Objective:To investigate the efficacy of triamcinolone acetonide injection behind the eyeball in the treatment of Purtscher disease and its effects on vision, inflammatory factors, nitric oxide (NO) and endothelin-1 (ET-1) of aqueous fluid.Methods:A total of 64 patients with Purtscher disease admitted to First People′s Hospital of Lanzhou City from January 2016 to January 2020 were selected and divided into two groups by random number table, with 32 cases in each group. The control group was given conventional treatment, and the observation group was injected with triamcinolone acetonide behind the eyeball on this basis. The total effective rate after 6 weeks of treatment, the best corrected visual acuity and hemodynamic indicators peak flow velocity (V max), end-diastolic flow velocity (V min), resistance index (RI) of ophthalmic artery and central retinal artery during systole, aqueous humor inflammatory factors tumor necrosis factor-α (TNF-α), interleukin (IL)-1β, IL-2, IL-6, NO, ET-1, and adverse reactions after 3 and 6 weeks of treatment were compared between the two groups. Results:After 6 weeks of treatment, the total effective rate in the observation group was higher than that in the control group: 96.9% (31/32) vs. 75.0% (24/32), and the difference was statistically significant ( χ2 = 4.655, P<0.05). After 3, 6 weeks of treatment, the best corrected visual acuity in the observation group was higher than that in the control group: 0.44 ± 0.13 vs. 0.35 ± 0.12, 0.88 ± 0.16 vs. 0.62 ± 0.15, and the difference was statistically significant ( P<0.05). After 3, 6 weeks of treatment, the V max and V min of the ophthalmic artery and central retinal artery in the observation group were higher than those in the control group: after 3 weeks of treatment: (29.42 ± 0.93) cm/s vs. (28.65 ± 0.90) cm/s, (8.04 ± 1.08) cm/s vs. (6.95 ± 1.12) cm/s, (8.42 ± 1.21) cm/s vs. (8.39 ± 1.19) cm/s, (4.05 ± 0.61) cm/s vs.(3.58 ± 0.57) cm/s; after 6 weeks of treatment: (31.72 ± 1.03) cm/s vs. (29.58 ± 0.95) cm/s, (9.81 ± 1.06) cm/s vs. (7.78 ± 1.15) cm/s, (12.01 ± 1.23) cm/s vs. (10.82 ± 1.07) cm/s, (4.65 ± 0.47) cm/s vs. (4.02 ± 0.36) cm/s; the RI of the ophthalmic artery and central retinal artery in the observation group were lower than those in the control group: after 3 weeks of treatment: 0.76 ± 0.06 vs. 0.80 ± 0.05, 0.70 ± 0.03 vs. 0.76 ± 0.04; after 6 weeks of treatment: 0.71 ± 0.05 vs.0.75 ± 0.04, 0.68 ± 0.04 vs.0.72 ± 0.03, and the differences were statistically significant ( P<0.05). After 3 and 6 weeks of treatment, the levels of TNF-α, IL-1β, IL-2, IL-6 of aqueous fluid in the observation group werelower than those in the control group: after 3 weeks of treatment: (2.61 ± 0.38) μg/L vs.(4.75 ± 0.41) μg/L, (3.45 ± 0.28) μg/L vs.(6.28 ± 1.05) μg/L, (6.28 ± 0.34) μg/L vs. (9.45 ± 1.14)μg/L, (9.82 ± 1.66) ng/L vs. (12.45 ± 2.31) ng/L; after 6 weeks of treatment: (0.98 ± 0.23) μg/L vs. (1.44 ± 0.27) μg/L, (1.11 ± 0.36) μg/L vs. (1.69 ± 0.38) μg/L, (3.68 ± 1.02) μg/L vs. (5.73 ± 1.15) μg/L, (4.11 ± 1.19) ng/L vs. (7.38 ± 1.06) ng/L, and the differences were statistically significant ( P<0.05). After 3, 6 weeks of treatment, the levels of NO in the observation group washigher than that in the control group: (56.49 ± 9.17) μmol/L vs. (50.22 ± 8.68) μmol/L, (60.18 ± 8.27) μmol/L vs. (53.24 ± 7.96) μmol/L; the levels of ET-1 waslower than that in the control group: (60.77 ± 9.61) ng/L vs. (65.02 ± 10.85) ng/L, (56.59 ± 7.22) ng/L vs. (61.18 ± 6.76) ng/L, and the differences were statistically significant ( P<0.05). The incidence of adverse reactions in the two groups had no statistical significance ( P>0.05). Conclusions:The injection of triamcinolone acetonide behind the eyeball to treat Purtscher disease can improve ocular hemodynamics, inhibit inflammation, improve vascular endothelial function and improve visual acuity. It has significant curative effect and certain safety.

目的 通过对合并睑板腺功能障碍的白内障患者进行手术前、后眼表的检查评估,分析睑板腺功能状态在白内障手术围手术期的重要性.方法 选取2017年3月1日-2017年4月1日在兰州市第一人民医院眼科行白内障超声乳化手术的患者120例(120只眼),按照术前有无睑板腺功能障碍(MGD)分为2组,A组为睑板腺功能正常组,B组为合并MGD组,均由同一医师按照顺序及流程在术前、术后1周进行快速干眼评估问卷调查(SPEED)、泪膜脂质层厚度测量(LLT)、泪膜破裂时间(BUT)、泪液分泌试验(SIT)、睑板腺分泌的评估(MGE)检查.结果 手术前B组的各项眼表评估数据均明显异常,与A组相比较有统计学意义(tsPEED=--35.042,tLLT=10.959,tBUT=48.915,tSn=7.914,tMGEE=25.924,均P＜0.05);手术后B组的各项眼表评估数据与A组比较有统计学意义(tsPEED=-23.729,tLLT=16557,tBUT=25.621,tSIT=9.064,tMGE=26.005,均P＜0.05);手术后B组的SPEED评分、LLT、BUT、SIT、MGE评分均发生明显变化,与术前比较有统计学意义(tsPEEDD=-8.664,tLLT=10.393,tBUT=5.373,tsIT=4.472,tMGE=9.292,均P＜0.05).结论 白内障手术可以加重合并睑板腺功能障碍患者的眼表状况,需重视围手术期眼表的评估.

Objective:To observe clinical effects of panretinal photocoagulation (PRP) combined with compound XueShuanTong capsules in the treatment of non proliferative diabetic retinopathy (NPDR).Methods:All 116 patients (116 eyes) were randomized into two groups.58 cases of the control group were treated by PRP only,while 58 cases of the observation group accepted PRP and oral administration of compound XueShuanTong capsules.The vision changes,clinical effects and retinal thickness of both groups were observed before and after treating.Results:Total effective rate of the observation group was 84.48％,higher than 62.07％ of the control group,and the difference had statistical meaning (P＜0.05).Total visual acuity of the observation group was 82.76％,higher than 56.90％ of the control group,and the difference showed statistical meaning (P＜0.05).The difference showed statistical meaning in the comparisons of retinal thickness before and after treating within the groups (P＜0.05);the difference indicated statistical meaning in the comparisons between both groups after treating at different times (P＜0.05).Conclusion:Oral administration of compound XueShuanTong capsules combined with PRP could improve therapeutic effects of NPDR.

白内障超声乳化手术的出现大大降低了老年性白内障的致盲率,因其切口小、反应轻、术后恢复快等优点在临床广泛应用,且逐渐从复明手术发展为以改善视功能为目的的屈光性手术,但同时伴随的角膜内皮细胞损伤,引起角膜水肿、角膜混浊,严重者甚至出现角膜内皮失代偿等并发症,对该手术方式的进一步发展提出巨大挑战.故如何减少术中及术后角膜内皮细胞的损伤,成为广大临床工作者研究重点.本文针对各种可引起角膜内皮细胞损伤的因素进行综述,并讨论相应解决方法.

目的 探讨白内障超声乳化手术联合术后激光光凝治疗老年白内障伴糖尿病黄斑水肿(DME)的凹视网膜厚度、眼压的相关性研究.方法 老年白内障伴DME患者72例,根据随机对照表分为对照组和试验组各36例,对照组均行标准化白内障超声乳化联合人工晶状体置入手术,试验组在对照组的基础上,于手术后1 w予以激光光凝治疗.治疗后对比分析两组临床疗效、视力提高率、中心凹视网膜厚度(CMT)、眼压降低、视力变化以及并发症发生率情况.结果 治疗后试验组临床总有效率、视力提高率高于对照组(P<0.05).两组CMT、眼压降低,且试验组低于对照组,视力提高,且试验组高于对照组(P<0.05).两组并发症发生率比较差异无统计学意义(P<0.05).结论 白内障超声乳化手术联合术后激光光凝治疗老年白内障伴DME的临床疗效显著,并发症发生率较低,适宜临床应用推广.

目的 观察对硬核白内障患者在行超声乳化术时采取高负压吸引下手法劈核技术治疗对减少术后并发症的意义.方法 86例(86眼)以硬核白内障为诊断且行手术治疗患者,随机分为劈核组与分核组,每组43例(43眼).劈核组采用高负压吸引下手法劈核法,分核组采用乳化分核法,均行超声乳化术.比较两组患者并发症情况及术后矫正视力.结果 两组患者均顺利完成手术.劈核组术中出现后囊膜破裂1例,分核组术中出现后囊膜破裂3例,比较差异无统计学意义(P>0.05);两组虽然术中出现并发症,但均顺利植入人工晶状体.劈核组术后出现轻、中、重度角膜水肿分别为3、1、0例,术后角膜水肿总发生率为9.30%;分核组术后出现轻、中、重度角膜水肿分别为1、6、9例,术后角膜水肿总发生率为37.21%;两组患者术后角膜水肿总发生率比较,差异具有统计学意义(P<0.01).轻、中度角膜水肿5 d内均消失,重度角膜水肿对症治疗后10 d内消失.劈核组矫正视力<0.5者9例(9眼,占20.93%),≥0.5且<1.0者5例(5眼,占11.63%),≥1.0者29例(29眼,占67.44%);分核组矫正视力<0.5者11例(11眼,占25.58%),≥0.5且<1.0者5例(5眼,占11.63%),≥1.0者27例(27眼,占62.79%);两组患者术后1周矫正视力比较差异无统计学意义(P>0.05).结论 患有硬核白内障患者采用高负压吸引下手法劈核超声乳化术,可有效降低术后并发症发生率,手术安全有效,值得临床推广应用.

原发性开角型青光眼是导致视网膜中央静脉阻塞，严重影响患者视力的高危因素之一。本文介绍1例由原发性开角型青光眼并发的视网膜中央静脉阻塞病例，通过介绍其发病及治疗过程，分析其发病原因，探讨如何有效防止类似病例再次发生及有效治疗方法。

Objective To research the recovery of the visual cortical function mediating visual motion perception in ametropic amblyopia after regular amblyopia treatment using 3.0 Tesla functional MRI (fMRI).Methods In this prospective study,blocks-designed fMRI experiment was performed on nine children with first was diagnosed as ametropic amblyopia,and review fMRI after one week,two weeks and one month.During the study,the patients were asked to view stimuli through rotating the checkerboard,which contrast ratio approach to 100％ and frequency approach to 8 Hz,Functional MRI data were processed by using SPM8 which based on the Matlab 7.12.The matrix data of each treatment stage were acquired bv hypothesisdriven research,and before and after self-control study (matched t-test) was performed in each group to acquire average cerebral cortex activated functional images data.The different mapping between each group during visual motion stimulus was also acquired.Results The functional area that is bilateral occipital lobe (Mean t of the right BA18=1.236 1 ;Mean t of the left BA18=1.521 1; Mean t of the right BA19=1.6845; Mean t of the left BA19=1.591 7,P＜0.005) and the visual association area (V5) (The right BA37 was activated and Mean T=1.201 4;The right BA21 was activated and Mean t=1.145 0,P＜0.005) expanded in different levels after amblyopia treatment two weeks; After four weeks,the bilateral occipital lobe (Mean t of the right BA18=1.0024; Mean t of the left BA18=1.743 1; Mean t of the right BA19=1.2253; Mean t of the left BA19=1.181 3,P＜0.005) showed activation on the small area compare with two weeks ago.Conclusion In the early functional training of the older children's ametropic amblyopia,reconstruction the visual cortical function mediating visual motion perception was more difficulty and unstable.

目的:探讨年龄相关性白内障的发生与晶状体前囊膜中P33ING1表达之间的相关性。方法:收集30例年龄相关性白内障及10例透明晶状体前囊膜,采用免疫组织化学法,分别观察透明晶体组和白内障组晶状体上皮细胞中P33ING1阳性表达水平。结果:白内障患者晶状体囊膜中P33ING1含量较正常人明显增高。结论:P33ING1在年龄相关性白内障的形成过程中起重要作用。

Objective:To compare the effect of postoperative visual acuity,corneal endothelial cells after the small incision extracapsular cataract extraction for different development stage of the age-related cataract. Methods:To Collect 148 age-related cataract cases in our hospital from 2009 to 2011 to hold small incision extracapsular cataract extraction,they were divided into two groups by crystal nucleus hardness, the preoperative and postoperative visual acuity,corneal edema and corneal endothelial cell density were analyzed respectively. Results:There are significant correlation in postoperative 3 days visual and crystal nucleus hardness,but no significant correlation in postoperative 1 week visual and crystal nucleus hardness; the two groups of corneal endothelial cell density analysis difference was statistically significance;the two groups of postoperative corneal edema degree difference have statistical significance. Conclusion:For crystal nucleus hardness higher age-related cataract patients,the small incision extracapsular cataract extraction influence the corneal endothelial and don't influence the visual acuity.

Objective:To study the influence of phacoemulsification for cataract surgery for count of corneal endothelial cells.Methods:64 patients with cataract in our hospital from January 2008 to December 2010 were selected as research object,and they were randomly divided into control group(small incision cataract extraction without ultrasonic phacoemulsification group) 32 cases and observation group(ultrasonic emulsification surgery group) 32 cases according the surgery methods,then the count and density of corneal endothelial cells,proportion of hexagonal cell of two groups before and after the surgery at third month were analyzed and compared.Results:The count and density of corneal endothelial cells,proportion of hexagonal cell of observation group after the surgery were all higher than those of control group,all P0.05,there were all significant differences.Conclusion:The harmful effects of phacoemulsification for cataract surgery for count of corneal endothelial cells is smaller than that of small incision cataract extraction without ultrasonic phacoemulsification.

目的探讨532氩激光治疗视网膜经脉阻塞的临床疗效。方法选取2008年1月至2011年2月于兰州市第一人民医院进行治疗的80例视网膜经脉阻塞患者为研究对象,将其随机分为对照组(药物治疗组)40例和观察组(532氩激光治疗组)40例,后将两组患者的治疗总有效率及并发症发生率进行统计及比较。结果观察组在各型视网膜经脉阻塞中总有效率均高于对照组,并发症发生率低于对照组,P均<0.05,均有显著性差异。结论 532氩激光治疗视网膜经脉阻塞的临床疗效较好,且安全性也较高,值得临床推广应用。