金属骨小梁AVN重建系统治疗早期股骨头坏死临床研究

目的评价金属骨小梁AVN重建系统治疗早期股骨头坏死的临床疗效。方法123例早期股骨头坏死患者分为观察组63例和对照组60组,观察组行金属骨小梁AVN重建系统植入术,对照组行股骨头坏死重建棒植入术;比较2组髋关节Harris评分、影像学评分、临床疗效及不良反应。结果2组术后髋关节Harris评分、影像学评分、临床疗效及不良反应比较差异无统计学意义（P〉0．05）。结论金属骨小梁AVN重建系统植入术与股骨头坏死重建棒植入术疗效相当。     

钉棒固定椎间融合器治疗腰椎滑脱20例临床疗效分析

目的 研究钉棒固定椎间融合器治疗腰椎滑脱的临床疗效.方法 选择在某院就诊的20名腰椎滑脱患者的临床资料,按照手术方式不同分为接受PLIF的观察组和PLF的对照组,观察中出血量、手术持续时间、椎间隙高度、椎体融合情况以及术后生活质量,并用SPSS 18.0软件进行统计学分析.结果 观察组平均手术时间(132.23±19.21) min、术中出血量(583.73±43.79) ml,均明显多于对照组;观察组椎间隙高度(9.72±1.02) mm,明显高于对照组的(8.23±0.93) mm;椎体融合率90％,明显高于对照组的60％;观察组生活质量优7例、良2例、可1例、差0例,明显好于对照组.结论 经后路钉棒固定椎间融合器(Cage)植骨融合术(PLIF)虽然耗时较长、术中出血较多,但是能够有效增加椎间隙高度、提高椎体融合率、改善生活质量.     

Magnetically controlled growing rod in 13 patients with early-onset scoliosis and spinal improvement

Objective

The aim of this study was to examine the use of magnetically controlled growing rods as a method of providing spinal improvement while preventing thoracic insufficiency in patients with early-onset scoliosis (EOS).

Evolutionary loss of cone photoreception in balaenid whales reveals circuit stability in the mammalian retina

The classical understanding of mammalian vision is that it occurs through “duplex” retinae containing both rod and cone photoreceptors, the signals from which are processed through rod‐ and/or cone‐specific signaling pathways. The recent discovery of rod monochromacy in some cetacean lineages provides a novel opportunity to investigate the effects of an evolutionary loss of cone photoreception on retinal organization. Sequence analysis of right whale (Eubalaena glacialis; family Balaenidae) cDNA derived from long‐wavelength sensitive (LWS) cone opsin mRNA identified several mutations in the opsin coding sequence, suggesting the loss of cone cell function, but maintenance of non‐photosensitive, cone opsin mRNA‐expressing cells in the retina. Subsequently, we investigated the retina of the closely related bowhead whale (Balaena mysticetus; family Balaenidae) to determine how the loss of cone‐mediated photoreception affects light signaling pathways in the retina. Anti‐opsin immunofluorescence demonstrated the total loss of cone opsin expression in B. mysticetus, whereas light microscopy, transmission electron microscopy, and bipolar cell (protein kinase C‐α [PKC‐α] and recoverin) immunofluorescence revealed the maintenance of cone soma, putative cone pedicles, and both rod and cone bipolar cell types. These findings represent the first immunological and anatomical evidence of a naturally occurring rod‐monochromatic mammalian retina, and suggest that despite the loss of cone‐mediated photoreception, the associated cone signaling structures (i.e., cone synapses and cone bipolar cells) may be maintained for multichannel rod‐based signaling in balaenid whales. J. Comp. Neurol. 524:2873–2885, 2016. © 2016 Wiley Periodicals, Inc.     

玻璃棒法按摩睑板腺联合常规疗法治疗睑板腺功能障碍的临床疗效

目的：探讨玻璃棒法按摩睑板腺与常规疗法联合治疗睑板腺功能障碍(MGD)的临床疗效。

方法：回顾性分析2016-08/2017-06我院收治的MGD患者130例220眼,根据治疗方式不同进行分组,其中给予常规治疗即1g/L氟米龙滴眼液联合自行热敷的患者设为对照组(65例112眼),给予圆头玻璃棒按摩睑板腺联合常规疗法的患者设为联合组(65例108眼)。比较两组患者治疗前后眼表疾病指数量表(OSDI)评分、泪膜破裂时间(BUT)、基础泪液分泌试验(SⅠt)、角膜荧光素染色(CFS)评分、睑缘评分、睑板腺分泌物性状评分和眼压情况及临床治疗有效率。

结果：治疗前,两组患者OSDI评分、BUT、SⅠt、CFS评分、睑缘评分、睑板腺分泌物性状评分、眼压情况差异均无统计学意义(P>0.05)。治疗2wk后,联合组患者OSDI、CFS、睑缘及睑板腺分泌物性状评分均低于对照组,BUT和SⅠt均大于对照组,差异均有统计学意义(P<0.01); 两组患者眼压均有所升高,但均≤21mmHg,两组间差异无统计学意义(P>0.05)。治疗2wk后,联合组总有效率为92.6%(100/108),对照组总有效率为78.6%(88/112),差异具有统计学意义(P<0.05)

结论：玻璃棒法按摩睑板腺与常规疗法联合治疗MGD能够有效改善眼表症状和睑板腺分泌功能,促进泪液分泌,提高临床治疗有效率。     

Clinical characteristics of recessive retinal degeneration due to mutations in the CDHR1 gene and a review of the literature

Background: The clinical phenotype of patients presenting with autosomal recessive CDHR1-related retinopathy has not been well described.

Materials and Methods: This is a retrospective case series of patients presenting to a single institution. Clinical data, including age, visual acuity, dilated fundus exam, fundus photos, fundus autofluorescence (FAF), optical coherence tomography, full-field electroretinograms (ERGs), and results of genetic testing, were collected.

Results: Four patients were identified to have biallelic mutations in the CDHR1 gene. All four patients were found to have at least one c.783G>A (p.Pro261 = ) mutation. A novel splice site mutation, c.152-2A>G, was identified in two patients. Patients became symptomatic between the fourth and sixth decades of life. Three patients presented initially with nyctalopia and peripheral visual field constriction, and one patient presented with simultaneous onset of photophobia and nyctalopia. The fundus appearance was characterized by macular atrophy with or without peripheral retinal pigment epithelium changes and arteriolar attenuation. FAF showed a hyperautofluorescent ring surrounding a central area of speckled hypoautofluorescence. Full-field electroretinography was available on three patients and showed decreased cone-and-rod responses.

Conclusions: CDHR1-related retinal dystrophy should be considered in adult patients with a retinal dystrophy who present with symptoms of cone-and-rod dysfunction and macular atrophy on ophthalmoscopic examination.     

Expression of the somatostatin subtype 2A receptor in the rabbit retina

In the retina, somatostatin influences neuronal activity likely by acting at one or more somatostatin subtype (sst) receptors. Somatostatin and somatostatin-binding sites are distributed predominantly to the inner retina. The present study has investigated the cellular expression of one of the sst receptors, the sst_2A receptor isoform, in the rabbit retina. These studies have used a new polyclonal antibody directed to the predicted C-terminus of mouse sst_2A(361–369) receptor. Antibody specificity was tested by preadsorption of the primary antibody with a peptide corresponding to sst_2A(361–369). sst_2A Receptor immunoreactivity was localized mainly to the plasma membrane of rod bipolar cells and to sparsely occurring, wide-field amacrine cells. Immunostaining in rod bipolar cells was strongest in the axon and axon terminals in lamina 5 of the inner plexiform layer (IPL) and was weakest in the cell body and dendrites. Double-labeling experiments using a monoclonal antibody against protein kinase C (PKC; α and β), a rod bipolar cell-selective marker, showed complete colocalization. In horizontal sections of retina, immunostained bipolar cell bodies had a dense distribution, which is in agreement with the reported distribution of rod bipolar cell bodies. Immunoreactive amacrine cell bodies were located at the border of the inner nuclear layer and the IPL, and thin varicose processes ramified mainly in laminae 2 and 4 of the IPL. These observations indicate that somatostatin influences visual information processing in the retina 1) by acting presynaptically on rod bipolar cell axon terminals and b) by influencing the activity of sparsely occurring amacrine cells. J. Comp. Neurol. 393:93–101, 1998. © 1998 Wiley-Liss, Inc.     

寰枢椎后路椎弓根钉棒内固定技术在幼儿上颈椎疾患中的应用

目的：探讨后路寰枢椎椎弓根钉棒内固定技术在1～5岁幼儿上颈椎疾患中的应用效果。方法：回顾性研究本团队2013年5月～2022年3月采用寰枢椎椎弓根钉棒内固定技术治疗的上颈椎疾患幼儿13例，男10例，女3例；年龄15～68个月，平均43.85±17.56个月；体重9～22.5kg，平均16.32±3.23kg。患儿的主要临床表现为颈部疼痛伴活动受限，其中2例患儿伴有四肢乏力，1例患儿颈部偏斜为主要表现；术前美国脊髓损伤协会（American Spinal Injury Association,ASIA）分级C级2例，D级1例，E级10例。术前常规行张口位正侧位以及动力位X线片、CT骨三维重建、椎动脉CT血管造影（CT angiography,CTA）、MRI平扫或增强检查。常规行床边枕颌带或颅骨牵引，麻醉下颅骨牵引，13例患儿皆可获得完全或大部分复位，遂行后路寰枢椎复位椎弓根钉棒内固定术，所有椎弓根螺钉直径为3.5mm；除外4例新鲜单纯Ⅱ型齿状突骨折伴寰枢椎脱位患儿，其他病例皆行自体髂骨植骨融合；对3例因颅颈交界畸形或寰枢椎发育异常无法行寰枢椎椎弓根钉棒内固定术患儿采用枕颈固定融合方式治...