简介：目的探讨鼻内镜辅助下颈前小切121甲状腺手术的疗效、临床经验和手术注意事项，并与传统手术进行比较。方法我科术前确诊的单发甲状腺腺瘤患者26例，肿瘤最大直径〈4．0cm，均行鼻内镜辅助颈前小切口腺叶切除术，观察疗效，并与同期具有可比性的30例经传统手术治疗的患者资料进行比较。结果2组患者的肿块均完整切除，切口均Ⅰ期愈合。术后无声音嘶哑、呛咳、继发血肿等并发症。无手术死亡病例。鼻内镜辅助下颈前小切口组的手术时间较对照组长（t=9．139，P〈0．05），术中出血量较对照组大（t=12．648，P〈0．05）。小切口组患者的瘢痕长度、患者满意度、住院天数明显优于对照组，差异有统计学意义（P〈0．05）。结论鼻内镜辅助下颈前小切口甲状腺手术安全、可靠，能有效避免神经、血管损伤，具有并发症少、微创、美容的优点，值得临床推广。

简介：AIM:Todescribethedesignandpreliminaryresultsofthehospitalbasedepidemiologicalstudyfordiabeticretinopathy(HBESDR),anongoingepidemiologicalstudytoestimatetheprevalenceofdiabeticretinopathy(DR)andtoelucidatetheclinical,anthropometric,biochemicalandanyotherriskfactorsassociatedwithdiabeticretinopathy.METHODS:Totally2000diabeteswillberecruitedfromtheDiabeteseyeclinicintheFirstAffiliatedHospitalofChinaMedicalUniversity.AllsubjectsunderwentbloodsugarestimationandOralGlucoseToleranceTesttodiagnosediabetes.Alldiabeteswouldundergocompletequestionnaire,acomprehensiveeyeexamination.Bloodandurinewouldbecollectedforbiochemicalinvestigations.AllfundusphotographsforanyDRwillbegraded.Participantswhoneedtreatmentwillbesenttotheophthalmicclinicandfollow-upintervalprogramforallsubjectswillbesuggested.Acomputerizeddatabaseiscreatedfortherecords.RESULTS:Todate,1174diabeteshavebeenrecruited,therewere350(29.81%)DRinalldiabetes,mostofthemwerewithmildnon-proliferativediabeticretinopathy(NPDR)(139,39.71%);71(20.29%)moderateNPDR,66(18.86%)severeNPDR,74(21.14%)proliferativediabeticretinopathy(PDR).Females,longerdurationofdiabetes,familyhistoryofdiabetesandhypertensionhadastatisticallysignificantincreaseinriskofanyDR.CONCLUSION:ThestudyisexpectedtoprovideanestimateoftheoverallprevalenceofDRandtheprevalencewithdifferentdurationofdiabetesandalsoabetterunderstandingoftheriskfactorsassociatedwithDR.

简介：<正>上海医科大学眼耳鼻喉科医院眼科主办的继续医学教育项目"青光眼诊治进展"学习班于1999.12.19～12.25在上海举办,来自贵州、广西、四川、浙江、江苏、福建、山东、辽宁、宁夏、湖北、上海等11个省、市自治区、直辖市的62名眼科医生正式注册参加了学习。学习班内容丰富,不但有青光眼常规药物、手术治疗的原则、技巧,术中、术后并发症的防治,用于青光眼诊断及随访的各种新型检测技术及仪器介绍,青光眼药物治

简介：结膜松弛症是老年人常见眼病，但一直为国内眼科医师所忽视，易造成误诊、漏诊。上海中医药大学附属普陀医院经过十几年的探索，对结膜松弛症的诊疗技术进行了系统研究，已经形成规范的诊疗方案。特举办国家级Ⅰ类（6分）继续教育项目“结膜松弛症的发病机制及手术治疗”（项目编号：20110702052）学习班，并系统演示结膜松弛症手术治疗录像、现场观摩手术。

简介：目的对改良翼状胬肉手术方法进行安全性评估的研究。方法188例翼状胬肉患者随机分为实验组和对照组。实验组接受改良方法进行翼状胬肉手术。对照组按照《眼科手术图谱》传统翼状胬肉切除术方法进行手术。记录所有患者手术时间、术后角膜上皮修复时间。术后每周随访,记录术后1周、2周、3周、4周时结膜充血情况及结膜充血完全消退时间。随访3个月,记录发生角巩膜溃疡、结膜肉芽以及翼状胬肉复发的病例数。结果实验组有96人完成随访,对照组有92人完成随访。实验组患者角膜上皮修复时间为2.42±0.68天,对照组为4.27±1.05天,P〈0.05,差别有统计学意义;实验组结膜充血评分术后1周、2周、3周、4周时分别为3.31±0.47、2.76±0.74、1.89±0.860.94±0.70,对照组分别为3.84±0.37、3.58±0.67、2.93±0.71、1.85±0.78,两两比较P〈0.05,差别有统计学意义。结膜充血消退时间实验组为5.15±0.92周,对照组为7.20±1.08P〈0.05,差别有统计学意义。实验组未发生结膜肉芽,对照组为14例,P〈0.05,差别有统计学意义。实验组发生角巩膜溃疡4例、复发4例,对照组为7例、5例,P〉0.05,差别无统计学意义。结论改良的翼状胬肉手术方法在术后角膜上皮修复时间、术后结膜充血程度、结膜充血消退时间、结膜肉芽发生率上忧于传统手术方法,差别有统计学意义。在角膜溃疡发生率、翼状胬肉复发率上改良手术方法与传统手术差别无统计学意义。

简介：由海军总医院全军耳鼻咽喉头颈外科中心主办的激光技术在耳鼻咽喉微创外科中的应用学习班将于2009年9月1-4日在河南省焦作市举行。该学习班为国家级继续医学教育项目（编号：2009-07-01-083），授予Ⅰ类继续医学教育学分8分。联系方式：北京市海淀区阜成路6号海军总医院全军耳鼻咽喉头颈外科中心；

简介：·AIM:Toinvestigatethetherapeuticeffectsofnanophtha-locyaninephotosensitizersonanexperimentalratchoroidalneovescularization(CNV)model,aswellastoevaluatethecytotoxicityofwhichonhumanretinalpigmentepithelia(HRPE)andhumanretinalendothelialcells(HRECs).·METHODS:Twotypesofphotosensitizers,G1-ZnPc(COOH)8andG1-ZnPc(COOH)8/mrespectively,wereadministratedforphotodynamictherapy(PDT)afterasuccessfulestablishmentofCNVmodelonBrown-Norway(BN)ratsviafundusphotocoagulation.Thetherapeuticeffectsofthetwodrugswereassessedthroughopticalcoherencetomography(OCT),fluoresceinfundusangiography(FFA)andtransmissionelectronmicroscopy(TEM).Forcytotoxicitytests,cellcountingkit-8(CCK-8)assaysandchangesofmitochondrialtransmembranepotential(△Ψm)wereconductedonHRPEandHRECsafterinitialuptakeofthetwodrugs.·RESULTS:Bothphotosensitizersdemonstratedanimprove-mentofvascularleakageandclosureofCNV1weekafterPDTasconfirmedbyfundusimage,OCT,FFAandTEM.TwoweeksafterPDT,G1-ZnPc(COOH)8/mshowedabetterCNVclosureeffectversusG1-ZnPc(COOH)8(P<0.05).Asignificantdifference(P<0.01)wasfoundinuptakeofthetwodrugsinHRPEandHRECs,withnodifferencebetweenthedrugs(P>0.05).BothphotosensitizersshowedcytotoxicityonHRPE,butG1-ZnPc(COOH)8/minducedalowercellviability.·CONCLUSION:G1-ZnPc(COOH)8/mmediatedPDTisbetterthanG1-ZnPc(COOH)8inCNVclosureandalsohavetheadvantageoffastmetabolismleadingtolesssideeffect.·

简介：目的探讨缩短小切口非超乳白内障摘除人工晶体晶植人术学习曲线的途径.方法对2006年萧县彭年光明行动中完成29例小切口非超乳白内障摘除人工晶体晶植入术的病例进行回顾性分析.结果通过最先完成17例小切口非超乳白内障摘除人工晶体晶植入术部分手术操作步骤,循序渐进最后独立完成12例小切口非超乳白内障摘除人工晶体晶植入术的全部操作步骤.结论熟练掌握白内障囊外摘除+人工晶体植入技术,是缩短小切口非超乳白内障摘除+IOL植入学习曲线的关键因素.

简介：目的观察初学者学习0．7毫米微创白内障手术改良法的临床效果。方法随机选取门诊和住院白内障患者50人,由初学者在老师指导下应用0．7毫米微创白内障手术改良法施行手术。研究内容包括手术时间,术中灌注液应用量,术中并发症等。结果手术时间随着学习的进程总体呈下降趋势,从开始10例平均时间61分22秒下降到第5个10例的18分54秒。特别是30例后下降明显。共7例9次并发症发生。第4例出现后囊破裂,未行玻璃体切割的情况下成功植入人工晶状体于睫状沟内。前10例中共有2例,第2和4个10例中各1例术中角膜上皮水肿。另外还有1例发生后弹力层撕裂,两例切口撕裂,1例结膜水肿。结论经过短期的0．7毫米微创白内障手术改良法训练,初学者可从传统同轴超声乳化安全转换至0．7毫米微创白内障手术。

简介：AIM:Todeterminethehistopathologicalchangesofrifampicinappliedintravitreallyonretinalganglioncellsbymeansofstereologicalandhistopathologicalmethods.METHODS:Forthisstudytwenty-fourNewZealandadultrabbitsweredividedintofourgroups(n=6foreachgroup).50μg/0.1mL(group1),100μg/0.1mL(group2),150μg/0.1mL(group3)and200μg/0.1mL(group4),rifampicinwereinjectedintothevitreousoftherighteyesofanimals,theirlefteyeswereusedascontrol(group5).Afterthe28thdayofapplication,animalswereanesthetisedwithxylazine(8mg/kg,IM)andthentheireyeswereenucleatedimmediately.Patternsweretakenawayandeyeswerepreparedforbothstereologicalandelectromicroscopicobservation.RESULTS:Dependingonthehighdoseofrifampicin,somehistopathologicalchangessuchascytoplasmicdilatationanddamagedmembranewereobservedontheelectromicroscopiclevel.Usingquantitativeexamination,whichwasdoneatthelightmicroscopiclevel,itwasshownthatthenumberofneuronsdecreasedlinearlyasrifampicindoseincreasedwhencomparedwiththecontrolgroup.CONCLUSION:Basedonthesefindings,low-doserifampicin(50μg/0.1mL)maybeusefulfortreatmentoftheoculardiseases.

简介：·AIM:Toinvestigatetheantifibroticeffectoffreeze-driedbilayeredfibrin-bindingamnioticmembraneontrabeculectomyinarabbitmodel.·METHODS:Twenty-fourJapanesewhiterabbitswererandomizedintothreegroups:theexperimentalgroup(oculartrabeculectomyincombinationwithfreeze-driedbilayeredfibrin-bindingamnioticmembranetransplantation),thecontrolgroup(oculartrabeculectomyincombinationwithnaturalbilayeredfibrin-bindingamnioticmembrane)andtheblankgroup(singletrabeculectomy).Clinicalobservation,hematoxylin-eosinstaining,Massionstaining,real-timePCRandimmunohistochemistryforα-SMAwereperformedondays7,14,21and30followingsurgery.·RESULTS:Statisticaldifferenceswerenotedinsurvivalanalysisandintraocularpressure(IOP)amonggroupsondays7,14,21and30followingsurgery.Histology,immunoh-istochemistryandreal-timePCRfurtherdemonstratedthattrabeculectomyincombinationwithfreeze-driedbilayeredfibrin-bindingamnioticmembraneresultedingoodwoundhealingandnoscarformation.·CONCLUSION:Self-madefreeze-driedbilayeredfibrin-bindingamnioticmembranemayinhibittheformationofscarringinglaucomaaftertrabeculectomy.·

简介：AIM:Toadaptthelowvision-relatedqualityoflife(LVQOL)instrumentintoTurkishlanguageandtoassessitsvalidityandreliability.METHODS:Thestudywasconductedin387patientsattendingtheCentreofLowVisionRehabilitation,FacultyofMedicine,AnkaraUniversity.Forstatisticalanalyses,theSpearman’scorrelationcoefficient,Cronbach’salphacoefficientandConfirmatoryFactorAnalysis(CFA)wereused.RESULTS:AccordingtoresultsofCFA,theiteminthe'Adjustment'subscalebecauseofhavingthefactorloadingbelow0.40,wasexcludedfromthequestionnaire.ThereliabilityofthequestionnairewasassessedaccordingtoCronbach’salphacoefficients.Thereliabilityofthe'DistanceVision,Mobility,andLighting'subscalewas?琢=0.863;ofthe'Adjustment'subscalewas?琢=0.694;'ReadingandFineWork'was?琢=0.791,and'ActivitiesofDailyLiving'was?琢=0.770.Sotheseresultsindicatethatthequestionnaireisreliabletomeasurethevisionrelatedqualityoflifeoflow-visionpatients.Thecorrelationsbetweenthesubscaleswerealsoanalyzed,andthecorrelationbetween'Adjustment'and'ReadingandFineWork'wasfoundtobethelowest(rs=0.336,P<0.001),whereasthestrongestcorrelationwasfoundbetweenthe'ReadingandFineWork',and'ActivitiesofDailyLiving'.Additionally,the'Adjustment'dimensionshowedthestrongestcorrelationwithonly'DistanceVision,Mobility,andLighting'dimension.CONCLUSION:Afterremovingthelastitemintheseconddimension,theTurkishadaptationofalldimensionsoftheLVQOLhasbeenshowntobereliable,validandsuitableforuseinpatientswithlowvisioninTurkey.

简介：AIM:ToevaluatetheeffectofCollagencross-linkingonthepreventionofmeltinginrabbitcorneasafteralkaliburn.·METHODS:TwentyNewZealandwhiterabbitswererandomlydividedintomodelcontrolgroupandcollagencross-linkingtreatmentgroup.Thesecondgroupofrabbitsreceivedcollagencrosslinkedtreatment.Bothgroupswereappliedwithantibioticeyedropstopreventinfection.Thecorneaswereevaluatedformelting,opacity,pathologicalandimmunohistochemistry,recordthechangeswhen28daysaftertheanimalswerekilled.·RESULTS:Inthecontrolgroup,6outof8rabbitsshowedcornealmeltingafterinjury(14±4)days,whiletwocornealperforated.Incollagencross-linkingtreatmentgroup,onerabbitshowedcornealmeltingafterinjury23days,withoutcornealperforation;cornealdissolutionratebetweenthetwogroupswassignificantlydifferent(P<0.05).Pathologicalexaminationsuggestedthatinthetreatmentgroup,mildcornealedema,milddamagetocollagenfibers,inflammatorycellinfiltrationwassignificantlylessthanthecontrolgroup.Immunohistochemistryshowedthatcornealcollagenfibersarrangedinneatrowsinthecontrolgroup.·CONCLUSION:Collagencross-linkingtreatmentnotonlycanpreventanddelaythecornealmeltingafteralkaliburn,butalsocanreducethedestructionofcornealcollagenfibersandinfiltrationofinflammatorycellsinthecornealtissue.