单焦点框架眼镜欠矫与青少年单纯性近视进展的关系

目的　研究用单焦点框架眼镜进行全矫或者欠矫对青少年单纯性近视进展的影响。方法　回顾性研究 2 0 0 0年8月～ 10月我院视光门诊部就诊青少年 6 0例 12 0眼 ,随访12～ 2 6个月 ,平均 (14 .2 2± 4 .35 )月。全矫组与欠矫组各 30例 6 0眼 ,每组男 14例 2 8眼 ,女 16例 32眼 ,初次检查时全矫组 9～ 16岁 ,平均 (12 .6 5± 1.89)岁 ;欠矫组 9～ 16岁 ,平均(12 .38± 1.83)岁。按最大正镜最佳视力原则进行主觉验光、双眼平衡、试戴镜后记录最佳视力时全矫度数 ,随机予部分患者欠矫 - 0 .2 5～ - 0 .5 0DS ,随访至少 12个月 ,复查时记录全矫度数。结果　欠矫组和全矫组柱镜年进展分别为 (- 0 .10± 0 .2 5 )DC、(- 0 .10± 0 .17)DC ,2组间差异有显著统计学意义(P =0 .0 0 7) ;球镜年进展分别为 (- 0 .5 8± 0 .30 )DS、(- 0 .17± 0 .15 )DS ,2组间差异有显著统计学意义 (P =0 .0 0 0 ) ;等效球镜年进展分别为 (- 0 .6 3± 0 .31)DS、(- 0 .2 1± 0 .12 )DS ,2组间差异有显著统计学意义 (P =0 .0 0 0 )。结论　青少年单纯性近视患者配戴单焦点框架眼镜时 ,欠矫者近视进展比全矫者快。早发现近视、早全矫近视、尽量缩短欠矫时间是减慢近视进展的有效措施     

超声对低眼压时视轴、视网膜、脉络膜的影响

目的探讨低眼压对视轴、视网膜、脉络膜的影响及其临床意义.方法对同一个人的双眼眼压差＞4 mm Hg的1 213人,用A/B型眼用超声波测其视轴,并用B超或超声生物显微镜(ultrasound biomicroscope,UBM)对视网膜、脉络膜、睫状体进行检查.将有眼压异常或有视网膜脱离、脉络膜脱离、睫状体脱离等疾病的眼列为患眼.分别将患眼与健侧眼的视轴值、眼压值作对照比较,及低眼压对视网膜、脉络膜、睫状体的影响,分组进行统计比较分析.结果1.一侧眼压低于正常值的患眼其视轴较健侧眼视轴短,且眼压越低视轴越短;2.当低眼压回升至正常时,视轴也随之有不同程度的恢复;3.一侧眼压高于正常值,并＞健侧眼的眼压时,其视轴与健侧眼的视轴值无明显差异;4.部分患眼有视网膜脱离或脉络膜脱离,其眼压值于正常范围或略≤健侧眼的眼压时,其视轴与健侧眼的视轴值相等或略短;5.有视网膜脱离、脉络膜脱离或睫状体脱离眼的眼压,多低于正常值,低于健侧眼.结论当眼压过低时视轴缩短,并易继发视网膜脱离、脉络膜脱离、睫状体脱离等,经治疗患眼眼压恢复正常后,其视轴也随之有不同程度的恢复,然而一侧眼压呈高眼压时,其视轴与健侧眼无明显差异.     

脑苷肌肽对rd小鼠视网膜细胞保护作用的研究

目的观察脑苷肌肽(cattle encephalon glycoside and ignotin,CEGI)对体外分离的rd小鼠视网膜细胞的保护作用,旨在探求CEGI对视网膜以及视神经损伤相关疾病的治疗效果,为临床用药提供客观依据和指导。方法采用体外分离rd小鼠视网膜细胞悬液,用MTT和台盼蓝染料排斥法观察CEGI和神经生长因子(NGF)对细胞活性的影响。结果 MTT实验示CEGI8.00mg·L-1、0.04g·L-1、0.20g·L-1和NGF0.04mg·L-1、0.20mg·L-1对视网膜细胞活性有促进作用,尤其以CEGI0.04g·L-1和NGF0.20mg·L-1最为明显,细胞增殖率分别为130.0%±21.8%和124.0%±13.3%。若将二者组合使用,可使细胞增长率达到132.0%±9.1%,与药物空白对照组100.0%±10.1%相比差异均有统计学意义。台盼蓝染料排斥试验结果显示0.04g·L-1CEGI组活细胞比例在除5min外的各时间点,都明显高于对照组,而0.20mg·L-1NGF组也可保护视网膜细胞,主要以短时间点为主(5min～1d),与对照组相比差异均有统计学意义(均为P<0.05)。结论 CEGI有促进视网膜细胞生长发育作用,对rd小鼠视网膜细胞有一定的保护作用。     

Revisiting the latent structure of ADHD: is there a ‘g’ factor?

Background: Attention‐deficit/hyperactivity disorder (ADHD) is presumed to be heterogeneous, but the best way to describe this heterogeneity remains unclear. Considerable evidence has accrued suggesting that inattention versus hyperactivity‐impulsivity symptom domains predict distinct clinical outcomes and may have partially distinct etiological influence. As a result, some conceptualizations emphasize two distinct inputs to the syndrome. Yet formal testing of models that would accommodate such assumptions using modern methods (e.g., second‐order factor and bifactor models) has been largely lacking. Methods: Participants were 548 children (321 boys) between the ages of 6 and 18 years. Of these 548 children, 302 children met DSM‐IV criteria for ADHD, 199 were typically developing controls without ADHD, and 47 were classified as having situational or subthreshold ADHD. ADHD symptoms were assessed via parent report on a diagnostic interview and via parent and teacher report on the ADHD Rating Scale. Results: A bifactor model with a general factor and specific factors of inattention and hyperactivity‐impulsivity fit best when compared with one‐, two‐, and three‐factor models, and a second‐order factor model. Conclusions: A bifactor model of ADHD latent symptom structure is superior to existing factor models of ADHD. This finding is interpreted in relation to multi‐component models of ADHD development, and clinical implications are discussed.     

糖尿病性白内障术后角膜内皮细胞的变化

目的:观察糖尿病性白内障患者超声乳化术后角膜内皮细胞形态学的变化,探索糖尿病患者术后角膜内皮细胞的变化规律及影响因素。方法:随机选取28例(32眼)非胰岛素依赖型糖尿病合并老年性白内障患者行经透明角膜切口的白内障超声乳化吸除术联合折叠式人工晶体植入术。所有患者于术前、术后3月分别行角膜中央区和手术切口区内皮细胞观察,检测其细胞密度、六角形细胞比例和变异系数。结果:白内障超声乳化术后角膜内皮细胞密度和六角形细胞比例均呈现逐渐下降趋势,变异系数渐增加。术后切口区内皮细胞密度低于中央区,有显著性差异。六角形细胞比例低于中央区,变异系数高于中央区。结论:白内障超声乳化术中,糖尿病患者角膜内皮受到超声因素和机械因素的双重损伤。手术切口区内皮细胞丢失明显大于中央区,所以对于白内障患者尤其合并糖尿病者,在超声因素(能量、时间)损伤的基础上,应注意机械因素的作用;并且这种创伤对角膜内皮的影响可能更大。     

Statin Use in Relation to Intraocular Pressure,Glaucoma, and Ocular Coherence Tomography Parameters in the UK Biobank

PurposeThe purpose of this study was to evaluate the relationship between statin use and glaucoma-related traits.MethodsIn a cross-sectional study, we included 118,153 UK Biobank participants with data on statin use and corneal-compensated IOP. In addition, we included 192,283 participants (8982 cases) with data on glaucoma status. After excluding participants with neurodegenerative diseases, 41,638 participants with macular retinal nerve fiber layer thickness (mRNFL) and 41,547 participants with macular ganglion cell inner plexiform layer thickness (mGCIPL) were available for analysis. We examined associations of statin use with IOP, mRNFL, mGCIPL, and glaucoma status utilizing multivariable-adjusted regression models. We assessed whether a glaucoma polygenic risk score (PRS) modified associations. We performed Mendelian randomization (MR) experiments to investigate associations with various glaucoma-related outcomes.ResultsStatin users had higher unadjusted mean IOP ± SD than nonusers, but in a multivariable-adjusted model, IOP did not differ by statin use (difference = 0.05 mm Hg, 95% confidence interval [CI] = −0.02 to 0.13, P = 0.17). Similarly, statin use was not associated with prevalent glaucoma (odds ratio [OR] = 1.05, 95% CI = 0.98 to 1.13). Statin use was weakly associated with thinner mRNFL (difference = −0.15 microns, 95% CI = −0.28 to −0.01, P = 0.03) but not with mGCIPL thickness (difference = −0.12 microns, 95% CI = −0.29 to 0.05, P = 0.17). No association was modified by the glaucoma PRS (P_interaction ≥ 0.16). MR experiments showed no evidence for a causal association between the cholesterol-altering effect of statins and several glaucoma traits (inverse weighted variance P ≥ 0.14).ConclusionsWe found no evidence of a protective association between statin use and glaucoma or related traits after adjusting for key confounders.     

带虹膜隔人工晶状体在严重眼外伤中的应用价值

目的 探讨带虹膜隔人工晶状体在外伤性无虹膜无晶状体眼中的应用价值。方法 2000年4月～2003年4月应用Morcher公司生产的带虹膜隔人工晶状体治疗13例严重外伤后无虹膜无晶状体眼．均行人工晶状体二期植入术。探讨带虹膜隔人工晶状体植入术的适应证、手术方法、并发症防治及效果。结果 所有病例畏光症状改善或消失，视力均有不同程度的提高。结论 带虹膜隔人工晶状体治疗严重外伤后无虹膜眼有重要的临床意义，不仅畏光症状改善或消失，而且重建了眼前段，挽救了濒于残疾的伤眼，获得了较好的视力。