眼球表面结膜皮样瘤及皮脂肪瘤的CT分析

目的　探讨眼球表面结膜皮样瘤及皮脂肪瘤的临床、病理及CT特征,评价CT检查的价值。方法　回顾性分析手术病理证实的眼球表面结膜皮样瘤及皮脂肪瘤12例,其中皮样瘤5例,皮脂肪瘤7例。女性多于男性(11∶1),均为单眼单个病灶,右眼多于左眼(9∶3)。术前均行常规眼眶CT横断面扫描,其中5例行增强扫描,分析其临床、病理及CT特征。结果　CT上病灶均表现为附着于眼环颞侧的新月形低密度影,最大25mm×15mm,最小8mm×5mm,外缘结膜下均有1~3mm厚的囊壁,增强后囊壁中度强化。皮样瘤较小,壁较厚,CT值-55~-75HU。皮脂肪瘤较大,壁较薄,CT值-80~-120HU。结论　CT检查可明确病灶的大小、范围、性质,以及与眼环、外直肌、泪腺等的关系,有助于提高手术成功率,减少并发症。     

Comparative anatomy of mammalian conjunctival lymphoid tissue: a putative mucosal immune site

Organized mucosa-associated lymphoid tissue (O-MALT) is defined by mucosal lymphoid follicles with unique overlying lymphoepithelia, and classically appears in tissues with a simple columnar epithelium. Within follicle-associated epithelium, goblet cells are characteristically absent, replaced by ultrastructurally distinct antigen-absorptive cells, termed M cells (or microfold cells) for the appearance of their apical cell membranes. To determine if mammalian conjunctiva, with its stratified squamous epithelium, can be considered as a site of O-MALT, we compared the light and electron microscopic anatomy of conjunctiva from fourteen species of non-human adult mammals, and the conjunctiva of human adults harvested at autopsy. Lymphoid follicles in the conjunctiva were demonstrated in all mammals studied except for mice and rats. In those mammals with conjunctival lymphoid follicles, the follicle-associated conjunctival epithelium was notable for an absence of goblet cells. Transmission electron microscopy demonstrated an intimate association of lymphocytes with surface epithelial cells, but epithelial cell morphology was uniform overlying the follicle, and other ultrastructural features of M cells were absent. Therefore, conjunctival lymphoid follicle-associated stratified squamous epithelium demonstrates some but not all features of O-MALT lymphoepithelia. Further studies are necessary to determine what role conjunctival lymphoid tissue may play in mucosal immunity.     

结膜印迹细胞学与干眼症常用检查方法的相关性研究

目的： 以结膜印迹细胞学检查结果为参考，评估患者主诉、泪膜破裂时间、泪液分泌试验以及角膜荧光素钠染色等干眼症诊断方法的客观性。方法：收集2007年6月至10月眼科门诊干眼症患者127例（254眼），正常人26例（52眼），常规行泪膜破裂时间、泪液分泌试验以及角膜荧光素钠染色检查后，0.04％盐酸奥布卡因滴眼液眼表麻醉，使用4 mm×5 mm梯形0.22 μm孔径醋酸纤维素滤纸（Millipore公司）印取颞侧球结膜细胞，95％乙醇固定，行PAS染色。使用有序logistic回归统计学方法分析以上四个因素和结膜印迹细胞学检查结果的相关性。结果：干眼症患者127例（254眼），其中男性40例（80眼），女性87例（174眼），男女比例：1∶〖KG-*2〗2.18，男性平均年龄60.33岁，女性平均年龄46.55岁。干眼症患者中非Sjgrens综合征患者116例（232眼），占89％，Sjgrens综合征患者11例（22眼），占8.66％。正常人26例（52眼）。 有序logistic回归分析显示，患者主诉、泪膜破裂时间、泪液分泌试验、角膜荧光素钠染色四项检查与结膜印迹细胞学结果的相关P值分别为0.000，0.147，0.607，0.000。 结论: 患者主诉和角膜荧光素钠染色与结膜印迹细胞学具有较好的相关性，而泪膜破裂时间和泪液分泌试验与结膜印迹细胞学无明显相关性。     

Conjunctival cicatrizing disease presenting with lacrimal obstruction

Patients with conjunctival cicatrizing disease may develop lacrimal obstruction. Little is published on lacrimal obstruction as the presenting feature of otherwise asymptomatic cicatrizing conjunctival disease. The records of all patients presenting between 1994 and 2015 with lacrimal obstruction found to have cicatrizing conjunctival disease were reviewed. Demographic details, clinical findings, disease progression and treatment were analyzed. Thirty-five patients (25 female), aged 43–91 years (median 74, mean 71.3 years) had epiphora and a mild conjunctival cicatrizing process. Nine patients had onset of epiphora after cataract surgery. All except one patient had obstruction of the proximal lacrimal system (punctum and/or canaliculus). In 14 cases, the obstruction was unilateral (both puncta or canaliculi), with one progressing to bilateral obstruction after 11 years. In 19, all 4 puncta or canaliculi were obstructed. Two patients had unilateral nasolacrimal duct obstruction; one developed contralateral canalicular obstruction 2 years later. Conjunctival biopsies were obtained in 19 of 35 cases (54%), and OCP immunohistochemistry was positive in 7/19 (37%). All other biopsies showed chronic inflammation. Two patients had lichen planus. In follow-up (range 0.1–11 years, mean 3.2 years), 2 patients’ conjunctival disease progressed mildly, and 3 progressed moderately, with 2 of these 5 having positive OCP immunohistochemistry, and 1 having lichen planus. Patients with conjunctival cicatrization may present with lacrimal obstruction, usually punctal or canalicular. Conjunctival disease is usually mild and non-progressive, but patients should be monitored for disease progression.     

Cellular dynamics of corneal wound re-epithelialization in the rat: II. DNA synthesis of the ocular surface epithelium following wounding

To determine the fate of ocular surface epithelial cells in response to corneal injury, epithelial cells undergoing DNA synthesis were labeled at discrete time points following abrasion. A 3-mm diameter epithelial defect was made in the center of the rat cornea. One hour prior to sacrifice, animals received an intraperitoneal injection of [³H]-thymidine. DNA synthesis in the regenerating epithelium was of low abundance (<2%). The undamaged corneal epithelium had a labeling index (LI) that was markedly elevated from unwounded specimens in the first 48 h after abrasion. The LIs of suprabasal cells were increased at 24 h and 36 h; these cells were believed to be displaced basal epithelial cells. Basal and suprabasal cells of the limbus and conjunctiva exhibited increases in LIs from unwounded subjects at singular timepoints (within 24 h of injury). These results, using rigorous statistical analysis, show that DNA synthesis is not impeded — but rather often accelerated — following denuding of the corneal epithelium. Re-epithelialization is not dependent on DNA synthesis in the regenerating region, but appears to be related to an increase in DNA synthesis (along with centripetal migration) in the adjacent, undamaged epithelium. The increase in DNA synthesis occurring in the limbus and conjunctiva does not directly supply cells to the regenerating region within the 72 h required for epithelial restitution, but is conjectured to serve in replenishing ocular surface epithelial cells used in the repair process.     

心血通对冠心病患者球结膜微循环及血液流变性的影响

目的和方法 静脉滴注心血通注射液治疗冠心病患者４２例,观察治疗前后球结膜微循环,血液流变性的变化,以评价其临床疗效。结果 治疗后球结膜微循环明显改善,微动脉管径增宽,缺血压减少,血流速度增加,红细胞聚集减轻,较治疗前形态与流态积份值下降（Ｐ均〈０．０１）。红细胞订指数、血浆粘度、全血粘度（低切值）较用药前改善（Ｐ均〈０．０５）。同时,患者心前区疼痛等症状,心电图,心功能,肾功能均明显好转,总有效率     

Sarcoma de Kaposi conjuntival gigante por el virus de inmunodeficiencia humana: remisión total tras terapia antirretroviral y quimioterapia sistémica

Case report

A 35-year-old male patient with a large unilateral haemorrhagic conjunctival tumour lesion and another contralateral haemorrhagic conjunctival flat lesion associated with violaceous cutaneous macules on the extremities and angiomatous lesions in the upper gastrointestinal tract as initial clinical manifestation of HIV-related immunodeficiency. Cutaneous, gastric mucosal and conjunctival biopsy was consistent with Kaposi's sarcoma with complete remission after highly active antiretroviral therapy and systemic chemotherapy.

1至4个月龄正常婴幼儿结膜囊菌群分布特征分析

目的 探讨1至4个月龄正常婴幼儿结膜囊的菌群分布及其相关影响因素.方法 横断面研究方法.2009年1至3月天津医科大学眼科中心与天津市妇女儿童保健中心合作,采取简单随机抽样研究方法选择109例接受眼病筛查的1至4个月龄的健康小儿,进行双眼结膜囊分泌物取材并做细菌培养和鉴定.应用卡方检验、t检验和回归分析方法对数据进行统计学处理,分析结膜囊细菌种类和分布以及相关影响因素.结果 结膜囊分泌物培养阳性的小儿26例(36只眼),占23.9%.共检出7种44株细菌,包括革兰阳性球菌25株,革兰阳性杆菌18株,革兰阴性杆菌1株.其中类白喉棒状杆菌17株(17/44,38.6%),表皮葡萄球菌16株(16/44,36.4%),金黄色葡萄球菌6株(6/44,13.6%).单眼分离出2种细菌者8只眼(8/36,22.2%),均为葡萄球菌和类白喉棒状杆菌.不同月龄、性别及喂养方式的细菌培养结果差异无统计学意义(X2=0.351,X2=0.001,X2=1.182,P值均大于0.05).结膜囊培养阳性者26例(36只眼),培养阴性者83例(166只眼),两组小儿的出生体重、胎龄及受检周龄比较差异无统计学意义(t=0.078,t=0.940,t=0.686,P值均大于0.05).本研究中性别、年龄、出生体重、胎龄及喂养方式不影响结膜囊带菌状态(Wald X2=0.001,Wald X2=0.003,Wald X2=0.117,Wald X2=1.307,Wald X2=1.490,P值均大于0.05).结论 婴儿期结膜囊正常菌群已经建立,以表皮葡萄球菌和类白喉棒状杆菌为主要菌种.葡萄球菌与类白喉棒状杆菌有共生现象.小儿结膜囊带菌状态相关影响因素仍需进一步研究.     

Normal ocular flora in healthy eyes from a rural population in Sierra Leone

Purpose To identify the normal conjunctival flora in a rural population in Sierra Leone and compare the normal ocular flora of a developing country with that of the developed world. Methods Conjunctival swabs obtained from healthy right eyes of 276 residents of Masungbo, Sierra Leone, were analyzed for growth of microorganisms. Results The most commonly isolated organisms from conjunctival swabs of healthy eyes were coagulase-negative Staphylococcus (28.6%), fungus (26.0%), Staphylococcus aureus (19.9%), Gram negatives other than Pseudomonas/Haemophilus (9.8%), Nocardia/Actinomyces (6.5%), and Pseudomonas aeruginosa (6.2%). Conclusions There is a high prevalence of fungal and bacterial colonization of healthy eyes in a rural population of Sierra Leone. A relationship may exist between resident normal flora and the etiology of ocular infections.     

糖尿病角结膜上皮病变的临床研究

目的 通过对2型糖尿病患者的泪膜和眼表病变进行临床检测,探讨2型糖尿病与泪膜和角结膜上皮改变的相关性.方法 对25例(50只眼)糖尿病住院患者和25例(50只眼)无糖尿病者(年龄匹配)做眼表检查,包括泪膜破裂时间(BUT),泪液分泌试验(Schirmer I),角膜荧光素染色,结膜印迹细胞学榆查,并对结果进行统计学分析.结果 尿病组98.0%的眼泪膜破裂时间小于10s,泪膜破裂时间(4.56±2.02)s低于对照组(6.76±4.11)s;66.0%的患者泪液分泌试验小于5mm,泪液分泌值(4.52±2.84)mm低于对照组为(6.28±3.65)mm;角膜上皮着色占58.0%,结膜杯状细胞密度下降,鳞状上皮化生程度加重.结论 糖尿病患者泪膜稳定性显著下降,是引起十眼症的主要原因.对糖尿病病人进行泪膜破裂时间、泪液分泌试验、角膜荧光素染色、结膜印记细胞学检查有助于早期发现糖尿病的角结膜上皮病变.