复发尖锐湿疣中人乳头瘤病毒相关序列的检测

用聚合酶链反应及其产物斑点杂交技术，对２９例复发尖锐湿疣中人乳头瘤病毒（ＨＰＶ）相关序列进行检测和分型，结果显示复发尖锐湿疣中：ＨＰＶ６：６５．５％，ＨＰＶ１１：２４．１％，ＨＰＶ１６：３１．０％，ＨＰＶ６／１１：１３．８％，ＨＰＶ６／１６：１０．４％，ＨＰＶ１８未检测出来，所用探针以外的型别：３．４％。     

Paired comparison of contrast sensitivity in diffractive multifocal IOLs and conventional monofocal IOLs

Multifocal intraocular lens (IOL) optics produce a retinal image of reduced contrast, which results from splitting incoming light between multiple focal points. This study sought to determine whether the reduced-contrast image results in functional loss of contrast sensitivity. Contrast sensitivity was measured in patients in the US Food and Drug Administration (FDA) study of the 3M Diffractive IOL, using the Pelli-Robson Letter Chart. Fifty-eight of these patients, including six from our clinic, were 'best-case' patients with no pathology, and also had paired multifocallmonofocal implants. Data from these 'best-case' patients with paired eyes indicate no functional difference in contrast sensitivity. Additional data obtained on our six patients with the Regan Low Contrast Charts suggest small predictable differences may exist for some patients at very low contrast levels. Further study is needed to determine whether these differences have functional significance.     

宫颈湿疣的诊断及其与宫颈癌发生的关系

为探讨宫颈湿疣的诊断及其与宫颈癌发生的关系，作者对４８例宫颈湿疣、４６例宫颈癌进行了细胞学、组织病理学、阴道镜、免疫组化及ＨＰＶ—ＤＮＡ相关序列及超微结构检查。细胞学诊断宫颈湿疣的阳性率为７０．８３％。３９例外阴、阴道尖锐湿疣中，２１例经阴道镜检查并活检证实有宫颈湿疣。单纯宫颈湿疣免疫组化检查ＨＰＶ抗原的检出率为６３．１５％。宫颈湿疣及宫颈癌ＨＰＶ—ＤＮＡ基因相关序列的检出率分别为４２１％及８５％。依靠细致的妇科检查，对外阴、阴道湿疣及宫颈刮片异常的患者常规作阴道镜检查及其引导下的宫颈活检，不难作出宫颈湿疣的诊断。     

Trial of Trachoma Rapid Assessment in a subdistrict of northern Nigeria

PURPOSE. To assess the usefulness of Trachoma Rapid Assessment (RA) in priority ranking of trachoma areas. METHODS. RA was conducted concurrently with a cross-sectional trachoma prevalence survey in some villages selected from the communities at risk for trachoma in the Kaita Local Government Area of northern Nigeria. The RA team consisted of two ophthalmic nurses. Pen torches and loupes were used for the examination. Data were collected on the seven components of the RA ‘information pyramid’ for all the selected villages. The data were analyzed using the RA methodology guidelines to determine the priority villages for trachoma intervention. This was compared with the ranking from the cross-sectional trachoma prevalence survey. RESULTS. The results of RA were found to be in agreement with the cross-sectional survey in 53.3% of the villages in the priority ranking of trichiasis, while in the priority ranking of active trachoma the agreement between the two methods was found to be 60%. The risk factors for trachoma were shown to be of high magnitude in all the villages using both the RA method and the prevalence survey. CONCLUSION. RA may be a more useful tool when applied to a vast area where the risk of trachoma is likely to differ greatly between different parts of the area. In the determination of the trichiasis pattern of a community by RA, it may be more useful to use the actual number of trichiasis cases in the area rather than the prevalence of trichiasis. The operational definition of some risk factor indicators seems very subjective and vague. The RA method needs more validation to sharpen the indicators used.     

尖锐湿疣患者HPV型别及DNA载量与复发的关系

目的研究天津地区尖锐湿疣（CA）患者人乳头瘤病毒（HPV）6/11、16/18型及DNA载量与复发的关系。方法采用实时荧光定量聚合酶链反应（FQ-PCR）检测CA患者皮损中HPV型别及DNA载量,并随访至少3个月观察有无复发。结果83例CA标本中,HPV阳性80例（96.4%）,其中单纯HPV6/11型63例,单纯HPV16/18型4例,HPV6/11型和HPV16/18型混合感染13例,不同型别复发率比较无统计学差异（P〉0.05）。HPV6/11阳性标本中,复发组与未复发组DNA载量比较有统计学差异（P〈0.05）。结论CA患者的HPV感染以HPV6/11型为主,患者疣体中HPV DNA载量与复发有关。     

CO2激光联合盐酸氨酮戊酸散光动疗法治疗尖锐湿疣的疗效观察

目的观察CO2激光联合外用盐酸氨酮戊酸散光动疗法（aminolevulinic acid hydrochloride for topical powderphotodynamictherapy,ALA-PDT）治疗尖锐湿疣的临床疗效与安全性。方法治疗组36例患者,经CO2激光术后联合ALA-PDT,1周治疗1次,连续治疗3周;对照组28例患者,经CO2激光术后,联合使用咪喹莫特乳膏涂抹患处,1周3次,连续使用8周。2组患者均在末次治疗后第1周进行疗效评价和不良反应观察,第4～8周观察复发率。结果末次治疗1周时,2组疣清除率均为100%,无统计学差异（P〉0.05）;2组均无全身不良反应,局部不良反应治疗组为13.89%,主要为红肿、疼痛、渗液,对照组为64.29%,主要为疼痛、糜烂、红肿、红斑等,具统计学差异（P〈0.05）。结论 CO2激光联合ALA-PDT治疗尖锐湿疣,清除速度快,疣体清除率高,复发率低,安全,耐受性好,无明显副作用,值得临床推广。     

卡介菌多糖核酸联合高频电离子术及自体疣植入治疗尖锐湿疣

目的 观察卡介菌多糖核酸联合高频电离子术及自体疣植入治疗尖锐湿疣的临床疗效。方法121例尖锐湿疣患者随机分成治疗A组（n=41）、治疗B组（n=40）和对照组（n=40）,治疗A组给予卡介菌多糖核酸联合高频电离子术及自体疣针剌植入法治疗,治疗B组给予卡介菌多糖核酸联合高频电离子术及自体疣手术植入法治疗,对照组仅给予高频电离子术治疗。分别对其疗效、复发率及不良反应等进行观察,并对针刺植疣法与手术植疣法两种操作方法进行比较。结果总有效率治疗A组为95．1％,治疗B组为92．5％,对照组为70％。治疗A组及B组复发率明显低于对照组。针剌植疣法与手术植疣法疗效相近。结论卡介菌多糖核酸联合高频电离子术及自体疣植入治疗尖锐湿疣具有较好的疗效,针刺植疣法与手术植疣法疗效相近,但前者简便易行,创伤小。     

遂宁地区83例尖锐湿疣患者高危型人乳头瘤病毒检测及临床表现分析

目的:探讨遂宁地区尖锐湿疣患者高危型人乳头瘤病毒(高危型HPV)检测及病变临床特点。方法:采用荧光定量聚合酶链式反应(Q-PCR)方法检测遂宁地区83例尖锐湿疣患者病变组织中的高危型HPV。结果:83例尖锐湿疣患者中高危型HPV阳性率为79.5%;病变部位以外阴部发病率最高,占55.4%;尖锐湿疣患者发病年龄以20～40岁为最多,占61.4%;高危型HPV阳性检出率也以20～40岁为最高,占82.4%。结论:遂宁地区尖锐湿疣患者中高危型HPV阳性检出率较高,感染高峰年龄为20～40岁。     

女性假性湿疣104例临床分析

目的 :总结外阴假性湿疣及尖锐湿疣的鉴别诊断。方法 :对各种外阴赘生物患者进行病理学检查 ,以确诊假性湿疣及尖锐湿疣。结果 :对 1 5 2例外阴赘生物患者 ,经病理证实 1 0 4例为假性湿疣 ,4 8例为尖锐湿疣。结论 :外阴假性湿疣发病率逐渐上升 ,不必心理恐慌而应注意个人卫生。     

Visual acuity and retinal function in patients with Bardet-Biedl syndrome

OBJECTIVE:

Bardet-Biedl syndrome is a genetic, multisystem disorder that causes severe visual impairment. This condition is characterized by retinal dystrophy, obesity, digit anomalies, renal disease, and hypogonadism. The purpose of this study was to analyze visual acuity and full-field electroretinogram findings in patients with the Bardet-Biedl syndrome phenotype.

METHODS:

The visual acuity of a group of 23 patients (15 males) with ages ranging from 6-36 years (mean = 15.8±6.4; median = 14.7) was assessed. Retinal function was evaluated by full-field electroretinography, and dark-adapted thresholds were assessed.

RESULTS:

Visual acuity in the better-seeing eye was 20/40 or better in 5 patients (21.7%), 20/50-20/150 in 13 (56.5%) patients, 20/200-20/400 in 2 (8.7%) patients and worse than 20/400 in one (4.3%) patient. The mean acuity in the better-seeing eye was 0.7±0.6 logMAR (20/100, Snellen equivalent). Scotopic rod and maximal responses were non-detectable in 21 (91.3%) patients, and cone responses were non-detectable in 15 (65.2%) patients. Elevated dark-adapted visual thresholds were observed in all 19 patients who were able to be assessed, with 10 (52.6%) patients having thresholds greater than 30 dB.

CONCLUSIONS:

In a relatively young cohort of patients with Bardet-Biedl syndrome, only 21% had 20/40 or better vision. ERG scotopic responses were absent in the majority of cases, with cone responses being observed in less than half of cases. These findings showed the early deleterious effects in retinal function and visual acuity caused by this condition.