AIM:To investigate the expression of cyclin dependent kinase inhibitors p21 and p27 in different ages of rabbit lens epithelial cells(LEC).METHODS:p21 and p27 in lens anterior capsule membranes in 10, 20 and 30 weeks old rabbits were measured by RT-PCR and Western blot in levels of mRNA and protein.RESULTS:p21 in rabbit lens anterior capsule membranes had similar expression with p27 in levels of mRNA and protein. Their expressions were highest in youth rabbits, while lowest in middle aged rabbits. The differences of both p21 and p27 among different ages of rabbit LEC were significant(P<0.05).CONCLUSION:p21 and p27 may play a balancing role in the process of cycle regulation in rabbit LEC, which provides a reference for researches related to prevent posterior capsular opacification(PCO).

目的:研究干眼症的病因,为干眼症的诊断提供依据,减少误诊的发生。方法:回顾性分析83例确诊为干眼症的患者的发病原因,并分析其中16例发生误诊的病例。诊断方法为依据干眼症症状、泪膜稳定性下降、泪液分泌减少及眼表损害等表现,并按一定的诊断步骤进行。结果:干眼症患者83例中最常见的原因是视屏终端综合征24例（29%）、慢性睑缘炎12例（14%）、干燥综合症12例（14%）。有10例误诊为慢性结膜炎,有2例误诊为病毒性角膜炎,另有4例干眼症的病因诊断错误。结论:干眼症的发病原因虽不是诊断干眼症的必备条件,但认识并积极寻找干眼症的病因可以为诊断提供依据,同时也可减少误诊的发生。

AIM:To evaluate the role of intercellular adhesion molecule-1(ICAM-1) in the pathogenesis of diabetic cataract,and to investigate the effects of transforming growth factorβ-1(TGF - β1) on the expression of ICAM-1 in the lens epithelium cells.METHODS:Totally 120 SD rats were randomly divided into two groups:normal control group and diabetic cataract group.Diabetic model was built in diabetic cataract group.Immunohistochemical streptavidin-peroxidases(SP) method was used to observe changes of the expression of ICAM-1 in the lens epithelium cells in two groups.RT-PCR method was used to detect the effects of TGF-β1 and TGF-β1 antibody on the expression of ICAM-1 in the cultured human lens epithelium cells.RESULTS:The expression of ICAM-1 in the lens epithelium cells was significantly higher in diabetic cataract group than that in normal control group,and increasing with the development of disease (P<0.01).The expression of ICAM-1 in the lens epithelium cells was significantly increased in TGF-β1 cultured group,which had statistical significance compared with normal serum cultured group(P<0.05).The expression of ICAM-1 was significantly inhibited in TGF-β1 antibody cultured group,which had statistical significance compared with TGF-β1 cultured group(P<0.05).CONCLUSION:TGF-β1 could induce the expression of ICAM-1 in the lens epithelium cells,and played an important role in the occurence of diabetic cataract through promoting attachment and proliferation of lens epithelium cells.

目的:观察糖尿病性白内障晶状体上皮细胞转化生长因子β-1(TGF-β1)、细胞间粘附分子-1(ICAM-1)和Ⅰ-胶原(COL-Ⅰ)的表达,用以研究ICAM-1在糖性白内障发病机制中的作用。方法:120只SD大鼠随机分为两组,在糖尿病组中,一次性腹腔注射STZ建立糖尿病模型;用免疫组化SP法分别于2、4、8周末观察糖尿病性白内障晶状体上皮细胞中ICAM-1、TGF-β1和COL-Ⅰ表达变化及其相关性。结果:在糖性白内障组晶状体上皮细胞中ICAM-1、TGF-β1和COL-Ⅰ的表达明显增高,与对照组比较差异有统计学意义,且TGF-β1与ICAM-1和COL-Ⅰ之间的表达表现出明显的正相关关系。结论:在糖性白内障组晶状体上皮细胞中ICAM-1的表达明显增高,TGF-β1可以促进晶状体上皮细胞ICAM-1和COL-Ⅰ的表达,ICAM-1通过介导细胞与细胞间、细胞与细胞外基质粘附,促进HLEC的粘附、增生和移行,从而在糖性白内障中发挥重要作用。

目的 研究羊膜移植在兔角膜碱烧伤早期治疗中的作用机制.方法 对60只新西兰白兔随机分为碱烧伤组、羊膜移植组及正常对照组,实验组建立角膜碱烧伤模型,羊膜移植组于烧伤后30min实施羊膜移植手术.术后14、30、60d,观察分析角膜病理组织学改变;并应用计算机图像分析系统对角膜组织中基质金属蛋白酶-2(Matrix metalloproteinase-2,MMP-2)和基质金属蛋白酶组织抑制剂-2(Tissue inhibitors of metalloproteinase-2,TIMP-2)的表达进行半定量测定.结果 羊膜移植组角膜浸润及角膜基质坏死溃疡程度均较同期碱烧伤组为轻,角膜MMP-2的表达显著降低(P＜0.05),而TIMP-2表达显著升高(P＞0.05).结论 羊膜移植可提高角膜TIMP-2表达的水平并抑制MMP-2的活性,从而在角膜碱烧伤的早期治疗中起到抑制角膜炎症和溃疡的作用。

Objective To observe the influence of amniotic membrane transplantation(AMT) for early alkali burn in rabbits on corneal epithelium inflammatory reaction and the forming of new vessels.Methods 60 New Zealand white rabbits were randomly divided into:alkali burn group(A),fresh amniotic membrane transplantation group(fAMT),preserved amniotic membrane transplantation group(pAMT) and control group(C).The models of corneal alkali burns were set up in all rabbits.Surgical operations 30 min after burn.The corneal conditions were observed by histopathology and using a computer image analysis system to count polymorphonuclear neutrophils(PMN) and microvessel,and the enzymatic activities of the t-PA and PAI-1 in corneal extracts were measured by chromogenic substrate method.Results The healing of cornea epithelium in groups AMT were faster than group A.The number of PMN and microvessel counts in groups AMT was less than the group A(P<0.001).The t-PA/PAI-1 ratio in group AMT was lower than that in group A(P<0.01),and t-PA/PAI-1 ratio was lower in group fAMT than that in group pAMT(P<0.05).Conclusion The amniotic membrane transplantation has strong effect on promoting corneal epithelial healing,lessening inflammatory reaction and decreasing the forming of new vessels.And the fresh amniotic membrane transplantation is better than the preserved one.

目的:通过对棘阿米巴角膜炎病例的报道、分析,引起对棘阿米巴角膜炎的重视以早期诊断、早期治疗。方法:对2003年6月至2006年8月在我院收住院的22例(23眼)棘阿米巴角膜炎患者诱因、临床表现、实验室检查、治疗及预后进行回顾性分析。结果:发病诱因:戴角膜接触镜者2例(3眼),污水溅入眼内者1例(1眼),异物溅入眼内者2例(2眼),眼睛被异物刺伤者6例(6眼),原因不明者11例(11眼)。22例均经10%KOH或生理盐水湿片法镜检查见棘阿米巴包囊或滋养体。经药物与手术联合治疗,取得较好疗效。结论:棘阿米巴角膜炎的早期诊断至关重要,其危险因素除了佩戴角膜接触镜外,角膜外伤、异物也是重要的危险因素。

Objectives To investigate the effect of amniotic membrane transplantation(AMT) for early alkali burn in rabbits and its influence on the activity of t-PA and PAI-1.Design Randomized,comparative experimental study.Participants Seventy-two New Zealand white rabbits were randomly divided into four groups,that was,alkali burn(A) group,fresh amniotic membrane transplantation(fAMT) group,preserved amniotic membrane transplantation(pAMT) group,and control(C) group.Every group included 18 rabbits.The right eye was served as experimental eye.Methods Models of corneal alkali burns were set up in three experimental groups.The right eye was respectively transplanted amniotic membrane in AMT group after 30min.14 days,30 days,and 60 days post-surgery,corneal conditions were observed with a computer image analysis system,and enzymatic activities of t-PA and PAI-1 in corneal extracts were measured with chromogenic substrate method.Main Outcome Measures Clinical,histologic,and enzymatic activities examinations including fluorescence stain in corneal epithelium,area of corneal lesion,the optical density level of corneal lesion,(t-PA) and total(PAI-1) competence,and(t-PA/PAI-1) ratio.Results 14,30,60 days postoperatively,enzymatic activities of(t-PA) and(t-PA/PAI-1) ratio in pAMT and fAMT were both lower than those in A(P0.01).14 days after operation,enzymatic activities of(t-PA) in fAMT decreased more obviously than those in pAMT(P=0.022),while enzymatic activities of total(PAI-1) increased more obviously in fAMT than those in pAMT(P=0.001),and 14,30 days after operation(t-PA/PAI-1) ratio was lower in fAMT than that in pAMT(P=0.000,P=0.030).Conclusions Activities of(t-PA) and(t-PA/PAI-1) ratio were decreasing after amniotic membrane transplantation,which confirmed on step that amniotic membrane play the role of suppressing inflammation,reducing scar,and promoting epithelium heal.fAMT is better for treatment than pAMT.

数字减影血管造影(data substraction angiography,DSA)是利用电子计算机处理数字化的影象信息,以消除骨骼和软组织的影响的减影技术,是新一代血管造影的成像技术.DSA常用于心血管造影,有助于心脏、大血管的检查.现我科利用DSA对眼眶血管畸形进行检查和治疗,取得了良好效果,特报告如下.

患者男,43岁.以"右眼视力下降,伴胀痛、头痛1个月"为主诉入院.查体:一般情况良好,心肺肝脾未见异常.眼科检查:右眼视力无光感,左眼视力0.8,眼球活动无受限.右眼睑水肿,眼球轻度突出,结膜混合充血、水肿,角膜呈雾状混浊、水肿,知觉减退.

目的观察自体角膜缘上皮移植术治疗翼状胬肉的疗效.方法在显微镜下用自体角膜缘上皮移植术对42例(50只眼)翼状胬肉患者进行治疗,术后随访6～32个月.结果 42例角膜上皮愈合良好,角膜透明、光滑,未见复发.结论自体角膜缘上皮移植可为病变区角膜及结膜提供新的干细胞来源,是治疗翼状胬肉的有效方法.

目的探讨板层角膜移植治疗角膜病变的疗效.方法对11例(12只眼)角膜疾患行治疗性角膜板层移植术.结果12只眼病灶全部切除,术后植片成活率100%,治愈率100%,视力有不同程度的提高.结论采用角膜板层移植治疗角膜溃疡、巨大胬肉、皮样瘤等角膜疾患疗效良好.

糖皮质类固醇致青光眼有逐年增多的趋势,多发生于男性青少年,该病与滥用激素和监控不严有关.本文对23例(41眼)糖皮质类固醇性青光眼进行临床分析.治疗应根据用药时间,眼压控制程度及视盘、视功能损害的程度采取相应的措施.强调要加强卫生宣教工作,合理用药、提高广大医务工作者对这一医源性疾病的警觉,尽量减少糖皮质类固醇青光眼的发生.

目的探讨眼睑肿物的临床、病理学分类及手术方法.方法回顾性分析1996年～2001年收治44例眼睑肿物患者年龄分布及病理分类;结合病例讨论肿物切除及整形术应注意的问题.结果恶性肿瘤中居前2位者为基底细胞癌、睑板腺癌,良性肿瘤中居前2位者为色素痣,血管瘤和多发性神经纤维瘤.39例手术切除,2例睑板腺癌术后复发再手术,后愈合好,2例死亡,余患者疗效好.结论对眼睑肿物进行分析有利于临床诊断以及指导治疗方案.

1997～2001年,笔者行美容重睑术119例,现将其中资料较完整的100例手术体会报告如下. 1 临床资料 1.1 一般资料本组100例均为双眼,女性90例,男性10例;年龄22.35±1.076岁(16～66岁),其中18～28岁89例(89%). 1.2 术式选择[1] 双重睑术的手术方法有三类:切开缝合法、缝线法、埋存缝线法.根据不同年龄、眼睑皮肤、眶脂、内眦赘皮等不同情况选择不同手术方法:88例行切开缝合法,其中单纯切开缝合法75例(85.23%),切开去皮法8例(9.09%),切开去脂法5例(5.08%);12例做埋存缝线法.

例1,男,20岁,农民.因双眼红痛、视力下降、虹视3年多并逐渐加重为主诉入院.检查:全身无特殊.双肾B超检查未见异常.视力:右0.25,左0.25(不能矫正).双眼结膜混合性充血,角膜轻度水肿,角膜直径1 2mm,前房轴深约4mm,周边深度1.5CT,瞳孔儿圆直径为3mm,对光反应迟钝.虹膜广泛萎缩呈灰白色,表层皱襞和隆起消失,睫状部多处呈楔状缺损并见新生血管.

自2000年以来,我们对泪道不同部位阻塞的51例56只眼,采用不同方法的硅胶逆行插管术,治疗效果满意,现报告如下. 1 一般资料

我院近20年共收治7例眶内猬氏裂头蚴,其中4例自眶内手术取出了活动的虫体,3例有敷贴生青蛙史,临床表现类似,现报告如下. 1 临床资料

糖尿病视网膜病变是糖尿病常见的并发症,也是眼科致盲的重要原因,本文通过测定糖尿病视网膜病变患者红细胞膜ATP酶的活性[1,2]及平均红细胞体积,并与无视网膜病变的糖尿病患者及健康志愿者进行比较,探讨红细胞膜ATP酶活性改变及红细胞体积的改变与糖尿病视网膜病变的关系.