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Silicon oil fit-into anterior chamber: two crystal eyes, intraocular tension has been controlled by releasing silicon oil , silicon oil fit-into one eye again, silicon oil filling exceed one month, useless of expectant treatment, after checking the reattachment of retina, doing the silicon oil dislodge from anterior chamber and vitreous cavity; there aphakia eyes by prone position and draping hypotensive drug: two iris ambitus excision aperture membrane occlusor eyes by lasering at 6 clock or perforating again., iris ambitus excision at 6 clock by lasing .one by iris ambitus excision affiliation anterior chamber plasty, acuity of vision has been elevated different degree after intraocular tension controlled.

硅油进入前房者:有晶体眼中2眼经前房放油眼压控制,其中1眼硅油再次进入前房,硅油填充亦超过1个月,经保守治疗无效,检查眼底视网膜复位后,同时行前房和玻璃体腔硅油取出术;无晶体眼中3眼经俯卧位加点降眼压药物,眼压控制,2眼虹膜周切孔膜闭者经过激光6点位打孔或重复打孔处理眼压控制,1眼作6点位周切孔重建,1眼行虹膜周切联合前房成形术,眼压控制。96眼眼压控制后,视力均有不同程度提高。

Objective To investigate the clinical features, causes of blindness and diagnosis of Vogt Koyanagi Harada syndrome Methods The data of 157 patients with VKH syndrome were reviewed and analyzed Patients were carefully examined with slit lamp, ophthalmoscope, three mirror lens, fundus fluorescein angiography, indocyanine green angiography and HLA typing Results Headache was noted in 73 5% of these patients Simultaneous involvement of both eyes occurred in 80 8% of these patients Chroiditis,papilledema and edema of the retina adjacent to the optic nerve were noted in 100% of these patients in the posterior uveitis stage, whereas recurrent granulomatous anterior uveitis (98 4%),"sunset glow" fundus (95 8%) and Dalen Fuchs nodules (71 2%) were the common ocular findings in the recurrent anterior uveitis stage The common causes of blindness were papillitis, exudative retinal detachment and complicated cataract in the posterior uveitis stage, anterior uveal involvement stage and its recurrent stage Poliosis (36 3%) and alopecia (35 0%) were the most common extraocular findings Early irregular patches of fluorescence, followed by localized hyperfluorescent spots were the typical findings of FFA Dilation of choroidal vessels and leakage of ICG from the choroidal vessels were the common ICGA findings The prevalence of HLA DR4 and HLA DRw53 in patients (54 9% and 71 8% respectively) was significantly higher than that in controls (14 7% and 38 2% respectively) Conclusions VKH syndrome is characterized by chroiditis, papillitis or neuroretinitis in the posterior uveitis stage, followed by a generalized uveitis with a typical recurrent granulomatous anterior uveitis Extraocular findings and relevant examinations including FFA, ICGA and HLA typing are helpful to the diagnosis of VKH syndrome

目的探讨Vogt-Koyanagi-Harada综合征患者的临床特征、盲目原因及诊断等有关问题。方法对在1996年1月至2000年12月间就诊资料完整的157例VKH综合征患者进行回顾性分析,并对裂隙灯、眼底镜、三面镜、荧光素眼底血管造影(fundus fluorescein angiography,FFA)、吲哚青绿血管造影(indocyanine green angiography,ICGA)及人类白细胞抗原分型等检查结果进行分析。结果 VKH综合征最常见的前驱症状为头痛(102例,73.5%),双眼同时患病118例(80.8%);后葡萄膜炎期眼部主要表现为脉络膜炎、视乳头及附近视网膜水肿(100.0%);前葡萄膜炎反复发作期眼部表现为复发性肉芽肿性前葡萄膜炎(128例,98.4%)、晚霞状眼底改变(95.8%)及Dalen-Fuchs结节(71.2%);后葡萄膜炎期、前葡萄膜受累期及前葡萄膜炎反复发作期导致盲目的主要原因分别为视乳头炎、视网膜脱离及并发性白内障;毛发变白(36.3%)及脱发(35.0%)是最常见的眼外表现;炎症活动期FFA典型表现为斑驳状高荧光,ICGA发现脉络膜血管扩张、通透性增高等改变;VKH综合征患者HLA-DR4及HLA-DRw53的阳性率(54.9%及71.8%)显著高于正常对照组(14.7%及38.2%)。结论 VKH综合征患者在后葡萄膜炎期眼部典型表现为双侧脉络膜炎、视乳头炎或神经视网膜炎,随后出现以反复发作的肉芽肿性前葡萄膜炎为特征的全葡萄膜炎。眼外症状及相关的辅助检查包括FFA、ICGA 及HLA分型等有助于VKH综合征的诊断。

The diagnostic features for the species include deep excavation on the posteroventral margin of the premaxilla, a diastema between the premaxillary and maxillary teeth, a a number of many pits and ridges on the anterolateral surface of the antorbital fossa, the posterolateral process of the parietal being long and sharply posteriorly directed, the column ar -like margin of the pterygoid process of the quadrate, the bifurcated posterior margin of the dentary, a distinctive groove posterior to the anterior carina on the medial surface of the premaxillary tooth crowns, absence of ventrolateral processes on intercentrum of t he atlas, T-shaped centrum of the first caudal in ventral view, transverse process on anterior caudals with rounded , and strongly anteroposteriorly expanded distal end, presence of two fossae separated by an oblique ridge on the lateral side of the anterior chevrons near the articular end, and pubis strongly curved psoteriorly.

这一属种的主要鉴定特征包括:前上颌骨后腹缘有一深凹、前上颌齿和上颌齿之间有一齿缺、眶前窝外表面前部有许多坑窝和脊、顶骨侧后突伸向后方、方骨的翼骨支边缘柱状、靠近前上颌齿齿冠舌面前缘有槽、环椎间椎体外腹突缺失、第一尾椎椎体腹视 T 形、前部尾椎横突远端前后向强烈扩展呈圆形、前部脉弧近端外侧面有两个被一斜脊分离的窝以及耻骨强烈向后弯曲。通过分析千禧中国鸟龙的96个骨骼学特征,发现其中21个特征支持奔龙类与鸟类的亲缘关系最近,9个特征支持奔龙类与伤齿龙类亲缘关系最近,25个特征支持奔龙类、伤齿龙类和鸟类亲缘关系较为接近。

The constant nutritional arteries of the great saphenous vein-saphenous nerve on the medial foot: Perforator at medial side of the tendon of the tibialis anterior ,it is (2.27±0.43)cm distal to the intermalleolar line .it passes across the medial side of the tendon of the tibialis anterior and pierces the deep fascia between the upper and lower bundle of the inferior extensor retinaculum with a diameter of (0.72±0.04)mm;The length of it after piercing the deep fascia is (7.3±0.6)mm,It has an emerging rate of 95%; Perforator between tendons ,it is (3.02±0.39)cm distal to the intermalleolar line;it pierces the deep fascia between the tendons of tibialis anterior and extensor digitorum longus with a diameter of (0.57±0.06)mm ;The length of it after piercing the deep fascia is (7.4±0.6)mm .It has an emerging rate of 94%; A constant distal fascial perforator pierces the deep fascia between abductor hallucis muscle and medial side of first metatarsal bone (1.97±0.23)mm distal to the first metatarsophalangeal joint with a diameter of (0.50±0.03)mm.

足内侧大隐静脉-隐神经营养血管近端来自内踝前动脉较为恒定,外径较大的穿支有:踝间线远端(2.27±0.43)cm,经胫骨前肌腱内侧、伸肌下支持带上、下束间穿出,外径(0.72±0.04)mm ,穿出深筋膜的长度为(7.3±0.6)mm,出现率为95%;踝间线远端(3.02±0.39)cm,经胫骨前肌腱与趾伸肌腱穿出,外径(0.57±0.06)mm,穿出深筋膜的长度为(7.4±1.2)mm ,出现率为94%;3远端来自交通支最为恒定,外径较大的穿支于踇展肌与第一跖骨内侧缘之间穿出深筋膜,距第一跖趾并节近端(1.97±0.23)cm,直径(0.50±0.03)mm,穿出深筋膜的长度为(6.5±0.5)mm,出现率为100%。

Anterior capsule remained group: In the 17 cases with intact anterior capsule, anterior subcapsuler turbidness and opaque star clump at center or pericenter area were shown 1 month and 3 months after surgery respectively.

保留前囊组:所有病例在术后1月均出现逐渐加重的前囊浑浊,在前囊中央造孔的病例,通过小孔可窥见眼底。

RESULT: 1.Ouabain act on lens sodium-pump,under the LM,lens anterior capsular membrane discontinuous,epithelium cells clustered,occluding zonule seperated,lens fiber layers fractured.Under the EM,cells totally hollowed,mitochondria swelling,myelin figure appeared.RT-PCR examine the expression condition of αsubunit of sodium pump on mRNA level,α1、α2 and α3-isoform are all decreased.2.Digoxin act on lens sodium-pump,under the LM,lens cell oedema,linkage distructed,extensive exfoliation.Under the EM,plasma appeared little half-transparant hollow region,mitochondria swelling and ridge disappeared. RT-PCR examine,α1、α2 and α3-isoform are all decreased.3.Amphotericin B act on lens sodium-pump,under the LM,lens epithelium cells linked tightly,arranged in-line,lens fiber layers arranged tightly and regularily.Under the EM,abbundant cellular organes,exuberant cells function indicated. RT-PCR examine the expression condition of αsubunit of sodium pump on mRNA level,α1 and α3-isoform are increased significantly,demonstrated isoform-specific action.4D-thyroxine act on lens sodium-pump,under the LM,lens plasmalemma integrated,cells arranged tightly and regularily.Under the EM,nucleus fission appeared,desmosome half-desmosome and tensile microfilaments linked the cells. RT-PCR examine,α2 and α3-isoform are increased, also demonstrated isoform-specific action.5.Vitamin E act on lens sodium-pump,under the LM,lens anterior capsular membrane continuous and smooth,epithelium cells tightly linked,lens fiber layers appearede hollow region occasionally.Under the EM,lateral membrane high density belt appeared,abundant nucleolus. RT-PCR examine,onlyα1-isoform are increased, demonstrated significantly isoform-specific action.6.DMSO act on lens sodium-pump,under the LM,lens anterior capsular membrane slightly thicker,cells linkage partly distructed.Under the EM,plasmalemma denaturation,mitochondria swelling.RT-PCR examine,α1、α2 and α3-isoform are all altered slightly and haven't significant meanning.

结果:1、哇巴因作用于晶状体钠泵后,光镜下晶状体前囊膜断裂、上皮细胞聚积、闭合连接分离、纤维板层裂隙,电镜下全层细胞空泡化、线粒体肿胀出现髓样结构,RT-PCR法检测晶状体钠泵α亚单位α1、α2及α3三种重整异构体在mRNA水平的表达均减弱。2、地高辛作用于晶状体钠泵后,光镜下晶状体细胞水肿、细胞连接破坏、广泛剥离,电镜下胞质见少许半透明空化区、线粒体肿胀嵴消失,RT-PCR法检测晶状体钠泵α亚单位α1、α2及α3三种重整异构体在mRNA水平的表达均减弱。3、两性霉素B作用于晶状体钠泵后,光镜下晶状体上皮细胞紧密连接、线状排列、纤维板层紧密规整,电镜下细胞器丰富、细胞功能旺盛,RT-PCR法检测α1及α3表达显著增强、具有一定的重整异构作用特异性。4、D甲状腺素作用于晶状体钠泵后,光镜下晶状体质膜完整、细胞排列紧密规整,电镜下胞核见分裂像、细胞间有桥粒、半桥粒及张力微丝,RT-PCR法检测α2及α3表达均增强、亦有一定的重整异构作用特异性。5、维生素E作用于晶状体钠泵后,光镜下晶状体前囊膜连续光滑、上皮细胞紧密连接、纤维板层偶见空化,电镜下囊侧膜内有高电子密度带、细胞核仁丰富,RT-PCR法检测仅有α1的表达显著增强、具有极强的重整异构作用特异性。6、二甲基亚砜作用于晶状体钠泵后,光镜下晶状体前囊膜轻度增厚、细胞连接部分破坏,电镜下质膜变性、线粒体肿胀,RT-PCR法检测晶状体钠泵α亚单位α1、α2及α3三种重整异构体在mRNA水平的表达无显著改变。

Methods The refractive state, corneal refractive power, anterior ocular segment length, vitreous length and ocular axial length were measured for 1 336 eyes, including 523 hyperopic eyes, 199 emmetropic eyes and 614 myopic eyes. The relationships of these elements were studied. Results CP had no effect on the refractive state.

检测1 336只眼的屈光状态、角膜屈光力(corneal refractive power, CP)、眼前节长度(anterior ocular segment length, ASL)、玻璃体腔径(vitreous cavity length, VL)及视轴长度(ocular axial length, AL),其中远视523只眼,正视199只眼,近视614只眼。

During en mass retraction of upper anterior teeth with straight wire technique, the length of anterior hook mainly influenced anteroposterior moving pattern of anterior teeth. As anterior hook increased from 0 to 6mm, labiolingual displacements of lateral incisor varied form lingual tipping to lingual translation and lingual controlling root movement, while 3-D displacements of other teeth only increased in account.

3直丝弓矫治技术整体内收上前牙时,牵引钩的长度主要影响前牙的矢状向位移方式:牵引钩长度增加至6mm的过程中,除侧切牙在唇舌向上由舌向倾斜运动变为舌向整体平移和舌向控根运动外,前牙的三维位移只有数量的增大,趋势基本保持不变。

The results were expressed in mean±1SD. Pearson X~2 test and One-way ANOVA test were used. The data analyzed using the SPSS (version 11.5). Results: The sensitivity, specificity, positive and negative value of US for the LPEH model on the children cadaver were 88%, 84%, 79%, 91%, respectively. With regard to the thickness of femora head cartilage, the thickness of the anterior layer or posterior layer, there were no significant differences among three groups. However, the anterior layer was thicker than the posterior layer in three groups. The fluid in hip joint was detected in all of 21 symptomatic hips, which was clear commonly (90%) in early procedure. The amount of fluid in anterior recess showed a positive correlation with age (p .05). No fluid was detected in the asymptomatic and normal hips (2mm). The mean maximum width of inferomedial recess was significantly larger than that of anterior recess (12.50±4.04mm vs.4.35±0.8mm, p 0.05) in the symptomatic hip joints. The echogenic entrapped labral plicaes were demonstrated in the inferomedial recess in all of 21 children with LPEH, whose length and width ranged from 5.3mm-25.0mm (mean,15.6±5.6mm) and from 4.0mm-17.0mm (mean,8.9±7.8mm).

结果1,尸体LPEH髋关节模型的超声诊断敏感性、特异性分别为88%、84%,阳性预测值、阴性预测值分别为79%、91%。2,21例患儿的LPEH患髋(21侧)、健髋(21侧),以及21例正常儿童健髋(42侧)的超声检查显示:髋关节周围软组织及股骨头无形态结构差别;股骨头软骨厚度无统计学差异(3.5±0.5mm vs.3.6±0.4mm vs.3.6±0.5mm,p>0.05);关节囊前层及后层厚度无统计学差异(前层厚度2.79±0.74 mm vs.2.56±0.40mm vs.2.56±0.72mm;后层厚度2.70±0.82mm vs.2.48±0.54mm vs.2.44±0.58mm,p>0.05),但LPEH患髋关节囊前、后层均较后二组有增厚趋势。3,LPEH患髋均存在关节腔内积液,且早期较为清晰;积液以髋关节内下间隙明显,内下间隙较前间隙明显增宽(12.50±4.04mm vs.4.35±0.8mm,p<0.05),其内见嵌顿滑膜唇皱襞呈稍强回声的占位性团块,长约15.6±5.6mm,宽约8.9±7.8mm,90.5%(19/21)嵌顿皱襞内未见血流信号。4,所有LPEH患髋治疗后超声复诊均显示正常。

Results The anterior bundle of ulnar collateral ligament originates from the inferior aspect of the medial epicondyle and inserts immediately adjacent to the joint surface on the ulna near the sublimis tubercle. The posterior bundle originates from the medial epicondyle slightly posterior to its most inferior portion and inserts broadly on the olecranon process. The lateral collateral ligament arises from the inferior aspect of the lateral epicondyle. Two types of conjoined lateral collateral and annular ligamentous insertions on the ulna were observed. Type Ⅰ(61.2%) was bilobate and type Ⅱ(38.8%) was a single broad conjoined type with insertion on the ulna. The anterior band of anterior bundle was more tighten than the posterior band as the elbow flexed less than 60°. When the elbow flexed over 60°, the two parts of anterior bundle were equally tightened. The posterior bundle was tightened as the elbow was flexed more than 90°. The lateral collateral ligament was tightened gradually as the elbow moved in flexion.

结果(1)尺侧副韧带前束起于肱骨内上髁的前下方,止于尺骨冠突内侧的小结节;后束起于肱骨内上髁的内下方,止于尺骨鹰嘴内侧的骨面;(2)桡侧副韧带起于肱骨外上髁的外下方,其纤维部分止于环状韧带,部分止于尺骨冠突的外下方;桡侧副韧带和桡骨环状韧带在尺骨上的止点有两种类型:Ⅰ型占61.2%,桡侧副韧带的部分纤维汇于环状韧带的尺骨止点,另一部分纤维单独止于稍远的尺骨上;Ⅱ型占38.8%,桡侧副韧带和环状韧带形成一宽的纤维止于尺骨上;(3)在肘关节屈曲60°以前,尺侧副韧带前束的外侧部紧张而内侧部较松弛,肘关节屈曲超过60°后,前束内外侧处于同程度的紧张状态;尺侧副韧带的后束在肘关节屈曲超过90°后才被拉紧;(4)桡侧副韧带在肘关节不同屈曲状态时其紧张度逐渐增加,当肘关节屈曲超过90°时,桡侧副韧带被明显拉长。

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