简介：~~

简介：<正>DearSir,IamDr.Zhong-ShanChenfromtheDepartmentofOphthalmology,WuhanGeneralHospitalofGuangzhouMilitaryCommand,HubeiProvince,China.Iwritetopresenttwocaseswithserpiginouschoroiditis(SC)whichisarare,usuallybilateral,chronic,progressiveinflammationofthechoroid,choriocapillarisandretinalpigmentepithelium.InthispaperwepresentedthedifferentoutcomesofSCpatientswithorwithoutsystemicandoculartreatmentsafterlong-termfollow-up.

简介：·AIM:Toinvestigatethetherapeuticeffectsofnanophtha-locyaninephotosensitizersonanexperimentalratchoroidalneovescularization(CNV)model,aswellastoevaluatethecytotoxicityofwhichonhumanretinalpigmentepithelia(HRPE)andhumanretinalendothelialcells(HRECs).·METHODS:Twotypesofphotosensitizers,G1-ZnPc(COOH)8andG1-ZnPc(COOH)8/mrespectively,wereadministratedforphotodynamictherapy(PDT)afterasuccessfulestablishmentofCNVmodelonBrown-Norway(BN)ratsviafundusphotocoagulation.Thetherapeuticeffectsofthetwodrugswereassessedthroughopticalcoherencetomography(OCT),fluoresceinfundusangiography(FFA)andtransmissionelectronmicroscopy(TEM).Forcytotoxicitytests,cellcountingkit-8(CCK-8)assaysandchangesofmitochondrialtransmembranepotential(△Ψm)wereconductedonHRPEandHRECsafterinitialuptakeofthetwodrugs.·RESULTS:Bothphotosensitizersdemonstratedanimprove-mentofvascularleakageandclosureofCNV1weekafterPDTasconfirmedbyfundusimage,OCT,FFAandTEM.TwoweeksafterPDT,G1-ZnPc(COOH)8/mshowedabetterCNVclosureeffectversusG1-ZnPc(COOH)8(P<0.05).Asignificantdifference(P<0.01)wasfoundinuptakeofthetwodrugsinHRPEandHRECs,withnodifferencebetweenthedrugs(P>0.05).BothphotosensitizersshowedcytotoxicityonHRPE,butG1-ZnPc(COOH)8/minducedalowercellviability.·CONCLUSION:G1-ZnPc(COOH)8/mmediatedPDTisbetterthanG1-ZnPc(COOH)8inCNVclosureandalsohavetheadvantageoffastmetabolismleadingtolesssideeffect.·

简介：质量是一个难以描述及定义的概念。人们对质量的评定各有不同的见解。拿出租车旅行来打个比方。你如何评定旅行的质量？你的评定时基于司机是否有礼貌还是车子的豪华程度？或者以你安全到达目的地为标准？如果让你的司机来评价同样一场旅行的质量，他们可能认为旅途中没有抛锚或没有被交通事故耽搁就是好。评定质量有很多不同的标准，以那一点为准取决于你的角色。

简介：生物力学是研究组织或器官的力量与功能之间关系的学科，对研究眼科疾病的预防、发生、发展、诊疗具有重要作用。眼球是一个封闭的近似球体的器官，眼球内外的每一组织都有一定张力，而且相互联系，互为影响。眼内外及球壁某一局部组织的改变，可能会影响眼球某一区域组织的生物力学或功能的改变。随着生物力学的方法增多，大家越来越重视对眼部组织生物力学的研究，达到预防和治疗眼部疾病的目的。如使用胶原交联增强角膜的强度，防治圆锥角膜或扩张性角膜疾病；又如后巩膜加固术增强巩膜力学的方法来治疗或预防高度近视等。对眼外肌、角膜、巩膜、虹膜、晶状体的生物力学的研究是目前热点，本文就目前眼部生物力学的研究热点做一综述。

简介：目的探讨老年性聋临床听力表现特点。方法选用41例老年性聋患者进行纯音测听检查和言语测听检查（言语识别阈，言语识别率和合成语句检查）。结果纯音听力图以高频缓降和高频陡降为主。静态下言语识别率和合成语句检查得分均高于噪声下言语识别率和竞争声合成语句检查，差异有显著性意义（P〈0．01）。老年性聋纯音听力损害程度与言语识别率不完全一致。结论老年性聋患者不仅有耳蜗、听神经受损和退变，更有中枢分辨能力的蜕化。

简介：AIM:Toinvestigatethespecialtyoftranscranialsurgerythroughpterionalapproachforremovalofcranio-orbitaltumors,introducetheophthalmologicalexperiencesofenteringtheorbittoreducetheincidencerateofassociatedcomplicationsofthisoperation.·METHODS:Weperformedaretrospectiveanalysisofaseriesof37casesinvolvingpatientswhounderwenttranscranialsurgerythroughpterionalapproachfortreatmentofcranio-orbitaltumorsinourdepartmentinthepast8years.Pterionapproachcraniotomywasperformedtoallpatients.Afterremovingtumorsintheskullbytheneurosurgeon,ophthalmologistremovedtumorsinorbit.Wetookmeasuresbelowtodecreasecomplications,includinggroundingopticcanalthroughanabrasivedrillingwhennecessary,hangingvariousextraocularmusclestobeexposedforprotection,refrigeratingbyrefrigerationheadstoremovetumors,atlastsewinguporbitseptumaftersurgery.·RESULTS:Tumorswereremovedcompletelyin32cases,andincompletein5casesduetoextensiveinvasionintothecavernoussinusorsphenoidsinus.Ofallthecases,benigntumorsweredemonstratedin28cases(75.6%,28/37)andmalignantin9(24.3%,9/37).Themostcommonlesiontypewasmeningiomain11cases(29.7%,11/37).Extraocularmuscles(EOM)impairment,occurringin21cases(56.7%,21/37),wasthemostfrequentpostoperativecomplication.Themostseriousconsequencewasvisionlossoccurredin4cases(10.8%,4/37).Othercomplications,suchas11casesoftransientblepharoptosis29.7%(11/37),5casesofmydriasisin13.5%(5/7);2casesofcerebrospinalrhinorrheain5.4%(2/37).·CONCLUSION:Cranio-orbitaltumorscanberemovedcompletelyusingtranscranialapproach,andthepterionalapproachoffersexcellentexposure.Cooperationofinterdisciplinaryteamofneurosurgeonsandophthalmologistsconducestofulluseofrespectiveprofessionaladvantages.Theexperienceofophthalmicoperationtechnologycandecreaseoccurrenceofocularcomplicationsaftersurger

简介：AIM:Toevaluatetheeffectsandsafetyofphacoemu-lsification(Phaco)orsmall-incisionextracapsularcataractsurgery(SICS)andintraocularlens(IOL)implantationforagedpatients.METHODS:Totally137agedpatients(149eyes)underwentcataractoperationinthecaseofstablesystemiccondition,thebloodpressurelessthan160/95mmHg,bloodglucoselessthan8mmol/L,andunderthehelpofelectrocardiogramsurveillancebyanesthesiologistsduringtheoperation.106agedpatients(114eyes)underwentPhacowhile31agedpatients(35eyes)underwentSICS.Thepostoperativevisualacuity,cornealendothelialcellloss,surgerytimeandmajorcomplicationswereobservedandanalyzedretrospectively.RESULTS:Thebest-correctedvisualacuity(BCVA)of≥0.6wasachievedin135eyes(92.6%)at1monthpostoperatively(χ2=259.730,P<0.001).Foragedpatients,bothPhacoandSICScouldsignificantlyimprovevisualacuitywithnosignificantdifference(χ2=4.535,P>0.05).Postoperativecornealendothelialcelllosswas18.6%,inPHACOgroup,theratewas18.5%;inSICSgroup,theratewas19.0%,thedifferenceofwhichwasnosignificant(χ2=0.102,P>0.05).Thesurgerytimewasdifferentintwogroups.Noseverecomplicationsoccurred.CONCLUSION:BothPhacoandSICScombinedwithIOLimplantationforagedpatientsareeffectiveandsafe.Beforesurgery,detailedphysicalexaminationshouldbeperformed.Whenthesystemicconditionisstable,cataractsurgeryforagedpatientsissafe.

简介：目的：分析婴幼儿泪囊炎患者的主要致病菌和药物敏感性,为临床合理用药提供依据。方法：采集83例86眼婴幼儿泪囊炎患者的泪囊分泌物进行细菌培养和药敏试验分析。结果：患者86眼中,84眼细菌培养阳性,阳性率为97.7%,共分离出细菌94株,其中革兰氏阳性菌67株,占71.3%,革兰氏阳性菌的前三位敏感药物为利福平、左氧氟沙星、氯霉素;革兰氏阴性菌27株,占28.7%,革兰氏阴性菌前三位敏感药物为左氧氟沙星、氯霉素、夫西地酸、头孢他啶。结论：G＋菌为婴幼儿泪囊炎的优势致病菌,其中以草绿色链球菌和表皮葡萄球菌最常见。G＋菌较G-菌耐药性高,左氧氟沙星、氯霉素等治疗婴幼儿泪囊炎有效。

简介：目的：研究及观察视神经萎缩患者球后动脉血流动力学及球结膜微循环指标的变化情况。方法：选取2013-04/2014-10于本院进行诊治的70例视神经萎缩患者为观察组,同时期的70名健康同龄人员为对照组,然后将两组的球后动脉血流动力学及球结膜微循环指标进行比较,并比较观察组中不同分类及严重程度患者的上述检测指标。结果：观察组的球后动脉血流动力学及球结膜微循环指标均差于对照组,且观察组中重度患者的检测结果差于轻度及中度患者,中度患者的检测结果则差于轻度患者,均有显著性差异（P〈0.05）,而不同分类患者之间的检测结果则无显著性差异（P〉0.05）。结论：视神经萎缩患者球后动脉血流动力学及球结膜微循环指标的变化较大,且本病患者的检测结果受疾病严重程度的影响较大。

简介：目的：探讨可视化角膜生物力学分析仪（CorvisST）测量正常角膜、顿挫期圆锥角膜、亚临床期圆锥角膜、临床期圆锥角膜的生物力学变化,分析不同进展期圆锥角膜生物力学特征,为更早期地诊断圆锥角膜提供临床依据。方法：病例对照研究。选取顿挫期圆锥角膜15眼为顿挫组,亚临床期圆锥角膜23眼为亚临床期组,临床期圆锥角膜40眼为圆锥角膜组,欲行近视激光手术和正常角膜志愿者40眼为正常组（对照组）,应用CorvisST测定各组的生物力学参数,并进行比较分析,绘制受试者工作曲线（ROC）。结果：正常角膜与顿挫期圆锥角膜生物力学各参数差异均无统计学意义（P〉0.05）。正常角膜与亚临床期组第二压平长度（AL2）、第一压平速率（AV1）、最大压陷曲率半径（HC-radius）、最大压陷深度（DA）间的差异有统计学意义（P〈0.05）。正常角膜与圆锥角膜组除第二压平速度（AV2）、最大压陷时间（HC-time）、最大压陷屈膝峰间距（PD）差异无统计学意义外,其余生物力学数据差异均有统计学意义（P〈0.05）,ROC曲线分析DA对于圆锥角膜诊断效率最高（曲线下面积0.891±0.028）。结论：顿挫期圆锥角膜生物力学较正常角膜无改变,亚临床期圆锥角膜生物力学较正常角膜部分参数有改变,但其参数单独诊断圆锥角膜特异性和敏感性均较差。临床期圆锥角膜生物力学较正常角膜明显改变,DA诊断效率最高。

简介：板层角膜移植术常用于治疗角膜病变,可分为前板层角膜移植术、中间板层移植术和后板层角膜移植术.其中后板层角膜移植术是近年来发展较快的手术方式.板层角膜移植的供体也有多种类型,各有其特点,人工角膜和异种角膜的应用仍需要进一步的研究.

简介：目的观察在全身麻醉鼓室成形术前行手术区域利多卡因局部浸润对于术中血流动力学稳定及术后镇痛的效果。方法将60例拟在全身麻醉下行鼓室成形术的患者随机分为2组（n=30）,L组在全身麻醉诱导完成后于手术区域（耳后手术切口及耳道内）行1%利多卡因混合1∶20万肾上腺素10mL多点浸润注射;N组在全身麻醉诱导完成后于手术区域行0.9%生理盐水混合1∶20万肾上腺素10mL多点浸润注射。2组患者麻醉方法相同,记录患者全身麻醉诱导完毕即刻（T1）、切皮时（T2）、耳腔成形时（T3）、出麻醉后监测治疗室（PACU）时（T4）和术后6h（T5）的平均动脉压（MAP）及心率。记录患者PACU内的苏醒时间、镇静评分（Ramesay评分）,记录患者T4和T5的疼痛程度（视觉模拟评分）。结果在T2、T3及T4,L组MAP和心率显著低于N组（P〈0.05）。术后6h2组患者的MAP、心率差异无统计学意义（P值分别为0.143、0.094）。在PACU内,L组Ramesay评分高于N组（P=0.009）。T4、T5的镇痛评分L组显著低于N组（P值分别为0.0002、0.043）。结论全身麻醉鼓室成形术前行手术区域利多卡因局部浸润可明显改善围术期由于创伤应激引起的血流动力学波动,同时减轻患者术后疼痛。

简介：目的：探讨糖尿病患者黄斑中心凹下脉络膜厚度（SFCT）与脉络膜血流动力学指数及糖化血红蛋白之间的关系。方法：选择在我院眼科及内分泌科住院治疗的2型糖尿病患者78例156眼作为研究对象。其中男39例,女39例,平均（59.8±6.2）岁。根据ETDRS糖尿病视网膜病变分级方法,将患者分为无视网膜病变组、轻中度NPDR组、重度NPDR组、PDR组。采用EDI-OCT与超声多普勒对四组患者进行脉络膜厚度测量与脉络膜血流动力学指数测量。并记录所有患者的血糖化血红蛋白含量。采用多元线性回归分析SFCT与血流动力学指数与糖化血红蛋白的相关性。结果：NDR患者组舒张末期血流速度（EDV）明显高于其它患者组,SFCT较其它各组偏薄,差异有统计学意义。四组患者收缩期峰值血流速度（PSV）无统计学差异;重度NPDR组血管阻力指数（RI）高于NDR组及轻中度NPDR组;PDR组RI进一步增高,差异有统计学意义。SFCT与糖化血红蛋白有显著正相关性（b=0.540,P〈0.001）;SFCT与DR分级（P=0.341）、PSV（P=0.770）、EDV（P=0.131）及RI（P=0.084）无显著相关性。结论：糖尿病患者SFCT与血流动力学各指数无相关性。糖化血红蛋白是糖尿病患者SFCT的影响因素之一。

简介：目的制备左氧氟沙星热敏型耳用凝胶，并对其体外释放性能进行检测。方法制备以泊洛沙姆407为基质的左氧氟沙星热敏性耳用凝胶，根据中耳温度筛选泊洛沙姆407的最佳处方浓度，采用立式Franz扩散池模型对该制剂的体外释放性能进行研究。结果左氧氟沙星检测浓度的线性范围为3．0～10．5mg／L，在此浓度范围内吸光度（A）和浓度（c）呈良好的线性关系，即C（mg／L）=12．582A＋0．2976（r=0．9986，n=6）；平均回收率为100．09％，相对标准偏差（RSD）=0．61％（n=6）；泊洛沙姆407在处方中的最佳浓度为17％；药物释放具有一定的控释性，释放符合零级动力学特征。结论该耳用热敏型凝胶具有较好的控释性能，且制备方法简单，用药剂量易于控制。

简介：AIM:Toevaluatetheefficacyandsafetyoftrabeculectomy,phacotrabeculectomyplusintraocularlensimplantation(phacotrab+IOLgroup)andphacoemulsificationwithIOL(phaco+IOL)inprimaryangle-closureglaucoma(PACG).METHODS:Itwasasystematicreviewandmeta-analysis,randomizedcontrolledtrials(RCT)andclinicalcontrolledtrials(CCT)werecollectedthroughelectronicsearchesoftheCochraneLibrary,PubMed,EMbase,WanfangDatabaseonline,ChinesejournalFull-textDatabase,ChineseScientificJournalsFull-textDatabase(fromthedateofbuildingthedatabasetoOctober2010)Wealsocheckedthebibliographiesofretrievedarticles.Alltherelateddatathatmatchedourstandardswereabstracted.ThequalityofincludedtrialswasevaluatedaccordingtotheDutchCochraneCentre.RevMan5.0softwarewasusedforMeta-analysis.RESULTS:Atotalof5RCTand11CCTinvolving1495eyeswereincluded.Theresultsofmeta-analysisshowedthatphacotrab+IOLgroupwassuperiorthantrabeculectomy(trabgroup)(MD-3.93,95%CI[-7.31,-0.54])whichwasalsosuperiorthanphaco+IOLgroup(MD0.52,95%CI[0.10,0.95])indecreasingIntraocularPressure(IOP).Phacotrabgroup(MD-1.45,95%CI[-1.68,-1.22])andphacogroup(MD-1.12,95%CI[-1.87,-0.37])arebothdeeperthantrabgroupintheanteriorchamberdepth.Inincreasingthecoefficientofoutflowfacilityofaqueoushumor(Cvalues)therewasnostatisticaldifferenceinthethreegroups.Andtherewasnostatisticaldifferencebetweenphacotrabgroupsandphacogroupsinvisualacuitybutphacotrabgroupwassuperiorthanphacogroup(MD1.07,95%CI[0.73,1.40])intheuseofIOP-loweringdrugs.Therewasnostatisticaldifferenceamongthreegroups.CONCLUSION:Currentevidencesuggeststhatphacotrab+IOLgroupwassuperiorthantrabgroupwhichwasalsosuperiorthanphaco+IOLgroupindecreasingIOP.Phacotrabgroupandphacogrouparebothdeeperthantrabgroupintheanteriorchamberdepth.PhacotrabgroupwassuperiorthanphacogroupintheuseofIOP-loweringdrugs.

简介：AIM:Toreporttheeffectivenessandsafetyofprimary23-Gauge(G)vitreoretinalsurgeryforrhegmatogenousretinaldetachment(RRD).·METHODS:Inthisretrospectivestudy,49eyesof49consecutivepatientswhounderwentprimary23-Gtransconjunctivalsuturelessvitrectomy(TSV)forRRDbetweenJanuary2007andJuly2009atourinstitutionwereevaluated.·RESULTS:Meanfollow-uptimewas8.9±7.7months(1-28months).Retinalreattachmentwasachievedwithasingleoperationin47(95.9%)of49eyes.Intwoeyes(4.1%),retinalredetachmentduetonewbreakswassuccessfullytreatedwithreoperationusingthe23-GTSVsystem.MeanlogMARvisualacuitywas2.01±0.47preoperativelyand1.3±0.5postoperatively(P<0.001,Pairedt-test).Meanpreoperativeintraocularpressure(IOP)was14.1±2.8mmHg.MeanpostoperativeIOPwas12.3±3.6mmHgat1day,13.1±2.1mmHgat1week,14.3±2.2mmHgat1month.Iatrogenicperipheralretinalbreakwasobservedin1eye(2.0%)intraoperatively.Nosutureswererequiredtoclosethescleralorconjunctivalopenings,andnoeyesrequiredconvertionofsurgeryto20-Gvitrectomy.·CONCLUSION:Primary23-GTSVsystemwasobservedtobeeffectiveandsafeinthetreatmentofRRD.

简介：AIM:ToinvestigatetheroleofRho-associatedproteinkinase(ROCK)inhibitor,Y27632,inmediatingtheproductionofextracellularmatrix(ECM)componentsincludingfibronectin,matrixmetallo-proteinase-2(MMP-2)andtypeIcollagenasinducedbyconnectivetissuegrowthfactor(CTGF)ortransforminggrowthfactor-β(TGF-β)inahumanretinalpigmentepithelialcellline,ARPE-19.METHODS:TheeffectofY27632ontheCTGForTGF-βinducedphenotypeinARPE-19cellswasmeasuredwithimmunocytochemistryasthechangeinF-actin.ARPE-19cellsweretreatedwithCTGF(1,10,100ng/mL)andTGF-β(10ng/mL)inserumfreemedia,andanalyzedforfibronectin,laminin,andMMP-2andtypeIcollagenbyRT-qPCRandimmunocytochemistry.CellswerealsopretreatedwithanROCKinhibitor,Y27632,toanalyzethesignalingcontributingtoECMproduction.·RESULTS:TreatmentofARPE-19cellsinculturewithTGF-βorCTGFinducedanECMchangefromacobblestonemorphologytoamoreelongatedswirlpatternindicatingamesenchymalphenotype.RT-qPCRanalysisanddifferentgeneexpressionanalysisdemonstratedanupregulationinexpressionofgenesassociatedwithcytoskeletalstructureandmotility.CTGForTGF-βsignificantlyincreasedexpressionoffibronectinmRNA(P=0.006,P=0.003respectively),lamininmRNA(P=0.006,P=0.005),MMP-2mRNA(P=0.006,P=0.001),COL1A1mRNA(P=0.001,P=0.001),COL1A2mRNA(P=0.001,P=0.001).PreincubationofARPE-19withY27632(10mmol/L)significantlypreventedCTGForTGF-βinducedfibronectin(P=0.005,P=0.003respectively),MMP-2(P=0.003,P=0.002),COL1A1(P=0.006,P=0.003),andCOL1A2(P=0.006,P=0.004)geneexpression,butnotlaminin(P=0.375,P=0.516).CONCLUSION:OurstudydemonstratedthatbothTGF-βandCTGFupregulatetheexpressionofECMcomponentsincludingfibronectin,laminin,MMP-2andtypeIcollagenbyactivatingtheRhoA/ROCKsignalingpathway.Duringthisprocess,ARPE-19cellswereshowntochangefromanepithelialtoamesenchymalphenotypeinvi

简介：目的探讨脑干听觉诱发电位(brainstemaudioevokedpotential,BAEP)在婴儿耳聋早期诊断的应用价值.方法500例婴儿从出生到6wk内耳声发射(otoacousticemissions,OAE)3次未通过者,拟诊耳聋的患儿进行听阈及BAEP检查.如听阈在65dBSPL以上或BAEP异常者,1～2个月后来复查.如患儿月龄在6-12个月以上,听阈仍在65dBSPL以上者就进行干预及治疗.结果1000耳中正常98耳、轻度耳聋515耳、中度耳聋234耳、重度耳聋80耳、极聋72耳.1～2个月后来复查的有754耳,正常的占233耳、轻度耳聋271耳、中度耳聋203耳、重度耳聋23耳、极度耳聋24耳.与首次比较差异有显著性(P＜0.01).结论BAEP检查可以检测婴幼儿听力损害的程度,及跟踪随访,并早期干预,早期治疗及早期语言训练成为可能,使患儿聋而不哑.

简介：目的探讨手法小切口白内障摘除术中后囊膜破裂的原因以及术中的处理方法。方法对22例22眼手法小切口白内障摘除术中后囊膜破裂的原因及处理方法进行回顾性总结。结果发生后囊膜破裂22例22眼,除1例未植入人工晶体外,一期植入人工晶体21例,占95.45%,术后视力0.5以上8眼,无严重并发症发生。结论手法小切口白内障摘除术中后囊膜破裂虽然难以避免,但只要处理措施得当,完全可以取得满意的手术效果,避免严重并发症的发生,并使患者获得良好的视功能。