SMILE术中第二术眼不同保护措施泪膜稳定性的对比研究

目的通过应用Keratograph 5M眼表综合分析仪对飞秒激光小切口角膜基质透镜取出手术(SMILE)术中第二术眼不同保护措施的首次泪膜破裂时间(NIKBUTf)和平均泪膜破裂时间(NIKBUTav)变化情况进行对比研究,观察不同保护措施对泪膜稳定性的影响。方法选取2019年6月至2019年11月在重庆眼视光眼科医院行SMILE手术的患者作为研究对象。患者左眼为观察眼,SMILE术中在右眼行手术时,左眼按照不同处理方法分为3组,分别给予小牛血去蛋白眼用凝胶点眼、使用眼罩,以及空白对照。并分别在右眼手术前后,使用Keratograph 5M眼表综合分析仪,完成左眼NIKBUTf和NIKBUTav检测,进行对比研究。采用SPSS 25.0进行统计学分析。结果共35例患者(35左眼)纳入研究,其中小牛血去蛋白眼用凝胶组12例,眼罩组11例,空白对照组12例。重复测量方差分析NIKBUTf和NIKBUTav均存在时间效应和分组效应,且时间与分组存在交互作用(P<0.05)。凝胶组左眼NIKBUTf在右眼手术前和右眼手术后即刻无统计学差异(P>0.05),凝胶组左眼NIKBUTav在右眼SMILE手术后即刻较右眼手术前延长(P<0.05)。眼罩组和对照组(空白)左眼NIKBUTf和NIKBUTav在右眼手术后即刻均缩短(P<0.05)。对照组NIKBUTf和NIKBUTav缩短最明显(P<0.05)。结论不同保护措施和时间变化均对NIKBUTf和NIKBUTav产生了影响,小牛血去蛋白提取物眼用凝胶应用于SMILE术中第二术眼的保护措施起到了保护泪膜稳定性的作用。眼罩对第二术眼的泪膜保护作用并不明显,常规手术操作对第二术眼无保护措施的情况下泪膜稳定性最差。     

两例 SMILE 术中特殊情况更改 SBK 手术的疗效观察

目的：通过对同一患者双眼不同手术方式的自身对比，了解飞秒扫描后改SBK手术的疗效差异，为不同患者屈光手术方式的选择提供临床指导依据。方法回顾分析2例右眼行飞秒激光小切口透镜取出术（ SMILE），左眼SMILE术中负压环脱失和激光扫描不良透镜分离困难而改行机械刀制瓣准分子激光手术（ SBK）的患者，比较术后视力、等效球镜（ SE）、对比敏感度（ CSF）、波前像差（ HAOS）以及泪膜破裂时间（ BUT）、泪液分泌功能试验（ Schimer I）和SPEED、OSDI干眼症状问卷调查分析差异。结果（1）术后个月，均能达到最佳矫正视力（BSCVA），等效球镜均在±0．75 D以内，双眼比较无显著性差异。（2）CSF的比较，左右眼无显著性差异，略低于正常水平。（3）术后3个月，BUT和Schimer检查中，双眼无显著性差异。（4）HAOS比较中，总像差RMS和高阶像差这两项， SMILE眼低于SBK眼；球差（S）的比较，SMILE眼高于SBK眼。（5）SPEED和OSDI问卷评分双眼无显著差异。结论 SMILE失败眼改SBK后视觉质量与SMILE眼无显著差异，其视觉质量、疗效不受影响。     

地塞米松不同给药途径对下颌阻生第三磨牙拔除术后的疗效观察

目的:评价地塞米松不同给药途径(冠周局部注射和口服)在预防下颌阻生第三磨牙拔除术后肿胀、疼痛及张口受限中的疗效。方法:对480例患者的下颌阻生第三磨牙根据阻生类型进行分组(高位、中位、低位),每组中再分为实验组(拔牙术后局部注射地塞米松)和对照组(拔牙术后口服地塞米松),对患者术后第1、3、7天进行随访分析,对患者肿胀指数、疼痛程度和张口受限程度进行统计分析。结果:在拔牙术后第1天和第7天,高位组、中位组和低位组中的实验组与对照组在肿胀指数、疼痛程度和张口受限程度方面比较差异无统计学意义(P>0.05);术后第3天,高位组和中位组中的实验组与对照组在肿胀指数、疼痛程度和张口受限程度差异无统计学意义(P>0.05),低位组中的实验组与对照组相比,在肿胀反应中具有更好的预防效果(P<0.05),在疼痛程度和张口受限程度中具有一定的缓解效果(P>0.05)。结论:下颌阻生第三磨牙拔除术后,冠周局部给予地塞米松能够防治和减轻术后肿胀、疼痛以及张口受限的发生。     

环境水样中痕量铜的浊点萃取-火焰原子吸收光谱测定法

目的建立环境水样中痕量铜的浊点萃取(cloud point extraction,CPE)-火焰原子吸收光谱(flame atomic absorption spectrometry,FAAS)测定法。方法样品在p H 9.5的条件下,加入0.4 ml的1 mmol/L 2-(5-溴-2-吡啶偶氮)-5-二乙氨基酚(5-Br-PADAP)溶液,0.1%氯化钙溶液0.1 ml,5%(W/V)Triton X-114溶液0.8 ml,40℃加热15 min后离心,采用火焰原子吸收光谱法进行检测。结果在2~240μg/L的线性范围内,所得回归方程为A=0.002 7c+0.024 6,r=0.995 8。以3倍信噪比计算,方法的检出限为0.62μg/L,富集倍数为36.58倍,平均加标回收率为96.28%~98.08%,RSD为1.67%~3.13%。结论该方法简单、灵敏,具有良好的重现性,适用于环境水样中痕量铜的测定。     

小切口白内障囊外摘除术中应用大直径前囊口处理大硬核白内障的手法

目的：临床分析大硬核白内障患者实施小切口白内障囊外摘除术中对大直径前囊口处理的运用。方法随机选取该院在2013年1月-2014年1月实施治疗的200例(200眼)白内障患者，所有患者均实施小切口白内障囊外摘除术治疗，并应用大直径前囊口处理手法，观察患者的临床治疗视力改善效果。结果和治疗前相比，200例患者在治疗后1d、1周、1个月、3个月的最佳矫正视力均显著偏高，差异有统计学意义(P<0.05)；术后1周、3个月和治疗前相比，患者的角膜屈光度有显著提升，差异有统计学意义(P<0.05)；术后平均散光度数逐渐从顺规性散光转向逆归性散光。结论大硬核白内障患者实施小切口白内障囊外摘除术中对大直径前囊口处理应用，能够对患者的视力实施良好的纠正，效果显著，值得推广应用。     

Comparison of Protective Effects of Safflor Injection and Extract of Ginkgo Biloba on Lung Ischemia/Reperfusion Injury in Rabbits

Objective:To observe the protective effects of safflor Injection(SI) and extract of Ginkgo biloba(EGB) on lung ischemia-reperfusion injury(LIRI) and investigate its mechanism.Methods:In vivo rabbit model of LIRI was reconstructed.Forty rabbits were randomly and equally divided into four groups:sham-operation group(sham group),ischemia-reperfusion group(model group),ischemia-reperfusion plus SI group(safflor group) and ischemia-reperfusion plus EGB injection group(EGB group).Malondialdehyde(MDA) content,superoxide dismutase(SOD) and xanthine oxidase(XO) activity in serum were measured.The wet/dry weight ratio(W/D) of the lung tissue and activity of myeloperoxidase(MPO) were also tested.Ultrastructure change of the lung tissue was observed by the electron microscope.The expression of intercellular adhesion molecule-1(ICAM-1) was measured by immunohistochemistry(IHC).Results:In the model group,MDA and XO increased and SOD decreased in serum compared with the sham group(P<0.01).The values of W/D,MPO and ICAM-1 of the model group were higher than those of the sham group(P<0.01),but those of the safflor group and EGB group were significantly lower than those of the model group(P<0.01).The IHC demonstrated that ICAM-1 expression in lung tissue of the model group was significantly higher than those of the safflor group(P<0.01).Compared with safflor group,in the EGB group MDA,XO,MPO decreased,SOD and ICAM-1expression increased(P<0.05),but the change of W/D was not statistically significant(P>0.05).Conclusions:SI and EGB may attenuate LIRI through antioxidation,inhibition of neutrophil aggregation and down-regulation of ICAM-1expression.But EGB had more effect on the antioxidation,while SI did better on regulating ICAM-1 expression.     

Joint 3-D vessel segmentation and centerline extraction using oblique Hough forests with steerable filters

ContributionsWe propose a novel framework for joint 3-D vessel segmentation and centerline extraction. The approach is based on multivariate Hough voting and oblique random forests (RFs) that we learn from noisy annotations. It relies on steerable filters for the efficient computation of local image features at different scales and orientations.ExperimentsWe validate both the segmentation performance and the centerline accuracy of our approach both on synthetic vascular data and four 3-D imaging datasets of the rat visual cortex at 700 nm resolution. First, we evaluate the most important structural components of our approach: (1) Orthogonal subspace filtering in comparison to steerable filters that show, qualitatively, similarities to the eigenspace filters learned from local image patches. (2) Standard RF against oblique RF. Second, we compare the overall approach to different state-of-the-art methods for (1) vessel segmentation based on optimally oriented flux (OOF) and the eigenstructure of the Hessian, and (2) centerline extraction based on homotopic skeletonization and geodesic path tracing.ResultsOur experiments reveal the benefit of steerable over eigenspace filters as well as the advantage of oblique split directions over univariate orthogonal splits. We further show that the learning-based approach outperforms different state-of-the-art methods and proves highly accurate and robust with regard to both vessel segmentation and centerline extraction in spite of the high level of label noise in the training data.