外伤眼玻璃体切割手术中驱逐性脉络膜上腔出血的临床观察

驱逐性脉络膜上腔出血是内眼手术中较为少见、但最为严重的并发症，它可导致患者视功能丧失和眼球萎缩。玻璃体切割手术是近年来眼科发展最迅速的内眼手术之一，手术中发生脉络膜上腔出血的危险因素主要是老年人、全身心血管疾病（高血压、糖尿病）、近视眼、青光眼、眼内炎症等。我院近年实施的玻璃体切割手术患者中，5例眼外伤患者在手术中发生了脉络膜上腔出血，现将其临床特征报道如下。     

先锋必对兔眼视网膜的毒性实验研究

为探讨先锋必对视网膜的毒性作用和评估玻璃体内注射先锋必的安全剂量,采用眼底镜观察及光镜、电镜技术对注射3种不同剂量先锋必的兔视网膜标本进行观察。结果：5～10mg先锋必注射后兔眼视网膜未发现明显异常,20mg剂量注射后视网膜损伤仅局限光感受器外节。提示玻璃体腔注射先锋必的安全剂量5～10mg。     

糖尿病性视网膜病患者的光学视觉质量分析

目的：利用双通道视觉质量分析系统（OQASTMⅡ）对糖尿病性视网膜病（DR）患者的光学视觉质量进行评估,探讨DR的疾病严重程度对光学视觉质量的影响以及视网膜病变对光学质量的影响。方法：在此次研究中分为4组：1组（31只眼）,无糖尿病（DM）或DR;2组（31只眼）,有DM但无DR;3组（31只眼）,轻度至中度非增殖期糖尿病性视网膜病（NPDR）;4组（31只眼）,重度NPDR;共纳入124例124只眼。所有患者受试眼接受裂隙灯、散瞳眼底镜检查、超广角激光扫描眼底镜检查、黄斑光学相干断层扫描和血红蛋白A1c水平（HbA1c）检查。用OQASTMⅡ测量客观散射指数（OSI）、斯特列尔比（SR）、调制传递函数截止频率（MTF cutoff）,分析DR不同疾病严重程度的光学视觉质量的变化,分析OSI、MTF cutoff、SR与糖尿病病程、HbA1c水平的相关性。结果：四组患者的OSI、SR、MTF cutoff差异有统计学意义（P<0.001),且组间两两比较差异均有统计学意义（均为P<0.05）。HbA1c、糖尿病病程与OSI、MTF cutoff、SR无显著相关性（均P>...     

血清补体C1q水平与增殖性糖尿病视网膜病变的关系

目的：探讨血清补体C1q水平与增殖性糖尿病视网膜病变（PDR）的关系。方法：选取2021年5月—2022年4月在武汉大学人民医院眼科就诊确诊为2型糖尿病（T2DM）导致的PDR患者作为PDR组,在内分泌科就诊确诊为T2DM患者作为T2DM组,共129例,其中PDR组61例,T2DM组68例,回顾性分析所有研究对象的数据资料。二元Logistic回归分析危险因素。ROC曲线评估C1q预测价值。Pearson分析C1q与白细胞计数等指标的相关性。结果：PDR组总C1q水平、女性C1q水平显著高于T2DM组。二元Logistic回归分析显示,C1q升高是PDR的危险因素,且男女性无差异。ROC曲线分析显示,总C1q≥239.55 mg/L或男性C1q≥192.35 mg/L或女性C1q≥238.10 mg/L时可能会发生PDR。Pearson相关性分析显示,总C1q与白细胞计数和中性粒细胞百分比均呈正相关。结论：血清C1q水平升高是PDR的危险因素。     

全反式视黄酸对诱导为神经元样细胞的脐带间充质干细胞分化和凋亡的影响

Objective To evaluate the role of different concentration of all-trans retinoic acid (ATRA)on the morphology,proliferation and apoptosis in inducing umbilical cord mesenchymal stem cells (MSC) into neuron-like cells in vitro,and screen the optimal concentration of ATRA.Methods It was an experimental study.The third passage of MSC was placed in 24-well cell culture plates at a density of 1×104/well.After the adherent of cells,the medium was changed to DMEM/F-12 containing different concentration of ATRA(0.25 μmol/L,0.5 μmol/L,1.0 μmol/L,2.0 μmol/L,4.0 μmol/L)for 24 h respectively.The cells cultured without ATRA were taken as the coutrol group.After another 24 h,the morphologic changes of induced cells were observed by inverted microscope and cell proliferation,apoptosis of ATRA was analyzed using the MTT colorimetric assay.We take another control group and ATRA groups to detect the apoptotic and positive stained percentage of induced cells by Annexin V-FITC/PI combining flow cytometry.The optimal concentration of ATRA was determined by all the above-mentioned index.According to the nature of the material,analysis of variance (ANOVA) was employed for absorption value and apoptosis rate in different concentration of ATRA for 24 h,t test for further comparision between two groups.T-test were also used between the positive expression of induced neuron-like cells and the control group.Results Compared to the control group,ATRA at the concentration of 0.25 μmoL/L did not inhibit the proliferation of umbilical cord MSC obviously(t=0.72.1.32,P>0.05).Part of MSC wele floating instantly at the moment of adding ATRA of 4.0 μmoL/L and no adherent cells were observed after 24 h'culture.Exposed to ATRA at the concentration of≥1.0 μmol/L for 24 h,the proliferation of MSC were significantly inhibited,showing a dose-dependent manner(t=8.8,18.9,22.1;P<0.01).0.5 μmol/L of ATRA did not affect the proliferation of cells and its moephology remained normal;1.0 μmol/L of ATRA affected very few cells;but 2.0 μmoL/L of ATRA cultured for 24 h inhibited the proliferation of cells obviously than 1 h.and the cells increased in size and became flattened.Flow cytometry showed that the rate of apoptosis between the control group and≥1.0 μmol/L groups were significantly different(t=9.88,19.95,31.61;P<0.01).Conclusion In the process of inducing umbilical cord MSC into neuron-like cells,0.5 μmol/L ATRA was the optical concentration.≥1.0 μmol/L ATRA can inhibit the cell proliferation,increase the apoptosis of cells significantly and caused obvious damages.     

间接检眼镜激光在玻璃体切割术中的应用

目的 探讨间接检眼镜激光在玻璃体切割术中应用的方法和疗效。方法 对７６例７８只眼行玻璃体切割手术,术中应用间接检眼镜激光对视网膜进行光凝的范围是中周部以前的视网膜,重点是多膜裂孔缘周围的视网膜、视网膜新生血管膜及视网膜无灌注区。曝光时间１００ｍｓ,输出功率为２４０～６５０ｍＷ,在裂孔缘视网膜及新生血管膜上形成Ⅲ级光斑,视网膜无灌注区形成Ⅰ～Ⅱ级光斑。结果 未脱离的视网膜及脱离的视网膜在重水或硅油充填复位的条件下顺利地进行了间接检眼镜激光光凝。术后２周内对其中的１９例２２只眼行眼底荧光造影（ＦＦＡ）检查,１３例需补充光凝。术后１月复查,光斑色素增生,视网膜裂孔封闭好,术后３个月复查ＦＦＡ,２１只眼视网膜无灌注区和新生血管消失。     

舌下腺的游离移植治疗重症干眼症的应用解剖学研究

目的:从解剖学角度探讨舌下腺游离移植治疗重症干眼症的可行性。方法:在 30 侧经动脉灌注红色乳胶的头颈部标本上解剖观测舌下腺的大小、血供来源、静脉回流以及头面部可供吻合血管的外径和走行。结果:舌下腺在三大唾液腺中体积最小,其血供主要来自舌下动脉或颏下动脉,静脉回流通过动脉的伴行静脉注入颈内静脉;面部可供吻合的血管为颞浅动脉前(额)支。结论:舌下腺游离移植治疗重症干眼症是可行的。     

个体化EH复合材料修复额眶部骨缺损

目的:观察个体化EH复合材料修复额眶部骨缺损的临床效果。方法:从2009-01/2012-06用三维CT影像技术及计算机数控成型技术,制作个体化EH复合材料定制体,对35例额眶部骨缺损患者进行手术修复,随访6～24mo。结果:额眶部形态恢复效果满意,有2例术后发现皮下积液,经针刺抽吸清除及加压包扎后消失。无排异感染等并发症。结论:个体化EH复合材料具有良好的生物相容性,操作方便,外形满意,术后并发症较少,是一种比较理想的额眶部骨缺损修复材料。