液相芯片技术是一种利用混悬在液相中的分类编码微球作为反应及信号检测载体，集合流式细胞技术、激光技术、数字信号处理技术及传统化学技术为一体的新型生物分子检测技术。它充分利用发展成熟的流式细胞术检测原理，对目标分子（如核酸、蛋白质等）进行高通量分析。目前已在生物医学研究中得到了广泛的应用。现就其技术原理、特点及其在泪液细胞因子检测中的应用作简要介绍。
Liquichip (Multiplexed microsphere-based flow cytometric assays) is a new biomolecular detection technology using encoded microspheres suspended in liquid as reaction and detection carrier, which is an integration of flow cytometry, laser technology, digital signal processing and traditional chemical technology. It is a high-throughput analyzer for the target molecular (e.g. nucleic acid and protein) based on the principles of flow cytometry. Liquichip is now widely used in biomedical analyses. This article briefly reviews the principle and characteristic of liquichip and its application in tear cytokine analysis.
目的：探讨全视网膜光凝及术后应用羟苯磺酸钙治疗糖尿病视网膜病变的疗效。方法：选取96例患者，共175只眼，随机分为对照组(48例，86只眼)和研究组(48例，89只眼)。两组均予全视网膜激光光凝治疗，其中研究组术后再予羟苯磺酸钙继续12周治疗。12周后，观察两组患者治疗前后视力、血液流变学的变化。结果：治疗后研究组在视力>1.0范围的患者明显多于对照组(χ2=6.779，P=0.009)， 而2组在视力≤0.4，0.4~0.6，0.7~1.0范围患者视力差异比较分别为( χ2=0.003，P=0.955)，(χ2=1.640，P=0.200)，(χ2=2.148，P=0.143)。治疗后研究组患者的血浆粘度、红细胞压积、红细胞变形指数、纤维蛋白原改善均优于对照组(P<0.05)。研究组总有效率89.9%，对照组75.6%，两组差异比较(χ2 =6.302，P=0.012)。结论：全视网膜激光光凝及术后应用羟苯磺酸钙治疗糖尿病性视网膜病，能有效提高视力及临床疗效，可能与改善患者血液流变相关。
Objective: To investigate the curative effect of the postoperative retinal laser photocoagulation and calcium dobesilate in the treatment of diabetic retinopathy. Methods: Selected 96 patients, 175 eyes, randomly divided into control group (48 cases, 86 eyes) and study group (48 cases, 89 eyes). Two groups were all given retinal laser photocoagulation treatment, while the study group continued to receive calcium dobesilate for 12 weeks after treatment. After 12 weeks, observed the eyesight, change of blood rheology of the two groups. Results: After the treatment, the patients with vision >1.0 in the study group were significantly more than the control group (χ2 =6.779, P=0.009), in the vision range of ≤0.4, 0.4~0.6, 0.7~1.0, the difference between the two groups was (χ2 =0.003, P=0.955), (χ2 =1.640, P=0.200), (χ2=2.148, P=0.143), respectively. After treatment, plasma viscosity, erythrocyte deposited, erythrocyte deformation index, fibrinogen in the study group were better than those in the control group (P<0.05). The total effectiveness in the study group was 89.9%, in the control group was 75.6%, the difference was statistically significant (χ2=6.302, P=0.012). Conclusion: The whole retinal laser photocoagulation and postoperative application of calcium dobesilate in treating the diabetic retinopathy can effectively improve eyesight and clinical curative effect, which may be associated with improving blood rheology.
大部分眼科手术/操作具有创伤小、疼痛刺激轻等特点，因此，选择眼表面麻醉即可满足手术的镇痛的需要，促进了眼科日间手术的广泛开展。其中，盐酸奥布卡因滴眼液是常用的眼科表面麻醉剂，具有麻醉起效迅速、镇痛作用强、持续时间久(约13 min)等特点，已经广泛应用在眼内手术中，在使用过程中，盐酸奥布卡因滴眼液对瞳孔及血管无影响，保证了眼内手术的安全。盐酸奥布卡因滴眼液能提供良好的眼表环境，对角膜厚度及角膜上皮厚度影响轻微，从而满足屈光手术的需要。此外，盐酸奥布卡因滴眼液能提供良好的术后镇痛，减少术后镇痛药物的使用，降低斜视术后患儿的躁动发生率。不含防腐剂的表面麻醉剂不影响麻醉剂的起效时间及镇痛效果，对眼表的影响轻微，从而创造良好的手术操作环境，提高手术效果，降低并发症和手术风险，是眼科手术中较为理想的表面麻醉药物。文章就盐酸奥布卡因滴眼液的作用机制及麻醉效果、药代动力学、临床疗效、安全性等进行综述。
Most ophthalmic surgeries are characterized by small incisions and mild pain, therein, the choice of topical anesthesia can meet the needs of surgeries and accelerate ophthalmic surgeries to be conducted in day surgery model. 0.4% oxybuprocaine hydrochloride eye drops is one of commonly used topical anesthetics for ophthalmic surgery, which has the characteristics of rapid onset and sufficient analgesia with long duration (about 13 minutes). Oxybuprocaine hydrochloride eye drops has been widely and safely used in intraocular surgery without affecting the pupil and blood vessels. Meanwhile, oxybuprocaine hydrochloride eye drops has negligible effects on corneal thickness and corneal epithelial thickness to meet the needs of refractive surgery. In addition, oxybuprocaine hydrochloride eye drops can provide sufficient postoperative analgesia, reduce the use of postoperative analgesics and the incidence of emergence agitation in children after strabismus surgery. The preservative-free topical anesthetic would be one of ideal topical anesthetics as it can provide a good surgical condition and reduce complications and risks of post-operative infections without changing the onset time and analgesia effects. This article provides a review of the mechanism, analgesia, pharmacokinetics, clinical efficacy, and safety profiles of 0.4% oxybuprocaine hydrochloride eye drops.
目的:通过观察对金黄色葡萄球菌性角膜溃疡的疗效,筛选克拉霉案眼用凝胶的合适浓度。方法:角膜实质层接种法建立40只家兔右眼金黄色葡萄球菌性角膜溃疡模型,将模型随机分成5组,每组8只免(8只眼),各组分别给予空白基质、0.1%克拉素眼用凝胶、0.25%克拉霉素眼用凝胶、左氧氟沙星凝胶、0.25%克拉霉素眼用凝胶联合重组牛碱性成纤维细胞生长因子(Recombinant bovine basic fibroblast growth factor, Rb-bFGF)，每天4次，每次2滴，分别在第1、3、5、7、10、14 天观察角膜病变情况及溃疡面积大小。结果:在相同的给药方法下，0.1%克拉霉素眼用凝胶、0.25%克拉素眼用凝胶、左氧沙星凝胶、0.25%克拉霉素眼用凝胶联合Rb-bFCF均能使金黄色葡萄球菌性角膜溃疡面积缩小角膜病变好转，与空白基质组相比有统计学差异(P < 0.05)：0.25%克拉素眼用凝胶组疗效明显优于0.1%克拉荐素眼用凝胶组(P < 0.05)。结论:制备的 0.25%克拉霉素眼用凝胶对金黄色葡萄球菌性角膜溃疡疗效肯定，可以进一步开发应用于临床。
Purpose:To screen proper concentration of clarithromycin ophthalmic gel by observingthe efficacy of different concertrations of clarithromycin ophthalmic gel for treatingstaphylococcal corneal ulcers.
Methods:Corneal ulcer was induced in the right eye of 40 rabbits, 3.0 x 10°CFU/mlstaphylococcus aureus suspension was injected midstromally into the central cornel.These rabbits were divided randomly into $ groups ,each group received respectivelytopical blank matrix, clarithromycin ophthalmic gel 0.1%, clarithromycin ophthalmicgel 0.25%,levofloxacin ophthalmic gel, clarithromycin ophthalmic gel 0.25% andrecombinant bovine basic fibroblast growth factor (Rb-bFGF), 4 times every day, 2drops each time. The eyes were examined respectively with the slit lamp beforetreatment(day0), on day3, day5, day7, day 10, day 14 to observe theprogression of corneal ulceration. including the area of the corneal ulcer and mark of keratitis.Resuls:Under the same way of giving medicine, experimental coreal ulcer studiesshowed a statistically significant decrease in all tratement groups on measurements ofthe area of the comeal ulcer and mark of keratitis(P<0.05), and clarithromycinophthalmic gel 0.25% had a better action than clarithromycin ophthalmic gel 0.1%against staphylococcus aureus corneal ulcer.
Conclusion:Clarithromycin ophthalmic gel 0,25% was proved to be an effective ocularmedication for the therapy of gram-positive bacterial corneal ulcer.
青光眼是一组以病理性眼压升高为主要危险因素的，以青光眼性神经萎缩和视野缺损为主要特征的全球首位不可逆性致盲眼病。超声睫状体成形术(UCP)是一种新型非侵入性青光眼治疗技术，其降眼压主要原理为利用高强度聚焦超声破坏睫状突上皮细胞以减少房水生成，并增加葡萄膜巩膜通道的房水流出。UCP适应证广泛，早期主要用于各类难治性青光眼患者，特别是晚期及绝对期患者，研究者发现其除降眼压外，还能够显著缓解该类患者的局部疼痛。近年来，UCP在未经手术治疗的青光眼患者和早、中期青光眼病例中，也表现出了良好的降眼压效果，同时显示出较少的并发症和较轻的术后反应，并可重复治疗。然而不同类型青光眼UCP疗效存在一定差异，且为达最佳治疗效果，其治疗需匹配恰当的探头型号以及适当的治疗扇区。现有较广泛应用于国外的基于眼轴和白到白参数的公式计算方法，测算精度并不适用于国人，然而精准度更高的模型法，其便捷性仍有待进一步提高。UCP虽可减少降眼压药物用量，但术后用药策略的调整仍可能导致眼压波动。综上，针对UCP手术的适应证选择、手术参数设计、疗效预判以及术后管理策略等，仍有待开展相关临床研究，以期为其临床应用提供更加可靠的依据。
青光眼是一组以病理性眼压升高为主要危险因素的，以青光眼性神经萎缩和视野缺损为主要特征的全球首位不可逆性致盲眼病。超声睫状体成形术(UCP)是一种新型非侵入性青光眼治疗技术，其降眼压主要原理为利用高强度聚焦超声破坏睫状突上皮细胞以减少房水生成，并增加葡萄膜巩膜通道的房水流出。UCP适应证广泛，早期主要用于各类难治性青光眼患者，特别是晚期及绝对期患者，研究者发现其除降眼压外，还能够显著缓解该类患者的局部疼痛。近年来，UCP在未经手术治疗的青光眼患者和早、中期青光眼病例中，也表现出了良好的降眼压效果，同时显示出较少的并发症和较轻的术后反应，并可重复治疗。然而不同类型青光眼UCP疗效存在一定差异，且为达最佳治疗效果，其治疗需匹配恰当的探头型号以及适当的治疗扇区。现有较广泛应用于国外的基于眼轴和白到白参数的公式计算方法，测算精度并不适用于国人，然而精准度更高的模型法，其便捷性仍有待进一步提高。UCP虽可减少降眼压药物用量，但术后用药策略的调整仍可能导致眼压波动。综上，针对UCP手术的适应证选择、手术参数设计、疗效预判以及术后管理策略等，仍有待开展相关临床研究，以期为其临床应用提供更加可靠的依据。
目的: 研究 TGF-β1 短期眼部应用对兔角膜碱烧伤后整合素 β1 表达和角膜上皮愈合的影响,探求其对角膜碱烧伤的治疗作用。方法: 制备大耳白家兔角膜碱烧伤模型, 一组给予 TGF-β1 (浓度为 200 ng /ml) 局部滴眼, 每日 3 次, 连续 7 日; 另一组给予 PBS 溶液代替, 处理相同。于角膜碱烧伤后每日观察角膜上皮愈合面积, 并于烧伤后 6 h、1 d、3 d、7 d 和 14 d 5 个时间点应用免疫组化方法检测 TGF-β1 实验组与 PBS 组角膜整合素 β1 表达情况。结果: 烧伤后 4 d、10 d、11 d、12 d 和 14 d 实验组和对照组上皮愈合率比较, 差异有统计学意义(P < 0.05) , 两组随着上皮修复过程的进行, 整合素 β1 的表达均逐渐增加, 烧伤后 7 d、14 d两个时间点实验组和对照组整合素 β1 平均灰度值比较, 差异有显著性(P < 0.05) 。结论: TGF-β1 在活体实验中能促进整合素 β1 的表达, 而后者的增加可以促进角膜上皮细胞向损伤区域的移行和粘附, 从而减少碱烧伤愈合过程中上皮再次脱落现象, 有利于创伤愈合。
Purpose: To observe the effect of TGF-β1 applied topically to the alkali-injured rabbit eye on corneal epithelial wound healing and expression of integrin β1 and its therapeutic action on corneal alkali burns.
Methods: Alkali burn was produced in 60 corneas from 30 rabbits. Two groups were randomly divided. One group was treated with TGF-β1 solution (200 ng /ml) topically 3 times one day within the first 7 days, the other group was treated with phosphate-buffered saline (PBS) solution. The injured eyes were photographed after the fluorescence staining with a digital camera and the pictures were analyzed with computer-aided picture analysis system to calculate the rate of corneal epithelial healing. The expression of integrin β1 was investigated in the point 6 h, 1 d, 3 d, 7 d, 14 d after the injury by means of immunohistochemical analysis.
Results: On the 4th, 10th, 11st, 12nd and 14th days after the burning, the rate of corneal epithelial healing of TGF-β1 groups was markedly higher than that of the PBS group (P < 0.05) . The expression of integrin β1 in the cornea epithelial cells gradually increased during the wound healing. On the 7th and 14th days after the burning, the expression of integrin β1 in the cornea epithelial cells of TGF-β1 group was remarkably higher than that of the PBS group(P < 0.05) .Conclusions: TGF-β1 could up-regulate integrin β1 in vivo corneal alkali burn model, which could stimulate the cornea epithelial cells to migrate and adhere to the cornea stroma, that can reduce the cases of the epithelial cells_detachment from the cornea stroma and sustain the corneal reepithelization.
目的：评价欧堡Daytona 200度超广角激光扫描检眼镜检查近视患者眼底周边部视网膜病变的应用价值。方法：本研究为前瞻性病例研究，收集爱尔眼科医院要求行屈光手术的近视患者1 000例(2 000只眼)，分别进行小瞳下欧堡Daytona 200度超广角激光扫描检眼镜眼底检查和散瞳后三面镜检查，记录检查结果并进行比较分析。结果：通过欧堡Daytona 200度超广角激光扫描检眼镜检查发现有周边视网膜病变共230例(310只眼)，检出阳性率为15.50%；三面镜检查发现周边部视网膜病变共242例(322只眼)，检出阳性率为16.10%。两种检查方法对近视患者周边部视网膜病变检出阳性率具有很好的一致性(Kappa值0.8~1.0)。结论：欧堡Daytona 200度超广角成像系统为检查周边部视网膜病变提供了更省时高效的方法，在屈光手术前筛查视网膜周边部病变，具有广阔的临床应用前景。
Objectives: To evaluate the clinical value of peripheral retinal diseases in myopic patients examined by 200-degree ultra-wide field laser ophthalmoscope (Daytona). Methods: This was a prospective case-control study. We collected 1 000 myopic patients (2 000 eyes) who were scheduled to undergo refractive surgery in Aier Eye Hospital. They were examined by 200-degree ultra-wide field laser ophthalmoscope (Daytona) with non-mydriasis and three-mirror contact lens with mydriasis. The examination results were recorded and statistically analyzed. Results: A total of 230 cases (310 eyes) with peripheral retinopathy were found by 200-degree ultra-wide field laser ophthalmoscope (Daytona). The positive rate was 15.50%; 242 cases (322 eyes) with peripheral retinopathy were found by three- mirror contact lens, and the positive rate was 16.10%. The two methods were consistent in the detection of peripheral Retinopathy in myopic patients (the Kappa value is between 0.8 and 1.0). Conclusion: 200-degree ultra-wide field laser ophthalmoscope (Daytona) is an effective and rapid method for detecting peripheral retinopathy. It provides a broad clinical application prospects for peripheral retinopathy screening before refractive surgery.
目的：利用信息化手段，优化眼遗传病患者的随访途径，降低病历资料缺失率，助力临床检验科室高效运营。方法：通过态势分析法搜集需求，基于微信公众号平台“中山大学眼科医院小儿遗传”，搭建眼遗传病信息管理系统。根据是否使用眼遗传病信息管理系统、是否受到人员流动限制，将2017年7月1日—2023年11月30日来院进行基因检测的患者分为四组：传统组、传统+人流限制组、微信组和微信+人流限制组，通过χ2检验对眼遗传病信息管理系统进行性能评价。结果：源软件架设在阿里云电子政务平台的眼遗传病信息管理系统，通过加密通讯与医院网络交互。系统主要分为基因检测业务、数据管理和系统管理三大模块。使用该系统的患者或亲属可以在任意时间和地点，自主上传病历资料、签署知情同意书、查询基因检测报告，如有需要还能进行一对一的沟通实现长期随访。在此过程中，患者的临床信息实现数字化。研究共纳入10 662例患者对该系统进行性能评价，使用眼遗传病信息管理系统后，患者病历资料缺失率显著降低，由12.2%(传统+人流限制组)降至2.7%(微信+人流限制组)；患者二次来访率由最高的70%(传统组)降至最低的11.7%(微信组)；两类比较差异有统计学意义(P<0.001)。结论：眼遗传病信息管理系统的使用显著降低患者病历资料缺失率和眼遗传病患者的二次来访率。
Objective: To optimize the follow-up approach for patients with ophthalmic genetic diseases through informational technology, reduce the loss rate of cases, and facilitate the efficient operation of the clinical laboratory. Methods: Using the SWOT analysis method to collect requirements, ‘Pediatric Genetics of Zhongshan Ophthalmic Center’, an ophthalmic genetics information management system for ophthalmic genetic diseases was established on the Wechat public platform. Based on whether the ophthalmic genetic disease information management system was used and there were personnel mobility restrictions, patients who underwent genetic testing in the hospital for genetic testing from July 1, 2017, to November 30, 2023, were divided into four groups: traditional group, traditional+ lockdown group, Wechat+ lockdown group, and Wechat group. Te chi-square test was used to evaluate the performance of the ophthalmic genetic information management system. Results:The ophthalmic genetic disease information management system, which is based on open-source sofware and hosted on the Alibaba Cloud e-government platform, interacts with the hospital network through encrypted communication. Te system was divided into three modules: gene detection business, data management, and system management. By the system, patients or relatives can upload medical records, sign informed consent, inquire about genetic test reports at any time and anywhere, and conduct one-on-one communication to achieve long-term follow-up if necessary. In this process, the patient's clinical information was digitized. A total of 10,662 patients were included in the study to evaluate the performance of the system. The loss rate of cases was decreased from 12.2%to 2.7%, and the rate of second visits was reduced from 70% to 11.7%, which were statistically different, respectively (P< 0.001). Conclusion: Te application of the ophthalmic genetic information management system has signifcantly reduced the loss rate of cases and the rate of second visits in patients with ophthalmic genetic diseases.
因不同的眼部和神经性疾病，导致视觉功能严重受损，为低视力患者日常活动(如阅读及驾驶)及生活质量、心理健康带来严重的影响。人们对外界信息的感知主要来源于视觉，除威胁生命的重大疾病外，对人感官影响最大的损害当属视觉损伤。且随着人口日益老龄化，该问题日趋加重，低视力已成为目前全球范围内一个严重的公共卫生问题。目前，低视力康复发展面临着临床和科研的巨大挑战，要研发出一种能有效改善视觉功能，同时能兼顾多种功能的视障辅助技术，这需要医学、生物学、工程学、微电子学、计算机学等多学科的共同发展和相互合作。低视力康复通过为患者提供适宜的视障辅助技术，最大化利用患者的残余视力及视觉功能，改善与低视力相关的功能限制，有效改善其独立性和整体生活质量，使其独立生活、工作并融入社会成为可能。该文对经典的助视器、人工视觉(视觉假体/视觉感官替代设备)、经颅刺激及视觉生物反馈训练等视障辅助技术在低视力康复中的应用进展进行综述。
Patients with low vision are severely impaired in visual function due to different ocular and neurological disorders,which have a serious impact on their daily activities (such as reading and driving), quality of life and mental health.People's perception of external information mainly comes from vision. Expect for the life-threatening major diseases,visual damage has the greatest impact on people's senses. With the ageing of the population, the problem is getting worse, and low vision has become a serious public health problem in the world. Currently the development of low vision rehabilitation is facing a huge challenge in clinical and scientific research, to develop a visual impairment assistance technology that can effectively improve visual function while balancing multiple functions. It requires the joint development and cooperation of multiple disciplines such as medicine, biology, engineering, microelectronics, and computer science. Low vision rehabilitation provides patients with appropriate visual impairment assistance technology,maximizing the use of residual vision and visual function of patients, improving the functional limitations associated with low vision, effectively improving their independence and overall quality of life, and makes it possible for them to live, work and integrate into the society independently. This article reviews the progress in the application on visual impaired assistive technologies such as classic visual aids, artificial vision (visual prostheses/visual sensory replacement devices), transcranial stimulation and visual biofeedback training in low vision rehabilitation.
目的：比较轻、中、重度近视患儿之间的视觉功能的差异，探索虚拟现实下的短期可塑训练对近视视觉功能的改善效果。方法：选择2022年6月—2022年9月就诊于苏州大学附属儿童医院的6~16岁儿童102例，按照屈光度分为正常对照组、轻度近视组和中重度近视组，进行眼科常规检查和视知觉功能检查，并进行视觉短期可塑训练。结果：近视患儿存在立体视功能缺损，近视程度与精细立体视功能损害呈正相关，各组之间比较差异具有统计学意义(P<0.05)，部分患儿存在中心凹抑制。训练后，轻度近视组的中距离精细立体视功能得到改善，比较差异具有统计学意义(P<0.05)。结论：近视患儿存在立体视功能异常和中心凹抑制，且立体视功能的损害随着近视程度的增加而加重。轻度近视患儿部分精细立体视功能经过虚拟现实短期可塑训练可得到改善，而中重度近视患儿精细立体视功能改善不明显。
Objective: To compare the difference of visual function among children with myopia in different diopter, and explore the effect of short-term plastic training of virtual reality on visual function improvement. Methods: The 102 children aged 6-16 years who admitted to Children's Hospital of SoochowUniversity from June 2022 to September 2022 were recruited and divided into control group, mild myopia group and middle and high myopia group according to diopter. Routine ophthalmologic examination and visual perception function examination were carried out, and short-term plastic training was implemented. After the training, visual perception function examination was completed again. Results: There were significant differences in stereoscopic function defect at different distances among myopic children, a negative correlation between myopia and stereoscopic function was found. while there were several cases have foveal suppression. After training, the fine stereopsis at medium distance of the mild myopia group was significantly improved with significance statistical difference. Conclusions: Myopia can lead to the abnormality of stereopsis and foveal suppression in children. The defect of binocular visual function increases with the increase of myopia. Short term plastic training of virtual reality can partially improve the fine stereoscopic function of mild myopia children whileshowsnosigni ficanceimprovementof the fine stereoscopic function in middle and high myopia group.
