ophthalmia, intermediate uveitis, retinal vasculitis. It is worth mentioning that, combined use of drugs is not surrounded by large type of medication, but a rational treatment for various based on factor analysis, it reflects the "aestheticism" concept. Combined use of drugs can be combined application of two, three or more drugs. Combination therapy should pay attention to the following points: 1. Appropriate drug combination mechanism, effect of different drug combination; not the same side effects, superimposed so as not to cause side effects lead to serious consequences; the glucocorticoid is a basic drug combination; the combination of the dosage of each drug should generally be less than single dose at. There is no fixed drug combination mode, according to the authors experience, combination methods commonly used are the following: ① glucocorticoid and cyclophosphamide; ② glucocorticoid combined with chlorambucil; ③ glucocorticoid combined with cyclosporine; ④ glucocorticoid combined with sulfur Zun purine; the glucocorticoid and cyclophosphamide and cyclosporine; the glucocorticoids combined with azathioprine and cyclosporine (see section). (five) "uphold" the strategy of long-term use of immunosuppressive therapy of uveitis is often cause some side effects, such as leukopenia, liver, kidney dysfunction, borrowing terms of traditional Chinese medicine, that is in the process of "Quxie" injured "righteousness", and not without the disease resistance, at this time should be given to "uphold" traditional Chinese medicine balance Yin and Yang Qi and blood, reduce or avoid the side effects of immunosuppressive agent brings, the restoration of righteousness, can tolerate drug treatment, the treatment to continue, otherwise the patient may be due to the side effects of the drug and was forced to suspend treatment, withdrawal means losing effective treatment in patients with uveitis. Visible patients during treatment with immunosuppressive drugs, according to syndrome differentiation of traditional Chinese medicine, combined with traditional Chinese medicine treatment, can play a good supporting role. In addition, traditional Chinese medicine on uveitis to restore a certain role in promoting, for some patients with systemic manifestations such as irritability, Yi Nu, insomnia, fatigue, constipation, loss of appetite and so on also has very good curative effect.
Summary

Yang Peizeng, male, born in June 24, 1957, Henan Puyang people. Originally the Ophthalmological Center of Zhongshan University Professor, doctoral supervisor, Department of Ophthalmology Center Deputy Director and director of the Institute, deputy director of the State Key Laboratory of Department of Ophthalmology, director of Academic Committee, Zhongshan University uveitis research center of Zhongshan University (medical) vice chairman. Now he is the director of the Department of Ophthalmology, First Affiliated Hospital of Chongqing Medical University, vice president, professor and director, Chongqing City Municipal Key Laboratory of Department of Ophthalmology, doctoral tutor. A, learning and work experience at the end of 1982, graduated from the medical department of Henan Medical College from January to 1984, 1983 in the First Affiliated Hospital of Henan Medical University from 1984 to 1987, Department of Ophthalmology, Department of Ophthalmology Shi Cong famous scientist Professor Zhang Xiaofang of China to pursue a master's degree from 1987 to 1990, Professor Shi Cong of our country famous scientist Mao Wenshu in the centre of Zhongshan Department of Ophthalmology Department of Ophthalmology, Zhongshan Medical University, Professor Mao died, Shi Cong Li Shaozhen, in 1990 received a doctorate of medicine and philosophy, after his graduation in 1992, promoted to associate professor in 1995, promotion, in 1998 was appointed as doctoral tutor. From 1994 to 2002 5 times successively in Holland country, USA Casey Department of Ophthalmology Department of Ophthalmology.Cooperative research institute. 2008 April so far in the Department of Ophthalmology of First Affiliated Hospital of Chongqing Medical University. Two, the Fund (fund was more than 30. The total amount for about 20000000 yuan) the person in charge of the project subject mainly, the National Natural Science Foundation of innovation group fund, 3600000 yuan, key project of National Natural Science Fund, 1450000 yuan, the national "eleven five" science and technology support program, clinical science key project 1680000 yuan, the Ministry of Health Hospital Affiliated to Ministry of education, 1000000 yuan, Changjiang Scholars research funding, 2000000 yuan, the National Outstanding Youth Science Fund, 800000 yuan, the Ministry of education "trans century talent" fund, 300000 yuan, the National Natural Science Foundation (3), 640000 yuan, Guangdong Province natural science fund research team the project, 150 ~ 2000000 yuan, Guangdong Province Science and technology plan project (international technology cooperation plan), 800000 yuan, Guangdong Province Natural Science Fund project, 150000 yuan of · of Ministry of education of higher school fund, the excellent young teacher foundation of Ministry of education, science and research fund, Ministry of health, Guangdong Province Natural Science Fund, Guangdong provincial key technology research projects, Guangdong Province, Guangdong Province Science and technology projects of medical engineering foundation projects, nearly 200 yuan, 200000 key projects of Chongqing Scientific Committee Chongqing City Health Bureau key item 200000
Author brief introduction

Kefeng saga, Xuehai vast, fearless tough, uprise experience is far; the patients, so the exercise one's inventive mind, unique eye. This is I and Dr. Yang Peizeng in the treatment of 20 years from the acquaintance, he is committed to uveitis disease the clinical practice and experimental research to deep feelings and impressions left by assault. As well known, uveitis patients in different age often repeated acute and severe vision loss, the complex etiology, clinical manifestations of various types. Modern medicine has known from the main pathogenesis and immune function of human eye was closely related to the variation of pathogenic factors, but the specific individual patient is often not easy to accurately detect. Since the 20th century, the full understanding and effective prevention and treatment of many patients with specific pathogenesis is still quite difficult. The industry of many persistent severe uveitis patients often afraid of a lack of orders, and step back, to become a professional clinical and research progress has lagged behind the "big" issue. Professor Yang Peizeng since twentieth Century 80 years so far, in the scientific experimental uveitis research, medical science is closely related to clinical medical, to explore, practice, from the pathogenesis, pathogenic factors and treatment for stronger measures, continue to introduce new awareness, made more and better treatment effect. And Professor Yang in the long-term treatment of medical ethics is a bosom is daily and utter innocence, in the majority of the popularity, and sickness ophthalmopathy patients effective, so famous, renowned domestic and internationally renowned at home and abroad, become an independent school. For nearly ten years, Professor Yang according to the uveitis system and a large number of scientific and medical data, published "and" writing "uveitis clinical uveitis" two books in 1998 and 2004 respectively, uveitis and the clinical medicine, results in theory and application of basic categories are brilliant expositions, already has a wide range of influence in the Department of Ophthalmology professional circles. Now professor Yang Peizeng from the greater accumulation of clinical experience and research work, organize further summarized, "written by" the diagnosis and treatment of uveitis. Which provides a number of important image of clinical manifestation and treatment of patients with different types of uveitis in the process he sinks in more than 2000 pieces of the map, the total of 200 remaining ten thousand words, rich in content, magnanimous. In the companion the uveitis series of monographs, focusing on clinical thinking and practice content in patients with various types of uveitis, as detailed and thorough analysis. The deep intension, form a unique creative writing. The author will be listed for each type of uveitis eye project in the etiology, symptoms, diagnosis, treatment and so must the statement, the concise articles writing. Of all the diseases are cited author to heal the typical clinical cases, and with the case presentation, namely "to" experience and Enlightenment ", to give a specific diagnosis and treatment of patients with different disease process, efficacy, prognosis and diagnosis experience of treatment, the theory analysis and practice carefully. Which contains many practical, relevant and original paper, concise and comprehensive and demolish with penetrating criticism. Condensed crystalline author clinical thinking and wisdom, is also significant in clinical medicine and scientific research in the knowledge fine, and sent for the article works handy mature skill and the finishing touch. In addition, the book also another chapter, "uveitis principle strategy" a paper for the scientific clinical thinking of treatment of uveitis, the overall understanding of the disease, the treatment principle and rational treatment should have a different strategy, highlights, all having substance in speech and pragmatic truth-seeking, precious experience for the treatment of uveitis Xun summary and clinical thinking deeply in theory level. Professional clinical and academic achievement in the diagnosis and treatment of uveitis bearing "" book of all scientific rigor, many high perspicacity and highly creative, classic and known as the standard. I was optimistic the advent of Hebei, and in promoting professional, play and play a good role to benefit the students and benefit the patients.
Catalogue of books

Introduction uveitis ideas, principles and strategies, uveitis four thinking two, uveitis, three basic principles of uveitis treatment strategy first uveitis related knowledge first chapter uveal anatomy and physiology, the two, iris, ciliary body, three of four choroidal second chapter uveitis concept classification and concept, classification, two third chapter uveitis, etiology and pathogenesis, infection factors of uveitis mechanism two, autoimmune factors cause uveitis mechanism three, various damage caused by uveitis fourth chapter uveitis related concept second uveitis diagnosis first chapter uveitis diagnostic procedures, two, determine a summary uveitis occurs three, determine the nature, determine the uveitis four uveitis causes or type five, determine the uveitis stage second chapter uveitis history collection, regional distribution of a family history of two, three, four, five age gender, race six, Shi Qi, general history of eight, nine, ocular history history the third chapter uveitis eye examination, visual acuity of two, eye lid three, Four, episcleritis, scleritis conjunctiva and scleral transillumination was abnormal in five, keratitis, corneal disease and uveitis in six, ciliary congestion and mixed with seven, eight, scleral hyperaemia keratic precipitates in nine, anterior chamber flare, cell and float ten, hypopyon and pseudo hypopyon eleven, anterior chamber exudates and exudation film twelve, iris, pupil change thirteen fourteen, hyphema in fifteen, angle change sixteen, after the real and the changes of ciliary body, lens, vitreous body seventeen change eighteen change nineteen, fundus changes in twenty, the fourth chapter uveitis intraocular pressure change auxiliary check, uveitis auxiliary examination of fundus fluorescein angiography were two, three, indocyanine green angiography, ultrasound biomicroscopy four five six, ultrasound, optical coherence tomography technology seven, visual field examination eight, multifocal electroretinogram examination nine, other two, laboratory examination, laboratory examination of three species of uveitis in third uveitis first chapter introduction to how to realize the uveitis, uveitis in this diseases two, uveitis, original thinking And the strategy of the three, second chapter of uveitis in treatment of glucocorticoid and its use in the treatment of uveitis, glucocorticoids, basic structure and function of two derivatives, glucocorticoids, three species of glucocorticoid action mechanism of four, glucocorticoid pharmacokinetics five, glucocorticoid treatment of uveitis preparation and administration method of typical case 1 typical cases of 2 typical cases of 3 typical cases of 4 typical cases of 5 the third chapter immune inhibitors and their use in the treatment of uveitis, cyclophosphamide, chlorambucil, three, two, four, FK506 five, cyclosporine, methotrexate, azathioprine, colchicine, six seven eight, mycophenolate mofetil, nine people recombinant interferon 0c- ten, according to the TNF biologics chapter fourth non steroidal anti-inflammatory drugs and their use in the treatment of uveitis, pharmacokinetics and metabolism of two, three, application effect and its mechanism of dose and route four, commonly used non steroidal anti-inflammatory drug ophthalmic preparation five, indications, side effects six seven, note fifth chapter cycloplegic and mydriatic agent and its use in the treatment of uveitis, pharmacology, a two common ciliary muscle Paralytic agent and mydriatic agent three, cycloplegic and mydriatic agent in the treatment of uveitis in the application of the sixth chapter of uveitis treated with traditional Chinese medicine, Chinese medicine treatment of uveitis in a two, uveitis syndrome differentiation of the seventh chapter of uveitis complications of treatment a, uveitis complications two, uveitis complications of treatment fourth the first chapter of the article uveitis anterior uveitis, two, an overview of acute anterior uveitis in three, chronic anterior uveitis in chapter second, intermediate uveitis, two, a concept of epidemiology in three, etiology and pathogenesis, clinical manifestations, complications of four five six, seven, eight types of diagnosis, differential diagnosis, diagnosis of nine note ten, treatment the third chapter eleven, prognosis of uveitis after one, two, three, the concept of classification of white spot syndrome four, clinical manifestations, diagnosis, differential diagnosis of five six seven, treatment...... Yang Peizeng @##@ index "The diagnosis and treatment of uveitis" tells the story of the main pathogenesis and immune function of human body of modern medicine has known the affected eye was closely related to the variation of pathogenic factors, but the specific individual patient is often not easy to accurately detect. Since the 20th century, the full understanding and effective prevention and treatment of many patients with specific pathogenesis is still quite difficult. The industry of many persistent severe uveitis patients often afraid of a lack of orders, and step back, to become a professional clinical and research progress has lagged behind the "big" issue. Professor Yang Peizeng since twentieth Century 80 years so far, in the scientific experimental uveitis research, medical science is closely related to clinical medical, to explore, practice, from the pathogenesis, pathogenic factors and treatment for stronger measures, continue to introduce new awareness, made more and better treatment effect.
Chapter excerpt

Kefeng saga, Xuehai vast, fearless tough, uprise experience is far; the patients, so the exercise one's inventive mind, unique eye. Professor Yang Peizeng's "uveitis in diagnosis and treatment of" deep intension, form a unique creative writing. Of all the diseases are cited author to heal the typical clinical cases, and with the case presentation, titled "the experience and Enlightenment", to give a specific diagnosis and treatment of patients with different disease process, efficacy, prognosis and diagnosis experience of treatment, the theory analysis and practice carefully. Which contains many practical, relevant and original paper, concise and comprehensive and demolish with penetrating criticism. Condensed crystalline author clinical thinking and wisdom, is also significant in clinical medicine and scientific research in the knowledge fine, and sent for the article works handy mature skill and the finishing touch. In professional clinical and academic achievement in the book bearing are scientific rigor, many high perspicacity and highly creative, classic and known as the standard. -- a prominent feature of the book is to be concise and to the point, Luo Chengren clear, illustrated. The control characters and over 2000 illustrations in reading, easily from the column into understanding the different characteristics of each type of uveitis section of the text, so as to master the diagnosis, differential diagnosis and treatment principle and specific method. Book uveitis expertise, philosophical thinking, medical ideology and aesthetics as a whole, financial education, wisdom and love into a furnace. Believe it, not only make you get uveitis specialized knowledge, more praiseworthy for one's excellent conduct is also will be philosophical and ideological enlightenment and art. Zhang Xiao -- real read by Pei "diagnosis and treatment of uveitis," a Book (remove the professional content cannot read the) is a solid sense of beauty. The dissemination of the philosophy and thinking of the aromatic, reflects the respect for life, love and dedication, a record of his unremitting pursuit of life and beyond. I sincerely wish: until the time when flowers are blooming, he laughed in the leaves! @##@ -- Li Ping "The diagnosis and treatment of uveitis" by people's Medical Publishing house.
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  •   The book is of good quality, but also read only the first, very professional
  •   A fairly detailed content, add the remaining books about uveitis of large gaps, but the clinical encounter is really a lot of uveitis
 

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