新生血管性青光眼患者眼内白介素-6和血管内皮生长因子的定量测定

目的定量测定新生血管性青光眼患者和白内障患者房水及玻璃体内血管内皮细胞生长因子(vascularendothelialgrowthfactor,VEGF)、白细胞介素6(interleukin6,IL6)的浓度,并分析其临床意义。方法采用酶联免疫吸附测定法,分别测定32例新生血管性青光眼患者(分为两组,其中第Ⅱ组曾接受过全视网膜光凝治疗)、18例白内障患者(第Ⅲ组)的房水及玻璃体内VEGF、IL6浓度,所有患者标本均于手术中穿刺所得。结果第Ⅰ组房水及玻璃体内VEGF、IL6浓度明显高于其他两组,差异有显著性;而第Ⅱ组与第Ⅲ组相比,差异无显著性。结论眼内VEGF、IL6浓度增高在新生血管性青光眼的发生过程中起重要作用。     

视网膜缺血再灌注后即早基因C-FOS、C-JUN的表达

目的观察大鼠视网膜缺血再灌注(retinal ischemia reperfusion，RIR)后，凋亡即早基因c-los、e—jun及白介素1β(IL-1β)多肽在视网膜各层细胞中的表达变化，进一步明确凋亡即早基因和白介素1β与RIR损伤发生机制的关系。方法采用前房灌注生理盐水，形成130mmHg(17．3kPa)高眼压，诱导大鼠视网膜缺血60min，解除高眼压，建立RIR模型。缺血60min，再灌注1h、3h．6h、12h、24h后作视网膜石蜡切片，观察c—fos、c-jun及IL-1β的免疫组化结果。结果正常对照组未见c—fos、c-jun及IL-1β的表达，RIR后，c-fos、c—jun在视网膜神经节细胞层(ganglion cell layer，GCL)和内核层(inner nuclear layer，INE)的表达为，再灌注1h少量表达，3h达到高峰，6h开始下降，12h、24h几乎趋于正常组表达。IL-1β在再灌注12h、24h出现表达。而外核层(outer nuclear layer，ONE)几乎均无无阳性表达。结论c—fos、c-jun及IL-1β参与RIR损伤的发生，RIR中视网膜节细胞层和内核层细胞存在凋亡征象。     

骨桥蛋白及其受体CD44在白内障及正常晶状体上皮细胞中的表达

目的探讨骨桥蛋白(osteopontin,OPN)及其受体CD44在白内障患者及正常晶状体上皮细胞中的表达规律及意义。方法采用免疫组织化学法检测22例前囊下白内障1、7例核性白内障、14例皮质性白内障患者和11例正常晶状体上皮细胞中OPN和CD44的表达,并进行阳性细胞计数和各组间比较。结果OPN与CD44在前囊下白内障晶状体上皮细胞中的阳性表达率为56.48%±4.14%和45.55%±5.52%,在皮质性白内障为4.36%±1.12%和3.05%±1.02%,在核性白内障和正常晶状体中表达为阴性。前囊下白内障组中OPN及CD44的阳性表达率与核性白内障、皮质性白内障及正常人晶状体比较,差异有显著性(P<0.01),经Spearman等级相关分析,前囊下白内障患者晶状体上皮细胞中OPN和CD44的阳性表达率呈正相关(r=0.866)。结论OPN及CD44在前囊下白内障及皮质性白内障晶状体上皮细胞中均表达为阳性,在前囊下白内障晶状体上皮细胞中表达明显增强,两者在前囊下白内障的形成过程中可能起重要作用。     

缺血再灌注大鼠视网膜细胞线粒体钙含量与组织型纤溶酶原激活物活性的相关性

目的观察缺血再灌注大鼠视网膜细胞线粒体钙含量与组织型纤溶酶原激活物（tissue-type plasminogena etivator，TPA）活性的变化，探讨两者之间的相关性。方法采用提高眼压法造成视网膜缺血后，恢复眼压形成血流再灌注。实验分正常对照组和缺血1h再灌注1h组、缺血1h再灌注2h组、缺血2h再灌注1h组、缺血2h再灌注2h组四个实验组，每组各取10例测定视网膜细胞线粒体钙浓度与TPA活性的变化，并进行相关性分析。结果缺血再灌注后，大鼠视网膜细胞线粒体钙含量与TPA活性随缺血和再灌注时间的延长而升高（P〈0．01），两者之间呈显著相关性（r=0．524，P〈0．01）。结论缺血再灌注可引起视网膜细胞线粒体钙含量的升高，从而导致视网膜组织TPA活性的增高，引起视网膜组织结构和功能的损伤。     

2005～2010年《中国斜视与小儿眼科杂志》文献计量分析

目的分析《中国斜视与小儿眼科杂志》载文、引文及著者的数量特征及其蕴含的情报价值。方法用文献计量学的方法对2005~2010年《中国斜视与小儿眼科杂志》的载文、引文和著者的情况进行统计分析。结果《中国斜视与小儿眼科杂志》6年载文505篇,期均载文量21.04篇,篇密度为0.44,合著率82%,合作度3.04;平均引文率92.67%,篇均引文量6.7条,主要引文类型为期刊(81.14%)和图书(18.45%),引文语种主要是英语和汉语,各占50.96%和48.74%,期刊自引率10.79%,普赖斯指数30.45%,被引用频次前17位的中外文期刊的文献引用量占期刊引文总量的59.45%。结论《中国斜视与小儿眼科杂志》是斜视与小儿眼科领域高质量的专业核心期刊,学术质量稳步增加,在我国斜视与小儿眼科学的发展和建设方面发挥着积极的作用。     

Scientometric analysis and mapping of 20 years of glaucoma research

AIM: To provide a scientometric analysis in the field of glaucoma. METHODS: A bibliometric method was used to obtain a view of the scientific production in field of glaucoma by data extracted from the Institute for Scientific Information (ISI) from 1993 to 2013. Specific parameters were retrieved from the ISI. Articles about glaucoma were analyzed regarding the topics’ structure, history, and document relationships using HistCite software. Also, the trends in the most influential publications and authors were analyzed. RESULTS: The number of articles was constantly increasing, and most highly cited articles addressed clinical and epidemiologic topics in this field. During the past three years, there has been a trend towards genomic research studies and also more molecular translational research. CONCLUSION: This was the first scientometric report on glaucoma, analyzing the characteristics of papers and the trends in scientific production. A constant increase was observed in the number of papers, while the subject of papers had a shift in the past three years towards genomic research studies.     

埃塞俄比亚德布拉巴汗地区盲目分析

埃塞俄比亚德布拉巴汗市医院眼科门诊病人１４３６人中查出盲目患者１６８人，占门诊病人的１１．７％。其中双眼盲６７人，占门诊病人的４．６７％，占盲人的３９．８８％；单眼盲１０１人，占门诊病人的７．０３％，占盲人的６０．１２％。通过分析，初步找出了在埃塞的三大致盲病因，即白内障、青光眼和眼外伤。其中白内障具有重要的开盲意义。     

间歇性外斜视患者远距离立体视的临床特点

目的探讨间歇性外斜视患者远距离立体视的临床特点及其相关影响因素，为手术时机的选择提供参考依据。方法利用Optec 3500视觉检查仪检查61例间歇性外斜视患者的远距离立体视。采用Titmus立体图检查近距离立体视。结果①术前远距离立体视丧失的比例和视锐度损伤的程度均明显高于近距离立体视。②术后远距离立体视重建的比例提高和立体视锐度改善显著。③术后患者的远距离立体祝与病程呈正相关。结论①患者术前远距离立体视大部分丧失，近距离立体视保持较好。②手术矫正可明显提高患者的远距离立体视，主要影响因素为病程。③远距离立体视锐度可作为选择手术时机的一个重要参考依据。     

角膜移植后局部淋巴结内树突状细胞数量及趋化因子CCL19含量的变化

目的研究角膜移植后局部淋巴结内树突状细胞数量及趋化因子CCL19含量的变化。方法应用免疫组织化学技术测定大鼠角膜移植后局部淋巴结内趋化因子CCL19含量及树突状细胞数量。结果自体移植组术后局部淋巴结内CCL19含量升高,持续至术后第3天(P<0.05),以后恢复至正常水平(P>0.05)。同种异体移植组,局部淋巴结内CCL19含量在术后1～3d与自体移植组差异无显著性(P>0.05),以后持续上升,至后期显著高于正常组及自体移植组,于第7天达高峰(P<0.05)。树突状细胞数量与CCL19变化趋势一致。结论角膜移植后局部淋巴结内CCL19表达增高,促进树突状细胞的迁移,这可能是同种异体移植排斥反应启动与进展的重要因素。     

Cost-effectiveness of Descemet stripping automated endothelial keratoplasty versus penetrating keratoplasty in patients with endothelial dysfunction in India

Purpose:The aim of this study was to compare the cost-effectiveness and perform cost-utility analysis of Descemet stripping automated endothelial keratoplasty (DSAEK) vs. penetrating keratoplasty (PK) in Indian population.Methods:This was an institutional, ambispective, observational study. Patients who underwent PK or DSAEK for endothelial dysfunction were included and followed up for 2 years; those with other ocular comorbidities were excluded. The analysis was performed from the patient’s perspective receiving subsidized treatment at a tertiary care hospital. Detailed history, ophthalmic examination, total expenditure by patient, and clinical outcomes were recorded. The main outcome measures were best spectacle-corrected visual acuity (BSCVA), graft survival (Kaplan–Meier survival estimates), incremental cost-effectiveness ratio (ICER), and incremental cost-utility ratio (ICUR). Utility values were based on quality-adjusted life years (QALYs) associated with visual acuity outcomes. Statistical analysis was performed using SPSS software package, version 12.1; a value of P < 0.05 was considered statistically significant.Results:A total of 120 patients (PK: 60, DSAEK: 60) were included. At 2 years, for a similar logMAR BSCVA, [PK (0.32 ± 0.02), DSAEK (0.25 ± 0.02); P = 0.078], the overall cost for PK (13511.1 ± 803.3 INR) was significantly more than DSAEK (11092.9 ± 492.1 INR) (difference = 1952.6 INR; P = 0.01). ICER of DSAEK relative to PK was –39,052 INR for improvement in 1 logMAR unit BSCVA. ICUR of DSAEK relative to PK was –1,95,260 INR for improvement in 1 QALY.Conclusion:DSAEK was more cost-effective than PK in patients with endothelial dysfunction at 2 years.     

不同类型视网膜脱离患者视网膜下积液蛋白质结构分析

为比较不同类型视网膜脱离（ＲＤ）患者视网膜下积液（ＳＲＦ）蛋白质结构的异同，我们用傅里叶拉曼（ＦＴＲａｍａｎ）和傅里叶红外（ＦＴＩＲ）光谱测定不同类型ＲＤ患者血清及ＳＲＦ蛋白质结构。结果发现不同类型ＲＤ患者血清的两种光谱很相似，但的析两各光谱因类型和病程而异。不同类型ＲＤ患者ＳＲＦ不仅有芳香族结构明显改变，而且脂蛋白结构也有改变。     

Intermediate uveitis of pars planitis type in identical twins

The occurrence of intermediate uveitis in monozygotic twins has rarely been reported in literature. We report the occurrence of this disease condition in identical twins. Twin sisters presented with typical features of intermediate uveitis, which appeared three years earlier in one of the sisters. They were treated with posterior subtenon injection of triamcinolone acetonide and recovered well. Systemic evaluation and laboratory investigations did not reveal any etiology. Cytogenetic high-resolution analysis did not reveal any chromosomal abnormalities. Pedigree analysis revealed no specific transmission pattern. No other family members in three generations had similar ocular disease. Our report indicates that a detailed family history should be taken in intermediate uveitis and examination of other siblings of patients with intermediate uveitis should be performed. This revised version was published online in July 2006 with corrections to the Cover Date.     

外伤性前房积血732例临床分析

目的探讨外伤性前房积血的年龄分布、致伤物、并发症及治疗结果。方法对732例(732眼)前房积血进行分析。结果732例中,发病年龄以20~29岁最多;致伤原因以拳击伤最常见;并发症以外伤性瞳孔散大最多见;绝大部分患眼的视力可以在保守治疗的情况下恢复;732例中,视力恢复到0.6以上的为509例,占69.53%。结论外伤性前房积血的处理原则是仔细全面检查,在促进积血吸收的同时及早发现并预防并发症。一旦有并发症,要积极治疗并严格掌握手术适应症。     

人晶状体蛋白质组研究中双向电泳技术的初步建立与优化

目的:初步建立人晶状体蛋白质组研究中的双向电泳分离技术,提高晶状体蛋白分辨率和重复性。方法:采用固相pH梯度(IPG)等电聚焦(IEF)为第一向、SDS-PAGE垂直电泳为第二向的双向电泳技术,对样品的处理、水化、等电聚焦、SDS-PAGE等步骤进行了优化。结果:样品经3次重复实验,获得了蛋白质斑点数(133±7)个,蛋白质斑点在IEF方向平均偏差为(2.13±0.17)mm,在SDS-PAGE方向平均偏差为(1.78±0.21)mm,相对百分含量的标准差为(4.01±1.64)%。结论:双向电泳适合于人晶状体蛋白质组的研究。     

近视及近视散光眼高阶像差的研究

目的分析近视及近视散光眼高阶像差的分布特点,探讨高阶像差的相关因素,为个体化切削术前病例合理筛选提供客观依据。方法利用Allegretto Wavelight Ana-lyzer像差仪对来我中心欲行准分子激光原位角膜磨镶术(laser situ in keratomileusis,LASIK)的142例(273眼)近视及近视散光患者进行波阵面像差检测并分析结果。结果①4mm瞳孔直径下垂直像差C7与最佳矫正视力(best correctivevision acuity,BSCVA)呈负相关(r=-0.147,P=0.05)。水平彗差C8在不同瞳孔直径下与BSCVA无明显相关性。球差C12在6 mm瞳孔直径下与BSCVA呈负相关(r=-0.151,P=0.044)。②左右眼之间高阶像差比较差异无显著性(P>0.05),男女性别之间高阶像差RMS 3-6比较差异无显著性(P>0.05)。③C7与年龄呈明显负相关(P<0.01),C8与年龄无明显相关性(P>0.05),C12与年龄呈明显正相关(P<0.01)。④RMS3、RMSh与柱镜呈明显正相关(P<0.05),RMS4与球镜无明显相关性(P>0.05)。RMS5在瞳孔大于6mm时与柱镜呈明显正相关(P<0.05),RMS6在瞳孔大于6mm时与球镜呈明显正相关(P<0.05)。结论①眼别与性别对近视及近视散光眼的高阶像差无明显影响。②C7主要受散光和年龄影响,C12主要受年龄影响。③对欲行个体化角膜切削的近视患者,术前除了要考虑总的高阶像差、角膜的不规则性,大瞳孔和再次手术修补等适应证外,还应考虑C7、C12和年龄等因素,综合制订切削方案。     

正常大鼠视网膜电图振荡电位时域和频域分析

用快速傅里叶转换（FFT）方法，对正常wistar大鼠暗适应ERG振荡电位进行频域和时域分析，在OPs能量集中区确定通频带，结果发现50只大鼠OPs通频带的低频端为52．9±5．4Hz，高频端为155．3±10．7Hz，频域中总能量、最高能量的变异性较大，时域中的各子波振幅和总振幅的变异程度也大于潜伏期。     

Moorfields回归分析及多变量区别分析诊断开角型青光眼

目的研究Moorfields回归分析(MRA)及多变量区别分析(MDA)的2个指标FSM和RB诊断开角型青光眼的能力,及MRA在视盘整体和视盘分区间的差异。方法对23例正常人(26眼)、26例可疑开角型青光眼患者(32眼)和21例开角型青光眼患者(21眼)进行HRT-Ⅱ和OCTOPUS视野计G2-TOP程序两项检查。结果视盘整体MRA、FSM、RB与视野缺损指数间相关系数分别为0.537、-0.565、-0.716(P<0.01),且3个组间差异均有统计学意义(P<0.01),随着视盘面积增大,MRA、FSM和RB特异性均下降。可疑组中视盘分区MRA与视野检查一致率均高于整体,一致率最高分区为颞下(78.13%)。各分区中MRA敏感性、特异性最高的分区为颞上和颞下。结论MRA和MDA检测开角型青光眼能力较强,且与视野检查间存在较好的相关性,但应用于大视盘分析时须谨慎下结论。     

豚鼠形觉剥夺性近视眼后极部巩膜蛋白多糖水平的变化

目的观察豚鼠形觉剥夺性近视眼模型后极部巩膜蛋白多糖水平的变化,探讨其在哺乳类动物近视眼发生机制中的作用。方法出生2~3周的断乳花色豚鼠20只,随机均分成2组。遮盖组右眼予不透明眼罩遮盖2周,去遮盖组右眼遮盖2周后去遮盖1周。左眼开放为自身对照眼。于实验开始及结束时检影、测眼轴,达规定时限后处死动物,取后极部巩膜,行免疫组织化学及RT-PCR反应,检测decorin核心蛋白及其mRNA的表达。试验数据采用配对t检验和方差分析进行统计学处理。结果豚鼠遮盖组诱导的相对近视约-8.15 D,眼轴相对增长约0.63 mm;去遮盖组相对近视约-4.30 D,眼轴相对增长约0.57 mm。去遮盖组屈光程度下降值明显小于遮盖组(F=5.974,P<0.05)。免疫组织化学法及RT-PCR法示遮盖组和去遮盖组的实验眼和自身对照眼后极部巩膜均有decorin核心蛋白及其mRNA表达;其mRNA相对含量在组内比较差异均有显著性(P<0.05)。结论豚鼠形觉剥夺性近视眼后极部巩膜decorin mRNA表达显著降低,去除遮盖后其表达上调,提示decorin可能参与了形觉剥夺性近视眼的发生。     

糖尿病患者泪膜及角结膜上皮稳定性的改变

目的了解糖尿病患者眼表上皮及泪膜稳定性改变情况。方法选50名糖尿病患者100眼,52名健康对照者104眼,性别年龄成组匹配,分别进行角膜知觉检查、基础泪液分泌试验(SchirmerⅠ)、泪膜破裂时间检查(BUT)、角膜荧光素染色、结膜印迹细胞学检查、糖尿病眼底检查、眼底照相或荧光造影,观察杯状细胞及结膜化生情况,问卷调查干眼。结果糖尿病组角膜知觉下降(P<0.05),SchirmerⅠ试验值、BUT值均下降(P<0.05);角膜荧光素染色阳性增加(P<0.05);杯状细胞丢失、结膜鳞状化生明显(P<0.05)。糖尿病眼底病变程度与SchirmerⅠ试验、BUT呈负相关,与角膜荧光素染色、结膜鳞状化生等级呈正相关(P<0.05),与病程无相关性(P>0.05)。结论糖尿病可导致患者泪液分泌减少、泪膜稳定性下降及角结膜上皮的损害,在伴周围神经病变的患者中表现尤其明显,且损害程度与糖尿病视网膜病变程度具有相关性。     

Detecting the displacement of periodic patterns

Observers were asked to detect the direction of displacement of a 30 c/deg grating. They were virtually unable to perform this task when the component was presented alone but when either a 28 or a 32 c/deg component (neither of which moved) was added to the 30 c/deg component observers were extremely sensitive to displacements of the 30 c/deg component. These results suggest that the detection of displacements cannot take place within narrow-band spatial channels, but relies on a mechanism which compares the output of channels in different spatial positions.