简介:AIM:Tocharacterizetheclinicalfeatures,diagnosis,treatmentandprognosisofuveitisassociatedwithankylosingspondylitis(AS)inChinesepatients.·METHODS:TwohundredandthreepatientswithuveitisassociatedwithASfollowed-upintheThirdMilitaryMedicalUniversityDapingHospitalbetween2005and2010wereretrospectivelyevaluatedinthisstudy.Completeophthalmologicalexaminationswereevaluatedatbaselineandduringthefollow-upperiod.Thegender,age,follow-uptime,meanfrequencyofuveitisonset,andaccompanyingeyeexaminationfindings,history,demographicalparameterswerereviewed.Allthepatientspresentedcompleteclinicalandradiologic(sacroiliac,lumbar,dorsalandcervicalspine,knee,ankle,shoulder,hip,elbow)evaluation.HLA-B27typingwasalsosearched.·RESULTS:Therewere203patientsdiagnosedwithASassociateduveitis.AllshowedsacroiliacX-raychangesindicativeofAS.Therewere184maleand19femalepatients.Theaverageageofpatientswas35±12(range18-50).Meanfollow-upperiodwas2.4years(1-5years).Acuteanterioruveitiswasthemostcommontypeofuveitisinbothgenders.121eyespresentedunilateralinvolvement(55.2%),and92eyespresentedbilateralinvolvement(45.3%)withonsetalternately.22eyesoccurredhypopyon,16eyeswerefoundanteriorvitreouscells,7eyeswerenotedreactivemacularedemaorexudation,29eyespresentedposteriorsynechiaeofiris,and14eyespresentedcataract,9eyespresentedsecondaryglaucoma,2eyespresentedbendcornealdegenerationand1eyespresentedatrophyofeyeball.Atthefinalvisit,uveitiswaswellcontrolledinmostpatients.·CONCLUSION:ASassociatedwithuveitisinChinesepatientsmainlymanifestsasacuteanterioruveitis.AcombinationofcorticosteroidswithothermydriasisagentsiseffectiveformostASassociatedwithuveitispatients.Ingeneral,theprognosisisgoodinthesecases.
简介:目的探讨制霉菌素泡腾片与湿润烫伤膏水浴后混合物(简称制霉菌素油剂)的广谱抗真菌、改善耳道内环境、恢复耳道上皮分泌及自洁功能的效果。方法以60例行真菌涂片滴入氢氧化钾镜于下检查确诊为真菌性外耳道炎的患者为研究对象,2周为1个疗程,不得中途退出。常规清洁耳道,待耳道干燥后涂布制霉菌素油剂,治疗3~5次后评估患者耳道不适症状的改善、分泌物质与量的变化、上皮充血糜烂的恢复、真菌的检测分型与培养药敏变化。结果药剂分布均匀,耳内分泌物易排出,患者的舒适度与上皮功能恢复改善快。结论制霉菌素有广谱杀真菌效果,合用湿润烫伤膏的油剂可改善耳道内环境。制霉菌素油剂治疗真菌性外耳道炎符合耳道生理病理治疗需求,效果良好。
简介:目的:探讨糖尿病患者黄斑中心凹下脉络膜厚度(SFCT)与脉络膜血流动力学指数及糖化血红蛋白之间的关系。方法:选择在我院眼科及内分泌科住院治疗的2型糖尿病患者78例156眼作为研究对象。其中男39例,女39例,平均(59.8±6.2)岁。根据ETDRS糖尿病视网膜病变分级方法,将患者分为无视网膜病变组、轻中度NPDR组、重度NPDR组、PDR组。采用EDI-OCT与超声多普勒对四组患者进行脉络膜厚度测量与脉络膜血流动力学指数测量。并记录所有患者的血糖化血红蛋白含量。采用多元线性回归分析SFCT与血流动力学指数与糖化血红蛋白的相关性。结果:NDR患者组舒张末期血流速度(EDV)明显高于其它患者组,SFCT较其它各组偏薄,差异有统计学意义。四组患者收缩期峰值血流速度(PSV)无统计学差异;重度NPDR组血管阻力指数(RI)高于NDR组及轻中度NPDR组;PDR组RI进一步增高,差异有统计学意义。SFCT与糖化血红蛋白有显著正相关性(b=0.540,P〈0.001);SFCT与DR分级(P=0.341)、PSV(P=0.770)、EDV(P=0.131)及RI(P=0.084)无显著相关性。结论:糖尿病患者SFCT与血流动力学各指数无相关性。糖化血红蛋白是糖尿病患者SFCT的影响因素之一。
简介:目的:对比分析伴虹膜异色的青光眼睫状体炎综合征与Fuchs综合征患者的临床表现及特点,对两种疾病的鉴别要点作出分析及总结,利于临床医生对这两种疾病进行鉴别诊断。方法:对本院自2000年至今收治住院的3例伴虹膜异色的青光眼睫状体炎综合征(Posner-Schlossman’ssyndrome,PSS)患者进行详细的临床检查及研究,根据其临床资料总结出该病的临床特点,并对伴虹膜异色的PSS与Fuchs综合征的鉴别要点作出分析及总结。结果:共收集了3例伴虹膜异色的PSS患者,均为单眼反复发病,病程均在10a以上,发作时眼压明显升高,可达30.00~60.00mmHg,持续时间一般为3~7d,可自行缓解或用药后缓解,间歇期眼压正常,该3例患者除了具有典型的PSS表现外,虹膜均轻度异色。总结了该病在发作期及间歇期的临床表现,从发病情况、眼压波动情况、KP形态、晶状体情况、眼底及视功能情况详细论述了伴虹膜异色的青光眼睫状体炎综合征与Fuchs综合征的区别,并针对两种疾病的治疗提出了不同建议。结论:结合我们所提出的鉴别要点,对患者进行详细的临床检查,可以对这两种疾病进行鉴别诊断。
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.
简介:目的:通过测定糖尿病性白内障患者血清中糖代谢指标、胰岛素抵抗与房水和血清中炎症因子的水平,探讨其相关性。方法:随机选取我院2017-02/2018-01糖尿病性白内障患者69例(观察组)和白内障患者65例(对照组),检测两组患者血清中糖化血红蛋白(HbA1c)、空腹血糖(FPG)、空腹胰岛素(FINS)的水平,计算胰岛素抵抗指数(HOMA-IR);同时检测房水和血清中的胰岛素样生长因子-1(IGF-1)、白细胞介素-6(IL-6)含量,对HbA1c、HOMA-IR与房水和血清中IGF-1、IL-6含量进行相关性分析。结果:对照组血清中的FPG、HbA1c、HOMA-IR,以及房水和血清中IGF-1、IL-6含量显著低于观察组,差异有统计学意义(均P<0.05)。HbA1c与房水及血清中的IGF-1和IL-6均呈正相关(P<0.05)。HOMA-IR与房水及血清中的IGF-1和IL-6均呈正相关(P<0.05)。结论:糖尿病性白内障患者HbA1c、HOMA-IR与房水及血清中的IGF-1、IL-6含量具有相关性,通过对上述指标的测定可以辅助判断病情。
简介:AIM:Toinvestigatetheantifibroticeffectofthefreeze-driedbilayeredfibrin-bindingamnioticmembraneasadrugdeliverysystemonglaucomasurgeryinrabbitmodel.Theaimofthisstudywastoprepareanovellocaldeliverysystemforthesustainedandcontrollablereleaseof5-Fu.METHODS:Twenty-fourJapanesewhiterabbitswererandomizedintothreegroups:theexperimentalgroup(oculartrabeculectomyincombinationwith5-Fuloadedfreeze-driedbilayeredfibrin-bindingamnioticmembranetransplantation),thecontrolgroup(oculartrabeculectomyincombinationwith5-Fu)andtheblankgroup(singletrabeculectomy).HEstaining,massionstainingandimmunohistochemistryforα-SMAwereperformedondays7,14,21and30followingsurgery.Theconcentrationof5-Fuinrabbitaqueoushumorwasexaminedbyhighperformanceliquidchromatography(HPLC)3daysafterthesurgery.RESULTS:Statisticaldifferenceswerenotedinintraocularpressureamonggroupsonday7,14,21and30followingsurgery.Histologyfurtherdemonstratedthattrabeculectomyincombinationwithfreeze-driedbilayeredfibrin-bindingamnioticmembraneyieldedwellwoundhealingandnoscarformationandwasbeneficialforlongtermeffect.CONCLUSION:HPLCshowedagoodslow-releaseeffectwithfreeze-driedbilayeredfibrin-bindingamnioticmembrane.
简介:目的比较周边虹膜切除术与超声乳化联合人工晶状体植入术治疗早期原发性闭角型青光眼的临床效果。方法选择仅局部用药即可控制眼压在正常范围内的早期闭角型青光眼合并白内障患者48例(54眼),应用周边虹膜切除术对28例(32眼)早期闭角型青光眼进行手术治疗,其结果与同类病人(20例22眼)的超声乳化联合人工晶状体植入术治疗结果进行比较。术前,术后一个月内每周一次,半年内每月一次,半年后三个月一次做眼压、裂隙灯检查直至1年。比较两者在术后眼压控制、视力恢复及前房情况,并作统计学分析。结果应用周边虹膜切除术治疗组术后平均眼内压为15.2±3.1mmHg,而同类病人经超声乳化联合人工晶状体植入术治疗后平均眼内压为14.9±2.6mmHg。分别经周边虹膜切除术和超声乳化联合人工晶状体植入术治疗,两类病人眼内压在术后早期无明显差异(P〉0.05)。经超声乳化联合人工晶状体植入术治疗,18眼(81.8%)最佳矫正视力提高,0.4者占63.6%,经周边虹膜切除术治疗术后最佳矫正视力无明显提高,其中8眼视力不增反降,最佳矫正视力0.4者占18.8%,两者差异有显著性(P〈0.05)。经周边虹膜切除术治疗术后中央前房深度无明显变化,而经超声乳化联合人工晶状体植入术治疗术后中央前房深度显著加深,两者差异性明显(P〈0.05)。结论原发性闭角型青光眼早期患者施行超声乳化联合人工晶状体植入术,术后房角显著加宽,中央前房深度显著加深,矫正视力也不同程度提高,且并发症少。
简介:目的:系统评价拉坦前列素(Latanoprost)滴眼液与噻吗心安(Timolol)滴眼液降眼压的有效性和安全性。方法:计算机检索PubMed,Medline,CNKI及中国生物医学文献数据库收录的,并辅以手工检索、因特网搜索的有关拉坦前列素与噻吗心安治疗原发性开角型青光眼和高眼压症的随机对照试验(RCT)。按照纳入和排除标准限定研究对象,通过Jadad评分量表进行文献质量评估后,针对眼压下降比例、药物不良反应2项内容,使用Cochrane协作网提供的RevMan5.0软件进行Meta分析。结果:共纳入9项RCT,合计555例患者。Meta分析结果显示:(1)拉坦前列素滴眼液与噻吗心安滴眼液降眼压效果,在2,6,12wk时差异均有统计学意义(P<0.01),加权平均差(WMD)分别为:在2wk[WMD=-0.76,95%CI(-1.32,-0.20)],在6wk[WMD=-1.15,95%CI(-1.68,0.63)]和12wk[WMD=-1.01,95%CI(-1.42,-0.61)]。(2)随访结束时,结膜充血、异物感为拉坦前列素的两种较为常见的不良反应,但其发生率拉坦前列素组与噻吗心安组比较,结膜充血的发生率[OR=2.25,95%CI(0.99,5.08)],异物感的发生率[OR=2.48,95%CI(1.02,6.03)],显示二者差异均无统计学意义。结论:治疗原发性开角型青光眼和高眼压症,拉坦前列素降眼压效果在用药12wk内较噻吗心安好;两者在12wk内引起结膜充血、异物感、虹膜色素加深、视野损害等的不良反应方面,差异不明显。由于纳入研究的样本量偏小,且方法学质量中等,致使本系统评价结果论证强度不高,因此还需要开展更多的高质量的临床随机对照研究,以便更客观、准确、全面地评价其疗效和安全性。
简介:目的比较急性中心性浆液性脉络膜视网膜病变(CSC)的患侧与对侧眼视网膜频域相干光断层扫描(OCT)的图像特征。方法应用频域OCT对30例(60眼)单眼发病急性CSC患者患侧和对侧眼的黄斑部视网膜显微结构进行检测,比较患侧组与对侧组黄斑中心凹外核层厚度、光感受器层(IS/OS层)、视网膜色素上皮(RPE)形态差异。结果所有30例患者患侧眼均有不同程度黄斑部视网膜浆液性脱离,对侧眼中有4眼(13.3%)存在轻度视网膜浆液性脱离;患侧组黄斑中心凹外核层厚度均值为(95.32±24.87)μm,对侧组为(98.80±14.36)μm,两组差异无统计学意义(t=1.627,P=0.110)。患侧组中IS/OS层厚度均匀一致者12眼(40.0%),对侧组20眼(66.7%);患侧组IS/OS层厚度均匀一致伴内外节缺损、不均、凸起增厚者共18眼(60.O%),对侧组共10眼(33.3%),差异有统计学意义(X2=4.28,P=0.038)。患侧组中出现RPE异常者有24眼(80.0%),对侧组中有8眼(26.7%),差异有统计学意义(x。=17.143,P=0.000)。结论频域OCT能清晰显示急性CSC患者的细微病理结构改变,单眼发病CSC患者中一部分对侧眼存在IS/OS层和RPE异常,但是其发生率较患侧眼低。(中国眼耳鼻喉科杂志,2013,13:165—167)
简介:·AIM:Toexploretheeffectofimmunizationwithcopolymer-1(COP-1)andretinalstemcells(RSCs)transplantationoninterferon-gamma(IFN-γ)levelsinaratexperimentalglaucomamodel.·METHODS:Anexperimentalglaucomawasinducedbyargonlaserphotocoagulationoftheepiscleralveinsandlimbalplexusintherighteyeofrats.Immediatelyfollowingglaucomainduction,ratswereimmunizedwithCOP-1.RSCswereculturedandtransplantedintravitreallyintotheeyesofglaucomamodelanimals1weekpost-lasertreatment.Sixexperimentalgroupswereused:COP-1/RSC,PBS/RSC,COP-1/PBS,PBS/PBS,glaucomamodelgroup,andanormalcontrolgroup.TheconcentrationofIFN-γinaqueoushumor(AH)andserumwasmeasuredbyenzyme-linkedimmunosorbentassay(ELISA)ineachofthesixgroups.Retinalganglioncell(RGC)survivalwasassessedbyquantifyingapoptosisusingHoechststaining.·RESULTS:ConcentrationsofIFN-γinAHandserumofratsthathadundergoneglaucomainductionwerehigherthanthoseofnon-inducedcontrolrats.TheconcentrationsofIFN-γinAHandserumoftheCOP-1/RSCstreatedgroupweredeterminedtobe2371.9ng/Land710.9ng/L,respectively,whichweresignificantlylowerthanthoseintheothertreatedgroups(P<0.05).Infact,IFN-γlevelsinthedualtreatedgroupwerereducedtobackgroundlevels.TheCOP-1/RSCgrouphadlowernumberofapoptoticRGCsthantheotherthreeexperimentalgroups(P<0.05).·CONCLUSION:ThereducedlevelsofIFN-γinAHandserumoftheCOP-1/RSCgroupmayberelatedtosynergisticeffectsbetweenRSCstransplantationandCOP-1immunemodulation.ItislikelythatthelowerlevelsofIFN-γpreventedRGCsglaucomatousapoptosis.·
简介:AIM:ToinvestigatetheexpressionsoftypeIcollagen,α2integrinandβ1integrinintheposteriorscleraofguineapigswithdefocusmyopiaandwhetherbasicfibroblastgrowthfactor(bFGF)injectioninhibitstheformationanddevelopmentofmyopiabyupregulatingtheexpressionoftypeIcollagen,α2integrinandβ1integrin.METHODS:After14daysoftreatment,therefractivestateandaxiallengthweremeasuredandthelevelsoftypeIcollagen,α2integrinandβ1integrinwereassayedintheposteriorscleraeofgroupsofguineapigsthatworeamonocular-7Dpolymethylmethacrylate(PMMA)lensorhad-7DlenswearfollowedbytheperibulbarinjectionofPhosphateBufferSolution(PBS)orbFGF.Theuntreatedfelloweyeservedasacontrol.Guineapigswithnotreatmentservedasnormalgroup.·RESULTS:Theresultsshowedthat14daysofmonoculardefocusincreasedaxialeyelengthandrefraction,whilebFGFdeliveryinhibitedthemmarkedly.Further,itwasalsofoundthatthemonocular-7DlenscoulddecreasethelevelsoftypeIcollagen,α2integrinandβ1integrinexpressions,while,unlikePBS,bFGFincreasedthemsignificantlyincomparisontocontralateralcontroleyesandnormaleyes.CONCLUSION:bFGFcanpreventtheformationanddevelopmentofdefocusmyopiabyupregulatingtheexpressionsoftypeIcollagen,α2integrinandβ1integrin.Takentogether,ourresultsdemonstratethatbFGFpromotesscleraremodelingtopreventmyopiainguineapigs.
简介:AIM:ToidentifythegeneticdefectinaChinesefamilywithbilateralprogressivechildhoodposteriorcataract.METHODS:Atwo-generationfamilywasrecruitedinthisstudy.Familyhistoryandclinicaldatawererecorded.AllreportedcandidategenesassociatedwithcongenitalposteriorcataractwerescreenedbydirectDNAsequencing.·RESULTS:Allaffectedindividualspresentedposterioropacitiesinthelens.Directsequencingofthecandidategenesshowedaheterozygousc.2668C>TvariationinEPHA2gene,whichresultedinthereplacementofargininebycysteineatcodon890(p.R890C).Thismutationwasfoundintwoaffectedindividuals,butwasnotobservedin200normalcontrols.·CONCLUSION:Wereportanovelmutation(p.R890C)intheEPHA2receptortyrosinekinasegene.ThefindingexpandsthemutationspectrumofEPHA2inassociationwithposteriorcataract.