Cutibacterium acnes chronic endophthalmitis is the most common cause of delayed infectious endophthalmitis after intraocular surgery and perforating injury, which has the characteristics of delayed onset, smoldering, recurrence and phacophagia. C. acnes is an anaerobic gram-positive bacillus which is difficult to culture.Polymerase chain reaction (PCR) provide improved diagnostic results over traditional culture techniques.Hitherto, although there is no consensus on treatment strategies, treatment methods include intraocular antibiotics, pars plana vitrectomy combined with partial or total capsulectomy, intraocular lens removal/replacement, the visual outcomes are generally favorable.Since C. acnes endophthalmitis may be masqueraded as non-infectious iridocyclitis or posterior capsular opacity in the early stage, misdiagnosis and erroneous long-term treatment with corticosteroids or Nd: YAG capsulotomy may lead to deterioration of intraocular inflammation, this paper aims to review the etioloty, clinical features, laboratory tests, treatment strategies and outcomes of C. acnes endophthalmitis, which may provide reference for fellow clinicians.

The reproductive disorder of dairy cows is the main reason for the decrease of the fecundity of dairy cows.Understanding the pathogenic mechanism of the reproductive disorder of dairy cows can prevent the reproductive disorder of dairy cows in advance,which is of great significance for the improvement of the reproductive rate of dairy cows.From cows congenital reproductive barriers,acquired sexual reproduction barrier,contagious infectious factors,nutritional factors,autoimmune,environmental stress factors,improper breeding technology,the respect such as reproductive organs disease class analysis,provide more theoretical basis for farmers,farmers suit the prevention,to guide production.

奶牛繁殖障碍是使奶牛繁殖力降低的主要原因.笔者从奶牛子宫内膜炎、子宫脱出、胎衣不下、子宫颈炎、难产类产科疾病;持久黄体、卵巢囊肿、卵巢静止、奶牛激素紊乱性疾病;隐性流产、稽留性流产;体细胞数偏高乳房炎导致的奶牛繁殖性能低下;生殖器官畸形、异性双胞胎母犊等奶牛先天性繁殖障碍等方面加以分析,为养殖者提供了更多的理论依据,利于养殖者对症治疗,来指导生产.

Objective: To evaluate the demographics, etiology composition, clinical characteristics and surgical outcomes of acquired ptosis patients. Methods: Retrospective case-series study. The clinical records of 176 consecutive patients (312 eyes) with acquired ptosis were reviewed from January 2009 to December 2018 in the Ophthalmology Department of Tianjin Medical University General Hospital. The demographics, etiology composition, clinical characteristics, surgical strategies and outcomes were analyzed. Results: There were 59 male (33.5%) and 117 female (66.5%) patients suffering acquired ptosis, with an average age of (64±7) years. The disease was bilateral in 136 cases and unilateral in 40 cases. There were four etiological components of acquired ptosis: 145 cases (82.4%) of aponeurotic ptosis, 17 cases (9.6%) of neurogenic ptosis, 10 cases (5.7%) of myogenic ptosis and 4 cases (2.3%) of traumatic ptosis. The clinical characteristics of acquired ptosis varied significantly depending on etiology. Ptosis surgeries were performed on 152 cases (279 eyes), and the success rate was 92.1% (140/152). Surgical procedures included levator aponeurosis surgeries on 148 cases (275 eyes), frontal muscle suspensions on 2 cases (2 eyes) and conjunctival-Müller's ectomies on 2 cases (2 eyes). Conclusions: Acquired ptosis is more likely to occur in senile and female populations with bilateral eyelids involved mostly. Aponeurotic ptosis is the predominant type of acquired ptosis. The treatment is performed according to the clear etiological diagnosis based on clinical features, and operations are efficient for most patients with acquired ptosis. (Chin J Ophthalmol, 2021, 57: 844-849).

This study was performed with the aim to investigate the correlations of tumor necrosis factor-alpha (TNF-α) gene promoter polymorphisms with the risk of thymoma-associated myasthenia gravis (T-MG) in a northern Chinese Han population. Between June 2005 and June 2015, 305 MG patients (150 males and 155 females, MG group) and 293 healthy volunteers (negative control (NC) group) were enrolled in this study. Among the MG patients, there were 121 patients with thymoma-associated MG (T-MG group) and 184 without T-MG (NT-MG group). Enzyme-linked immunosorbent assay (ELISA) was used for the serum TNF-α level. Polymerase chain reaction–restriction fragment length polymorphism was conducted to determine genotype and allele frequencies of TNF-α gene promoter -1031T/C, -857C/T and -863C/A. The haplotype was analyzed with the SHEsis software. Logistic regression analysis was performed for correlations between TNF-α gene promoter polymorphisms and the risk of T-MG. The T-MG group had higher frequencies of the CT/TT genotype and T allele of -857C/T than the NT-MG and NC groups. The frequencies of the CC genotype and C allele of -1031T/C were higher in the T-MG group than in the NT-MG and NC groups, and higher in male patients in the T-MG group than in male patients in the NC group. TTA and TTC haplotypes exhibited lower frequencies in the T-MG group than in the NT-MG group. The ocular MG patients exhibited lower frequencies of the TT genotype and T allele of -857C/T than the generalized MG patients did. The TNF-α level was elevated in the T-MG group compared with that in the NC and NT-MG groups, indicating that the TC+CC and CT+TT genotypes were increased compared with the TT and CC genotypes in the -1031T/C and -857C/T, respectively. Logistic regression analysis suggested that expressions of anti-acetylcholine receptor antibodies, Osserman’s classification, -1031T/C and -857C/T polymorphisms and the TTA haplotype were the independent risk factors for T-MG. These findings reveal that TNF-α -1031T/C and -857C/T polymorphisms and the TTA haplotype may be correlated with the occurrence of T-MG in a Northern Chinese Han population.

Objective To explore the experimental study for a rapid,radical and minimally invasive method for dacryocystitis. Methods Seven New Zealand rabbits (14 eyes) were randomly divided into control group (1 rabbit,2 eyes),Pingyang group (6 left eyes) and fosfomycin sodium glucose group (6 right eyes).The different hardeners were injected into rabbit lacrimal duct:The control group was injected with normal sodium (9 g·L-1);The Pingyang group with bleomycin (1 mg·kg-1),dexamethasone (10 mg),lidocaine (2 g·L-1,2 mL) and normal sodium (2 mL);Fosfomycin sodium glucose group with fosfomycin sodium powder (2 g) and glucose (2.78 mol·L-1,20 mL).The lacrimal sac was extracted,and the pathological changes at 1 week and 2 weeks after injection were observed. Results No significant change appeared in the control group,the mucosa was columnar epithelium,the basic structure of the lacrimal mucosa was normal.At 1 week after injection,the lacrimal duct was unobstructed in Pingyang group,the mucosa epithelium was edema,the infiltration of inflammatory cells in sub-epithelium was seen;The lacrimal duct was obstructed in fosfomycin sodium glucose group,the mucosa epithelium was edema,many infiltration of inflammatory cells in sub-epithelium was seen.At 2 weeks after injection,the lacrimal duct was unobstructed in Pingyang group,the mucosa epithelial cells proliferated with irregular structure,few epithelial cells were immersed in soft tissue,the infiltration of inflammatory cells in sub-epithelium was seen;The infiltration of inflammatory cells in lacrimal sac was seen,the mucosa epithelium was mostly lost,some blood and collagen were exudated,lacrimal sac was obstructed with obvious atrophy,no obvious adhesion with the surrounding tissue was seen. Conclusion Fosfomycin sodium glucose sclerotherapy for rabbit lacrimal duct has better blocking effect,injection of 2 weeks can lead to atrophy of lacrimal sac,and the efficacy and safety are superior to pingyangmycin,especially applicable to the elderly patients with chronic dacryocystitis,which can not be implemented or not willing to operation with systemic complications,and has the important clinical value.

眼睑赘皮是东方人常见的一种眼睑异常,尤以儿童多见,表现为上睑和(或)下睑越过睑缘的水平皮褶,睫毛后倾摩擦结膜和角膜.大部分患儿没有症状,且有随年龄增长而自愈的倾向,但也有部分患儿反复出现角膜糜烂,严重的还会影响视功能.关于眼睑赘皮的治疗方法、手术指征及手术时机的选择目前国内尚无统一的标准,且临床上常被误诊为睑内翻.本文结合国内外近年的研究进展,简要阐述了眼睑赘皮的流行病学特点、发病机制、临床特征和治疗方法等.

例1 患者女,62岁,因左眼流泪、流脓1年于外院诊为慢性泪囊炎,多次行泪道冲洗无效,于2009年1月来本院门诊检查,左眼上泪小点呈鱼嘴样噘起,生理盐水冲洗上泪小点,反流伴脓液,下泪小点冲洗通畅.挤压上泪小管可见豆渣样脓性分泌物溢出,伴异味,细菌培养阴性,诊断左眼慢性上泪小管炎.无菌条件下行上泪小点和泪小管切开,术中发现上泪小管膨大,内有大量灰白色豆渣样物质,用刮勺清除脓性物质后,以庆大霉素稀释液2 mg/ml冲洗,术后局部滴用左氧氟沙星滴眼液.术后第1天,于切开的上泪小管用庆大霉素稀释液冲洗,有少量豆渣样物冲出.术后第3天、第5天冲洗,均无脓性物质反流,上泪小管呈劈裂样,冲洗不通畅.随访10个月,无复发。

有研究表明,视神经损伤可以引起视网膜干细胞标志物表达增多[1,2].为进一步了解视神经损伤激活视网膜干细胞情况,我们应用液压冲击颅脑损伤仪(FPI)建立视神经损伤动物模型.观察胚胎视网膜十细胞同源转录因子(Chx10)和神经干细胞标志物巢蛋白(nestin)的表达,现将结果报道如下. 1 材料和方法

> 角巩膜裂伤在眼外伤中占很大比例,而有组织缺损的角巩膜裂伤并不多见,且伤口很难处理。2006年4月,我们收治1例利用翻转原位板层巩膜瓣修补邻近角巩膜缘组织缺损的患者,取得较好疗效。患者女性,46岁,因"左眼被拳击伤20 h",于2006年4月20日于我院眼科就诊。眼部检查:右眼裸眼视力1.0,左眼为手动/30 cm。右眼角膜透明,前房深浅正常,瞳孔圆,对

眼部整形美容学是全身整形美容学中独立存在的一个专业性很强的学科,它是以眼科专业理论为基础,结合人体美学、容貌美学理论,运用医学审美与外科相结合的手段,来增强眼部的容貌美观和/或矫治眼部的一些先天或后天的畸形.

例1 女 74岁因双眼逐渐视力下降10年,于2004年4月5日来我院就诊.既往高血压史25年,结肠炎术后4年.全身检查:血压160/85mmHg(1mmHg=0.133lPa),心电图示心肌缺血.视力右眼0.25,矫正0.5;左眼0.15,不能矫正.双眼结膜无充血,角膜透明,KP(一),房水闪光(一),前房深浅正常,瞳孔缘环形色素脱失,虹膜表面未见灰白色头皮屑样沉着物,瞳孔圆,直径3m,对光反应存在.

Objective To explore the effects of vitrectomy on neovascular glaucoma combined with vitreous hemorrhage. Methods Seven eyes of 7 patients with neovascular glaucoma combined with vitreous hemorrhage underwent vitrectomy combined with phacoemulsification, panretinal photocoagulation, and trabeculectomy. The preoperative visual acuity ranged from light perception to 0.2, and the mean preoperative intraocular pressure was 54 mm Hg (38-64 mm Hg)(1 mm Hg=0.133 kPa). The mean follow-up was 8 months (6-15 months). Results The postoperative visual acuity ranged from light perception to 0.4, and the mean postoperative intraocular pressure was 17 mm Hg (10-30 mm Hg) which was significantly lower than preoperative one ( P 0.05). The postoperative complications mainly included fibrosis exudates in anterior chamber (7 eyes), intraocular pressure elevation 1-2 weeks after the operation (2 eyes), and postoperative suprachoroid-cavity hemorrhage (2 eyes). Conclusion Vitrectomy combined with phacoemulsification, panretinal photocoagulation, and trabeculectomy may be effective procedures for some cases of neovascular glaucoma combined with vitreous hemorrhage.

Objective To report the surgical outcome of small incision trabeculectomy for closure angle glaucoma.Methods In a retrospective study, 50 patients (69 eyes) who had closure angle glaucoma and need filtering surgery were divided into two groups. Small incision trabeculectomy was performed on 27 patients(35 eyes) ,as observed group,complex trabeculectomy were performed on 23 patients(29 eyes) ,as contral group. Compared postoperative IOP and complication between the two groups.Results There was significant difference in IOP between two groups in first week after operation(P0.05),the observed group is higher than the control group; there was no significant difference in IOP after that by t test.Postoperative complications: early postoperative aqueous leakage and transient hyphema were same in two group;the observed group(6/35) was less than the control group (16/29) in shallow anterior chamber.Conclusion Small incision trabeculevtomy is more safe and simple than complex trabeculectomy and it can reach the same decreasing IOP level as complex trabeculectomy.

患者男,62岁.因左眼视力渐进性下降2年,加重1个月.于2001年3月以虹膜肿物、并发性白内障收入我院.眼部检查:视力右眼1.2,左眼眼前1 m指数.右眼正常.

目的评价玻璃体切割术治疗增生型糖尿病视网膜病变黄斑裂孔疗效,并分析有关因素.方法 12例增生型糖尿病视网膜病变黄斑裂孔患者接受玻璃体切割术治疗.硅油填充3眼,18%C3F8填充9眼.平均随访6个月(3～24个月).结果黄斑裂孔闭合率83%(10/12),视网膜复位率83%(10/12).术后视力提高10眼(83%,10/12),不变2眼(17%,2/12).并发症主要包括术后短暂高眼压2眼,晶状体核硬化3眼,视网膜脱离复发2眼.结论玻璃体切割术是治疗增生型糖尿病视网膜病变黄斑裂孔安全有效的方法.