Immunocytochemical Study of Cells in the Vitreous of Proliferative Virteoretretinopathy

Purpose: To identify the cellular components of vitreous samples obtained during vit-rectomy for proliferative vitreoretinopathy(PVR).Methods: With the use of three intermediate filament (IF) proteins, vimentin, glialfibrillary acidic protein (GFAP), and cytokeratin (CK), cytocentrifuge slides of 14fresh vitreous aspirates were detected with immunohistochemical technique.Results: All the specimens contained epithelial-like proliferative cells with or withoutpigment and some membrane-like pieces. Immunocytochemical staining showed that76.0-90.0% cells stained for CK, 17.4-29.6% cells expressed GFAP, and 80.1-91.0% cells were positive for vimentin.Conclusions : Majority of cells in the vitreous samples originated from retinal pigmentepithelial cells (RPE) and glial cells in PVR. Expression of IF proteins may be determinedby tissue of origin and local microenvironment. Eye Science 1999 ; 15; 13 - 16.     

后巩膜加固术对视网膜振荡电位的影响

目的　为了更进一步地了解后巩膜加固术治疗高度进行性近视的疗效和机理。方法　采用日本产Ｎｅｕｒｏｐａｃｋ Ｆｏｕｒ ４１０４ Ｋ 电生理仪,对２６ 例５２ 眼高度进行性近视行后巩膜加固术前、术后视网膜振荡电位进行定量分析。结果　术前、术后振荡电位总振幅经统计学处理有非常显著性差异,波的潜伏期无显著性差异。结论　本文认为后巩膜加固术可改善视网膜血液循环,并对机理进行了探讨     

手术治疗挫伤性睫状体脱离的体会

目的 探讨治疗挫伤性睫状体脱离的最佳手术方法。方法 对４５例挫伤性睫状体脱离的病例进行睫状体固定缝合术。结果 ４５例手术全部成功,术后眼压较术前平均升高９．９８ｍｍＨｇ。视力均有明显提高,治愈率１００％。结论 睫状体固定缝合术是治疗挫伤性睫状体脱离最直接的理想的手术方法。     

高度近视白内障小切口超声乳化摘除术

目的：探讨经透明角膜隧道对高度近视白内障患者行超声乳化摘除术的可行性及手术技巧。方法：对２１６例高度近视合并白内障患者,经角膜缘隧道切口行超声乳化吸出,并植入软性或硬性人工晶体。对超声乳化能量、时间、负压及术后视力、散光及并发症进行观察。结果：采用较低能量、中度真空压力及中低档流速行超声乳化吸出,术后视力≥０．８者１４３例,≥０．５者４９例。术前近视力≥０．８者,术后远视力常较佳。术前及术后散光３．０ｍｍ切口组无统计学差异,５．５ｍｍ切口组有统计学差异。未见明显严重并发症。结论：透明角膜超声乳化联合软性或硬性人工晶体植入,是高度近视白内障较理想的手术方式。     

Lipoprotein levels in patients with pregnancy induced hypertension

The purpose of this prospective study was to investigate the levels of Lp(a), Apo(a), VLDL, LDL and HDL in 23 patients with pregnancy induced hypertension (PIH) and in 20 control. The Mann-Whitney U tests was used for comparisons between the two groups. Serum Lp(a) and Apo(a) levels were sigificantly raise in the PIH group (p < 0.05 andp < 0.05 respectively) and no significant correlations could be demonstrated for other lipoproteins.     

中医药治疗糖尿病视网膜病变的临床与实验研究近况

综述了近年来中医药治疗糖尿病视网膜病变的研究状况及有待解决的问题。     

Acute fulminant invasive fungal sinusitis]

OBJECTIVE: To discuss the clinical presentation, diagnostic criterion and treatment principle of acute fulminant invasive fungal rhinosinusitis (AFFS). METHODS: Six patients were diagnosed as AFFS based on history, nose, especially eye symptoms with or without fever, sinus CT and MRI, endoscopic and cytological findings in the nasal cavity. Surgical debridement was performed on 5 of 6 biopsy proven AFFS patients, one of them being amputated of the orbital content. With the original disease controlled simultaneously, 4 of 5 patients were prescribed with systemic amphotericin B or liposomal amphotericin B (1 case) and one with Itraconazole orally. One patient had not been involved with any of the anti-fungi measures. RESULT: Mucor (Zygomycetes) was identified on culture in 1 patient, Rhizopus species in 2, Aspergillus in 1, Alternaria in 1 and mixed Mucor and Rhizopus in 1. All patients were proved of tissue invasion histopathologically through biopsy. One patient died without any anti-fungi therapy on the 7th admission day, 3 patients survived for 88 days, 32 and 6 months respectively and died of original diseases (diabetes 1, leukaemia 2). One patient survived 9 months and lost for follow-up, 1 patient survived 11 months after treatment. CONCLUSION: A high index of suspicion and early endoscopic investigation through nasal cavity with fungal investigation should highly be strengthened for recognition of this disease. MRI findings should be considered as, or even more, important as that of CT scan on the early diagnoses. Extensive and aggressive surgical debridement, prompt and enough dosage of antifungal therapy intravenously, together with serious controlling of the underlying disease, all take important roles in the complete control of the disease.     

少年儿童鼻内镜手术远期疗效及相关临床因素探讨

目的 探讨接受内镜鼻窦手术少年儿童鼻窦炎患者的疗效及影响疗效的相关因素。方法 接受内镜鼻窦手术的少年儿童鼻窦炎性疾病患者268例(432侧)，年龄3～17岁，平均14．3岁，男186例，女82例。全身麻醉176例，局部麻醉12例。188例(305侧)术后随访超过1年，占病例总数70．1％。随访在鼻内镜下进行，以黏膜表面麻醉为主。术后综合治疗包括：清理术腔、鼻腔冲洗、抗生素、激素、黏液促排剂及免疫调节剂等。结果 慢性鼻窦炎89例(147侧)，慢性鼻窦炎、鼻息肉86例(142侧)，鼻窦黏液囊肿13例(16侧)。治愈132例(70．2％)，好转43例(22．9％)，无效13例(6．9％)。术后头痛缓解率93．1％(175／188)，其次为鼻堵为85．1％(160／188)，脓涕60．1％(113／188)。11例手术前后无变化，2例症状较术前加重。术前56例失嗅者，术后34例(60．7％)改善或恢复。术后症状完全缓解123／188例(65．4％)，部分缓解52／188例(27．7％)，总有效率为93．1％。8例(4．3％)接受再手术。结论 少儿慢性鼻窦炎、鼻息肉内镜鼻窦手术远期疗效满意，应重视术中黏膜合理取舍和积极处理中鼻甲；随访质量为影响手术远期疗效重要因素。患者就医和手术前是否进行了规范药物治疗为手术适应证重要前提。     

急性爆发性真菌性鼻窦炎

目的　探讨急性爆发性真菌性鼻窦炎 (acutefulminantfungalsinusitis ,AFFS)的临床特征、诊断标准及治疗原则。方法　回顾收治的 6例较典型的AFFS病例诊断和治疗过程。其中结合全身疾病病史 ,发热伴颜面部、眼部及鼻部症状 ,影像学 ,鼻内镜及鼻腔分泌物真菌涂片检查 ,在患者就诊的 2 4h内做出初步诊断 5例。在此基础上鼻内镜下行全组鼻窦开放术 ,切除全部坏死组织至露出新鲜创面 5例。根据临床及影像学表现 ,进行眶内容物切除 1例。术后同时进行原发病治疗以及全身抗真菌治疗 5例。结果　 6例病例经过病理、真菌涂片及培养证实为鼻窦黏膜侵袭性真菌感染 ,其中毛霉菌 1例 ,根霉菌 2例 ,链隔孢霉菌 1例 ,曲霉菌 1例 ,毛霉菌根霉菌混合 1例。 1例未在第一时间诊断 ,且未经抗真菌治疗的患者于住院第 7天死亡 ,1例抗真菌治疗及清创术后 88d死亡 ,2例分别于治疗后 3 2个月和 6个月死于白血病 ,2例经上述治疗后分别随访 9个月和 11个月无复发 ,后者为本组唯一进行眶内容物摘除者。结论　根据病史 ,眼或颜面症状 ,鼻腔内干痂以及影像学尤其是磁共振成像 ,分泌物真菌涂片检查 ,可以在患者到鼻科就诊的 2 4h内做出AFFS的诊断。包括及时彻底的根治性清创 ,足量静脉内二性霉素B注射 ,完全控制原发病以及足够的全身支     

面神经液压与面神经电图的相关性研究

目的　探讨面神经电图作为面神经减压手术指征的病理生理学基础。方法　利用电生理仪和伺服微变量微压系统 ,对正常和压榨伤后面瘫不同时期的豚鼠 ,作面神经电图检查 ,再采用微创测压法进行面神经液压的测量 ,得出面神经损伤后不同时期的面神经动作电位降幅及相应的面神经液压 ,并观察不同时期面神经光镜和电镜下的组织学改变。结果　面神经损伤 3d至 3周 ,随着面神经液压的升高 ,面神经动作电位降幅百分数亦增加 ,二者间有明显相关性 ,损伤后 2周和 3周 ,面神经液压和面神经动作电位降幅的相关系数分别为 0 88和 0 51。神经液压的变化与面神经Wallerian变性各期组织学改变相一致。结论　在面瘫 3周内 ,面神经电图的改变可间接反映面神经液压的变化 ,并可为面神经减压术的时机提供客观、可靠的实验依据。