目的:探讨金银花提取物对脂多糖(LPS)诱导的急性前部葡萄膜炎(AAU)小鼠的抗炎作用,并阐明其作用机制.方法:将50只BALB/c小鼠随机分为对照组,模型组,低、中和高剂量金银花提取物组,每组10只.低、中和高剂量金银花提取物组小鼠灌胃给予250、500和750 mg·kg-1金银花提取物,对照组和模型组小鼠均给予等体积生理盐水.连续给药15 d后,除对照组外其余各组小鼠于玻璃体腔内注射125 mg·L-1LPS建立小鼠AAU模型.采用HE染色观察小鼠眼组织病理形态表现,采用实时荧光定量PCR法(RT-qPCR)和Western blotting法检测小鼠眼组织中Toll样受体4(TLR4)及核因子κB(NF-κB)mRNA和蛋白表达水平,采用酶联免疫吸附测定法(ELISA)检测小鼠眼组织中肿瘤坏死因子α(TNF-α)、白细胞介素6(IL-6)和白细胞介素10(IL-10)水平.结果:对照组小鼠眼组织结构完整,无炎症细胞浸润;模型组小鼠视网膜水肿,葡萄膜组织中出现大量炎症细胞浸润;与模型组比较,低、中和高剂量金银花提取物组小鼠葡萄膜组织中炎症细胞浸润不同程度减轻.与对照组比较,模型组小鼠眼组织中TLR4及NF-κB mRNA和蛋白表达水平明显升高(P<0.05),TNF-α、IL-6和IL-10水平明显升高(P<0.05);与模型组比较,低、中和高剂量金银花提取物组小鼠眼组织中TLR4及NF-κB mRNA和蛋白表达水平明显降低(P<0.05),TNF-α、IL-6和IL-10水平明显降低(P<0.05);与低剂量金银花提取物组比较,中和高剂量金银花提取物组小鼠眼组织中TLR4及NF-κB mRNA和蛋白表达水平明显降低(P<0.05),TNF-α、IL-6和IL-10水平明显降低(P<0.05);与中剂量金银花提取物组比较,高剂量金银花提取物组小鼠眼组织中TLR4及NF-κB mRNA和蛋白表达水平明显降低(P<0.05),TNF-α、IL-6和IL-10水平明显降低(P<0.05).结论:金银花提取物可通过TLR4/NF-κB信号通路下调炎症细胞表达,减轻AAU小鼠的眼部组织炎症反应,且呈剂量依赖性.

目的 观察超声乳化晶状体摘除加人工晶体植入联合小梁切除术治疗白内障合并急性闭角型青光眼的效果及安全性.方法 选取符合纳入及排除标准的白内障合并急性闭角型青光眼86例(98眼),根据治疗方法不同将其分为观察组43例(52眼)和对照组43例(46眼).观察组采用超声乳化晶状体摘除加人工晶体植入联合小梁切除术治疗,对照组采用单独小梁切除术治疗.观察比较两组术前及术后1个月视力、眼压及超声生物显微镜测量指标[中央前房深度(ACD)、房角开放距离500(AOD500)、小梁虹膜角(TIA)、小梁睫状体距离(TCPD)]水平,以及术后1个月并发症发生情况.结果 术前,两组视力、眼压及超声生物显微镜测量指标比较差异均无统计学意义(P>0.05).术后1个月,两组视力均较术前升高,眼压均较术前降低;且观察组视力明显高于对照组,眼压明显低于对照组,差异有统计学意义(P<0.05).术后1个月,观察组ACD、AOD500、TCPD较术前延长,TIA较术前增大;观察组超声生物显微镜测量指标均较对照组明显改善,差异有统计学意义(P<0.05).术后1个月,观察组总并发症发生率低于对照组,差异有统计学意义(P<0.05).结论 超声乳化晶状体摘除加人工晶体植入联合小梁切除术治疗白内障合并急性闭角型青光眼可提高患者视力,降低眼压,改善房角结构,减少手术并发症发生,应作为白内障合并急性闭角型青光眼的首选术式.

目的 探讨血红素氧合酶(HO)-1在糖尿病大鼠视网膜中的表达及意义.方法 30只大鼠根据随机数字法分为对照组(正常大鼠)、糖尿病组(糖尿病模型)、氯高铁血红素(hemin)组(糖尿病模型+hemin治疗).免疫荧光染色观察视网膜HO-1、核因子相关因子(Nrf)2、磷酸化细胞外调节蛋白激酶(pERK)表达,RT-PCR检测大鼠视网膜HO-1、Nrf2、pERK mRNA表达,Western印迹测定各组大鼠视网膜HO-1、Nrf2、pERK蛋白表达.结果 免疫荧光染色显示:HO-1为绿色荧光,Nrf2、pERK为红色荧光,对照组大鼠只检测到极少量的HO-1、Nrf2、pERK阳性表达.糖尿病组大鼠HO-1、Nrf2、pERK阳性表达均增加,hemin组大鼠视网膜HO-1、Nrf2、pERK阳性表达明显增加.糖尿病组、hemin组大鼠视网膜HO-1 mRNA和HO-1蛋白相对表达量均显著高于对照组(P<0.05),hemin组大鼠视网膜HO-1 mRNA和HO-1蛋白显著高于糖尿病组(P<0.05).糖尿病组、hemin组大鼠视网膜Nrf2 mRNA和Nrf2蛋白相对表达量均显著高于对照组(P<0.05),hemin组大鼠视网膜Nrf2 mRNA和Nrf2蛋白显著高于糖尿病组(P<0.05).糖尿病组、hemin组大鼠视网膜pERK mRNA和pERK蛋白相对表达量均显著高于对照组(P<0.05),hemin组大鼠视网膜pERK mRNA和pERK蛋白显著高于糖尿病组(P<0.05).结论 糖尿病大鼠视网膜HO-1水平升高,HO-1水平升高可能通过Nrf2/ERK信号通路对糖尿病视网膜发挥保护作用.

BACKGROUND: Studies have found that chondroitin sulfate proteoglycans degradation with chondroitinase canpromote the migration of Müller cells on the retina, but whether it could promote the migration of adipose-derivedmesenchymal stem cells in retinal degeneration rats is unclear.OBJECTIVE: To investigate the effect of chondroitin sulfate proteoglycans degradation with chondroitinase on adipose-derived mesenchymal stem cell treatment for retinal degeneration in rats.METHODS: Human adipose-derived mesenchymal stem cells were isolated and cultured. A retinal degeneration ratmodel was established followed by administration of adipose-derived mesenchymal stem cells+chondroitinase into thesubretinal space. The migration of adipose-derived mesenchymal stem cells and retinal cell apoptosis in rats aftertransplantation were observed.RESULTS AND CONCLUSION: The human adipose-derived mesenchymal stem cells could be successfully cultured.The labeling rate of BrdU to the human adipose-derived mesenchymal stem cells was more than 90.0%. At 7 days aftermodeling, the outer nuclear layer of the retina was collapsed, and a large amount of photoreceptor cells were dissected.The outer nuclear layer was attached to the Bruch''s membrane, and the retina was arched. The central retina andperipheral retina were damaged. In normal rats, the retinal layers were clear, and the photoreceptor cells arrangedregularly; and the retinal pigment epithelium was complete. The migration rate of adipose-derived mesenchymal stemcells in adipose-derived mesenchymal stem cells+chondroitinase group was higher than that in adipose-derivedmesenchymal stem cells group (P < 0.05). There was no significant difference in the apoptotic rate of retinal cellsbetween the two groups (P > 0.05). These experimental findings show that chondroitin sulfate proteoglycans degradationwith chondroitinase can enhance the migration ability of human adipose-derived mesenchymal stem cells on the retina.

BACKGROUND:Autologous hard palate mucosa has been validated to be a substitute of the tarsal conjunctival. OBJECTIVE:To investigate the treatment outcomes of autologous hard palate mucosa applied in the eyelid reconstruction. METHODS:180 patients (180 eyes) with eyelid defects aged 10-63 years old were recruited, including 122 males and 58 females, and subjected to the transplantation of autologous hard palate mucosa. In the same time, flaps were designed and transferred into the defected eyelid soft tissues. All patients were followed up for over 3 months to observe the treatment outcomes. RESULTS AND CONCLUSION:Three months after surgery, viscous secretions were found in the implanted region and conjunctival sac, which were relieved and eliminated by usage of antibiotic drops. All implanted hard palate mucosa survived within 1 year, neither infections nor falling off occurred, and blood vessels growth into the implant-tissue conjugation that inosculated with the host vessels presenting no rejection. The implants revealed different degrees of shrink in 132 patients, but the eye function was normal. During the hospitalization, some uncomfortable feeling such as eye pain had been relieved, and the wound showed no infections and healed well. During the follow-up, there were eight patients with slight lower eyelid ectropion and three with hypophasis. The length or height difference of both eyelids was within 2 mm, except those who lost eye bal s. These results suggest that autologous hard palate mucosa achieve satisfactory outcomes in the eyelid reconstruction and possesses good histocompatibility.

目的 评价伴有角膜规则散光的白内障患者植入散光多焦人工晶状体的效果.方法 在这项前瞻性非随机性研究中,我们选取伴有角膜规则散光的白内障患者,术前均佩戴眼镜矫正屈光不正.在所有手术患者中均植入ACRYSOF IQ ReSTOR Multifocal Toric IOL人工晶状体于后囊袋中.术后三个月时,我们对人工晶状体的居中性,远中近视力,残余球镜,残余柱镜,对比敏感度进行了评价;给所有病人发放病人满意度和视觉感觉的调查问卷.结果 我们研究了19个病人（36只眼）.术前5米处平均矫正视力为0.1（±0.08）,30厘米处平均矫正视力0.08（±0.11）.术后36眼（100%）受试眼裸眼远视力大于等于0.5,25眼（69.44%）裸眼近视力大于等于0.5.术前平均散光是-2.19（±0.53）.经过3个月的随访,平均散光为 -0.44 D（±0.27）（P〈0.001）.对比敏感度升高.在最后的随访中,87.5%病人能够脱离眼镜,远中近视力均良好.约34%的患者报告晕、眩.结论 散光多焦人工晶状体对白内障伴角膜散光的患者是一种简单,安全,准确的选择.这种操作使患者在生活质量上得到了很大的提高.

Objective To detect the macular retinal thickness,best corrected visual acuity (BCVA),diopter and eye axis length of children with hyperopic amblyopia,exploring the morphological changes of amblyopic retina,expecting new evidence for diagnosis and treatment.Methods Children from the department of ophthalmology in the First Hospital of Hebei Medical University from January 2013 to June 2015,whose clinical datas were recorded.Finally according to the criteria of expert consensus,96 children (ages 4-10 years) meeted the inclusion criteria were selected,including 48 cases (91 eyes) with hyperopic amblyopia and 48 cases (96 eyes) of normal control of healthy children in the department of ophthalmology in our hospital during the same period.The BCVA and diopter for all children were given by the same optometrist detection.Binocular macular retinal thickness of all children were carried out by frequency domain OCT examination.The retinal thickness in all macular areas (A1-A9) were recorded.All eye axis length were measured with IOLMaster.Data were compared by independent t test and Pearson correlation analysis.Results In the 2 groups the A1 area were the most thin (262±19 μm,250±20 μm),the difference between the 2 groups was statistically significant (t=2.93,P＜0.05);The thickness (A2-A5) of the inner loop was the most thick,which were (301±21 μm,305±22 μm),and there was no significant difference between the 2 groups (t=0.36,P＞0.05);The average thickness of the outer ring (A6-A9):(272±25 μm,269±17 μm),there was no significant difference between the 2 groups (t=0.21,P＞0.05).There was a positive correlation between macular thickness and corrected visual acuity (r=0.29,P＜0.05) within the lower region of the amblyopia group.There was a positive correlation between the macular thickness and diopter in the nasle side external ring (r=0.40,P＜0.01).A negative correlation and the axial length of the eyes (r=-0.40,P＜0.01).Conclusion Partial retinal macular thickness was different in children with hyperopic amblyopia.Those changes may be related to the pathogenesis of amblyopia.There was a correlation between macular thickness and corrected visual acuity,diopter,and axial length.

目的 观察白内障超声乳化联合前部玻璃体切除术后睫状沟内植入Toric散光晶状体(IOL)的效果.方法 选择白内障患者72例74眼,其中超声乳化术术中因后囊破裂行前部玻璃体切除术后睫状沟内植入Toric IOL 20例20眼(观察组),超声乳化术后顺利植入囊袋Toric IOL 52例54眼(对照组),比较两组术前最佳矫正视力及术后3个月裸眼视力、Toric IOL旋转度数.结果 两组术后3个月裸眼视力显著高于术前最佳矫正视力,角膜散光均较术前降低,P均<0.05;两组术后3个月裸眼视力、残留散光、IOL旋转度数及顺时针、逆时针旋转眼数比较,P均>0.05.结论 Toric IOL在白内障超声乳化联合前部玻璃体切除术后植入睫状沟与常规植入囊袋内效果无明显差异.

BACKGROUND: Spherical Toric intraocular lens can effectively correct the preoperative astigmatism of cataract patients, but it is unclear whether the aspheric Toric lens is better than the spherical Toric lens to improve the quality of vision. OBJECTIVE: To evaluate the optical quality after implantation of aspheric toric intraocular lens in cataract surgery. METHODS: Seventy-three cataract patients with corneal astigmatism (80 eyes) were enrol ed, including 37 males and 36 females, aged 47-83 years. Among them, 36 cases were implanted with aspheric Toric intraocular lens (test group), and the other 37 cases were implanted with spherical Toric intraocular lens (control group). Postoperative examinations were performed at 3 months, including axial intraocular lens, uncorrected visual acuity, corrected visual acuity, residual astigmatism, contrast sensitivity, and wavefront aberration. RESULTS AND CONCLUSION: Three months after implantation, the axial view, uncorrected visual acuity, corrected visual acuity and residual astigmatism showed no differences between the two groups; no shape deviation and lens decentration occurred; there was no case required to remove the lens or subjected to secondary adjustment. In the test group, the moderate and high spatial frequency contrast sensitivity at the scotopic or scotopic glare state was significantly higher than that in the control group (P < 0.05), the total higher order aberrations and spherical aberrations at a pupil diameter of 5.0 mm and spherical aberration at a pupil diameter of 3.0 mm were significantly less than those in the control group (P < 0.05). Additional y, there were no differences in scattering index, cut-off frequency of the modulation transfer function, Strehl ratio and visual acuity at 9%, 20% and 100% contrast between the two groups. These findings indicate that the aspheric and spherical toric intraocular lenses have similar effects in improving the astigmatism and raising the uncorrected visual acuity, but the former one is superior to the latter one in improving scotopic vision, and total higher order aberrations and spherical aberrations.

BACKGROUND:Monofocal and multifocal Toric intraocular lens that have been widely used in clinic exhibit xcelent biological and optical characteristics and have good safety and stability after implantation. OBJECTIVE:To compare the outcomes and rotation stability in patients with cataract and astigmatism after implantation of monofocal and multifocal intraocular lens. METHODS:A total of 210 patients with cataract and astigmatism who received phacoemulsification and intraocular lens implantation were included in this study. Of them, 105 patients were assigned to monofocal intraocular lens implantation and the other 105 patients to multifocal intraocular lens implantation. Uncorrected visual acuity, best corrected visual acuity, residual astigmatism were reexamined at 1, 3 weeks and 1 month after surgery. The rotation of Toric intraocular lens was determined. The incidence of complications and spectacles- independent rate were recorded. RESULTS AND CONCLUSION:Visual acuity and residual astigmatism in each group were significantly improved after 1 week of intraocular lens implantation (P < 0.05); furthermore, these two indicators became better over time. Improvement of visual acuity and residual astigmatism in multifocal intraocular lens group was more obvious than that in monofocal intraocular lens group. Postoperative intraocular lens rotation at < 5° occurred in both groups. The intraocular lens rotation degree in multifocal intraocular lens group was higher than that in monofocal intraocular lens group at different time points (P < 0.05). There were no significant differences in incidence of complications and spectacles-independent rates between two groups at 1 month after surgery. These results demonstrate that&nbsp;multifocal Toric intraocular lens provides better visual acuity and residual astigmatism improvement, while monofocal Toric intraocular lens provides better rotation stability.

Objective To study trabeculectomy combine phacoemulsification and intraocularlens implantation influence on optic nerve. Methods The study groups （primary closed-angle glaucoma） include A group （phacoemulsification and intraocular lens implantation n = 40） ; B group （ trabeculectomy n = 30） ; C group （trabeculectomy combine phacoemulsifieation and intraocular lens implantation n = 35 ） ; D group （ phacoemulsification and intraocular lens implantation after trabeculectomy n = 38 ）. Each group were measured blood flow index with color doppler flow imaging before three-days and after one-week and three-months, record visual acuity, IOP, ACD, C/D, measure field of vision. Results Hemodynamics show that blood flow index was improved after conjoined operation evidently, become statistically significant. ACD were deepen evidently, become statistically significant. Conclusion Trabeculectomy combine phacoemulsification and intraocular lens implantation can cut down the IOP sure and stably, so it can preserve the optic nerve and the visual acuity. Key words: combined operation ;  glaucoma;  cataract;  hemodynamics

各种原因所致的角膜穿孔伤为眼科急症.穿孔可以引起浅前房、低眼压、虹膜后粘连等,若不迅速妥善处理,会引起眼内感染、低眼压性黄斑水肿或继发性青光眼,甚至失明.

泪小管断裂是眼外伤常见的疾病,内眦部睑部外伤常伴有泪小管断裂,如不如期吻合,可造成泪溢并影响美观.我院2004年7月至2007年7月共收治外伤性泪小管断裂42例,均行泪小管断裂吻合术,报告如下.

Objective To investigate the treatment of traumatic hyphema of children. Methods All the 86 cases (86 eyes) were selected from the patients who were admitted to our hospital from 2005 to 2007. Results Among the 86 cases,77 cases of traumatic hyphema were complete absorption,6 cases were performed puncture of anterior chamber,3 cases were performed trabeculectomy.The visual acuity of most patients recovered up to more than 0.5. Conclusions The effecttiveness that traumatic hyphema of children were done rational therapy was satisfactory.

目的 探讨眼球钝挫伤前房积血的治疗方法.方法 对66例眼球钝挫伤前房积血患者的临床资料进行回顾性分析.结果 66例前房积血患者,经治疗完全吸收56例(89.53%),行前房穿刺冲洗术8例(6.98%),行小梁切除术2例(3.49%).视力恢复<0.3者4例(6.06%),0.3～0.5者23例(34.85%),0.5～1.0者33例(50%),＞1.0者以上16例(24.24%).结论 眼球钝挫伤前房积血经合理治疗效果是满意的.