LASIK矫治儿童高度远视性屈光参差术后视力、屈光度及角膜地形图分析

目的探讨LASIK矫治儿童高度远视性屈光参差的有效性、稳定性及角膜形态的变化对视力的影响,以便指导手术设计,提高手术疗效。方法对51例6~14岁患儿53只高度远视性屈光参差眼LASIK术后1、3、6和12个月进行视力、屈光度及角膜地形图的随访。结果术后各时间段的平均裸眼远、近视力,平均矫正远、近视力都明显好于术前;术后第1个月模拟角膜镜度数(simulatedkeratoscope reading,Sim k)的等效值较术前平均增加4.89 D,球镜屈光度较术前平均减少5.73 D。术后1~3个月Sim k等效值平均回退量为0.42 D,球镜屈光度的平均回退量为0.45 D;术后3~6个月两者的回退量分别为0.30 D和0.32 D;术后6~12个月两者仍然有0.26 D和0.23 D的回退,在各时间段中两者的回退变化相一致;Sim k的差值与柱镜屈光度的变化相符:术后较术前明显减少,术后各时间段相比较差异无显著意义。结论 LASIK矫治儿童高度远视性屈光参差是有效的,但是稳定性低于成人及儿童高度近视性屈光参差,角膜地形图检查可准确显示术后角膜的形态变化:在成人LASIK术后角膜地形图的形态变化基础上具有一定的自身特点,掌握这些特点对手术设计的改进和手术疗效的预测具有重要的临床意义。     

准分子激光presbyMAX程序矫正老视

目的:探讨阿玛仕准分子激光Presby MAX Hybird矫正老视模式,对矫治老视及屈光不正的临床效果。方法:Presby MAX Hybird模式矫正屈光不正和老视患者17例34只眼,平均年龄(50.5±9.1)岁。术前平均裸眼远视力(0.43±0.34)、手术前等效球镜从(3.75～-8.25)D;100%矫正远视力≥0.8、手术前平均的老视度数为(+1.74±0.44)D(0.5～2.25 D)。角膜瓣采用Wavelight FS200飞秒激光制作,厚度120μm,直径8.5 mm,蒂位于上方;矫正方法为主视眼视远为主,非主视眼视近为主,手术前检查项目主要包括裸眼远视力、裸眼近视力、矫正视力、等效球镜;手术后随访3个月,对手术后的裸眼远视力、裸眼近视力、矫正远视力、等效球镜、不适症状等进行统计学分析。结果:术后3个月随访时,76.5%主视眼的裸眼远视力在0.8以上、52.94%主视眼的裸眼远视力在1.0或以上;81.3%患者主视眼的术后屈光度在±0.5 D以内;70.6%非主视眼的眼裸眼近视力≥0.5;35.3%的患者非主视眼裸眼近视力≥0.8;87.0%的患者非主视眼屈光度在0～-1.5 D;2例看远有叠影影和雾视、1例夜间视物不清、2例主诉有夜晚眩光。结论:Presby MAX Hybird老视矫正模式在短期内显示了较好的预测性、稳定性和安全性,但非主视眼的裸眼远视力有下降的趋势,手术前有屈光不正的患者更愿意接受手术。随着手术技术的改进和程序设计的完善,Presby MAX Hybird在矫正老视方面将得到推广。     

阿玛仕准分子激光矫正老视初步结果分析

正目的:探讨阿玛仕准分子激光PresbyMAX Hybird矫正屈光不正和老视模式,对矫治老视及屈光不正的临床效果。方法:对17例34只眼患者,选择PresbyMAX Hybird模式矫正屈光不正和老视,角膜瓣采用Wavelight FS200飞秒激光制作,厚度120μm,直径8.5 mm,蒂位于上方;矫正方法为主视眼视远为主,非主视眼视近为主,手术前检查项目主要包括裸眼远视力、裸眼近视力、矫正视力、等效球镜;手术后随访3个月,对手术后的裸眼远视力、裸眼近视力、矫正远     

PRK与LASIK矫治远视的疗效比较

目的 对准分子激光屈光性角膜切削术（PRK）和准分子激光原位角膜磨镶术（LASIK）联合可蚀盘矫治远视的疗效进行比较。方法 使用可蚀盘联合三棱镜抛光技术。对25例患者40只远视眼进行矫治。其中PRK16眼，LASIK24眼，患者术前屈光度 1.62- 6.25D。术后随访12个月。结果 术后12个月，PRK组有2眼（12.5%)，LASIK组有3眼（12.5%)最佳矫正远视力丢失2行以上；而最佳矫正近视力丢失2行以上者分别为1眼（6.3%)和2眼（8.3%)。平均裸眼远视力PRK组为0.55,LASIK组为0.68；平均裸眼近视力PRK组为0.66，LASIK组为0.85，PRK组有12眼（75.0%)，LASIK组有20眼（83.3%)残余屈光度在-1.00D- 1.00D之间。术后1-3个月，PRK组平均回退量为0.95D,LASIK组的平均回退量为0.76D；术后3-6个月，其回退量分别为0.35D和0.08D；术后6-12个月，回退量分别为-0.22D和0.00D。两种术式疗效比较差异均有显著意义。结论 使用可蚀盘联合三棱镜矫治远视是安全的，PRK与LASIK两种方法均可获得满意的远期疗效。但LASIK较PRK更容易稳定，且有效性和预测性更好。     

准分子激光原位角膜磨镶术治疗儿童远视性屈光参差

目的 评价准分子激光原位角膜磨镶术(excimer laser in situ keratomileusis,LASIK)治疗儿童远视性屈光参差的疗效.方法 使用美国Summit公司的SVS Apex plus准分子激光系统及Moria公司的微型板层角膜切割系统(LSK),对8例9～14岁远视性屈光参差患者进行LASIK手术,术后进行双眼视训练和系统的弱视治疗.结果 术后裸眼视力和矫正视力明显提高,术前平均最佳矫正视力0.23,术后6个月平均最佳矫正视力0.65;屈光度明显降低,但平均仍残留 2.81D;8例患者全部建立同时视和融合功能,6例有立体视功能.结论 LASIK治疗儿童远视性屈光参差安全有效,可明显提高视力,恢复和建立双眼视功能.     

LASIK矫正近视性屈光参差对双眼视觉的影响

目的探讨准分子激光手术矫正近视性屈光参差对双眼视觉的影响及临床价值。方法近视性屈光参差患者35例67只眼,常规LASIK,术后随访12～38个月,观察手术前后裸眼视力、最佳矫正视力及双眼视觉。结果术后1年裸眼视力达到或超过术前最佳矫正视力91.0%者61只眼。双眼屈光参差度数手术前为（4.56±2.15）D,手术后为（0.52±0.26）D,较术前明显降低。术前1例有正常近立体视,8例为亚正常立体视,26例为立体盲。术后1年,14例患者有正常近立体视,19例为亚正常立体视,2例为立体盲。术后1年的近立体视与术前比较有明显提高,差异有显著意义（P〈0.05）。术后1年的近立体视较与术前戴框架镜比较也有明显的改善。结论 LASIK治疗近视性屈光参差不仅提高患者的裸眼视力,并改善双眼视觉功能,恢复正常或部分立体视。     

准分子激光原位角膜磨镶术治疗—10D以上近视疗效观察

采用LASIK手术治疗-10D以上近视303眼。术前平均裸视力0.1±0.05(0.005～1.0),平均屈光度(-15.25±5.25)D(-10.00D～-26.00D),散光度数(-4.25±2.12)D(-0.75～-6.25D),术前平均屈光力(K)值43.60±1.52。随访8～12个月,平均裸眼视力升至0.52±0.25(0.25～1.0),平均屈光度降至( 0.85±2.59)D,K值降至37.53±1.73,散光度数降至(0.00±1.52)D(0.00～-3.00D)。结果表明LASIK治疗-10D以上高度近视效果可靠,预测性强,手术精确度高,优于PRK。     

飞秒激光小切口基质透镜取出术治疗近视性屈光参差的临床研究

目的研究飞秒激光小切口基质透镜取出术(small incision lenticule extraction,SMILE)治疗近视性屈光参差的治疗效果。方法采用回顾性研究,近视患者19例30只眼,采用SMILE矫正,记录术前,术后1天,术后1周,术后1、3、6个月的裸眼视力、最佳矫正视力、屈光度、屈光参差程度进行对比研究。结果 30只眼术后裸眼视力均显著提高,术后1天、1周、1个月裸眼视力呈逐渐上升趋势(P0.05),而术后1、3、6个月裸眼视力稳定,差异均无统计学意义(P0.05);所有患者,按近视程度较高眼及近视程度较低眼分别统计,术后1天,1周,1、3、6个月的双眼裸眼视力之间无统计学差异(P0.05);术后3只眼最佳矫正视力提高一行,未出现最佳矫正视力下降的情况;所有患者术后屈光参差均得到有效矫正,术后1天,1周,1、3、6个月同一患者的近视程度较高眼与近视程度较低眼的屈光度无统计学差异(P0.05);术后双眼屈光度差值平均为(0.40±0.27)D。结论 SMILE治疗近视性屈光参差术后视力好、屈光状态稳定、不受术前双眼近视程度差异的影响,是一种安全、有效、稳定性好的屈光参差矫正方法。     

LASIK治疗成人单眼近视性屈光参差性弱视的疗效观察

目的探讨准分子激光原位角膜磨镶术（laser in situ keratomileusis,LASIK）治疗成人单眼近视性屈光参差性弱视的效果和安全性。方法前瞻性观察47例成人单眼近视性屈光参差性弱视眼的LASIK手术后1、6和12个月时的裸眼视力,并与该眼术前最佳矫正视力进行比较。结果所有患者术后1、6和12个月时弱视眼的裸眼视力（uncorrected visual acuity,UCVA）均等于或大于术前的最佳矫正视力（the best corrected visual acuity,BCVA）,并且随术后时间的延长UCVA有逐渐提高的趋势,且未发现手术并发症,所有患者均对手术结果表示满意。术后1、6和12个月时弱视眼的UCVA高于术前BCVA的分别为37、38和38只眼,约占术眼的78.7%、80.8%、80.8%。结论 LASIK手术治疗成人单眼近视性屈光参差性弱视安全、有效。     

近视性屈光参差与双眼视觉关系的研究

目的：探讨近视性屈光参差对双眼视觉的影响。方法：选择屈光度差≥2D近视92例,分别检查裸眼视力、屈光状态、最佳矫正视力、矫正前后双眼视功能,分析屈光参差对双眼视觉的影响。结果：（1）戴框架眼镜矫正视力≥0.6与〈0.6组近立体视锐度比较,差异非常显著（P〈0.01）。（2）高度屈光参差组（2～5.75D）与重度屈光参差组（≥6D）矫正后近立体视锐度比较,差异非常显著（P〈0.01）。（3）近视性屈光参差者矫正前后融合功能及远、近立体视功能比较,差异显著（P〈0.05）。（4）近视性屈光参差者矫正后,具有正常近立体视功能的屈光参差度数为（3.125±0.685）D,具有异常近立体视功能的屈光参差度数为（3.928±1.549）D,立体视锐度缺失的屈光参差度数为（6.817±2.667）D。结论：近视性屈光参差对双眼视觉有显著影响。     

成批煤气爆燃烧伤的救治体会

报道治疗因煤气泄漏爆炸烧伤病员7例，经应用MEBT技术积极救治，其中6例于伤后17天痊愈出院，另一例特重伤员也于伤后30天康复出院。作者认为：应严格按照MEBT／MEBO要求进行规范治疗，正确处理生命体征、休克、感染、脏器功能和创面的辨证关系。同时，不能忽视外科营养在过程中的重要作用，它是创面修复的物质保证。     

Glutamine supplementation in vitro and in vivo,in exercise and in immunodepression

In situations of stress, such as clinical trauma, starvation or prolonged, strenuous exercise, the concentration of glutamine in the blood is decreased, often substantially. In endurance athletes this decrease occurs concomitantly with relatively transient immunodepression. Glutamine is used as a fuel by some cells of the immune system. Provision of glutamine or a glutamine precursor, such as branched chain amino acids, has been seen to have a beneficial effect on gut function, on morbidity and mortality, and on some aspects of immune cell function in clinical studies. It has also been seen to decrease the self-reported incidence of illness in endurance athletes. So far, there is no firm evidence as to precisely which aspect of the immune system is affected by glutamine feeding during the transient immunodepression that occurs after prolonged, strenuous exercise. However, there is increasing evidence that neutrophils may be implicated. Other aspects of glutamine and glutamine supplementation are also addressed.     

新疆石河子地区奶牛隐性乳房炎的调查与分析

采用LMT法对新疆石河子地区三个规模化奶牛场泌乳牛群进行了隐性乳房炎检测,共检测994头泌乳牛3976个乳区.结果表明:奶牛隐性乳房炎阳性率为81.9%,乳区阳性率为49.1%.数据分析表明,不同年龄、胎次以及有无卧床奶牛的隐性乳房炎阳性率差异显著(P<0.05),后乳区的隐性乳房炎感染率显著高于前乳区感染率(P<0.05),隐性乳房炎乳区发生数也明显影响当日产奶量(P<0.05).     

Sex differences in neuromuscular fatigability in response to load carriage in the field in British Army recruits

Objectives

Women are resistant to neuromuscular fatigue compared to men in response to a range of exercise tasks. The sex differences in the neuromuscular responses to load carriage have yet to be investigated.

Decrease in eccentric hamstring strength in runners in the Tirol Speed Marathon

Background

The local muscular endurance of knee flexors, during eccentric work in particular, is important in preventing or delaying kinematic changes associated with fatigue during treadmill running. This result, however, may not be transferable to overground running.

Objective

To test the hypothesis that overground running is associated with eccentric hamstring fatigue.

Methods

Thirteen runners (12 male and one female) performed an isokinetic muscle test three to four days before and 18 hours after a marathon. Both legs were tested. The testing protocol consisted of concentric and eccentric quadriceps and hamstring contractions.

Results

There were no significant differences between peak torque before and after the race, except that eccentric peak hamstring torque (both thighs) was reduced.

Conclusion

Overground running (running a marathon) is associated with eccentric hamstring fatigue. Eccentric hamstring fatigue may be a potential risk factor for knee and soft tissue injuries during running. Eccentric hamstring training should therefore be introduced as an integral part of the training programme of runners.     

肺心病慢性呼吸性酸中毒合并代谢性酸碱失衡判断方法探讨(附80例次血气分析)

目的：对42例肺心病慢性呼吸性酸中毒患者的80例次血气测定结果。方法：用不同的酸碱图（卡）及代偿公式进行酸碱类型的初步差别分析。结果：结合临床表现、各种影响因素与治疗反应等作出综合判定。结论：比较二种判定的差异，并提出较为实用、可靠的判断建议，以助于复合型呼吸性酸碱失衡的临床诊断与处理。     

Oxalosis in primary hyperoxaluria in infancy

Primary hyperoxaluria (PH1) is a rare inborn autosomal recessive metabolic disorder due to the deficiency of hepatic alanine-glyoxylate-aminotransferase. This deficiency results in excessive synthesis and urinary excretion of oxalate, inducing renal stone formation and deposition of calcium oxalate in the kidney, bone, myocardium, and vessels (systemic oxalosis, SO) in the most severely affected individuals. We report renal and skeletal changes in a 3-month-old girl with PH1 and SO. Intense cortico-medullary hyperechogenicity and increased homogeneous radiopacity of normal-sized kidneys suggested the diagnosis of SO. Skeletal survey showed osteopenia and characteristic symmetrical metaphyseal transverse bands in long bones, progressively becoming more dense and migrating towards the diaphysis. Multiple pathological and slowly healing fractures of the limbs occurred at the dense band level. A radiopaque rim was then observed in flat bones, epiphyseal nuclei, and vertebral bodies. Inflammatory granulomatous reaction, induced by the presence of oxalate crystals in the marrow spaces, coexisted with progressively evident radiological signs of secondary hyperparathyroidism, with partially overlapping features. The patient was treated by peritoneal dialysis and hemodialysis until combined liver–kidney transplantation. There are no previous reports of infants treated with hemodialysis for more than 2 years.     

Interventional radiology in oncology in private practice

Interventional oncology in private practice requires expert training and can be performed in a stand-alone facility for type 1 procedures in a hospital setting for type 2 and 3 procedures where subspecialized radiologists, state-of-the-art equipment, and postprocedure hospital monitoring are available. A multidisciplinary effort with oncologists, internal medicine physicians and anesthesiologists is necessary. The practice of interventional oncology requires around the clock availability, meticulous and established protocols and procedures and a financial investment. On the other hand, it is professionally gratifying because of constant technical advances and the impact on patients.