色素膜炎白内障的超声乳化摘除联合人工晶体植入术的应用

目的：探讨超声乳化白内障摘除联合后房型人工晶体植入术在色素膜炎并发白内障治疗中的应用,方法：对40例（43只眼）色素膜炎并发白内障患者行超声乳化白内障摘除及后房型人工晶体植入,观察术前,术中和术后的眼部情况,随访时间为3个月至3年,结果：95％术眼术后视力明显提高,术中25．58％术眼在小瞳孔下操作,术中并发症有前房出血（2．33％）,后囊膜破裂（4．65％）,术后瞳孔的均能维持生理性圆形无上移,术后并发症有早期角膜水肿（23．26％）,虹膜后粘连（1．40％）,后囊膜混浊（46．51％）,黄斑囊样水肿（2．33％）,人工晶体表面机化物（4．65％）,结论：超声乳化白内障摘除联合后房型人工晶体植入术治疗色素膜炎并发白内障 安全有效的。     

22-三体1例

患儿,女,出生6 h因重度窒息入院.患儿为二胎二产,胎龄41周,于2008年10月5日在外院剖宫产分娩,出生时羊水过少,羊水Ⅱ度粪染,出生阿氏评分评1-3-5分,以新生儿重度窒息、缺血缺氧件脑病由我院出诊接回.     

生长抑素联合乌司他丁治疗急性胰腺炎疗效分析

目的探讨生长抑素联合乌司他丁治疗急性胰腺炎的临床效果。方法 92例急性胰腺炎患者随机分为观察组和对照组,各46例。观察组和对照组均给予常规处理。对照组患者在上述基础上给予生长抑素,观察组患者同时给予生长抑素和乌司他丁治疗,观察两组治疗效果。结果观察组患者住院时间为(26.4±4.9)d,死亡1例(2.2%),总有效率95.7%;对照组患者住院时间为(32.1±4.1)d,死亡8例(17.4%),总有效率80.4%。观察组住院时间和死亡率均低于对照组,差异具有统计学意义(P<0.05);观察组总有效率高于对照组,差异具有统计学意义(P<0.05)。结论生长抑素联合乌司他丁治疗急性胰腺炎疗效显著,缩短住院时间,降低死亡率,值得借鉴。     

角膜和全眼高阶波前像差的特点及年龄相关性变化的研究

Objective To investigate age-related changes in corneal and ocular monochromatic high-er-order aberrations and elucidate the distribution of corneal primary spherical in Chinese. Methods Using Traeey-iTrace visual function analyzer (EyeSys corneal topography combined with a ray-tracing aberrometer),113 normal eyes of 59 Chinese,mean age of 33.81+20.50 years (range,5-73 years),were evaluated for corneal and ocular monochromatic total higher-order aberrations (HOAs), primary spherical aberration (Z40),total spherical (TS),total coma (TC),and total trefoil aberration (TT) in the central 6mm diameter. Correla-tion analysis was also performed to assess the association between age and both corneal and oeular higher-order aberrations. Results The mean Zemike coefficient of Z40 was (0.27±0.07) ?m (range,0.130～0.451). Al-though corneal Z40 increased slightly with age,the correlation was small and insignificant (r =0.172,p =0.069 ). However, ocular Z40 had a positive correlation with age (r =0.545,p =0.000 ). Analyzer showed positive correlations with age for both corneal (r=0.499,p =0.000) and ocular (r=0.427,p =0.000) HOAs. Positive correlations were also observed between age and both corneal (r=0.149,p =0.021 ) and ocular (r=0.253,p =0.007) TC. Corneal and ocular TT (r =0.344,p =0.000; r=0.185,p =0.050,respectively) were increased with age. No significant correlation was found between corneal TS and age (r =0.180,p =0.057 ), but TS of the whole eye in-creased with age (r =0.560,p =0.000). There was a positive correlation between corneal and ocular HOAs (r =0.327,p=0.000),TC (r=0.233 ,p=0.013),and TT (r=0.481 ,p=0.000) aberration. Conclusions These re-suits also suggest that the ocular HOAs,TC,and TT increase with age,mainly because of the increase in corneal HOAs,TC,and TT; and the ZAO aberration increases with age,mainly because of the increase in Z40 in the internal optics. Individual variability in corneal primary spherical aberration was observed in Chinese.Therefore, preoperative measurement of corneal Z40 is crucial to the selection of aspheric IOL.     

cAMP反应元件结合蛋白(CREB)在正常发育大鼠视皮层的表达研究

正常视觉信息输入对初期视皮层的发育和修饰至关重要。视觉发育的特点是存在一个关键期 ,在此期内控制信息输入将导致皮质联系的显著变化。转录因子 -c AMP反应元件结合蛋白 ( CREB)在多种有机体的信号传导通路中的枢纽作用和其参与长时程突触可塑性的生理活动提示 ,它可能参与了在视皮层发育中发挥重要作用的分子机制。本研究应用免疫组织化学方法和 Western blot技术 ,对 P14、P2 2、P3 0、P45和 P90年龄组 Sprague-Dawley大鼠视皮层内 CREB的免疫反应性进行观察和分析。结果证明 ,CREB在视皮层各层内的蛋白表达时程与视觉发育的关键期一致 ,其免疫反应性在 P2 2至 P45期间达到高水平 ,成年后的蛋白表达出现下调。结论 :视觉可塑性降低的同时存在 CREB表达的显著改变 ,但该蛋白表达改变与突触传递和可塑性的关系尚待阐明     

cAMP反应元件结合蛋白(CREB)在单眼剥夺弱视大鼠视皮层中的表达研究

目前已对突触可塑性的基本特性有了相当程度的认识 ,但对其发育中神经元可塑性的内在分子机制尚待进一步阐明。不少研究提示 ,c AMP反应元件结合蛋白 ( CREB)在学习、记忆和长时程增强 ( LTP)过程中参与长时程突触的可塑性调节 ,推测其在视觉系统可塑性中也发挥着重要作用。本研究通过建立幼年大鼠单眼剥夺弱视模型 ,应用免疫组织化学方法 ,对视觉发育关键期末 ( P45 )大鼠和成年 ( P90 )大鼠视皮层中 CREB和 p CREB的免疫反应性进行观察、比较和分析。结果 :视觉发育关键期内进行单眼视觉剥夺对大鼠视皮层内总 CREB的蛋白表达没有产生显著影响 ,而 p CREB在 P45大鼠的剥夺眼对侧视皮层单眼反应区的 / 、 层中的蛋白表达较剥夺眼同侧视皮层的相应区域弱 ,该差异在该年龄大鼠的双眼反应区及成年后大鼠视皮层内不存在。结论 :CREB可能通过该磷酸化形式在视觉系统可塑性中发挥作用     

角膜和全眼高阶波前像差的特点及年龄相关性变化的研究

Objective To investigate age-related changes in corneal and ocular monochromatic high-er-order aberrations and elucidate the distribution of corneal primary spherical in Chinese. Methods Using Traeey-iTrace visual function analyzer (EyeSys corneal topography combined with a ray-tracing aberrometer),113 normal eyes of 59 Chinese,mean age of 33.81+20.50 years (range,5-73 years),were evaluated for corneal and ocular monochromatic total higher-order aberrations (HOAs), primary spherical aberration (Z40),total spherical (TS),total coma (TC),and total trefoil aberration (TT) in the central 6mm diameter. Correla-tion analysis was also performed to assess the association between age and both corneal and oeular higher-order aberrations. Results The mean Zemike coefficient of Z40 was (0.27±0.07) ?m (range,0.130～0.451). Al-though corneal Z40 increased slightly with age,the correlation was small and insignificant (r =0.172,p =0.069 ). However, ocular Z40 had a positive correlation with age (r =0.545,p =0.000 ). Analyzer showed positive correlations with age for both corneal (r=0.499,p =0.000) and ocular (r=0.427,p =0.000) HOAs. Positive correlations were also observed between age and both corneal (r=0.149,p =0.021 ) and ocular (r=0.253,p =0.007) TC. Corneal and ocular TT (r =0.344,p =0.000; r=0.185,p =0.050,respectively) were increased with age. No significant correlation was found between corneal TS and age (r =0.180,p =0.057 ), but TS of the whole eye in-creased with age (r =0.560,p =0.000). There was a positive correlation between corneal and ocular HOAs (r =0.327,p=0.000),TC (r=0.233 ,p=0.013),and TT (r=0.481 ,p=0.000) aberration. Conclusions These re-suits also suggest that the ocular HOAs,TC,and TT increase with age,mainly because of the increase in corneal HOAs,TC,and TT; and the ZAO aberration increases with age,mainly because of the increase in Z40 in the internal optics. Individual variability in corneal primary spherical aberration was observed in Chinese.Therefore, preoperative measurement of corneal Z40 is crucial to the selection of aspheric IOL.     

不同类型白内障的高阶像差

目的 比较白内障和透明晶状体的高阶像差并分析不同类型白内障的高阶像差特点。方法 使用Tracey像差仪分别测量3．0mm和5．0mm瞳孔直径下皮质性白内障（36例40眼）、核性白内障（25例27眼）以及后囊下性白内障（26例26眼）的高阶像差，28例透明晶状体眼（28眼）作为对照组，使用两个独立样本的t检验进行统计分析。结果 3．0mm瞳孔直径下，皮质胜白内障（0．148±0．086）μm、核性白内障（0．137±0．064）μm以及后囊下性白内障（0．209±0．181）μm的总高阶像差均高于对照组（0．069±0．028）μm，差异均具有统计学意义；其中，三叶草是最主要的像差成分。5．0mm瞳孔直径下，皮质性自内障（0．439±0．161）μm、核性自内障（0．443±0．14）μm以及后囊下性白内障（0．590±0．204）μm的总高阶像差均高于对照组（0．253±0．097）μm，差异均具有统计学意义；其中，三种白内障类型中最主要的高阶像差分别为彗差（0．243±0．135）μm、球差（0．231±0．122）μm以及三叶草（0．343±0．191）μm。结论与正常透明晶状体对比，自内障的高阶像差明显增加，不同类型的白内障具有不同的高阶像差特点。     

高度远视白内障患者人工晶状体屈光度数计算公式的选择

目的 比较Haigis、SRKⅡ、Hoffer Q、Hollady、SRK/T公式的准确性,以期为高度远视白内障患者植入的人工晶状体(IOL)屈光度数计算提供参考.方法 比较性研究.分析了24例(31只眼)行超声乳化白内障吸除联合后房型人工晶状体植入术的高度远视白内障患者,术前分别应用A超和IOL Master测量眼轴长度,计算人工晶状体度数,术后验光获得实测屈光度数.比较应用IOLMaster测量时Haigis、SRKⅡ、Hoffer Q、Hollady、SRK/T公式预测植入人工晶状体屈光度数的准确性,以及两种生物测量方法对各公式预测误差的影响.两种测量方法间的比较采用配对t检验.结果 (1)应用IOL Master测量时,Haigis公式的平均预测误差最小(0.37±0.14),随后依次为Hoffer Q、Hollday、SRK/T、SRK Ⅱ公式,分别为-0.70±0.12,-0.97±0.15,-1.25±0.14,-1.46±0.13.Haigis公式引起轻度的过矫,而其他公式则产生不同程度的欠矫.(2)A超的预测误差偏向正值,而IOL Master的预测误差却偏向负值.在A超测量眼轴时,Hoffer Q公式较为精确(-0.39±0.16),而在使用IOL Master时,Haigis更为精确(0.37±0.14).结论 高度远视白内障患者选择IOL屈光度数的计算公式,使用IOL Master测量时,建议选择Haigis公式,而采用A超测量时,选择Hoffer Q公式则能获得较为准确的IOL屈光度数.     

角膜和全眼高阶波前像差的特点及年龄相关性变化的研究

Objective To investigate age-related changes in corneal and ocular monochromatic high-er-order aberrations and elucidate the distribution of corneal primary spherical in Chinese. Methods Using Traeey-iTrace visual function analyzer (EyeSys corneal topography combined with a ray-tracing aberrometer),113 normal eyes of 59 Chinese,mean age of 33.81+20.50 years (range,5-73 years),were evaluated for corneal and ocular monochromatic total higher-order aberrations (HOAs), primary spherical aberration (Z40),total spherical (TS),total coma (TC),and total trefoil aberration (TT) in the central 6mm diameter. Correla-tion analysis was also performed to assess the association between age and both corneal and oeular higher-order aberrations. Results The mean Zemike coefficient of Z40 was (0.27±0.07) ?m (range,0.130～0.451). Al-though corneal Z40 increased slightly with age,the correlation was small and insignificant (r =0.172,p =0.069 ). However, ocular Z40 had a positive correlation with age (r =0.545,p =0.000 ). Analyzer showed positive correlations with age for both corneal (r=0.499,p =0.000) and ocular (r=0.427,p =0.000) HOAs. Positive correlations were also observed between age and both corneal (r=0.149,p =0.021 ) and ocular (r=0.253,p =0.007) TC. Corneal and ocular TT (r =0.344,p =0.000; r=0.185,p =0.050,respectively) were increased with age. No significant correlation was found between corneal TS and age (r =0.180,p =0.057 ), but TS of the whole eye in-creased with age (r =0.560,p =0.000). There was a positive correlation between corneal and ocular HOAs (r =0.327,p=0.000),TC (r=0.233 ,p=0.013),and TT (r=0.481 ,p=0.000) aberration. Conclusions These re-suits also suggest that the ocular HOAs,TC,and TT increase with age,mainly because of the increase in corneal HOAs,TC,and TT; and the ZAO aberration increases with age,mainly because of the increase in Z40 in the internal optics. Individual variability in corneal primary spherical aberration was observed in Chinese.Therefore, preoperative measurement of corneal Z40 is crucial to the selection of aspheric IOL.