Ethnopharmacological relevance: Qijia Rougan decoction (QJ), consisting of eight herbs and two animal drugs, is an effective traditional Chinese medicine with hepatoprotective and antifibrotic effects. However, its underlying action mechanism remains unclear. Aim of the study: To explore the mechanism underlying the treatment of liver fibrosis in rats by QJ.Materials and methods: Rats with fibrosis were constructed using carbon tetrachloride (CCl4). The QJ was orally administered to fibrotic rats. Hepatic pathological changes were evaluated using hematoxylin and eosin and Masson's trichrome staining. The differentially expressed proteins (DEPs) in QJ were analyzed using quantitative proteomics. Subsequently, the underlying mechanisms in liver fibrosis after QJ treatment were validated using Western blotting.Results: The QJ markedly improved liver function and attenuated fibrotic progression. Based on the tandem mass -tag based (TMT) proteomics, we identified 818 common DEPs between QJ vs Model and Model vs Control, including 296 upregulated and 522 downregulated DEPs, which mostly participate in metabolic pathways, oxidation-reduction reactions, and collagen biosynthetic processes. In addition, we found that QJ reduced he-patocellular death by inhibiting the expression of caspase proteins, repressing pro-apoptotic proteins, and pro-moting anti-apoptotic proteins. We further demonstrated that QJ suppressed the Akt/mTOR pathway. Conclusion: QJ exerted hepatoprotective effects in CCl4-induced rats through multi-pathway regulation. This study provides protein information on liver fibrosis treated with QJ.

Fuzheng Xiaozheng prescription (FZXZP) is an effective formula for the treatment of different kinds of chronic liver diseases. However, its potential molecular mechanisms in treating hepatocellular carcinoma (HCC) have not been investigated thoroughly. The aim of this study is to elucidate the targets and intrinsic mechanisms of FZXZP and their active components for the treatment of HCC. The efficacy of FZXZP against HCC was clarified through a rat HCC model and HCC cell culture. Network pharmacology and molecular docking were utilized to predict the mechanism of action and effector components of FZXZP. The key mechanism and targets were verified by the construction of overexpression and knockout cell models. The results showed that FZXZP greatly delayed the development of HCC in vivo experiments, as evidenced by biochemical evaluations, H&E analyses and growth inhibition of HCC. FZXZP dramatically inhibited cell viability and proliferative capacity and induced the apoptosis of hepatoma cells in vitro. Moreover, network pharmacology analyses demonstrated that the EGFR family and apoptosis-related targets were found to be the most significant in bioinformatics analysis. Furthermore, the EGFR/STAT3 signal axis might be the most likely target of FZXZP in anti-HCC due to the fact that it could be down-regulated by FZXZP with an upward trend of Bax, Caspase-3, Caspase-8, Caspase-9 and an inverse trend of Bcl2. Importantly, the above targeted signal axis was finally validated by our knockdown and overexpression analyses. Meanwhile, flow cytometry and TUNEL staining also revealed that FZXZP significantly induced apoptosis in the EGFR-overexpressing HCC cell line. The molecular docking results revealed that the key effector components of FZXZP that exerted the above regulatory roles were wogonin and glycitein. All of these results suggest that FZXZP could significantly delay HCC development by inhibiting proliferation and promoting apoptosis of HCC cells, and the EGFR/STAT3 signal axis might be a critical signal axis of FZXZP in suppressing HCC progression.

Background: The Zhuyu pill (ZYP), composed of Coptis chinensis Franch. and Tetradium ruticarpum (A. Jussieu) T. G. Hartley, is an effective traditional Chinese medicine with potential anti-cholestatic effects. However, the underlying mechanisms of ZYP remain unknown.Objective: To investigate the mechanism underlying the interventional effect of ZYP on mRNA-seq analysis in cholestasis rat models.Materials and methods: This study tested the effects of a low-dose (0.6 g/kg) and high-dose (1.2 g/kg) of ZYP on a cholestasis rat model induced by α-naphthyl-isothiocyanate (ANIT, 50 mg/kg). Serum biochemistry and histopathology results were used to evaluate the therapeutic effect of ZYP, and mRNA-Seq analysis was performed and verified using real-time fluorescence quantitative PCR (qRT-PCR). GO, KEGG, and GSEA analyses were integrated to identify the mechanism by which ZYP impacted cholestatic rats.Results: ZYP was shown to significantly improve abnormal changes in the biochemical blood indexes and liver histopathology of cholestasis rats and regulate pathways related to bile and lipid metabolism, including fatty acid metabolism, retinol metabolism, and steroid hormone biosynthesis, to alleviate inflammation, cholestasis, and lipid metabolism disorders. Relative expression of the essential genes Cyp2a1, Ephx2, Acox2, Cyp1a2, Cyp2c11, and Sult2a1 was verified by qRT-PCR and showed the same trend as mRNA-seq analysis.Conclusion: ZYP has a significant anti-cholestatic effect by regulating bile metabolism and lipid metabolism related pathways. These findings indicate that ZYP is a novel and promising prospect for treating cholestasis.

Medicinal plants are the primary sources for the discovery of novel medicines and the basis of ethnopharmacological research. While existing studies mainly focus on the chemical compounds, there is little research about the functions of other contents in medicinal plants. Extracellular vesicles (EVs) are functionally active, nanoscale, membrane-bound vesicles secreted by almost all eukaryotic cells. Intriguingly, plant-derived extracellular vesicles (PDEVs) also have been implicated to play an important role in therapeutic application. PDEVs were reported to have physical and chemical properties similar to mammalian EVs, which are rich in lipids, proteins, nucleic acids, and pharmacologically active compounds. Besides these properties, PDEVs also exhibit unique advantages, especially intrinsic bioactivity, high stability, and easy absorption. PDEVs were found to be transferred into recipient cells and significantly affect their biological process involved in many diseases, such as inflammation and tumors. PDEVs also could offer unique morphological and compositional characteristics as natural nanocarriers by innately shuttling bioactive lipids, RNA, proteins, and other pharmacologically active substances. In addition, PDEVs could effectively encapsulate hydrophobic and hydrophilic chemicals, remain stable, and cross stringent biological barriers. Thus, this study focuses on the pharmacological action and mechanisms of PDEVs in therapeutic applications. We also systemically deal with facets of PDEVs, ranging from their isolation to composition, biological functions, and biotherapeutic roles. Efforts are also made to elucidate recent advances in re-engineering PDEVs applied as stable, effective, and non-immunogenic therapeutic applications to meet the ever-stringent demands. Considering its unique advantages, these studies not only provide relevant scientific evidence on therapeutic applications but could also replenish and inherit precious cultural heritage.

EDITORIAL article Front. Endocrinol., 07 December 2023Sec. Clinical Diabetes Volume 14 - 2023 | https://doi.org/10.3389/fendo.2023.1345489

Zhuyu pill (ZYP) is a traditional Chinese medicine prescription composed of two drugs, Coptis chinensis Franch. and Tetradium ruticarpum (A. Jussieu) T. G. Hartley, and is commonly used in the clinical treatment of diseases of the digestive system. However, the mechanism underlying the effect of ZYP on colitis remains unclear. In this study, a colitis rat model was induced with 2,4,6-trinitro-benzenesulfonic acid (TNBS, 100 mg/kg) and treated with ZYP (low dose: 0.6 g/kg, high dose: 1.2 g/kg). Disease activity index, colonic weight index, and weight change ratio were used to evaluate the model and efficacy. LC-MS and 16S rRNA gene sequencing were used to measure differences in fecal metabolism and microorganism population among the control, model, low-dose ZYP, and high-dose ZYP groups. To elucidate the mechanism of interventional effect of ZYP, Spearman correlation analysis was used to analyze the correlation between fecal metabolism and fecal microbial number. High-dose and low-dose ZYP both exhibited significant interventional effects on colitis rat models, and high-dose ZYP produced a better interventional effect compared with low-dose ZYP. Based on a metabolomics test of fecal samples, significantly altered metabolites in the model and high-dose ZYP treatment groups were identified. In total, 492 metabolites were differentially expressed. Additionally, sequencing of the 16S rRNA gene in fecal samples revealed that the high-dose ZYP could improve TNBS-induced fecal microbiota dysbiosis. Ultimately, changes in tryptophan metabolism and Firmicutes and Gammaproteobacteria populations were detected after ZYP treatment in both colitis and cholestasis. Therefore, we conclude that tryptophan metabolism and Firmicutes and Gammaproteobacteria populations are the core targets of the anti-inflammatory effect of ZYP. These findings provide a scientific basis for further investigation of the anti-inflammatory mechanism of ZYP in the future.

Aging is a key risk factor for angiogenic dysfunction and cardiovascular diseases, including heart failure, hypertension, atherosclerosis, diabetes, and stroke. Members of the NAD+-dependent class III histone deacetylase family, sirtuins, are conserved regulators of aging and cardiovascular and cerebrovascular diseases. The sirtuin SIRT6 is predominantly located in the nucleus and shows deacetylase activity for acetylated histone 3 lysine 56 and lysine 9 as well as for some non-histone proteins. Over the past decade, experimental analyses in rodents and non-human primates have demonstrated the critical role of SIRT6 in extending lifespan. Recent studies highlighted the pleiotropic protective actions of SIRT6 in angiogenesis and cardiovascular diseases, including atherosclerosis, hypertension, heart failure, and stroke. Mechanistically, SIRT6 participates in vascular diseases via epigenetic regulation of endothelial cells, vascular smooth muscle cells, and immune cells. Importantly, SIRT6 activators (e.g., MDL-800/MDL-811) have provided therapeutic value for treating age-related vascular disorders. Here, we summarized the roles of sirtuins in cardiovascular diseases; reviewed recent advances in the understanding of SIRT6 in vascular biology, cardiovascular aging, and diseases; highlighted its therapeutic potential; and discussed future perspectives.

Background: Liver fibrosis is an independent contributor of chronic liver diseases, and regressing liver fibrosis is considered a potential therapeutic target for chronic liver diseases. We aimed to explore the effects and mechanism of sorafenib in liver fibrosis. Methods: Male Sprague Dawley (SD) rats were subjected to subcutaneous injection of carbon tetrachloride (CCl4) for 8 weeks to induce liver fibrosis and then treated with sorafenib. The degree of liver fibrosis was analyzed by hematoxylin-eosin (H&E) staining, Masson staining, and Picrosirius red (PSR) staining. Serum biochemical indexes were detected by fully automatic biochemical analyzer or enzyme-linked immunosorbent assay (ELISA). Quantitative real-time polymerase chain reaction (qRT-PCR) was performed to detect the expression of profibrotic genes. Immunohistochemical staining and Western blotting were carried out to evaluate the levels of lysine crotonylation. Results: Liver index was reduced with oral sorafenib in CCl4-induced rats. Serum liver function (alanine aminotransferase (ALT), aspartate aminotransferase (AST), and total bilirubin (TBIL)) and fibrosis indicators (type III procollagen (PC-III), hyaluronic acid (HA), and laminin (LN)) were attenuated with sorafenib treatment. Sorafenib improved the hepatic structure and fibrotic progression. The expression of fibrosis-related genes was remarkely reduced with sorafenib treatment. Meanwhile, sorafenib inhibited alpha-SMA and collagen I cumulation induced by CCl4 injection. Besides, protein lysine crotonylation especially the crotonylated H2BK12 (H2BK12cr) and crotonylated H3K18 (H3K18cr) were reversed by sorafenib, which were decreased in response to CCl4 treatment. Spearman correlation analysis shown lysine crotonylation expression was negatively correlated with serum fibrotic indicators. Conversely, crotonylation-regulated enzymes, which negatively regulate protein crotonylation, were increased in response to CCl4 treatment, while sorafenib reduced their expression. Conclusion: Sorafenib exerts significant anti-fibrotic effects through mediating crotonylation-regulated enzymes and protein crotonylation in fibrotic rats.

ObjectiveThis study aimed to investigate the prevalence of glaucoma with associated factors in the rural populations of 10 provinces in China.DesignA population-based cross-sectional study.MethodsAll participants aged 6 years or older from 10 provinces completed visual acuity testing, slit-lamp examination, ophthalmoscopy and non-contact tonometry. Glaucoma suspects underwent fundus photography, Goldmann applanation tonometry, visual field testing and gonioscopy. Glaucoma was determined according to the International Society of Geographical and Epidemiological Ophthalmology classification scheme. Associations of demographics and medical factors with glaucoma were assessed using multiple logistic regression models.ResultsFrom June 2017 to October 2018, 48 398 of 52 041 participants were included in the final analyses. The age-standardised prevalence of glaucoma was 1.7% (95% CI 1.55% to 1.78%) among the participants older than 6 years, which was 2.1% (95% CI 1.93% to 2.23%) in participants aged over 40 years. The constituent ratios of glaucoma were: 44.4% primary angle-closure glaucoma (PACG), 34.7% primary open-angle glaucoma, 2.6% congenital glaucoma and 18.3% other types of glaucoma. Increasing age, smoking, cerebral stroke, type 2 diabetes, higher education (college or more) and higher personal income were significant risk factors for PACG. The unilateral and bilateral blindness rates in the entire study population were 4.692% and 1.068%, respectively. A family history of glaucoma was a significant risk factor for the prevalence of glaucoma and blindness in at least one eye.ConclusionsRural populations have a high prevalence of glaucoma, which should be included in chronic disease management programmes in China for long-term care.

Cardiovascular diseases (CVD) have become the leading causeofmorbidityandmortalityworldwide.During the past twodecades,manyexperimentalandpreclinical studies have highlighted the critical roles of histone modifications (eg, acetylations andmethylations) in regulating cardiovasculardevelopment,homeostasis, anddiseaseprogressionby regulating gene transcription. The well-studied histone acetylations such as H3K9ac and H3K27ac activate gene transcription and have shown critical functions in cardiovascular homeostasis and remodeling. For instance,while class I and II histone deacetylases (HDACs) generally promote the development of cardiac hypertrophy and diabetic cardiomyopathy, most class III HDACs (Sirtuins) exhibit cardioprotective capacity. The inhibitors of class I HDACs have been proven to repress cardiac remodeling and heart failure.

Cardiovascular diseases (CVDs) are the leading cause of morbidity and mortality worldwide. Metabolic dysfunction is a fundamental core mechanism underlying CVDs. Previous studies generally focused on the roles of long-chain fatty acids (LCFAs) in CVDs. However, a growing body of study has implied that short-chain fatty acids (SCFAs: namely propionate, malonate, butyrate, 2-hydroxyisobutyrate (2-HIBA), β-hydroxybutyrate, crotonate, succinate, and glutarate) and their cognate acylations (propionylation, malonylation, butyrylation, 2-hydroxyisobutyrylation, β-hydroxybutyrylation, crotonylation, succinylation, and glutarylation) participate in CVDs. Here, we attempt to provide an overview landscape of the metabolic pattern of SCFAs in CVDs. Especially, we would focus on the SCFAs and newly identified acylations and their roles in CVDs, including atherosclerosis, hypertension, and heart failure.

Background: Glaucoma is the commonest cause of irreversible blindness worldwide. The Rural Epidemiology for Glaucoma in China (REG-China) was conducted to investigate the present status of glaucoma in rural China. Methods: The REG-China Study is a cross-sectional study in a nationally representative sample of population aged 6 years or older from ten provinces, autonomous regions, and municipalities in rural areas of China. All participants underwent a comprehensive eye examination, including visual acuity, intraocular pressure, slit-lamp microscopy, direct ophthalmoscopy, and further investigations. Findings: From June to October 2018, 52 041 individuals were invited to participate, of whom 48 398 were included in the final analysis. The overall prevalence of glaucoma was 1·6% (95% CI 1·52–1·77) among the population aged 6 years or older. The prevalence of all types of glaucoma in persons aged 40 years or older was 2·0% (95% CI 1·96–2·85); 58·2%, and 19·8% had primary angle-closure glaucoma (PACG) or primary open-angle glaucoma (POAG), respectively. Increasing age, marital status, history of cerebral infarction, location areas and family history of glaucoma were significant risk factors for both PACG and POAG. The overall blindness rate of glaucoma was 31·1% (95% CI 25·91%-34·82%). Those who were older, men, and divorced/separated were more likely to become blindness due to glaucoma. Interpretation: Glaucoma should be included in chronic disease-management programs in China for long-term care and continuous management of high-risk cases. Funding Statement: This research was supported by the National Natural Science Foundation of China (grant no. 81830026) and the Natural Science Foundation of Tianjin (grant no. 18ZXDBSY00030). Declaration of Interests: The authors declare there are no competing interests. Ethics Approval Statement: The study protocol was approved by the ethics review committee of Tianjin Medical University and other participating institutes. We obtained written informed consent from all study participants.

目的:探讨静脉注射在乙酰氨基酚对玻璃体切割术后的应用.方法:选取91例行单眼玻璃体切割术患者为研究对象,根据用药不同分为三组,分析三组术后疼痛、恶心呕吐、围手术期焦虑以及睡眠情况.结果:麻醉诱导前、插管1 min后、拔管前及离开麻醉恢复室前,三组患者血压及心率差异均无统计学意义(P>0.05);在麻醉恢复室、术后2 h、术后4 h同对照组相比,A组、B组VRS评分均明显偏低(P<0.05);对照组PONV人数明显多于A组和B组(P<0.05),且术后2天SAS、AIS评分明显高于A组和B组(P<0.05).结论:静脉注射对乙酰氨基酚作为超前镇痛药物可以有效控制玻璃体切割术后疼痛和术后恶心呕吐,还可以有效缓解患者术后焦虑、有助于改善患者睡眠.

Marine deoxygenation caused by eutrophication occurs continually in coastal zones, and alters microbial variety and energy shunt. Previous studies showed that 16S rRNA Thaumarchaeota widely distributed in marine environments, including the costal hypoxic zones, however, their activity is still unexplored. Here, by using metatranscriptomics and absolute quantification of 16S rRNA genes approaches, we investigated the microbial activity and composition in deoxygenated water column of Bohai Sea in summer. Our results indicated that dissolved oxygen (DO) largely controls their activity and composition. As DO decreasing, the transcriptional activity of Thaumarchaeota increased significantly with invariable absolute abundance, while the transcripts of photoautotroph Cyanobacteria decreased significantly. Biofunctional analysis showed transcripts of Thaumarchaeota were preferential assigned in clusters of orthologous gene (COG) “Energy production and conversion”, containing ammonia monooxygenase subunits A, B, C and Ferredoxin-related proteins. Additionally, the expression of NO-forming nitrite reductase family enzymes and metabolism of archaeal carbon fixation (3-hydroxypropionic acid / 4-hydroxybutyric acid cycle) were also enhanced in low DO water. In contrast, Proteobacteria, the dominated bacterial group in our study area, showed a comparable abundance and transcripts throughout water column, and performed for COG “Translation, ribosomal structure and biogenesis” and “Posttranslational modification, protein turnover, chaperones”. Comparatively, such results implied an intensified chemoautotrophic carbon fixation pathway for Thaumarchaeota in hypoxia zones, emphasizing their global ecological role.

目的 探讨对糖尿病视网膜病变(DR)患者施予羟苯磺酸钙、中医当归补血汤加减治疗的疗效情况.方法 纳入该次研究的150例对象均为2017年5月—2018年5月该院收治的DR患者,所有对象入院后均接受常规调脂、降压,同时采取羟苯磺酸钙治疗的75例为A组,另外施予羟苯磺酸钙、中医当归补血汤加减治疗的75例为B组,对比其结果.结果 治疗后B组QOL评分、炎性因子水平与血管内皮因子水平均优于A组,差异有统计学意义(t=21.310、12.407、31.086、12.241、14.796、7.614,P<0.05);A组有效率是46.67％,较B组78.67％低,差异有统计学意义(χ2=15.074,P<0.05).结论 对DR患者施予羟苯磺酸钙、中医当归补血汤治疗,可改善眼底症状和缓解机体炎症,促进生活质量与疗效的进一步提高.

BACKGROUND: Glaucoma is the commonest cause of irreversible blindness worldwide. Factors associated with the development of glaucoma have been examined in several studies, but not in the Chinese rural population. The China Rural Glaucoma Cohort Study (China-RG Study) was conducted to investigate the present status of glaucoma in China. METHODS: The China-RG Study is a population-based study (June–October 2018) that included 22 rural areas from ten provinces in China and enrolled 52,041 individuals (age >6 years). Participants completed a comprehensive eye examination, including visual acuity, intraocular pressure (IOP), slit-lamp microscopy, direct ophthalmoscopy, and further investigations. Associations of demographics and medical factors with glaucoma were assessed using multiple logistic regression models. Disability (YLD) and quality-adjusted life-years (QALYs) were used to express adverse health outcomes of glaucoma; cost-effectiveness analysis was conducted to evaluate the superiority of glaucoma-screening program. FINDINGS: Overall prevalence of glaucoma was 1.6% (95% CI 1.52–1.77%); 58.2%, and 19.8% had primary angle-closure glaucoma (PACG) or primary open-angle glaucoma (POAG), respectively. Increasing age, history of cerebral infarction, marital status, location, and family history of glaucoma were significant risk factors for both PACG and POAG. Cost–benefit analysis indicated savings of approximately 286,56.57 million yuan in direct medical expenses nationwide by adopting the proposed screening mode. INTERPRETATION: Glaucoma should be included in chronic disease-management programs in China for long-term care and continuous management of high-risk cases. The scope and inclusions of basic public health services should be expanded, especially to include ophthalmic diseases. FUNDING STATEMENT: This research was supported by the National Natural Science Foundation of China (grant no. 81830026) and the Natural Science Foundation of Tianjin (grant no. 18ZXDBSY00030)DECLARATION OF INTERESTS: The authors declare there are no competing interests.ETHICS APPROVAL STATEMENT: Ethics approval for study conduct was obtained from the institutional ethics committee of Tianjin Medical University General Hospital; all participants provided written informed consent prior to study participation.

目的 分析白内障术后黄斑水肿应用五苓散结合补阳还五汤加减治疗的效果.方法 选取2017年1月至2018年1月本院收治的白内障术后黄斑水肿患者80例(80眼),随机分为两组,各40例.对照组应用常规药物治疗,研究组在此基础上应用五苓散合补阳还五汤治疗,比较两组治疗效果.结果 两组治疗后的BCVA、CST、平均厚度与总体积比较,差异具有统计学意义(P<0.05).研究组治疗有效率为95.0％,对照组有效率为75.0％,对比差异具有统计学意义(P<0.05).结论 白内障术后黄斑水肿采用五苓散与补阳还五汤加减治疗,可有效缓解患者临床症状,提高临床治疗有效率,值得推广.

目的 探讨TNF-a在外伤性增生性玻璃体视网膜病变(PVR)发病中的作用.方法 32只青紫蓝兔随机分为正常组(8只)与模型组(24只),通过对模型组兔眼建立外伤性PVR模型,分别在造模后10、20和30 d行眼底照相;视网膜组织HE染色、TNF-α免疫组化染色;RT-PCR检测视网膜组织中TNF-α mRNA含量的变化.结果 成功建立外伤性PVR模型,HE染色及眼底照相可见模型组PVR的各个分级的表现.模型组在造模后10、20和30 d,视网膜组织中TNF-α免疫染色呈强阳性.TNF-a mRNA的相对表达量明显高于正常组(P＜0.05).绪论TNF-α表达水平升高可能在外伤性PVR的发病中起重要作用.

1961年,苏联成功发射世界上第一艘载人飞船东方一号,航天员作为人类使者开始了探索太空的旅程.1961年,美国实施“双子星座”计划,历时5年,其中一项任务就是要求宇航员观察其视力在飞行中的变化,表明当时科学家已经在考虑失重环境对人类眼睛的影响[1].201 1年,Mader等[2]对7位在太空中工作了6个月的宇航员的眼部进行检查,发现他们的眼球出现了不同程度的多种改变,包括:眼压一过性升高,视乳头水肿,脉络膜皱褶,眼球变扁,远视偏移,近视力减弱,视网膜神经纤维层增厚,视网膜棉绒斑等.其实,在此之前的数年里,美国NASA(National Aeronautics and Space Administration)太空医学部就已发现,经过长期太空作业的宇航员会出现不同程度的上述眼部症状.在回归地面生活后,这些眼部病理改变在数周内逐渐修复,但部分病例可持续近两年[3].宇航员的眼部生理病理变化及其机制引起了许多学者的重视,并对此进行了多方面的探讨和研究.笔者对长时间太空作业的宇航员眼部出现的生理病理变化及其机制综述如下.

目的 评价改良节段式自体巩膜长隧道在白内障超声乳化联合Ahmed青光眼阀植人术中应用的安全性及有效性.方法 采用改良自体巩膜长隧道行Ahmed青光眼阀植入术联合白内障超声乳化吸除治疗合并白内障或浅前房的难治性青光眼患者21例(24眼),检测手术前后眼压,术后随访期间前房内引流管长度,管道走形及管径大小,阀盘位置,术后阀管暴露的情况.结果 所有患者的平均随访时间为10.8个月(4～15个月).术前患者平均眼压(36.83±12.63) mmHg,术后末次随访平均眼压(18.36±8.24)mmHg,术后眼压较术前明显降低(P＜0.01).术后第一天,阀体前缘距离角膜穿刺口内缘的距离为11.89±0.14mm,前房内管道长度为3.01±0.34mm,末次随访时距离为11.65±0.38mm,前房内管道长度为2.96±0.37mm;随访期间阀体位置及前房内管道长度未见明显改变(差异无统计学意义,P＞0.05).所有患者随访期间均未见阀体及阀管暴露.结论 改良自体节段式巩膜长隧道应用于白内障超声乳化吸除联合Ahmed青光跟阀植入,具有管道不被压迫,管道走形笔直,不易发生管道退缩暴露等并发症、中长期眼压控制理想,是治疗难治性青光眼并发性白内障的有效方法.