Evaluation of Dry Eye after Minimal in Situ Conjunctival Incision for Segmental Scleral Buckling Surgery

Objective: To compare dry eye signs and symptoms after minimal in situ conjunctival incision for segmental scleral buckling surgery. Methods: In this prospective clinical study, consecutive patients, enrolled in the Department of Ophthalmology, the First Affiliated Hospital of Xi'an Jiaotong University, from May 2015 to April 2017, who had minimal in situ conjunctival incision or standard segmental scleral buckling surgery were assessed. Dry eye markers including the ocular surface disease index (OSDI) and subjective symptom questionnaire, tear-film assessment using Keratograph 5M corneal topography, Schirmer Ⅰ testing, and fluorescein staining were sequentially evaluated preoperatively and at 1 day, 1 week, and 1 month postoperatively. A Chi-square test, Student's t-test or Mann-Whitney U test was used to compare differences between the two groups. Results: Seventy-eight patients (78 eyes) with similar baseline characteristics were recruited. Most patients developed dry eye postoperatively. Subjective symptoms and fluorescein staining scores elevated from baseline, tear break-up time and Schirmer Ⅰ testing values decreased postoperatively, which peaked at 1 day and did not return to baseline within 1 month. There were no significant differences between the 2 groups (all P>0.05) at 1 day and 1 week except for the higher tear meniscus height (Z=1.04, P=0.041), noninvasive first tear break-up time and average break-up time (t=2.51, P<0.001), and Schirmer Ⅰ test values (Z=2.34, P=0.043), in the minimal in situ conjunctival incision group at 1 month postoperatively. OSDI scores and subjective symptoms were lower in the minimal in situ conjunctival incision group at 1 week and 1 month postoperatively (OSDI: t1 week=2.54, P=0.012; Z1 month=-1.03, P=0.020; subjective symptoms: t1 week=3.04, P=0.011; t1 month=3.94, P<0.001). Sub group analysis using flouesecein staining showed obvious worsening 1 day, 1 week and 1 month postoperatively in patients with preoperative dry eye (Z=-2.42, P<0.001; Z=-1.54, P=0.034; Z=-1.83, P=0.041). Conclusions: Segmental scleral buckling surgery can induce or aggravate dry eyes. Compared with standard procedures, minimal in situ conjunctival incision segmental scleral buckling surgery can improve and shorten the ocular surface discomfort in the early postoperative period, especially in patients with dry eyes before surgery.     

干燥法保存角膜材料在板层角膜移植术中的疗效观察

目的评价干燥脱水法保存的角膜材料在板层角膜移植术中的疗效。方法保存角膜片选自我院符合临床标准的、无水氯化钙硅胶干燥贮存罐内的、复水后透明完整角膜片159片。病例来源于我院眼表角膜病区行板层角膜移植的住院患者159例，包括感染性角膜溃疡、睑球粘连性血管翳性角膜白斑、角膜化学及热灼伤、复发性翼状胬肉、角膜边缘变性和不明原因角巩膜自溶等病例，分别进行了不同术式的板层角膜移植术。结果保存角膜复水合格率为89．83％，一次手术成功145眼，治愈率91．20％。结论用干燥法保存的角膜材料进行板层角膜移植术成功率高。用干燥脱水法保存角膜材料不受特殊条件限制，方法简便且相对安全。     

Optimization of the aerosolization properties of an inhalation dry powder based on selection of excipients

The aim of this study was to investigate the influence of formulation excipients on physical characteristics of inhalation dry powders prepared by spray-drying. The excipients used were a series of amino acids (glycine, alanine, leucine, isoleucine), trehalose and dipalmitoylphosphatidylcholine (DPPC). The particle diameter and the powder density were assessed by laser diffraction and tap density measurements, respectively. The aerosol behaviour of the powders was studied in a Multi-Stage Liquid Impinger. The nature and the relative proportion of the excipients affected the aerosol performance of the powders, mainly by altering powder tap density and degree of particle aggregation. The alanine/trehalose/DPPC (30/10/60 w/w/w) formulation showed optimal aerodynamic behaviour with a mass median aerodynamic diameter of 4.7 μm, an emitted dose of 94% and a fine particle fraction of 54% at an airflow rate of 100 L/min using a Spinhaler inhaler device. The powder had a tap density of 0.10 g/cm³. The particles were spherical with a granular surface and had a 4 μm volume median diameter. In conclusion, optimization of the aerosolization properties of inhalation dry powders could be achieved by appropriately selecting the composition of the particles.     

酶标仪干试剂氰化高铁法测定血红蛋白的探讨

目的 建立一种在酶标仪上用干试剂测定血液血红蛋白的检测方法.方法 将氰化高铁血红蛋白法的试剂干燥在酶标板的微孔内,封存备用.测定时将水溶血后的样品加入微孔,混匀,10min后测定OD值.结果 血红蛋白在25～175g/L内有良好的线性关系(r=0.998 3),结果与全自动血液分析仪SE-9000具有较好的一致性,显色后的吸光度值2h内无明显变化.结论 酶标仪干试剂法测定血红蛋白结果准确可靠,测定过程简便,是一种快速测定血红蛋白的好方法.     

干热环境下猪腹部火器伤的细菌学特点

目的观察沙漠干热环境下猪腹部火器伤后体温变化及伤道、血液中的细菌学特征,为战时创伤救治提供理论依据。方法沙漠干热组和常温组各42头长白仔猪,均随机等分为对照组、伤后1h、2h、4h、8h、12h和24h共7个亚组,实验各组建立猪腹部肠管火器伤模型后,测量其在相应时间点的体温,并进行伤道周围组织和分泌物细菌的定量和定性分析,以及血液的细菌培养及菌群分析。结果实验各组动物体温逐渐升高,沙漠干热组中伤后4h体温已达(40.7±1.3)℃,常温组中伤后12h体温方达(40.0±0.5)℃。沙漠干热组中伤后4h伤道的每克组织细菌数为(4.39±0.51)×105,常温组中伤后8h伤道的每克组织细菌数为(5.93±0.78)×105,达到感染的临界值。各组弹道分泌物中均有表面菌群,沙漠干热组和常温组分别于伤后2h组和4h组开始可检测到肠道菌群;沙漠干热组和常温组分别于伤后2h组和4h组开始血液的细菌培养阳性,可检测到表面菌群和肠道菌群。结论沙漠干热环境条件下腹部肠管火器伤后体温升高明显,细菌繁殖快、容易入血,应尽早合理地清创和使用广谱抗生素。     

眼球表面的蒸发与干眼

通过对眼球表面蒸发量的测定与研究发现,过强的眼表蒸发会导致干眼。眼表蒸发受多种因素影响,如眼表温度、睑板腺功能、环境湿度与空气质量、暴露性眼病和角膜接触镜的配戴等。从这一角度来说,有效减少眼表蒸发对治疗干眼有重要的意义。     

生晒参超微饮片对脾虚小鼠小肠黏膜形态学的影响

目的观察生晒参超微饮片对脾虚小鼠小肠黏膜形态学的影响。方法选用雄性昆明种小鼠,随机分为正常组、空白对照组、生晒参汤剂组、生晒参超微饮片全剂量组(含生药2.5g/kg)及生晒参超微饮片1/2剂量组(含生药1.25g/kg),采用利血平法制备脾虚动物模型,分别给予生理盐水、生晒参超微滤液及生晒参传统汤剂,造模及给药后处死小鼠,取小肠空肠段作光镜HE染色观察小鼠小肠黏膜形态改变,电镜观察小肠超微结构变化。结果用药后生晒参超微饮片全剂量组能明显改善脾虚小鼠小肠上皮微绒毛,改善细胞质和细胞器结构,有显著的修复作用。结论生晒参超微饮片对脾虚小鼠小肠黏膜的修复作用优于生晒参传统汤剂。     

蒸玄参两种提取方法的比较研究

目的选择蒸玄参的提取工艺。方法以哈巴俄苷、肉桂酸、醇浸出物及干浸膏为指标,对半仿生提取法(简称SBE法)和水提取法(简称WE法)进行比较。结果综合评Y值:SBE法>WE法。结论蒸玄参饮片颗粒采用SBE法为佳。     

永久性泪点塞植入术治疗眼干燥症

目的探讨泪点塞植入治疗眼干燥症的疗效。方法眼干燥症21例(42眼)。采用美国奥德赛永久性泪点塞(以下简称泪点塞)植入下泪点,滴人工泪液(0.1%爱丽滴眼液)每天1~2次,并逐渐减少直至停用人工泪液。结果21例(42眼)经泪点塞植入的方法治疗,结果如下:(1)Schirmer试验Ⅰ:治疗前为:(1.64±2.35)mm,治疗后为:(4.76±3.79)mm。(2)泪膜破裂时间治疗前为:(3.71±1.09)s,治疗后为:(7.43±2.74)s。(3)患者主觉症状明显改善,其中完全消失18例(36眼)、好转3例(6眼)。所有患者的滴药次数由原来的4~8次,逐渐减至为0~1次。随诊3~12月。结论泪点塞植入治疗眼干燥症是一种简单易行而效果可靠的方法。     

门诊眼干燥症人群状况调查

目的了解眼科门诊眼干燥症人群组成情况、症状及眼表状况。方法分析2003年12月～2005年3月我院门诊诊断为眼干燥的445例(886眼)患者的临床资料,包括性别、年龄、职业、工作环境、症状、裂隙灯检查、泪膜破裂时间检查(breakuptime,BUT)、基础泪液分泌试验(SchirmerItest,SIt)及角结膜荧光素(fluorescent,F1)染色的检查。结果男性患者180例(40.4%),女性患者265例(59.6%)。年龄21～65岁,平均37.4岁,其中以30～39岁年龄段人数最多(187例),占42%.职业分布中文字工作者最多(178例),占40%.患者症状有干涩感(81.1%)、结膜充血(26.1%)、视疲劳(24.0%)、畏光(21.6%)、异物感(20.0%)、眼痒(16.2%)、眼胀(8.1%)、烧灼感(6.7%)、晨起睁眼困难(4.0%)及睫毛上有碎屑(3.6%)。BUT检查≤5s者618眼,6～10s者268眼。SⅠt检查≤5mm/5min者505眼,5～10mm/5min者143眼,≥10mm/5min者238眼。角膜荧光素染色评分<1分者248眼,1～3分者391眼,≥4分者247眼。结论眼干燥症分布人群广泛,以中青年女性及文字工作者多见,症状明显且多样化,眼表损害较轻微。