AIM: To investigate the protective effect of heme oxygenase-1 (HO-1) against H2O2-induced apoptosis in human ARPE-19 cells. METHODS: The lentiviral vector expressing HO-1 was prepared and transfected into apoptotic ARPE-19 cells induced by H2O2. Functional experiments including cell counting kit-8 (CCK-8) assay, flow cytometry (FCM) and mitochondrial membrane potential assay were conducted. RESULTS: The ultrastructure of ARPE-19 cells was observed using transmission electron microscope (TEM). It was found that exogenous HO-1 significantly ameliorated H2O2-induced loss of cell viability, apoptosis and intracellular levels of reactive oxygen species (ROS) in ARPE-19 cells. The overexpression of HO-1 facilitated the transfer of nuclear factor erythroid-2-related factor 2 (Nrf2) from cytoplasm to nucleus, which in turn upregualted expressions HO-1 and B-cell lymphoma-2 (Bcl-2). Furthermore, HO-1 upregulation further inhibited H2O2-induced release of cysteinyl aspartate specific proteinase-3 (caspase-3). CONCLUSION: Exogenous HO-1 protect ARPE-19 cells against H2O2-induced oxidative stress by regulating the expressions of Nrf2, HO-1, Bcl-2, and caspase-3.

Objective:To investigate the protective effect of adeno-associated virus (AAV) vector-mediated heme oxygenase-1 ( HO-1) gene overexpression on retinitis pigmentosa (RP) models in rats. Methods:Eighty healthy male SD rats were selected and randomized into the blank control group, RP model group, AAV-GFP group and AAV-HO-1-GFP group, with 20 rats in each group.The RP model was established via tail vein injection of 1% sodium iodate solution at the dose of 50 mg/kg.Rats in the RP model group, AAV-GFP group and AAV-HO-1-GFP group were subretinally injected with normal saline, AAV-GFP virus and AAV-HO-1-GFP virus according to grouping.Rats in the blank control group were administrated with subretinal injection of equal volume of normal saline.The eyeballs of rats were enucleated on 14th day after molding.The retinal structure and thickness were detected by hematoxylin-eosin staining; apoptosis in retinal tissue was detected by TUNEL assay; the expression levels of cysteinyl aspartate specific proteinase 3 (caspase 3), B-lymphoma-2 (bcl-2) and HO-1 protein in rats retina was identified by Western blot.The use and care of the animals complied with the Statement of the Association for Research in Vision and Ophthalmology (ARVO). The study protocol was approved by an Ethics Committee of The Second Affiliated Hospital of Fujian Medical University (No.202188).Results:Hematoxylin-eosin staining results showed normal retinal structure in the blank control group, obvious retinal structure damage with thinned and wavy outer nuclear layer in the RP model group and AAV-GFP group, and mild retinal structure damage with slightly thinned outer nuclear layer in the AAV-HO-1-GFP group.Compared with the blank control group, the outer nuclear layer was significantly thinner in the RP model group and AAV-GFP group (both at P<0.05). Relative expression level of HO-1 protein in the RP model group, AAV-GFP group, and AAV-HO-1-GFP group was 0.76±0.21, 0.76±0.16, 0.92±0.05, respectively, which were all significantly higher than 0.48±0.25 in the blank control group (all at P<0.05). The relative expression level of HO-1 protein in the AAV-HO-1-GFP group was significantly higher than that in the RP model group and the AAV-GFP group (both at P<0.05). There were significant differences in apoptosis rate, the relative expression levels of bcl-2 and caspase 3 protein among the four groups ( F=1 596.333, 1 043.806, 364.331; all at P<0.01). The apoptosis rate and the relative expression level of caspase 3 were significantly higher, and the relative expression level of bcl-2 was lower in the RP model group and AAV-GFP group than those in the AAV-HO-1-GFP group (all at P<0.05). Conclusions:AAV-mediated overexpression of HO-1 gene can protect the retina of RP rats.

目的 观察改良睑板腺管针刺疏通法治疗早期急性睑板腺炎的效果.设计 前瞻性比较性病例系列.研究对象 2015年3月至2017年8月福建医科大学附属第二医院105例早期急性睑板腺炎患者.方法 按就诊单双日随机分为针刺组(56例)和对照组(49例).每组根据症状轻重和有无扩散分为重组和轻组.针刺组中重组31例、轻组25例;对照组中重组28例、轻组21例.针刺组采用改良睑板腺管针刺疏通法治疗,即梅花针从化脓的睑板腺(通常1～3个)腺管开口垂直缓慢刺入3～4 mm排脓.轻组配合改良睑板腺压榨法挤压,重组只轻轻按摩挤压,疏通开放睑板腺开口.对照组采用常规的保守治疗.平均随访时间(6.50±3.84)天.主要指标 治愈率.结果 针刺组总治愈率(92.86％)明显高于对照组(67.35％)(P=0.000).轻组治愈率针刺组(96.00％)高于对照组(80.95％)(P=0.04);重组治愈率针刺组(90.32％)高于对照组(57.14％)(P=0.000).针刺组病程(5.0±2.98)天,优于对照组的(8.4±3.86)天.针刺组的手术率(轻组4.00％、重组9.68％)均低于对照组(轻组23.81％、重组42.86％)(P均＜0.05).结论 采用改良睑板腺管针刺疏通法对早期急性化脓性睑腺炎能有效地对睑板腺腺管进行疏通排脓,缩短病程,减少手术切开率.

Demodex is a slender and chronic parasitic mite. Ocular demodex, which resides mainly in the follicles, meibomian gland and sebaceous gland, can cause foreign body sensations, eye itching, dry eye and other symptoms. In recent years, more and more literature has reported that demodex can cause a variety of eye diseases, such as blepharitis, meibomian gland dysfunction, chalazion, conjunctivitis, keratitis and pterygium. In addition, demodex is associated with the occurrence of basal cell carcinoma of the eyelid. As a pathogenic factor, demodex has attracted more and more attention from ophthalmologists. This review discusses the status of research on demodex-related eye diseases, in order to raise the awareness and attention of ophthalmologists.

AIM: To investigate the clinical value of epalrestat combined with compound anisodine in treatment of non-proliferative diabetic retinopathy(NPDR).METHODS: According to the random remainder method, they were divided into A, B and C three groups. Group A was treated with calcium dobesilate, group B was treated with epalrestat, and group C was treated with epalrestat combined with compound anisodine. All groups were treated for 6mo. The BCVA and fundus color photos, fundus fluorescein angiography(FFA), oscillatory potentials of electroretinogram(ERG-Ops)and optical coherence tomography(OCT)were performed before and after 1mo, 3mo and 6mo of treatment. The therapeutic effect was evaluated. RESULTS: Before treatment, there was no statistical difference among the three groups in BCVA, Ops wave amplitude or central macular thickness(P>0.05). The BCVA was improved, Ops wave amplitude was increased and the central macular thickness was decreased in the three groups after 1mo, 3mo and 6mo of treatment. Compared with the same group before treatment, there were statistically significant differences(P<0.05). The improvement of visual acuity at different time and the increase of Ops wave amplitude were better in group B than group A, better in group C than group B, while the decrease of central macular thickness was greater in group B than group A, greater in group C than group B(all P<0.05). The total effective rate among the three groups were significant difference(P<0.05), and the total effective rate of group C was better than that of group B and group A(P<0.0167).CONCLUSION: Epalrestat combined with compound anisodine is effective in treatment of DR. The combined treatment can significantly improve the visual acuity, relieve macular edema and promote the recovery of retinal function.

目的 探讨糖皮质激素联合自体血清治疗非感染性角膜溃疡的临床疗效.方法 将本院收治的40例(40眼)非感染性角膜溃疡患者随机分为两组(n=20),对照组患者局部应用糖皮质激素滴眼液,观察组在对照组基础上加用自体血清,对比两组患者的治疗效果.结果观察组患者的治愈率、总有效率分别为50.0％、85.0％,均显著高于对照组(10.0％、55.0％)(P<0.05).观察组中,角膜溃疡轻度者的治愈率、总有效率最高,重度者的治愈率、总有效率最低,治愈率、总有效率随着溃疡程度的加重而呈下降趋势.轻度、中度、重度三组的治愈率、总有效率比较存在显著性差异(P<0.05).结论 糖皮质激素联合自体血清治疗非感染性角膜溃疡能够有效提高临床治疗效果,其是一种安全、有效的治疗手段.

目的:评价免疫抑制剂冲击治疗(TAO)对眼表症状的改善效果.方法:选取笔者所在医院收治的58例TAO患者作为研究对象,使用随机数字表法分为两组(n=29),对照组应用抗甲状腺药物进行常规治疗,研究组在常规治疗基础上加用免疫抑制剂进行冲击治疗.观察两组患者治疗前后的眼表症状、炎性因子、T淋巴细胞亚群水平变化.结果:研究组治疗后的眼球突出度、睑裂高度、眨眼次数均显著低于对照组,泪膜破裂时间显著长于对照组,差异有统计学意义(P<0.05).研究组治疗后的IL-6、IL-17、CD8+水平显著低于对照组,CD3+、CD4+、CD4+/CD8+水平显著高于对照组(P<0.05).研究组患者的治疗总有效率为86.21％,显著高于对照组的62.07％,差异有统计学意义(P<0.05).结论:免疫抑制剂冲击治疗TAO能够有效改善眼表症状,减轻炎性状态,增强机体免疫功能,提高临床治疗.

总结267例冠心病患者介入治疗后应用四联抗栓药物发生出血的观察与护理,重视患者的心理护理及健康教育,密切观察病情,有针对性的加强观察对控制出血的发生及减少出血对患者造成的危害有重要的作用.

Objective To investigate ocular surface abnormality,corneal hypoesthesia to study the relationship between corneal hypesthesia and ocular surface abnormality in systemic lupus erythematosus(SLE).Methods A case-controlled study was adopted.Seventy SLE subjects(140eyes)and 62non-rheumatic diseases subjects(124eyes)were recruited.To understand the situation of ocular surface abnormality,with Schirmer'sⅠtest(sIt),tear film Break Up Time(BUT),corneal fluorescein staining were used to examine all the subjects.Then according to the judgment of keratoconjunctivitis sicca(KCS)of the three indicators of data,and the incidence of KCS was recorded.Central corneal sensation(CCS)were measured.The patients with KCS SLE were asked whether they had dry eye symptoms,and the incidence of dry eye symptoms was recorded.Results Compared with control subjects,the observation group was for low values of sIt(t=5.49,P0.01),low BUT value(t=6.54,P0.01),corneal fluorescein staining positive rate increased(χ2=82.563,P0.001),the high incidence of KCS(χ2=16.381,P0.001).The observation group corneal hypoaffectivity(t=4.492,P0.001);SLE corneal perception and SIt,BUT,corneal fluorescein staining there is a certain correlation between the positive rate.Combined with KCS in SLE patients with dry eye symptoms of corneal sensitivity was higher than that of dry eye symptoms,the difference has statistical significance(t=3.426,P0.01).Conclusion Obvious decrease in patients with SLE corneal perception is prone to ocular surface damage.Ocular surface damage of severe KCS patients without dry eye complaints is probably because of its low corneal perception.

总结14例植入埋藏式心率转复除颤器患者的护理,术前重视患者的心理护理及健康教育,术后密切观察病情,实施整体护理对于手术的成功及并发症的减少有重要的作用.

近年来,急性心肌梗塞(以下简称AMI)经皮冠状动脉介入治疗(以下简称PCI)已得到充分肯定.急诊经皮冠状动脉腔内成形术(以下简称PTCA)可即时开通闭塞血管,成功率高、残留狭窄小、有效保护心脏功能、大大降低近期和远期死亡率,缩短住院天数[1].已成为一种治疗AMI的首选方法.冠状动脉内支架术可减少PTCA后冠脉急性闭塞和再狭窄的发生率,常与PTCA合并应用[2].我科于2003年3月成功为1例AMI并发阿斯综合征的患者施行急诊PTCA及支架术.现将抢救及护理体会报告如下.

冠状动脉介入治疗的主要并发症为急性冠状动脉闭塞、再狭窄.约20%～25%的急性冠状动脉闭塞是由于冠状动脉内血栓形成,也是冠状动脉介入治疗后再狭窄的主要因素,因此在冠状动脉介入治疗中常规使用大剂量肝素抗凝[1],以防止溶栓后再狭窄,尤其是重组组织型纤溶酶原激活剂(r-tPA)半衰期较短,尽早应用肝素抗凝更为重要.而监测肝素治疗使用最广泛的方法是活化部分凝血活酶时间(简称APTT)测定.现就5例冠状动脉r-tPA溶栓治疗后应用APTT监测肝素用量的护理体会总结如下.