简介:Oculardrugtransportbarriersposeachallengefordrugdeliverycomprisingtheocularsurfaceepithelium,thetearfilmandinternalbarriersoftheblood-aqueousandblood-retinabarriers.Oculardrugdeliveryefficiencydependsonthebarriersandtheclearancefromthechoroidal,conjunctivalvesselsandlymphatic.Traditionaldrugadministrationreducestheclinicalefficacyespeciallyforpoorwatersolublemoleculesandfortheposteriorsegmentoftheeye.Nanoparticles(NPs)havebeendesignedtoovercomethebarriers,increasethedrugpenetrationatthetargetsiteandprolongthedruglevelsbyfewinternalsofdrugadministrationsinlowerdoseswithoutanytoxicitycomparedtotheconventionaleyedrops.Withtheaidofhighspecificityandmultifunctionality,DNANPscanberesultedinhighertransfectionefficiencyforgenetherapy.NPscouldtargetatcornea,retinaandchoroidbysurficialapplicationsandintravitrealinjection.ThisreviewisconcernedwithrecentfindingsandapplicationsofNPsdrugdeliverysystemsforthetreatmentofdifferenteyediseases.
简介:目的探讨地塞米松(dexamethasone,DEX)治疗豚鼠爆震性听力损失的给药途径。方法将24只成年豚鼠经脉冲噪声(167dBSPL,间隔2s,80发)暴露后,随机分为3组,每组8只。A组常规耳后切口,将浸透DEX的明胶海绵颗粒置于圆窗龛上。B组在手术显微镜下找到鼓膜,穿刺后将浸透DEX的明胶海绵颗粒置于圆窗龛上。C组手术方法同A组,给予生理盐水。分别于爆震前,爆震后24h及治疗后3周检测豚鼠听性脑干反应(auditorybrainstemresponse,ABR)。琥珀酸脱氢酶染色(succinicdehydrogenase,SDH)基底膜铺片,观察毛细胞。结果ABR检测结果显示:治疗后3周A组和C组ABRclick反应阈移差异有统计学意义(P=0.003);A组和B组,B组和C组比较差异均无统计学意义。SDH基底膜铺片观察3组毛细胞,见A组和B组毛细胞恢复均较C组好,但是A组恢复更佳。结论耳后径路和鼓膜直接穿刺给予DEX对豚鼠爆震性听力损失均有作用,前者效果明显。(中国眼耳鼻喉科杂志,2008,8:15-17)
简介:目的探讨并分析眼科白内障超声乳化手术中表面麻醉给药的观察及护理。方法采用统计分析方法选取2014年3月-2016年2月期间在本院接受治疗的患有白内障疾病患者80例为研究对象,对所有患者采取白内障超声乳化手术同时采取表面麻醉给药方法配合治疗,同时采取术前教育、心理护理、术后护理的综合护理手段帮助治疗,观察并分析患者术后情况。结果经过相应的治疗,患者术后1d、16d、80d视力达到0.5以上占总数的97.5%(78/80),其中视力达No.8及以上患者占总数33.75(27/80),视力达No.3及下患者占总数的2.5%(2/80)。结论针对白内障超声乳化手术中给于表面麻醉治疗的同时实施相应的护理配合治疗可以显著提高患者的疾病治愈率,帮助患者视力恢复,值得深入挖掘。
简介:目的:系统评价白内障超声乳化吸除术前加用非甾体抗炎药(nonsteroidalanti-inflammatorydrugs,NSAIDs)对术后黄斑囊样水肿(cystoidmacularedema,CME)的影响。方法:计算机检索CochraneLibrary、PubMed、BMC、中国期刊全文数据库(CNKI)、维普中文期刊数据库(VIP)。收集NSAIDs的不同给药时机(试验组予以NSAIDs术前及术后局部点眼治疗,对照组予以NSAIDs术后治疗)对白内障超声乳化吸除术后CME及黄斑中心凹厚度影响的临床随机对照试验文献。采用RevMan5.2软件及Stata12.0软件进行Meta分析。结果:共纳入6项研究。术前是否加用NSAIDs对白内障超声乳化吸除术后CME的发生在术后1wk差异无统计学意义(OR=1.58,95%CI:0.48~5.18,P〉0.05)、术后1mo差异无统计学意义(OR=0.78,95%CI:0.30~2.00,P〉0.05),术后3mo差异有统计学意义(OR=0.22,95%CI:0.11~0.43,P〈0.01);黄斑中心凹厚度在术后1wk差异无统计学意义(WMD=-7.20,95%CI:-15.17~0.77,P〉0.05)、术后1mo差异无统计学意义(WMD=-3.98,95%CI:-14.05~6.08,P〉0.05),术后3mo差异有统计学意义(WMD=-18.25,95%CI:-33.80~-2.70,P〈0.05)。结论:术前及术后联合应用NSAIDs治疗可以显著降低白内障超声乳化吸除术后CME的发生,降低术后黄斑中心凹的厚度,提示NSAIDs的术前术后联合应用较单独术后应用更具有优越性。
简介:目的:研究家兔静脉注射头孢哌酮钠/舒巴坦钠在眼内的透过性及蓄积作用。方法:用高效液相色谱法(highperformanceliquidchromatography,HPLC)测定给药后不同疗程时间点各组兔眼房水和玻璃体中的药物浓度。结果:房水中舒巴坦钠的药物浓度分别为23.4±4.8和23.6±3.7mg/L;头孢哌酮钠浓度分别为8.9±1.2和8.9±1.7mg/L;玻璃体中舒巴坦钠浓度分别为71.2±4.6和69.3±6.8mg/L,头孢哌酮钠未检出。结论:头孢哌酮Ca/舒巴坦钠静脉注射后在正常的眼内透过性不良。
简介:AIM:Toassesstheeffectivenessofimmunosuppressantsintheprophylaxisofcornealallograftrejectionafterhigh-riskkeratoplastyandnormal-riskkeratoplasty.METHODS:WesearchedtheCochraneCentralRegisterofControlledTrials(CENTRAL),MEDLINE,EMBASE,CNKI,VIPandreferencelistsofarticles.Dateofmostrecentsearch:18June,2011.Allrandomisedcontrolledtrials(RCTs)assessingtheuseofimmunosupressantsinthepreventionofgraftrejection,irrespectiveofpublicationlanguage.Twoauthorsassessedtrialqualityandextracteddataindependently.Onlydichotomousoutcomes(cleargraftsurvival,ratioofimmunereactionsandsideeffects)wereavailableandwereexpressedasrelativerisk(RR)and95%confidenceintervals(CI).RESULTS:Sevenstudieswereincludedinthisreview.Inthecomparingofmycophenolatemofetil(MMF)withplacebo,theresultsshowedMMFcouldsignificantlyreduceimmunereactionscomparedwithplacebo(RR1.0895%Cl0.95to1.21),butnoeffectoncleargraftsurvival(RR1.1195%Cl0.90to1.35).Incleargraftsurvivalandimmunereactions,MMFandcyclosporineA(CsA)showedsimilareffect(RR1.1195%Cl0.90to1.35,andRR1.48,95%Cl0.56to3.93,respectively).Tacrolimus(FK506)andsteroidshowedsimilareffectsoncleargraftsurvivalandimmunereactions(RR0.32,95%CI0.02to6.21,andRR1.00,95%CI0.88to1.14,respectively).Nodrugrelativesideeffecthasbeenfound.CONCLUSION:MMFmayreduceimmunereactionsinbothnormal-riskandhigh-riskrejectionofpenetratingkeratoplasty.CsAandFK506showedsimilareffectsasMMF.However,duetothelackoflargeclinicaltrials,theevidenceremainweak,thequalityofevidenceswereratedasverylowtomoderate.Large,properlyrandomised,placebo-controlled,doublemaskedtrialsareneededtoevaluatetheeffectofimmunosuppressants.
简介:目的观察自制全结膜囊羊膜固定器在重症眼表烧伤行羊膜遮盖手术中应用效果。方法在11例(13眼)眼部重症烫伤患者治疗中采用自制全结膜囊羊膜固定器将羊膜固定于眼表及眼睑皮肤面。根据病情需要更换羊膜,随访3月至3年。结果患者平均手术时间为(8.0±3.0)分钟;眼表组织上皮化时间(13.2±11.3)天。重复手术次数3.5次,患者手术依从性良好,观察病例无角膜穿孔,无睑球粘连。结膜囊狭窄5例,角膜斑翳5例,角膜血管化2例。结论采用自制全结膜囊羊膜固定器手术,缩短手术时间,无创伤,重症烧伤患者可多次重复手术,特别适合重症眼表烧伤早期治疗,减少晚期严重并发症的发生。
简介:目的探讨前列腺素类药结合玻璃体腔注射雷珠单抗治疗新生血管性青光眼的效果。方法伴发高眼压的新生血管性青光眼患者160例根据随机数字表法分为治疗组80例与对照组80例,两组都给予复合式小梁切除术,对照组选择拉坦前列腺素辅助治疗,治疗组选择拉坦前列腺素联合玻璃体腔注射雷珠单抗辅助治疗。结果治疗后治疗组与对照组的治疗有效率分别为97.5%和88.8%,治疗组的治疗有效率明显高于对照组(P〈0.05)。两组治疗后最佳矫正视力都明显提高,而眼压都明显下降,与治疗前对比差异明显(P〈0.05);同时治疗后治疗组的最佳矫正视力与眼压也都明显好于对照组(P〈0.05)。治疗期间治疗组的眼结膜充血、前房炎症反应、角膜水肿、一过性视觉模糊等并发症发生率都明显低于对照组(P〈0.05)。所有患者治疗后随访调查6个月,治疗组的治疗后3个月与6个月的复发率分别为1.3%和5.0%,而对照组分别为7.5%和13.8%,治疗组治疗后3个月与6个月的复发率明显少于对照组(P〈0.05)。结论前列腺素类药结合玻璃体腔注射雷珠单抗治疗新生血管性青光眼能促进眼压的降低,改善视力水平,安全性好,降低复发,从而有利于近远期疗效的提高。
简介:AIM:Toaddressissuesininteroperabilitybetweendifferentfundusimagesystems,weproposedawebeyepicturearchivingandcommunicationsystem(PACS)frameworkinconformancewithdigitalimagingandcommunicationinmedicine(DICOM)andhealthlevel7(HL7)protocoltorealizefundusimagesandreportssharingandcommunicationthroughinternet.METHODS:Firstly,atelemedicine-basedeyecareworkflowwasestablishedbasedonintegratingthehealthcareenterprise(IHE)EyeCaretechnicalframework.Then,abrowser/serverarchitectureeye-PACSsystemwasestablishedinconformancewiththewebaccesstoDICOMpersistentobject(WADO)protocol,whichcontainsthreetiers.RESULTS:Inanyclientsysteminstalledwithwebbrowser,clinicianscouldlogintheeye-PACStoobservefundusimagesandreports.Multipurposeinternetmailextensions(MIME)typeofastructuredreportissavedaspdf/htmlwithreferencelinktorelevantfundusimageusingtheWADOsyntaxcouldprovideenoughinformationforclinicians.Somefunctionsprovidedbyopen-sourceOviyamcouldbeusedtoquery,zoom,move,measure,viewOICOMfundusimages.CONCLUSION:Suchwebeye-PACSincompliancetoWADOprotocolcouldbeusedtostoreandcommunicatefundusimagesandreports,thereforeisofgreatsignificanceforteleophthalmology.
简介:目的:探讨眼附属器B细胞非霍杰金淋巴瘤(B—cellnon-Hodgkinlymphoma,NHL)中Skp2,p27和PTEN的表达。方法:收集1995年到2011年青岛大学附属医院眼科石蜡包埋标本,用免疫组化法分别检测眼附属器B细胞NHL(n=30)标本中Skp2,p27和PTEN的表达,以眼部反应性淋巴组织增生(n=10)作为对照组。以患者的年龄、性别、发病部位,病理类型作为眼附属器B细胞NHL的的分类标准。结果:Skp2,p27和PTEN的表达与患者的年龄、性别、发病部位无关,而与病例类型有关。眼附属器B细胞NHLSkp2表达率与眼部反应性淋巴组织增生相比显著增高。p27,PTEN表达率与反应性淋巴组织增生相比显著降低。随眼附属器B细胞NHL病理分级的提高,Skp2的表达显著增高,p27和PTEN的表达显著降低。在黏膜相关淋巴组织结(mucosa—associatedlymphoidtissue,MALT)外边缘区B细胞淋巴瘤(diffuselargeB—celllymphoma,DLBCL)中,Skp2分别与p27,VFEN成负相关,p27和PTEN成正相关。结论:Skp2的表达升高,p27,PTEN蛋白的缺失以及可能与眼附属器B细胞NHL的发生有关;其中在MALT外边缘区DLBCL中,三种蛋白存在相关性。联合三种蛋白的检测眼附属器B细胞NHL的不同病理类型有重要意义。
简介:目的观察Ex-press青光眼引流器植入术治疗难治性青光眼患者的疗效及安全性。方法选取2015年月—520177月我院难治性青光眼患者74例(74眼),依据治疗方案不同分组,各37例(37眼)。观察组行Ex-press青光眼引流器植入术,对照组行小梁切除术。统计对比两组手术成功率及并发症发生情况。结果观察组手术成功率.49%(32/较对8637)照组59.46%(22/37)高,且并发症发生率18.92%(7/37)较对照组40.54%(15/37)低,差异有统计学意义(P〈0.05)。结论Ex-press青光眼引流器植入术应用于难治性青光眼治疗中,可进一步提高治疗效果,且安全性较高。
简介:AIM:Toinvestigatetheaccuracyofintraocularpressure(IOP)asmeasuredbyaReichertOcularResponseAnalyzer(ORA),aswellastherelationshipbetweencentralcornealthickness(CCT)andIOPasmeasuredbyORA,Goldmannapplanationtonometry(GAT),anddynamiccontourtonometry(DCT).·METHODS:Atotalof158healthyindividuals(296eyes)werechosenrandomlyformeasurementofIOP.AfterCCTwasmeasuredusingA-ultrasound(A-US),IOPwasmeasuredbyORA,GAT,andDCTdevicesinarandomizedorder.TheIOPvaluesacquiredusingeachofthethreetonometrieswerecompared,andtherelationshipbetweenCCTandIOPvalueswereanalyzedseparately.TwoIOPvalues,Goldmann-correlatedIOPvalue(IOPg)andcorneal-compensatedintraocularpressure(IOPcc),weregotusingORA.ThreegroupsweredefinedaccordingtoCCT:1)thincornea(CCT<520μm);2)normal-thicknesscornea(CCT:520-580μm);and3)thickcornea(CCT>580μm)groups.·RESULTS:Innormalsubjects,IOPmeasurementswere14.95±2.99mmHgwithORA(IOPg),15.21±2.77mmHgwithORA(IOPcc),15.22±2.77mmHgwithGAT,and15.49±2.56mmHgwithDCT.Meandifferenceswere0.01±2.29mmHgbetweenIOPccandGAT(P>0.05)and0.28±2.20mmHgbetweenIOPccandDC(P>0.05).TherewasagreatercorrelationbetweenIOPccandDCT(r=0.946,P=0.000)thanthatbetweenIOPccandGAT(r=0.845,P=0.000).DCThadasignificantcorrelationwithGAT(r=0.854,P=0.000).GATwasmoderatelycorrelatedwithCCT(r=0.296,P<0.001),whileIOPccshowedaweakbutsignificantcorrelationwithCCT(r=0.155,P=0.007).TherewasastrongnegativecorrelationbetweenCCTandthedifferencebetweenIOPccandGAT(r=-0.803,P=0.000),withevery10increaseinCCTresultinginanincreaseinthisdifferenceof0.35mmHg.Thethickcorneagroup(CCT>580μm)showedtheleastsignificantcorrelationbetweenIOPccandGAT(r=0.859,P=0.000);whilethethincorneagroup(CCT<520μm)hadthemostsignificantcorrelationbetweenIOPccandGAT(r=0.926,P=0.000).ThecorrelateddifferencesbetweenIOPccan