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【目的】检测缺氧诱导因子-1（HIF-1）在兔结膜伤口愈合模型的表达水平，并研究其在结膜瘢痕形 成中的作用。【方法】48只新西兰白兔根据不同观察时间点（术后12h和1、 3、 5、 7d以及空白对照组）随机分为 6组。对所有实验组动物构建低位结膜瓣，术后观察术区并评估结膜血管化水平。实时荧光定量PCR和蛋白免 疫印迹（Westernblot）检测术区HIF-1α的表达水平，根据病理切片评估术区结膜纤维化水平。【结果】Western Blot结果显示HIF-1α蛋白表达水平在术后第3天（P＜0.001）和第5天（P＜0.001）均高于空白对照组。在术后不 同时间点，HIF-1α的mRNA水平的变化趋势与HIF-1α的蛋白水平的变化趋势相一致。术后结膜血管化水平与 HIF-1α的蛋白水平呈正相关关系（r=0.626；P＜0.001）。此外，术后第3天［（37.88±6.88）%；P=0.006］、第5 天［（47.50±6.26）%；P＜0.001）］和第7天［（53.45± 3.78）%；P＜0.001）］的胶原纤维含量高于空白对照［（23.61 ±5.26）%］。【结论】构建兔结膜伤口愈合模型后，HIF-1α在兔结膜和Tenon’ s囊组织存在表达。HIF-1α过表 达可能促进兔结膜伤口愈合。

[目的]探讨皮肤干细胞诱导分化为结膜上皮细胞,为组织工程结膜探索一种新型的种子细胞,为严重眼表疾病的治疗奠定基础。[方法]在体外培养纯化鉴定恒河猴皮肤干细胞,并用Hoechst 33342标记,标记后的皮肤干细胞与结膜上皮细胞进行Transwell非接触共培养10d,然后对诱导后的细胞用细胞免疫化学以及流式细胞术检测结膜上皮细胞的特异性表面标志,包括角蛋白4和粘蛋白4,同时检测细胞的Hoechst 33342表达情况。[结果]纯化后的皮肤干细胞比例接近90%。Hoechst 33342标记后的皮肤干细胞胞核显示蓝色荧光。在与结膜上皮细胞共培养10d后,皮肤干细胞显示结膜上皮细胞的标志粘蛋白4和角蛋白4阳性,流式细胞术检测阳性细胞比例分别为49.9%和95.6%,同时细胞还显示胞核的Hoechst 33342表达。[结论]灵长类动物恒河猴的皮肤干细胞,在体外的适宜条件下,可诱导分化为有结膜上皮细胞特征的细胞。

【目的】观察人骨髓间充质干细胞（mesenchymal stem cells，MSCs）在保存人羊膜及兔眼表结膜基质上分化的情况。【方法】24只新西兰兔随机分为2组。实验组：培养有人MSCs的羊膜移植组，将人MSCs接种在保存人羊膜上培养4d，用5-溴脱氧尿嘧啶（BrdU）标记后移植到兔眼表结膜缺损区；对照组，单纯羊膜移植组。分别于移植后1，2，3，4，6和8周，摘取各组实验眼行组织学和免疫组织化学检查，组织学检查移植到兔结膜基质的MSCs的存活、形态变化以及移植局部的反应等情况；免疫组织化学检测移植到结膜基质的带有BrdU标记的细胞角蛋白3／12（CK3／CKl2）和角蛋白13（CK13）的表达。【结果】MSCs接种到羊膜后能在羊膜上生长，与羊膜共培养4d后，MSCs贴附羊膜生长迅速，组织学特征无明显改变。用羊膜负载MSCs移植到兔结膜缺损区，术后免疫组织化学检测结膜上皮层CK13表达阳性，CK3／CK12表达阴性，在重建的结膜上皮层可检测到BrdU核阳性细胞，未见异常增殖细胞。【结论】人羊膜可作为MSCs的载体，采用人羊膜负载MSCs行兔结膜移植，MSCs能在兔结膜上皮层存活并增殖。

【目的】探讨羟基磷灰石板对矫正眼眶爆裂性骨折的作用及手术方法。【方法】23 例病人, 男18 例, 女性5 例, 先依眼眶CT 扫描确定骨折位置及眼眶组织的嵌顿情况, 再从骨折位置的骨膜下探查并把嵌顿的软组织复位, 然后, 用2 mm 厚的羟基磷灰石板从骨膜下填充骨折凹陷区。手术过程注意避免损伤眶内的神经和血管等重要组织, 对合并眶缘骨折缺损 者用钛网成形。手术前后常规测量眼球突出度, 对视力高于0.1 者行同视机检查, 术后平均随访18.2 个月。【结果】所有病 人眼球内陷得到不同程度的矫正, 18 例(78.3 %)从术前双眼球突出度相差4 ～ 10 mm 恢复至术后相差

【目的】评价先天性睑裂狭小综合征的手术治疗效果。【方法】对 50 例先天性睑裂狭小综合征, 采用改良 Y-V 矫 正联合内眦韧带缩短法矫正内眦赘皮,缩短内眦间距,3 个月后二期行额肌瓣悬吊术矫正上睑下垂。【结果】经随访 6 个月～ 5 年, 证实能达到矫正内眦赘皮,延长睑裂 ,缩短内眦间距和充分上提上睑的目的, 治疗效果满意。【结论】改良 Y-V 矫正联合 内眦韧带缩短法和额肌瓣悬吊术是治疗先天性睑裂狭小综合征的效果确切、简便又安全的手术方法。

目的】分析多孔羟基磷灰石(HA)义眼台眶内植入后的并发症并探讨其原因。【方法】回顾眶内植入羟基磷灰石 义眼台320 例, 随诊6 月～ 4 年。【结果】320 例中发生并发症的有46 例(14.4 %), 其中义眼台暴露41 例(12.8%), 义眼台位置 异常2 例, 其它并发症包括义眼台慢性感染、结膜肉芽肿等。义眼台暴露的发生时间为术后7 d～ 6 月, 范围为2 ～ 15 mm 。【结 论】羟基磷灰石义眼台眶内植入最常见的并发症是义眼台暴露, 并发症的发生原因与多种因素有关, 包括术前眼病史、包裹义 眼台的异体巩膜的排斥溶解、义眼台的选择、缝合技术、术后眼眶的放射治疗等。

In the intelligent diagnosis of pancreatic lesions by ultrasonic endoscopy, a diagnostic model based on the twin network architecture was proposed to address the problems of misdetection, omission and low accuracy in the detection of pancreatic lesions in different age groups and genders, as well as the detection of pancreatic lesions in multiple sites. The model consists of two improved ConvNeXt models, which perform the task of pancreatic site classification and the task of locating cancerous areas without labelling the cancerous sites with Grad_CAM, respectively. The improved ConNeXt model uses feature fusion to combine detailed texture and abstract semantic information, and the fusion ratio relationship of feature vectors is solved through experimental exploration to improve the classification accuracy and stability of the model. Experiments show that the twin ConvNeXt network model improved by feature fusion achieves a classification accuracy of 98. 34% for pancreatic sites and up to 99. 47% for cancerous sites, and the activation regions generated by Grad_CAM are highly consistent with the real cancerous regions, which provides an effective auxiliary diagnosis for doctors. [ABSTRACT FROM AUTHOR]

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To realize intelligent cancer diagnosis for pancreatic images returned by endoscopic ultrasonography, the classic classification and recognition network AlexNet and SE attention mechanism are combined with in this paper. The proposed SE-AlexNet network can accurately detect cancerous images and discriminate the pancreatic parts to which the normal images belong. In order to verify the reliability and superiority of the algorithm, a series of comparison experiments are carried out under the self-made dataset in the paper, including the model comparison experiments between the basic network AlexNet and other classical classification networks, and the comparison experiments of various models improved and obtained by inserting different attention mechanism in different positions. The results show that the overall precision and recall rate of SE-AlexNet model can reach 99.56% and 98.69%. For cancerous images, the detection precision and recall rate are 100%, which can achieve an effective auxiliary diagnosis for practical endoscopic ultrasonography of pancreatic cancer. [ABSTRACT FROM AUTHOR]

摘 要 为探讨羟基磷灰石义眼座植入后义眼座暴露的治疗方法, 选8 例病人, 先用钻磨器将其暴露的羟 基磷灰石义眼座打磨平滑, 再用同源供体的新鲜异体板层巩膜和球结膜覆盖义眼座的暴露区。结果显示:8 例 病人有7 例术后6 周巩膜结膜移植片完全愈合, 安装义眼后外观满意;1 例术后1 周巩膜结膜植片溶解脱落, 2 周后取出义眼座。作者认为联合同源异体巩膜结膜移植治疗羟基磷灰石义眼座植入后暴露是效果良好的治疗 方法。