手术治疗巨大裂孔视网膜脱离的预后分析

目的：探讨不同的手术方法对巨大裂孔视网膜脱离病例的预后影响。方法：回顾１９９５年１月～１９９７年３月间我院住院治疗的巨大裂孔视网膜脱离７２例７３眼。手术方法分为四种。结果：术后随访３月,总视网膜解剖复位率为５７／７３（７８．１％）,其中单纯型为１４／１６（８７．５％）,复杂型为４３／５７（７５．４％）。单纯型与复杂型患眼的术后复位率无统计学差异。环扎加压术后,单纯型患眼的复位率高于复杂型。对于复杂型患眼,玻璃体手术合并环扎加压术与否对其复位率无影响;玻璃体手术中使用Ｃ１０Ｆ１８与否对其复位率无影响。结论：环扎加压术对于治疗单纯型巨大裂孔视网膜脱离,尚属一种有效的方法。Ｃ３Ｆ８气体和全氟碳液是治疗有翻转后瓣的巨大裂孔视网膜脱离的有效手段。部分复杂型巨大裂孔视网膜脱离常用硅油填充。根据患眼的具体情况,选择合适的手术方法至关重要。     

视网膜切开与切除术在复杂性视网膜脱离手术中的应用

目的探讨视网膜切开与切除术在复杂性视网膜脱离手术中的临床应用。方法对１９９７年９月至１９９８年１２月间行视网膜切开与切除的２４例复杂性视网膜脱离患者作回顾性分析。其中巨大裂孔性网脱１５例,外伤牵引性视网膜脱离２例,增殖性血管性视网膜病变２例,复发性视网膜脱离３例,前部ＰＶＲ２例。手术联合玻璃体切除联合巩膜扣带技术,三通道睫状体平部晶体／玻璃体切除、膜剥离、过氟化碳液体使用、眼内激光、硅油－过氟化碳液体交换填充硅油或气体－过氟化碳液体交换填充Ｃ２Ｆ６气体。其中采用视网膜切开１０例,视网膜切除１０例,视网膜切开联合切除４例。结果２４例患者近期（出院时）观察视网膜解剖复位２２例,有效率为９１．７％,１９例视力不同程度的改善。１５例巨大裂孔僵硬边缘切除或裂孔两边松驰性视网膜切开,解剖复位１４例,视力改善。术后随访１９例,时间为３～１４月（平均６月）,视网膜复位１８例,占９４．７％,视力≥０．０５者９例,占５０％,眼球萎缩及低眼压１例。结论视网膜切开与切除术提高了复杂性视网膜脱离手术的成功率。     

Functional transmitters at retinal ganglion cells in the cat

The effects of iontophoretically applied putative neurotransmitters and their antagonists on the responses of retinal ganglion cells were studied in the optically intact eye of anaesthetized cats. L-aspartate enhanced and a N-methyl-D-aspartate receptor blocker, 2-amino-5-phosphonovalerate, blocked visual excitations of "sustained" cells, whereas acetylcholine enhanced, and the nicotinic receptor blocker, dihydro-beta-erythroidine, blocked those of "transient" cells. GABA enhanced and bicuculline blocked inhibitions of on-centre cells, but glycine enhanced and strychnine blocked those of off-centre cells, whether the cells were "sustained" or "transient". The possibility that: (A) aspartate may be an excitatory transmitter at both "on-" and "off-sustained" cells and acetylcholine, at both "on-" and "off-transient" cells; (B) GABA may be an inhibitory transmitter for on-centre, and glycine, for off-centre cells, is discussed.     

A highly predictable animal model of retinoblastoma

Summary A new animal model of retinoblastoma was developed in newborn inbred CDF rats by intravitreous inoculation of retinal tumor cells (5×10⁴/5 l) derived from the cultured tumor cell line EXP-5. The retinal tumor from which the cell line originated was induced by a single intravitreous inoculation of human adenovirus serotype 12 (5 l of 10⁸ TCID 50/0.1 ml) in syngeneic rats. Within 1 month after intravitreous moculation of EXP-5 cells, a clinically recognizable ocular tumor was obtained in all 39 rats. Ad 12-specific T-antigens were demonstrated in the cultured tumor cells using immunofluorescent techniques. Morphologically these tumor cells closely resembled retinoblastuma, with poorly differentiated intracytoplasmic organelles, solitary cilia with a 9+0 tubule pattern, and abnormal nuclear membrane associated with a set of basal bodies. The significance of this highly manipulable retinal tumor cell line is the capability of providing a full-fledged intravitreous tumor in 1-month-old CDF rats, whose actual life span is known to be 42 months. Transplantable retinal tumors described to date are reviewed breifly and compared with the presently reported cell line.Supported by USPHS grants EY-CA01667, R01-EY-03171, and P30 EY-01784, by grants from the Retina Research Foundation, Houston, Texas, and by the Massachusetts Lions Eye Research Fund Inc.     

Effects of Red Palm Oil on Serum Lipids and Plasma Carotenoids Level in Chinese Male Adults

Objective Effects of red palm oil on major plasma carotenoids, tocopherol, retinol and serum lipids were evaluated when used in Chinese diet. Methods Red palm oil group (RPO) composedof 20 male subjects(aged 18-32) and soybean oil group (SBO) composed of 22 male subjects     

92例妊高征性视网膜病变的临床分析

目的 探讨妊高性视网膜病变的临床意义。方法 对92例妊高征孕产妇进行眼底检查，将视网膜病变的情况与患者的视力、血压、水肿、蛋白尿和病程进行分析。结果 妊高征患者视网膜病变的发病率为82．6％，视网膜病变越重患者视力越差，视网膜病变的发生及严重程度与妊高征患者的高血压、蛋白尿成正比关系。结论 妊高征性眼底检查，对妊高征诊断、处理及预后起重要作用。     

食管拔脱结肠重建食管(附18例分析)

 目的　探讨食管拔脱结肠重建食管术 (esophagealreplacementwithcolonERC)治疗颈、胸上段食管癌的可行性和实用性。方法　经颈、腹径路实施食管内翻拔脱切除病变食管 ,并用ERC获得了满意疗效 ,对该术操作要点 ,食管拔脱的可行性进行讨论。结果　全组无手术死亡 ,1例发生颈部吻合口瘘 ,1 8例术后随访 6年 ,存活超过 1年者 1 3例 ,超过 3年者 8例 ,超过 5年者 5例 ,5年生存率为 2 7.8%。结论　食管内翻拔脱ERC治疗颈 ,胸上段食管癌的特点为 :避免开胸术创伤 ,保留自体胃功能 ,术后生存期长 ,生活质量好。     

视网膜脱离复位术后屈光改变的临床研究

目的　了解视网膜脱离复位术后屈光状态的改变及恢复情况。方法　收集 39例 (39只眼 )手术复位成功的孔源性视网膜脱离患者 ,于术前及术后 1周、1、3、6月分别进行检影验光 ,A超测量眼轴长度 ,角膜曲率计检查 ,观察动态变化情况。结果　术前本组孔源性视网膜脱离中 ,近视眼占 82 .0 5 %。 >4 .0 D者占 6 9.2 3% ,眼轴长度>2 6 mm者占 6 9.2 3%。 3例环扎术后 ,全部眼轴加长 ,近视度加深。术后 1周及 1月时 ,散光值 >2 .0者为 12 .82 % ,术后 3个月逐渐减少。放射状加压术后散光值更大 ,差异有显著性 (P <0 .0 5 ) ,但 6个月内能恢复原状。结论　术前眼轴越长 ,近视度越高 ,发生孔源性视网膜脱离机会越多。环扎术后 ,眼轴变长 ,近视度加深 ,且半年内无明显改善。环形加压术或放射状加压术后早期 ,近视度数降低 ,向远视方向改变 ,从 +0 .5 D～ +5 .0 D不等 ,1月时最为明显。放射状加压术更易引起角膜曲率改变 ,散光值更大。但这种屈光改变是暂时性的 ,术后 6个月逐渐恢复原状 ,并趋于稳定。临床上适宜于视网膜脱离复位术后 6个月重新验光配镜。     

压力及维生素B1作用下视网膜神经细胞p53、MDM2及Ref1基因的表达

目的:探讨压力及压力加维生素B1联合作用下SD大鼠视网膜神经细胞p53、MDM2及Ref1基因的表达情况。方法:新生SD大鼠视网膜神经细胞体外培养,倒置相差显微镜观察细胞的生长情况,细胞分单纯加压组、实验加压组(加入维生素B1)及未加压对照组,于加压后2 d(培养第9~10天)行苔盼兰染色检查计数细胞成活率,p53免疫组化检查并提取细胞总RNA,用逆转录聚合酶链反应法检测p53、MDM2及Ref1基因的表达。结果:单纯压力组p53／MDM2基因的表达较正常未加压组增强,Ref1基因表达无增强;而维生素B1作用后的加压组,其p53／MDM2基因的表达较单纯加压组明显减弱。结论:压力作用下视网膜神经细胞的损害有凋亡机制参与,维生素B1对压力作用下视网膜神经细胞具有保护作用。     

PVR B 级的裂孔性视网膜脱离术后复发与玻璃体病变关系临床分析

目的回顾分析近10年PVR B级的裂孔性视网膜脱离术后复发与玻璃体病变的关系.方法对429例(435只眼)PVR B级的裂孔性视网膜脱离施行巩膜扣带术治疗,其中41只眼术后复发(9.43%),分析术后复发与玻璃体病变的关系.结果术前玻璃体正常组与浓缩组的复发率(3.19%与12.33%)之间差异有显著性(P＜0.05);正常组与条索牵引组间的复发率(3.19%与14.29%)之间差异有极显著性(P＜0.01);正常组与总体组的复发率(3.19%与9.43%)之间差异有显著性(P＜0.05);术前无玻璃体后脱离组与玻璃体后脱离组间的复发率(5.56%与12.90%)之间差异有显著性(P＜0.05).视网膜脱离术前各种玻璃体的情况在视网膜脱离复发时均有不同程度地加重.结论PVR B级的裂孔性视网膜脱离术前玻璃体病变和玻璃体后脱离对术后复发影响明显.重视玻璃体-视网膜界面动态变化,可进一步提高手术治愈率.