Statement of problem. The conventional workflow for the fabrication of implant-supported fixed complete dentures (IFCDs) is complex and makes it impossible to maintain jaw relationships. A fully digital workflow might solve this problem.Purpose. The purpose of this clinical study was to develop a completely digital workflow aided by a cone beam computed tomography (CBCT) scan for the fabrication of IFCDs and to evaluate the accuracy of this workflow with regard to the maintenance of jaw relationships.Material and methods. All participants received a preoperative CBCT scan while wearing radiographic diagnosis dentures and occluding in the maximum intercuspal position. After the implant surgery, CBCT scanning, intraoral scanning, and stereophotogrammetry were performed to identify jaw anatomy, soft tissue, and the 3-dimensional (3D) locations of the implants, respectively. Then, all data were merged to transfer jaw relationships and generate digital casts to fabricate interim prostheses. A posttreatment CBCT scan was performed while the participants were wearing the interim prostheses and occluding in the maximum intercuspal position. The preoperative and postoperative jaw relationships were compared by CBCT cephalometric analysis. A meaningful and unacceptable difference was defined as 0.8 degrees and 2.4 degrees, respectively.Results. Six participants (6 jaw relationships, 9 arches, and 58 implants) were included. All interim prostheses were stable and achieved symmetric occlusion after only minimal adjustment. A total of 18 angles were measured. Three angles revealed a meaningful minimal difference, and 1 angle revealed an unacceptable minimal difference. No prosthodontic complications were reported during the study.Conclusions. A completely digital workflow for fabricating IFCDs achieved sufficient accuracy for the maintenance of jaw relationships throughout the treatment. (J Prosthet Dent 2023;129:116-24)

Statement of problem. Conventional impression techniques for complete arch implant-supported prostheses are technique-sensitive. Stereophotogrammetry (SPG) and intraoral scanning (IOS) may offer an alternative to conventional impression making. Purpose. The purpose of this prospective study was to compare the accuracy of IOS and SPG for complete arch implant scans and to evaluate the passive fit of frameworks fabricated with SPG.Material and methods. Laboratory scanning of gypsum casts, SPG, and IOS were performed for all participants. The data regarding the abutment platform were superimposed to calculate the 3D deviation of SPG and IOS compared with that of laboratory scanning as an evaluation of accuracy. The effect of implant position and number on accuracy was analyzed. The more accurate technique between SPG and IOS was used to fabricate the titanium frameworks, as was laboratory scanning. The passive fit of the frameworks was assessed by clinical examination, the Sheffield test, and panoramic radiography.Results. Seventeen participants (21 arches, 120 implants) were included. The accuracy of SPG ranged from 2.70 mu m to 92.80 mu m, with a median (Q1, Q3) of 17.00 (11.68, 22.50) mu m, which was significantly more accurate than that of IOS, ranging from 21.30 mu m to 815.60 mu m, with a median (Q1, Q3) of 48.95 (34.78, 75.88) mu m. No significant correlation was found between position or number of implants and 3D deviation in the SPG group. A weak positive correlation was found between implant number and 3D deviation in the IOS group. SPG and laboratory scanning were used to fabricate titanium frameworks. The passive fit between the frameworks and abutment platforms was confirmed.Conclusions. SPG, which was not affected by position or number of implants, was more accurate than IOS and comparable with laboratory scanning. The frameworks fabricated based on SPG and laboratory scanning were comparable in their passive fit. The SPG technique may be an alternative to laboratory scanning for complete arch implant scans. (J Prosthet Dent 2023;130:564-72)

Background: To assess the prevalence and demographics of lower eyelid epiblepharon in Chinese preschool children and to evaluate its association with refractive errors. Methods: In this population-based, cross-sectional study , a total of 3,170 children aged 3 to 6 years from Beijing, China underwent examinations including weight, height, cycloplegic autorefraction and slit-lamp examination of external eyes. The adjusted odds ratios (AORs) and 95% confidence intervals (CI) were calculated to evaluate. The prevalence of lower eyelid epiblepharon in preschool children and its association with refractive errors were analyzed. Results: The prevalence of lower eyelid epiblepharon was 26.2%, which decreased with age with 3-, 4-, 5-, and 6-year-old being 30.6%, 28.0%, 15.0%, and14.3%, respectively. Boys had a higher risk of having epiblepharon than girls with ORs = 1.41 (95%CI, 1.20-1.66) and no significant correlation was detected between BMI and epiblepharon after adjustment of age and sex. Epiblepharon was associated with significantly higher risk of refractive errors including astigmatism (OR = 3.41; 95% CI, (2.68-4.33)), myopia (OR = 3.55; 95%CI, (1.86-6.76)), and hyperopia (OR = 1.53; 95% CI, (1.18-1.99)). Among astigmatic epiblepharon preschoolers, with-the-rule is predominant (80.9%) and epiblepharon severity was associated with astigmatism severity (p = 0.019). Conclusions: There is a high prevalence of lower eyelid epiblepharon in Chinese preschool children, particularly among boys and the youngers. Preschoolers with lower eyelid epiblepharon are subject to higher risk of developing astigmatism, myopia, and hyperopia, than those without. An increased attention should be paid to this eyelid abnormality in preschool population.

乐乐和圆圆既是同学,又是邻居.周末,旅游归来的乐乐在小区门口碰到圆圆,兴奋地跟她分享旅途中的趣事.然而圆圆却一脸愁容,根本没有兴趣听乐乐说话. "怎么啦?圆圆,什么事情令你这么不开心?"乐乐察觉到圆圆的不悦,关切地问道.

This case history report describes a comprehensive digital workflow for implant treatment and occlusal reconstruction to provide a systematic protocol for implant-supported restorations in edentulous patients. In this case, a restoration-oriented surgical protocol was created using an oral implant planning and design software. The implant surgery was completed under the guidance of a fully guided surgical template. This is the first report of the combined application of computer-aided diagnosis axiograph and neuromuscular evaluation systems in implant-supported occlusal reconstruction. Digital technologies can increase the accuracy, efficiency, and comfort of implant treatment and achieve satisfactory occlusal reconstruction outcomes in edentulous patients.

The retina is sensitive to injury resulting from oxidative stress (OS) due to its high oxygen consumption. Patients with retinitis pigmentosa suffer from excessive OS. N‑acetylcysteine (NAC) is used as a mucolytic agent for the clinical treatment of disorders, such as chronic bronchitis and other pulmonary diseases. The aim of the present study was to investigate the role of hexokinase 2 (HKII) in retinal OS injury. Amyloid β (Aβ)1‑40 was used to establish a cellular model of OS. Cell viability was measured with a Cell Counting Kit‑8 assay, and the apoptosis, reactive oxygen species (ROS) and mitochondrial membrane potential (MMP) of cells were analyzed via flow cytometry with corresponding kits. The mRNA and protein levels were detected by reverse transcription‑quantitative PCR and western blot analyses, respectively. It was observed that Aβ1‑40 reduced the expression of HKII in the mitochondria of retinal pigment epithelial ARPE cells and impaired mitochondrial antioxidant functions. Additionally, knockdown of HKII promoted apoptosis, and increased ROS levels and the MMP. NAC attenuated the inhibition of mitochondrial functions induced by Aβ1‑40. The knockdown of HKII was revealed to decrease the levels of Bcl‑2, manganese superoxide dismutase (SOD) and copper‑zinc‑SOD, and increase the levels of cleaved caspase‑3, Bax and cytochrome c. The present findings suggested that the dissociation of HKII induced by OS induces apoptosis and mitochondrial damage. This study provided improved understanding of the mechanisms underlying the effects of OS on retinal epithelial cells.

Purpose. The correlations between the axial length-to-corneal radius (AL/CR) ratio and corneal astigmatism (CA) were studied by prospectively analyzing and comparing survey data from school children in the Beijing urban area from 2014 to 2015. Methods. In this longitudinal study, a total of 2,970 students were enrolled in 2014, and 2,179 students were enrolled in 2015. The students were in grades 1 and 4 of primary schools located in the Yangfangdian district of Beijing. The students were examined using the standard logarithmic visual acuity chart for uncorrected visual acuity (UCVA) and IOLMaster for ocular components. Results. From 2014 to 2015, the students from grades 1 and 4 had significantly worse UCVA results, longer axial lengths (AL), and greater AL/CRs (p<0.001). The boys had a longer AL and corneal radius (CR) than the girls (p<0.001). A significantly higher rate of increased CA was observed for the students with increased AL/CR than for those with decreased or unchanged ratios (AL/CR for grade 1, X2 = 12.304, p=0.001; for grade 4, X2 = 29.044, p<0.001). In addition, with increased AL/CR over one year, the CA value of the students in grades 1 and 4 became significantly larger (grade 1, p=0.001; grade 4, p<0.001); moreover, the UCVA became worse (p<0.001). Conclusions. We found that UCVA and AL growth were affected by aging. An increase in the AL/CR ratio is a risk factor for the progression of corneal astigmatism for school children.

目的 研究学龄前儿童双眼散光的轴向对称模式.设计 横断面调查.研究对象 3～4岁学龄前儿童164例.方法 采用美国伟伦Suresight手持式自动验光仪收集2017年6-8月在幼儿园体检的学龄前儿童的屈光资料,选取两种散光对称模型(直接对称模型和镜像对称模型)对学龄前儿童的不同散光对称模式进行统计分析,并研究性别、球镜值、散光值、散光类型和双眼散光差异等与散光轴向对称模型的关系.主要指标散光轴向差异.结果 直接对称模型的散光轴向差异中位数是8°,大于镜像对称模型的4°(P＜0.01).完全直接对称模式和完全镜像对称模式的比例分别为0％和6％.直接对称模型和镜像对称模型的散光轴向差异在15°以内的比例分别是77％和87％.直接对称模型和镜像对称模型中,顺规散光的轴向差异值均最小,中位数分别为8°和3°.对于直接对称模型,散光类型和双眼散光差异与双眼散光轴向差异呈正相关(R=0.42,P＜0.01;R=0.22,P=0.01);对于镜像对称模型,散光类型和双眼散光差异与双眼散光轴向差异呈正相关(R=0.44,P＜0.01;R=0.14,P=0.04),散光值与双眼散光轴向差异呈负相关(R=-0.20,P=0.01).结论 学龄前儿童双眼散光的轴向对称模式更倾向于镜像对称;双眼散光差异最小的和顺规性散光儿童的双眼轴向差异最小.

Objective:To evaluate the efficacy of the multimedia visual perceptual learning system for improving visual acuity in pediatric patients with amblyopia and to discuss factors influencing the therapeutic effects of perceptual learning.Methods:This was a prospective randomized controlled study Amblyopic children aged from 3 to 11 years (n=112) were recruited from the ophthalmology clinic.Participants were randomly assigned to the experimental group that utilized the multimedia visual perceptual learning system or a control group utilizing the synoptophore.All subjects underwent perceptual learning and patching or refractive correction,depending upon the individual situation.After the baseline visit,follow-up visits were held after 10,20,and 30 treatments.Finally,the clinical efficacy and improvement of visual acuity in the two groups were analyzed and compared,using chi-square test,independent-samples t test,Pearson correlation test.Results:The curative effect of the experimental group was better than the control group at different training periods (Z=-4.128,-4.806,-3.063,P＜0.O0 1).The change in visual acuity in the experimental group was significantly higher at the 10th and 20th training sessions (t=3.471,3.290,P＜0.05).In the moderate and severe amblyopia groups,the curative effect of the experimental group was better than the control group (Z=-3.050,P=0.021),and was the same as in the anisometropic amblyopia group (Z=-2.864,P=0.004) and 7-11 year-old group (Z=-2.631,P=0.009).There was a moderate correlation at baseline and an improvement in visual acuity in both groups (r=0.690,0.650,P＜0.05).Conclusions:The multimedia visual perceptual learning system can achieve an optimal effect in a short period of time.The improvement in vision relates to the sex of the patient,and the degree and type of amblyopia,which are clinically significant to amblyopia therapy.

The traditional treatment of amblyopia includes best optical correction,patching or atropine penalization of the fellow eye.Nevertheless,a deeper understanding of the pathogenesis of amblyopia has been obtained based on a much deeper understanding of experimental animal model of amblyopia,electrophysiology and neurobiochemistry.Activating the visual plasticity after the end of the sensitive or critical period of visual development has been proved to be feasible.Thus,a variety of new therapies,such as,perceptual learning,video gaming,dichoptic training,transcranial magnetic stimulation have been applied to treat amblyopia in children and adults.All these new therapies,collectively called behavioral treatment,serve restoring cortical plasticity and reducing interocular suppression as a strategy for the reinstatement of visual functions in amblyopic patients.

China is one of the countries with high incidence of myopia in the world, which has attracted the attention of the national health care department. However, at present, there are still no convenient and effective methods to prevent and treat myopia in modern medicine at home and abroad. In this paper, the author compared the similarities and differences between modern medicine and traditional Chinese medicine in the prevention and treatment of myopia by searching relevant literature. The modern medical study of pathogenesis of myopia and the traditional Chinese medical perception of holistic theory of myopia, the idea of prevention-oriented eye care in modern medicine and the theory of treating before disease attacking in traditional Chinese medicine, the modern medicine and traditional Chinese medicine therapy and other aspects were analyzed mainly. Finally, the application value and orientation of Chinese medicine in the prevention and control of juvenile myopia were explored to find a new developing way. Key words: Juvenile myopia; Traditional Chinese medicine; Modern medicine; Prevention and control; Orientation; Innovation-driven development

·Ocular refraction is mainly decided by the axial length, corneal power and lens power. Of these three refractive elements, only the change of cornea has aroused the most controversial discussion. Cornea has changed varying with refractive state and population characteristics. This paper is designed to review the information currently available concerning the change of the cornea in emmetropia and myopia.

目的 分析不同年龄段小学生眼球生物学参数与屈光状态间的相关性,为大规模群体近视防控筛查敏感指标的确定提供参考.方法 随机抽取房山区小学校区450名6～12岁学龄儿童.采用1％盐酸环喷托酯散瞳,RM-8000计算机验光仪验光;光学相干生物测量仪(IOLMaster)测量眼轴及平均角膜曲率,计算平均角膜曲率半径、轴径比.结果 在低年龄组(6～8岁)中,眼轴与屈光度呈负相关(r=-0.244,P＜0.01),与角膜曲率半径呈正相关(r=0.500,P＜0.01),屈光度与轴径比呈负相关(r=-0.284,P＜0.01);高年龄组(9～12岁)中,眼轴与屈光度呈负相关(r=-0.613,P＜0.01),与角膜曲率半径正相关(r=0.644,P＜0.01),屈光度与轴径比呈负相关(r=-0.809,P＜0.01).高年龄组、低年龄组儿童屈光度与角膜曲率半径均无统计学相关性(r值分别为-0.029,-0.026,P值均＞0.05).不同屈光类型中,低、中度近视组儿童屈光度与眼轴(r=-0.687,-0.797)、轴径比(r=-0.589,-0.836)相关性均有统计学意义(P值均＜0.01);眼轴与平均角膜曲率半径在远视、正视组相关程度高(r值分别为0.809,0.812,P值均＜0.01).结论 学龄儿童屈光发育中,眼轴延长与近视发生密切相关;角膜曲率半径随眼轴增长而代偿性增大.轴径比与屈光状态显著相关,可有效评估群体近视发生趋势.

Background Multiple inflammatory factors in aqueous humor are indicated to be correlated with postoperative macular edema (ME) in type 2 diabetic patients who received phacoemulsification (Phcao) cataract surgery. To analyze the correlation of aqueous inflammatory factors and cytokines with postoperative ME in these patients is significant for the treatment. Objective This study was to ascertain whether cytokines in the aqueous humor can predict ME in type 2 diabetic patients following Phaco cataract surgery. Methods One hundred and thirty-six eyes of 136 consecutive patients with type 2 diabetes were included from January 2010 to April 2012 in Tianjin Eye Hospital. All the patients received Phaco cataract surgery and 0.1 ml aqueous fluid was collected from each eye during the surgery under the informed consent. Twenty-seven cytokines in aqueous humor samples were simultaneously assayed using multiplex bead immunoassay. Central foveal thickness was measured using OCT before and after surgery, and ME was defined as an 30% increase in foveal thickness after operation. The correlations of 27 aqueous cytokines with ME were analyzed. Results Phaco surgery was successfully performed in all the eyes, and 116 eyes completed the follow-up with the finishing rate 85.29%. ME occurred in 29.31% eyes (34/116) 4 weeks after surgery and were assigned to the ME (+) group; while 70.69% eyes (82/116) did not appear ME as the ME (-) group. The patients showed the matched demography between the two groups (all at P>0.05). The mean macular thickness value was (237.24±24.16) μm in the ME (+) group 4 weeks after operation, which was significantly higher than (162.41±21.33) μm before operation and (185.53±18.35) um in the ME (-) group (both at P<0.001). Compared to the ME(-) group, the concentrations of interleukin-1β (IL-1β), IL-6, IL-8, interferon-induced protein-10 (IP-10), monocyte chemotactic protein-1 (MCP-1) and vascular endothelial growth factor (VEGF) in aqueous of the ME (+) patients were significantly elevated (all at P<0.01). In addition, these factors showed positive correlation with the postoperative central foveal thickness (r=0.288, P=0.005; r=0.345, P=0.008; r=0.256, P=0.016; r=0.377, P=0.007; r=0.423, P=0.001; r=0.279, P=0.012) . However, the aqueous levels of IL-10 and IL-12 before operation were significantly lower in the ME(+) group compared with the ME(-) group (P=0.003, 0.017), and showed negatively correlated with the postoperative central foveal thickness (r=-0.327, P=0.013; r=-0.264, P=0.036). Logistic regression analysis showed that higher glycosylated hemoglobin and above mentioned factors were risk factors of ME following Phaco cataract surgery (OR=1.25, P=0.026; OR=1.31, P=0.006; OR=3.62, P<0.001; OR=1.82, P=0.007; OR=1.58, P<0.001; OR=4.21, P<0.001; OR=5.36, P<0.001; OR=0.19, P=0.011; OR=0.31, P=0.013). Conclusions The increases of aqueous IL-1β, IL-6, IL-8, IP-10, MCP-1, VEGF and decreases of IL-10, IL-12 are associated with postoperative ME in type 2 diabetic patients following Phaco cataract surgery. Key words: Diabetes/complication; Retinopathy; Cytokine; Macular edema; Aqueous humor; Risk factors; Humans

为了提高临床眼科教学效果,探讨在整合医学理念下开展问题为导向(problem-based learning,PBL)教学法的改革实践.选择全身疾病的眼部表现章节为主要内容,以学生为中心的教育方式,分组分内容进行准备,课程后通过教学评估系统进行教学效果评价并与以往比较,发现评估分值明显提高.因此,PBL教学方法结合整合医学知识更适合于眼科临床课程教育阶段的医学生,使学生们树立整体与局部、眼与全身的理念,提高学生的自主学习能力.

Low vision and blindness are increasingly becoming health and socioeconomic problems worldwide.However, the severity of these vision problems varies considerably between the developed and developing countries where the prevalence and distribution of low vision and blindness are affected differently by the socioeconomic and cultural factors.Moreover, the causes of vision problems are not necessarily the same for patients in different age groups within the same country or region.Therefore, it is imperative to characterize the epidemiologic features and identify causes of low vision and blindness in all societies. Similarly,it is important and necessary to enforce the implementation of visual rehabilitation programs in patients with visual disorders.The objective of this article is to assess the current status of visual rehabilitation and discuss the demand for visual rehabilitation personnel in China,with a particular focus on the characteristics of vision problems and rehabilitation in young children .

With the rapid development of economy and society,since the reform and opening up,there is an urgent demand for high -level personnel of ophthalmology.Clinical gradu-ates of ophthalmology are important groups in medical service in the future.In view of the problems in the postgraduate culture of ophthalmology,combined with our own experience in the post-graduate education,we put forward several suggestions of cooperative training of clinical ability and scientific research,in order to improve the comprehensive ability of graduate student of oph-thalmology.

AlM:To discuss the feasibility of microcoria optometry in screening for children ametropia. METHODS: Totally 217 school - age children were selected, included 94 first-grade students ( 6 ~ 8 years old) and 123 fourth-grade students ( 9 ~12 years old ) . Refractive diopter was measured with automatic refractor RM-8000 to evaluate the accuracy of micocoria optometry in screening ametropia.RESULTS: After cycloplegia, both the mean sphere diopter and cylinder diopter in grade one students changed significantly (P<0. 05), the mean sphere diopter in grade four students changed significantly (P<0. 05), while the mean cylinder diopter had no statistical difference ( P>0. 05 ) in grade four students. Different refractive type: before and after mydriasis spherical myopia, spherical equivalent difference was 0. 263 ± 0. 618 and 0.216±0.653D, with statistical significance (P<0.01);ln hyperopia group, spherical myopia, spherical equivalent difference was 0. 947±0. 946 and 1. 039±0. 984D, with statistical significance ( P = 0. 000 ). The lenticular difference between the two groups were not statistically different ( P > 0. 05 ). Choosing small pupil computer optometry for ≤- 1. 00D, ≥- 0. 50D child myopia or hyperopia could get more accurate value of diagnostic cutoffs, Youden index was 0. 672 and 0. 580. CONCLUSlON: Microcoria optometry can be as a effective method of screening of children with ametropia, but if for optometry, school-age children must accept mydriasis.

目的 探讨视网膜分支静脉阻塞(branch retinal vein occlusion,BRVO)患者急性期及恢复期血浆同型半胱氨酸(homocysteine,Hcy)水平的变化.方法 连续收集42例BRVO患者作为观察对象,选择42名年龄、性别与观察对象相匹配的、无其他影响Hcy病史的非视网膜疾病患者作为对照组.BRVO发生后3d、1个月、3个月、6个月抽取BRVO患者的空腹静脉血,对照组抽取单次空腹血,采用高效液相色谱荧光检测法检测Hcy,用放射免疫法测定维生素B12、叶酸水平,C677T MTHFR基因多态性采用聚合酶链反应进行分析.结果 BRVO患者阻塞发生后3d Hcy水平(11.01±4.09) μmol·L-1与对照组(10.04±3.67) μmol·L-1相比,差异无统计学意义(P =0.257).BRVO患者的Hcy水平在发生阻塞后逐渐升高,BRVO发生后1个月Hcy达到高峰(13.27±5.81) μmol·L-1,6个月时下降到正常水平(11.17±4.36) μmol·L-1.同时,BRVO患者Hcy水平在BRVO发生后3 d(r =0.343)、1个月(r=0.381)、3个月(r=0.432)、6个月(r =0.360)都与黄斑区视网膜厚度呈显著的正相关(均为P＜0.05).然而,BRVO患者Hcy水平的变化与维生素B12、叶酸水平以及C677T MTHFR基因多态性无关(均为P＞0.05).结论 患者发生BRVO后Hcy水平一过性升高,本研究结果不支持Hcy是BRVO的独立危险因素的推测,然而Hcy水平的变化可能是疾病本身引起的.

Amblyopia is a developmental abnormality that results from physiological alterations in the visual cortex and impairs form vision. Based on multimedia, visual perceptual learning was widely applied in amblyopia treatment. Perceptual learning provided an impor-tant new method for treating amblyopia both in children and adults, and it reflects alterations of neural responses in the visual pathway. The therapeutic efficacy of perceptual learning was related to age, amblyopic types and degrees, training time and programs closely.