Objective To observe the characteristics of magnetic resonance angiography of(MRA) ophthalmic artery in patients with diabetic retinopathy (DR).Methods A total of 36 eyes of DR patients (DR group) diagnosed by clinical examination were included in the study.Among them,there were 42 eyes in 21 males and 15 eyes in 15 females.The average age was 55.2 years old.The average duration of diabetes was 7.56 years.All eyes were examined by MRA and fluorescein fundus angiography (FFA) in the ophthalmic artery.At the same time,24 eyes of 12 patients were examined by computed tomography angiography (CTA).Twenty-two healthy volunteers with age and gender matching were selected as the control group.Among them,there were 13 males and 9 females.All patients underwent MRA examination of the ophthalmic artery;at the same time,5 eyes of 5 eyes were examined by CTA.MRA and CTA were classified into three grades according to the development condition and shape change of the ophthalmic artery.0 grade:no abnormality;grade Ⅰ:mild lesion;grade Ⅱ:obvious lesion.According to the results of FFA examination,it was divided into no obvious disease stage,background stage,proliferative stage,proliferative stage.The morphological features of the MRA of the ophthalmic artery in the DR group and the control group were compared.The relationship between the MRA grading of the ophthalmic artery and the FFA staging was observed in the DR group.The consistency analysis between the MRA and CTA grades of the ophthalmic artery in the DR group was performed by Kappa test;the relationship between the MRA grade and the FFA staging of the ophthalmic artery was analyzed by Spearson correlation analysis of the same data with two-way ordered attributes.Results In 44 eyes of the control group,the MRA in grade 0 and Ⅰ of the ophthalmic artery were 41 and 3 eyes,respectively;all eyes of the CTA examination of the ophthalmic artery were grade 0.In 72 eyes of the DR group,the MRA in grade 0,Ⅰ,and Ⅱ of the ophthalmic artery were 28,28,and 16 eyes,respectively.Among the 24 eyes examined by CTA,there were 13,6,and 5 eyes in grade 0,Ⅰ,and Ⅱ,respectively.In the DR group,the classification of MRA and CTA of the ophthalmic artery was highly consistent (Kappa value =0.86).There were significant differences in the number of eyes with different grades of MRA in the DR group and the control group (Z=-5.74,P=0.000).In 72 eyes of the DR group,there were 8,12,22,and 30 eyes in no obvious disease stage,background stage,proliferative stage,and proliferative stage,respectively.Correlation analysis showed that there was a significant correlation between MRA grading and FFA staging in the DR group (r=0.405,P=0.000).Conclusions MRA can show the changes of ophthalmic artery morphology and reflect DR staging to a certain extent.It has a high consistency with FFA vascular changes.

目的 探究健康管理理念在体检服务中的应用效果.方法 选取2016年5—10月在河南省人民医院接受体检的400名体检者为研究对象,体检后给予其针对性的锻炼指导、人文关怀、健康教育等进行健康管理,1 a后观察记录体检人员的肥胖、高血压、糖尿病、心电图异常、尿蛋白阳性等的改善情况.结果 体检人员接受健康管理干预后的肥胖、心电图异常、尿蛋白阳性、亚健康发生率均低于干预前,差异有统计学意义(P均<0.05).体检人员接受健康管理前后高血压、糖尿病的发病率比较,差异无统计学意义(P均>0.05).结论 健康管理理念应用于体检服务中,可以提升人们的健康意识,预防和控制疾病的发生,值得推广应用.

目的：对糖尿病视网膜病变患者就诊情况进行调查，探讨其发病影响因素，为其防治提供依据。方法随机间断对2013年9月至12月河南省立眼科医院造影室糖尿病视网膜病变（2型糖尿病）患者80例进行问卷调查，通过询问获得患者就诊情况，眼底血管造影确定糖尿病视网膜病变分级。结果因不适或其他病就诊发现的糖尿病患者与日常体检发现的糖尿病患者视网膜病变的轻重相比，差异无统计学意义（P ＞0．05）。不同级别医院就诊的患者糖尿病视网膜病变轻重相比，差异有统计学意义（P ＜0．05），大部分患者首诊时，医师未告知其定期检查眼底。结论内分泌医师及患者对糖尿病视网膜病变的重视程度不足，延误了糖尿病视网膜病变的治疗。国家需加大公共卫生投入，加强对患者进行预防糖尿病视网膜病变教育。

目的 探讨近红外自发荧光(near-infrared autofluorescence,NIA)及眼底荧光血管造影(fundus fluorescein angiography,FFA)检查在黄斑脉络膜裂伤合并视神经钝挫伤中的临床意义.方法 对确诊为黄斑脉络膜裂伤合并视神经钝挫伤的16例(16眼)患者进行NIA和FFA检查,观察其眼底变化特点.结果 12眼黄斑脉络膜裂伤合并视网膜下出血,FFA示部分脉络膜裂伤被视网膜下出血所遮蔽而不能显影;4眼为单纯黄斑脉络膜裂伤,FFA晚期示脉络膜裂伤呈完整的条索状强荧光.16眼的NIA均可穿透斑片状视网膜下出血显示脉络膜裂伤形成的弧形或线形弱荧光.16眼NIA所测脉络膜裂伤长度为(1.47±0.48) mm,较FFA所测脉络膜裂伤长度(0.49±0.25) mm长,差异有统计学意义(t=13.15,P=0.00).结论 NIA可发现黄斑区视网膜下出血遮蔽的脉络膜裂伤,FFA可显示视神经钝挫伤,两者结合有助于及早确诊黄斑脉络膜裂伤合并视神经钝挫伤,为及时治疗提供帮助.

Objective To explore the clinical significance of near-infrared autofluorescence (NIA) combined with optical coherence tomography (OCT) in patients with choroidal rupture in the posterior pole of the retina.Methods Eleven (11 eyes) with choroidal rupture or combined with subretinal hemorrhage in the posterior pole of the retina were examined by fundus fluorescein angiography (FFA),NIA and OCT inspection,and recorded the results of the length of the choroidal rupture measured respectively on NIA and FFA images.Results Both FFA and NIA could show the choroidal ruptures in 8 patients with no subretinal hemorrhage,there were no significant differences between the two groups in the length measure of the choroidal rupture (t =1.06,P =0.31＞0.05).OCT could display the location of the choroidal rupture and the relationship with macular fovea from section.NIA combined with OCT could bring a three-dimensional evaluation and follow-up the change of subreitnal hemorrhage in 3 patients with choroidal rupture.The examination time of NIA combined with OCT was about 35.56％ of FFA,and the cost was about 38.64％ of FFA.Conclusions NIA and OCT are both noninvasive examination,NIA combined with OCT can bring a more simple and economic assessment patients with choroidal rupture or combined with subretinal hemorrhage in the posterior pole of the retina.

对患有眼底疾病的80岁及以上高龄患者,荧光素血管造影(FFA)和吲哚青绿血管造影(ICGA)是重要的诊断方法[1-2]。但眼底血管造影为有创性检查,存在一定的不良反应[3]。并且高龄患者常并存高血压、心脏病及肾病等全身疾病,其中一些严重全身疾病不符合FFA或ICGA检查的适应证[4,5]。近年推广的眼底自身荧光(FAF)、光相干断层扫描(OCT)等无创性光学影像学检查可以代替部分FFA检查[6,7]。对高龄患者眼底病所需检查进行分类,缩小FFA检查范围有助于降低其引

目的探讨纳米脂质体槲皮素（nanoliposomal quercetin,nLQ）联合8-Br-cAMP对培养的人Rb44细胞组蛋白脱乙酰化酶的抑制效应。方法将培养的Rb44细胞分为4组:nLQ组,以40μmol·L-1nLQ培养;8-Br-cAMP组:以20μmol·L-18-Br-cAMP培养;nLQ+8-Br-cAMP组;以40μmol·L-1nLQ和20μmol·L-18-Br-cAMP共培养;对照组:不加nLQ或8-Br-cAMP。应用MTT实验检测细胞生长抑制率（GSR）。应用免疫斑点印迹检氉测脱乙酰化酶抑制物、NF-κBp65、磷酸化IκBα及c-myc的表达。对表达的靶信号以图像分析仪扫描灰度值。结果与对照组相比,nLQ组和8-Br-cAMP组GSR达44%±1%和40%±1%,均为P＜0.05;nLQ+8-Br-cAMP组GSR达60%±1%,P＜0.01。nLQ组、8-Br-cAMP组、nLQ+8-Br-cAMP组与对照组相比,脱乙酰化酶抑制物、NF-κBp65及c-myc的表达均减低,均为P＜0.05;而磷酸化IκBα的表达均增强,均为P＜0.05。结论 nLQ联合8-Br-cAMP可下调脱乙酰化酶抑制物表达,上调磷酸化IκBα的表达同时可抑制NF-κBp65的表达。

目的 纳米脂质体槲皮素(nanoliposomal quercetin,nLQ)可抑制PI3K/AKt信号途径,8-Br-cAMP为PKA Ⅱ型激动剂,探讨二者协同诱导人视网膜母细胞瘤(retinoblastorma,Rb)44细胞的恶性逆转化效应.方法 将培养的Rb44细胞分为4纽:(1)加纳米脂质体槲皮素(终浓度为40 μmol·L-1)组(nLQ组);(2)加8-Br-cAMP(终浓度为20 μmol·L-1)组(Br组);(3)联合药物组(nLQ+Br组);(4)不加药物培养的对照组.以MTT实验检测培养的各组Rb44细胞生长抑制率,采用免疫细胞化学和蛋白质免疫斑点印迹检测PTEN、cyclin D1、c-myc、p21waf1、MMP9及VEGF的表达,原位杂交技术检测p16、Rb抑癌基因的表达.结果 MTT实验显示联合药物组的细胞生长抑制率显著高于任何单个药物组.与对照组相比,nLQ和8-Br-cAMP组明显抑制培养的Rb44细胞的生长,并呈现协同抑制效应.免疫细胞化学及蛋白质免疫斑点印迹显示:与对照组相比,cyclin D1、c-myc、MMP9、VEGF的表达下调,PTEN、p21waf1表达上调.原位杂交显示:与对照组相比,药物组的p16及Rb抑癌基因的表达上调.结论 nLQ或8-Br-cAMP可诱导人Rb44细胞恶性逆转化,且呈协同效应.

Behcet综合征是一种影响全身多器官的慢性疾病,我国属高发地区.本病累及眼与全身其他器官时,预后均不良,但临床上往往只注意眼部病变,忽略全身症状,故常误诊为虹睫炎及一般葡萄膜炎,影响了对其及时有效的治疗.本文对误诊原因进行分析,报告如下.

Objective: To clarify the effect of gene expression regulator on dynamics in HXO-Rb44 cells. Methods: The HXO-Rb44 cells in virvo were treated with all-trans retinoic acid and 8-Br-cAMP at dose of 1×10-5moI/L and 2×10-5moI/L respectively for 24 h、48 h、72 h. The proliferative cell nuclear antigen (PCNA) was detected byprotein dot blot, the cell cycle detected by flow-cytometry.Results: In AT-RA group and 8-Br-cAMP group the inhibition of Rb44 cell growth was demonstrated. The difference between experiment group and control group was significant,P0.01,besides, there was a negative correlation between PCNA-IR A value and the days (day 1, 2, 3, P0.01) . The effects of 8-Br-cAMP and AT-RA on the percentages of Go/G1 and S phases became increased and decreased respectively with the time lasted.Conclusion: The G1 block was induced and poliferation was inhibited by AT-RA and 8-Br-cAMP in HXO-Rb44 cells.

全反式维生素A酸(all-trans retinoic acid, AT-RA)能抑制肿瘤细胞的增殖而达到治疗肿瘤的目的[1,2].我们采用AT-RA对视网膜母细胞瘤(Retinoblastoma, RB)株进行增殖抑制的实验研究,以期探索肿瘤治疗的新途径.

目的通过检测基因表达调控物全反式维甲酸对HXO-Rb44细胞端粒酶活性及细胞周期变化的影响,探讨治疗视网膜母细胞瘤的新途径.方法将视网膜母细胞瘤株HXO-Rb44分为对照组及实验组,分别进行体外培养24、48、72 h后,以PCR-ELISA方法检测其端粒酶活性及用流式细胞仪检测细胞周期变化.结果实验组与对照组的端粒酶活性有显著差异(P＜0.01),实验组的端粒酶活性与药物作用时间之间,呈显著负相关(r=-0.775 6,F=33.216,P＜0.01).实验组细胞周期发生变动,即G1期比率上升,S期比率下降.结论基因表达调控物全反式维甲酸可减弱HXO-Rb44细胞端粒酶活性,影响其周期变化,抑制其增殖.

本文应用彩色多普勒血流显像(CDFI)对38例有长期吸烟病史的2型糖尿病(2-DM)患者眼内动脉血流动力学进行检测,评价其临床意义. 1资料与方法 1.1临床资料根据WHO(1999年)标准确诊的2-DM患者38例,均为长期吸烟血压正常的2-DM男性患者,年龄35～47岁,平均39.3岁;烟龄10～30年,平均21年.

目的通过检测中国汉族人视网膜色素变性患者的载脂蛋白Ｅ表型，探讨其基因变异与视网膜色素变性发病的关系。方法采用等电聚焦及免疫印迹方法检测正常人和视网膜色素变性患者的ａｏｐＥ表型。结果视网膜色素变性患者中ε４基因频率明显上升（χ２＝１２．９８３，Ｐ＜０．０１），ε２，ε３基因频率与正常对照组无差异。ａｏｐＥ ε４等位基因与视网膜色素变性的发病有关联（ＲＲ＝２５．０７１，Ｐ＜０．０１）。结论ａｏｐＥ ε４基因可能是视网膜色素变性发病的又一遗传因素。

端粒酶与肿瘤的增殖为近年研究领域的热点之一.端粒酶在肿瘤的发生、发展过程中起重要作用.它的活性是维持染色体长度和功能的重要保证.端粒酶激活可使细胞不断增殖而避免衰老死亡.因此可通过抑制或激活端粒酶活性应用于临床治疗.综述涉及端粒酶及其与肿瘤及有关眼科疾病的关系等.

目的: 通过检测中国汉族人视网膜色素变性患者的载脂蛋白E表型及孔源性视网膜脱离病人视网膜下液(SRF)及血液中载脂蛋白E(apoE)的含量,探讨载脂蛋白E与视网膜疾病的关系.方法: 采用等电聚焦及免疫印迹方法检测正常人和视网膜色素变性患者的aopE表型及ELISA方法测定孔源性视网膜脱离病人视网膜下液(SRF)及血液中载脂蛋白E(apoE)的含量.结果: aopE的ε4等位基因与视网膜色素变性的发病有关联(RR＝25.071 P＜0.01).SRF中apoE的含量与视网膜脱离的范围及时间相关(P＜0.01).结论: aopE的ε4基因可能是视网膜色素变性发病的又一遗传因素;apoE与孔源性视网膜脱离的损伤修复有关.

目的了解载脂蛋白AI(apoAI)、载脂蛋白B(apoB)与糖尿病视网膜病变的关系.方法用火箭免疫电泳法对24例2型糖尿病视网膜病变(DR)患者,28例2型糖尿病眼底正常者(DM)和50名健康者血液进行了载脂蛋白AI、载脂蛋白B的测定.结果 DR组的apoAI,apoAI/apoB值均低于DM组(P＜0.05及＜0.01),apoB值高于DM组(P＜0.01).结论载脂蛋白AI、载脂蛋白B代谢异常可能是糖尿病视网膜病变的致病因素之一.

目的 探讨氧化应力、5种抗白内障药物对晶状体一氧化氮合酶 (NOS)活性及一氧化氮 (NO)水平的影响。方法 建立晶状体温育模型 :培养液分 7组 :( 1)对照组含DMEM 10ml;( 2 )～ ( 7)组含DMEM 10ml外尚有 3 0 %H2 O2 0 2ml ,FeCL3 2mg ,并于 ( 3 )～ ( 7)组中分别加入海珠神、麝珠明目、益视安、晶福及视明露滴眼液各 1 0ml ,晶状体制备匀浆上清 ,测NOS ,NO ,MDA。结果 1.正常人、兔、SD鼠晶状体的NOS活性分别为 ( 6 45± 1 5 7)、( 18 0 3± 8 2 0 )、( 13 61± 2 13 )U/mgpro .,人、兔晶状体内均测不出NO ,而SD鼠NO为 ( 5 2 79± 2 0 79) μmol/mgpro .。 2 .氧自由基诱导温育晶状体NOS活性上升 1 5倍 (P <0 0 0 1) ,但晶状体内测不出NO。 3 .抗白内障药物影响NOS活性及NO水平 ,海珠神、麝珠明目、益视安及晶福组与氧化组相比显示抑制NOS活性 ,分别下降 15 % ,9% ,6%及 5 5 % ,而视明露组诱导NOS活性上升 41% (P <0 0 0 1)。 4.氧化组晶状体MDA上升 2 15倍 ,各抗白内障药物组MDA下降至对照组以下 ,证明 5种抗白内障药物都是抗氧化剂。结论 氧自由基诱导晶状体NOS活性上升 ,NO测不出。NO与白内障是否有关尚待深入研究。