上下泪小管同时断裂35例手术分析

目的探讨上、下泪小管同时断裂的手术治疗方法。方法上、下泪小管同时断裂共35例,按手术方式分为两组。A组:27例同时行上、下泪小管吻合术;B组:8例仅行下泪小管吻合术。结果A组27例较少发生内眦角变形、睑外翻,上下泪点复位良好。结论为求上、下泪小管断裂术后能达到解剖复位及功能复位,同时行上、下泪小管断裂吻合效果较好。     

改良泪道探通术治疗新生儿泪囊炎

新牛儿泪囊是婴幼儿常见病，作者应用自制的泪道探通冲洗针对28例新生儿泪囊炎进行了泪道探通冲洗治疗观察．疗效满意．报告如下。     

面斜裂整形修复中泪道重建术的探讨

为了解决面斜裂整形修复中泪道重建的难题，１９８９年３月～１９９５年１月，对４例患者治疗中设计了三种手术方法：泪小管鼻腔吻合术；静脉血管或口腔粘膜移植重建泪道术；改良的泪囊鼻腔吻合术。术后重建的泪道置入导管３～６个月。经术后６个月～１年的观察，面部畸形整复，溢泪消失，红汞试验及泪道检查均通畅，效果满意。认为，应根据泪道畸形程度的不同，选择合适的手术方法，以取得最佳疗效。     

改良泪道探通术注入素高捷疗眼膏治疗泪道阻塞的临床观察

目的 :探讨改良泪道探通术注入素高捷疗眼膏治疗泪道阻塞的临床效果。方法 :用 7～ 9号腰脊穿刺针针头去尖 ,磨光后制成改良空管式泪道探针。为慢性泪囊炎 98例、10 2眼探通泪道后沿空管注入素高捷疗眼膏 ,使之布满泪道内壁 ,尽快修复探通的泪道内皮 ,达到扩张疏通的目的。以同一疾病 84例、85眼为对照组 ,以 1～ 3号银质泪道扩张针扩通泪道 ,留针 15min ,隔日 1次 ,共扩张 2～ 3次 ,扩张后用 0 .2 5 %氯氟液冲洗。结果 :术后随访 3个月 ,观察组治愈率为 97.0 5 %,对照组治愈率为 9.4 1%,差异有高度显著性 (P<0 .0 1)。 结论 :用改良的泪道探针探通泪道后注入素高捷疗眼膏 ,促使泪道修复 ,是治疗泪道阻塞或狭窄的有效方法。     

Acute pseudotumor of the orbit

A case is presented of a 22-year-old man with a history of bilateral eye injection, lacrimation, and rhinorrhea. The right orbit was inflamed and its globe proptotic, with medial and lateral gaze deficits. Tomography revealed swelling about the right lacrimal gland. He was admitted and treated with high-dose steroids, which caused regression of his symptoms. This presentation and response to steroids is pathognomonic for acute pseudotumor of the orbit, a condition rarely described in the emergency medicine literature. If left untreated, treudotumor of the orbit may progress to blindness and ophthalmoplegia.     

激光泪道成形术治疗泪道阻塞的临床观察

目的 观察激光泪道成形术治疗泪道阻塞的效果及复发病例再次激光联合插管治疗的效果。方法 采用Nd：YAG激光泪道成形术治疗泪道阻塞102例。132眼。对复发病例。再次行激光联合插管治疗。结果 113眼一次治愈，有效9眼。术后10眼复发，再次行激光联合插管治疗，7眼治愈，3眼未愈。本组总治愈率90．9％，有效率97．7％。结论 Nd：YAG激光泪道成形术治疗泪道阻塞操作简单，安全有效，复发病例联合插管治疗可以提高治愈率。     

泪囊黏液囊肿的鼻泪管支架植入治疗观察

目的 评价鼻湘管支架植入术在治疗泪囊黏肿中的应用价值。方法 对21例（21眼）泪囊黏滚囊肿患者行鼻泪管支架植入术，逆行扩张鼻泪道后植入特制的鼻泪管支架，术前术后行数字减影泪道造影检查，分析其疗效。结果 21眼均成功植入鼻泪管支架，手术成功率为100%，术后随访2—43个月，有效率为100%。无严重并发症的发生。结论 鼻泪管支架植入术治疗泪囊黏液囊肿操作简便，具有良好的临床效果，值得推广。     

泪点栓塞治疗眼干燥症

目的　探讨泪点栓塞治疗眼干燥症的手术方法 ,评价临床治疗效果。方法　临床确诊并经其他方法治疗无效眼干燥症患者 ,先采用临时性可溶性泪点栓治疗 ,对其中有效者行永久性泪点栓 ,栓塞泪点及泪小管。结果　栓塞后所有病例症状均有所改善 ,其中完全消失 2 5例 ,减轻 7例。角膜荧光素着色明显减少 ,泪液量明显增加 ,泪液分泌试验由治疗前的平均(2 67± 1 3 2 )mm到治疗后的 (10 13± 2 16)mm。泪膜破裂时间明显延长 ,术前平均 (3 42± 0 93 )秒 ,术后平均 (8 3 4± 3 5 8)秒。均无明显并发症。结论　采用泪点栓塞治疗眼干燥症可以有效地减少泪液排出 ,延长泪膜破裂时间 ,重建泪液平衡 ,动态地改变眼表面泪液动力学。具有操作简单、疗效确切、并发症少及有可逆性等优点     

高频电灼加留置硅胶管治疗泪小管阻塞

目的 探讨高频电灼联合硅胶管植入术治疗泪小(总)管阻寨的适应证,手术方法和临床疗效.方法 对2年来行高频电灼联合硅胶管植入术治疗的泪道阻塞62例(68只眼),进行回顾性分析.结果 62例(68只眼)泪小(总)管阻塞有效率达88.2%.结论 高频电灼联合硅胶管植入术治疗泪小(总)管阻塞具有成功率高,操作简便,并发症少,经济,损伤小和美观等优点,具有临床适用价值.     

Distinct roles for GFRalpha1 and GFRalpha2 signalling in different cranial parasympathetic ganglia in vivo

Neurturin (NRTN), signalling via the GDNF family receptor alpha2 (GFRalpha2) and Ret tyrosine kinase, has recently been identified as an essential target-derived factor for many parasympathetic neurons. NRTN is expressed in salivary and lacrimal glands, while GFRalpha2 and Ret are expressed in the corresponding submandibular, otic and sphenopalatine ganglia. Here, we have characterized in more detail the role of GDNF and NRTN signalling in the development of cranial parasympathetic neurons and their target innervation. Gfra1 mRNA was expressed at E12 but not in newborn cranial parasympathetic ganglia, while Gfra2 mRNA and protein were strongly expressed in newborn and adult cranial parasympathetic neurons and their projections, respectively. In newborn GFRalpha1- or Ret-deficient mice, where many submandibular ganglion neurons were still present, the otic and sphenopalatine ganglia were completely missing. In contrast, in newborn GFRalpha2-deficient mice, most neurons in all these ganglia were present. In these mice, the loss and atrophy of the submandibular and otic neurons were amplified postnatally, accompanied by complete loss of innervation in some target regions and preservation in others. Surprisingly, GFRalpha2-deficient sphenopalatine neurons, whose targets were completely uninnervated, were not reduced in number and only slightly atrophied. Thus, GDNF signalling via GFRalpha1/Ret is essential in the early gangliogenesis of some, but not all, cranial parasympathetic neurons, whereas NRTN signalling through GFRalpha2/Ret is essential for the development and maintenance of parasympathetic target innervation. These results indicate that GDNF and NRTN have distinct functions in developing parasympathetic neurons, and suggest heterogeneity among and within different parasympathetic ganglia.