高血压和视网膜动脉硬化与年龄相关性黄斑变性调查

目的 研究高血压、视网膜动脉硬化与年龄相关性黄斑变性发病的相关性.方法 前瞻性系列病例研究.收集296名体检患者的临床资料,包括全身和眼部的诊治详情.按性别不同,分别统计高血压、视网膜动脉硬化、年龄相关性黄斑变性的发病率,分析高血压、视网膜动脉硬化与年龄相关性黄斑变性之间的相关性.结果 高血压患者中并发年龄相关性黄斑变性的发病率明显高于血压正常人年龄相关性黄斑变性的发病率(x2=15.72,P＜ 0.01);视网膜动脉硬化患者中年龄相关性黄斑变性的发病率也显著高于无视网膜动脉硬化者的年龄相关性黄斑变性的发病率(x2=23.74,P＜0.01),两组对照相比差异有统计学意义.高血压的程度与年龄相关性黄斑变性的发病率呈正相关关系(F=0.743,P＜0.05).结论 高血压、视网膜动脉硬化与年龄相关性黄斑变性三者之间关联紧密,高血压、视网膜动脉硬化可能是年龄相关性黄斑变性发病的危险因素之一.     

颌骨骨旁骨肉瘤1例报告及文献复习

骨旁骨肉瘤(parosteal osteosarcoma,POS)是一种发展缓慢、恶性程度较低的骨肉瘤.其中,约70%的病变位于股骨远端的屈侧,也可见于胫骨近端及肱骨近端,扁骨极少受累.临床上,发生于颌骨的骨旁骨肉瘤非常罕见.本文报道1例发生于上颌骨的骨旁骨肉瘤,并结合相关文献对上颌骨旁骨肉瘤的临床、CT影像学表现及病...     

原发性开角型青光眼患者的视觉障碍分析及其康复治疗

【摘 要】 目的:了解原发性开角型青光眼患者的视觉障碍原因及患者与视觉相关的生活质量（VRQL）情况,观察相应的康复治疗效果。方法: 通过眼科常规检查（必要时验光）及Humphrey300视野等检查分析500例POAG患者（890眼）的视觉障碍情况,采用调查问卷和评分的方法了解患者VRQL及自我评价。根据检查和调查结果制定和实施相应的康复治疗,包括准确矫正屈光不正、健康教育宣讲、助视器验配等。结果: （1）青光眼患者的VRQL和自我评价均明显下降;（2）视觉障碍的主要原因是屈光不正（占97.99％,且51.61%的屈光不正眼未得到合理的矫正）,其次为青光眼性视神经损害（占26.29％）、并发性白内障、合并其他眼部疾病等;（3）低视力患者44例（占9.89％）,其病因是青光眼性视神经萎缩(32眼)、各类眼底病变(23眼)、各类角膜病变（11眼）等（10眼）;（4）经康复指导及矫正屈光不正等措施,患者的自我评价及VRQL评分均得到显著提高（p<0.01）;（5）对25例低视力患者进行助视器的验配,其中,21例患者达到脱残标准（脱残率84％）,所有患者的近视力均提高2行以上。结论：POAG患者的视觉障碍较为严重和普遍,需引起重视;采取相应的康复指导（尤其是准确矫正屈光不正）等可显著提高患者的VRQL和自我评价。     

周期性张应力诱导成纤维细胞凋亡中p38MAPK信号通路的作用

背景：当牙齿受异常咬合力时会导致牙体吸收、牙周组织的大量破坏。目的：研究牙周膜成纤维细胞在受到周期性张应力刺激后是否发生凋亡及p38MAPK信号通路是否参与该凋亡过程。方法：取4～7代成纤维细胞,同步化后随机分为对照组、加力组和SB203580组。加力组和SB203580组细胞加载力值为12%表面应变率,加力频率为6个循环/min,即5s拉伸,5s松弛。SB203580组细胞在加力前1h加入终浓度为20mmol/L的p38MAPK抑制剂SB203580。分别在加力6,12,24h,取各组细胞,流式细胞仪检测细胞凋亡,RT-PCR检测细胞凋亡基因baxmRNA的表达。结果与结论：与对照组比较,加力后成纤维细胞凋亡率及baxmRNA表达增加（P〈0.05）,且随着加力时间的延长而增强,12h达高峰,之后逐渐下降。与加力组比较,SB203580组对应时间点细胞凋亡减少（P〈0.05）,baxmRNA表达降低。说明细胞受到力学刺激会发生凋亡,而丝裂原活化蛋白激酶p38MAPK信号通路参与了该凋亡过程。     

粘附机制与口腔粘膜鳞状细胞癌侵袭和转移关系的研究进展

细胞和细胞 ,细胞和细胞外基质间的粘附和相互作用是细胞生物学的基本现象之一。粘附作用主要由存在于细胞表面的细胞粘附分子所介导。粘附分子参与正常细胞间的信号传递、细胞识别等 ,维持着正常组织的完整性。该类分子的表达异常在肿瘤的侵袭和转移中扮演着重要的角色。作者主要综述一些主要的粘附分子——整合素 ,钙依赖粘附素系统与口腔鳞状细胞癌侵袭和转移相关性研究的进展     

体外光动力疗法致血管内皮细胞和视网膜色素上皮细胞凋亡的研究

目的 研究体外光动力疗法（PDT）诱导的血管内皮细胞和视网膜色素上皮（RPE）细胞凋亡情况。 方法 将体外培养的血管内皮细胞和人RPE细胞与血药浓度（1.0 μg/ml）相当的光敏剂verteporfin共同孵育，根据孵育时间的不同，每种细胞分成6组：0、5、15、30、60、120 min组。孵育至上述时间后，分别用光敏剂最大吸收波长光照（689 nm、功率密度为600 mW/cm2的二极管激光），能量密度为2.4 J/cm2，光照时间为83 s。用流式细胞仪检测3 h后各组细胞凋亡比例，实验重复进行3次。 结果 PDT后3 h，血管内皮细胞在6组的凋亡比例分别为：0.01±0.01、0.25±0.02、0.32±0.02、0.41±0.04、0.49±0.03和0.61±0.02；RPE细胞各组的凋亡比例分别为：0.02±0.01、0.22±0.01、0.31±0.02、0.38±0.03、0.47±0.05和0.58±0.03；两种细胞的凋亡比例均随细胞与光敏剂孵育时间的延长而增加；两种细胞在相同时间组的凋亡比例经t检验差异均无统计学意义(P>0.05)。 结论 PDT可致RPE细胞和血管内皮细胞快速凋亡，在相同的体外环境下，PDT对两种细胞所诱导的凋亡反应无明显选择性。 (中华眼底病杂志, 2006, 22: 253-255)     

消旋聚乳酸膜材料生物相容性的组织学评价

目的 采用动物实验方法,评价国产可降解消旋聚乳酸（poly DL-lactic acid,PDLLA)膜的组织反应和生物相容性。方法 将国产可降解PDLLA膜和不可降解的膨体聚四氟乙烯（ePTFE)莫膜分别植入大鼠背部两侧皮下组织中,分别于第1、2、4、8、12周5个时段于光镜下观察组织学反应。结果 两种材料周围的组织反应均类似于淋巴细胞、浆细胞、巨噬细胞、异物巨细胞浸润为主的非特异性物炎症反应;PDLLA膜周围的纤维包膜比较疏松,4周后膜周围的炎症细胞浸润显著减轻,ePTFE膜周围中性粒细胞浸润和异物异细胞存在的时间较长。结论 国产PDLLA膜具有较轻的组织反应和较理想的生物相容性。     

改变参数光动力疗法治疗黄斑区脉络膜新生血管性疾病的短期疗效分析

目的 分析改变参数光动力疗法治疗黄斑区脉络膜新生血管性疾病的短期疗效.方法 9例(12只眼)脉络膜新生血管患者进行改变参数光动力疗法治疗.改变的参数包括:(1)药物静脉推注时间,由标准的10 min缩短至5 min以内;(2)激光照射时间,由标准的83 s减至42 s;余治疗参数不变.治疗后3个月内随访患者糖尿病性视网膜病变早期治疗研究(ETDRS)视力表最佳矫正视力、眼部裂隙灯检查情况,并在治疗后3个月行眼底血管荧光造影(fun-dus fluorescein angiography,FFA)、光学相干断层扫描(optical coherence tomography,OCT)等检查.结果 在治疗后3 d 12只眼(100.0%)均未出现视力下降,其中4只眼ETDRS视力提高接近或大于3行;治疗后3个月11只眼(91.7%)视力保持稳定或提高,1只眼视力下降3行.全部患眼中,7只眼(58.3%)在治疗后3个月复查FFA和(或)OCT检查呈现较治疗前好转改变.5只眼治疗前为边界清楚的典型性病灶.治疗后3个月复查FFA,2只眼造影晚期荧光渗漏停止,1只眼荧光渗漏减少,2只眼仍见荧光渗漏;5只眼为轻微典型性及隐匿性病灶,2只眼治疗前有视网膜色素上皮脱离,治疗后3个月均明显好转;2只眼为近瘢痕期病灶,治疗前已伴有广泛视网膜色素上皮纤维血管化形成的病灶,治疗后FFA检查无明显改变.结论 光动力疗法缩短静脉给药时间及局部激光照射时间,治疗后短期内患者视力下降较少出现,可能对视网膜色素上皮脱离患者有较好治疗作用,但能否对新生血管起剑抑制作用仍不十分明确.     

非穿透性小梁手术与小梁切除术治疗青光眼的远期疗效对照研究

Objective To evaluate clinical outcomes of non-penetrating trabecular surgery (NPTS)and trabeculectomy surgery (TS) in the treatment of primary open angle glaucoma (POAG). Methods It was a case-control study.A total of 63 patients (63 eyes) with POAG were observed retrospectively.Thirty one eyes and 32 eyes underwent NPTS and TS,respectively.Intraocular pressure(IOP),filtration bleb,visual field and post-operative complications were observed for 6-60 months.The CMH X2 test was used to analyse the difference of them.Results After operation.the IOP in the NPTS group were from(13.87±4.88)mm Hg(1 mm Hg=0.133 kPa) to (24.01±6.55)mm Hg,the IOP in the TS group were from(11.90±4.92)mm Hg to(19.10±7.43)mm Hg.The IOP in the NPTS group was significantly higher than that in the TS group (F=5.137,P<0.05).The ratio of sustained filtration bleb of NPTS group after surgery was 25/31(80.6%),while 6/31 were flat filtration bleb.There were statistically significant difference in the rate of disappearance of filtration bleb between these two groups(X2=8.129,P<0.05).The difference of visual field loss postoperatively between these two groups was not statistically significant.The incidence rate of newly developed cataract after NPTS and TS was 6/31 and 12/32.respectively.The difierence of rate of complication between these two groups was statistically non-significant(X2=3.797,P<0.05).The successful rate after NPTS and TS was 61.54%(16/26)and 14.29%(4/28),respectively.The difference of successful rate between these two groups was statistically significant(X2=14.463,P<0.05).Conclusions Both NPTS and TS are effective methods for the treatment of POAG.Postoperative complications after NPTS are less than those of TS.But patients with TS could maintain a lower IOP than those with NPTS.Long-term efficacy of NPTS is uncertain.it's important to choose the suitable surgery to gain a high success rate.     

非穿透性小梁手术与小梁切除术治疗青光眼的远期疗效对照研究

Objective To evaluate clinical outcomes of non-penetrating trabecular surgery (NPTS)and trabeculectomy surgery (TS) in the treatment of primary open angle glaucoma (POAG). Methods It was a case-control study.A total of 63 patients (63 eyes) with POAG were observed retrospectively.Thirty one eyes and 32 eyes underwent NPTS and TS,respectively.Intraocular pressure(IOP),filtration bleb,visual field and post-operative complications were observed for 6-60 months.The CMH X2 test was used to analyse the difference of them.Results After operation.the IOP in the NPTS group were from(13.87±4.88)mm Hg(1 mm Hg=0.133 kPa) to (24.01±6.55)mm Hg,the IOP in the TS group were from(11.90±4.92)mm Hg to(19.10±7.43)mm Hg.The IOP in the NPTS group was significantly higher than that in the TS group (F=5.137,P<0.05).The ratio of sustained filtration bleb of NPTS group after surgery was 25/31(80.6%),while 6/31 were flat filtration bleb.There were statistically significant difference in the rate of disappearance of filtration bleb between these two groups(X2=8.129,P<0.05).The difference of visual field loss postoperatively between these two groups was not statistically significant.The incidence rate of newly developed cataract after NPTS and TS was 6/31 and 12/32.respectively.The difierence of rate of complication between these two groups was statistically non-significant(X2=3.797,P<0.05).The successful rate after NPTS and TS was 61.54%(16/26)and 14.29%(4/28),respectively.The difference of successful rate between these two groups was statistically significant(X2=14.463,P<0.05).Conclusions Both NPTS and TS are effective methods for the treatment of POAG.Postoperative complications after NPTS are less than those of TS.But patients with TS could maintain a lower IOP than those with NPTS.Long-term efficacy of NPTS is uncertain.it's important to choose the suitable surgery to gain a high success rate.