儿童羟基磷灰石义眼台植入的临床分析

目的:观察儿童羟基磷灰石义眼台植入的临床效果。方法:回顾性分析不同原因造成眼球摘除的31例患儿,其中男性 21例,女性 10例,年龄 3岁～14岁,平均 8.2岁,采用义眼台一期植入 20例,义眼台二期植入 11例,植入直径 18mm义眼台者 17例,植入 20mm义眼台者 14例。结果:31例患儿术后 1例结膜裂开,5例出现轻度上睑沟凹陷,随访 1年～8年,所有患者无感染、无排斥、无义眼台暴露,运动好,外观满意。结论:儿童患者应尽可能一期植入义眼台,采用巩膜包裹义眼台植入的 3岁～6岁患儿选择 18mm直径的义眼台,而 7岁～14岁患儿尽量接近成人选用 20mm直径的义眼台。注意手术操作、术后用药及护理可减少术后并发症。     

剖宫手术中对子宫肌瘤处理的研究

剖宫手术中，对合并的子宫肌瘤是否行肌瘤剔除术存有争议。现就本院剖宫产时对子宫肌瘤的不同处理的病例进行分析，以研究剖宫产时对子宫肌瘤的处理方案。     

硬性透气性隐形眼镜(RGP)矫正圆锥角膜的疗效分析

目的: 评价硬性透气性隐形眼镜( RGP) 矫正圆锥角膜屈光异常的疗效。方法: 选择我院 2004- 05/2005- 12 收治的 25 例( 43 眼) 圆锥角膜患者配戴 RGP, 观察视力、角膜曲率、配适状况、舒适度及并发症。结果: RGP矫正视力均好于或等于框架球柱面联合镜。其中优于框架球柱面联合镜片者 37 眼( 86.0%) , 二者视力相等者 6 眼( 14.0 %) , 矫正视力低于框架球柱面联合镜者 0眼, 经统计学处理, 两者有显著性差异( P< 0.01) 。配戴RGP 6mo 时角膜曲率值没有明显变化。本组病例配适良好, 合并症少而轻。结论: 经 6mo 随访观察, RGP 对圆锥角膜的视力矫正明显优于框架眼镜, 是目前矫正圆锥角膜的非手术治疗的有效方法。     

子宫背带式缝合术对宫缩乏力性剖宫产产后出血患者的疗效

目的:研究子宫背带式缝合术对宫缩乏力性剖宫产产后出血患者的止血效果及其对术后康复的影响。方法:选取2014年3月~2017年8月我院收治的78例宫缩乏力性剖宫产产后出血患者作为研究对象,根据治疗方案的不同分为观察组和对照组,每组39例。对照组采用催产素、安列克和子宫动脉上行支结扎术治疗,观察组采用子宫背带式缝合术治疗。比较两组的止血有效率、出血控制时间、术后24 h出血量、住院时间、月经复潮时间、输血率和术后感染发生率。结果:观察组的止血有效率高于对照组,差异有统计学意义,P0.05;观察组术后24 h出血量少于对照组,差异有统计学意义,P0.05;观察组的出血控制时间、住院时间和月经复潮时间均短于对照组,差异有统计学意义,P0.05;观察组的输血率和术后感染发生率均低于对照组,差异有统计学意义,P0.05。结论:采用子宫背带式缝合术治疗宫缩乏力性剖宫产产后出血,能有效减少术后出血量,缩短出血控制时间和住院时间,提高止血有效率,促进月经复潮,降低输血率和术后感染发生率。     

J2对同种异体穿透性角膜移植模型大鼠CD4+和CD8+T细胞免疫功能的抑制

BACKGROUND: J2 takes functional domain (MHC CD4-D1/) of complex conjugate of CD4 molecule and MHC class II molecule as a target, and is a small molecule compound obtained by computer screening from a chemical data containing hundreds of thousands of organic compounds. In the previous study, J2 was used in mouse models of skin transplantation and keratoplasty by oral and intraperitoneal injection. Results verified that J2 could prolong the survival time of grafts, and suppress occurrence of rejection. To better play the role of a drug targeting and to reduce systemic toxicity, J2 will be further utilized in local treatment of keratoplasty rejection. OBJECTIVE: To investigate the inhibitory effect of new immunosuppressive agent J2 on CD4+ and CD8+ T cell immune functions in rat models receiving allogenic penetrating keratoplasty. METHODS: Allogeneic penetrating keratoplasty model was established using the adult female Wistar rats as donors and Sprague-Dawley rats as recipients. Group A: normal Sprague-Dawley rats were injected with 0.05 mL placebo subconjunctivally. Surgery rats were randomly divided into three groups. Group B: allograft rats were injected with 0.05 mL placebo subconjunctivally after autologous keratoplasty. Group C: allograft rats were injected with 0.05 mL placebo subconjunctivally. Group D: allograft rats were injected with 1% J2-nanosuspension 0.05 mL subconjunctivally. The distribution of T cell subsets in peripheral blood was detected using flow cytometry at 3 days, 1, 2 and 3 weeks after transplantation and compared among groups.  RESULTS AND CONCLUSION: There was no significant difference in total CD3+ T cells, CD4+ T cells, CD8+ T cells and CD4+/CD8+ in peripheral blood lymphocytes in group B at various time points. At 3 days and 1 week after surgery in group C, no significant difference in total CD3+ T cells, CD4+ T cells and CD8+ T cells was detected. At 1 and 2 weeks, the number of total CD3+ T cells, CD4+ T cells and CD8+ T cells increased, showing significant differences (P < 0.05). In group D, no significant hyperplasy was found in CD4+ T cells and CD8+ T cells at 1 and 2 weeks. The horizontal comparison of the same time point: the total CD3+ T lymphocytes of group D was significantly less than group C at 3 days, 1 and 2 weeks after operation (P < 0.05), whereas there was no significant difference at 3 weeks between the group D and group C. The number of CD4+ T lymphocytes in group D was less than in group C at 3 days and 1 week, but with no significant difference. The ratio of CD4+/CD8+ had no significant difference in group D compared with group C at 3 days, 1 and 3 weeks. J2 inhibits T lymphocyte proliferation and then inhibits T cell-mediated corneal allograft rejection.       

首诊眼科的猴痘1例

患者男性, 35岁, 因右眼进行性睁眼困难伴双眼丘疹3周就诊于眼科。1月前患者有高危同性性行为, 脐样丘疹首发于眼部, 进展迅速。皮损样本聚合酶链反应检测猴痘病毒阳性、人类免疫缺陷病毒阳性、梅毒血清学阳性;诊断为"眼部猴痘病毒感染"。(本文已于2023年9月18日出版在中华眼科杂志官网)     

成骨不全合并双眼角膜扩张行保留角膜缘的板层角膜移植术1例

患者男性, 15岁, 生后基因检测确诊为成骨不全, 视力不佳。该患者双眼全角膜不均匀薄变, 呈球形扩张, 右眼更重。行右眼保留角膜缘的板层角膜移植术, 术后右眼视力提升, 矫正视力为0.5, 角膜曲率下降, 角膜厚度显著增加, 手术效果满意;左眼病情进展将进一步手术治疗。