准分子激光二次屈光性角膜切削术治疗残余近视

目的　评价准分子激光二次屈光性角膜切削术治疗准分子激光屈光性角膜切削术(PRK) 术后残余近视的疗效。方法　对因PRK 术后残余近视而进行再次激光治疗的42 例(58 眼) 病人的临床资料作回顾性分析。二次PRK 术后随访时间为6 ～24(14 ±5) 个月。结果　58 眼二次PRK 术前残余近视度为- 5-55 D±2-67 D( - 0-75 ～- 14-00 D) ,术后为- 0-15 D±0-94 D( 0-75 ～- 2-75D) ,其中44 眼(75-9 % ) 最后屈光度稳定在预矫正度的±1-00 D 以内;二次PRK 术后裸眼视力为0-71 ±0-33 ,其中54 眼(93-1 % ) 裸眼视力≥0-6 ,3 眼(5-2 % ) 最佳矫正视力损失≥1 行;二次PRK 术前角膜雾浊均为0 级,术后42 眼为0 级,15 眼为0-5 级,1 眼为1-0 级。结论　二次PRK 治疗残余近视具有较好的安全性、预测性和屈光稳定性。     

准分子激光治疗高度和超高度近视

目的评价准分子激光原位角膜磨镶术(laserin-situkeratomileusis,LASIK)和准分子激光角膜切削术(photorefractivekeratectomy,PRK)治疗高度、超高度近视的临床效果.方法对于术前近视-6.00～-14.75D的患者102只眼施行PRK手术,近视-6.00～-22.00D的患者118只眼施行LASIK手术.按术前屈光度分组,Ⅰ组-6.00～-9.75D;Ⅱ组-10.00～-14.75D;Ⅲ组-15.00～-22.00D.术后随访半年以上,并将结果比较分析.结果术后裸眼视力≥0.5者,Ⅰ组中PRK为93.9%;LASIK为98.4%.Ⅱ组中PRK为75.0%;LASIK为93.8%.Ⅲ组中PRK为0.0%;LASIK为65.2%.术后裸眼视力≥1.0者,,Ⅰ组中PRK为79.2%;LASIK为82.5%.Ⅱ组中PRK为35.0%;LASIK为46.9%.Ⅲ组中PRK为0.0%;LASIK为8.7%.术后屈光度在±1.0D以内者Ⅰ组中PRK为63.4%;LASIK为66.7%.Ⅱ组中PRK为15.0%;LASIK为46.9%.Ⅲ组中PRK为0.0%;LASIK为8.7%.角膜上皮下混浊PRK治疗组中占59.8%;而LASIK则占4.2%.术后散光增加PRK治疗组为17.6%;LASIK治疗组占21.2%,尚未发现严重并发症.结论对高度和超高度近视患者,LASIK临床治疗效果优于PRK手术.     

准分子激光屈光性角膜切削术治疗近视的远期疗效

目的评价准分子激光屈光性角膜切削术(PRK)治疗近视的远期疗效.方法178例344眼屈光度为-1.00～-19.00D患者分为Ⅰ组-1.00～-6.00D,165眼,Ⅱ组-6.25～-10.00D,129眼,Ⅲ组≥-10.25D,50眼.PRK术后对患者的视力、屈光度、角膜上皮下基质混浊等进行3年随访.结果3年时裸眼视力达到术前最佳矫正视力者Ⅰ组为90.9%(150眼),Ⅱ组为72.9%(94眼),Ⅲ组为40.0%(20眼);屈光度在预期矫正度±1.00D以内者,Ⅰ组为95.8%(158眼),Ⅱ组76.0%(98眼),Ⅲ组为28.0%(14眼);角膜上皮下基质混浊,0～0.5级的Ⅰ组、Ⅱ组均为100%,Ⅲ组为90.0%(45眼).结论PRK治疗近视,低中度近视的远期效果满意,对-6.25～-10.00D的高度近视有效,但不如低中度近视的效果好,而对于≥-10.25D的超高度近视患者远期疗效不理想.     

准分子激光上皮瓣下角膜磨镶术治疗近视的早期疗效观察

目的　评价 L ASEK治疗近视的早期疗效观察。　方法　应用日本产 NIDEK EC- 5 0 0 0型准分子激光机对 2 0眼不同程度近视 (- 1.5 0～ - 11.0 0 D)行 L ASEK治疗 ,术后 1～ 3个月对视力、屈光度及角膜雾样混浊 (Haze)进行随访。　结果　术后 1～ 3个月裸眼视力均达到 0 .5以上 ,≥ 1.0者达 70 % ,2 0眼最后一次复查屈光度在± 1.0 0 D以内者为 18眼 , 级 Haze者为 1眼。　结论　准分子激光上皮瓣下角膜磨镶术是治疗近视安全有效的方法之一。     

准分子激光角膜切削术治疗低中度近视术后3年疗效分析

 目的 评价准分子激光角膜切削术(Photo refractive keratectomy,PRK)治疗低、中度近视疗效的长期稳定性及疗效。方法 对屈光度为-1.50——6.00 D的134眼行PRK术,根据术前屈光度分为2组,即低度组(≤-3D)和中度组(＞-3D),观察其术后3a以上患者的视力、屈光度及角膜曲率。结果 PRK术后3a裸眼视力≥1.0者120眼(89.6％),低度组为97.3％,中度组86.6％。术后平均屈光度为(-0.62±0.67)D,预期矫正度在±1.00D者85.2％,低度组97.3％,中度组73.2％。结论 PRK矫治低、中度近视远期疗效满意。     

固体扫描式激光屈光性角膜切削术治疗高度近视180眼结果分析

目的探讨固体扫描式激光屈光性角膜切削术(PRK)治疗高度近视的疗效和安全性.方法应用美国产LightBladeTMⅡ型固体激光手术系统进行扫描式屈光性角膜切削术,治疗高度近视180眼,随访2年,回顾性地分析疗效和并发症,探讨其有效性和安全性.结果106例患者,平均年龄28.5岁.术前近视-6.25～-16.00D,平均等效球镜屈光度-8.19±0.53D;固体激光PRK术后24个月-0.53±0.56D.平均角膜屈光力术前43.24±0.26D,术后40.22±0.44D.术后1、6、12和24个月,试图矫正和实际矫正屈光度相差±1.00D内分别为94.44%、90.55%、93.33%、92.11%,相差±2.00D内分别为98.33%、93.89%、98.33%、98.68%.术后2年,裸眼视力≥1.0占56.59%,≥0.5占94.74%,89.47%达到术前最好矫正视力,3.95%超过1～2行,6.58%下降1～2行.术后角膜Haze轻微,术后2年,88.16%角膜透明,不留痕迹,9.21%Ⅰ级Haze,2.63%Ⅱ级Haze.12眼屈光回退再手术.6眼激素性眼压升高,用药后控制了眼压.结论固体激光治疗高度近视安全、有效,没有发现威胁视力的并发症.     

准分子激光治疗中度近视临床疗效分析

目的　评价准分子激光治疗中度近视的有效性和预测性。方法　分别应用准分子激光屈光性角膜切削术和准分子激光原位角膜磨镶术对中度近视共 10 85眼进行治疗和临床疗效对照分析。结果　术前准分子激光屈光性角膜切削术组和准分子激光原位角膜磨镶术组平均裸眼视力分别为 (0 .11± 0 .0 5 )和 (0 .0 6±0 .0 4 ) (P <0 .0 5 ) ,平均等值球镜屈光度分别为 (- 3.6 3± 1.5 5 )、(- 4 .87± 0 .93)D(P <0 .0 5 ) ;术后 6个月准分子激光屈光性角膜切削术组平均裸眼视力为 (1.12± 0 .2 3) ,等值球镜屈光度为 (- 0 .4 9± 0 .4 3)D ,而准分子激光原位角膜磨镶术组平均裸眼视力为 (1.18± 0 .17) (P >0 .0 5 ) ,等值球镜屈光度为 (- 0 .5 8± 0 .4 0 )D(P >0 .0 5 )。结论　准分子激光屈光性角膜切削术和准分子激光原位角膜磨镶术两种方法治疗中度近视均具有准确性高、预测性良好的特点。     

准分子激光上皮下角膜磨镶术治疗准分子激光角膜切削术后屈光回退的临床疗效观察

目的探讨准分子激光上皮下角膜磨镶术（LASEK）治疗准分子激光角膜切削术（PRK）术后屈光回退的疗效及安全性。方法对21例36只眼PRK术后屈光回退患者施行LASEK。LASEK术前的平均屈光度为（-1.98±0.65）D,平均角膜厚度为（470.17±18.46）μm,LASEK平均切削深度为（36.58±11.24）μm。结果术后第12个月裸眼视力1.0以上22只眼（占61.1%）,0.8以上31只眼（占86.1%）,0.5以上36只眼（占100%）,平均屈光度为（-0.18±0.53）D,未见最佳矫正视力下降,术后裸眼视力较术前明显提高,差异有显著意义（P〈0.05）。角膜瓣混浊0级29只眼（占80.6%）,0.5级5只眼（占13.9%）,1级2只眼（占5.5%）。结论 LASEK治疗PRK术后屈光回退安全有效,长期效果有待随访观察。     

Moria M2自动微型角膜刀在LASIK近视矫正手术中的应用

目的　探讨MoriaM2自动微型角膜刀在准分子激光原位角膜磨镶术手术中的安全性及有效性。 方法　应用MoriaM2微型角膜刀联合Allegretto鹰视准分子激光器行准分子激光原位角膜磨镶术912例 (1785眼)。根据术前屈光度不同分为两组,一组屈光度≤-6.00D,二组屈光度>-6.00D。观察术中、术 后角膜瓣并发症及术后视力、屈光状况。结果　术后第1天,所有患者裸眼视力较术前显著提高,其中1608 眼(90.1%)达到术前最佳矫正视力,129眼(7.2%)超过术前最佳矫正视力。第一组术后裸眼视力≥1.0者占 95.1%,第二组≥1.0者占82.3%,随访3～12个月视力基本稳定。术后12个月3例(5眼)屈光回退在 -1.25～-1.75D之间。角膜瓣相关并发症4眼(0.22%)。结论　MoriaM2自动微型角膜刀在准分子激光 原位角膜磨镶术中具有较高的安全性和有效性。     

准分子激光上皮瓣下角膜磨镶术治疗近视的早期疗效观察

目的 评价LASEK治疗近视的早期疗效观察。方法 应用日本产NIDEK EC-5000型准分子激光机对20眼不同程度近视(-1．50～-11．00D)行LASEK治疗，术后1～3个月对视力、屈光度及角膜雾样混浊(Haze)进行随访。结果术后1～3个月裸眼视力均达到0．5以上，≥1．0者达70％，20眼最后一次复查屈光度在士1．00D以内者为18眼，Ⅱ级Haze者为1眼。结论准分子激光上皮瓣下角膜磨镶术是治疗近视的安全有效的方法之一，但尚需临床进一步随访、观察，及基础理论的研究。     

无体征缺血性脑血管病脑电地形图,脑电图CT对比观察

对临床表现头昏头痛，而无体征的２００例脑梗塞和５０例短暂性脑缺血发作患者进行了脑电地形图，脑电图，ＣＴ对比观察，结果表明：脑梗塞组脑电地形图异常率９０．０％，脑电图异常率６５．６％，ＣＴ异常率９７．５％，短暂性脑缺血发作组三种检查异常率分别为５８％、３０％、４％，脑梗塞组ＣＴ异常率均高于其它两种检查，而短暂性脑缺血发作组脑电组形图异常率匀高于其它两种检查。因此脑电地形图在早期诊断无体征缺血性脑血管     

消炎痛治疗兔眼前节创伤性炎症的实验研究

本文观察了消炎痛结膜下注射治疗眼前带创伤性炎症,发现消炎痛对自由基有很强的抑制作用。治疗眼房水中MDA值和化学发光值与对照眼相比较,P<0.01。     

A simple angiographic method for assessing aorto-femoral bypass grafts

Direct puncture of femoral bypass grafts in the groin with retrograde injection of contrast was employed to assess the lower abdominal aorta, iliac and lower limb arteries. The technique was effective, simple, quick and safe.     

多层螺旋CT肝脏兼容性血管造影在肝癌介入治疗中的应用价值

目的 探讨多层螺旋CT（MSCT）肝脏兼容性血管造影在肝癌介入治疗中的应用价值。方法 MSCT肝癌CT检查患者45例,于动脉期22s、门静脉期55s行肝脏双期增强扫描,采用MPVR、MIP、VR、SSD重建技术行肝动脉、门静脉兼容性血管成像。其中22例作了肝动脉DSA造影及介入治疗。结果 动脉期肝动脉血管造影（SCTA）显示肿瘤血管31例,肿瘤染色17例,动-门脉分流（APS）9例。门脉期门静脉造影（SCTP）检出肿瘤对门静脉的侵犯25例,门静脉癌栓16例。MSCT显示的肿瘤血管、肿瘤染色、供血动脉的来源分布、APS及门静脉癌栓与DSA图像基本一致。MPVR、VR有利于检出肝癌供血动脉、肿瘤血管、肿瘤染色、APS及门静脉癌栓。结论 MSCT肝脏兼容性SCTA、SCTP血管造影,可为临床及肝癌介入治疗方案的制定提供更多信息。     

1-Alpha-hydroxy vitamin D in dialysis bone disease: radiological changes after 6 and 12 months of treatment

Biochemical, radiological and histological indicators of dialysis bone disease were studied before, 6 months (58 patients) and 12 months (48 patients) after starting treatment with 1 alpha-OH D3. Radiographic healing of subperiosteal erosions was seen after 6 months in 60% and after 12 months in 77% of affected patients. Radiographic improvement, however, was not significantly related to reductions in resorptive surfaces seen on quantitative bone histology, nor to changes in plasma concentrations of immunoreactive parathyroid hormone. Metastatic calcification appeared or increased in 43% of patients after 6 months and 52% after 12 months. Periosteal new bone developed or increased in 14% of patients after 6 months and 17% after 12 months. Both metastatic calcification and periosteal new bone formation were associated with high plasma phosphate concentrations, but not with plasma calcium, alkaline phosphatase or parathyroid hormone concentrations. Treatment with 1 alpha-OH D3 produces radiological improvement in the majority of patients with dialysis bone disease, but the lack of correlation with histological changes confirms the need for regular radiographic examination. Metastatic calcification and periosteal new bone formation probably represent toxicity of 1 alpha-OH D3 but may be minimised by phosphate restriction.     

New radiotherapeutic techniques in nuclear ophthalmology

Various aspects of radiotherapeutic techniques used in treating ocular tumors are discussed. Previous and current "standard" modalities are briefly reviewed, including beta and gamma emitters, 60Co, 125I, and charged particles. In particular, emphasis is placed upon techniques under development that use biomolecules to physiologically target radioactive or stable isotopes to ocular melanoma. These procedures include 35S-thiouracil, 127I-deoxyuridine in conjunction with irradiation with photons from 145Sm, neutron capture therapy, and various combinations of the above. Thiouracil shows particular promise because of its incorporation during malanin synthesis in growing melanoma. Radiosensitization and stimulation of Auger cascades via introduction of iodine in DNA followed by irradiation with activating photons of appropriate energy (from 145Sm) has been shown to be effective in vitro. Various molecules may be used to transport boron to ocular melanoma, including thiouracil, thus allowing selective irradiation of tumor cells via 10B (n, alpha) 7Li reaction.     

小牛胸腺肽治疗乙型肝炎的疗效研究

本文报告了小牛胸腺肽(CTP)治疗乙肝患者50例(慢迁肝23例,慢活肝16例,重症肝炎11例)和HBsAg携带者10例的结果,CTP对消除或减轻临床症状和体征,改善肝功能具有明显的疗效,对慢迁肝,慢活肝和重症肝炎的治疗效果基本相同,各组间无显著性差异。对HBV血清学指标无重要改变,对HBsAg携带者疗效不侍。并对剂景、疗程与疗效的关系进行了讨论。     

Intraluminal contrast agents for MR imaging of the abdomen and pelvis

Magnetic resonance (MR) imaging of the abdomen and pelvis with use of gastrointestinal (GI) contrast agents is slowly emerging as a valuable diagnostic tool. In the past few years, considerable effort has been expended on developing an oral contrast agent to serve as a bowel marker during abdominal and pelvic imaging. Four major categories of agents have been studied: compounds with positive contrast-enhancing characteristics (ie, which increase signal intensity), which may be either miscible or immiscible with bowel contents, and compounds with negative contrast-enhancing characteristics (ie, which decrease signal intensity), which also may be miscible or immiscible. Compared with precontrast images, MR images acquired after administration of GI contrast agents have shown increased anatomic delineation of the bowel lumen, pancreas, and paraaortic nodes, allowing increased detection of pancreatic lesions, improved assessment of bowel wall lesions, and distinction between intrahepatic and extrahepatic lesions. This review focuses on the general physics and requirements for intraluminal GI contrast media for MR imaging, the currently used intraluminal agents and their regulatory status, current and near-future availability, and cost considerations.