老年股骨骨折病人围手术期护理

目的　探讨老年股骨骨折病人手术前后的护理。方法　采取整体护理与康复指导等措施。结果　通过对 83例老年股骨骨折手术病人的整体化护理 ,使病人的肢体功能恢复情况及病人的满意度有了明显改善和提高 ,与以前的责任制护理相比有显著差异性 (P <0 .0 1)。结论　对病人采用整体护理 ,使老年股骨骨折病人早日康复。     

MIR204 n.37C>T variant as a cause of chorioretinal dystrophy variably associated with iris coloboma,early-onset cataracts and congenital glaucoma

Four members of a three-generation Czech family with early-onset chorioretinal dystrophy were shown to be heterozygous carriers of the n.37C>T in MIR204. The identification of this previously reported pathogenic variant confirms the existence of a distinct clinical entity caused by a sequence change in MIR204. Chorioretinal dystrophy was variably associated with iris coloboma, congenital glaucoma, and premature cataracts extending the phenotypic range of the condition. In silico analysis of the n.37C>T variant revealed 713 novel targets. Additionally, four family members were shown to be affected by albinism resulting from biallelic pathogenic OCA2 variants. Haplotype analysis excluded relatedness with the original family reported to harbour the n.37C>T variant in MIR204. Identification of a second independent family confirms the existence of a distinct MIR204-associated clinical entity and suggests that the phenotype may also involve congenital glaucoma.     

白内障超声乳化术及手术配合23例

目的 :介绍超声乳化术治疗早期白内障的优越性及巡回护士在手术过程中的配合要点。方法 :对 2 3例 2 5只眼的手术临床资料作回顾性分析。结果 :术后一周视力≥ 0 .5者 2 2例 ,0 .3以下者 3例。影响视力主要是术前诊断有弱视、陈旧性虹膜炎等症。结论 :使用超声乳化仪治疗早期白内障手术简便、安全、可靠 ,并需巡回护士在手术中的密切配合     

山羊肝精口服液的研制与早中期白内障的防治

山羊肝精口服液是经多年临床经验及反复研究所得的成果,剂型恰当,工艺合理,质量可控,稳定性好。药效学试验说明,本制剂具有健壮身体,抗疲劳的功能。毒理学试验与临床观察说明山羊肝精口服液具有安全性。     

The need for cataract surgery: projections based on lens opacity, visual acuity, and personal concern

AIM: To assess the projected needs for cataract surgery by lens opacity, visual acuity, and patient concern. METHODS: Data were collected as part of the Melbourne Visual Impairment Project, a population based study of age related eye disease in a representative sample of Melbourne residents aged 40 and over. Participants were recruited by a household census and invited to attend a local screening centre. At the study sites, the following data were collected: presenting and best corrected visual acuity, visual fields, intraocular pressure, satisfaction with current vision, personal health history and habits, and a standardised eye examination and photography of the lens and fundus. Lens photographs were graded twice and adjudicated to document lens opacities. Cataract was defined as nuclear greater than or equal to standard 2, 4/16 or greater cortical opacity, or any posterior subcapsular opacities. RESULTS: 3271 (83% response) people living in their own homes were examined. The participants ranged in age from 40 to 98 years and 1511 (46.2%) were men. Previous cataract surgery had been performed in 107 (3.4%) of the participants. The overall prevalence of any type of cataract that had not been surgically corrected was 18%. If the presence of cataract as defined was considered the sole criterion for cataract surgery with no reference to visual acuity, there would be 309 cataract operations per 1000 people aged 40 and over (96 eyes of people who were not satisfied with their vision, 210 eyes of people who were satisfied with their vision, and three previous cataract operations). At a visual acuity criterion of less than 6/12 (the vision required to legally drive a car), 48 cataract operations per 1000 would occur and people would be twice as likely to report dissatisfaction with their vision. CONCLUSIONS: Estimates of the need for cataract surgery vary dramatically by level of lens opacity, visual acuity, and patient concern. These data should be useful for the planning of health services.     

The effect of technology on the indications for cataract surgery

Before the introduction of modern ophthalmic surgical technology following World War II, cataract extraction was easier and safer to perform if the cataract was far advanced (mature) and both eyes were involved. The surgeon was constrained from early surgery by the frequency of severe complications, the long convalescent period, and the distortions of aphakic glasses. Now it is easier to perform phacoemulsification and implant lenses in the early stages of cataract formation when the nucleus is soft and the posterior lens capsule has not been weakened with age. Also, modern small-incision extracapsular cataract extraction has a low rate of complications and a short convalescent period. It is feasible to extract a clear lens or one with minimal opacifications and have a grateful patient. The surgeon is capable of improving the refractive state of the eye by selecting the power of the intraocular lens. These facts have led to instances where cataracts have been extracted that were responsible for minimal or no symptoms. This revised version was published online in July 2006 with corrections to the Cover Date.     

Macular edema induced by phacoemulsification

Purpose: To characterise the association between lens phacoemulsification and the development of macular edema. Methods: We studied 15 patients who underwent lens phacoemulsification in our clinic between January and April 1998 performed by the same surgeon. Ultrasound power and cumulative time was noted. Follow-up was performed at 1 day, 1 week, 1, 3 and 6 months after operation. On each visit corneal thickness, best corrected visual acuity, biomicroscopy and fluorescein angiography were performed. Patients with systemic diseases and/or retinal diseases were not included. Results: Visual acuity was inversely related to the amount of energy delivered during phacoemulsification. In patients who had received more than 1 Joule of energy, fluorescein angiography revealed a higher incidence of blood retinal barrier breakdown. Corneal thickness was not correlated with the ultrasound energy used. Conclusions: Excessive use of power during phacoemulsification may hamper the postoperative evolution of cataract surgery. This revised version was published online in July 2006 with corrections to the Cover Date.     

老年性白内障晶状体上皮细胞凋亡的DNA片段分析及TUNEL检测

目的 探讨老年性白内障晶状体上皮细胞凋亡的生化特征。方法 用ＤＮＡ片段分析及ＴＵＮＥＬ法共检测３１例老年性白内障患者晶状体上皮细胞凋亡。结果 ＤＮＡ片段分析显示,老年性白内障患者晶状体上皮细胞有ＤＮＡ“梯状”图谱,而健康成年人晶状体上皮细胞未见ＤＮＡ断裂现象;ＴＵＮＥＬ检测发现,老年性白内障患者晶本上皮细胞中有凋亡细胞,而健康成年人晶状体上皮中无明显的凋亡细胞。结论 老年性白内障发生与晶状体上皮细     

高频透热撕囊法在白内障手术中的应用

目的:评价在白内障手术中使用高频透热撕囊仪作连续环形撕囊的效果。方法:在30例(34眼)患者进行白内障囊外摘出联合后房型人工晶体植入术中,先向前房注入透明质酸钠,然后使用高频透热撕囊仪作晶体连续环形撕囊术。结果:有3眼术中出现小的晶体前囊放射状撕裂,所有病例术后角膜无水肿,无其他术后合并症,术后一周31眼矫正视力≥0.5,占91.2％。结论:此法操作简便,易于掌握,是一个安全有效的连续环形撕囊的方法。尤其适用于过熟期白内障,儿童先天性白内障和外伤性白内障的截囊。眼科学报1999;15:121—123。     

不同手术切口对白内障术后视力和屈光力的影响

目的　评价白内障不同的手术切口对术后视力恢复的影响。方法　对１８６ 只眼老年性、并发性、发育性和无角膜瘢痕的外伤性白内障行ＥＣＣＥ（ＣＣＣ） 加ＩＯＬ。切口为１１ ｍ ｍ ,隧道６ ｍ ｍ 及反眉状５ ．５ ｍ ｍ 巩膜切口,手术后１ ｗｋ ,１ ｍ ｏ ,３ ｍ ｏ 进行视力和屈光检查与比较。结果　随着手术切口的缩小和手术切口的改进,角膜散光明显减少,视力明显提高。结论　提示反眉状隧道式白内障摘出术ＩＯＬ 术具有有效控制术后散光,全面重建视功能的优点