环加氧酶-2对神经胶质瘤细胞株的多药耐药影响

目的 探讨环加氧酶2(cyclooxygenase-2,COX-2)在人神经胶质瘤细胞株SHG44发生多药耐药过程中的作用和机制.方法 应用阿霉素浓度递增和间歇诱导法建立SHG44/ADM耐药株,采用过表达COX-2和COX-2特异抑制剂NS398分别干预SHG44/WT和SHG44/ADM细胞株,免疫印迹法检测COX-2和MDR-1的表达量,酶联免疫分析PGE2产生量,荧光分光光度计检测细胞内阿霉素浓度.结果 过表达COX-2增加细胞PGE2生成量,同时增加MDR-1表达和活性;NS398抑制细胞PGE:生成量,减少MDR-1表达和活性.结论 COX-2参与神经胶质瘤细胞的多药耐药.     

神经生长因子对视网膜脱离视细胞保护作用的实验研究

目的 探讨神经生长因子(NGF)对视网膜脱离(RD)视细胞损伤的保护作用。方法 选用健康青紫蓝兔36只随机分为正常对照组、NGF治疗组和生理盐水(NS)模型组，实验组右眼RD模型制作后，NGF治疗组每天结膜下注射NGF0．1mL(1mg／mL)2次；NS模型组每天结膜下注射NS0．1mL，2次；实验动物于3d、14d后处死，取眼球壁做光镜、电镜检查。结果 光镜、电镜检查NGF治疗组内外节损害较轻、视细胞数较多、外核层较厚、视网膜结构和层次排列较好。NGF治疗组视网膜外核层凋亡细胞计数少于NS模型组。视网膜脱离后14d外核层厚度NGF治疗组厚于NS模型组；NGF治疗组视网膜外核层细胞计数多于NS模型组。结论 结膜下注射NGF对视网膜脱离后视细胞损伤有一定的保护作用。     

飞秒激光联合Cionni张力环植入治疗外伤性晶状体不全脱位的有效性和安全性

目的:探讨飞秒激光辅助晶状体超声乳化吸除联合Cionni 改良张力环(MCTR)植入治疗外伤性晶状体不全脱位的有效性和安全性.方法:外伤性晶状体不全脱位患者11例11眼,90°≤脱位<120° 4眼,120°≤脱位<180° 5眼,180°≤脱位<270° 2眼.应用接触式LenSx飞秒激光白内障手术操作平台完成前囊膜切开、晶状体预劈核、切口制作.部分患者行前段玻璃体切割.囊袋拉钩稳定囊袋,超声乳化白内障吸除,MCTR植入及巩膜层间缝合固定,晶状体囊袋内植入IOL.分析术后视力、术中术后并发症、前囊口、IOL和MCTR位置及眼压情况.结果:随访2mo.所有患者均顺利完成手术,其中5眼联合前段玻璃体切割术.植入双钩MCTR 4眼,单钩7眼.术后术眼最佳矫正视力≥0.5者4眼,0.3~<0.5者3眼,0.1~<0.3者3眼,<0.1者1眼.与术前矫正视力比较,差异有统计学意义(P<0.05).所有IOL位置居中,MCTR固定钩稳定地位于虹膜与晶状体囊膜间.术中、术后常见并发症为结膜下出血、前囊切开不完全、皮质残留、继发性青光眼和后囊膜混浊.结论:飞秒激光辅助白内障超声乳化吸除可以提高撕囊成功率,降低核乳化吸除难度,联合MCTR植入是外伤性晶状体不全脱位手术的理想术式选择.     

带虹膜隔折叠式人工晶状体植入兔眼的初步观察

目的 观察新型带虹膜隔折叠式人工晶状体(intraocular lens,IOL)植入兔眼的手术切口及术后反应,评价其与现有IOL的差异.方法 新西兰大白兔20只(20只眼),沿瞳孔缘剪除部分虹膜,行晶状体超声乳化吸除术.然后将其随机分为空白对照组、常规折叠式.IOL植入组、Morcher虹膜隔硬性IOL,植入组、带虹膜隔折叠式IOL植入组,每组5只眼.术后1周、2周、1个月和3个月用裂隙灯显微镜观察并拍照,术后1周检测各组角膜内皮细胞密度,术后3个月取出ILO并行扫描电镜检查,实验眼行组织病理学检查.结果 手术切口大小:空白对照组与常规折叠式IOL,植入组为2.6mm,Morcher虹膜隔硬性IOL植入组为10mm,带虹膜隔折叠式IOL植入组为5 mm.随访期间各组IOL均居中并保持原透明度.带虹膜隔折叠式IOL植入后的前房炎性反应重于空白对照组及常规折叠性IOL植入组,相比Morcher虹膜隔硬性IOL植入组则略有减轻.带虹膜隔折叠式IOL植入组在术后3个月可见周边虹膜色带略变浅,并有1例出现IOL襻移位.结论 新型带虹膜隔IOL可明显减少同类型IOL手术切口的大小,但需在材料的生物相容性、襻支撑性和虹膜隔色彩持久度方面进一步改进.     

兔晶状体超声乳化后囊膜混浊模型的建立与观察

目的 建立一种微创、安全、有效、快速的兔晶状体超声乳化后囊膜混浊模型,为更高要求的实验作准备.方法 新西兰大白兔11只(22只眼),行双眼超声乳化术,分别于术后1 d、3 d、1周、2周和术后1、2、3个月对术眼进行裂隙灯显微镜及组织病理学检查,观察兔眼前、后节反应,后囊膜混浊形成时间、部位、发展过程及组织形态学改变.结果 后囊膜混浊由周边部向中央区发展,伴Elschnig小体和晶状体纤维生成,其程度随时间推移日渐加重;术后3个月均出现不同程度的后囊膜混浊.结论 成功建立兔晶状体超声乳化后囊膜混浊模型,可为更高要求研究后囊膜混浊的实验做准备.     

角膜屈光手术后人工晶状体度数计算的初步研究

Objective To evaluate the results of cataract surgery in myopia patients after laser in situ keratomileusis(LASIK)and to compare the predictability of various methods of intraccular lens(IOL)power calculation.Method Seventeen cases (24 eyes)who had LASIK for myopia were divided into two group by with or without history of corneal power data.Corneal power was obtained by autokeratometry,corneal topography.Pentacam and IOLMaster.The IOL power was calculated with the clinical history method,Feiz-Mannis formula,Feiz-Mannis method and other methods.Postoperative final refraction and the deviation of the final spherical equivalent (SEQ) from the refractive target were measured 3 month after the surgery.Two sample t-test.linear correlation and regression analysis,paired t-test and Bland-Altman method of agreement were used to analyze these data.Results In the group with history data,the mean corneal power was(43.28±1.21)D and the mean SEQ was(-15.33±4.36)D before the LASIK surgery.In the group without history data,the mean SEQ was(-10.11±3.12)D.Before cataract surgery,the mean corneal power was(36.96±2.07)D and(36.85±1.40)D in these two groups.The mean arithmetic refractive prediction error after cataract surgery was(-0.66±1.27)D and(-0.47 ± 0.82)D in these two groups, respectively. Data calculated by using Hamed-Wang-Koch method, Masket Formula, Koch/Maloney method, Shammar method and Pentacam ERK method were lower than the emmetropic IOL power. Data calculated by using Feiz-Mannis Formula, Latkany Method, Savini method, Armberri Double K method were overestimated. The mean arithmetic errors of clinic history method, Corneal Passby Method and Haigis-L Formula were not significantly different from the predict refraction (P=0. 364, 0. 318 and 0. 069;t=0. 956,-1. 057 and -1. 911, respectively). There was strong correlation between the value calculated by using Feiz-Mannis Method or Haigis-L Formula and the true power (r = 0. 921,0. 915; P = 0. 000 and 0. 000,respectively). But none of the values calculated by these method could fully agree with the true value.Conclusions IOL power should be calculated accurately to avoid undercorrection. We recommend the combination of clinical history method, Feiz-Mannis Method, Corneal Passby Method and Haigis-L Formula for the calculation of IOL power.     

阿司匹林对萘性白内障α-晶状体蛋白分子伴侣活性的保护作用

目的探讨低剂量阿司匹林对萘性白内障α-晶状体蛋白分子伴侣活性的保护作用。方法将45只150～160g雌性sD大鼠随机分为空白对照组（无特殊处理）、萘性白内障组（每日0．5mg／kg萘灌胃3d后改为每日1mg／kg）和阿司匹林组（萘灌胃4h后每日100mg／kg阿司匹林灌胃）。应用定期图像分析和高效液相色谱（HPLC）法分离纯化α-晶状体蛋白,紫外分光光度法测定其抑制热诱导的β—L晶状体蛋白变性的能力。结果3周时萘性白内障组晶状体开始出现混浊,程度逐步加重,阿司匹林组混浊早期进展较萘性白内障慢,6周后进展程度接近于萘性白内障组。实验2周时3组晶状体混浊程度的比较差异无统计学意义（F：0．032,P=0．969）。实验第4、6、8、10周时3组晶状体混浊程度比较差异均有统计学意义（F=5031．130,P=0．000：F=115964．000,P=0．000;F=169846．500,P=0．000;F=195431．200,P=0．000）,且空白对照组与萘性白内障组、空白对照组与阿司匹林组、阿司匹林组与萘性白内障组之间的差异均有统计学意义（P=0．000）。阿司匹林组的α-晶状体蛋白分子伴侣活性高于萘性白内障组。结论低剂量阿司匹林通过保护n一晶状体蛋白分子伴侣活性延缓萘性白内障大鼠晶状体混浊的进展,此作用在白内障早期尤为明显。     

非计划截囊眼Neosonix爆破模式在白内障超声乳化手术中的安全性研究

连续环形撕囊（continuous circular capsulorhexis,CCC）是目前白内障手术最为合理的破囊方法,其成功与否直接影响到晶状体超声乳化术的顺利进行。CCC失败往往需被迫改为开罐式截囊。此时,如采用裂核或劈核式超声乳化术,由于该手术对囊膜和晶状体悬韧带施加较大的压力易致后囊膜破裂、晶状体核入玻璃体腔等严重并发症。为寻找一种安全有效的CCC失败眼的晶状体超声乳化术,本次研究应用Neosonix爆破模式联合旋转切削法施行CCC失败眼的晶状体超声乳化术15例（15眼）,获得较为满意的效果。现报道如下。     

短发夹状RNA干扰bcl-2后诱导人晶状体上皮细胞凋亡的实验研究

目的 应用RNA干扰技术抑制人品状体上皮细胞(HLEC)bcl-2基因表达,观察诱导其细胞凋亡情况,为防治晶状体后囊膜混浊提供新的策略.方法 实验研究.设计2条以bcl-2基因为靶标的短发夹RNA(shRNA),克隆入质粒PGCsi表达载体,分别命名为P1、P2,经脂质体转染入永生性HLEC系SRA01/04,48 h后检测转染效率和bd-2的基因及蛋白表达情况,并检测HLEC的细胞凋亡情况.多组间及组间计数资料的比较,采用随机区组设计的方差分析.结果 重组质粒经自动基因测序仪测序,证实构建成功.转染后48 h,流式细胞仪测得P1、P2转染率为44.1%、47.2%.免疫印迹法测得P1、P2组的bcl-2蛋白表达较对照组降低,实时荧光定量聚合酶链反应法测得P1、P2组的bcl-2 mRNA相对表达量为0.435、0.476,较对照组降低(F=1672.4,P<0.05),流式细胞仪双染法测得P1、P2组HLEC的细胞凋亡率分别为42.3%、45.4%,较对照组增加(F=1756.2,P<0.05),并且活化型caspase-3蛋白的表达增加.结论 P1、P2可抑制HLEC的bcl-2基因表达,并诱导HLEC凋亡.(中华眼科杂志,2009,45:636-640)     

角膜屈光手术后人工晶状体度数计算的初步研究

Objective To evaluate the results of cataract surgery in myopia patients after laser in situ keratomileusis(LASIK)and to compare the predictability of various methods of intraccular lens(IOL)power calculation.Method Seventeen cases (24 eyes)who had LASIK for myopia were divided into two group by with or without history of corneal power data.Corneal power was obtained by autokeratometry,corneal topography.Pentacam and IOLMaster.The IOL power was calculated with the clinical history method,Feiz-Mannis formula,Feiz-Mannis method and other methods.Postoperative final refraction and the deviation of the final spherical equivalent (SEQ) from the refractive target were measured 3 month after the surgery.Two sample t-test.linear correlation and regression analysis,paired t-test and Bland-Altman method of agreement were used to analyze these data.Results In the group with history data,the mean corneal power was(43.28±1.21)D and the mean SEQ was(-15.33±4.36)D before the LASIK surgery.In the group without history data,the mean SEQ was(-10.11±3.12)D.Before cataract surgery,the mean corneal power was(36.96±2.07)D and(36.85±1.40)D in these two groups.The mean arithmetic refractive prediction error after cataract surgery was(-0.66±1.27)D and(-0.47 ± 0.82)D in these two groups, respectively. Data calculated by using Hamed-Wang-Koch method, Masket Formula, Koch/Maloney method, Shammar method and Pentacam ERK method were lower than the emmetropic IOL power. Data calculated by using Feiz-Mannis Formula, Latkany Method, Savini method, Armberri Double K method were overestimated. The mean arithmetic errors of clinic history method, Corneal Passby Method and Haigis-L Formula were not significantly different from the predict refraction (P=0. 364, 0. 318 and 0. 069;t=0. 956,-1. 057 and -1. 911, respectively). There was strong correlation between the value calculated by using Feiz-Mannis Method or Haigis-L Formula and the true power (r = 0. 921,0. 915; P = 0. 000 and 0. 000,respectively). But none of the values calculated by these method could fully agree with the true value.Conclusions IOL power should be calculated accurately to avoid undercorrection. We recommend the combination of clinical history method, Feiz-Mannis Method, Corneal Passby Method and Haigis-L Formula for the calculation of IOL power.