王向辉 章程 张国明

目的 了解地塞米松鼓室滴注对鼓室置管术后中耳通气功能的恢复作用。方法2011年4月—2012年12月,收集33例(56耳)复发性分泌性中耳炎患儿,研究组21例( 36耳),对照组12例(20耳),分别采用地塞米松鼓室滴注 常规药物治疗、常规药物治疗,对比置管术后1月、3月鼓室容积和咽鼓管通畅程度。所有数据采用SPSS16.0软件。结果：术后1月、3月鼓室容积,P值均﹥0.05,没有统计学差异,术后1月、3月咽鼓管通畅程度比较,Z值分别为-1.379、-0.976,差异没有统计学意义。结论：与常规治疗方法相比,地塞米松鼓室滴注对置管术后中耳通气状态的恢复没有显著促进作用。     

川芎嗪注射液与盐酸氟桂利嗪联合治疗偏头痛的效果研究

目的：探讨川芎嗪注射液联合盐酸氟桂利嗪治疗偏头痛的临床效果。方法选取偏头痛患者626例,按照分层随机法将其随机分为观察组（n=316）和对照组（n=310）,对照组采取盐酸氟桂利嗪治疗,观察组在对照组治疗的基础上,加用川芎嗪注射液治疗,比较2组的治疗效果。结果观察组治疗总有效率显著高于对照组,差异有统计学意义（P＜0.05）。结论川芎嗪注射液联合盐酸氟桂利嗪治疗偏头痛较单一用药疗效更好,并且较为安全,临床价值较高。     

丹溪玉屏风颗粒中黄芪甲苷的含量测定

目的:建立中成药丹溪玉屏风颗粒的含量测定方法。方法:应用HPLC-ELSD法,测定丹溪玉屏风颗粒中黄芪甲苷的含量。结果:以峰面积的自然对数为纵坐标,进样量的自然对数为横坐标作标准曲线,结果显示黄芪甲苷在0.4545～3.030μg峰面积的对数与黄芪甲苷进样量的对数呈良好线性关系。3批丹溪玉屏风颗粒黄芪甲苷含量分别为0.057,0.081,0.071mg.g-1。结论:建立的方法简便、准确快速、重现性好,可有效控制丹溪玉屏风颗粒的质量。     

膝关节T2＊WI与T1WI对交叉韧带显示的探讨

目的探讨永磁型低场强开放式磁共振膝关节运动成像T2＊WI与T1WI两种图像显示膝关节交叉韧带的特点及膝关节运动成像的检查方法。方法采用日立AIRIS-Ⅱ0．3T永磁型磁共振（magneticresonance,MR）,对40例正常膝关节行斜矢状面T2＊WI和T1WI运动成像扫描,对图像所显示膝关节交叉韧带的情况进行分析,同时对图像进行电影放映,显示膝关节交叉韧带在不同屈曲度时的情况。结果40例膝关节受检者中,斜矢状面T2＊WI和T1WI对膝关节前、后交叉韧带的显示均较好,但吖聊更优于T1WI。结论磁共振具有多层面多方位成像的功能和良好的软组织对比,能清晰显示膝关节各解剖结构,尤其是斜矢状面T2＊WI对交叉韧带的显示。采用低场磁共振膝关节作运动成像时不但交叉韧带显示良好,而且运动成像时随膝关节屈曲程度的不同,交叉韧带的变化情况也得以清晰显示。     

应用新一代AS-OCT观察高度近视白内障术后人工晶状体与后囊膜贴附的研究

目的：利用新一代眼前节OCT(AS-OCT)定量检测和分析高度近视长眼轴患者白内障术后人工晶状体与后囊膜贴附情况。

方法：采用回顾性病例观察研究设计。纳入2019-10/12于深圳市眼科医院接受晶状体囊外摘除,经超声乳化吸出联合人工晶状体植入术的白内障患者60例60眼,根据眼轴长度(axial length,AL)分为两组：高度近视长眼轴组(AL>26.00mm)和正常眼轴组(AL：22.00～24.5mm)各30例30眼。分别于术后1、7、30d用AS-OCT测量两组白内障术后人工晶状体光学面与后囊膜之间围成的空间平面面积(AREAP)和未贴附残留后囊膜的边长。采用Kaplan-Meier生存分析法分析两组术后不同时间点的人工晶状体与后囊膜贴附率,Log-Rank检验法比较贴附率。

结果：正常眼轴组术后1、7、30d的AREAP分别为0.81±0.37、0.33±0.19、0.14±0.06mm²,未贴附后囊膜边长分别为7.93±3.03、3.95±2.44、1.26±0.08mm,人工晶状体光学面与后囊膜贴附率分别为33%、67%、83%; 高度近视长眼轴组术后1、7、30d的AREAP分别为3.29±0.43、1.54±0.66、0.62±0.28mm²,未贴附后囊膜的边长分别为13.56±4.02、8.13±3.90、3.78±2.51mm,人工晶状体光学面与后囊膜贴附率分别为0、7%、23%。两组术后各时间点AREAP、未贴附后囊膜边长、人工晶状体光学面与后囊膜贴附率均有差异(P<0.05)。

结论：高度近视长眼轴患者白内障术后人工晶状体与后囊膜之间残留更大的空间,贴附需要更长时间。新一代AS-OCT可以清晰地显示晶状体后囊膜的影像,有望成为研究晶状体相关疾病的有效检查设备。     

糖尿病动脉硬化患者血清SSA和oxLDL检测的临床意义

目的 探讨血清淀粉样蛋白 A(serum amyloid A,SSA)和氧化型低密度脂蛋白(oxidized low density lipoprotein,oxLDL)在糖尿病(DM)动脉硬化发生、发展中的作用及相关性.方法 109例DM患者和61例健康对照分别采用ELISA方法测定oxLDL和散射比浊法测SSA水平并进行相关分析.结果 与对照组比较109例DM组血清SSA与oxLDL显著增高(P<0.01);DM动脉硬化患者血清oxLDL与SSA水平明显高于DM无动脉硬化患者,DM动脉硬化患者血清中oxLDL与SSA成一定的正相关(r=0.89,P<0.01).结论 oxLDL和SSA与糖尿病动脉硬化的发生发展密切相关,提示这两项指标可能是糖尿病动脉硬化病变过程中起着明显的促进作用.     

早产儿视网膜病1082例筛查报告及诊治分析

Objective To explore the early diagnosis and treatment of retinopathy of prematurity (ROP). Methods Totally premature infants with gestational ages of ＜ 34 weeks or a birth-weight ＜ 2 000 gwho were born in our hospital from July, 2004 to June, 2009, received ROP screen that was carried out by ophthalmologists with particular expertise in ROP using binocular indirect ophthalmoscope. The first screening began at 4 to 6 weeks postnatal age or 32 weeks of postconceptional age. The infants with threshold and prethreshold type Ⅰ ROP(severe) were treated with retinal laser photocoagulation. The infants with immature retinal blood vessels or stage 1 ～ 2 ROP or pre-threshold type Ⅱ ROP (mild) were followed up until retinal vessels are seen in zone Ⅲ or it gets to threshold and pre-threshold type Ⅰ ROP level. All clinical data were analyzed retrospectively. Results 1 082 of total 2 295 premature infants (47. 14% ) received ROP screening ia our department during the past5 years. 14. 23% ( 154/1 082) infants were diagnosed as ROP,the mild and severe ROP accounted for 7.94% (86/1 082) and 6. 28% (68/1 082) respectively. Six infants had to be rehospitalized as they developed into severe ROP during follow-up period. Of all the 68 infants with severe ROP,two infants with severe ROP were confirmed to be bilaterally blind because they had intermitted therapy for one year. Sixty-six infants ( 132 eyes) received various treatments. Sixty-three cases were treated with photocoagulation therapy alone. Of the remaining 3 infants with aggressive posterior ROP, two infants were injected intravitreously with antagonist of vascular endothelial growth factor (Avastin) and photocoagulation,One who was found retinal detachment after photocoagulation therapy alone and then treated with vitrectomy,was blind finally. The eyesight of total 65 infants were saved successfully, the success rate of treatment was 98.48% (65/66). During the surveillance period, none of the infants who had received photocoagulation died,but 10 infants died of the deterioration of the original disease before they were able to receive photocoagulation. Conclusion ROP screening is an effective measure to prevent the progression of ROP. Laser photocoagulation is a safe and effective method for the infants with severe ROP. Photocoagulation combined with Avastin can save the sight of the premature infants with aggressive posterior ROP.     

乳腺癌针吸细胞图像光度学计量研究

 目的　探讨乳腺癌针吸细胞图像光度学及与乳腺良性病变的量化差异和鉴别价值。方法　用MPIAS 5 0 0多媒体细胞图像分析仪 ,对 5 0例乳腺癌分胞体、胞核、胞浆三大结构进行了细胞图像光密度值12项指标的计量研究 ,并以 30例乳腺良性病变做对照。结果　在 12项指标中有 10项指标乳腺癌与乳腺良性病变有非常显著性差异 (P <0 .0 1) ,其中胞体及胞核分别有 3项 ;胞浆有 4项。特异度有 5项指标≥80 % (1项为 10 0 % ) ;灵敏度有 7项指标≥ 80 % (2项为 10 0 % ) ,且特异性强 ,灵敏度高的参数主要分布在细胞核和细胞浆中。结论　利用细胞图像分析仪对乳腺癌进行光度学分析 ,其多参数的光密度指标具有科学性和可信性及可比性 ,对乳腺癌与乳腺良性病变的鉴别诊断有重要参考价值。     

AgNOR在乳腺癌细胞核中的形态及定量研究

 本文对40例乳腺癌细胞核中的A_gNOR颗粒数目、大小、结构和形状进行了定量研究，并以40例乳腺良性病变做对照，在大颗粒、小颗粒和混合颗粒三项定量指标中，乳腺癌均明显高于乳腺良性病变（P<0.01），小颗粒定量特异度和灵敏度为100%。乳腺癌组织类型不同、恶性程度不同。A_gNOR数目、结构和形状也有不同。作者认为准确合理划分A_gNOR颗粒大小，用多参数做定量指标，结合颗粒结构和形状分析，对乳腺癌诊断有重要价值，对协助判断乳腺癌恶性程度及预后也有重要意义。