试析大型综合医院在社区医疗服务中的作用

根据国家城市卫生服务体系改革的原则及对基层医院和大医院的功能定位,分析大型综合医院在社区医疗服务中的作用。指出大型综合医院应加强与城市基层医院的联系,建立全科医生培训基地,为社区医疗服务输送适用人才,建立切实可行的转诊制度,成为社区医疗服务的坚强后盾,提高社区医疗服务的质量和水平,促进社区医疗服务的发展。     

锥兰联合茜素红活细胞染色法观察角膜中央碱烧伤内皮细胞愈合过程

目的:研究角膜碱烧伤内皮细胞的愈合过程。方法:锥兰联合茜素红内皮细胞染色法对角膜中央碱烧伤内皮细胞形态学变化进行观察。结果:伤后20分钟内皮细胞已破坏。72小时,损伤区的周边内皮细胞变形向创面内迁移。第7天后缺损区大部分范围均可见梭形细胞覆盖。结论:兔碱烧伤损伤区内皮细胞的修复由邻近内皮细胞变形,增殖和移行长入创面内完成,修复的内皮细胞具有纤维细胞特征。眼科学报1999;15:218-220。     

An Experimental Study on Homoharringtonine Liposome and Glaucoma Filtration Surgery

Purpose: To observe the inhibitory action of homoharringtonine liposome during the healing process of wounds in the filtering sitesMethods: posterior sclerectomies were performed in 14 rabbits. Postoperatively one eye of each rabbit received subconjunctival injections of HH liposome and fellow eye received saline injection in a randomized masked fashion.Results; Fourteen days after operation the IOP of experimental eyes reduced significantly (P < 0.01) as compared with the controlled eyes, and the number of remaining filtering blebs increased noticeably (P< 0.05). Pathohistological examination revealed that the number of fibroblasts per square micron in the filtering sites and the thickness of the scars in the center of the filtering sites of the experimental eyes were less than those of the controlled eyes. No serious ocular toxic and side effects were found.Conclusion : This experiment suggests that homoharringtonine liposome can markedly inhibit the scar formation of filtering sites after glaucoma fi     

Effect of Liposome—Encapsulated Total Alkaloid of Harmaline on Rabbit Lens Epithelial Cells：Experimental Study on the Prevention of Posterior Capsule Opacification

Purpose: To investigate whether liposome encapsulated total alkaloid of Harmaline (TAH) as a therapeutic agent is beneficial to prevention of posterior capsular opacifi-cation (PCO).Methods: Liposome-encapsulated TAH was prepared by modified freeze-thawing method. 0. 1ml of liposome-encapsulated TAH (0. 2mg/ml) was injected into the capsular bag during extracapsular lens extraction (ECLE) of each eye in total 10 rabbit eyes. Blank liposome or balance salt solution (BSS) was used as control. Slit-lamp examination and histopathological examination was used to evaluated capsule opacifica-tion. Intraocular pressure (IOP) , density and morphology of corneal endothelia cells, the amplitude and latency of b wave of ERG were measured.Results: The inflammatory response was mild both in TAH treated and the control group. PCO formation occurred in the control group 2 weeks postoperatively, but the posterior capsule was clear in TAH treated eyes. 4 weeks and 8 weeks after operation, PCO occurred both in TAH treated     

A Study on the Compliance of the Patients with Ocular Fundus Diseases

Purpose: To investigate the compliance of the patients with ocular fundus diseases with recommendation for follow-up examination after laser treatment, and the underlying reasons for non-compliance.Methods: 53 patients with ocular fundus disease were asked to fill in a questionnaire which includes the socio-demographic characteristics, fear of the fundus disease, conception of the laser treatment and the motivation for staying healthy. Variables were compared for the compliers group and the non-compliers group by chi-square test. Result; Of the 53 subjects, 35 were classified as non-compliers and 18 were classified as compliers. There was no statistically significant difference between the two groups on all selected socio-demographic factors, conception of the laser treatment and the motivation for staying healthy. Significant difference was found between the two groups on two of those items concerning the fear of the diseases (P<0. 05). About half of the participants showed the lack of knowledge about     

高频透热撕囊法在白内障手术中的应用

目的:评价在白内障手术中使用高频透热撕囊仪作连续环形撕囊的效果。方法:在30例(34眼)患者进行白内障囊外摘出联合后房型人工晶体植入术中,先向前房注入透明质酸钠,然后使用高频透热撕囊仪作晶体连续环形撕囊术。结果:有3眼术中出现小的晶体前囊放射状撕裂,所有病例术后角膜无水肿,无其他术后合并症,术后一周31眼矫正视力≥0.5,占91.2％。结论:此法操作简便,易于掌握,是一个安全有效的连续环形撕囊的方法。尤其适用于过熟期白内障,儿童先天性白内障和外伤性白内障的截囊。眼科学报1999;15:121—123。     

视紫红质基因型与视网膜色素变性临床表型相关性的初步研究

目的:对国人视网膜色素变性(retinitis pigmentosa RP)患者中视紫红质基因不同突变与临床表型相关性进行初步研究。方法:对经异源双链-SSCP和序列分析确定为视紫红质基因不同位点突变的3例RP患者,收集其详细临床资料,比较其异同。结果:详细描述了3例已知突变患者的临床表现。视紫红质基因不同位点突变,临床表现不尽相同,发生在杆细胞外节胞液侧的突变,常导致严重类型的Ⅰ型视网膜色素变性;而发生在杆细胞外节盘膜内的突变,常引起相对较轻的Ⅱ型视网膜色素变性。结论:本文3例视紫红质基因不同位点突变与临床表型有一定关系,但要建立基因突变与表型间确切的对应关系和规律,尚需积累更多病例资料进一步分析研究。眼科学报1999;15:204-206。     

RELATIONSHIP BETWEEN CORNEAL DELLEN AND TEARFILM BREAKUP TIME

The BUT of 51 strabismus patients were measured before and after operation. The average pre-op BUT was 28.75 seconds(10.96"-91.80"). The post-op BUT in all operated eyes were reduced significantly, no matter what procedures had been performed and whether dellen appeared or not(P<0.01). The BUT in the group complicated dellen reduced from 23.22"(pre-op) to 8.61"(post-op). The incidence of dellen was 22.54% in this study. The incidence of dellen after rectus resection procedure(47.75%) was much higher than that after rectus recession(5.13%)(P<0.01). This study showed that dellen was closelyre related to the BUT and occurred more often in the eyes on which resection procedure was performed. It is considered that excessive lacrimation and elevation of the bulbar conjunctiva near the limbus may disturb the stability of the precornea tearfilm and cause the tearfilm break up earlier. Local corneal dehydration and dellen formation may be caused by reduced BUT. The incidence of dellen after operation may be higher if the cornea was carefully observed.     

小分割分次立体定向放射治疗脑转移瘤近期疗效观察

目的观察小分割分次立体定向放射治疗(fractionated stereotatic radiation therapy,FSRT)脑转移瘤的近期疗效.方法15例病人单纯全脑外照射(WBRT组),中间平面剂量20～40Gy/10～20次/2～4周.17例病人接受FSRT(FSRT组),每次分次剂量为2.5～3.0Gy.其中11病人行单纯FSRT,中心总剂量为30～60Gy/1 0～20次/2～4周;6例病人先行WBRT,然后行FSRT,中心总剂量为46～60Gy/5～6周.结果KSP评分增加10分以上者,WBRT组为5 3.3%,FSRT组为82.4%.(P＜0.05).WBRT组有效率(CR PR)为50.0%;FSRT组有效率(CR PR)为80.0%.中位生存率:WBRT组为3.5月,FSRT组为10.0月.结论FSRT能有效地控制脑转移瘤,减轻神经系统症状,提高生存质量,延长病人生存期,而没有增加副作用,值得临床推广应用.     

超声观察肝癌多次肝动脉栓塞术治疗前后肝脏声像图的变化及其预后的评估

目的探讨超声在评估肝癌肝动脉栓塞术后肝硬变受损程度方面的价值.方法对43例原发性肝癌患者进行了肝动脉栓塞术前与术后临床肝功能检查及超声分析.结果多次肝动脉栓塞术后肝硬变程度加重,根据Child‘s分级肝功能下降率达67.4%,超声检查肝硬变加重率达70%.两者检查结果相一致.结论超声观察肝内回声的变化对评估多次肝癌肝动脉栓塞术后肝功能损害程度有重要作用.