原发性慢性闭角型青光眼血流动力学改变与视功能损害关系的临床研究

目的 :探讨眼底血流动力学改变与慢性闭角型青光眼视功能损害的关系。方法 :利用彩色多普勒超声技术 ( CDI)对慢性闭角型青光眼 ( CPCAG)患者的不同病程阶段的眼动脉 ( OA)、视网膜中央动脉 ( CRA)、睫状后短动脉 ( PCAs)的血流参数进行检测 ,对 CPCAG患者视野指数平均缺损值 ( MD)与 OA、CRA、PCAs阻力指数 ( PI)的相关性分别进行研究。结果 :1 CPCAG患者无论是OA还是 CRA、PCAs,其收缩期峰值血流速度 ( PSV)、舒张末期血流速度 ( EDV)、平均血流速度( Vmean)均较正常人减少 ,阻力指数 ( RI)较正常人高 ( P<0 .0 1 )。 2 CPCAG患者的视野 MD值与OA、CRA和 PCA的 RI之间呈显著负相关 ( P<0 .0 1 )。 3CPCAG组随着视野损害的不断进展 ,其眼底血流速度逐渐下降 ,在尚未出现眼底及视野改变的 CPCAG患者中 ,CRA的 EDV降低 ,与正常对照组相比存在显著差异 ( P<0 .0 5)。结论 :1 CPCAG患者存在着视盘和视网膜的血液供应障碍。 2 CPCAG患者的视野损害与眼底血管末梢阻力的增加有关。 3CDI对 CPCAG的早期诊断及病程监测具有重要价值。     

斗门县农村中老年人群原发闭角性青光眼流行病学调查

【目的】调查 5 0岁以上的中老年人群中的原发闭角性青光眼患病率。【方法】 1997年在广东省斗门县以村为单位 ,通过重组随机整群抽样确定检查对象 ,用ETDRS视力表检查裸眼视力、常戴镜视力和针孔视力 ,Schiotz计测定眼压 ,直接电眼底镜作视神经垂直C/D比的估计 ,手电筒侧照法和vanHerrick法测定前房深度 ,并结合急性发作史、前房角镜和视野检查作出诊断。【结果】在 5 34 2名实检对象 (受检率 92 7% )中 ,青光眼是第 5位致盲眼病。原发闭角性青光眼的患病率为1 0 % ,男性和女性中分别为 0 8%和 1 2 % ,在 5 0～ 5 9、6 0～ 6 9和 70～ 98岁年龄组中分别为 0 4%、0 8%和 1 6 % ,浅前房人群中为 5 9% ,经logistic回归校正混杂作用后 ,年龄和前房深度为独立的危险因素 ,以 5 0岁年龄组和深前房者为基准 ,70～ 98岁年龄组和浅前房者的调整比数比分别为 3 3和 11 3。【结论】原发闭角性青光眼是人群中重要的致盲眼病 ,老年和浅前房者是危险人群。     

自制穿刺床引流治疗肺底积液的临床应用研究

目的 自制穿刺床引流治疗肺底积液的可行性及临床意义。方法 使用穿刺床对１１例１２个肺底积液,２例,包裹性胸腔积液病人,在Ｘ光电视透视监测下穿刺引流,其中２例肿瘤所致肺底各病人下抽液后注入抗癌药治疗。结果 １２例肺底积液的１６次穿刺引流均获一次性成功,抽液量在８０～１５５０ｍｌ之间。胸膜内注药的２例患者,胸腔积液料得到满意控制。结论 自制穿刺床透用于流动型肺底积液、其它游离性胸腔积液及部分包裹性积液     

三种波长的激光小梁成形术临床疗效比较

目的　对氩激光、倍频Nd：YAG激光、半导体激光小梁成形术的疗效作一前瞻性的评价和比较。方法　随机地将原发性开角型青光眼病人50例84眼分为三个激光组,分别用氩激光、倍频Nd：YAG激光、半导体激光进行小梁成形术,随访三组的有效率。结果　三组各随访期的眼压下降有统计学意义。三组之间的眼压下降数和成功率无差别。结论　三种波长激光都能有效地进行小梁成形术。     

Thermoresponsive Reversible Unimer Micelles of Amphiphilic Fluorinated Copolymers

Amphiphilic fluorinated copolymers PEGMAx-co-FAy and TEGMAx-co-FAy are prepared by activators regenerated by electron transfer atom transfer radical polymerization (ARGET-ATRP). All polymers present a reversible thermoresponsive lower critical solution temperature-type behavior, and a cloud point temperature (T_c) in the range of 30–60 °C strictly dependent on the length of the oxyethylene side chain, the content of the hydrophobic counits, and the concentration of the solution. Combined small angle X-ray scattering (SAXS) and dynamic light scattering measurements are used to study the self-assembly behavior in water, organic solvents (tetrahydrofuran [THF] and dimethylformamide [DMF]), and a fluorinated solvent (hexafluorobenzene [HFB]). SAXS confirms the formation of compact-globular single-chain self-folded unimer micelles in water below T_c, which generally presents small hydrodynamic diameters (D_h ≤ 8 nm) as a result of the folding of the hydrophobic perfluorohexylethyl acrylate counits. The copolymers are also able to form reverse unimer micelle in HFB. The copolymers are not able to self-assemble in unimer micelles in THF or DMF solutions, in which they adopt conventional random coil conformations.     

组合硬化剂治疗肾囊肿远期疗效观察

目的：研究组合硬化剂对家兔胆囊的硬化作用,观察治疗肾囊肿的远期临床疗效。方法：应用四环素与氟美松组合硬化剂注入家兔胆囊,与生理盐水和无水乙醇对比观察其对胆囊壁的作用;与无水乙醇对比观察介入硬化治疗肾囊肿的疗效。组合硬化剂治疗组４１例,男２３例,女１８例,年龄４３岁－７２岁;无水乙醇对对照组４０例,男２８例,女１２例,年龄４５岁－７０岁。     

内窥镜辅助下显微神经血管减压术治疗 特发性偏侧面肌痉挛

目的为进一步提高神经血管减压术治疗特发性偏侧面肌痉挛的疗效。方法经乙状窦后小骨窗开颅加用内窥镜辅助显微血管减压术治疗特发性偏侧面肌痉挛３５例。结果术后３４例症状消失,１例症状减轻,３５例随访６个月至３年半,术后面肌抽搐消失者３３例,１例症状减轻,１例１年后复发。结论内窥镜可弥补手术显微镜的不足之处,减少组织损伤和判断错误,提高治疗效果。     

应用超声生物显微镜与房角镜检查眼前房角结果的比较

目的 比较应用超声生物显微镜（ｕｌｔｒａｓｏｕｎｄｂｉｏｍｉｃｒｏｓｃｏｐｙ,ＵＢＭ）与房角镜检查眼前房角的结果,为房角镜检查提供新的技术和资料。方法 采用双盲法分别对１０例（２０只眼）的眼前房角进行超声生物显微镜和裂隙灯显微镜房角镜检查。并将两种检查结果进行比较,采用等级相关法对获取的资料和结果进行统计学分析,（取α＝０．０５）。结果,两种检查法在宽房角状态下对房角的检查结果有较好的一致性, 在     

Epidemiological aids to clinical decision making in primary open angle glaucoma

We have described the epidemiological analysis of one aspect of the King's College Hospital computerised data base; namely initial intraocular pressure as an indicator of visual field loss. The methods involved the use of the four-fold table to determine sensitivity and specificity at different pressure levels. From these results (1) the changes in the pre and post test probability of field loss are calculated and (2) a sensitivity/specificity trade off curve or decision curve is constructed. In this way the optimal cut-off level or operating point for a population of specific type and composition can be determined. The factors concerned in decision making are always complex but such an approach allows a rational and quantifiable alternative to reliance on clinical impression and intuition. The results have significance in relation to decisions on the management of patients and on population screening programmes for glaucoma.     

The compensatory ‘rebound’ of reactive astrogliosis: glial fibrillary acidic protein immunohistochemical analysis of reactive astrogliosis after a puncture wound to the brain of rats with portocaval anastomosis

Summary This study was designed to compare the degree of reactive astrogliosis occurring around a puncture wound in the brain of normal rats and at different intervals after a similar puncture wound in rats with a portocaval anastomosis. The gliosis was evaluated by the number of astrocytes, the thickness of their processes and the intensity of the glial fibrillary acidic protein immunoreactivity. After the puncture wound in the brain of rats with a portocaval anastomosis, the gliosis varied at different intervals being: (1) decreased at 10 days, (2) markedly increased at 5 weeks and (3) significantly decreased at 8, 12, and 16 weeks. These findings suggest that 5 weeks after portocaval anastomosis, an active proliferation of the metabolically altered astrocytes occurs with heightened synthesis of glial fibrillary acidic protein in the period of adaptive compensation, the so-called compensatory rebound. At 8 weeks or more after portocaval anastomosis, these altered astrocytes were considered to be in the phase of decompensation and incapable of maintaining the reactive response which occurred in normal rats. The compensatory rebound and decompensatory decline illustrate the dynamic plasticity of the reactive astrogliosis.Supported by grant from the National Foundation of Natural Sciences No. 386-0956. This paper was read at the XIth International Congress of Neuropathology, September 7, 1990 in Kyoto, Japan