泪囊鼻腔吻合术是治疗鼻泪管阻塞性疾病的主要方法，根据手术径路分为2种不同的术式：一种是以内眦皮肤为切口的外径路泪囊鼻腔吻合术；另一种是内镜下泪囊鼻腔吻合术。与前者相比，后者手术创伤小、不影响眼轮匝肌、适应范围广，随着技术的提高而逐渐成为治疗鼻泪管阻塞性疾病的主要手段。本文就鼻泪管阻塞的发病因素、泪道梗阻部位的确定、经鼻内镜下泪囊鼻腔吻合术（endoscopic dacryocystorhinostomy，EDCR）手术方式的选择、高位EDCR的手术技巧、EDCR手术疗效的判定标准和术后的随访与用药，对经鼻内镜泪囊鼻腔吻合术进行介绍。.

"今天我去我家旁边的医院检查,大夫说我得了白内障,明天我去北京找你做了吧?是不是我随去随做呢?听说手术可简单了,几分钟就完,比割鸡眼都省事."放下老家舅舅打来的电话,我感觉受到了"一万点暴击",虽然很无语,可品了品、再细品,也算有几分道理.点几滴麻药就能做,手术切口不到3毫米,术中基本不出血,似乎"闲庭信步间",白内障已"灰飞烟灭".这样的手术你敢说不算小手术?

Objective::To investigate the infection of demodex folliculorum in patients with Sj?gren's syndrome (SS), and to determine the correlative relationship between demodexin eyelashes and the ocular surface characteristics.Methods::In this case control study, 22 patients (44 eyes) with SS (SS group, study group) and 21 dry eye patients (42 eyes) without SS (non-SS group, control group) were recruited from Peking University People's Hospital from January to June 2019. The 5-item dry eye questionnaire (DEQ-5), ocular surface disease index, non-invasive tear meniscus height, non-invasive break up time, corneal staining score, the drop out of the upper meibomian gland and the number of demodex in eyelashes were examined in both groups. A t test was used to compare the continuous variables differences between the two groups, a Chi-square test and Fisher's exact test were used to compare the categorical variables between the two groups, and Spearman correlation analysis was used to determine the correlation between the continuous variables of the 2 different groups. Results::The number of mites in the non-SS group was significantly higher than that of the SS group ( Z=-2.41, P=0.021). The number of mites in the SS group was correlated with the score on the DEQ-5 scale ( r=0.40, P=0.02) and the drop out of the upper meibomian gland ( r=-0.70, P=0.02), while the number of mites in the non-SS group was only correlated with the score on the DEQ-5 scale ( r=0.63, P=0.04). There was a significant difference in the drop out of the upper meibomian gland between the Demodex positive group and Demodex negative group ( Z=3.214, P=0.002). Conclusions::The number of demodex in the SS group is lower than that in the non-SS group. The score on the DEQ-5 scale and the drop out of the upper meibomian gland are correlated with demodex in the eyelashes.

最近,以眼妆为重心的"口罩妆"迅速升温,眼影盘、眼线笔、睫毛膏、美瞳等产品销量也随之大幅增加.眼妆虽迷人,但你知道眼睛的感受如何吗? 涂在眼部的化妆品,主要包括眼线、眼影、睫毛膏.拿眼线为例,眼线的种类包括眼线笔、眼线液、眼线粉和眼线膏,它们的成分大致相同,包含氧化钛、液状石蜡滑石粉、半油酸酯、月桂酸锌、防腐剂、着色颜料、香料等.这些物质对身体未必"友好",如研究发现半油酸酯会造成敏感者皮肤过敏;月桂酸锌偏碱性,对表层皮肤有一定破坏作用,如果掉到眼睛里自然不好.

目的 探讨鼻内镜下高位泪囊鼻腔吻合术(dacryocystorhinostomy,DCR)治疗单纯性慢性泪囊炎的临床疗效.方法 2016年2月～2019年6月我院采用高位DCR治疗28例(32眼)慢性泪囊炎,术中通过定位泪囊于中鼻甲腋上方8 mm,咬除上颌骨额突,暴露Rosenmüller瓣膜以充分暴露泪囊,制备黏膜瓣以减少术后吻合口狭窄机会.术后采用Munk评分评估患者主观溢泪情况,泪道冲洗及鼻内镜下观察以评估吻合口通畅情况,综合评估手术疗效及随访患者的满意度.结果 术中均可顺利定位泪囊,27例(31眼)切开泪囊后可明确暴露Rosenmüller瓣,其中1例(1眼)经二次手术后才可暴露Rosenmüller瓣.28例术后随访9～48个月,中位数22个月.溢泪Munk评分中位数由术前4分(2～5分)降至术后1个月0分(0～3分)(Z=-4.987,P=0.000)和术后3个月0分(0～3分)(Z=-4.998,P=0.000);术后3个月后吻合口逐渐稳定,术后1个月与术后3个月Munk评分无明显变化(Z=-0.850,P=0.395).鼻内镜下见96.9％(31/32)患眼泪囊吻合口通畅且上皮化良好,泪道冲洗通畅.患者对手术效果满意度评分5分占92.9％(26/28).结论 高位DCR通过准确定位泪囊、暴露Rosenmüller瓣膜,明显改善单纯性慢性泪囊炎患者的溢泪情况,具有明显的临床疗效.

人们对眼妆的偏爱追洲起来,至少持续了3000年之久.公元前1000多年的古埃及,人们就开始了化妆.之后的妆容演变中,各种特点和风格的妆容层出不穷.2020年这一场疫情,让眼妆再再次成为美妆的中,心.新冠病毒迫使我们每个人出门都必须戴上口罩.口罩遮挡住了我们绯红的脸颊和火热的唇,只露出我们心灵的窗户.所以着重于眼妆的“口罩妆”, 一时间在各大美妆平台迅速升温,点击率持续攀高.数据显示,目前关于“口罩妆”已有6万+篇笔记,而关于眼妆文章的阅读量增速,远高于底妆和唇妆.

Objective:To investigate the role of conjunctival impression cytology in the diagnosis of Sj?gren's syndrome (SS) and the immunological factors influencing conjunctival lesions.Methods:A total of 57 patients complaining about dry eye were collected, including 38 patients with primary Sj?gren's syndrome (pSS) and 19 patients with non-SS. Conjunctival impression cytology tests were performed for all patients, and they were scored by the Nelson method. Thirty-one patients with SS underwent serological tests such as autoantibodies, immunoglobulins, and complement. The correlation between the relevant data was compared using the t test and the rank sum test. Results:The Nelson grade ≥2 is the positive cut-off value for the diagnosis of SS. The sensitivity was 68.4%, and the specificity was 89.5%, and the area under the receiver operating characteristic curve (ROC) was 0.767. In patients with SS, there was statistical correlation between the results of conjunctival impression cytology and antinuclear antibody (ANA) ( χ2=4.664, P=0.031), anti-SSA antibody ( χ2=8.58, P<0.01), anti-SSB antibody ( χ2=6.13, P=0.013), anti-SSA-52 antibody ( χ2=6.48, P=0.011), immunoglobulin (Ig)G ( t=-4.344, P<0.01) and rheumatoid factor (RF) ( U=25.0, P<0.01). Conclusion:Con-junctival impression cytology has certain value in the diagnosis of SS and can be used to evaluate conjunctival lesions in SS. Serum ANA, anti-SSA antibody, anti-SSB antibody, anti-SSA-52 antibody, IgG, and RF levels are significantly associated with the degree of conjunctival lesions, and can be considered as an indirect evidence of conjunctival involvement in SS.

俗话说,眼睛是心灵的窗户,随着年龄增长, “窗户”自身也会出现老化.有一种眼病,专挑老年人下手,它就是老年白内障.幸好,这种病治疗起来并不困难,大部分患者可以重获光明.围绕老年白内障的经典十问,让您一目了然.

目的 评估系统性红斑狼疮(SLE)患者体内细胞色素P450(CYP)3A5,CYP3A4,CYP2D6基因多态性对羟氯喹(HCQ)血药浓度的影响.方法 收集130例服用羟氯喹大于1年以上的SLE患者,用高效液相色谱法对其体内羟氯喹浓度进行测定,通过Sanger法测定患者的CYP3A5,CYP3A4,CYP2D6基因型,并分析每个基因型与羟氯喹血药浓度的关系.结果 共有130例患者纳入研究.CYP3A5(rs776746)各基因型组中,野生纯合子(TT)组、突变杂合子(TC)组、突变纯合子(CC)组的羟氯喹血药浓度分别为(410.5±112.2),(1368.8±218.3),(1980.8±644.7)ng·mL-1,3组间差异均有统计学意义(均P<0.05);CYP3A4 rs28371759基因的突变杂合子组的羟氯喹血药浓度为(8319.9±7246.4)ng·mL-1,明显高于野生纯合子组(1470.3±219.4)ng·mL-1,组间差异有统计学意义(P<0.05).CYP2D6 rs1065852各基因型组中突变纯合子组(GG组)的羟氯喹血药浓度最高为(2089.8±479.4)ng·mL-1,野生纯合子组(AA)组血药浓度最低为(1103.1±198.9)ng·mL-1,差异有统计学意义(P<0.05).CYP2D6 rs1135840各基因型组之间的羟氯喹血药浓度分别为(1423.9±198.8)和(1716.0±654.7)ng·mL-1,差异无统计学意义(P>0.05).结论 中国SLE患者中CYP3A5*3、CYP3A4*18B、CYP2D6*10基因多态性与羟氯喹血药浓度有关.基因多态性解释不同患者服用相同剂量和频次的羟氯喹表现出波动的血药浓度的原因.建议口服羟氯喹前进行药物基因检测.

Background Ultraviolet radiation is one of factors of the formation of age-related cataract.Indole-3-carbinol(I3C) is a plant chemical material with inhibitory effect on oxidative-induced cell damage and formation of amyloid fibrils,and the oxidative damage and amyloid fibrils are associated with cataract.However,the relationship between I3C and α-crystallin is in study. Objective This study was to evaluate the effects of ultraviolet-B laser irradiation on the secondary structure of α-crystallin and to explore the protection of I3C to chaperone activity of α-crystallin. Methods The fresh eyeballs were obtained from 1-year-old cattle to prepare the purified lens α-crystallin by gel chromatography.α-Crystallin was isolated from cattle lenses using gel chromatography.The purified α-crystallin was collected using fast protein liquid chromatography ( FPLC ) and exposed to 1:308 nmultraviolet-B at different irradiation intensities ( 23.75,118.75,475.00,1187.50,2375.00,4750.00,11 875.00,23 750.00 mJ/cm2 ) and then to ultraviolet-B 2:308 nm with irradiation intensities of 28 535.00,6730.00,3435.00,1910.00,1040.00 mJ/cm2.Ultraviolet-absorbance spectra,tryptophan fluorescence and N-formylkynurenine (N-FK)fluorescence spectra of both irradiated and non-irradiated α-crystallin were measured.I3C at the concentrations of 50 μmol/L and 100 μmoL/L were added to the α-crystallin solution to perform a catalase (CAT) thermal aggregation to confirm the chaperone activity of the α-crystallin,and the α-crystallin solution without any I3C was used as control.The ratios of A360 between various intervene groups with control group were calculated using spectrophotometry.Results The A280 values of the α-crystallin declined to 10％ at the ultraviolet-B irradiation intensity of 1187.5 mJ/cm2 and that at the intensity of 23.75 J/cm2 lowed to 2％.A negative correlation was seen between the ultraviolet-B irradiation intensity and the A280 value of the α-crystallin (R2=0.925 ) and a positive correlation was found between ultraviolet-B with N-FK ( R2 =0.949 ).Ultraviolet-B irradiation intensity showed a negative correlation with Trp fluorescence intensity (R2 =0.996 ).CAT hot condensed experiment revealed that after addition of different concentrations of indole-3-carbinol,the relative A360 values at various ultraviolet-B irradiation group were significantly higher than those of the control group (P =0.000),and the decreasing degree of chaperone activity of α-crystallin was lower than that of the control group ( P =0.000 ). Conclusions The study suggests that I3C can protect the chaperone activity of α-crystallin from photooxidation,and the ultraviolet-B laser may be a good exposure source compared with ultraviolet lamp.The ultraviolet-B laser irradiation causes the alteration of structure and chaperone activity of α-crystallin.