目的：分析角膜后前表面曲率半径比值(B/F比值)与年龄相关性白内障患者术后屈光误差的关系，探讨B/F比值对人工晶状体(intraocular lens,IOL)度数计算精确性的影响。方法：选取2019年3—11月在天津医科大学眼科医院白内障中心就诊，并拟行单眼白内障手术的年龄相关性白内障患者共197例(197眼)，术前应用Pentacam眼前节分析仪测量患者眼前节生物参数，并以B/F比值下限25%、上限25%为界将患者分为下25%组、25%～75%组、上25%组。术后3个月应用全自动电脑验光仪评估患者术后屈光状态，并计算患者术后屈光误差(postoperative refractive error,PE)，比较三组平均屈光误差(mean refractive error,ME)、平均绝对误差(mean absolute error,MAE)、中位数绝对误差(median absolute error,MedAE)以及屈光误差在±0.25、±0.50、±0.75、±1.00、>±1.00 D范围内百分比差异。结果：B/F比值与年龄相关性白内障患者术后屈光误差呈中度相关(r=?0.445, P<0.001)。随着B/F比值增大，患者术后屈光状态由远视向近视漂移，术后3个月MAE、MedAE分别为0.55 D、0.46 D。屈光误差在±0.25、±0.50、±0.75、±1.00、>±1.00 D范围的百分比分别为29.4%、52.8%、71.6%、87.6%、12.7%。根据正常年龄相关性白内障人群B/F比值优化得到的矫正角膜折射指数计算角膜曲率后，MAE、MedAE分别为0.51、0.43 D，均低于矫正前(P<0.05)。结论：B/F比值对年龄相关性白内障患者术后屈光状态有影响。随着B/F比值的增加，白内障患者术后屈光状态由远视逐渐向近视漂移，且B/F比值越偏离正常平均值，患者的屈光误差绝对值越大。
Objective: To analyze the relationship between corneal B/F ratio and postoperative refractive error in age-related cataract patients, and to explore the impact of B/F ratio on the accuracy of intraocular lens power calculation. Methods: A total of 197 age-related cataract patients (197 eyes) who were treated in the cataract center of our hospital from March 2019 to November 2019 and were going to undergo monocular cataract surgery were selected. The biological parameters of the anterior segment were measured by Pentacam anterior segment analyzer before surgery, and the patients were divided into three groups (25% below the B/F ratio, 25%~75%, and 25% below the B/F ratio) with the lower limit and the upper limit of 25%. Three months after surgery, the postoperative refractive state of patients was evaluated by automatic computerized refractometer, and the postoperative refractive error (PE) was calculated, and the percentage differences of mean refractive error (ME), mean absolute error (MAE), median absolute error (MedAE) and refractive error in the range of ±0.25, ±0.50, ±0.75, ±1.00 and < ±1.00D were evaluated. Results: The B/F ratio was moderately correlated with postoperative refractive error in age-related cataract patients (r= ?0.445, P < 0.001). With the increase of B/F ratio, the refractive state of patients shifted from hyperopia to myopia after surgery, and the MAE and MedAE were 0.55 D and 0.46 D respectively in 3 months after surgery. The percentages of refractive error in the range of ±0.25, ±0.50, ±0.75, ±1.00 and < ±1.00 D were 29.4%, 52.8%, 71.6%, 87.6% and 12.7%, respectively. After adjusting the corneal curvature according to the B/F ratio of the population based on our previous study, MAE and MedAE were 0.51 D and 0.43 D, respectively, which were lower than those before correction (P< 0.05). Conclusions: There is a correlation between B/F ratio and postoperative refractive error in age-related cataract patients. As the B/F ratio increased, the refractive state of the patient gradually drifted from farsightedness to myopia after cataract surgery, and the more the B/F ratio deviated from the normal average, the greater the absolute value of the patient's refractive error.
目的：研究缺氧诱导因子-1(hypoxia inducible factor-1，HIF-1)信号通路在高眼压状态下的表达情况。方法：利用前房注射磁性微球法建立大鼠高眼压动物模型，通过荧光金逆行标记观察视网膜神经节细胞(retinal ganglion cells，RGCs)的存活情况，提取视网膜组织行Western印迹检测HIF-1α、血管内皮生长因子-A(vascular endothelial growth factor A，VEGF-A)-和促红细胞生成素(erythropoietin，EPO)的表达，并分析HIF-1α的变化趋势与眼压之间的关系。结果：高眼压1 d时平均眼压为(40.33±2.94) mmHg，第3天为(68.83±2.85) mmHg，第10天时下降至(43.67±3.67) mmHg，后趋于稳定，与对照眼相比差异均有统计学意义(P<0.01)。高眼压2周时中央、中间和周边视网膜的RGCs存活率分别为61.1%±1.1%，68.5%±8.5%和73.6±3.6%，至高眼压3周迅速下降，分别为33.2%±3.2%，43.4%±3.4%和51.4%±2.1%。高眼压3 d时，眼压值达最高，HIF-1α，VEGF-A和EPO的表达亦达高峰，与对照组相比差异均有统计学意义(P<0.01)；后随着眼压值下降，表达也随之逐渐减少。眼压升高3 d，7 d，2周分别与对照组的HIF-1α/GAPDH的蛋白灰度比和眼压值间的相关系数为0.977，0.886，0.763，差异具有统计学意义(P<0.01)。结论：HIF-1α的表达在一定条件下与眼压值呈正相关，该通路的早期激活可能在高眼压病程中扮演重要的角色。
Objective: To evaluate the expression of hypoxia inducible factor-1 (HIF-1) signaling pathway in the state of intraocular hypertension. Methods: We established an intraocular hypertension model of BN rats model of BN rats through the injection of magnetic microspheres into anterior chamber angle, and then evaluated this model by measuring the survival rates of retinal ganglion cells (RGCs) through retrograde Fluorogold labelling. Western blot was used to detect the protein expression of HIF-1α, vascular endothelial growth factor A (VEGF-A) and erythropoietin (EPO) in the retinal tissue, and HIF-1α protein’s alterable trend as well as its relationship with intraocular pressure (IOP) was analyzed. Results: The IOP was (40.33±2.94) mmHg at the ffrst day affer elevation, (68.83±2.85) mmHg at the third day, and (43.67±2.94) mmHg at the tenth day, then kept stable later. TTe survival rates of RGCs among central, middle and peripheral retina decreased from 61.1%±1.6%, 68.5%±2.0%, 73.6%±1.5%, at the second week to 33.2%±1.8%, 43.4%±2.4%, 51.4%±2.1% at the third week, the differences were statistically signiffcant (P<0.01). The protein expression of HIF-1α, VEGF-A and EPO reached the peak at the third day when the IOP was at the highest level, then decreased with the drop of IOP. The correlation coefffcient between the protein gray value of HIF-1α/GAPDH and IOP among the 3rd day, 7th day, 2 weeks and the control was 0.977, 0.886, 0.763 respectively (P<0.01). Conclusion: The expression of HIF-1α had a positive relationship with IOP in certain condition, and the early activation of HIF-1 signaling pathway might play an important role in the process of glaucoma.
目的：评价海藻糖滴眼液对摘除眶内眶外泪腺的实验性大鼠干眼的疗效。方法：SD 大鼠 30 只，随机分成正常组、对照组、实验组，每组 10 只（20 只眼）。正常组不给予处置，实验组和对照组通过摘除大鼠主泪腺制作干眼动物模型。对照组和实验组于造模完成术后 1 周后分别给予生理盐水、海藻糖滴眼液点双眼，每天 4 次，治疗共 4 周。分别于造模术前和造模术后 1、2、3、5 周进行基础泪液分泌试验（Shirmer I test），角膜上皮荧光染色评分检测；造模 5 周后将大鼠处死，采用免疫组织化学方法对结膜上皮细胞中 Bcl-2 和 Bax 凋亡基因蛋白表达进行检测，观察干眼动物模型结膜上皮细胞凋亡与眼表干眼病变及组织损伤的关系。结果：基础泪液分泌试验结果显示，对照组和实验组除术后第 5 周比较差异有统计学意义外（P < 0.05），其余时间点差异无统计学意义（P > 0.05），术后各时间点与正常组比较差异均有统计学意义（P < 0.05）。造模术后第 1 周，对照组和实验组角膜荧光染色评分明显高于正常组；术后第 2 周后，对照组和实验组评分差异无统计学意义（P > 0.05），随着时间的延长，术后第 3 周和第 5 周，两组评分差异均有统计学意义（P < 0.05），且实验组评分小于对照组。结膜上皮细胞免疫组织化学检测结果显示：正常组结膜上皮细胞 Bax 蛋白阳性表达的细胞数较对照组和实验组少，与对照组比较，差异有统计学意义（P < 0.05），与实验组比较差异无统计学意义（P > 0.05）；正常组可见大量 Bcl-2 蛋白阳性表达，且多于实验组，差异无统计学意义（P > 0.05），多于对照组，差异有统计学意义（P < 0.05）；对照组结膜上皮细胞中可见大量 Bax 蛋白阳性表达于细胞质，呈棕黄色颗粒，实验组中 Bax 蛋白阳性表达相对于对照组明显较少，两者差异有统计学意义（P < 0.05）；实验组结膜上皮细胞中可见大量 Bcl-2 蛋白阳性表达，对照组 Bcl-2 蛋白表达相对于实验组明显减少，差异有统计学意义（P < 0.05）。结论：海藻糖滴眼液可以减少角膜表层上皮脱落，对结膜上皮细胞有一定的保护作用，可以拮抗结膜上皮细胞的凋亡，从而增强角结膜上皮屏障功能，改善由干燥引起的眼表上皮的损伤。海藻糖溶液可用于眼表上皮疾病的潜在临床应用，为治疗眼表疾病如干眼症提供治疗选择。
Objective: To observe the efficacy of trehalose eye drops on experimental dry eye rat with removal of inside and outside lacrimal glands. Methods: A total of 30 SD rats were randomly divided into a normal group, a control group, and an experimental group, with 10 rats for each group (20 eyes). The normal group was not treated, and the experimental group and the control group were made into a dry eye animal model by removing the main lacrimal gland of the rat. The control group and the experimental group were given with normal saline and trehalose eye drops once a week after the completion of modeling, 4 times a day for 4 weeks. Shirmer I test and fluorescence staining test were carded before and 1, 2, 3, and 5 weeks after modeling. After 5 weeks of modeling, the rats were sacrificed and the expression of Bcl-2 and Bax apoptosis protein in conjunctival epithelial cells was detected by immunohistochemistry in order to observe the relationship between apoptosis of conjunctival epithelial cells and dry eye lesions and tissue damage in dry eye animal models. Results: Schirme I test results showed that there was no significant difference between the control group and the experimental group (P > 0.05) except for the 5th week after operation (P < 0.05). There was a statistical difference between the two groups and the normal group at each time point after surgery (P < 0.05). At the first week after modeling, the corneal fluorescence staining scores of the control group and the experimental group were significantly higher than those of the normal group. After the second week after surgery, there was no significant difference between the control group and the experimental group (P > 0.05). The prolongation of time, the 3 week and the 5th week after surgery, the difference between the two groups was statistically significant (P < 0.05), and the score of the experimental group was smaller than the control group. The immunohistochemical results of conjunctival epithelial cells showed that the number of Bax protein positive cells in the normal conjunctival epithelial cells was less than that in the control group and the experimental group. The difference between the normal group and the control group was statistically significant (P < 0.05). There was no significant difference between the two groups (P > 0.05). There was a large amount of Bcl-2 protein in the normal group, which was more than the experimental group. The difference was not statistically significant (P > 0.05), which was more than the control group. The difference was statistically significant (P < 0.05); a large amount of Bax protein was positively expressed in the cytoplasm and brownish-yellow particles in the conjunctival epithelial cells of the control group. The positive expression of Bax protein in the experimental group was significantly less than that in the control group, and the difference was statistically significant (P < 0.05). A large amount of Bcl-2 protein was positively expressed in the conjunctival epithelial cells of the experimental group, and the expression of Bcl-2 protein in the control group was significantly decreased compared with the experimental group (P < 0.05).Conclusion: Trehalose eye drops can reduce epithelial detachment of the cornea and have a protective effect on conjunctival epithelial cells, which can antagonize the apoptosis of conjunctival epithelial cells, thereby enhancing the keratoconjunctival barrier function and improving the ocular surface epithelium caused bydryness. The potential clinical application of trehalose solution for ocular surface epithelial diseases and provide treatment options for ocular surface diseases, such as dry eye.
目的：探讨正常成年 SD 大鼠的明视视网膜电图（Electroretinogram，ERG）特征。
方法：选取正常 9～12 周 SD 大鼠 60 只，使用罗兰视觉电生理仪记录大鼠右眼的明视闪光 ERG。使用 SPSS 统计分析 a 波、b 波和明视负波反应（Photopic negative response，PhNR）的隐含期和振幅。比较雄性和雌性 SD 大鼠明视 ERG 特征。
结果：每只 SD 大鼠均能记录到稳定的 a 波、b 波和 PhNR，其中 a 波的隐含期和 PhNR 的隐含期及振幅均符合正态分布，而其余指标均不符合正态分布。PhNR 的隐含期为 124.6±8.5 ms，其变异系数最小（0.07）。PhNR 的振幅为（11.3±4.2）μV，变异系数为 0.37。雄性和雌性 SD 大鼠明视 ERG 的各反应波之间无显著差异。
结论：在正常成年 SD 大鼠，明视闪光 ERG 是一项客观评价大鼠明视状态下视网膜功能的手段，PhNR 可以作为一项稳定的评价内层视网膜功能的指标。
Purpose: To study the characteristics of photopic flash electroretinogram (ERG) in normal adult SD rats.
Methods: Sixty normal adult SD rats aged 9 to 12 weeks old were enrolled in this study. Photopic flash ERG was recorded from these 60 SD rats. The results were analyzed with SPSS.
Results: Stable a, b and PhNR waves could be recorded in each rat. The implicit time of a wave, implicit time and amplitude of PhNR fit normal distribution. The implicit time of PhNR was (124.6 ± 8.5) ms with the smallest coefficient of variation of 0.07. The amplitude of PhNR was (11.3 ± 4.2) μV and the coefficient of variation was 0.37. There was no difference between the results of female and male rats.
Conclusion: Photopic flash ERG is an objective method in evaluating the retinal function in rats and PhNR can be used as a sensitive index of inner retinal function.
Purpose: To investigate the effect of intravitreal injection of basic fibroblast growth factor (bFGF) on activation and proliferation of endogenous retinal progenitor cells in the Royal College of Surgeons (RCS) rat.
Methods: Twenty-four rats were studied after the 30th postnatal day (≥30). Eighteen RCS-p+/LAV rats were divided into 3 groups: bFGF-treated, vehicle-treated, and untreated groups randomly, and 6 RCS-ray+p+/Lav rats were used as normal controls. 6 μl of bFGF (5 μg /10 μl) or vehicle was injected into the vitreous on day 31, 33, and 35 after birth (P31, P33, P35) in the bFGF group and vehicle group respectively, and no injections were administered in the untreated and control groups. All the rats were euthanized, and their eyes were enucleated, hemisected, and fixed at 50 days after birth for immunohistochemistry and measurement of outer nuclear layer thickness.
Results: Nestin and Chx10 were positive in all retinal layers. Intravitreal injection of bFGF in retina-dystrophic RCS (RCS-p+/Lav) rats induced intense labeling for the retinal progenitor cell markers Chx10 and Nestin, which were highly colocalized. Fluorescence intensity for both labels was somewhat less in the control rats, and much less in the vehicle-injected rats as well as in the untreated RCS rats. The outer nuclear layer (ONL) was significantly thicker in the bFGF group than that in the vehicle-treated or untreated group (P < 0.01), but thinner than that of the control group (P < 0.01). No significant difference was observed in the ONL thickness between the vehicle group and untreated group (P > 0.05).
Conclusion: bFGF may contribute to the activation of retinal progenitor cells in RCS rats, thus counteracting degeneration by promoting the proliferation of the progenitor cells.
Purpose: To investigate the effect of intravitreal injection of basic fibroblast growth factor (bFGF) on activation and proliferation of endogenous retinal progenitor cells in the Royal College of Surgeons (RCS) rat.
Methods: Twenty-four rats were studied after the 30th postnatal day (≥30). Eighteen RCS-p+/LAV rats were divided into 3 groups: bFGF-treated, vehicle-treated, and untreated groups randomly, and 6 RCS-ray+p+/Lav rats were used as normal controls. 6 μl of bFGF (5 μg /10 μl) or vehicle was injected into the vitreous on day 31, 33, and 35 after birth (P31, P33, P35) in the bFGF group and vehicle group respectively, and no injections were administered in the untreated and control groups. All the rats were euthanized, and their eyes were enucleated, hemisected, and fixed at 50 days after birth for immunohistochemistry and measurement of outer nuclear layer thickness.
Results: Nestin and Chx10 were positive in all retinal layers. Intravitreal injection of bFGF in retina-dystrophic RCS (RCS-p+/Lav) rats induced intense labeling for the retinal progenitor cell markers Chx10 and Nestin, which were highly colocalized. Fluorescence intensity for both labels was somewhat less in the control rats, and much less in the vehicle-injected rats as well as in the untreated RCS rats. The outer nuclear layer (ONL) was significantly thicker in the bFGF group than that in the vehicle-treated or untreated group (P < 0.01), but thinner than that of the control group (P < 0.01). No significant difference was observed in the ONL thickness between the vehicle group and untreated group (P > 0.05).
Conclusion: bFGF may contribute to the activation of retinal progenitor cells in RCS rats, thus counteracting degeneration by promoting the proliferation of the progenitor cells.
目的：评价海藻糖滴眼液对摘除眶内眶外泪腺的实验性大鼠干眼的疗效。方法：SD大鼠30只，随机分成正常组、对照组、实验组，每组10只(20只眼)。正常组不给予处置，实验组和对照组通过摘除大鼠主泪腺制作干眼动物模型。对照组和实验组于造模完成术后1周后分别给予生理盐水、海藻糖滴眼液点双眼，每天4次，治疗共4周。分别于造模术前和造模术后1，2，3，5周进行基础泪液分泌试验(Shirmer I test)，角膜上皮荧光染色评分检测；造模5周后将大鼠处死，采用免疫组织化学方法对结膜上皮细胞中Bcl-2和Bax凋亡基因蛋白表达进行检测，观察干眼动物模型结膜上皮细胞凋亡与眼表干眼病变及组织损伤的关系。结果：基础泪液分泌试验结果显示，对照组和实验组除术后第5周比较差异有统计学意义外(P<0.05)，其余时间点差异无统计学意义(P>0.05)，术后各时间点与正常组比较差异均有统计学意义(P<0.05)。造模术后第1周，对照组和实验组角膜荧光色染色评分明显高于正常组；术后第2周后，对照组和实验组评分差异无统计学意义(P>0.05)，随着时间的延长，术后第3周和第5周，两组评分差异均有统计学意义(P<0.05)，且实验组评分小于对照组。结膜上皮细胞免疫组织化学检测结果显示：正常组结膜上皮细胞Bax蛋白阳性表达的细胞数较对照组和实验组少，与对照组比较，差异有统计学意义(P<0.05)，与实验组比较差异无统计学意义(P>0.05)；正常组可见大量Bcl-2蛋白阳性表达，且多于实验组，差异无统计学意义(P>0.05)，多于对照组，差异有统计学意义(P<0.05)；对照组结膜上皮细胞中可见大量Bax蛋白阳性表达于细胞质，呈棕黄色颗粒，实验组中Bax蛋白阳性表达相对于对照组明显较少，两者差异有统计学意义(P<0.05)；实验组结膜上皮细胞中可见大量Bcl-2蛋白阳性表达，对照组Bcl-2蛋白表达相对于实验组明显减少，差异有统计学意义(P<0.05)。结论：海藻糖滴眼液可以减少角膜表层上皮脱落，对结膜上皮细胞有一定的保护作用，可以拮抗结膜上皮细胞的凋亡，从而增强角结膜上皮屏障功能，改善由干燥引起的眼表上皮的损伤。海藻糖溶液可用于眼表上皮疾病的潜在临床应用，为治疗眼表疾病如干眼症提供治疗选择。
Objective: To observe the efficacy of trehalose eye drops on experimental dry eye rat with removal of inside and outside lacrimal glands. Methods: A total of 30 SD rats were randomly divided into a normal group, a control group, and an experimental group, with 10 rats for each group (20 eyes). The normal group was not treated, and the experimental group and the control group were made into a dry eye animal model by removing the main lacrimal gland of the rat. The control group and the experimental group were given with normal saline and trehalose eye drops once a week after the completion of modeling, 4 times a day for 4 weeks. Shirmer I test and fluorescence staining test were carded before and 1, 2, 3, and 5 weeks after modeling. After 5 weeks of modeling, the rats were sacrificed and the expression of Bcl-2 and Bax apoptosis protein in conjunctival epithelial cells was detected by immunohistochemistry in order to observe the relationship between apoptosis of conjunctival epithelial cells and dry eye lesions and tissue damage in dry eye animal models. Results: Schirme I test results showed that there was no significant difference between the control group and the experimental group (P>0.05) except for the 5th week after operation (P<0.05). There was a statistical difference between the two groups and the normal group at each time point after surgery (P<0.05). At the first week after modeling, the corneal fluorescence staining scores of the control group and the experimental group were significantly higher than those of the normal group. After the second week after surgery, there was no significant difference between the control group and the experimental group (P>0.05). The prolongation of time, the 3 week and the 5th week after surgery, the difference between the two groups was statistically significant (P<0.05), and the score of the experimental group was smaller than the control group. The immunohistochemical results of conjunctival epithelial cells showed that the number of Bax protein positive cells in the normal conjunctival epithelial cells was less than that in the control group and the experimental group. The difference between the normal group and the control group was statistically significant(P<0.05). There was no significant difference between the two groups (P>0.05). There was a large amount of Bcl- 2 protein in the normal group, which was more than the experimental group. The difference was not statistically significant (P>0.05), which was more than the control group. The difference was statistically significant (P<0.05); a large amount of Bax protein was positively expressed in the cytoplasm and brownish-yellow particles in the conjunctival epithelial cells of the control group. The positive expression of Bax protein in the experimental group was significantly less than that in the control group, and the difference was statistically significant (P<0.05). A large amount of Bcl-2 protein was positively expressed in the conjunctival epithelial cells of the experimental group, and the expression of Bcl-2 protein in the control group was significantly decreased compared with the experimental group (P<0.05).Conclusion: Trehalose eye drops can reduce epithelial detachment of the cornea and have a protective effect on conjunctival epithelial cells, which can antagonize the apoptosis of conjunctival epithelial cells,thereby enhancing the keratoconjunctival barrier function and improving the ocular surface epithelium caused by dryness. The potential clinical application of trehalose solution for ocular surface epithelial diseases and provide treatment options for ocular surface diseases, such as dry eye.
目的：探讨品管圈在提高玻璃体切除术后患者俯卧位执行率中的应用效果。方法：成立品管圈活动小组，选定提高玻璃体切除术后患者俯卧位执行率作为活动主题，运用品管圈工具和方法，对现状进行分析，找出影响因素，制定相应的措施并组织实施，比较品管圈活动前后玻璃体切除术后患者俯卧位执行率情况。结果：玻璃体切除术后患者俯卧位执行率由活动前的64.70%提高到95.83%。结论：运用品管圈能显著提高玻璃体切除术后患者俯卧位执行率，值得临床推广。
Objective: To explore the effect of quality control circle on improving the prone position execution rate of patients after vitrectomy. Methods: Establish quality control circle activity group, select improving the prone position execution rate of patients after vitrectomy as the activity theme, use quality control circle tools and methods to analyze the status quo, find out the influencing factors, formulate corresponding measures and implement them, and compare the prone position execution rate of patients before and after quality control circle activity. Results: The prone position execution rate of patients after vitrectomy increased from 64.70% to 95.83%.Conclusion: The application of quality control circle can significantly improve the prone position implementation rate of patients after vitrectomy, which is worthy of clinical promotion.
