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1.
目的 探讨新鲜羊膜移植治疗严重的急性炎症期和瘢痕期眼表疾病的可行性并对其疗效进行评价。方法 选择本院急性化学伤、热烧伤共 5例 (6只眼 ) ,复发性蚕蚀性角膜溃疡 8例 (8只眼 ) ,各种原因导致的大面积睑球粘连 42例 (49只眼 ) ,共计 5 5例 (6 3只眼 )临床连续住院患者 ,分别行单纯新鲜羊膜移植术 38例 (46只眼 ) ,羊膜移植联合板层角膜移植术 8例 (8只眼 ) ,羊膜移植联合角膜缘移植术 9例 (9只眼 )。术后均经印迹细胞学追踪观察移植后羊膜上皮细胞存活的时间。术后随访观察 6~ 18个月 ,平均 11个月。结果  5 5例术后临床上均未见新鲜羊膜植片急性排斥反应。严重急性眼烧伤的 6只眼中 ,术后 5只眼无角结膜进行性溶解和穿孔 ,无新生血管和假性胬肉侵入角膜表面 ,虹膜亦未见萎缩 ,视力有不同程度的提高。复发性蚕蚀性角膜溃疡 8只眼术后未见复发。严重睑球粘连 49只眼中 ,46只眼恢复了眼球的运动功能 ,3只眼术后 3个月再次发生睑球粘连。泪液分泌功能基本正常者羊膜上皮细胞移植后可存活约 3个月。结论 新鲜羊膜移植可有效地用于重建角结膜表面 ,减轻炎性反应 ,减少新生血管的生成 ,抑制纤维组织增生 ,同时可用于防止蚕蚀性角膜溃疡的复发。充分清除眼表的病变组织和羊膜移植片的缝合固定 ,对羊膜  相似文献
2.
灯盏细辛注射液对鼠实验性高眼压视神经轴浆运输的影响   总被引:46,自引:0,他引:46  
探讨灯盏细辛注射液是否对急性实验性高眼压大鼠视神经浆运输阻滞有促进恢复作用。方法健康SD大鼠30只,右眼制作成急性高眼压模型后,随机分成3组。A组6只鼠,做经左侧上丘逆行辣根过氧化物酶(horse radish peroxidase,HRP)标记,并行视网膜神经节细胞(retinal gangion cells,RGCs)计数。B组12只鼠,再分灯盏细辛腹腔注射治疗组与对照组,每组各6只鼠,高眼压  相似文献
3.
表皮生长因子受体家族在翼状胬肉上皮内的异常表达   总被引:31,自引:0,他引:31  
目的 了解表皮生长因子受体(epidermal growth factor receptor,EGFR)家族的EGFR、ErbB2及ErbB3蛋白在翼状胬肉上皮内的表达。方法 用免疫荧光组织化学及Western blot地15例初发期翼状胬肉患者切除的翼状胬肉组织进行EGFR、ErbB2及ErbB3蛋白的检测,并与正常人结膜组织进行对照。结果 免疫荧光组织化学染色显示,在正常结膜上皮中,EGFR蛋  相似文献
4.
PURPOSE: To compare the expression of the pro- and anti-inflammatory forms of interleukin (IL)-1 in the tear fluid and conjunctival epithelium of normal eyes and those with dry-eye disease. METHODS: The concentrations of IL-1 alpha, IL-1 beta (precursor and mature forms), and IL-1 receptor antagonist (IL-1Ra) were measured by ELISA in tear fluid samples obtained from normal individuals and patients with dry eye who had rosacea-associated meibomian gland disease (MGD) or Sj?gren's syndrome (SS) aqueous tear deficiency (ATD). These cytokines were also measured in normal tear fluid before and after nasal stimulation to induce reflex tearing. The relative expression of these cytokines was evaluated in conjunctival impression cytology specimens and conjunctival biopsy tissue obtained from normal subjects and SS ATD-affected patients using immunofluorescent staining. Matrix metalloproteinase (MMP)-9 concentration and activity in the tear fluid were evaluated with gelatin zymography and with an MMP-9 activity assay kit, respectively. RESULTS: Compared with normal subjects, the concentration of IL-1 alpha and mature IL-1 beta in the tear fluid was increased, and the concentration of precursor IL-1 beta was decreased in patients with MGD (P < 0.05, P = 0.02, and P < 0.01, respectively) and SS ATD (P < 0.001, P = 0.02, and P < 0.001, respectively). There was no significant change in the concentration of IL-1 alpha, precursor IL-1 beta, and IL-1Ra in reflex tear fluid, indicating that the lacrimal glands may secrete these cytokines. The activity of MMP-9, a physiological activator of IL-1 beta, was significantly elevated in the tear fluid of both dry-eye groups compared with normal subjects. A strong positive correlation was observed between the intensity of corneal fluorescein staining and the tear fluid IL-1 alpha concentration (r(2) = 0.17, P < 0.02) and the mature-to-precursor IL-1 beta ratio (r(2) = 0.46, P < 0.001). Positive immunofluorescent staining for IL-1 alpha, mature IL-1 beta, and IL-1Ra was observed in a significantly greater percentage of conjunctival cytology specimens from eyes with SS ATD than in those from normal eyes (P < 0.01 for IL-1 alpha, P < 0.009 for mature IL-1 beta, and P < 0.05 for IL-1Ra). CONCLUSIONS: Dry-eye disease is accompanied by an increase in the proinflammatory forms of IL-1 (IL-1 alpha and mature IL-1 beta) and a decrease in the biologically inactive precursor IL-1 beta in tear fluid. Increased protease activity on the ocular surface may be one mechanism by which precursor IL-1 beta is cleaved to the mature, biologically active form. The conjunctival epithelium appears to be one source of the increased concentration of IL-1 in the tear fluid of patients with dry-eye disease. These results suggest that IL-1 may play a key role in the pathogenesis of keratoconjunctivitis sicca.  相似文献
5.
正常人角膜前后表面地形及全角膜厚度的研究   总被引:21,自引:2,他引:19  
目的 了解正常人的角膜前后表面形态及全角膜厚度,为诊断异常角膜提供参考依据。方法 应用Orbscan角膜地形图仪对46例正常人(46只眼)的角膜进行检测,建立其正常参数。结果正常人角膜最薄处为(0.55±0.33)mm,平均位于距视轴(0.90±0.51)mm处。32例(70%)角膜最薄点位于颞下方,11例(24%)位于颞上方,2例(4%)位于鼻下,1例(2%)位于鼻上方。角膜厚度以角膜中央最薄(0.56±0.03)mm,角膜上方最厚(0.64±0.03)mm。模拟角膜屈率(SimK)为(44.24±1.61/43.31±1.66)D,散光度为(0.90±0.41)D。角膜前表面高度地形图的图形中,岛形最多,其次为不完全嵴形。角膜后表面高度地形图的图形中,岛形最多,其次为规则嵴形及不完全嵴形。在前表面角膜屈率地形图的图形中,对称蝴蝶结形最多,其次为椭圆形及不对称蝴蝶结形。在角膜厚度彩色地形图中,椭圆形最多,其次为圆形。结论 了解正常人全角膜厚度、角膜高度形态及角膜前表面角膜屈率地形图将为诊断异常角膜提供依据。Orbscan角膜地形图仪是一种测量角膜地形及全角膜厚度的有用工具,在角膜屈光手术中将具有重要的应用价值。  相似文献
6.
目的 评价干眼病患者的角膜表面规则性及人工泪液对其角膜表面规则性的影响。方法 应用TMS 1角膜地形图仪检测正常人 33例 ( 6 4只眼 )及干眼病患者 2 2例 ( 42只眼 )的角膜表面规则指数 (surfaceregularityindex ,SRI)、表面不对称指数 (surfaceasymmetryindex ,SAI)及角膜预测视力(potentialvisualacuity ,PVA) ,并对干眼病患者应用人工泪液前后角膜表面规则性及PVA的变化进行观察。结果 干眼病患者的SRI、SAI及PVA值分别为 0 .31± 0 .2 2、0 .30± 0 .16及 2 0 /17.89± 2 0 /3.0 4;而正常人分别为 1.2 8± 0 .73、1.0 5± 1.17及 2 0 /33.45± 2 0 /13.99。干眼病患者的SRI和SAI值较正常人明显升高 ,PVA值则明显降低 ,各组间比较差异有非常显著性 (P <0 .0 0 1)。干眼病患者的平均散光度( 2 .10± 1.96 )D明显较正常人 ( 1.13± 0 .5 3)D高 (P =0 .0 2 )。在干眼病患者中 ,SRI与SAI与角膜荧光素染色程度呈正相关 (SRI:P =0 .0 0 5 ;SAI:P =0 .0 16 ) ,而平均PVA与平均实际矫正视力比较差异无显著性。干眼病患者角膜地形图中对称蝴蝶结形所占的比例较正常人明显降低 ,而不规则形者所占比例则明显升高。干眼病患者在滴用人工泪液后 ,SRI、SAI和平均散光度均明显降低 (P值分别为<0 .0 0 1,<0 .0 0  相似文献
7.
临时人工角膜用于严重眼外伤的眼前后段联合手术   总被引:13,自引:2,他引:11  
目的评价临时人工角膜下眼前后段联合手术对严重眼外伤病变的治疗价值。方法对眼球穿通伤所致的眼球前后段严重的病变18例(18只眼),按伤眼的适应证,施行临时人工角膜下的玻璃体切除、眼内异物取出术、视网膜复位术及相关各种眼内显微技术(视网膜前膜剥离、重水液下操作、眼内硅油填充、眼内电凝和眼内激光等)和穿透性角膜移植术或自体角膜片转位移植术,观察其术后的转归及恢复情况。结果所有术眼的眼球均得到了保留,14只眼的视力较术前提高,其中5只眼的视力达到0.1以上,3/10只眼术后再次出现视网膜脱离,2只眼出现角膜植片混浊,各有1只眼出现玻璃体混浊和继发性青光眼,其中1只眼与术前一样为眼球萎缩。结论临时人工角膜下的眼前后段联合手术是目前治疗严重眼外伤病变的唯一有效的方法  相似文献
8.
Liu Z  Pflugfelder SC 《Ophthalmology》2000,107(1):105-111
PURPOSE: To evaluate the effect of long-term contact lens wear on corneal thickness, curvature, and surface regularity. DESIGN: A prospective, clinic-based, case-control study. PARTICIPANTS: A total of 40 eyes of 20 normal subjects and 64 eyes of 35 subjects wearing contact lenses for more than 5 years were evaluated. METHODS: The Orbscan Corneal Topography System was used to evaluate the entire corneal thickness and curvature, anterior curvature and the anterior and posterior elevation topographic patterns in normal eyes and subjects wearing contact lenses on a regular basis for more than 5 years. Indices of TMS-1 Corneal Topography System were used to determine corneal surface regularity in subjects wearing contact lenses and normal eyes. All topographic examinations were performed after contact lenses had been removed for at least 2 weeks. MAIN OUTCOME MEASURES: The entire corneal thickness, curvature, surface regularity index (SRI), surface asymmetry index (SAI), potential visual acuity (PVA) and topographic patterns were compared between normal eyes and subjects wearing contact lenses for more than 5 years. RESULTS: The 64 eyes of 35 subjects evaluated by the Orbscan instrument had an average of 13.45 +/- 6.42 years of contact lens wear. The mean corneal thickness in the center and in eight peripheral areas measured in contact lens wearing subjects was significantly reduced by about 30 to 50 microm compared to normal subjects (P < 0.001 for central and peripheral sites). No correlation was noted between central corneal thickness and degree of myopia in diopters (r = 0.15, 0.10 < P < 0.25). The corneal curvature, maximum keratometry (Max K) and minimum keratometry (Min K) readings, were significantly steeper in eyes wearing contact lenses than normal eyes (P < 0.01 for Max K and Min K measured by both instruments). No difference in the mean corneal astigmatism was noted between groups. The SRI and SAI, but not the PVA index, of the TMS-1 were significantly greater in contact lens wearers than in the control group (P < 0.01 for both SRI and SAI, P = 0.15 for PVA). The color-coded patterns of all curvature and elevation maps made with both instruments showed no significant difference between subjects wearing contact lenses and the control group. There was no significant difference between corneal curvature measurements taken with the Orbscan System or the TMS-1 System in both normal and contact lens groups. CONCLUSIONS: Long-term contact lens wear appears to decrease the entire corneal thickness and increase the corneal curvature and surface irregularity.  相似文献
9.
山东省莱芜市白内障手术复明效果及术后并发症的调查   总被引:11,自引:2,他引:9  
目的 了解白内障手术后的复明情况,并探讨其影响因素及有效的解决方法。方法 采用大样本含量分层整群随机抽样法对山东省莱芜市人群进行普查,记录白内障患者的手术类型、术后视力及术后并发症情况,将结果进行统计学分析。结果 共查出白内障术后患者1089例(1274只眼)。盲和低视力的发生率分别为4.87%和23.70%。术后发生角膜失代偿,继发性青光眼、晶状体后囊膜混浊、黄斑囊祥水肿和视网膜脱离者650只眼(51.02%),治疗后因这些术后并发症导致的盲及低视力发生率由治疗前的4.87%、23.70%分别降至1.96%和6.01%。白内障针拨术和囊内白内障摘除术的手术脱盲率和最终脱残率最低,术后并发症的发生率最高。结论 适当选择白内障手术类型;对农村地区白内障术后患者进行定期随诊及普查,及时发现,治疗术后并发症,对提高白内障手术的脱盲率和脱殖率具有极为重要的意义。  相似文献
10.
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