老年2型糖尿病性白内障的术后疗效评价

目的　探讨白内障现代囊外摘除人工晶体植入术和超声乳化白内障吸除人工晶体植入术治疗老年 2型糖尿病性白内障的疗效。方法　选择老年 2型糖尿病性白内障患者 52例 (59眼 )。 31例 (36眼 )为 ～ 级核 ,采用现代白内障囊外摘除 -后房型人工晶体植入术。 2 1例 (2 3眼 )为 ～ 级核 ,采用超声乳化白内障吸除后房型人工晶体植入术。结果　术后疗效评价采用术前和术后平均裸眼视力等级资料配对秩和检验。结果术后裸眼视力≥ 0 .5者占 54.2 % ,≥ 0 .3者占 94.8%。术前和术后裸眼视力有非常显著差异 (Z=4.70 7,P<0 .0 0 0 1 )。结论　白内障现代囊外摘除人工晶体植入术和超声乳化白内障吸除人工晶体植入术治疗老年 2型糖尿病性白内障疗效肯定 ,94.8%患眼视力改善≥ 0 .3。     

白内障超声乳化摘除并人工晶体植入术的护理体会

1998年以来 ,我院行白内障超声乳化摘除联合后房型人工晶体植入术 4 5 2例。现将护理体会总结如下。临床资料 :本组男 2 14例 ,女 2 38例 ;年龄 3～ 92岁。老年性白内障 30 9例 ,外伤性白内障 112例 ,先天性白内障 19例 ,并发性白内障 12例。患者均行白内障超声乳化摘除术联合后房型人工晶体植入术。术后并发角膜水肿者 37例 ,一般 1周内角膜恢复透明 ,重者 2个月内恢复透明 ;并发虹膜睫状体炎者 5 0例 ,经给予抗生素和皮质类固醇眼水点眼及湿热敷 ,1～ 10天内恢复正常 ;继发性青光眼 8例 ,经降眼压处理 ,眼压稳定。术前护理 :术前应做视力…     

80岁以上白内障患者门诊手术安全性的评价

目的 探讨80岁以上老年人白内障门诊行超声乳化人工晶体植入术的安全性及临床效果。方法 对184例（226眼）80岁以上老年白内障门诊患者行超声乳化人工晶体植入术，观察其安全性、术中、术后并发症及视力恢复等。结果 226眼均安全地在门诊实行手术，术中无严重全身并发症发生。术后3个月198眼（87．6％）视力＞0．5，102眼（45．1％）＞1．0，主要并发症为角膜水肿58眼（26．2％），后囊破裂12眼（5．3％），后囊混浊16眼（7．1％）。结论 80岁以上老年白内障患者门诊行超声乳化人工晶体植入术是安全有效的，关键是术前认真进行眼部及全身状况检查，并作全身疾病的相应处理，手术中减少刺激并尽量减少术后并发症。     

高度近视白内障摘除及后房型人工晶体植入术（附46例报告）

对４６例（５２只眼）高度近视患者施行白内障囊外摘除或超声乳化摘除及后房型人工晶体植入术。治疗结果：眼轴为２６￣３０ｍｍ组中术后矫正视力≥０．５者占９２．５％,眼轴〉３０ｍｍ者则视力恢复差。认为白内障摘除及后房型人工晶体植入术是治疗高度近视白内障的有效方法。     

超声乳化联合人工晶体植入术对急性闭角型青光眼合并白内障的疗效

目的评价伴有白内障的急性闭角型青光眼应用超声乳化白内障摘除联合人工晶体植入术的疗效。方法原发性急性闭角型青光眼合并白内障应用超声乳化白内障吸除联合后房型折叠式人工晶体植入的患者22例30眼,其中临床前期16眼,急性发作期14眼。随访3-12个月。对治疗效果进行分析。结果与术前相比术后矫正视力明显提高(P<0.01);术后眼压较术前下降(P<0.01);临床前期及发作期病人术后中央前房深度(ACD)与术前相比加深(P<0.01);术后房角与术前相比开放范围增大(P<0.01)。结论采用超声乳化白内障摘除联合人工晶状体植入术治疗急性闭角型青光眼,对开放房角、加深前房、解除瞳孔阻滞、控制眼压、有效提高视力有一定作用。     

80岁及以上患者老年性白內障超声乳化的疗效及安全性

目的 探讨80岁及以上患者老年性白内障超声乳化吸除及人工晶状体植入术的疗效及安全性。方法 将95例(10O只眼)80～96岁的老年性白内障患者定为高龄老年组，经角膜缘隧道切口进行超声乳化吸除及人工晶状体植入术，同期收治665例(671眼)60～79岁老年性白内障患者定为低龄老年组，使用相同的手术方法作对照。结果 高龄老年组术后第1天、1周和1个月视力达到或超过0．5者分别是30只眼、52只眼、74只眼。两组患者术后随访时间3个月～3年，随访时的视力达到0．5以上高龄老年组患者82只眼(82．0％)，低龄老年组583只眼(86．9％)。并发症主要有后囊膜破裂、玻璃体脱出、晶状体核碎块脱位、角膜水肿、后囊膜混浊。结论 高龄与低龄老年性白内障经超声乳化吸除及人工晶状体植入术均有较好的疗效及安全性。     

80岁以上老年人表面麻醉下白内障超声乳化及人工晶体植入术评价

我们于 1999年 9月至 2 0 0 2年 9月在表面麻醉下 ,对6 0 6例 (6 2 3眼 )老年白内障患者行白内障超声乳化吸出晶体和联合人工晶体植入术 ,并进行术中和术后观察 ,旨在探讨表面麻醉止痛效果及对高龄老年人术后视力的影响。　　一、对象和方法　　 1.对象 :6 0 6例 (6 2 3眼 )中 ,观察组 96例 (10 2眼 ) ,年龄80～ 87岁 ,平均 (77 4± 5 5 )岁 ,其中男性 5 6例 (6 0眼 ) ,女性 4 0例 (4 2眼 ) ,术前视力为光感～ 0 2 ;对照组 :5 10例(5 2 1眼 ) ,年龄 6 0～ 79岁 ,平均 (6 9 3± 7 1)岁 ,男性 2 90例(2 99眼 ) ,女性 2 2 0例 (2 2 2眼 ) ,视…     

表面麻醉下糖尿病患者白内障超声乳化手术52例临床观察

目的　探讨表面麻醉下糖尿病患者白内障超声乳化联合人工晶体植入术的临床效果。方法　临床确认空腹血糖控制在10 mmol/L以下的糖尿病患者52例（59眼）,经表面麻醉进行白内障超声乳化联合人工晶体植入术,观察其术后视力的恢复及并发症的情况。结果　表面麻醉成功率为100%,术后1 d视力≥0.5者30眼（50.85%）,术后1 w视力≥0.5者45眼（76.27%）,术中及术后并发症的发生率均很低。结论　表面麻醉下糖尿病患者的白内障超声乳化联合人工晶体植入术是安全有效的。     

老年高度近视患者白内障超声乳化临床观察

白内障超声乳化及人工晶体植入术具有对组织创伤小、术后视力恢复快、散光轻等优点 [1] ,眼科临床应用广泛。老年高度近视白内障患者具有特殊性 ,现将我们对 48例老年白内障患者施行超声乳化手术的体会介绍如下。1　临床资料1 .1　一般资料　本组患者 48例 (5 7眼 ) ,其中男 3 5例 ,女 1 3例 ;年龄 6 0～ 74岁 ,平均 6 5 .3岁。眼轴长度2 6 .0 2～ 3 2 .4mm,平均 2 7.1 mm;按 Locs 分级标准 级核 7眼 , 级核 2 4眼 , 级核 2 6眼 ;术前视力为0 .0 6～ 0 .3。1 .2　人工晶体度数的选择　术前测量角膜曲率和眼轴 ,根据 SRK 三元回归公式软件…     

小切口非超声乳化与超声乳化治疗老年性白内障疗效比较

目的 比较小切口非超声乳化与超声乳化治疗老年性白内障疗效.方法 对近期152例170眼老年性白内障患者,年龄61～78(平均68)岁,分别行该两种手术,并进行回顾性总结分析.结果 小切口非超声乳化白内障摘除术及人工晶体植入术与超声乳化白内障摘除术及人工晶体植入术1 w后的术后视力水平、散光程度、角膜中央厚度以及角膜内皮水肿程度相比无显著差异.结论 小切口非超声乳化与超声乳化治疗老年性白内障疗效相似.     

Three layer functional model and energy exchange concept of aging process

Relying on a certain degree of abstraction, we can propose that no particular distinction exists between animate or living matter and inanimate matter. While focusing attention on some specifics, the dividing line between the two can be drawn. The most apparent distinction is in the level of structural and functional organization with the dissimilar streams of ‘energy flow’ between the observed entity and the surrounding environment. In essence, living matter is created from inanimate matter which is organized to contain internal intense energy processes and maintain lower intensity energy exchange processes with the environment. Taking internal and external energy processes into account, we contend in this paper that living matter can be referred to as matter of dissipative structure, with this structure assumed to be a common quality of all living creatures and living matter in general. Interruption of internal energy conversion processes and terminating the controlled energy exchange with the environment leads to degeneration of dissipative structure and reduction of the same to inanimate matter, (gas, liquid and/or solid inanimate substances), and ultimately what can be called ‘death.’ This concept of what we call dissipative nature can be extended from living organisms to social groups of animals, to mankind. An analogy based on the organization of matter provides a basis for a functional model of living entities. The models relies on the parallels among the three central structures of any cell (nucleus, cytoplasm and outer membrane) and the human body (central organs, body fluids along with the connective tissues, and external skin integument). This three-part structural organization may be observed almost universally in nature. It can be observed from the atomic structure to the planetary and intergalactic organizations. This similarity is corroborated by the membrane theory applied to living organisms. According to the energy nature of living matter and the proposed functional model, the decreased integrity of a human body's external envelope membrane is a first cause of the structural degradation and aging of the entire organism. The aging process than progresses externally to internally, as in single cell organisms, suggesting that much of the efforts towards the restoration and maintenance of the mechanisms responsible for structural development should be focused accordingly, on the membrane, i.e., the skin. Numerous reports indicate that all parts of the human body, like: bones, blood with blood vessels, muscles, skin, and so on, have some ability for restoration. Therefore, actual revival of not only aging tissue of the human body's membrane, but the entire human body enclosed within, with all internal organs, might be expected. We assess several aging theories within the context of our model and provide suggestions on how to activate the body's own anti-aging mechanisms and increase longevity. This paper presents some analogies and some distinctions that exist between the living dissipative structure matter and inanimate matter, discusses the aging process and proposes certain aging reversal solutions.     

Unusual responses of nocturnal pineal melatonin synthesis and secretion to swimming: Attempts to define mechanisms

Abstract: The effect of swimming at night on rat pineal melatonin synthesis was compared with that of light exposure at night. Rats were forced to swim at 0030 hr (lights out at 2000 hr) and sacrificed by decapitation 15 and 30 min later, immediately after swimming. Other groups of animals were exposed to white light (650μW/cm²) for 15 and 30 min at same time. Swimming caused a rapid and highly significant drop in the melatonin content in the pineal gland; however, the activity of N-acetyltransferase (NAT), the supposed rate limiting enzyme in the melatonin production, was not changed. Despite the drop in pineal melatonin levels, serum concentrations of the indole remained elevated in the rats that swam. In contrast, melatonin levels in the pineal and serum of light exposed rats fell precipitously, accompanied by a significant suppression of NAT activity. Since we anticipated that the strenuous exercise associated with swimming may induce release of artrial natriuretic peptide (ANP) from the heart, which in turn could cause the release of pineal melatonin, in a second study we injected physiological saline intravenously to stretch the cardiac muscle and release ANP. Three milliliters of normal saline was injected during the day into the jugular vein of anesthetized rats that were pretreated with isoproterenol to stimulate pineal melatonin production. Animals were killed 15 min after the saline injection, and pineal NAT activity and pineal melatonin levels were measured. The saline injections caused no alteration in the elevated levels of either NAT or melatonin. These data suggest that the disparity in pineal NAT activity (which was high) and pineal melatonin (which was low), in animals swum at night, may not be caused by ANP which is released during strenuous exercise such as swimming.     

Melatonin and photoperiodic time measurement: Seasonal breeding in the sheep

Abstract: Well-established circadian physiology supports the view that photoperiodic time measurement utilizes the coincidence between the presence of light and a photosensitive phase of a 'biological clock' to alter reproductive status—the so-called external coincidence model of seasonal breeding. In this review, we examine the mechanism whereby photoperiod interacts with presumed suprachiasmatic nuclei activity to allow endogenous melatonin to normally synchronize reproductive activity to the optimal time of year. The Romney Marsh sheep is particularly explored as an experimental model. It is suggested that the on/off activity of seasonal reproduction may be a robust mechanism able to be predictably manipulated by the judicious use of the light/dark cycle and exogenous melatonin, but firmly based on circadian principles.     

The immunoneuroendocrine role of melatonin

Abstract: A tight, physiological link between the pineal gland and the immune system is emerging from a series of experimental studies. This link might reflect the evolutionary connection between self-recognition and reproduction. Pinealectomy or other experimental methods which inhibit melatonin synthesis and secretion induce a state of immunodepression which is counteracted by melatonin. In general, melatonin seems to have an immunoenhancing effect that is particularly apparent in immunodepressive states. The negative effect of acute stress or immunosuppressive pharmacological treatments on various immune parameters are counteracted by melatonin. It seems important to note that one of the main targets of melatonin is the thymus, i.e., the central organ of the immune system. The clinical use of melatonin as an immunotherapeutic agent seems promising in primary and secondary immunodeficiencies as well as in cancer immunotherapy. The immunoenhancing action of melatonin seems to be mediated by T-helper cell-derived opioid peptides as well as by lymphokines and, perhaps, by pituitary hormones. Melatonin-induced-immuno-opioids (MHO) and lymphokines imply the presence of specific binding sites or melatonin receptors on cells of the immune system. On the other hand, lymphokines such as -γ-interferon and interleukin-2 as well as thymic hormones can modulate the synthesis of melatonin in the pineal gland. The pineal gland might thus be viewed as the crux of a sophisticated immunoneuroendocrine network which functions as an unconscious, diffuse sensory organ.     

Serological survey of HIV and syphilis in pregnant women in Madagascar

Objectives Peripartal transmission of human immunodeficiency virus (HIV) and Treponema pallidum, the causative agent of syphilis, leads to severe consequences for newborns. Preventive measures require awareness of the maternal infection. Although HIV and syphilis testing in Madagascar could be theoretically carried out within the framework of the national pregnancy follow‐up scheme, the required test kits are rarely available at peripheral health centres. In this study, we screened blood samples of pregnant Madagascan women for HIV and syphilis seroprevalence to estimate the demand for systemic screening in pregnancy. Methods Retrospective anonymous serological analysis for HIV and syphilis was performed in plasma samples from 1232 pregnant women that were taken between May and July 2010 in Ambositra, Ifanadiana, Manakara, Mananjary, Moramanga and Tsiroanomandidy (Madagascar) during pregnancy follow‐up. Screening was based on Treponema pallidum haemagglutination tests for syphilis and rapid tests for HIV, with confirmation of positive screening results on line assays. Results Out of 1232 pregnant women, none were seropositive for HIV and 37 (3%) were seropositive for Treponema pallidum. Conclusions Our findings are in line with previous studies that describe considerable syphilis prevalence in the rural Madagascan population. The results suggest a need for screening to prevent peripartal Treponema pallidum transmission, while HIV is still rare. If they are known, Treponema pallidum infections can be easily, safely and inexpensively treated even in pregnancy to reduce the risk of transmission.     

Response of rat pineal melatonin to calcium, magnesium, and lithium is circadian stage dependent

Abstract: Herein we documented the response of pineal melatonin production to electrolytes known to be effective on pineal function in view of a possible circadian stage dependence. We studied the release of melatonin by perifused rat pineal glands at 2 different circadian stages corresponding to the middle of the light and dark periods, i.e., respectively, 7 and 19 HALO (Hours After Light Onset, L:D = 12:12). The initial efflux rates were, as expected, much higher in the perifusates of glands removed from rats sacrificed during the dark phase than of those removed during the light phase. After 3 hr of perifusion, melatonin release reached similar levels which were found constant up to the 8th hr of perifusion, whatever the circadian stage. Perifusion of the glands with physiological concentrations for the rat of calcium (5.2 mmol/1) and magnesium (1.34 mmol/1) resulted in a stimulatory effect on the pineal glands removed from rats sacrificed in the middle of the dark period (19 HALO), whereas no effects were observed on the pineal glands removed from rats sacrificed during the light (7 HALO). Lithium (0.28 and 0.55 mmol/1) was ineffective on melatonin release in pineal glands removed 7 and 19 HALO. Our results show differences in the initial efflux rates of melatonin and in the response of perifused pineal glands to calcium and magnesium according to the circadian stage.