四君子汤含药血清抑制晶状体上皮细胞凋亡的实验研究

目的　观察四君子汤含药血清对人晶状体上皮细胞（human lens epithelial cell，HLEC）凋亡的抑制作用，从而探讨四君子汤防治老年性白内障的机制。方法　30只SD大鼠随机分为2组，分别用四君子汤（1.725 g·kg^-1·d^-1）和生理盐水灌胃，用药7 d后经腹主动脉采血，离心提取四君子汤含药血清和空白血清冻存备用。细胞实验分为4组:阴性对照组、过氧化氢组（300 μmol·L^-1过氧化氢作用4 h）、空白血清组（300 μmol·L^-1过氧化氢作用4 h后加入体积分数20%空白血清作用12 h）和四君子汤含药血清组（300 μmol·L^-1过氧化氢作用4 h后加入体积分数20%四君子汤含药血清作用12 h），流式细胞仪检测HLEC细胞周期；透射电子显微镜观察各组HLEC超微结构的改变。结果　流式细胞仪检测结果示:过氧化氢组G1期细胞比例为（67.127±2.615）%，较阴性对照组明显增加，S期细胞比例为（24.603±2.547）%、 G2期细胞比例为（8.270±1.149）%，均较阴性对照组减少，差异均具有统计学意义（均为P＜0.05）。四君子汤含药血清组G1期细胞比例为（41.517±20.008）%，较过氧化氢组明显减少，S 期细胞比例为（38.423±10.213）%、G2期细胞比例为（20.060±11.004）%，均较过氧化氢组明显增加，差异均具有统计学意义（均为P＜0.05）。透射电子显微镜结果显示:阴性对照组胞膜完整，各细胞器结构正常；过氧化氢组细胞表面微绒毛消失，染色质凝集成块分布于核膜下，核膜欠完整，细胞质内可见溶酶体；空白血清组细胞质内空泡增多，线粒体、内质网等细胞器结构仍可见；四君子汤含药血清组胞膜完整，细胞质内可见少许空泡，线粒体、内质网等细胞器结构清晰。结论　四君子含药血清能有效抑制过氧化氢诱导的HLEC凋亡，这可能是四君子汤防治老年性白内障的机制之一。     

不同手术方式对老年性白内障患者眼血-房水屏障功能的影响研究

目的比较不同手术方式对老年性白内障患者眼血-房水屏障功能的影响。方法将2010年2月至2011年5月馆陶县人民医院收治的老年性白内障患者82例按照手术方式不同分为A、B两组,A组40例采用现代囊外摘除术,B组42例采用超声乳化吸出术,比较分析两组患者的疗效及眼血-房水屏障功能情况。结果 A组总有效率为95.0%,B组为97.6%,两组比较差异无统计学意义(P>0.05);A组术后房水蛋白浓度明显高于B组,两组间差异有统计学意义(P<0.05);A组并发症发生率为7.5%,B组为4.8%,两组比较差异无统计学意义(P>0.05)。结论现代囊外摘出术和超声乳化吸出术治疗老年性白内障均可获得良好的临床效果与安全性,前者对患者眼血-房水屏障功能损伤较大,在应用时要综合考虑。     

Molecular genetics of congenital nuclear cataract

A cataract is defined as opacification of the normally transparent crystalline lens. Congenital cataract (CC) is a type of cataract that presents at birth or during early childhood. CC is one of the most common causes of visual impairment or blindness in children worldwide. Approximately 50% of all CC cases may have a genetic cause which is quite heterogeneous. CC occurs in a variety of morphologic configurations, including polar/subcapsular, nuclear, lamellar, sutural, cortical, membranous/capsular and complete. Nuclear cataract refers to the opacification limited to the embryonic and/or fetal nuclei of the lens. Although congenital nuclear cataract can be caused by multiple factors, genetic mutation remains to be the most common cause. It can be inherited in one of the three patterns: autosomal dominant, autosomal recessive, or X-linked transmission. Autosomal dominant inheritance is the most frequent mode with high penetrance. There may be no obvious correlation between the genotype and phenotype of congenital nuclear cataract. Animal models have been established to study the pathogenesis of congenital nuclear cataract and to identify candidate genes. In this review, we highlight identified genetic mutations that account for congenital nuclear cataract. Our review may be helpful for genetic counseling and prenatal diagnosis.     

Antimicrobial activity in medicinal plants of the Scrophulariaceae and Acanthaceae

One hundred and one crude extracts obtained from various plant parts of 59 species representing mostly the plant families Scrophulariaceae and Acanthaceae have been investigated for their antimicrobial activity. Plants were selected using ethnobotanical and chemotaxonomic information. Growth inhibition using agar disk diffusion assays was determined against Escherichia coli, Pseudomonas aeruginosa, Staphylococcus aureus, and Candida albicans. Growth inhibitory activity against one or more of the microbial species was detected in over 40% of the samples.     

人工晶状体在婴儿白内障手术中应用现状与趋势

婴儿白内障手术仍然是目前眼科临床治疗的难题。由于人工晶状体(IOL)矫正无晶状体眼符合眼部生理要求且利于弱视的治疗,IOL植入术在婴儿白内障手术中的应用越来越多,植入年龄也越来越小。随着眼科显微技术和IOL设计的进一步发展,婴儿IOL植入的手术并发症也不断减少。从历史发展趋势看,白内障摘除同期IOL植入可能成为未来婴儿白内障手术的首选方式;但当前同期植入IOL的并发症不可忽视,所以应重视IOL在婴儿白内障手术中的临床应用研究。     

The clinical effects of sodium hyaluronate,polyethylene glycol,and dextran-70 eye drops in relieving dry eye after phacoemulsification

To compare the clinical efficacy of sodium hyaluronate eye drops, polyethylene glycol eye drops, and compound dextran eye drops in the treatment of dry eye after phacoemulsification of cataract.A total of 99 patients with dry eye after cataract phacoemulsification combined with intraocular lens implantation were treated in our hospital. Patients were divided into group A (sodium hyaluronate eye drops), group B (polyethylene glycol eye drops), and group C (dextran-70 eye drops). The clinical effect, tear film breakup time, basic tear secretion, corneal staining score, dry eye symptom score, and the incidence of ocular irritation were assessed.On the 3rd, 15th, 30th, and 60th day after operation, the tear film breakup time, corneal staining score, Schirmer I test, and dry eye symptom score in group A and group B were better than those in group C (P < .05). In addition, there were no significant differences in tear breakdown time, corneal staining score, Schirmer I test, and dry eye symptom score between group A and group B (P > .05). At 3 days to 60 days after operation, the incidence of dry eye in group A (12.12%) and group B (18.18%) was lower than that in group C (39.39%), and the incidence of dry eye in group A was significantly lower than that in group B (P < .05).The effect of sodium hyaluronate eye drops elicited a greater beneficial impact as compared to polyethylene glycol eye drops and dextran-70 eye drops.     

Anesthetic dilemma in planning bilateral cataract surgery for an infant associated with congenital cardiac anomaly

In a patient with tetralogy of Fallot (TOF) and pulmonary atresia, treating the cardiac problem or the associated congenital illness is always a challenge. We describe the challenges and successful initial management of bilateral cataract to prevent visual loss in an infant with TOF with pulmonary atresia.     

冷超声乳化白内障吸除手术应用于硬核白内障的疗效

目的研究冷超声乳化白内障吸除(CP)手术应用于硬核白内障的疗效。方法选择2012年4月至2013年4月在我院接受治疗的硬核白内障患者80例(92只眼)作为研究对象。为所有患者均实施CP手术,随访6个月,分析术后不同时期视力和屈光情况,角膜内皮情况以及并发症情况。结果手术前所有患者的视力均<0.01,术后1个月和3个月时患者的视力均>0.1,差异均有统计学意义(P<0.05)。但术后1个月与术后3个月在裸眼视力和矫正视力,以及球镜和散光等方面相比,差异均无统计学意义(P>0.05)。术后1个月和3个月的角膜内皮细胞的密度均显著少于术前,但术后1个月与术后3个月在内皮细胞的密度及密度减少率方面对比,差异均无统计学意义(均P<0.05)。患者在术中有6只眼发生后囊破裂,发生率为6.52%,未发生玻璃体外溢;有2只眼的部分晶状体核发生脱落至玻璃体腔,发生率为2.17%;有5只眼的睫状沟需固定人工晶状体,发生率为5.43%。手术后1周有8只眼发生角膜水肿,发生率为8.70%。手术后1至3个月有1只眼发生孔源性视网膜脱离。结论 CP术式治疗硬核白内障的疗效较好,并发症相对较少,利于患者的视力恢复,值得在临床推广应用。