过熟期白内障继发青光眼34例临床分析

目的:分析过熟期白内障继发青光眼的临床表现、治疗及预后,为临床诊疗工作提供参考.方法:收集四川大学华西医院2011-08/2014-08共收治的老年性白内障过熟期继发青光眼患者34例34眼.分析根据不同临床表现选择的不同治疗方法,以及相应的预后.结果:所选34例患者均急诊人院,人院时视力均不超过指数/眼前,眼压35 ～ 75mmHg.术前给予综合降眼压治疗,28例患者接受白内障超声乳化手术,6例行白内障囊外摘除术(ECCE),19例患者根据病情选择I期或Ⅱ期植人人工晶状体.术后所有眼痛缓解,30例眼压控制良好,1例行引流阀植入术,3例放弃治疗.17例植入人工晶状体者术后视力提高,最佳视力达0.7.结论:通过及时正确的诊断,术前积极控制眼压和炎症,精心手术,术后严密观察,积极抗炎治疗,大部分白内障过熟期继发青光眼患者可以取得较好的疗效.     

A new method of duplication of the chronic intraocular hypertension model: underwater electrocoagulation

To study the experimental method of inducing the chronic intraocular hypertension in rat eyes. · METHODS: Twenty Wistar rats were randomly divided into ocular hypertension and sham control groups. Intraocular pressure (IOP) was raised by electrocoagulating at least 3 episcleral and limbal veins on the right eye of each rat in ocular hypertension group and its contralateral eye was used as control. At 1, 2, 3, 4 and 8 week after the electrocoagulation of the veins, IOP were measured. · RESULTS: The treatment of electrocoagulation caused a significant IOP increase of the right eyes over the baseline, over the contralateral eyes, and over the sham control eyes (repeated measures ANOVA, P <0.001). At 1 week, IOP was 30.12±5.18mmHg, and maintained the high IOP up to 8 weeks. · CONCLUSION: The chronic intraocular hypertension model could be successfully created by electrocoagulating three or more episcleral and limbal veins.     

脂质体包裹人促甲状腺激素受体胞外段基因真核表达质粒的构建

目的:构建阳离子脂质体包裹的人促甲状腺激素受体胞外段基因真核表达质粒。方法:PCR扩增穿梭质粒PHMCMVTSHR289目的基因并连接于真核表达质粒pcD NA3.1+上,重组质粒pcD NA3.1+/TSHR289采用酶切及测序法鉴定。阳离子脂质体包裹重组质粒pcD NA3.1+/TSHR289。结果:重组质粒pcD NA3.1+/TSHR289用Hind III酶切后产物经0.8%琼脂糖凝胶电泳检测显示出现512bp条带。正向测序发现AAC突变为AAT,为同义突变。反向测序发现GCG突变为GCT,亦为同义突变。阳离子脂质体与重组质粒的体积质量比例为3∶1。结论:酶切及测序鉴定重组质粒pcD NA3.1+/TSHR289构建成功。     

中国民航招飞屈光度预测远视力模型研究及远视力标准初探

目的：在民航招飞学员中研究屈光度预测远视力的模型,并初步探讨中国民航招飞远视力范围标准。
　　方法：收集1219名中国民航飞行学院2006/2013年招飞体检学生的远视力和屈光度;以屈光度为自变量,远视力为因变量拟合指数回归曲线模型;依据模型计算不同屈光度对应的远视力预测值及其95%预测区间,并计算误差率,误差率=[(远视力预测值-实际均值)/实际均值]×100%。
　　结果：以屈光度( x)预测远视力( y)的曲线模型为：y=0.55e0.41x+e (R2=0.968),远视力预测误差率平均为3.64%;屈光度[0.00,-3.00] D范围的远视力预测区间[0.14,0.55]与现行标准(0.3≤远视力<0.7)有交叉。结论：该模型拟合效果良好,可根据屈光度预测合理的远视力范围。建议中国民航招飞时保持屈光度标准[0.00,-3.00]D不变,将远视力标准降至0.1。     

眼科见习教学改革的尝试

目的:通过对见习教学手段、方法和内容的改革,旨在提高眼科见习教学质量。方法:见习教学的改革尝试:(1)、影像资料的使用:眼的解剖生理和常见手术的电视录像片。(2)教师示范,学生相互检查,增加实际操作机会。(3)以问题为基础的教学方法,调动学生的学习积极性。(4)临床病例讨论,使学生掌握正确的临床思维方法。结果:通过对2006年春季医学院五、七年制316名学生进行问卷调查,总体见习教学效果用优、良、中、差表示,优占65%,良占30%,中占5%。学生最不满意之处是未能见到足够的患者和病种。结论:在目前的医疗环境和高校扩召的新形势下,积极进行眼科见习教学改革势在必行,而且是行之有效的。     

角结膜恶性黑色素瘤1例

原发于角膜的恶性黑色素瘤罕见,我们报道1例.女性,39岁.因左眼发红,发现新生物5mo,于2006-03-28入住我院眼科.眼部检查:右眼视力0.9针孔1.0,左眼视力0.7针孔0.9,光定位和色觉检查正常.左眼颞侧球结膜充血( ),颞侧角膜新生物呈囊状,向角膜中央浸润,角膜上皮层大量色素沉着.初步诊断:左眼角镆新生物(性质待定).于2006-03-29在局麻下行左眼角膜新生物切除 全板层角膜移植术,术中切除病变组织送病理检查示:左眼角结膜恶性黑色素瘤,免疫组化:HHB45( ),PCK(-).最后诊断:左眼角结膜恶性黑色素瘤.     

眼睑皮肤恶性黑色素瘤早期检测进展

眼睑皮肤恶黑瘤发病率低,预后差,在临床及病理上很难与其他肿瘤鉴别.本文回顾了国内外眼睑皮肤恶黑瘤相关基因、肿瘤标志物的文献,发现B-RAF、hTERT、NOS及melan-A均与眼睑皮肤恶性黑色素瘤发生、发展,早期检测相关,有利其鉴别诊断.     

青光眼药物治疗的回顾和展望

青光眼在全世界范围内是一个主要的致盲眼病.高眼压是多数青光眼主要的危险,也是抗青光眼药物治疗的重点.随着人们对青光眼发病机制的研究以及药理学知识和技术的发展,抗青光眼药物也有了很大进展.现就目前正在使用的抗青光眼药物做一综述性回顾并介绍正在研究开发的抗青光眼新药的药效及降眼压机制.     

A comparison study of the clinical features between Chinese and Indian primary congenital glaucoma patients

To summarize the clinical features of Chinese primary congenital glaucoma(PCG) and to investigate the discrepancies of the clinical features between the Chinese and Indian patients. · METHODS: Clinical records of 40 Chinese PCG patients were reviewed. The clinical features were summarized as several quantifiable clinical parameters and the severity of the disease was evaluated. Both the quantified clinical features and severity were statistically compared with those of the Indian patients, which were cited from the previously published articles. · RESULTS: Forty Chinese and 43 Indian patients were included in the study. In Chinese patients, sex ratio (male to female )was about 2:1, family history was presented in 3 patients(7.5%) and consanguinity was found in one patient (2.5%). The main symptoms and signs observed in Chinese patients spanned a wide spectrum of manifestations. The most frequent signs noted in the initial examination were enlarged eyeball (42.5%) and decreased visual acuity(VA)(35.0%). Compared with Indian patients, Chinese patients had a later onset, a delayed diagnosis , more severe corneal changes and more severe optic nerve damages(P <0.01). The combined trabeculectomy and trabeculotomy operation was preferred by both Chinese and Indian doctors whereas a higher proportion of Indian patients received the combined operation (P <0.01). The proportions of the severity grade were different between Chinese and Indian patients. Most Chinese patients were in the severe grade while most Indian patients were in the very severe grade (P <0.01). · CONCLUSION: Chinese PCG patients were sporadic and non-consanguineous. Compared with Indian patients, Chinese patients had a relative later onset, a delayed diagnosis and treatment. More attempts are needed in Chinese PCG prevention and treatment.     

中央角膜厚度对常用眼压计测量值的影响

眼压在青光眼和其他眼科疾病的诊断和疗效评估中起着很重要的作用。已经有不少研究发现,各种眼压计的测量值都受中央角膜厚度的影响。不同的眼压计所受影响不同。本文对中央角膜厚度和不同眼压计测量值的关系进行综述。