利多卡因球结膜下注射治疗重症电光性眼炎

电光性眼炎是眼科临床最常见的一种辐射伤。我科于2000年以来采用利多卡因球结膜下注射治疗重症电光性眼炎48例96眼，治疗效果令人满意，现介绍如下。     

润舒利多卡因治疗电光性眼炎

电光性眼炎足眼科较常见的急症，是一种职业性眼病。过去的治疗方法主要是用1％的卡因止痛，由于该药副作用较大，不宜过多重复使用，自1996年以来我们用润舒利多卡因治疗电光性眼炎36例，效果满意，报告如下：     

易贝滴眼液治疗电光性眼炎

电光性眼炎是在工农业生产和日常生活中常见的眼病，我科自2002年起用易贝滴眼液其中含重组人表皮生长因子(recombinant human epidermal growth factor，RhEGIF)40μg，由桂林华诺威基因药业公司生产，治疗电光性眼炎取得了较好疗效。     

电光性眼炎127例临床分析

目的探讨电光性眼炎的临床治疗及预防。方法对127例电光性眼炎进行临床分析，并用利多卡因、贝复够及润舒滴眼液综合治疗。结果全部病例均在较短时间内治愈。结论用此综合疗法对电光性眼炎有较好的疗效，预防是关键。     

中学生群体发生电光性眼炎临床分析

目的探讨群体电光性眼炎的临床特征及救治措施。方法中学生325人（650眼）同日突发电光性眼炎，经先后滴1％的卡因及1％荧光素钠滴眼液后作眼部检查。根据临床表现，分轻重2型。轻型：209例（64．30％）418眼。重型：116例（35．61％）232眼。给患者滴促进角膜损伤修复和预防感染的眼液治疗。结果患者经药物治疗3天后，先后均痊愈。结论对群体突发电光性眼炎宜现场救治，以赢得时间。日常应加强卫生健康教育，严格管理紫外线灯的正确使用。     

消炎痛防治电光性眼炎的研究

采用放免方法测定正常家兔角膜上皮内ＰＧＥ１、ＰＧＥ２、ＰＧＦ２α、ＰＧＩ２、ＴＸＡ２等前列腺素含量。并在紫外线照射前后分别采用０．２５％消炎痛油型滴剂滴眼。６小时后再次测定兔角膜上皮内ＰＧ５，发现ＰＧＥ、ＰＧＥ２、ＰＧＩ２和ＴＸＡ２合成均受到明显抑制（Ｐ＜０．０５－０．０１），且角膜炎症症反应较轻。但照射前后用药对角膜上皮内ＰＧ５合成的抑制无显著性差异（Ｐ＞０．０５）。结果提示前列腺素在电光性眼炎     

重组人表皮生长因子治疗电光性眼炎

电光性眼炎是在工农业发展和家庭装修业兴起的同时常见的眼病 ,我们自 2 0 0 1年 5月起用重组人表皮生长因子(ｒｅｃｏｍｂｉｎａｎｔｈｕｍａｎｅｐｉｄｅｒｍａｌｇｒｏｗｔｈｆａｃｔｏｒ,ｒｈＥＧＦ)治疗电光性眼炎取得了较好疗效。1　临床资料和方法1 1　对象选择 2 0 0 1年 5月至 2 0 0 2年 4月在我院门诊就诊的电光性眼炎患者 4 2例 (84只眼 )。其中男 37例 (74只眼 ) ,女例 (8只眼 ) ,平均年龄 38 7岁。1 2　用药方法将患者随机分为Ａ、Ｂ 2个组 ,每组各 2 1例 (42只眼 ) ,Ａ组局部滴加入含 0 3%妥布霉素的易贝滴眼剂 (含ｒｈＥＧ…     

电光性眼炎泪液中溶菌酶的测定

电光性眼炎泪液中溶菌酶的测定赵成荣陈卓吴艺张汗承周祖陈荣叠卢森许卿卿泪液中溶菌酶的浓度可反映泪腺的功能，同时与某些常见外眼病电光性眼炎有关。溶菌酶为泪液中主要的非特异性免疫因素，在眼局部抗感染免疫中起主要作用。目前对电光性眼炎泪液中溶菌酶含量的测定...     

电光性眼炎80例临床分析

目的 观察电光性眼炎的临床表现、治疗及效果。方法 对80例电光性眼炎患者进行综合分析。结果 43．75％24小时内症状消失。46．25％72小时痊愈;8例转变为慢性睑缘炎和结角膜炎。结论 从事焊接工作对眼睛的保护极其重要。     

不同眼用营养剂对电光性眼炎的疗效

目的 比较不同的眼用营养剂对电光性眼炎患者角膜上皮愈合时间、痛觉和泪膜稳定性的影响。方法 将12例24眼随机分成3组,分别加用含碱性成纤维细胞生长因子、10g/L羧甲基纤维素钠、多种氨基酸的滴眼液作为辅助治疗。结果 加用碱性成纤维细胞生长因子滴眼液组角膜愈合时间较其它两组缩短,加用10g/L羧甲基纤维素钠滴眼液组泪膜稳定性较其它两组增高。结论 碱性成纤维细胞生长因子有利于电光性眼炎角膜上皮的愈合,羧甲基纤维素钠有利于患者泪膜的稳定。     

布比卡因在斜视治疗中应用的研究进展

布比卡因是长效酰胺类钠通道阻滞剂,除麻醉作用外,肌注后还能导致局部骨骼肌细胞变性、坏死、再生,使肌肉增粗、肌力增强,有研究者提出可以利用这一特性治疗斜视.目前,已有研究者对以共同性水平斜视为主的患者进行试治疗,大多数患者的眼位得到不同程度的改善,同时,亦有学者在病理学、分子生物学及细胞生物学等方面对布比卡因的作用机制进行研究.本文将对布比卡因在斜视领域的试用现状及可能的作用机制进行综述,以探讨未来的研究方向.     

角膜缘血管选择性电凝联合羊膜移植治疗角膜新生血管

目的评价角膜缘血管选择性电凝联合羊膜移植治疗角膜新生血管的临床疗效。方法对感染、外伤等原因导致的角膜新生血管62眼行角膜缘血管选择性电凝联合羊膜移植术。所有患者术后随访12个月。结果术后5d视力提高1行以上者50眼，术后视力未见变化12眼。原有新生血管数量减少，角膜水肿混浊程度减轻，角膜炎症、角膜渍疡得到改善，角膜透明性有所提高。术后12个月，新生血管完全消失24眼，占38．71％；复发22眼，占35．50％．结论角膜缘血管选择性电凝联合羊膜移植治疗角膜新生血管有效，无明显副作用，能减轻急性期的炎症反应，为角膜复明手术提供良好的条件，但远期效果及复发问题有待进一步观察。     

Progress in corneal wound healing

Corneal wound healing is a complex process involving cell death, migration, proliferation, differentiation, and extracellular matrix remodeling. Many similarities are observed in the healing processes of corneal epithelial, stromal and endothelial cells, as well as cell-specific differences. Corneal epithelial healing largely depends on limbal stem cells and remodeling of the basement membrane. During stromal healing, keratocytes get transformed to motile and contractile myofibroblasts largely due to activation of transforming growth factor-β (TGF-β) system. Endothelial cells heal mostly by migration and spreading, with cell proliferation playing a secondary role. In the last decade, many aspects of wound healing process in different parts of the cornea have been elucidated, and some new therapeutic approaches have emerged. The concept of limbal stem cells received rigorous experimental corroboration, with new markers uncovered and new treatment options including gene and microRNA therapy tested in experimental systems. Transplantation of limbal stem cell-enriched cultures for efficient re-epithelialization in stem cell deficiency and corneal injuries has become reality in clinical setting. Mediators and course of events during stromal healing have been detailed, and new treatment regimens including gene (decorin) and stem cell therapy for excessive healing have been designed. This is a very important advance given the popularity of various refractive surgeries entailing stromal wound healing. Successful surgical ways of replacing the diseased endothelium have been clinically tested, and new approaches to accelerate endothelial healing and suppress endothelial-mesenchymal transformation have been proposed including Rho kinase (ROCK) inhibitor eye drops and gene therapy to activate TGF-β inhibitor SMAD7. Promising new technologies with potential for corneal wound healing manipulation including microRNA, induced pluripotent stem cells to generate corneal epithelium, and nanocarriers for corneal drug delivery are discussed. Attention is also paid to problems in wound healing understanding and treatment, such as lack of specific epithelial stem cell markers, reliable identification of stem cells, efficient prevention of haze and stromal scar formation, lack of data on wound regulating microRNAs in keratocytes and endothelial cells, as well as virtual lack of targeted systems for drug and gene delivery to select corneal cells.     

Topical indomethacin: inhibition of corneal wound healing in guinea pigs after severe alkali burn

Corneae of guinea pigs were burned with 200 microliters 1N-NaOH for 30 seconds. Topical application of 1%, 0.1%, or 0.025% indomethacin (IN) four times daily resulted in a marked delay of corneal re-epithelialization compared to corneae receiving the vehicle only. However, no retardation of corneal wound healing was observed when IN was injected intraperitoneally (5 mg/kg) twice daily, but hyperemia and chemosis were reduced. To study the proportion of retained IN in burned cornea, 0.1% IN was mixed with a tracer dose of [2-14C] IN: 3.4, 1.2, 0.42, and 0.24% of the dose were retained 20, 60, 180, and 360 minutes respectively after topical application of 15 microliters. Twenty minutes after application of 15 microliter 0.1% IN, the concentration of retained IN in the cornea was 31 micrograms/g, which is considerably higher than the average concentration of 0.358 microgram/ml found in human blood plasma after therapeutic doses of IN. Thus, the retardation of corneal wound healing may be explained by a cytotoxic effect of supratherapeutic concentrations of IN.     

血小板源性生长因子与角膜损伤修复

血小板源性生长因子(PDGF)在机体伤口愈合过程中具有重要的调节作用。由于角膜的特殊结构和功能,其伤口愈合的调节显得至关重要。本文简述PDGF的结构、受体、生物学活性及其在角膜伤口愈合中的作用。     

电场暴露抑制晶状体上皮伤口的愈合

目的探讨电场暴露对晶状体上皮伤口愈合的作用。设计实验研究。研究对象原代培养的牛晶状体上皮细胞。方法钝头玻璃针戳刺原代培养的牛晶状体上皮细胞单层形成圆形微伤口,暴露于场强为200mV/mm的直流电场2h(n=37),未受电场暴露的伤口作为对照(n=29),由Leica图像分析系统测量伤后0h、1h和2h的伤口面积。用抗F-actin荧光抗体染色观察伤口细胞微丝骨架。主要指标伤口面积及细胞微丝骨架的排列。结果与对照伤口比较,电场暴露伤口愈合延迟,电场暴露伤口伤后2h的平均面积(19106μm2±2167μm2)明显大于未接受电场暴露的对照伤口(8555μm2±1911μm2)(t=2.942,P=0.0045)。对照伤口细胞微丝骨架呈向心性排列,电场暴露伤口细胞微丝骨架则沿伤缘呈“索状”排列。结论生理强度的外源性电场可抑制晶状体上皮伤口的愈合。     

The conjunctiva in corneal epithelial wound healing

BACKGROUND/AIMS—During the healing of corneal epithelial wounds with limbal involvement, conjunctival epithelium often migrates across the denuded limbus to cover the corneal surface. It is believed that, over a period of time, conjunctival epithelium covering the cornea assumes characteristics of corneal epithelium by a process referred to as conjunctival transdifferentiation. The purpose of this study was to examine, clinically, the fate of conjunctival epithelial cells covering the cornea and to assess the healing of corneal epithelial wounds when the conjunctival epithelium was removed or actively prevented from crossing the limbus and extending onto the cornea.
METHODS—10 patients with conjunctivalisation of the cornea were followed for an average of 7.5 months. Five patients in this group had their conjunctival epithelium removed from the corneal surface and allowed to heal from the remaining intact corneal epithelium. In another four patients with corneal epithelial defects, the conjunctival epithelium was actively prevented from crossing the limbus by mechanically scraping it off.
RESULTS—The area of cornea covered by conjunctival epithelium appeared thin, irregular, attracted new vessels and was prone to recurrent erosions. Conjunctivalisation of the visual axis affected vision. Removal of conjunctival epithelium from the cornea allowed cells of corneal epithelial phenotype to cover the denuded area with alleviation of symptoms and improvement of vision. It was also established that migration of conjunctival epithelium onto corneal surface could be anticipated by close monitoring of the healing of corneal epithelial wounds, and prevented by scraping off conjunctival epithelium before it reached the limbus.
CONCLUSION—This study shows that there is little clinical evidence to support the concept that conjunctival transdifferentiation per se, occurs in humans. "Replacement" of conjunctival epithelium by corneal epithelial cells may be an important mechanism by which conjunctival "transdifferentiation" may occur. In patients with partial stem cell deficiency this approach can be a useful and effective alternative to partial limbal transplantation, as is currently practised.

Keywords: corneal epithelium; conjunctiva; stem cells; transdifferentiation     

角膜创伤愈合中上皮细胞的作用初探

目的 探讨角膜创伤愈合中上皮细胞与角膜基质成纤维细胞的作用关系。方法 用形态学方法观察兔角膜损伤后上皮细胞与角膜基质成纤维细胞动态变化相关现象。结果 发现基质成纤维细胞的增生活跃程度与上皮基底细胞的细胞层数和细胞大小密切相关。结论角膜上皮细胞在角膜创伤个性中起主导作用。     

Avastin对大鼠角膜结构和缺损愈合速率的影响

目的 评估贝伐单抗(bevacizumab,商品名Avastin)对大鼠角膜上皮缺损愈合速率及对正常大鼠角膜形态结构的影响.方法 健康雌性SD大鼠随机分为缺损组和正常组,缺损组包括实验A组和对照A组,均建立角膜上皮缺损模型,每组4只(8眼);正常组包括实验B组和对照B组,每组2只(4眼).上述实验组双眼均滴5 g·L-1的Avastin,对照组均滴生理盐水.A组于造模后12 h、18 h、24 h、36 h荧光素染色裂隙灯观察角膜上皮缺损修复情况,直至上皮缺损愈合;B组在连续滴眼7 d后做角膜组织病理学观察和透射电镜检查.结果 裂隙灯观察显示,在24 h内实验A组和对照A组角膜上皮愈合速率一致,36h时角膜上皮均已愈合;实验A组和对照A组在12 h、18 h、24 h角膜上皮缺损平均愈合速率比较,差异均无统计学意义(均为P>0.05);正常组滴眼7 d后,与对照B组比较,实验B组的光镜和电镜检查未见角膜结构改变及炎性细胞浸润.结论 短期局部应用5 g·L-1Avastin对大鼠角膜上皮缺损愈合速率和正常角膜结构无影响.