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玻璃体切割联合自体血清治疗黄斑裂孔性视网膜脱离

足背动脉穿支蒂皮瓣修复前足背侧皮肤软组织缺损疗效观察

目的 探讨足背动脉穿支蒂皮瓣修复前足背侧皮肤软组织缺损的临床疗效。 方法 2011 年 1 月—2016 年 6 月，应用足背动脉穿支蒂皮瓣修复前足背侧皮肤软组织缺损 16 例。男 10 例，女 6 例；年龄 17～65 岁，平均 28.5 岁。致伤原因：重物砸伤 9 例，交通事故伤 7 例。左足 7 例，右足 9 例。创面均位于跖跗关节以远前足背侧；合并肌腱外露 10 例，骨外露 6 例。急症修复 9 例，择期修复 7 例。创面范围 5.0 cm×4.0 cm～7.5 cm×7.0 cm。皮瓣切取范围为 6 cm×6 cm～9 cm×9 cm。 结果 1 例皮瓣术后第 2 天开始出现张力性水疱，皮瓣肿胀较严重，经对症处理后愈合；其余皮瓣及供区植皮均成活。术后 16 例均获随访，随访时间 6～18 个月，平均 8 个月。皮瓣颜色、质地、厚度均与周围正常组织相似，患足能正常穿鞋及负重行走。 结论 足背动脉穿支蒂皮瓣手术操作简便，无需牺牲主干血管，是修复前足背侧皮肤软组织缺损的有效方法之一。

过氟化碳液体在复杂性视网膜脱离手术中的应用

视网膜母细胞瘤误诊一例

邻指逆行指动脉皮瓣修复手术末节皮肤脱套伤

A COMBINATION OF ARTERIOVENOUS IMPULSE SYSTEM AND LOW-MOLECULAR-WEIGHT HEPARINS CALCIUM FOR PROPHYLAXIS OF DEEP VENOUS THROMBOSIS FOLLOWING TOTAL KNEE ARTHROPLASTY

Objective To analyze the effect of arteriovenous impulse system (AVIS) combined with lowmolecular-weight heparins calcium (LMWHC) for prophylaxis of deep vein thrombosis (DVT) following total knee arthroplasty (TKA). Methods From March 2006 to March 2008, 76 cases of osteoarthritis patients (76 knees) accepted TKA, including 25 males and 51 females with an average age of 66.6 years (range, 58-79 years). The affected knees were left side in 41 cases and right side in 35 cases. They were randomly divided into experimental group and control group before surgery. Then LMWHC and rehabil itation training were routinely given in two groups before and after surgery. However, only experimental group was treated with AVIS continually during the first four days and then two times a day for 30 minutes one time during 5-7 days. At 7 daysd after operation, color Doppler ultrasound was used to detect the occurrence condition of DVT. Results Five cases (13.16%) had thrombosis of calf and recovered after treated with urokinase and salvia in the experimental group. Eleven cases had thrombosis of calf and 3 cases had thrombosis of whole low extremities (36.84%), and improved after treated with urokinase and salvia in the control group. There was significant difference in DVT incidencerate between two groups (P lt; 0.05). No pulmonary embol ism or death was found in both groups. Conclusion AVIScan effectively accelerate the venous blood return velocity, a combination of AVIS and LMWHC has a better effect in theprevention of DVT following TKA.

玻璃体异物摘除联合后房人工晶体植入术

玻璃体视网膜手术治疗脉络膜缺损合并视网膜脱离

Application of iris fluorescein angiography in the diagnosis of intraocular diseases

　　Objective　To evaluate the application value of iris fluorescein angiography (IFA) in the diagnosis of ischemic center retinal vein occlusion (CRVO). Methods　Fifty-one patients (51 eyes) with CRVO which had been diagnosed by fundus fluorescein angiography （FFA）were studied. All patients underwent the examination of visual acuity, slit lamp biomicroscope，anterior segment color photography, intraocular pressure, FFA and IFA. The patients were classified as non-ischemic CRVO （20 eyes）and ischemic CRVO （31 eyes）. The 20 non-ischemic CRVO patients included 11 males and nine females, aged from 41 to 59 years. The 31 ischemic CRVO patients included 21 males and 10 females, aged from 28 to 62 years.FFA and IFA were performed for all the patients using Heidelberg retina angiograph, and the classic pictures were analyzed by the computer image processing system. The detection rate of iris neovascularization (NVI) by slit lamp biomicroscope and IFA was analyzed. All ischemic CRVO eyes underwent panretinal photocoagulation (PRP), and PRP was completed in 27 eyes and not completed in four eyes. Six months after PRP the regression of iris NVI was followed up. Results　All non-ischemic CRVO eyes （100.0%） had no neovascularization on papillary margin and iris by slit lamp biomicroscopy, and had no fluorescence (pigment blocked fluorescence) on IFA. Thirteen eyes （41.9%） and 23 eyes （74.2%） of the 31 ischemic eyes had NVI by slit lamp biomicroscope and IFA, respectively. The NVI detection rate of those two methods was statistically different （Z=-3.425，P=0.001）. NVI showed b fluorescence and leakage with variable patterns (small blocks, thin lines and irregular cross-links) by IFA. There was no fluorescence staining and leakage on papillary margin and iris in 27 eyes who completed the PRP, but the neovascular glaucoma (NVG) occurred in one eyes who discontinued the PRP treatment after one to two months. Conclusions　IFA has a high specificity in CRVO which hints the ischemic state of anterior segment. It is helpful to the early diagnosis of ischemic CRVO and the turnover of NVG.

Expression of hepatocyte growth factor receptor in human epiretinal membranes and RPE cells

Objective To investigate the expression of hepatocyte growth factor receptor (HGFR) in epiretinal membranes (ERM) of eyes with proliferative vitreoretinopathy (PVR) and cultured retinal pigent epithelium (RPE) cells. Methods Fifteen human epiretinal membranes were obtained from eyes undergone vitrectomy for rhegmatogenous retinal detachment complicated with PVR and observed by immunohistochemical examination to study the expression of HGFR. Using the immunohistochemical technique to evaluate the expression of HGFR in cultured RPE cells. Results In 6 membranes of PVR-grade C, HGFR were expressed in 5/6, and 7 cases were detected in 9 membranes of PVR-grade D.RPE cells express readily detectable levels of HGFR. Conclusion The findings indicate that HGF might be involved in the formation of epiretinal membranes in PVR. (Chin J Ocul Fundus Dis, 2002, 18: 221-223)