白内障伴青光眼患者术后胰岛素抵抗及炎症因子水平与视觉质量的关系

目的分析白内障伴青光眼患者术后胰岛素抵抗及炎症因子水平变化与视觉质量的关系。 方法选取47例(47眼)白内障伴青光眼患者为研究对象,均接受超声乳化+小梁切除术治疗。术前、术后7天、术后3个月检测患者客观散射指数(OSI)、点扩散函数(PSF)、调制传递函数截止频率(MTF cutoff)、胰岛素敏感指数及白细胞介素(IL)-1β、IL-10、IL-2水平。采用Pearson法分析视觉质量参数与胰岛素抵抗情况及炎症因子的相关性。 结果与术前比较,术后7天和术后3个月最佳校正视力、MTF cutoff及胰岛素敏感指数升高,且术后3个月更高(P＜0.05);与术前比较,术后7天和术后3个月眼压、角膜内皮细胞计数、PSF、OSI及血清IL-1β、IL-2、IL-10水平降低,且术后3个月更低(P＜0.05)。Pearson分析显示,术前、术后7天和术后3个月,白内障伴青光眼患者OSI与胰岛素敏感指数呈负相关(P＜0.05),与血清IL-1β、IL-2、IL-10水平呈正相关(P＜0.05);MTF cutoff与胰岛素敏感指数呈正相关(P＜0.05),与血清IL-1β、IL-2、IL-10水平呈负相关(P＜0.05);PSF与血清IL-1β水平呈负相关(P＜0.05)。术后7天和3个月,PSF与胰岛素敏感指数呈正相关(P＜0.05),与血清IL-2、IL-10水平呈负相关(P＜0.05)。 结论超声乳化联合小梁切除术对视觉质量的改善可能与胰岛素抵抗及炎症因子变化密切相关。     

Neu-Laxova syndrome: Prenatal ultrasonographic diagnosis,clinical and pathological studies,and new manifestations

A diagnosis of the Neu-Laxova syndrome (NLS) was made by ultrasonography at 32 wks of gestation. Ultrasonographic examination showed intrauterine growth retardation (IUGR), Dandy-Walker anomaly, choroid plexus cysts, receding forehead and microcephaly, bilateral cataract without prominent eyes, scalp edema with no generalized edema, retrognathia, curved penis, and flexion deformities of limbs. The findings in this case are consistent with NLS; however, they did not fit any of Curry's [1982] groups. Massive swelling of hands and feet were among the main manifestations in classic NLS cases. In the case presented herein, edema was noted only in the scalp. This might shed further light on the question of variability vs. heterogeneity in the NLS. This case shows the existing possibility of an early diagnosis of NLS and adds Dandy-Walker anomaly and choroid plexus cysts as new findings to this syndrome. © 1992 Wiley-Liss, Inc.     

中国东北汉族一个先天性白内障家系致病基因的鉴定

目的鉴定一个先天性白内障家系的致病基因。方法根据已知与先天性白内障有关的12个致病基因的染色体上的定位,分别选取3～4个的微卫星标记位点,对该家系进行连锁分析。通过测序鉴定致病基因。结果在1q21.1GJA8位点显示最大Lod值2.44。致病基因定位于1q21.1区的GJA8基因,构成缝隙连接的缝隙连接蛋白Connexin50。DNA序列分析鉴定显示其第2外显子的第191个碱基杂合突变T>G导致其蛋白产物第64位缬氨酸转变为甘氨酸。结论Connexin50的V64G新生突变是导致该家系的致病原因。     

FISH characterization of a supernumerary r(1)(::cen→q22::q22→sq21::) chromosome associated with multiple anomalies and bilateral cataracts

We describe the case of a 15‐year‐old girl with multiple congenital anomalies, dysmorphic features, severe kyphoscoliosis, growth and mental retardation, and the absence of speech, in whom 35% of the cells carried a supernumerary ring chromosome 1. Fluorescence in situ hybridization (FISH) analysis using YAC/BAC clones spanning the region from 1p13 to 1q21 made it possible to determine the genomic content and structure of the ring(1), which was found to consist of the cytogenetic bands 1q21–22. A complex structure was delineated in the ring chromosome with a partial inverted duplication delimited by markers WI‐7732 and WI‐607, with WI‐7396 and WI‐8386 being the boundaries of the single copy segment. Comparison of the clinical signs of other patients with mosaic r(1) reported in the literature allowed the identification of a patient sharing a number of clinical signs including cataracts. Given that mutations of the GJA8 gene encoding connexin 50 (Cx50) and mapping to 1q21 have been associated with the presence of cataracts, it is possible that a gain in copy number or a rearrangement of GJA8 may contribute to cataractogenesis.     

The Oxford Clinical Cataract Classification and Grading System

A composite slit-lamp based system for the clinical classification and grading of cataract is described. Cataract features are classified morphologically, and individual features are graded by comparison with standard diagrams mounted adjacent to the slit-lamp. Attention has been paid to relevant aspects of measurement theory, with equal interval steps between the grades. The image degrading effect of the cataract is assessed using a resolution target projection ophthalmoscope. The method may be used in conjunction with photographic and image analysing techniques.     

“健康快车”特殊条件下眼科手术器械漂洗方法的研究

 目的 探索在"健康快车"无流动水清洗设备的特殊条件下,复用眼科手术器械有效的漂洗方法。方法 研究分两个阶段进行,分别探索不同漂洗方法对手术器械多酶清洗剂清除效果和清洗质量的影响。分别选择无污染和模拟临床手术污染的白内障显微手术器械。A、B、C、D、F、G组为试验组,模拟"健康快车"条件下使用非流动水漂洗手术器械,A、B、C 3组的漂洗方法分别为"2、4、6 L水结合刷洗"、D组"不漂洗"、F组漂洗方法同B组、G组在B组的基础上增加"0.5 L水结合涮洗"的步骤。E、H组为对照组,遵守指南使用流动水漂洗手术器械。清洗效果评价：采用蛋白残留检测仪间接检测多酶清洗剂残留量;采用ATP生物荧光检测仪检测手术器械的清洗质量。结果 B组多酶清洗剂残留量为（1.90±0.23）μg/20把,B组与对照组［（3.45±0.46）μg/20把］的多酶清洗剂残留结果比较,差异无统计学意义（P=0.053）。G组ATP生物荧光检测结果为（9.46±1.50）RLU/把,G组ATP生物荧光检测结果与对照组［（11.60±1.44）RLU/把］比较,差异无统计学意义（P=0.339）。结论 结合两阶段试验结果,在"健康快车"无流动水清洗设备的特殊条件下漂洗眼科手术器械,推荐选用G组漂洗方法。     

Expression of P53 during lens epithelial cell apoptosis induced by ultraviolet

Cataract is a disease induced by multi- factorsand its pathologic mechanism isstill unknown.Ithasbeen accepted that ultraviolet irradiation ( UVR) isone of the most important pathogenesis.Li etal hasreported that UVR could induce the apoptosis of lensepithelial cells( LECs) and resulted in lens opacities.In order to study the pathologic mechanism of UVR-induced cataract at molecular and cellular levels,weinvestigated the apoptosisof LECs and the expressionof P5 3.1　 MATERIALSAND M…     

外伤性白内障人工晶状体植入术临床观察

目的 评价外伤性白内障人工晶体植入的疗效及问题。方法 对56例外伤性白内障人工晶体植入术后进行回顾性研究。结果 术后矫正视力≥0.5者48眼,占85.7%;0.1-0.4者6眼,占10.7%;0.1以下者2眼,占3.6%。结论 利用显微手术方法,使用粘弹剂,控制眼内炎症,选择好手术时机,可使手术效果满意。     

超声乳化术治疗色素膜炎并发性白内障

目的 评估色素膜炎并发性白内障超声乳化手术的疗效。方法 钝化分离瞳孔后粘连及剪除机化膜,牵拉扩张瞳孔后,采用原位碎核技术对19例（21只眼）色素膜炎并发性白内障行超声乳化,结果 术后1周矫正视力≥0.5者16只眼（76.2%）,≥0.2者18只眼（85.7%);手术并发症为虹膜损伤,角膜水肿,未见后囊膜破裂及角膜失代偿;术后19只眼（90.5%)恢复圆瞳孔;2只眼（9.5%)瞳孔不规则。结论 超声乳化术治疗色素膜炎并发性白内障,具有对虹膜损伤小,术后前房炎症反应轻,视力早期恢复等优点,值得推广应用。