目的:探讨糖皮质激素相关性中心性浆液性脉络膜视网膜病变(CSC)的临床特点及中西医治疗策略.方法:对1例因眼部炎症指征误诊为葡萄膜炎的双眼慢性CSC患者的诊疗经过进行分析.结果:本例患者因双眼视物模糊3个月就诊.根据病史、临床表现、眼科检查、辅助检查、试验性激素治疗及停激素改中药治疗后,患者病情明显好转,确诊为CSC.结论:激素相关性CSC常见于双边、非典型性CSC,治疗上应禁用激素,采用中医辨证论治,围绕"湿"与"虚"治以健脾除湿,采用参苓白术散加减疗效显著.

视网膜分支动脉阻塞是临床少见的眼科急症、危症,该文分析魏伟教授运用补阳还五汤加减治疗视网膜分支动脉阻塞1例的治疗过程,以期为中医药诊治该病提供新思路.

目的 基于网络药理学及分子对接研究消风散治疗过敏性结膜炎(AC)的作用机制.方法 利用中药系统药理学数据库与分析平台(TCMSP)筛选消风散所有化学成分及作用靶点,通过人类基因数据库(Geen Cards)、疾病相关的基因与突变位点数据库(Dis Ge NET)和疗效药靶标数据库(TTD)筛选出AC的相关靶点;并利用Venn软件获取化合物与疾病的共同靶点;借助STRING数据库绘制蛋白-蛋白质相互作用(PPI)网络图,结合Cytoscape 3.7.2软件进行拓扑分析筛选关键靶点;通过DAVID在线分析平台进行基因本体(GO)功能富集分析和京都基因与基因组百科全书(KEGG)通路分析;利用Swiss Dock进行目标成分与核心靶点进行分子对接.结果 消风散中共筛选出治疗AC的主要活性成分23个和共同靶点49个,PPI网络发现信号转导和转录激活因子3(STAT3)、白细胞介素6(IL-6)、JUN、白细胞介素4(IL-4)、血管内皮生长因子A(VEGFA)和丝裂原活化蛋白激酶14(MAPK14)可能是消风散治疗AC的关键靶点;GO功能富集分析涉及细胞对脂多糖的反应、免疫反应、内皮细胞凋亡过程的负调控、炎性反应、调节血压、T淋巴细胞增殖的正调控等方面;KEGG通路涉及肿瘤坏死因子(TNF)信号通路、T淋巴细胞受体信号通路、缺氧诱导因子1(HIF-1)信号通路、类风湿关节炎和炎症性肠病(IBD)信号通路等,这些作用通路可能是消风散防治AC的活性途径;分子对接结果表明槲皮素(Quercetin)与核心靶点之间均有较强的结合活性.结论 该研究初步揭示了消风散干预AC的潜在活性成分及其可能作用机制,为该方剂的临床应用和深入实验研究提供参考依据.

With complex development process and pathogenesis,age-related macular degeneration(ARMD)is a chronic and progressive macular degenerative disease,which is currently the leading cause of blindness in middle-aged and elderly people. Research showed that the choroidal thickness changed significantly in different stages and classifications of ARMD.Since choroid is a vascular structure capable of rapidly changing blood flow, the change in choroidal thickness may be mainly caused by the change in choroidal blood flow. In addition, the abnormal blood perfusion of choroid can further damage the function of the retinal pigment epithelium cells, resulting in hypoxia and ischemia of retinal pigment epithelium, and finally induced ARMD. At present, more and more people are aware of the importance of choroidal thickness changes in the diagnosis and treatment of ARMD. Therefore, this article will review the changes and pathogenesis of choroidal thickness and blood flow in the course or after treatment of ARMD, which may provide new predictor for ARMD onset, and provide new targets for the development of new treatments of ARMD.

肠道菌群是人体内种类最多、密度最大的微生物群落的总称.肠道菌群可通过与宿主共代谢,调控宿主多种生理功能、维持体内免疫平衡,进而维护人体健康.近年来的研究结果表明,肠道菌群与宿主的骨代谢密切相关.在多种病理状态或药物等引起肠道菌群改变后,可引起继发性的病理性骨丢失.随着高通量测序、基因敲除、无菌鼠繁殖等新技术的发展,越来越多的证据表明肠道菌群可通过直接调控,或通过内源性物质代谢调控,或改变与骨代谢相关的激素水平影响宿主的骨代谢.拟在全面阐述肠道菌群与骨代谢关系的基础上,总结肠道菌群调控骨代谢的潜在途径和常见中药的作用机制,并探讨其对主要骨代谢异常相关疾病在临床治疗和药物靶点研究中的启示.

目的 通过网络药理学研究方法,探讨芪明颗粒治疗糖尿病视网膜病变(DR)的作用机制.方法 通过TCMSP、Swiss Target Prediction、GeneCards和OMIM数据库检索芪明颗粒的主要活性成分、相关作用靶点和DR相关的靶点.通过STRING数据库结合Cytoscape软件进行拓扑分析,筛选出核心靶标并绘制网络互作图;将核心作用靶点与有效成分进行分子对接.利用DAVID数据库对核心靶点蛋白进行基因本体(G0)生物过程分析和京都基因与基因组百科全书(KEGG)通路富集分析.结果 (1)活性成分:通过TCMSP数据库筛选出芪明颗粒活性成分81个,作用靶点299个.(2)DR靶点:经GeneCards和OMIM数据库筛选获得相关的疾病靶点914个,将药物靶点与疾病靶点映射后共获得91个共有靶点.(3)化合物-靶点:通过Cytoscape3.7.2软件构建芪明颗粒治疗DR化合物一靶点相互作用网络图,筛选出关键活性成分21种,主要为槲皮素、山奈酚和水蛭素等.(4)蛋白互作网络(PPI):STAT3、JUN、SRC、IL6、AKT1、VEGFA等可能是芪明颗粒治疗DR的核心靶点.(5)GO和KEGG富集分析:GO富集分析确定了128个条目(P＜0.05),KEGG通路富集筛选得到96条信号通路(P＜0.05),主要有TNF信号通路、HIF-1α信号通路、TCR信号通路、VEGF信号通路、雌激素信号通路、MAPK信号通路、PI3K/Akt信号通路和NF-kB信号通路等.(6)分子对接:SwissDock分子对接结果显示山柰酚与STAT3、JUN、Src、IL6、AKT1有较好的结合活性.结论 芪明颗粒治疗DR的作用机制可能与抗炎、抗氧化、抑制新生血管生成、抑制细胞凋亡等作用有关.

目的 观察地奥司明单用及与康柏西普联用对SD糖尿病大鼠血管内皮生长因子(VEGF)、细胞间黏附分子-1(ICAM-1)和C反应蛋白(CRP)表达的影响,探讨地奥司明对糖尿病早期视网膜病变的保护作用.方法 将50只SD大鼠随机分为正常组、模型组、地奥司明组、康柏西普组和联合组,每组10只.除正常组外,其余组大鼠均采用高脂高糖饲养后腹腔注射链脲佐菌素诱导糖尿病模型,造模成功1个月后,地奥司明组每日给予地奥司明片溶液灌胃,康柏西普组给予康柏西普右眼玻璃体腔注射,联合组同时给予地奥司明灌胃和康柏西普玻璃体腔注射,模型组和正常组给予等量生理盐水灌胃,灌胃每日1次,康柏西普注射每月1次,共干预3个月.干预结束后取血检测ICAM-1和CRP含量,伊文思蓝(EB)检测大鼠视网膜微血管渗漏情况,HE染色观察视网膜各层结构,免疫组织化学染色观察视网膜中VEGF表达情况.结果 模型组大鼠血清ICAM-1和CRP含量和EB渗透量均明显高于正常组(P均＜0.05);地奥司明组、康柏西普组和联合组血清ICAM-1和CRP含量和EB渗透量均明显低于模型组(P均＜0.05),且联合组均明显低于地奥司明组和康柏西普组(P均＜0.05).HE染色显示正常组大鼠视网膜结构正常;模型组大鼠视网膜水肿,细胞排列紊乱,神经上皮层可见增生的毛细血管;地奥司明组视网膜水肿减轻;康柏西普组视网膜神经节细胞减少;联合组视网膜结构趋于正常.地奥司明组、康柏西普组和联合组大鼠视网膜VEGF染色均较浅,联合组仅见少量VEGF表达.结论 地奥司明单用及与康柏西普联用均可抑制糖尿病大鼠炎症因子的表达,减少视网膜血管壁的渗漏,对糖尿病大鼠视网膜有保护作用,且联用效果更好.

AIM: To investigate the therapeutic effects and mechanisms of Wu Ling San on retinopathy in diabetic rats.METHODS: The rats with hyperglycemia were divided into five groups: model group, Wu Ling San high dose group, low dose group, positive control group and normal groups each group of ten. After oral administration for 12wk, the expression of ICAM-1 and CRP in the serum of rats were measured by ELISA. After HE staining, retinal structure was observed under the light microscope. Blood retinal vascular barrier permeability was measured by Evans blue. The vascular endothelial growth factor(VEGF)expression of retinal tissue were observed by immunohistochemistryRESULTS: Compared with the normal group, the expression of CRP, ICAM-1 and the EB content in diabetic group were increased. The contents of CRP and ICAM-1 and EB permeability in Wu Ling San high dose group were lower than low dose group and positive control group(all P<0.05). There are retinal ganglion cell layer disorder, retinal edema, and positive VEGF immunohistochemistry expression in the diabetic group. Wu Ling San high dose group can improve retinal structure and reduce retinal edema. CONCLUSION: Wu Ling San can effectively reduce the expression of inflammatory cytokine, VEGF and retina edema in diabetic retinopathy rats, and also can improve the retinal microvascular in order to protect diabetic retinopathy.

目的:探讨枸杞多糖(LBP)对H2O2诱导人视网膜色素上皮细胞(ARPE-19细胞)自噬及对Beclin-1、LC3B表达的影响.方法:将ARPE-19细胞用不同浓度H2O2处理后应用透射电镜观察H2O2对ARPE-19细胞自噬的影响,蛋白质印迹法检测不同浓度的LBP对H2O2诱导ARPE-19细胞Beclin-1、LC3B Ⅰ和LC3B Ⅱ表达的影响.结果:H2O2诱导ARPE-19细胞12 h后,与对照组比较,H2O2 600 μmol·L-1组自噬表达显著增加.H2O2诱导后,ARPE-19细胞Beclin-1和LC3B Ⅰ、LC3BⅡ表达显著升高,LC3BⅡ/LC3B Ⅰ值升高(P＜0.0l).1 000 μg·mL-1 LBP+ 400 μmol·L-1 H2O2组Beclin-1、LC3B Ⅰ和LC3BⅡ表达显著降低(P＜0.01).结论:枸杞多糖能够降低Beclin-1、LC3B Ⅰ和LC3BⅡ表达,干预H2O2诱导所致ARPE-19细胞的自噬水平升高,干预效应在浓度为l 000 μg·mL-1时最为显著.

Age-related macular degeneration (AMD)is the leading cause of vision loss of those over the age of 65.Scholars at home and abroad are dedicated to the study of AMD. Because of the complexity of the disease ,there are no satisfactory therapies. Accurate ani-mal models of the disease could assist greatly in the development of new therapies. This article reviewed different experimental animal models of AMD used in recent studies.

目的 观察温面散对新西兰家兔完整皮肤及破损皮肤单次和多次接触受试物后所产生的局部刺激反应.方法 取温面散(相当于人用量的6倍)和赋形剂(60%乙醇)单次和多次于家兔完整皮肤和破损皮肤处给药后,肉眼观察皮肤红斑、水肿、色素沉着、出血点、皮肤粗糙或皮肤菲薄等情况.结果 肉眼观察未见皮肤红斑、水肿、色素沉着、出血点、皮肤粗糙或皮肤菲薄等情况.结论 温面散对皮肤基本无刺激性反应.