自体角膜缘干细胞联合羊膜移植治疗复发性翼状胬肉

目的　探讨自体角膜缘干细胞联合羊膜移植治疗复发性翼状胬肉的临床效果。方法　将 84例 (84只眼 )复发性翼状胬肉患者随机分为治疗组 (4 6例 )和对照组 (38例 )。治疗组采用自体角膜缘干细胞联合羊膜移植治疗 ,对照组行单纯羊膜移植 ,术后随访 3个月至 2年。结果　角膜上皮均于 1周内完全愈合。治疗组 4 6例中 3例复发 ,复发率为 6 .5 % ;对照组 38例中 9例复发 ,复发率为 2 3.7%。两组相比具有显著性差异 (χ2 =5 .0 0 6 ,P <0 .0 5 )。结论　自体角膜缘干细胞联合羊膜移植抑制了结膜下纤维组织增生 ,重建角膜缘部屏障功能 ,能有效治疗复发性翼状胬肉。     

转内皮抑制素基因治疗大鼠角膜新生血管

目的:探讨转染内皮抑制素(Endostatin)基因对酸烧伤引起的大鼠角膜新生血管的基因治疗。方法:通过限制性内切酶酶切反应、聚合酶链式反应、DNA测序及用NCBIBLAST软件与基因库序列比较的方法进行鉴定,鉴定后在大肠杆菌中扩增,用质粒纯化试剂盒抽提纯化;用750g/L硝酸银和250g/L硝酸钾混合烧灼液制作大鼠角膜新生血管模型,用结膜下注射脂质体包裹的质粒pBlast- hEndostatin来进行体内基因治疗。结果:实验证实质粒pBlast-hEndostatin含有人endostatin基因。结膜下注射脂质体包裹的质粒Tel押029-82245172Email押IJO.2000@163.compBlast-hEndostatin对酸烧伤引起的炎症性角膜新生血管有明显抑制作用,术后6,10,15d对角膜新生血管面积的抑制率分别为37%,40%,43%;对角膜新生血管密度也有明显的抑制作用,抑制率达40%。对角膜新生血管长度和角膜炎症细胞没有明显抑制作用。角膜新生血管面积与角膜水肿、角膜混浊呈正相关。结论:用结膜下注射脂质体包裹的内皮抑制素基因可以部分抑制酸烧伤引起的大鼠角膜新生血管。其作用机制是转基因产生的内皮抑制素蛋白直接抑制角膜新生血管的形成,而不是通过抑制炎症反应来抑制角膜新生血管的形成。     

小梁切除术联合自体巩膜植入术治疗青光眼的临床研究

目的观察小梁切除术联合自体巩膜植入术治疗青光眼的临床疗效。方法对12例(12眼)青光眼患者施行小梁切除术联合自体巩膜植入术。术后观察眼压、视力、滤过泡形态、并发症等,并做超声生物显微镜(UBM)观察。结果经3～18mo的随访,术后视力11眼(92%)维持不变或提高。眼压由术前平均(36.15±11.39)mmHg降至术后1a平均(13.21±4.98)mmHg,有非常显著性差异(P<0.01),末次随访眼压≤21mmHg者11眼(92%),其中9眼形成弥散性滤过泡,术后前房轻度变浅4眼,术后3～7dUBM检查睫状体脱离2眼,无其它并发症发生。结论小梁切除术联合自体巩膜植入术,能有效降低眼压,经济安全术后视力稳定,值得临床应用推广。     

早期原发性开角型青光眼的视网膜光阈值改变

目的:观察早期原发性开角型青光眼视网膜光敏度分布情况及改变特点。方法:采用日本TopconSBP2020自动视野SDT340程序检测早期原发性开角型青光眼与正常眼的中心3°视网膜光敏感度。结果:早期原发性开角型青光眼各方向的视网膜光敏度与正常眼比较有非常显著差异(P<0.01);早期原发性开角型青光眼上方视网膜光敏度与其他各方比较有显著差异(P<0.05);早期青光眼的MD,ST与正常眼比较差异非常显著(P<0.01)。结论:视网膜光敏度的定量检测能做为早期原发性开角型青光眼的较早期视功能检测。     

液氮冷冻治疗鳞屑性睑缘炎的疗效观察

目的:观察液氮冷冻治疗鳞屑性睑缘炎的临床疗效。方法:选取近几年在我院就诊的鳞屑性睑缘炎患者126例234眼,随机分为液氮冷冻治疗观察组65例120眼,每周2-3次治疗,6～10次为一疗程,同时滴用抗生素眼液及眼膏;药物治疗对照组61例114眼,采用滴抗生素眼液及眼膏和2％黄降汞眼膏,20—25 d为一疗程,经治疗二疗程后进行疗效比较。结果:观察组治愈64眼,有效30眼,无效26眼。有效、无效者继续治疗一疗程后治愈32眼,总治愈率80％,对照组治愈48眼,有效30眼,无效36眼,总治愈率42.11％,经统计学处理(X2=-35.47,P<0.01),差异有显著性。结论:液氮冷冻治疗鳞屑性睑缘炎有明显的疗效。     

固视野检查对甲状腺相关眼病眼外肌功能的测量分析

目的:探讨固视野检查对甲状腺相关眼病眼外肌功能测定的临床应用。方法:用视野弧计对甲状腺相关眼病患者进行固视野检查。结果:眼球运动不足为-4时,固视野在0°-15°之间:眼球运动不足为-3时,固视野在18°～28°之间;眼球运动不足为-2时,固视野在28°-38°之间;眼球运动不足为-1时,固视野在40°～43°之间;眼球运动正常时,固视野为45°～50°。结论:固视野检查对甲状腺相关眼病患者能准确而直观地显示各个方向眼球活动受限程度。     

N-甲-N-亚硝脲对大鼠视网膜光感受器的毒性作用

目的观察N-甲基-N-亚硝脲(N-methyl-N-nitrosourea,MNU)对SD大鼠视网膜光感受器细胞的毒性作用.方法雌性SD大鼠100只,分17组,正常对照组4只,其余组各6只.在大鼠生后50 d,分别一次腹腔注射MNU 50mg/kg、60mg/kg、70mg/kg和80mg/kg.在MNU处理后24、48、72 h和7 d处死大鼠,取眼球,做组织学检查.结果不同剂量的MNU均引起中心视网膜和周边视网膜损伤,其损害的程度与MNU的剂量呈正比.作用24 h后,可见视网膜光感受器细胞核固缩、破坏及光感受器外节部定向紊乱;48 h或72 h后,可见光感受器细胞丧失;7 d后,外颗粒层和光感受层几乎完全消失.结论MNU对大鼠视网膜光感受器细胞有选择性的毒性作用,该作用呈剂量和时间依赖性.     

上斜肌前部前徙术治疗上斜肌麻痹的外旋斜的研究

目的 观察术中可调整缝线的上斜肌前部前徙术治疗上斜肌麻痹的外旋斜的效果。方法 对6例(9眼)外旋斜患者(其中双眼外旋斜和单眼外旋斜各3例)行此术式，在术前、术中、术后1周分别行双马多氏杆检查第一眼位的主观旋转斜。分析旋转斜度与手术量的关系及治疗效果。结果 6例患者术前都存在正前方及下方双眼复视症状，第一眼位的外旋斜5～15。，平均10．5。。术毕双马多氏杆检查第一眼位为0^o～内旋斜5^o,平均内旋斜3．7^o。术后所有患者正前方及向下看复视症状消失，术后1周为外旋2^o～内旋4^o,平均内旋1．4^o。其中2例患者术后7个月复诊，一例外旋斜3^o；另一例为旋转斜0^o，都未出现明显复视症状。结论 术中可调整缝线的上斜肌前部前徙术是一种安全可靠的矫正上斜肌麻痹的外旋斜的手术方式，常需要过矫至内旋5^o左右来代偿术后出现的回退。     

The Relationship Between Quality of Life and Psychiatric Impairment for a Taiwanese Community Post-Earthquake

This purpose of this study was to investigate the relationship between quality of life and psychiatric impairment in a Taiwanese community located near the epicenter of the 1999 earthquake, as assessed four to six months after the natural catastrophe. Trained assistants interviewed the 4223 respondents using the disaster-related psychological screening test (DRPST), an instrument specifically designed and validated by senior psychiatrists for assessment of psychiatric impairment after natural catastrophe. Additionally, the 36-Item Short-Form Health Survey (SF-36) was used to evaluate quality of life. The collected results were analyzed using Windows SPSS 10.0 software. Psychiatric impairment rated moderate to severe was assessed for 1448 (34.3%) of the responding residents. The 4223 respondents were divided into 4 psychiatric-impairment groups based on DPRST score: healthy (n = 952); mild impairment (n = 1823); moderate impairment (n = 1126); and, severe impairment (n = 322). The four groups were compared for a number of salient factors, including gender, age, current marital status and psychiatric-impairment score, to determine impact on quality of life. Respondents assessed as psychiatrically impaired tended to be older, female, divorced/widowed, and less educated, and they were more likely to have experienced major familial financial loss as an immediate consequence of the earthquake. Further, the greater the severity of the psychiatric impairment, the lower the scores for quality of life, for both the physical and mental aspects of this important general indicator.     

Influences on participation in a community-based colorectal neoplasia screening program by virtual colonoscopy in Australia

Objective : To determine the effect of certain personal and health behaviour characteristics on participation in a community-based colorectal neoplasia (CRN) screening program using virtual colonoscopy.
Methods : The study population comprised randomly selected subjects from the State electoral roll; screening by virtual colonoscopy was offered through letter of invitation. For non-responders, a further invitation was sent a month later. Non-response after a further month led to subjects being considered non-participants. Non-participants were contacted by letter to complete a structured questionnaire; participants completed a similar questionnaire immediately after their screening virtual colonoscopy.
Results : Discussing the invitation to screening with someone else increased the likelihood of participation by 63% (prevalence ratio 1.63, 95% CI 1.38–1.93); knowing someone with cancer increased the likelihood of participation by 23% (PR 1.23, 95% CI 1.07–1.42). Among participants who discussed screening with another individual, the spouse was the most common (71%). Subjects who were single were less likely to participate (PR 0.79, 95% CI 0.67–0.94). The strongest reported influence for participation was information provided in the letter of invitation (29.8%). The most common reasons for non-participation were lack of time and perceived good health.
Conclusions and Implications : This study suggests that a simple strategy to facilitate participation is to encourage subjects to discuss screening with others; further, to recognise that this may be most difficult for those who are single. Information provided to subjects prior to screening positively contributes to participation.