左旋氧氟沙星滴眼及球结膜下注射的兔眼通透性比较

目的:比较左旋氧氟沙星(LVFX)点眼和球结膜下注射后家兔眼各组织的药物浓度及药代动力学参数.方法:将0.3%LVFX滴入或球结膜下注射入兔眼,在不同时点取角膜、房水、虹膜-睫状体、晶状体、玻璃体等组织,用高效液相色谱法测定组织中的药物浓度.结果:球结膜下注射LVFX后,不但在角膜、虹膜-睫状体中具有更高的药物浓度,而且在晶状体和玻璃体内也有较高的药物浓度,与滴眼组相比较,有显著差异(P＜0.01或P＜0.05).结论:球结膜下注射LVFX较滴入法更有利于治疗严重的眼部感染.     

Importance of accurate sampling techniques in microbiological diagnosis of endophthalmitis

Background

Endophthalmitis is an ocular emergency and bacteria are the commonest aetiological agents of infectious endophthalmitis. Any delay in treatment will result in serious complications like complete loss of vision. Therefore, obtaining the most appropriate sample is of paramount importance for a microbiologist to identify the aetiological agents that help the ophthalmologist in planning treatment.

Objetive

This study was undertaken to determine the intraocular specimen that is most likely to yield a positive culture on microbiological examination.

Methods

From 60 cases, intraocular samples were collected in the operation theatre under anaesthesia. The samples obtained were aqueous humour and vitreous humour by vitreous tap, vitreous biopsy or pars plana vitrectomy. The specimens were processed within half an hour, first by inoculating onto culture media and then direct smear examination by Gram’s Stain

Results

Eighty samples were obtained from 60 cases of which the most were vitreous fluid (vitreous biopsy/tap + vitrectomy fluid), i.e., 75%. Culture was positive in 88% vitrectomy fluid as compared to 74% in vitreous tap/biopsy followed by 20% in aqueous fluid.

Conclusion

Vitrectomy fluid appears to be the best sample for culture from clinically diagnosed endophthalmitis cases.     

CONCENTR.ATION OF SULFANILAMIDE IN THE AQUEOUS HUMOR. OF HUMAN EYES WITH SPECIAL REFERENCE TO LOCAL APPLICATION

Sulfanilamide is known to be a very diffusible substance and its ability to penetrate the tissues of the body has been considered an important factor in its therapeutic efficacy in combating infection. Marshall and his co-workers (1) have demonstrated that sulfanilamide readily enters various tissues and body fluids. Rambo (2) found it in the aqueous and vitreous humors and lens, and Bellows and Chinn (3) detected it in all ocular tissues and fluids after oral administration. With the exception of the studies of Bellows and Chinn on two patients and those of Mengel (4), who determined the concentration of sulfanila- mide in the aqueous and vitreous humors in three patients, all determinations have been made on the eyes of animals.     

环孢素脂质体滴眼液在兔眼组织的吸收

目的　研究环孢素脂质体滴眼液在兔眼组织的吸收。方法　 4 2只家兔 ,随机分成 0 .2 5、0 .5、1.0、2 .0、4 .0、6 .0、8.0h 7个时间组 ,每一时间组 6只家兔 (12只眼 ) ,右眼应用环孢素橄榄油滴眼液 ,左眼应用环孢素脂质体滴眼液。用药后分别在 7个时间点抽取房水 ,于 0 .5、1.0、2 .0h摘取眼球 ,分离角膜、虹膜、巩膜 ,采用高效液相色谱 质谱法测定各种组织中环孢素的含量 ,并计算药动学参数和脂质体制剂的相对生物利用度。结果　脂质体制剂吸收进入眼组织的环孢素浓度高于橄榄油制剂 ,且有显著性差异 (P <0 .0 5 )。房水的药代动力学结果表明 ,脂质体和橄榄油滴眼液的Tmax无显著性差异 ,但Cmax之间有显著性差异 (P <0 .0 1) ;脂质体滴眼液组的相对生物利用度明显高于橄榄油滴眼液组。结论　脂质体可以显著改善环孢素在眼部的吸收 ,提高药物在眼部各组织的分布及环孢素的生物利用度     

兔曲霉菌性角膜溃疡局部应用两性霉素B脂质体的研究

目的 探讨兔曲霉菌性角膜溃疡局部应用两性霉素B脂质体(Liposomal amphotericin B,LAmB)和两性霉素B(AmB)滴眼液后,角膜及房水中的药物代谢状况。方法 用105只新西兰白兔,随机分为5组,采用角膜“#”形划痕法制作兔实验性曲霉菌性角膜溃疡模型,分别应用0.5% LAmB、0.25% LAmB、0.5% AmB点眼,分别在用药后5 min、15 min、30 min、1 h、2 h、4 h、8 h,共7个时点,抽取兔眼房水并取下角膜,用高效液相色谱检测(high performance liquid chromatography,HPLC)测定角膜及房水中两性霉素B的药物浓度。结果 三组滴眼液在7个时间点角膜中的药物浓度均能超过MIC₉₀;在房水检测中,0.5%AmB滴眼液组房水中的药物浓度超过MIC₉₀时段在用药30 min后至2 h之间,而0.5% LAmB,0.25% LAmB滴眼液组在用药15 min后房水中的药物浓度分别达到(10.57±0.042)μg/mL和(7.55±0.170)μg/mL,8 h后仍能维持在MIC₉₀以上,药物浓度分别为(5.344±0.3673)μg/mL和(4.382±0.3591)μg/mL。结论 LAmB滴眼液具有较好的缓释作用和生物利用度,药物浓度稳定,作用时间长,0.25%LAmB滴眼液是局部治疗曲霉菌性角膜溃疡的合适浓度。     

弹性开放襻前房型人工晶状体植入术

目的：探讨弹性开放襻前房型人工晶状体植入术的方法、适应证及疗效。方法：对后囊膜破裂、玻璃体溢出57例白内障病人植入前房型人工晶状体，Ⅰ期植入46例，术后Ⅱ期植入11例。术后随访3个月-3年。结果：术后视力达0.5以上43例（占75.4％），术后并发症：角膜水肿，一过性眼压高，前房内玻璃体残留，瞳孔轻度上移，人工晶状体夹持。结论：对白内障术中后囊膜破裂玻璃体溢出者植入前房型人工晶状体，方法简洁，术后并发症少，疗效满意。     

玻璃体腔注射神经生长因子安全性研究及视网膜组织分布

目的：观察兔玻璃体腔注射鼠神经生长因子（mNGF）的安全性及其在视网膜组织的分布。方法兔玻璃体腔注射临床剂型mNGF30μg／100μL后1、7、30d进行行为学观察、裂隙灯眼前节检查、眼底检查、眼部B超及组织病理学检查,确定其使用安全性。玻璃体腔注射该剂量标记后的125I‐NGF15、30min,1、3、6、8、12、24、48h,观察视网膜药物峰浓度及达峰时间。结果兔眼玻璃体腔注射mNGF后,眼前节及眼底均未见明显损伤及炎性反应,眼部B超及组织HE染色未见明显眼组织结构异常。视网膜药物含量可于注射后3h达峰值（118．32±18．74）％ID／g,为眼部各组织中最高。结论玻璃体腔注射mNGF是安全的,玻璃体腔注射mNGF能够迅速在视网膜组织中聚集,达到较高药物浓度。     

Therapeutic Mechanism of Santeng Dingtong Recipe (三藤定痛方) on Monosodium Urate Crystal-Induced Rabbit Arthritis

Objective: To study the therapeutic mechanism of Santeng Dingtong recipe (STDT) on monosodium urate crystal (MSU) induced rabbit arthritis Methods: Forty-two rabbits were randomly divided into six groups, 7 in each group. Group 1 received 0.9% saline 2. 5 ml/kg per day by gastrogavage (ig) for 10 days; Group 2, 3 and 4 received STDT 0.125 g/kg, 1.0 g/kg and 8.0 g/kg per day respectively by ig for 10 days; Group 5 received colchicine 4. 5 mg/kg per day by ig for 4 days; and Group 6 was untreated. MSU crystals 10 mg /500ul containing polymyxin B 10 u/ml was injected into the knee joints of Group 1-5 to make rabbit arthritis models. Leukocytes in synovial lavage fluids was then counted and differentiated; pathological injury of synovial membranes was observed under HE staining; interleukin-1 beta (IL-1B), tumor necrosis factor alpha (TNFa) and leukotriene B4 (LTB4) content in synovial lavage fluids were determined by ELISA. Results: MSU caused a rapid leukocyte infiltration and increased production of IL-1     

伴睫状体脱离的复杂眼外伤联合手术27例

目的评价睫状体复位联合玻璃体切割在治疗伴有睫状体脱离的复杂眼外伤中的临床疗效。方法严重眼外伤患者27例,超声生物显微镜（UBM）探查所有外伤眼睫状体360°全周脱离,离断口的范围在3～5个钟点。术前视力光感～眼前手动,平均眼压（6.03±3.25）mmHg。伴随症状包括轻度角膜血染、外伤性扩瞳、前房积血、虹膜根部离断、晶状体脱位或半脱位、外伤性白内障、玻璃体混浊、视网膜脱离、脉络膜脱离等。所有患眼施行玻璃体切割联合睫状体修补术,其它操作包括晶状体切除、虹膜离断口修补、视网膜复位或巩膜外穿刺放液等。结果术后UBM显示所有患眼睫状体复位。所有外伤眼术后视力较术前明显提高。术后1月平均眼压（19.33±5.05）mmHg。24眼（88.89%）屈光间质清晰,所有患眼随访期间视网膜、脉络膜在位。结论对于睫状体离断口范围超过2个钟点的复杂眼外伤患者,玻璃体视网膜手术联合睫状体修补术可有效恢复眼球的解剖结构,并保存有效的的视功能。     

RP-HPLC法测定眼房水中三种不同剂型匹罗卡品含量

目的:建立反相高效液相色谱法(RP-HPLC)测定眼房水中匹罗卡品含量的方法.方法:RP-HPLC法采用ODS-C18柱,流动相:0.5%三乙胺的KH2PO4(10 mmol/L)缓冲液(pH 2.5)-乙腈(98/2,v/v),流速:1.0 ml/min,检测波长:215 nm.90只兔均分为3组,分别于每只兔眼滴入不同剂型滴眼剂50 μl,分别测定给药后5、10、30、40、60、90、120、180、240及360 min时眼房水中匹罗卡品滞留量,用二氯甲烷提取房水中药物.结果:RP-HPLC法适用于眼房水中匹罗卡品的含量测定,匹罗卡品质量浓度在0.1～20 μg/ml范围内线性良好(r=0.9998),平均提取回收率为68.1%±2.7%(n=9),日内精密度为2.87%,日间精密度为4.33%.3种不同剂型匹罗卡品50 μl滴眼后,药-时曲线下面积以1%脂质体为最高,且维持时间最长.结论:本方法易行,重现性好,线性范围广.将匹罗卡品滴眼液的剂型改为脂质体可以明显提高匹罗卡品的生物利用度,具有较好的应用前景.