实验性近视眼巩膜成纤维细胞黏弹性研究

目的　研究豚鼠镜片诱导型近视眼(lens induced myopia, LIM)后极部巩膜成纤维细胞黏弹性特性的变化。方法　取2周龄豚鼠10只制备LIM动物模型，对侧眼为自身对照眼，再随机选取10只正常2周龄豚鼠作为正常对照眼。将各组豚鼠后极部巩膜成纤维细胞作体外培养，并传1代，行光镜观察与免疫细胞化学染色法进行细胞鉴定，采用微管吸吮技术表征巩膜成纤维细胞的黏弹性特性。结果　经45天凹透镜诱导，实验眼与自身对照眼比较，诱导出(-8.95±0.60)D的相对近视，眼轴延长了(0.60±0.12) mm，两组有显著性差异，P<0.05；实验组凹透镜诱导前后变化差异有显著意义。凹透镜诱导45天后巩膜成纤维细胞粘弹性测定正常对照组(E(下标 ∞)=0.30055±0.07713kPa, E0=0.52553±0.14053kPa, μ=1.94124±1.03281kPa?s, n=52)和自身对照组(E(下标 ∞)=0.34792±0.09709kPa, E0=0.59722±0.18118kPa, μ=2.17855±1.22801kPa?s, n=49)均显著低于LIM组(E(下标 ∞)=0.43555±0.13043kPa, E0=0.76691±0.21674kPa, μ=4.17255±1.59239kPa?s, n=58)P<0.05，而正常对照组和自身对照组的各项黏弹性参数差异无显著意义(P>0.05)。结论　凹透镜诱导可以引起明显轴性近视。LIM组后极部巩膜成纤维细胞的黏弹性参数明显高于正常对照组和自身对照组。     

先天性脉络膜缺损合并视网膜脱离的病理机制和手术疗效分析

目的 探讨先天性脉络膜缺损合并视网膜脱离的病理机制和手术治疗效果。方法 对1996年1月～2002年11月在我院连续性治疗的24例（26只眼）患先天性脉络腆缺损合并视网膜脱离的患者进行研究分析,其中13只眼行巩膜冷冻、硅胶外垫压、、环扎、眼内注气术,另13只眼行玻璃体切除和二级管眼内光凝术。结果 经过2～80个月随访,平均37．6个月。巩膜扣带术的近期成功率和远期手术成功率分别为46．2％和38．5％;玻璃体切除术的近期手术成功率和远期手术成功率均为92．3％。结论 了解先天性脉络膜缺损合并视网膜脱离的病理机制有利于手术方式的选择,玻璃体切除联合二极管眼内光凝和硅油填充手术,能获得较好的手术成功率和较好的术后视力。     

Influence of Selective Laser Melting Technology Process Parameters on Porosity and Hardness of AISI H13 Tool Steel: Statistical Approach

The correct setting of laser beam parameters and scanning strategy for Selective Laser Melting (SLM) technology is a demanding process. Usually, numerous experimental procedures must be taken before the final strategy can be applied. The presented work deals with SLM technology and the impact of its technological parameters on the porosity and hardness of AISI H13 tool steel. In this study, we attempted to map the dependency of porosity and hardness of the tested tool steel on a broad spectrum of scanning speed—laser power combinations. Cubic samples were fabricated under parameters defined by full factorial DOE, and metallurgic specimens were prepared for measurement of the two studied quantities. The gathered data were finally analyzed, and phenomenological models were proposed. Analysis of the data revealed a minimal energy density of 100.3 J/mm3 was needed to obtain a dense structure with a satisfactory hardness level. Apart from this, the model may be used for approximation of non-tested combinations of input parameters.     

Assessment of the Prosthetic Replacement of Ocular Surface Ecosystem (PROSE) scleral lens on visual acuity for corneal irregularity and ocular surface disease

Purpose

To describe changes in visual acuity in patients fit with the Prosthetic Replacement of Ocular Surface Ecosystem (PROSE) with irregular corneas compared to those with ocular surface disease, as well as describe patient demographics and fitting indications for PROSE at an academic medical center.

Sensitive High-Resolution Melting Analysis for Screening of KRAS and BRAF Mutations in Iranian Human Metastatic Colorectal Cancers

Background: Investigations of methods for detection of mutations have uncovered major weaknesses of direct sequencing and pyrosequencing, with their high costs and low sensitivity in screening for both known and unknown mutations. High resolution melting (HRM) analysis is an alternative tool for the rapid detection of mutations. Here we describe the accuracy of HRM in screening for KRAS and BRAF mutations in metastatic colorectal cancer (mCRCs) samples. Materials and Methods: A total of 1000 mCRC patients in Mehr Hospital, Tehran, Iran, from Feb 2008 to May 2012 were examined for KRAS mutations and 242 of them were selected for further assessment of BRAF mutations by HRM analysis. In order to calculate the sensitivity and specificity, HRM results were checked by pyrosequencing as the golden standard and Dxs Therascreen as a further method. Results: In the total of 1,000 participants, there were 664 (66.4%) with wild type and 336 (33.6%) with mutant codons 12 and/or 13 of the KRAS gene. Among 242 samples randomly checked for the BRAF gene, all were wild type by HRM. Pyrosequencing and Dxs Therascreen results were in line with those of the HRM. In this regard, the sensitivity and specificity of HRM were evaluated as 100%. Conclusion: The findings suggest that the HRM, in comparison with DNA sequencing, is a more appropriate method for precise scanning of KRAS and BRAF mutations. It is also possible to state that HRM may be an attractive technique for the detection of known or unknown somatic mutations in other genes.     

近红外眼底自发荧光联合OCT评估孔源性视网膜脱离巩膜扣带术后早期黄斑结构的改变

目的近红外眼底自发荧光检查（NIA）联合OCT对孔源性视网膜脱离巩膜扣带术后早期黄斑结构的评估价值。方法前瞻性系列病例研究。对21例（21眼）伴黄斑脱离的孔源性视网膜脱离患者行巩膜扣带术,于术后3个月行NIA及OCT检查。观察检查图像的异常和手术后视力的恢复情况。对视力的变化进行配对t检验,NIA与术后BCVA的相关性采用双向无序分类变量资料的关联性进行分析。结果NIA：16眼表现为弱荧光周围围绕着强荧光,5眼表现为不均匀的强荧光。OCT：20眼存在黄斑下液;中心凹视网膜神经纤维层的厚度6眼变薄,14眼正常,1眼增厚;21眼IS/OS反射异常。视力恢复情况：术后3个月与术后1 d比较,NIA表现为弱荧光周围围绕着强荧光者,视力差异有统计学意义（t=9.922,P<0.05）,NIA表现为不均匀强荧光者,视力差异无统计学意义（t=2.409,P>0.05）,黄斑NIA表现与术后BCVA变化高度相关（C=0.502,P<0.05）。结论孔源性视网膜脱离巩膜扣带术后早期,黄斑结构与功能均尚未完全恢复,需要我们加以重视。     

灰兔眼巩膜厚度测量

目的测量灰兔不同部位巩膜厚度,了解巩膜部位与厚度变化关系,为经巩膜眼内给药实验研究提供诠释依据。方法 实验研究。49只（98眼）成年青紫蓝灰兔经麻醉后,安乐液处死,立即摘去眼球,随后放入1.25%戊二醛和1%多聚甲醛固定液固定,制成石蜡切片后行常规苏木精-伊红（HE）染色。经生物显微镜观察拍照后用图像分析软件测量从角巩膜缘部到视神经部的巩膜厚度。对测量结果采用广义估计方程（GEE）及Tukey′s HSD Post Hoc Test分析。结果 下半部分兔眼巩膜比上半部分巩膜薄,分别是（342.9±91.3）μm和（400.4±67.6）μm（x2=43.57,P<0.01,GEE）。上半部分巩膜厚度在赤道前后及后极部差异无统计学意义,平均为（366.8±56.3）μm。下半部分巩膜厚度在赤道前和赤道部为（340.9±72.5）μm和（340.8±76.3）μm,往后进一步变薄,赤道部后为（293.9±57.4）μm,后极部为（209.0±51.8）μm。上半部分和下半部分巩膜均在神经处最薄,分别为（273.5±90.5）μm和（187.7±60.1）μm,与其他部位相比,差异有统计学意义（P<0.05,Tukey′s HSD Post Hoc Test）。结论 兔眼巩膜上半部分比下半部分厚,从部位和厚度关系分析,厚度在角巩膜缘与赤道部之间变化较大,在赤道部和后极部之间变化较小。     

后巩膜加固术治疗高度近视眼的远期临床疗效观察

目的 回顾性观察后巩膜加固术治疗高度近视眼的远期疗效.方法 回顾性分析.随访观察16例(32只眼)高度近视眼患者行后巩膜加固患者术后10～13年眼轴、眼底及矫正视力情况.手术前后眼轴长度及最佳矫正视力比较采用配对t检验.结果 患者术后10年眼轴长度为(29.93±2.78)mm,与术前眼轴长度(29.28±2.41)mm相比,差异有统计学意义(t=5.14,P<0.05).术后与术前相比平均眼轴增长(0.643±0.661)mm,术后平均每年眼轴增长(0.056±0.058)mm.术后10年以上眼底情况稳定,并发脉络膜新生血管者占3.1%(1/32).患者术后10年矫正视力为0.52±0.32,与术前0.55±0.29相比,差异无统计学意义(t=0.26,P>0.05).结论 后巩膜加固术远期能够安全有效地延缓高度近视眼眼轴增长,稳定视力.远期效果提示该手术对预防高度近视眼并发脉络膜新生血管具有一定积极作用,但仍需更大样本的对照研究及相关基础实验研究进一步论证.(中华眼科杂志,2011,47:527-530)

Abstract：

Objective To assess the safety and efficiency of posterior scleral reinforcement surgery by analyzing data collected for more than ten years after the surgery. Methods Sixteen patients(32 eyes) with high myopia who underwent scleral reinforcement were followed up for more than ten years(10 to 13 years). Results Best corrected visual acuity was stable(t=0.26,P>0.05).The average axial elongation was 0.056 mm per year postoperation after surgery.The ratio of choroidal neovascularization in the operation group was 3.1%(1/32). Conclusions Posterior scleral reinforcement is a safe and effective.This procedure can prevent the development of choroidal neovascularization in high myopia.A control study with a larger group of cases as well as related basic is still required.     

巩膜扣带术治疗周边裂孔继发黄斑裂孔视网膜脱离的临床观察

目的 观察巩膜扣带术治疗视网膜周边裂孔继发黄斑裂孔视网膜脱离的手术疗效.方法 患者18例(18只眼),常规检眼镜下检查确诊为视网膜脱离,均为周边裂孔的視网膜脱离继发黄斑裂孔.治疗在局麻下行常规視网膜脱离复位术,冷凝周边裂孔,14例采用环扎带,周边裂孔位置外加压,4例单纯外加压.12例球内注入0.5~0.7 ml SF6...