视网膜色素上皮细胞氧化应激相关microRNA的鉴定

目的：应用miRNA表达谱芯片筛选视网膜色素上皮细胞与氧化应激相关的miRNA,为更加全面深入地研究年龄相关性黄斑病变(age-related macular degeneration,AMD)发生的分子机制提供新的思路。

方法：培养D407细胞,分别使用100、200、400μmol/L H₂O₂处理细胞24h后,Trizol试剂抽提细胞总RNA,使用Exiqon miRCURY LNA^TM microRNA表达谱芯片(miRBase 16.0数据库)检测不同浓度处理后D407细胞miRNA的表达差异,并将不同浓度处理后的变化进行聚类分析。使用Stem loop realtime PCR对芯片结果进行验证,并运用生物信息学方法预测差异miRNA调控的靶基因。

结果：芯片所包含的1 425个已知miRNA中,共有367个在不同浓度H₂O₂处理后表达发生变化。通过Treeview软件进行聚类分析发现miR-31等17个miRNA随H₂O₂浓度的升高呈现逐渐降低的趋势,miR-206等7个则逐渐升高。PCR验证显示芯片结果准确性较好。

结论：H₂O₂作用前后RPE的miRNA表达存在明显差异,miRNA作为转录后水平的调节分子,参与了细胞氧化应激反应,可能在AMD的发生发展中起有重要作用。     

血清TK1、CEA、CYFRA21-1、NSE联检对肺癌的诊断价值

为探讨胸苷激酶1（TK1）、癌胚抗原（CEA）、细胞角蛋白19片段（CYFRA21-1）及神经元特异性烯醇化酶（NSE）在肺癌诊断中的价值,本文对43例肺癌患者进行了以上四种指标的检测,现将结果报告如下。1资料和方法1.1对象     

囊袋张力环在超声乳化术中的应用探讨

目的评价开放型囊袋张力环（capsular tension ring,CTR）在晶状体半脱位患者进行超声乳化白内障吸除术中的应用。方法对15例（16只眼）合并晶状体半脱位的白内障患者行超声乳化白内障吸除术联合人工晶体（intraocular lens,IOL）种植术,术中种植CTR。结果术后3个月13只眼IOL正位,3只眼轻度倾斜偏位,视力满意,未出现CTR引起的并发症。结论超声乳化白内障吸出联合CTR种植术是治疗白内障合并晶状体半脱位患者的有效方法,手术操作简便,创伤小,有利于术后视功能的早期恢复。     

玻璃体液对培养人视网膜微血管内皮细胞和色素上皮细胞增生的影响

目的 探讨玻璃体液对培养的人视网膜微血管内皮细胞(human retinal capillary endothelialcells,HRCECs)和色素上皮(retinal pigmental epithelial cells,RPE)细胞增生的影响.方法 原代培养HRCECs和RPE细胞,鉴定并传至第3代,再分别培养在1:8、1:4、1:2(玻璃体液在总培养液中的体积比)的人玻璃体条件培养液(vitreous-conditioned medium,VCM)中,其中VCM分为有无血清2组,在不同作用时间(24～72h),采用四唑盐(tetrazolium,MTT)比色法检测VCM对人HRCECs和RPE细胞增生的影响.结果 在有血清时.与对照组比较,1:4、1:2的VCM在培养的各时间段对HRCECs的抑增生作用差异有显著性意义(P<0.05),而对RPE细胞和混合细胞(HRCECs和RPE混合1:1)的促增生作用差异有统计学意义(P<0.01).在无血清时与对照组比较,1:4VCM组在培养60、72h时以及1:2VCM组在培养24h,RPE细胞的增生差异有统计学意义(P<0.05),而1:2VCM组在培养48、印、72h时RPE细胞的增生差异有非常统计学意义(P<0.01);1:2VCM组在培养各时间段混合细胞的增生差异有统计学意义(P<0.05),均表现为促增生效应.结论 一定体积分数的人VCM抑制HRCECs的增生,但明显促进人RPE细胞以及混合细胞的增生,提示玻璃体中RPE细胞浸润是加重外伤增生性玻璃体视网膜病变和眼内血管增生性疾病的高危因素.     

蓝黄视野检查与RTA后极部视网膜厚度的相关研究

目的探讨视网膜厚度分析仪获得的后极部视网膜厚度丢失程度与蓝黄视野缺损的相关性。方法对25例37眼可疑青光眼;17例26眼早期青光眼;10例16眼中晚期原发性开角型青光眼患者分别进行标准视野检查、蓝黄视野检查、并用RTA获得后极部视网膜地形图。对获得的W/W、B/Y、RTA后极部视网膜厚度损伤程度分别进行等级评分,用Spearman等级相关来评价三种检测方法的相关性,并用直线回归分析评价RTA预测青光眼损伤程度的能力。结果(1)RTA测得的后极部视网膜厚度丢失程度与W/W视野检查损伤程度的相关性相对较小(r=0.601),但回归系数具有显著的统计意义(P<0.001)。(2)RTA测得的后极部视网膜厚度丢失程度与B/Y视野检查损伤程度有较高的相关性(r=0.864)。相应的回归系数具有显著的统计意义(P<0.001)。结论RTA后极部视网膜厚度测量是一种新的评估青光眼视神经损伤的途径,与蓝黄视野检查缺损程度具有较好的相关性,两种方法结合对青光眼的早期诊断具有重要的意义。     

超声乳化白内障吸除联合人工晶状体植入术后眼前节相干光断层扫描观察

Objective To investigate quantitative changes of the anterior segment configuration after clear corneal incision phacoemulsification and foldable intraocular lens (IOL) implantation with slit-lamp-adapted optical coherence tomography (SL-OCT). Methods In prospective consecutive case series, clear corneal incision phacoemulsification and foldable intraocular lens implantation were performed in 44 eyes of 40 patients. The changes of the anterior segment configuration were performed by SL-OCT before and 1 day, 1 week, 2 weeks and 1 month after surgery. SPSS 16.0 software was used to analyze statistical difference. Results For all patients, the central corneal thickness (CCT) and the incisional corneal thickness (ICT) increased significantly 1 day after surgery ( CCT increased 99. 59 μm, ICT increased 234. 57 μm;P = O. 490). At 1 month, the CCT almost had returned to baseline, but the ICT had been ticker about 19. 25 μm than baseline (P=0. 001) . The measurements of ACD, AODS00, AOD750, TISAS00, TISA750 also increased significantly 1 day after surgery. Although the ACD had no changes within 2 weeks( all P <0.05), it had been not stable. The changes of the width of the anterior chamber had been stable in the early period after surgery ( all P>0. 05). Conclusion The SL-OCT could impersonality and quantificationally evaluate the anterior segment changes induced by cataract surgery.     

MicroRNA在氧化应激诱导晶状体上皮细胞凋亡中作用的初步研究

目的：观察H2 O2处理对晶状体上皮细胞HLE-B3miRNA表达谱的影响,初步明确miRNA在氧化损伤诱导晶状体细胞凋亡中的作用及机制。
　　方法：100μmol/L H2 O2处理HLE-B324h后,收集细胞用Trizol法提取总RNA。使用芯片检测miRNA的表达,并且qRT-PCR对芯片结果进行验证。运用生物信息学方法预测差异miRNA调控的靶基因。
　　结果：HLE-B3细胞经H2 O2处理后,28个miRNA表达发生明显变化(18个上调,10个下调)。差异miRNA可能通过调控BCL2 L2和MIP的表达,参与了晶状体细胞凋亡,进而导致了白内障的发生发展。
　　结论：氧化损伤能够明显改变晶状体上皮细胞的miRNA表达谱,此变化可能在白内障的发生发展中起调节作用。     

角膜和全眼高阶波前像差的特点及年龄相关性变化的研究

Objective To investigate age-related changes in corneal and ocular monochromatic high-er-order aberrations and elucidate the distribution of corneal primary spherical in Chinese. Methods Using Traeey-iTrace visual function analyzer (EyeSys corneal topography combined with a ray-tracing aberrometer),113 normal eyes of 59 Chinese,mean age of 33.81+20.50 years (range,5-73 years),were evaluated for corneal and ocular monochromatic total higher-order aberrations (HOAs), primary spherical aberration (Z40),total spherical (TS),total coma (TC),and total trefoil aberration (TT) in the central 6mm diameter. Correla-tion analysis was also performed to assess the association between age and both corneal and oeular higher-order aberrations. Results The mean Zemike coefficient of Z40 was (0.27±0.07) ?m (range,0.130～0.451). Al-though corneal Z40 increased slightly with age,the correlation was small and insignificant (r =0.172,p =0.069 ). However, ocular Z40 had a positive correlation with age (r =0.545,p =0.000 ). Analyzer showed positive correlations with age for both corneal (r=0.499,p =0.000) and ocular (r=0.427,p =0.000) HOAs. Positive correlations were also observed between age and both corneal (r=0.149,p =0.021 ) and ocular (r=0.253,p =0.007) TC. Corneal and ocular TT (r =0.344,p =0.000; r=0.185,p =0.050,respectively) were increased with age. No significant correlation was found between corneal TS and age (r =0.180,p =0.057 ), but TS of the whole eye in-creased with age (r =0.560,p =0.000). There was a positive correlation between corneal and ocular HOAs (r =0.327,p=0.000),TC (r=0.233 ,p=0.013),and TT (r=0.481 ,p=0.000) aberration. Conclusions These re-suits also suggest that the ocular HOAs,TC,and TT increase with age,mainly because of the increase in corneal HOAs,TC,and TT; and the ZAO aberration increases with age,mainly because of the increase in Z40 in the internal optics. Individual variability in corneal primary spherical aberration was observed in Chinese.Therefore, preoperative measurement of corneal Z40 is crucial to the selection of aspheric IOL.     

蓝黄视野检查在青光眼早期诊断中的应用

青光眼是一类严重的致盲性疾病，其防治的关键是早期诊断。近年来，青光眼的诊断已逐步向针对性视功能检查和高敏感形态学检测水平过渡。蓝黄视野检查(SWAP或B／Y PM)针对性的分离检测视觉系统中短波视路的敏感性，是将色觉检查和视野检查结合起来而形成的一种新的视野检查方法。本文旨在对蓝黄视野检查在青光眼早期诊断中的应用进展做一综述。     

糖尿病性视神经病变的OCT图像特点分析

目的：回顾分析糖尿病性视神经病变( diabetic optic neuropathy, DON )的相干光断层成像( optical coherence tomography,OCT)的特点。
　　方法：回顾性系列病例研究。选择2013-12/2015-10西安交通大学医学院第二附属医院眼科门诊和内分泌科会诊期间诊断为2型糖尿病且伴有眼底病变的患者175例350眼的临床资料,记录患者的全身检查情况和疾病史,阅读所有患者的彩色眼底照相、荧光素眼底血管造影( fluorescein fundus angiography,FFA)、OCT的影像结果,并进行分析统计。
　　结果：通过FFA 检查视乳头具有异常荧光表现,确定有DON的有49例90眼,占25.7%。 OCT结果显示DON 90眼中15眼(16.7%)表现为视神经形态大致正常;20眼(22.2%)表现为视杯凹陷变小或消失,筛板前组织肿胀,同时伴有盘周神经纤维层水肿;26眼(28.9%)表现为视杯深陷,杯盘比变大;18眼(20.0%)表现为视盘内或视盘表面组织增生;11眼(12.3%)玻璃体视乳头牵拉,视盘边缘抬高。在FFA中有相同荧光表现的DON患眼,在OCT检查可表现出不同的组织形态。
　　结论：FFA从视神经的血循环状态变化定义DON,而OCT可以发现FFA所不能显示的视神经组织形态的变化,从而更清晰视神经病变的位置和原因,为治疗提供依据。OCT无创、快捷、费用低、可重复性强等优点有利于DON患者的复查及治疗效果追踪。