生物组织光传播特性的研究

光在组织中传播与组织的光学性质有关。折射率是组织光学性质最基本的参数,用来评价组织改变光线行进方向的参量。本文以菲涅耳公式为理论依据,尝试用空气—组织界面的反射率、生物组织薄膜的反射率和生物组织反射光的偏振分量,推算生物组织的折射率。 本文还探测了组织的前向散射和后向漫射分布。     

LASIK术后修氏和非接触眼压计测量结果的比较

目的　评价修氏眼压计和非接触眼压计 (NCT)在激光原位角膜磨镶术 (LASIK)后的眼压测量结果及其相互比较。方法　随机选择接受LASIK治疗的高度近视患者 16 5例 ,排除青光眼或高眼压症 ,于术前用非接触眼压计测量眼压 ,术后 1年以非接触眼压计和修氏眼压计进行测量。结果　 1)非接触眼压测量术前平均 (13.9± 2 .5 )mmHg ,术后 1年平均为 (7.0± 1.8)mmHg ;平均眼压测量值下降(6 .9± 2 .1)mmHg;2 )术后 1年眼压修氏测量平均为 (14.3± 3.5 )mmHg ,与非接触眼压测量比较 ,二者差异有显著性 (P <0 .0 5 )。 3)非接触眼压测量改变值与预期屈光度矫正值存在统计学的相关性 (r =0 .2 379,0 .0 0 2 >P >0 .0 0 1)。结论　术后NCT测量值与修氏眼压计测量值比较明显偏低 ,二者测量结果存在显著性差异 (P <0 .0 5 )。激光切削是导致手术后非接触眼压计测量结果下降的直接原因 ,其下降值与预期屈光度矫正值存在相关性 ,预期屈光度矫正值越大 ,下降值越大。LASIK术后不能按传统正常值衡量非接触眼压计测量结果 ,否则可能延误类固醇性青光眼的早期诊断。术后NCT测量值与修氏眼压计测量值比较明显偏低 ,其原因可能是由于两种眼压计的设计的原理不同     

以痛性眼肌麻痹为首发症状的鼻咽癌4例分析

目的：研究以痛性眼肌为首发症状的鼻咽癌临床特点及误诊原因。方法：回顾分析４例鼻咽癌患者首发临床症状。结果：痛性眼肌麻痹可以是鼻咽癌的首发症状,可有第Ⅲ,Ⅳ,Ⅴ,Ⅵ对颅神经损害。结论：神经系统症状可以是促使鼻咽癌患者的就诊的原发症状,应及时进行鼻咽部颁标准检查,ＣＴ,ＭＲＴ检查有助于确诊。     

41例卵巢黄体破裂临床分析

[背景 ]卵巢黄体破裂是妇科急腹症之一 ,误诊率较高 .[病例报告 ]对 41例经手术及病理检查确定诊断的卵巢黄体破裂进行了临床分析 ,发病年龄为 2 0～ 41岁 ,平均 2 9岁 ;多在月经周期后半期发病 ,占 6 5 % ;发生于左侧卵巢 2 1例 ,右侧卵巢 2 0例 ;腹腔内出血为 15 0～ 2 5 0 0mL ,其中少于 5 0 0mL者2 5例 ,占 6 1% ;休克 7例 ,占 17% .黄体破裂出血量的多少与破口大小无关 .[讨论 ]本病因有腹痛、月经周期延长、不同程度的腹腔内出血及不规则阴道流血 ,易误诊为异位妊娠     

Diagnosing,discarding, or de-VUSsing: A practical guide to (un)targeted metabolomics as variant-transcending functional tests

PurposeFor patients with inherited metabolic disorders (IMDs), any diagnostic delay should be avoided because early initiation of personalized treatment could prevent irreversible health damage. To improve diagnostic interpretation of genetic data, gene function tests can be valuable assets. For IMDs, variant-transcending functional tests are readily available through (un)targeted metabolomics assays. To support the application of metabolomics for this purpose, we developed a gene-based guide to select functional tests to either confirm or exclude an IMD diagnosis.MethodsUsing information from a diagnostic IMD exome panel, Kyoto Encyclopedia of Genes and Genomes, and Inborn Errors of Metabolism Knowledgebase, we compiled a guide for metabolomics-based gene function tests. From our practical experience with this guide, we retrospectively selected illustrative cases for whom combined metabolomic/genomic testing improved diagnostic success and evaluated the effect hereof on clinical management.ResultsThe guide contains 2047 metabolism-associated genes for which a validated or putative variant-transcending gene function test is available. We present 16 patients for whom metabolomic testing either confirmed or ruled out the presence of a second pathogenic variant, validated or ruled out pathogenicity of variants of uncertain significance, or identified a diagnosis initially missed by genetic analysis.ConclusionMetabolomics-based gene function tests provide additional value in the diagnostic trajectory of patients with suspected IMD by enhancing and accelerating diagnostic success.     

Plasma ionized magnesium in tubular disorders with and without total hypomagnesemia

 Selective electrodes have been designed for determining plasma ionized magnesium. In kidney disease the relationship between ionized and total circulating magnesium is often altered. Hence plasma ionized magnesium (ETH 7025 membrane) was determined in 25 patients with primary renal tubular disorders; 6 patients had total hypomagnesemia. Total plasma magnesium was never reduced in the remaining 19 patients. Plasma ionized magnesium values were low in the 6 patients with total hypomagnesemia. In 18 of the 19 patients without total hypomagnesemia plasma ionized magnesium values were not reduced. Ionized hypomagnesemia was noted in a patient with normal total plasma magnesium in the context of hypercalciuric nephrocalcinosis of unknown origin. The study demonstrates an excellent concordance between plasma total and ionized magnesium in tubular disorders associated with total hypomagnesemia and a good concordance in tubular disorders that are not linked with total hypomagnesemia. The determination of circulating ionized magnesium is of little value in the diagnostic work-up of the vast majority of renal tubular disorders. The determination might perhaps disclose latent hypomagnesemia in nephrocalcinosis of unknown cause. Received: 20 March 1998 / Revised: 28 May 1998 / Accepted: 29 May 1998     

PRK治疗RK后残余近视散光二年疗效分析

目的： 评价准分子激光屈光性角膜切削术治疗放射状角膜切开术后残余近视散光的预测性、稳定性和安全性。方法： 对５２ 眼 Ｒ Ｋ 术后残余近视散光患者行再次 Ｐ Ｒ Ｋ 治疗, 并连续随访两年以上。术前残余球镜屈光度－ ３７５±１３２ Ｄ,残余柱镜屈光度－ ２３６±１２５ Ｄ, 最佳矫正视力均≥０８。结果： 术后 ６ 个月球镜屈光度－ ０３２±０２４ Ｄ, 柱镜屈光度－ ０７８±０５２ Ｄ, 裸眼视力≥１０ 者４６ 眼 （８８４６％ ）, 术后 ２４ 个月球镜屈光度－ ０３７±０４２ Ｄ, 柱镜屈光度－ ０５６±０３７ Ｄ, 裸眼视力≥１０ 者 ４２ 眼 （８０７６％ ）。最佳矫正视力下降 １ 行以上者 ３ 眼 （５７６％ ）, 实际球镜矫正度与预期矫正度相差１０ Ｄ 以内 ５０ 眼 （９０１５％ ）, 柱镜相差 １０ Ｄ以内５１ 眼 （９８０７％ ）。结论： Ｐ Ｒ Ｋ 治疗 Ｒ Ｋ 术后残余近视散光的两年随访结果表明, 该方法预测性强、稳定性好和安全性高, 特别在矫正残余散光方面, 其结果令人满意。     

LASIK前后非接触眼压计测量结果的研究

目的：研究激光原位角膜磨镶术（LASIK）手术前后非接触眼压计（NCT）测量值的改变,及其与屈光度矫正值和术中角膜切削厚度之间的关系,方法：随机选择112眼接受LASIK治疗的高度近视患者,排除青光眼或高眼压症,于术前、术后3、6、12个月作非接触眼压测量,对术前、术后的非接触眼压测量值作u检验,并对眼压改变值与预期屈光度矫正值和术中角膜切削厚度作相关性分析,结果：①手术前后非接触眼压测量值的改变差异有显著性意义（P＜0.001）,术后一年平均眼压测量值下降0.931±0.293kPa;③术后一年眼压下降值与预期屈光度矫正值存在统计学上的相关性(r=0.1942,P＜0．05);术后一年眼压下降值与术中角膜切削厚度亦存在统计学上的相关性(r=0.2577,P＜0.001）,结论：LASIK术后不能按传统正常值衡量非接触眼压计测量结果,否则可能延误类固醇性青光眼的早期诊断,激光切削石角膜厚度变薄是导致手术后非接触眼压计测量结果下降的直接原因。     

Electrophysiological determination of the refractive state of the eye of the opossum

The refractive state of the eye of the South American opossum Didelphis marsupialis aurita was investigated with electrophysiological techniques. Using adult specimens, trapped from the wild, averaged cortical evoked responses were recorded from the region of projection of the central visual field. Stimuli consisted of a phase reversal of a square wave grating generated on a CRO screen, with luminance of 2.4 cd/m2 and contrast 0.84. The refractive state of the eye was altered by means of trial lenses and the amplitude of the cortical responses thus obtained compared to those obtained with no lens (control values). Refraction "tuning curves" were determined for each animal. The average refractive state was found to be -2.27 D indicating that this species when raised in its habitat shows, at low ambient luminosity, some degree of myopia. Determination of the Contrast Sensitivity Function indicate that induced ametropias lead to a reduction of the cut-off value of the spatial frequency and a loss of contrast sensitivity.     

高度近视黄斑出血相关因素分析

目的对高度近视黄斑出血的相关因素进行分析。方法对55例(69眼)高度近视黄斑出血的患者进行视力、屈光度、A/B超、眼底彩色照相及荧光素眼底血管造影(fundusfluoresceinangiography,FFA)检查。结果43例(78.2%)近视病程超过20年,54眼(78.3%)眼轴超过29mm,44眼(63.8%)出现后巩膜葡萄肿,所有患者屈光度均超过-10D,黄斑出血时8眼(11.6%)可见漆样裂纹,6眼(8.7%)显示视网膜下新生血管(subretinalneovaseularization,SRNV)。出血吸收后19眼(27.5%)可见漆样裂纹,9眼(13.0%)出现SRNV。结论近视病程超过20年、眼轴超过29mm、屈光度超过-10D、有后巩膜葡萄肿的患者容易发生黄斑出血,漆样裂纹与高度近视黄斑出血有密切的关系。高度近视黄斑出血分为两种类型:一种是不伴SRNV的单纯型出血,另一种是伴有SRNV的出血。单纯型黄斑出血预后较好,伴有SRNV的黄斑出血预后差,定期检查眼底及FFA,有助于早期发现SRNV。