我国九省眼病调查设计的抽样和测量方法

目的 设计国家卫生部医政司的我国9个省眼病调查的方案,以了解我国盲和视力损伤的患病率及主要原因,了解实施多年的白内障盲复明手术项目对白内障手术率和白内障手术覆盖率的影响。方法 2005年11月接受国家卫生部医政司实施全国眼病调查的任务后进行方案设计。以世界卫生组织1996年在北京顺义区和1997年在广东省斗门县实施的眼病研究方案为基础。调查方案起草后组织相关专家进行方案论证,接受本项目技术顾问国际委员会对方案的审核,最后由国家卫生部医政司和世界卫生组织防盲部门审核和通过调查方案。结果 结合我国各地的特点和全国眼病调查的规模,对调查方案进行了设计,内容包括目标人群和调查点的确定,样本量估计,随机抽样的设计,调查队的组成和组织,调查对象的确定,现场调查的流程,调查内容,盲和中重度视力损伤的诊断标准,质量控制措施,资料的处理方法。结论 所制定的调查方案成为了解盲和视力损伤患病率、确定盲和视力损伤的原因和白内障手术开展情况调查的实用性标准方案。     

电针干预对透镜诱导型近视豚鼠视网膜和视皮层中BDNF、NGF及AchE表达的影响

目的 探讨电针干预对透镜诱导型近视(LIM)豚鼠视网膜和视皮层中脑源性神经营养因子(BDNF)、神经生长因子(NGF)及乙酰胆碱酯酶(AchE)表达变化的影响.方法 将90只2周龄雄性豚鼠随机分为正常对照(NC)组、LIM组和LIM+电针治疗(LIM+EA)组.NC组豚鼠正常饲养,不进行干预;LIM组和LIM+EA组豚...     

儿童眼及视力保健信息化系统的创建与应用

目的：探索儿童眼及视力保健的信息化管理方法,介绍湖州市儿童眼及视力保健信息化系统的创建及应用情况。方法：以《儿童眼及视力保健技术规范》为蓝本,在儿童保健信息管理系统中增加儿童眼及视力保健信息管理模块,并建立数据库,通过市、县、乡三级儿童保健服务网络,实时收集、监测并管理儿童眼及视力保健信息。结果：儿童眼保健信息系统创建后,经在市、县、乡9个适宜技术单位试点应用基础上,逐步以点连线向全市112 个工作站点推广覆盖,录入系统信息4 千条,提高了本地区儿童眼保健服务质量与儿童眼病筛查率,有利于儿童眼保健档案建立,实现对儿童眼病现况的统计、分析。结论：儿童眼及视力保健信息化提高了儿童眼保健管理平,能为决策层决策提供全面的科学依据,是儿童保健事业发展的必然趋势。     

四川省整合防盲资源开展大规模白内障防盲手术的探讨

目的:探索四川省整合利用各种防盲资源,提高大规模白内障防盲手术项目的效率与质量的方法,推动防盲工作的发展。方法:分析比较2000年以来由卫生与残联各自单独与合作开展大规模白内障防盲复明手术项目效果。结果:四川省卫生与残联合作2004/2006高质高效完成8548例白内障防盲复明手术,取得了显著成果。手术质量与工作效率较卫生、残联各自单独开展有较大提高。结论:以政府为主导协调整合各方防盲资源开展防盲工作,是防盲工作可持续发展的方向。     

Proliferative diabetic retinopathy: pathophysiology of extraretinal complications and principles of vitreous surgery

Extraretinal complications of proliferative diabetic retinopathy are caused by neovascular and/or fibrovascular tissue growth and include vitreous hemorrhage, retinal detachment, and other effects damaging the retina and/or optic nerve. Exact features of fibrovascular tissue growth and secondary complications vary widely from case to case. However, the structural pathogenesis of this disease process is consistent because the abnormal tissue nearly always grows along the posterior vitreous surface. Therefore, differing topographic features and secondary complications are dependent on: (1) the places of origin and amount of fibrovascular proliferation, and (2) the location and extent of any posterior vitreous separation. The latter influences the configuration of the fibrovascular tissue growth and determines the effect on the underlying and adjacent retina. Surgical treatment of proliferative diabetic retinopathy is based on this fundamental structural pathophysiology. The -principles of surgery are to minimize damaging effects by reversing the optical and structural complications and preventing recurrence of similar problems. Therefore, the objectives of surgery are to remove any intravitreal opacities and to excise the posterior vitreous surface. To achieve these objectives, various specialized techniques are required, depending on the complexity of the vitreoretinal anatomy in each case. Still, when the objectives are achieved, the operation has similar beneficial immediate and long-term effects in most eyes. This paper discusses and illustrates the structural pathology of proliferative diabetic retinopathy and the principles and methods of surgical therapy, and it presents the results obtained and the complications encountered.     

辛伐他汀和替米沙坦对大鼠视网膜衰老的延缓作用及其机制

背景 他汀类药物具有显著的降脂、抗氧化、抗炎及调节血管内皮细胞功能等作用,而沙坦类药物能促进细胞因子的表达和调控细胞的生长.鉴于他汀类和沙坦类作用机制和药效的多效性,推测其对预防视网膜衰老具有一定的作用. 目的 研究辛伐他汀和替米沙坦对大鼠视网膜自然衰老的预防作用.方法 选择3月龄健康无眼疾SD大鼠66只,其中6只为青年组,其他大鼠常规饲养至9月龄后按随机数字表法将大鼠随机分为辛伐他汀组、替米沙坦组和对照组,每组各20只.辛伐他汀组和替米沙坦组大鼠分别用5 mg/(kg·d)辛伐他汀和8 mg/(kg·d)替米沙坦灌胃,对照组大鼠用等容量生理盐水灌胃,3个组大鼠均饲养至17月龄,将存活的辛伐他汀组12只、替米沙坦组10只和对照组8只大鼠经心脏灌注质量分数4％多聚甲醛溶液后摘取右侧眼球制备眼组织切片;青年组大鼠于3月龄时以同样方法获取眼组织切片.采用苏木精-伊红染色法检查各组大鼠视网膜厚度;采用免疫荧光染色技术检测视网膜神经节细胞(RGCs)标志物Thy-1、双极细胞标志物蛋白激酶C-α(PKC-α)、视锥细胞标志物opsin和视杆细胞标志物rhodopsin的表达,分别评估视网膜各级神经元的形态和视网膜各层的厚度. 结果 视网膜病理组织学检查显示,青年组大鼠视网膜结构清晰,细胞排列整齐;辛伐他汀组和替米沙坦组大鼠RGCs排列紊乱,细胞形态不规则;对照组大鼠视网膜感光细胞层内节(IS)、外节(OS)结构及RGCs排列紊乱.与青年组相比,辛伐他汀组、替米沙坦组和对照组大鼠视网膜总厚度及外核层(ONL)、外丛状层(OPL)、内核层(INL)、内丛状层(IPL)厚度均不同程度变薄,而感光细胞层厚度增加,差异均有统计学意义(均P＜0.01).Thy-1免疫荧光染色显示,与青年组相比,辛伐他汀组、替米沙坦组和对照组大鼠RGCs数量均减少,但辛伐他汀组大鼠RGCs数量较对照组增多,差异均有统计学意义(均P＜0.01).PKC-α荧光染色显示,辛伐他汀组、替米沙坦组和对照组轴突终扣密度均较青年组减少,辛伐他汀组大鼠双极细胞密度高于青年组和对照组,轴突终扣密度较对照组减少,差异均有统计学意义(均P=0.000).Opsin和rhodopsin荧光染色显示,辛伐他汀组、替米沙坦组和对照组大鼠视网膜OS厚度较青年组增加,替米沙坦组大鼠OS厚度较对照组下降,差异均有统计学意义(均P＜0.01).结论 随年龄增加,SD大鼠视网膜各层结构变薄,RGCs数量减少,双极细胞密度虽无明显变化,但突触联系减少,且视细胞OS层增厚.辛伐他汀可使RGCs数量和双极细胞密度增加,而替米沙坦可使增厚的视细胞OS层变薄,从而延缓视网膜的衰老.     

Endothelium-derived agents in pericyte function/dysfunction

The major components of blood vessels are the vascular endothelium and its supporting smooth muscle. Significant strides have been made in the understanding of the cellular and molecular biology of these two cell types and in particular their interactions have been the subject of much interest and debate over the past two decades. The vascular endothelium is now known to profoundly influence the synthetic and motor functions of the underlying smooth muscle and participate in the pathogenesis of all the major vascular disorders. Similarly, the vascular smooth muscle has important effects on the overlying endothelium, and any disruption in the cellular physiology of either cell type can result in dysfunction with important effects on blood flow and vascular permeability The majority of this accumulated knowledge relates to the vascular cells of the macrocirculation. Pericytes are the supporting cells of the microvasculature and a body of evidence is now available to show that similar regulatory mechanisms and vessel-wall cross-talk exists between these cells and the microvascular endothelium. Nowhere are these interactions more important than in the retinal microcirculation where autoregulation is vital for the maintenance of smooth and uninterrrupted blood flow. This review focuses on the interactions between retinal microvascular endothelial cells and their associated pericytes and examines the role of the endothelial cell and the pericyte in the pathogenesis of disease.     

鼠光感受器细胞层移植的方法及观察

目的 研究视锥和视杆细胞与周围组织间在解剖结构及是生理等方面的关系。方法 取２０只同龄Ｗｉｓｔａｒ和ＲＣＳ鼠作为供体和受体,利用视见解发削技术取得视锥及视杆细胞层,并植入ＲＣＳ鼠眼视网膜下。术后２周时摘除术眼,于光镜下观察交摄影。结果 术后２周,在视网膜完全复位的受体眼,移植的纯视锥和视杆细胞成活,可见移植细胞位于网膜下腔的视网膜色素上皮（ｒｅｔｉｎａｌ ｐｉｇｍｅｎｔ ｅｐｉｔｈｅｌｉｕｍ,ＲＰ     

我国眼视光学近五年发展状况及展望

本文主要回顾了我国近五年来眼视光学领域科学研究的状况,展示我国在近视基础研究和视觉科学应用研究方面的进步和成就,分析科学研究对解决临床视觉问题的指导作用和对大众眼保健的重要意义.本文通过展示具体研究现状和成果表明:眼的生物和光学双重属性赋予眼视光学研究的鲜明特色,多学科交叉合作进一步推动了眼视光学和视觉科研领域的创新.今后,我国眼视光学和视觉科学领域将直面更多的原创性和系统性研究工作,近视防治仍然是该领域长期而艰难的攻关课题.     

基于网络药理学和生物信息学探讨龙胆泻肝汤治疗葡萄膜炎的分子机制

目的：探讨龙胆泻肝汤治疗葡萄膜炎的药效学研究和分子机制分析。方法：实验研究。在体实验验证龙胆泻肝汤治疗葡萄膜炎的疗效,利用中药网络药理学数据和分析平台查询并筛选复方龙胆泻肝汤的入血有效成分,并进行网络拓扑分析其可能的治疗靶点。通过查询多种已知疾病靶点数据库,筛选葡萄膜炎的治疗靶点,并与有效成分治疗靶点构建出有效成分-疾病治疗靶点网络,并筛选出关键节点;拓扑分析关键节点参与的信号通路并进行富集分析,筛选出中药复方龙胆泻肝汤治疗葡萄膜炎的可能信号通路。结果：在体实验结果证实龙胆泻肝汤能够减轻大鼠结膜充血、虹膜粘连,减轻前房、睫状体和视网膜炎症细胞浸润,具有治疗葡萄膜炎的的作用;网络药理学分析显示龙胆泻肝汤治疗葡萄膜炎主要通过MAPK信号通路、促性腺激素信号通路和雌激素信号通路,减少炎症因子的产生和细胞浸润,调节机体免疫状况,调控葡萄膜炎的发生发展。结论：龙胆泻肝汤治疗葡萄膜炎可能主要是通过MAPK信号通路、促性腺激素信号通路和雌激素信号通路,调控炎症细胞和炎症因子、自身免疫等来实现。     

Development of the lens and zonulae in the human embryo]

The embryonic development and ultrastructures of the lens and zonulae in 212 eyes of 131 human embryos were studied by light and electronic microscopy, with the finding that the capsule and zonulae appeared earlier than previously reported. The laminate structure of the capsule was observed in the 7 week embryo, and the early structures of zonulae were discernible in the 10th week on the basement membrane of the non-pigmental epithelium of the ciliary body and on the capsule, indicating that the capsule was specialized basement membrane of the lenticular epithelial cells, and the zonulae originated from the non-pigmental epithelium of the ciliary body and the capsule of lens.     

细胞外基质相关分子在眼底新生血管形成中的作用

眼底新生血管形成是导致增生型糖尿病视网膜病变(PDR)、早产儿视网膜病变(ROP)及年龄相关性黄斑变性( AMD)患者视力丧失的主要原因之一.细胞外基质(ECM)固有成分中的胶原蛋白、弹性蛋白等经酶解后在体外研究及动物实验中已证实可促进脉络膜新生血管(CNV)、视网膜新生血管形成的发生.ECM黏附分子中的整合素α5β1与纤连蛋白在体外可促进内皮细胞黏附、增生,其抑制剂于体内则可抑制CNV、视网膜新生血管的发生,整合素αV β3及αV β5的抑制剂在体内也可发挥类似作用.黏附分子中的选择素及细胞间黏附分子则主要通过介导白细胞与内皮细胞间的相互作用促进新生血管形成.ECM降解相关的丝氨酸蛋白酶,尤其是尿激酶型纤溶酶原激活剂( uPA)(通过促进纤溶酶的生成)、基质金属蛋白酶(MMPs)(主要是MMP-2及MMP-9),在体外及体内实验中已证明可促进CNV、视网膜新生血管的发生,而I型纤溶酶原激活剂抑制剂(PAI-1)及组织金属蛋白酶抑制剂(TIMPs)则可抑制新生血管形成.对ECM相关分子在CNV、视网膜新生血管形成中作用的深入研究将为预防和治疗眼底新生血管形成提供新的思路和方法.     

近视防控博鳌宣言3.0版（中国眼谷）

2017年12月1日,中华医学会眼科学分会眼视光学组会同中国疾病预防控制中心及相关专家联合发布2017"近视科学防控"博鳌宣言（以下简称"博鳌宣言2017"）,首次明确提出将近视防控纳入慢病管理,并从建立视觉健康档案、增加户外活动、近距离用眼减负减量、规范矫正近视、科学控制近视、重视高度近视危害等方面提出建议性倡议。博...     

视皮层背侧、腹侧流视觉通路的研究进展

视皮层是大脑视觉信息的处理整合中心,灵长类动物的视皮层存在背侧和腹侧流2条相对独立而又相互联系的平行视觉信息通路。笔者总结了视皮层背侧通路（即where+how通路）、腹侧通路（即what通路）的发现、定位、功能以及二者的联系,并从视觉通路临床应用角度系统梳理了视觉皮层背侧、腹侧平行通路的研究进展。目前2条通路结构和功能相关性研究资料较少,对视皮层视觉通路的视觉信息分拣处理、相互作用及通路信息传递过程编码和神经整合处理机制尚缺乏深入研究。此外,关于2条通路的临床研究缺乏系统性和完整性,且研究结果分歧较大,今后需改进研究方法,加强深入研究视觉疾病视通路损害的结构和功能。本文通过对视皮层背侧通路、腹侧通路做—综述,以期为视觉信息的传递、加工和相关临床眼病防治研究提供理论基础。     

The spectrum and dynamics of free amino acids in the tissues of the bovine eye and their interaction with pilocarpine. III. The lens

The authors revealed by chromatographic analysis that in the investigated tissues of the bovine eye a 3% aqueous pilocarpine solution 2.5 hours after the last instillations alters specifically the levels of different free amino acids. In the capsule and anterior coat an increase was observed and in the nucleus and posterior coat a decline of the total amount of these components. In the control and pilocarpine-treated capsule and in the lenticular nucleus glutamic acid, is present in the highest concentration and in the anterior and posterior coat of the lens aspartic acid and lysine.     

近视巩膜组织重塑与相关基因研究进展

近视严重威胁着儿童的视力健康,高度近视可以导致多种并发症,甚至视力完全丧失。近年来随着近视发病率的持续增加,人们对近视认知水平的持续提升,儿童近视问题受到了广泛关注。目前近视发生和发展的具体机制尚不清楚,人们普遍认为巩膜是近视发生的效应器。随着近视不断发展,眼轴逐渐拉长,眼球的结构和功能随之发生改变,其中,眼轴过度延长导致巩膜重塑,后极部巩膜加速变薄,巩膜的组织结构和生物力学特性发生了重要改变,而相关基因表达的调控则是视觉信号引起巩膜重塑的关键。大量研究者借助于近视动物模型和基因测序技术发现,巩膜细胞外基质重塑与近视的发生和发展密切相关。文章就目前巩膜在近视发生发展中组织结构及相关基因的变化进行综述,为深入探究近视的巩膜重塑机制和寻找新的近视治疗靶点提供思路。     

Might and magic, lust and language – the eye as a metaphor in literature

The special anatomy and physiology of the eye predestine it to function as the primary mediator between the world within us and the world without. The way we respond to and reflect on our world is strongly associated with our eyesight. Since antiquity literature, the most important medium for propagating knowledge, has abounded with symbols for the motif `eye,' symbolizing the responsibility, independence and significance of the visual sense. Today the mechanisms of the modern information media engulf us with new and permanent stimuli. If we surrender ourselves uncritically to this profusion of images, we risk `overstraining' our sense of sight and losing the connection between perception and cognition. In the following a few references to the international non-medical literature may explain and illustrate the functions of the eye as a metaphor for the mind and describe the past and the prospects of visual perception.     

脉络膜血流灌注与儿童近视的相关性研究进展

近视是最常见的屈光不正类型。目前我国近视低龄化与快速增长特点明显,青少年儿童近视已成为全社会关注的公共卫生问题。视觉经验指导儿童屈光状态与正视化的发育。近视的发生与发展伴随着眼球结构改变,脉络膜呈现变薄趋势。脉络膜的厚度变化可能由血流灌注决定。脉络膜血流灌注下降可能导致巩膜缺血缺氧,缺氧诱导巩膜基质重塑和眼轴增长。本文就脉络膜血流与近视的相关性展开综述,提示关注脉络膜变化在近视防控中的意义。     

新世纪我国斜视弱视研究进展

近5年来,在中华医学会眼科学分会的指导和全体专业人员的共同努力下,我国斜视、弱视基础和临床研究取得了长足进步。我们的科研人员和临床工作者在弱视分子和神经机制研究、视觉发育的可塑性研究、弱视的脑功能成像研究、眼外肌滑车（Pulley）研究以及斜视弱视的诊断、治疗及流行病学研究方面均付出了辛苦的劳动,取得了丰硕的成果。我们期待在未来的10年中,本学科的工作能不断发展、不断提高。     

Distribution of tubulin, kinesin, and dynein in light- and dark-adapted octopus retinas

Cephalopod retinas exhibit several responses to light and dark adaptation, including rhabdom size changes, photopigment movements, and pigment granule migration. Light- and dark-directed rearrangements of microfilament and microtubule cytoskeletal transport pathways could drive these changes. Recently, we localized actin-binding proteins in light-/dark-adapted octopus rhabdoms and suggested that actin cytoskeletal rearrangements bring about the formation and degradation of rhabdomere microvilli subsets. To determine if the microtubule cytoskeleton and associated motor proteins control the other light/dark changes, we used immunoblotting and immunocytochemical procedures to map the distribution of tubulin, kinesin, and dynein in dorsal and ventral halves of light- and dark-adapted octopus retinas. Immunoblots detected alpha- and beta-tubulin, dynein intermediate chain, and kinesin heavy chain in extracts of whole retinas. Epifluorescence and confocal microscopy showed that the tubulin proteins were distributed throughout the retina with more immunoreactivity in retinas exposed to light. Kinesin localization was heavy in the pigment layer of light- and dark-adapted ventral retinas but was less prominent in the dorsal region. Dynein distribution also varied in dorsal and ventral retinas with more immunoreactivity in light- and dark-adapted ventral retinas and confocal microscopy emphasized the granular nature of this labeling. We suggest that light may regulate the distribution of microtubule cytoskeletal proteins in the octopus retina and that position, dorsal versus ventral, also influences the distribution of motor proteins. The microtubule cytoskeleton is most likely involved in pigment granule migration in the light and dark and with the movement of transport vesicles from the photoreceptor inner segments to the rhabdoms.