Peripapillary retinal nerve fibre layer thickness measurement with SD-OCT in normal and glaucomatous eyes:distribution and correlation with age

AIM:To determine peripapillary retinal fiber layer thickness (RNFL) measured with spectral domain optical coherence tomography (SD-OCT) in normal and glaucomatous eyes in a large sample of exclusively white population and compare results with other similarly constructed studies.METHODS:Average, maximum, minimum and per quadrant RNFL thickness were measured in normal and glaucomatous Greek patients with a scanning laser ophthalmoscope (SLO)/SD-OCT device. The effect of age in normal RNFL thickness was also determined.RESULTS: A total of 278 normal (278 patients) and 67 glaucomatous (67 patients) eyes were included in the study. Average RNFL thickness was 114.8±13.3μm in normal and 92.1±18.5μm in glaucomatous eyes (P<0.001). In normal discs, superior quadrant was the thickest, followed by the inferior, nasal and temporal. Decline of normal RNFL thickness with age was statistically significant for average RNFL thickness (1.92μm per decade of life) and for the superior and inferior quadrants of the disc.CONCLUSION:SD-OCT peripapillary RNFL measurements can be used to distinguish between normal and glaucomatous eyes and establish normative databases, since normal disc measurements differ between different ethnic groups and between different SD-OCT devices.     

纤维蛋白胶治疗兔大的不规则角膜穿通伤

背景 缝线缝合是目前标准的角膜穿通伤治疗方法,缝线缝合的缺点促使人们探索非缝合的手术方法,组织黏合剂是一种有前景的非缝合替代手术方法. 目的 探讨用纤维蛋白胶治疗兔大的不规则角膜穿通伤的效果.方法 18只清洁级健康白色獭兔,按照随机数字表法分成缝合组和黏合组,用15°角膜穿刺刀在角膜非瞳孔区形成V字形、总长度为6 mm的角膜全层穿通伤,缝合组和黏合组分别用10-0缝线对位间断缝合3～5针或用纤维蛋白胶联合临时缝线和治疗性绷带角膜接触镜治疗,每只兔均以右眼为实验眼,左眼为自身对照.比较2个组手术时间,并对术后裂隙灯显微镜观察结果进行比较,分别于术后1、3、8周行角膜组织病理切片评估2个组伤口的愈合修复情况.结果 黏合组的平均手术时间为(3.48±0.48) min,显著低于缝合组的(7.77-±1.30) min,差异有统计学意义(t=9.28,P＜O.01).术后裂隙灯显微镜观察发现,黏合组伤口愈合快且平整.角膜组织病理学检查发现,黏合组伤口愈合规则,炎症反应轻,无新生血管形成;而缝合组纤维排列不整齐,缝线周围有大量炎性细胞及巨噬细胞浸润,炎症反应较重,术后3周发现有新生血管形成.结论 与传统缝线相比,采用纤维蛋白胶联合临时缝线和治疗性绷带角膜接触镜的方法治疗兔大的不规则角膜穿通伤具有操作简单、手术时间短、术后刺激小、炎症反应轻、愈合时间短、伤口愈合规则、无新生血管形成的优点.     

ICL植入术矫正超高度近视的临床效果观察

目的:评估有晶状体眼后房型人工晶状体(ICL)矫正超高度近视的疗效及安全性。方法:对超高度近视患者20例40眼接受普通型ICL或散光型后房型人工晶状体(TICL)治疗,术前屈光度球镜-10.0～-18.0D,柱镜-0.25～-3.00D,等效球镜-15.32D,术后随访12mo,观察指标包括UCVA,BCVA、角膜地形图、主观和客观验光、角膜内皮细胞计数、眼压测量、裂隙灯检查。结果:术后12mo,裸眼视力≥0.8者占80.0%(32眼)。30.0%(12眼)的术眼BCVA较术前提高1行,15.0%(6眼)的术眼BCVA较术前提高2行。术后12mo术眼屈光度在±0.50D者达70.0%(28眼)。术前患者平均眼压为16±2.8mmHg,术后6mo平均眼压为17±3.4mmHg,术前术后相比较差异无显著性(t=0.518,P=0.776),术前患者角膜内皮细胞计数平均为2823±243.6个/mm2,术后6mo平均为2709±273.2个/mm2,术前术后比较无显著性差异(t=0.794,P=0.422)。未发生继发性青光眼、视网膜脱离及并发性白内障。结论:ICL植入术矫正超高度近视具有良好的疗效和安全性,远期效果有待进一步观察。     

角膜浅基质层针刺术联合软性角膜接触镜治疗丝状角膜炎临床观察

目的探讨角膜浅基质层针刺术联合软性角膜接触镜治疗丝状角膜炎的安全性和有效性。方法选择25例丝状角膜炎患者,表麻后刮除丝状物,间距0．5ram密集针刺病灶3ram范围内上皮层至浅基质层,术毕佩戴软性角膜接触镜,眼水点眼治疗原发病,随访观察。结果25例患者中21例症状完全消失,一次性治愈率84％,有效率100％。结论角膜浅基质层针刺联合软性角膜接触镜治疗丝状角膜炎是一种安全有效的方法,具有临床实用价值。     

正常人群和长期戴角膜接触镜者眼表细胞的细胞印记学研究

目的初步探讨正常人群和长期戴角膜接触镜者的眼表细胞的细胞形态,大小以及密度,并将两者进行比较研究。方法选取60名身体健康、无眼疾的自愿者,其中30名无角膜接触镜史,称为正常人群,另30名配戴角膜接触镜2个月及以上,利用醋酸纤维膜收集眼表细胞,在显微镜下观察各种细胞在HE和PAS染色后的情况。结果正常人群的眼表细胞经染色后在显微镜下清晰可见,上皮细胞、杯状细胞密度高,细胞饱满,边缘清晰;而长期戴角膜接触镜者眼表细胞在一个高倍镜下密度低,细胞塌陷,边缘模糊不清。结论长期配戴角膜接触镜,眼表细胞的形态、大小、密度等将会发生不同程度的改变,对眼表造成一定的损害。     

严重先天缺牙患者双侧双颧种植可行性的影像学评价

目的:探讨严重先天缺牙患者选择双侧双颧种植的可行性.方法:基于锥形束CT(cone-beamCT,CBCT)对21例严重先天缺牙患者行双侧双颧种植设计,测量虚拟植入的颧种植体在颧骨段影像学水平上的种植体-骨接触值(radiographic bone-to-implant contact,rBIC).采用SPSS 25....     

本科医学生“早期接触临床”教育评价指标体系构建研究

目的 构建临床医学专业本科生“早期接触临床”教育评价指标体系,为评价医学教学中开展“早期接触临床”教育提供指导依据。方法 通过文献研究法、德尔菲专家咨询法及层次分析法构建本科医学生“早期接触临床”教育评价指标体系并确定各指标权重。采用Excel 2010、SPSS 25.0进行数据录入及统计分析。结果 两轮专家函询的专家积极程度分别为100.00%（26/26）、96.15%（25/26）,专家权威系数分别为0.900、0.920,协调系数分别为0.255、0.175（P<0.05）。构建的本科医学生“早期接触临床”教育评价指标体系包括4项一级指标、12项二级指标和47项三级指标。结论 该指标体系具有较高的科学性和可靠性,经进一步验证后可作为临床医学专业本科生“早期接触临床”教育的评价工具。     

Mesoscale Analysis of the Effect of Interfacial Transition Zone on the Compressive Damage of Concrete Based on Discrete Element Method

The coarse aggregate–mortar interface transition zone (ITZ) has a great influence on the mechanical properties of concrete, which cannot be easily studied using laboratory tests in the mesoscale. In this paper, a series of axial compression tests were conducted using the discrete element method (DEM) on concrete specimens for four phases: coarse aggregates, mortars, aggregate–mortar interface transition zones, and voids. The effects of ITZ strength on macroscopic stress and microscopic cracks under different strength reduction factors were investigated through axial compression testing. With the increase in interface transition strength, the compressive strength of the concrete becomes stronger; moreover, the number of cracks decreases, and the anisotropy of contact orientation becomes weaker. Meanwhile, the direction of crack development and the damage mode of compressed concrete specimens were also dependent on the coarse aggregate–mortar interface strength coefficient.     

Non-Wetting and Non-Reactive Behavior of Liquid Pure Magnesium on Pure Tungsten Substrates

The wetting behavior of liquid magnesium drop on pure tungsten substrates was investigated, for the first time, with the sessile drop method combined with non-contact heating and capillary purification of a Mg drop from a native oxide film. A specially designed apparatus dedicated to the investigation of the high-temperature interaction of dissimilar materials was used. The comparative experiments were performed under isothermal conditions at temperatures of 700 °C and 740 °C using two atmospheres: Ar + 5 wt.% H₂ and pure Ar, respectively. During high-temperature tests for 180 s, the images of the Mg/W couples were recorded with CCD cameras (57 fps) from two directions of observation. The solidified drop/substrate couples were subjected to structural characterization using scanning electron microscopy (SEM) coupled with energy-dispersive X-ray spectroscopy (EDS). Under the applied measurement conditions, liquid Mg revealed non-wetting behavior on W substrates (a contact angle θ > 90°). The average value of the contact angle under the flowing Ar atmosphere at 740 °C was θ_av = 115°, whereas it was higher under the flowing Ar + 5 wt.%. H₂ atmosphere at a lower temperature of 700 °C, showing θ_av = 122°. Independently on employed atmosphere and temperature, SEM + EDS analysis of solidified sessile drop couples did not display any new phases and mass transfer between the Mg drop and the W substrate, whereas the presence of discontinuities at the Mg/W interface of cross-sectioned couples were well-distinguished. Non-wetting and a lack of permanent bonding between the Mg drop and W substrates have a good agreement with the Mg–W phase diagram calculated with the help of FactSage software and FTlite database, i.e., the non-reactive nature of the Mg/W couple because W does not dissolve in liquid Mg and it does not form any compounds with Mg. These findings allow for the recommendation of tungsten as a suitable refractory material for long-time contact with liquid Mg in different container-assisted methods of materials characterization as well as in liquid-assisted processing of Mg components.     

欧堡全景200激光扫描检眼镜在LASIK术前眼底筛查中的应用

目的评价欧堡全景200激光扫描检眼镜在准分子激光原位角膜磨镶术（LASIK）术前眼底检查中的应用价值。方法对我院636例（1262只眼）要求行LASIK手术的近视患者,将欧堡全景200激光扫描检眼镜的眼底检查结果与三面镜检查确诊结果相比较。结果欧堡全景200激光扫描检眼镜检查发现有较大临床意义的眼底病变45只眼,三面镜检查确诊眼底病变50只眼。欧堡全景200激光扫描检眼镜对眼底疾病筛查的敏感度达到90％。结论欧堡全景200激光扫描检眼镜为LASIK术前眼底疾病的筛选提供了一条简便、高效的途径,但不能完全替代三面镜眼底检查。