小鼠腭板旋转培养模型的建立及其初步应用

目的为研究全反式视黄酸(atRA)对小鼠腭板发育的影响及其致腭裂的机制,建立腭板旋转培养模型。方法于妊娠第12天取下小鼠胚胎腭移植体,以10-5～10-1μmolLatRA诱导,在旋转培养装置中连续培养72h,观察腭板发育融合情况。结果经72h培养后,对照组正常融合,与体内发育一致。atRA在10-5μmolL能促进腭板的融合,≥10-4μmolL抑制腭板的发育及融合,造成腭裂,融合率下降,并呈显著的剂量-效应关系。结论本模型中,腭板能在体外培养中存活并继续生长、发育、融合;atRA在10-5μmolL能促进腭板融合,高于10-4μmolL呈剂量-效应关系的抑制融合,造成腭裂,证明小鼠腭板旋转培养模型建立成功。     

Rathke囊肿的影像学诊断与鉴别诊断

目的:分析Rathke囊肿的CT和MRI表现,提高对该病的诊断水平。方法:回顾性分析经手术与病理证实的14例Rathke囊肿的CT及MRI资料。结果:14例Rathke囊肿,CT平扫8例,其中4例为低密度,2例等密度,1例高密度,1例囊壁可见钙化。3例CT增强扫描未见明显强化。MRI平扫主要显示为圆形或类圆形,5例位于鞍内,9例位于鞍内及鞍上。6例为长T1、长T2信号,5例为短T1、长T2信号,2例为短T1、短T2信号,1例信号不均匀。12例MRI增强扫描,其中10例未见明显强化,2例囊壁轻度强化。结论:Rathke囊肿囊液密度/信号变化多样,通过总结其影像特点并结合详细的影像学检查可对其中多数病例做出正确的定性诊断。     

腭咽环扎术后阻塞性睡眠呼吸暂停低通气综合征上气道形态的研究

目的：探讨腭咽环扎术（VRLP）后阻塞性睡眠呼吸暂停低通气综合征（OSAHS）患者的上气道形态特征.方法：应用纤维鼻咽镜和头影测量技术检查了6例VRLP后并发OSAHS患者、6例VRLP后未发生OSAHS和6例未手术腭裂患者的上气道形态,测量了鼻咽腔直径、腭咽环扎处咽腔直径、口咽腔直径、舌根后咽腔直径、下咽腔直径、舌骨至下颌骨的距离等6个相关参数,并应用单因素方差分析进行组间比较.结果：未手术腭裂患者上气道形态光滑,VRLP后上气道在软腭后区和舌根后区出现2处狭窄,VRLP后OSAHS患者上气道鼻咽部明显狭窄变形,为腺样体肥大所致.结论：X线头影测量技术是一种简单实用的评估VRLP后OSAHS的方法,建议VRLP术前行此检查以排除腺样体严重增生患者.     

后巩膜收缩术治疗病理性近视黄斑劈裂

目的：评估后巩膜收缩术对病理性近视黄斑劈裂的治疗效果。方法：回顾性研究。选取2014年12月 至2017年04月在南京市第一医院眼科行后巩膜收缩术的病理性近视黄斑劈裂患者24例（45眼）,观察手术前后患者的最佳矫正视力、眼轴长度、屈光度、黄斑区视网膜劈裂高度的状况与手术并发症。对相关计量资料进行重复测量方差分析。结果：患者术前,术后1个月、3个月、6个月及12个月的黄斑区视网膜劈裂高度分别为（494±31）、（299±24）、（256±24）、（200±22）、（168±25）μm,术后各时间点与术前比较差异有统计学意义（均P<0.05）。患者术后1、3、6个月眼轴长度分别为（28.6±2.1）、（28.9±2.0）、（29.3±2.0）mm,与术前[（30.5±2.2）mm]相比差异有统计学意义（P<0.05）,术后12个月眼轴（29.8±2.1）mm,与术前相比差异无统计学意义（P>0.05）。患者术后1个月、3个月的屈光度分别为（-15.14±5.16）D、（-15.64±5.05）D,与术前[（-17.33±7.43）D]相比差异有统计学意义（P=0.013、0.048）,术后6、12个月的屈光度分别为（-15.96±4.97）D、（-17.05±5.10）D,与术前相比差异无统计学意义（P>0.05）。患者最佳矫正视力差异无统计学意义（P>0.05）。结论：针对病理性近视黄斑劈裂伴或不伴视网膜脱离的治疗,后巩膜收缩术的安全性和可行性较好。     

Effects of palatine bone denudation repair with periosteal graft on maxillary growth: An experimental study in rats

BackgroundThe long-term goal of cleft palate repair is to provide normal maxillary growth and speech capacity. However, most surgical repairs of cleft palate result in areas of bone denudation on lateral aspects of the hard palate. It is widely acknowledged that palatal bone denudation and subsequent scar contracture resulting from cleft palate surgery can inhibit maxillary growth.MethodThis study is designed to investigate the effect of the periosteum on growth patterns of the maxilla. A total of 32 three-week-old Sprague-Dawley rats were randomly divided into a control group and three experimental groups: a mucosa excision group, a mucosa-periosteum excision group and a periosteal graft group. Nine weeks postoperatively the skulls were prepared for study and palatal widths and lengths were determined. The experimental groups were investigated for various histological changes.ResultsThere was no statistically significant difference for the maxillary measurements (palatal width and length) between the mucosa excision group and the periosteal graft group when compared with the control group. However, the mucosa-periosteum excision group compared to the control indicated a statistically significant decrease in the same measurements. There was also a statistically significant difference for the maxillary measurements between the periosteal graft group and the mucosa-periosteum excision group.It was demonstrated histologically that the density of the Sharpey's fibres and periodontal scar tissue showed a slight increase in the mucosa excision group and the periosteal graft group compared with the control group. In the mucosa-periosteum excision group, the density increased significantly as expected.ConclusionsAll of these findings testify that retaining the periosteum or replacement with a periosteum graft after surgery can prevent the inhibition of maxillary growth.