2014年 · 第94卷第17期

Myopia is a refractive error with high incidence in the world, especially in China. The prevalence rate of myopia exceeds 70% among specific people, such as college students, and it is one of the countries with high prevalence rate in the world. In recent years, the age of myopia is becoming advanced, the incidence rate is increasing year by year, and the ocular complications related to myopia are also increasing, such as retinal detachment, macular hemorrhage, cataract and glaucoma, etc., which can not only lead to visual damage, but also lead to blindness in severe cases. Blindness caused by pathological myopia has been one of the main causes of blindness in China and the primary factor of low vision. China is a big country of myopia, and it has more conditions and needs for the research of myopia pathogenesis, so it should play an important role in the research of myopia. However, the pathogenesis of myopia is unknown, and there are no effective interventions and prevention methods aimed at the etiology. If we can find methods or drugs that effectively delay the progression of myopia, it is of great significance to reduce the incidence of myopia and the occurrence of blinding complications, and even to prevent and treat blindness in China.

Vertebroplasty (VP) is the injection of bone cement or other bone materials through the vertebral pedicle or directly into the vertebral body to relieve pain and increase the mechanical strength of the diseased vertebra. After percutaneous vertebroplasty (PVP) for the treatment of vertebral hemangioma^[1]At present, it has become a minimally invasive spinal technique widely used in the treatment of various benign and malignant lesions of vertebral body. In this study, vertebroplasty for osteoporotic vertebral compression fractures was carried out to evaluate the clinical effect of vertebroplasty for osteoporotic vertebral compression fractures.

The patient was a 21-year-old female. He was admitted to hospital on March 29, 2013 with the main complaint of "headache for more than 20 days, right hand shaking, facial muscle twitching for more than 10 days, and salivation for 1 day". The patient experienced poor sleep and headache 20 days before seeing the doctor. The local hospital gave "Anshen Bu Nao Liquid" and "Vitamin B1" orally, but the symptoms did not improve significantly. More than 10 days ago, the patient experienced involuntary shaking of his right hand and involuntary twitching of his right facial muscles. When he was nervous, his speech was still clear, and the symptoms of "acupuncture" treatment were not relieved. That night, the patient experienced delirium, so he went to Henan Psychiatric Hospital, where he was diagnosed with "(1) schizophrenia and (2) viral encephalitis". He was given symptomatic supportive treatment such as antiviral (details unknown), but the symptoms did not improve. For further diagnosis and treatment, I went to the First Affiliated Hospital of Zhengzhou University. Physical examination: confusion, general spirit, unclear speech, inability to cooperate with advanced intelligent activities, bilateral pupils of equal size and round, with a diameter of 3 mm, sensitive to light reflection, inability to cooperate with the examination of remaining cranial nerves, and increased muscle tone of limbs. Extremity tendon reflex (+ +), neck strong, Kernig sign negative, Brudzinski sign negative. The bilateral pathological signs were not drawn out, and the physical examination of the remaining nervous system could not cooperate. Skull MRI: (1) Mild white matter demyelination in bilateral frontal lobes (Figure 1)； (2) Bilateral abnormal enhancement of frontal meninges; (3) paranasal sinusitis in the whole group; (4) There were no obvious abnormalities in brain MRA and MRV. Symptomatic and supportive treatment such as anti-infection, phlegm resolution and sedation were given. The patient had frequent intermittent occlusion, involuntary twitching around the mouth and hands. He was transferred to ICU on 2 Apr 2013. The patient was sedated with involuntary twitching at the angle of his mouth. ECG monitoring showed: body temperature 38.2℃, pulse 105 beats/min, breathing 14 beats/min, blood pressure 76/45 mmHg (1 mmHg =0.133 kPa), SpO₂Around 92%. The bilateral pupils are equal in size and round, about 1.5 mm in diameter, and reflect light slowly. Tendinous reflexes of both lower limbs unelicited, Babinski sign (–). At 15:03 on April 4, 2013, the patient's oxygenation decreased from 98% to 87%. ECG monitoring showed ventricular fibrillation and heart rate of 147 beats/min. Subsequently, the oxygenation decreased to 65%. Bilateral pupils were dilated and fixed, with a diameter of about 5 mm. Cardiopulmonary resuscitation was performed urgently, and the sinus heart rate recovered at 15:13. The light reflex was retarded, and the rescue was successful. At 19: 10, the heart rate suddenly decreased again, as low as 35 beats/min, and the oxygenation gradually decreased, as low as 70%. After rescue, the vital signs gradually stabilized. On 6 Apr 2013, tracheotomy and ventilator-assisted ventilation were performed, and PICCO was placed to monitor cardiac output. At 18: 34 on April 10, 2013, my blood pressure and heart rate suddenly decreased, and my blood pressure and heart rate gradually increased after rescue. Treatment measures: control of body temperature, control of convulsions, anti-infection, liver protection, nerve nourishment and other comprehensive treatment. The patient's family gave up treatment on April 12th and died en route. On May 10, 2013, HEK293 cells expressing N-methyl-D-aspartate receptor (NMDAR) antigen were used by indirect immunofluorescence assay to determine that the patient's serum anti-NMDAR antibody was moderately positive (Figure 2)。 Consistent with the diagnosis of anti-NMDAR encephalitis.