高度近视眼白内障手术疗效观察

目的　分析高度近视眼白内障手术效果。方法　高度近视合并白内障病例共１９１ 例（２７９ 只眼）,行白内障术后３ｍｏ以上,随访视力、眼屈光度及并发症,计算测量误差及ＳＲＫ－ＩＩ公式误差。结果　术后矫正视力０ ．５ 者２００ 只眼,占７１．７ ％ ;矫正视力＜ ０．１ 者１３ 只眼,占４ ．７ ％ － 眼轴越长,近视性眼底病变越重。术后发生视网膜脱离２ 只眼（０ ．７％） 。眼轴长度测量误差值平均为０．５３ｍｍ ,ＳＲＫ－ＩＩ公式计算的平均绝对屈光误差值为１．１２Ｄ。结论　高度近视眼白内障手术效果较一般人群差,且眼轴越长效果越差。     

高度近视白内障小切口超声乳化摘除术

目的：探讨经透明角膜隧道对高度近视白内障患者行超声乳化摘除术的可行性及手术技巧。方法：对２１６例高度近视合并白内障患者,经角膜缘隧道切口行超声乳化吸出,并植入软性或硬性人工晶体。对超声乳化能量、时间、负压及术后视力、散光及并发症进行观察。结果：采用较低能量、中度真空压力及中低档流速行超声乳化吸出,术后视力≥０．８者１４３例,≥０．５者４９例。术前近视力≥０．８者,术后远视力常较佳。术前及术后散光３．０ｍｍ切口组无统计学差异,５．５ｍｍ切口组有统计学差异。未见明显严重并发症。结论：透明角膜超声乳化联合软性或硬性人工晶体植入,是高度近视白内障较理想的手术方式。     

儿童角膜穿通伤合并外伤性白内障人工晶体植入术临床分析

本文回顾分析２６ 例 （２６ 眼） ５～１４ 岁儿童角膜穿通伤合并外伤性白内障植入后房型人工晶体的临床结果。对麻醉、人工晶体植入、后囊纤维膜样混浊进行了分析讨论。提示 ８ 周岁以上儿童常能在眼局部麻醉下顺利地完成手术。认为对儿童角膜穿通伤合并外伤性白内障植入人工晶体, 应视眼部伤情及术中情况, 权衡利弊, 区别选择Ⅰ期或Ⅱ期植入。作者观察到, 这类联合手术的后囊纤维膜样改变, 在术后一至二周即在不同程度上有所表现。     

Failure to find a relationship between mnestic skills of octogenarians and aluminum in drinking water

Summary High concentrations of aluminum (>80 g/l) in drinking water have been related to an elevated incidence of Alzheimer's disease. Mnestic and naming skills of residents living for >15 years in districts with high (98 g/l) or low (4 g/l) aluminum concentrations [Al] in the drinking water were evaluated in a population survey by examining 800 residents aged 81 to 85 using the mnestic subtest of the Mini Mental Status test (Zurich variant). The mnestic and naming performance of the octogenarians did not differ between the high- and low-content-areas. Since 73% of dementias are at least partly caused by Alzheimer's disease in the area examined and because the short test used discriminates demented from healthy octagenarians as well as tests involving extensive examinations, the findings of this study suggest with a high probability that the [Al] of drinking water is not an essential factor in the pathogenesis of senile dementia. The serum [Al] the urinary [Al] and the urinary [Al]/creatinine ratio were measured twice in ten clinically diagnosed Alzheimer patients and ten controls in both areas. No significant difference was found, which confirms the negative epidemiological findings.Parts of this study were presented at the joint meeting of the Swedish and Swiss Neurological Association in Interlaken, Switzerland, on May 22, 1990     

Study of the substructure of the Morgagni and Brunescens cataract with the TAO non-coating technique

Lens tissue from a Morgagni cataract was examined by SEM and TEM. For SEM, after prefixation with glutaraldehyde and postfixation with the tannic acid/arginine/OsO₄ non-coating (TAO) technique, and for TEM, after prefixation with glutaraldehyde, postfixation with OsO₄/K₄Fe(CN)₆ and poststaining with uranyl acetate/lead citrate. The TAO technique seems to be a particularly suitable postfixation method for the SEM investigation of cararact tissue because of the presence of the protein structures present. The cortical region showed areas of radially, instead of concentrically, arranged lens fibres, degenerated lens fibres with holes (vacuoles), broken ball and socket connections between the lens fibres, and oval or spherical structures varying in size from 0.5–20 m, the largest resembling a golfball, arising from the cytoplasm of degenerating lens fibres. The smallest, 0.2–0.5 m, appear to have been expelled from the furrowed lens epithelium.     

静脉溶栓治疗高龄急性心肌梗死患者的临床探讨

目的　探讨静脉溶栓疗法对高龄急性心肌梗死患者的疗效及安全性。 方法　将 82例高龄急性心肌梗死患者随机分为溶栓组和常规治疗组。溶栓组 40例 ,采用尿激酶静脉溶栓加皮下注射低分子肝素钙。常规治疗组 42例 ,除不用尿激酶及低分子肝素钙外 ,其余治疗均与溶栓组相同。 结果　 血管再通率溶栓组为6 5 %(2 6 / 40 ) ,常规治疗组为 14.3%(6 / 42 ) ,两组血管再通率比较差异具有显著性 (P <0 .0 5 )。溶栓组未见严重出血等并发症。住院 4周内病死率为 5 %。而常规治疗组病死率为 2 3.8%(10 / 42 ) ,两组比较具有显著差异性(P <0 .0 5 )。 结论　 尿激酶静脉溶栓治疗高龄急性心肌梗死可以提高冠脉再通率 ,降低死亡率和改善预后 ,是可行性治疗措施。     

老年斑、神经元纤维缠结与硫酸多糖

老年斑 (senileplaques ,SP)、神经元纤维缠结 (neurofib rillarytangles,NFTs)是老年性痴呆最典型的病理特征 ,其中SP的主要成分为 β样淀粉蛋白 (Aβ) ,NFTs主要由异常修饰的tau蛋白组成。许多研究发现硫酸多糖与SP、NFTs的形成密切相关。大量文献报道硫酸多糖与淀粉样前体蛋白(APP)、Aβ以及tau蛋白具有高度亲和性 ,它不仅可以促进APP的异常代谢 ,导致Aβ的大量产生 ,诱导其形成纤丝并聚集、沉积于细胞外 ,而且还可促进tau蛋白发生高度磷酸化 ,形成成对螺旋丝 (PHF)并聚集成NFTs。但也有文献报道外源性硫酸多糖具有促进APP的神经营养作用 ,抑制Aβ纤丝的形成 ,并增强磷酸酯酶PP2B的活性 ,从而减少tau蛋白的磷酸化修饰。并且硫酸多糖的糖基组成、糖链长度、硫酸基的数目及位置不同 ,它在SP、NFTs的形成过程中扮演的作用也不同 ,所以可通过分子结构改造而使硫酸多糖表现抑制SP、NFTs形成的活性 ,从而达到抗老年性痴呆的作用     

糖尿病患者白内障超声乳化术后的中药调理

将108例糖尿病白内障患者随机分成两组,经白内障超声乳化及人工晶体植入术后,中药组51例给予口服益气补肝肾及活血化瘀的方药,每日1剂,14天为1个疗程;西药组57人口服强的松30mg,每日1次,逐日递减,一周后改服消炎痛25mg,连服一周.结果:两组疗效比较无显著性差异,但中药解除了糖尿病患者手术后用激素治疗所致的血糖增高的后患.     

288例老年呼吸道感染患者病原菌分布特性及药敏分析

目的: 了解老年呼吸道感染患者病原菌的分布特点及药敏特性.方法: 对288例老年呼吸道感染患者痰样本(NCCLS法)进行细菌培养,K-B纸片法进行药敏测定.结果: 患者痰中共检出病原菌400株,细菌280株,其中G-杆菌147株,占36.75%, G 球菌133株,占33.25%.肺炎克雷伯菌及铜绿假单胞菌最敏感药的是头孢他啶,敏感率均为40%以上,肺炎链球菌和金黄色葡萄球菌最敏感药的是万古霉素;检出真菌120株,占30%,以白色念珠菌为主.结论: 进行病原菌跟踪监测及时的药敏试验,对及时控制老年呼吸道感染,是不可缺少的重要环节.     

石斛夜光颗粒剂对大鼠实验性白内障及家兔球结膜微循环的影响

目的：观察石斛夜光颗粒剂对大鼠实验性白内障的形成和家兔球结膜微循环的影响。方法：将１２０只大鼠随机分为对照组，模型组和丸药组，其中丸药组又分为大剂量组，中剂量组和小剂量组。分别记录实验开始后第１０天、第１５天和第２０天晶状体的混浊程度。将３２只家兔随机分为对照组、大剂量组、小剂量组和丸药组。灌胃给药６０ｍｉｎ后经耳静脉注射１０％高分子右旋糖酐６ｍｌ／ｋｇ，观察球结膜血管的改变。结果：大鼠实验性白内障的发生率在模型组、丸药组和大、中剂量组中分别为３３３％～６６７％、３６４％～６３６％和２７３％～７２７％，组间比较有显著差异（Ｐ＜００５）；在大中小剂量组中分别为２７３％～７２７％、３３３％～６６７％和４１７％～５８３％。家兔球结膜微循环观察显示在血液颜色、血流形态、血管口径、毛细血管交叉点数方面，各组间均有显著差异（Ｐ＜００５）。结论：石斛夜光颗粒剂具有延缓大鼠实验性白内障形成和改善家兔球结膜微循环的作用。