儿童远视性弱视矫正后近视化的临床观察

目的:探讨儿童远视性弱视矫正后近视化的相关因素。方法:选择3～12岁的远视性屈光不正性弱视患儿,经散瞳验光配镜,矫正视力均≤0.8,确诊后每半年复查1次,每年散瞳验光1次,随访期末矫正视力≥0.9,共138例(276眼)。随访期5～12年。结果:中度远视屈光度下降最慢,轻度和高度屈光度下降较快。轻、中、高远视3组病例的初诊年龄和观察时间差异无显著性(P>0.05),说明远视度数低的患儿容易发生近视。结论:在矫正远视性弱视的同时应预防近视的发生和发展。     

角膜上皮擦伤致复发性角膜上皮糜烂临床分析

目的分析角膜上皮擦伤所致继发性复发性角膜上皮糜烂的临床特征,为其诊断和治疗提供一定的帮助。方法回顾性分析9例角膜上皮擦伤所致继发性复发性角膜上皮糜烂患者的临床资料,包括患者病史、一般情况、临床特点、诊断与治疗及预后等。结果 9例患者中男4例,女5例;年龄18～51岁;初次发作距角膜外伤的时间间隔为2～24周,平均(8.8±6.5)周。致伤物分别为手指、眼镜、塑料、纸片等。典型的症状表现为早晨醒时或夜晚睡眠时突然发病,患眼出现疼痛、眼红、流泪、畏光、异物感等刺激症状。5例行保守治疗,4例行手术治疗;角膜上皮完全愈合时间为1～10d。未见严重眼部并发症。结论角膜上皮擦伤致继发性复发性角膜上皮糜烂具有典型的临床特征,表现为早晨睡醒或睡眠时突然发作的眼部刺激征,且有反复发作的特点,部分多次反复发作的患者需要手术治疗。该病的预后良好。     

Up-regulation of HIF-1α and VEGF Expression by Elevated Glucose Concentration and Hypoxia in Cultured Human Retinal Pigment Epithelial Cells

Summary： In order to explore the effect of high glucose concentration and high glucose concentration with hypoxia on the production of hypoxia-inducible factor-1α （HIF-1α） and vascular endothelial growth factor （VEGF）, human RPE cells were cultured in 5,56 mmol/L glucose （control group）, 5.56 mmol/L glucose with 150 !a mol/L COCl2 （hypoxic group）, 25 mmol/L glucose （high glucose group） and 25 mmol/L glucose with 150 μmol/L COCl2 （combination group）. RT-PCR was used to detect the expression of HIF-1α and VEGF mRNAs. Western blot analysis was used to measure the levels of HIF-1α and VEGF proteins. Although the small amount of HIF-1α protein was able to be detected in high glucose group but not in control group, there was no significant difference between the expression of HIF-1α mRNA of RPE cells in high glucose group and that of RPE cells in control group. As compared with RPE cells in control group, the mRNA expression and the protein synthesis of VEGF in high glucose group were up-regulated. As compared with RPE cells in hypoxic group, the expression of HIF-1α mRNA of RPE cells in combination group was not different, but the protein synthesis of HIF-1α, the mRNA expression and the protein synthesis of VEGF were more obviously up-regulated. In conclusion, high concentration glucose mainly influence the protein synthesis of HIF-1α of RPE cell, and HIF-1α protein is able to be accumulated in high concentration glucose. Under hypoxia, the HIF-1α protein induced by high concentration glucose is more stable, and the expression of VEGF is obviously increased. It is suggested that high concentration glucose may play a role in retinal neovascularization, especially at ischemia stage of diabetic retinopathy.     

颈浅淋巴结在大鼠角膜移植免疫中的作用

目的探讨颈浅淋巴结在角膜移植免疫中的作用,为抑制移植术后的免疫排斥反应提供新的思路。方法建立大鼠同种异体角膜移植模型,24只SD鼠为受体,12只Wistar鼠为供体,所有大鼠均为雌性。受体鼠再分为A、B、C、D4组,A组为正常角膜移植组,B组为正常角膜移植合并颈浅淋巴结切除组,C组为高危角膜移植组,D组为高危角膜移植合并颈浅淋巴结切除组。每组均为6只,其中1只于术后14d行植片病理学检查及巨噬细胞免疫组化染色。对各组角膜存活情况进行评分比较,评价疗效。结果各组植片存活时间分别是(10.40±1.14)d、(46.30±9.46)d、(7.00±1.58)d和(15.00±3.39)d。植片存活时间B组较A组、C组,D组较C组均明显延长,差异均具有显著性意义(P<0.05)。结论颈浅淋巴结在大鼠角膜移植免疫中起着非常重要的作用,颈浅淋巴结切除术能有效抑制正常及高危角膜移植术后的免疫排斥反应。     

荧光标记大鼠全角膜新生血管和淋巴管的方法研究

目的探讨标记大鼠全角膜新生血管和淋巴管的方法。方法应用心脏灌注荧光联合全角膜免疫荧光法．共焦显微镜下区分并标记全角膜的新生血管和淋巴管。结果适度的抗体浓度和灌注时间下可标记出全角膜新生血管和淋巴管。血管呈黄绿色，淋巴管呈红色。结论心脏灌注荧光联合全角膜免疫荧光法可用于标记大鼠全角膜新生血管和淋巴管。     

Ipsilateral Lymphadenectomy to Inhibit Corneal Allograft Rejection in Rats

Immunological rejection is the major cause ofcorneal allograft failure. Looking for safe and fea sible therapies to inhibit the rejection is vital inclinical practice. Yamagami[1] succeeded to inhibitcorneal allograft rejection of rats with failure in theinduction of delayed type hypersensitivity (DTH)reactivity by bilateral cervical lymphadenectomy.However, this therapy may be associated with se rious surgical trauma and complication. On the ba sis of Yamagamis' research, …     

经鼻内镜与传统盲视下鼻泪管逆行置管术治疗慢性泪囊炎的临床对比研究

目的　比较经鼻内镜下鼻泪管逆行置管术（endoscopic silicone tube intubation,ESTI）与传统盲视下鼻泪管逆行置管术（conventional blind silicone tube intubat ion,CBSTI）治疗慢性泪囊炎（chronic dacryo cystitis,CDC）的优劣性。方法　收集2014～2015年在我院就诊的CDC患者46例,22例行ESTI,24例行CBSTI,分析两组的手术时间、术中视觉模拟量表（VAS）评分、并发症和疗效。结果　ESTI术后治愈17眼,好转5眼,无效3眼,总有效率88.0%;CBSTI术后治愈14眼,好转6眼,无效5眼,总有效率80.0%,两组间无统计学差异（χ2=0.881,P =0.644）。ESTI和CBSTI的手术时间和术中VAS分别为（10.32±2.30）min和（25.32±4.87）min, 2.02±0.86和4.11±1.44,两组间有统计学差异（t =-13.918、-6.012,P 均=0.000）。ESTI的术后并发症更少（χ2=4.878,P =0.027）。结论　ESTI治疗CDC是一种微创且近期疗效高的术式,鼻内镜的可视化是传统置管的优化,有助于推广应用。     

角膜移植后角膜新生淋巴管与新生血管间的关联

目的:研究角膜移植后角膜新生淋巴管与新生血管间关联。方法:人角膜取自行二次角膜移植的19名患者。5核苷酸酶-碱性磷酸酶(5-nase-Alkaline phosphatase,5-NA-ALP)双重酶组织化学染色及淋巴内皮细胞受体(lymphatic vessel endothelial receptor,LYVE-1)、内皮细胞黏附因子-1(platelet endothelial cell adhesion modecule-1,PECAM-1)双重免疫组化法标记角膜中的新生血管和淋巴管,并进行淋巴管计数(lymphatic vessels counting,LVC)和血管计数(blood vessels counting,BVC),比较BVC与LVC之间的关联。结果:角膜中存在角膜新生血管12例(63%),存在角膜新生淋巴管5例(26%)。角膜新生淋巴管仅出现在血管化角膜中。角膜移植后BVC与LVC间呈显著性正相关(r=0.725;P<0.01)。结论:人角膜移植后角膜新生淋巴管与新生血管之间存在密切关联。