目的 探讨增生期糖尿病视网膜病变患者经全视网膜激光光凝治疗的临床效果。方法 选取2016年2月—2019年3月我院收治的增生期糖尿病视网膜病变患者97例,使用随机数表法分为观察组(49例)与对照组(48例)。对照组患者接受黄斑格栅样光凝治疗,观察组患者则接受全视网膜激光光凝治疗。收集2组患者手术前后视力、黄斑中心凹容积、乳头周边视网膜神经纤维层厚度及视网膜厚度变化情况等数据进行分析,并对比生活质量评分。结果 治疗前,2组患者视乳头旁视网膜神经纤维层厚度、黄斑中心凹容积以及视网膜厚度之间差异无统计学意义(P＞0.05),具有可比性。接受不同治疗后,观察组患者上述3项指标均优于对照组患者(P＜0.05)。观察组患者治疗总有效率为79.59%,高于对照组患者治疗总有效率59.18%(P＜0.05)。此外,观察组患者在精细动作、调节能力、日常生活及远视力、光感和移动4个维度评分均高于对照组患者(P＜0.05)。结论 与黄斑格栅样光凝治疗相比,增生期糖尿病视网膜病变患者接受全视网膜激光光凝治疗有助于改善其乳头周边视网膜神经纤维层厚度和黄斑区视网膜厚度,能够显著促进视力恢复,提升患者生活质量,疗效确切。

Objective To investigate the clinical effect of panretinal laser photocoagulation for proliferative diabetic retinopathy. Methods 97 cases of proliferative diabetic retinopathy in our hospital from Feb 2016 to Mar 2019 were enrolled in the study, and were divided into 2 groups randomly. The control group received treatment of macular grid photocoagulation, while the observation group received whole retina laser photocoagulation. Data of visual acuity, macular fovea volume, retinal nerve fiber layer thickness around nipple and retinal thickness before and after operation were collected and analyzed, and quality of life scores were compared. Results Before treatment, there was no significant difference in retinal nerve fiber layer thickness, macular fovea volume and retinal thickness between the two groups (P>0.05), which was comparable. After different treatments, the three indexes mentioned above in the observation group were better than those in the control group (P<0.05). The total effective rate of the observation group was 79.59%, which was higher than that of the control group (59.18%, P<0.05). In addition, the scores of fine motion, accommodation ability, daily life and distant vision, light perception and movement in the observation group were higher than those in the control group (P<0.05). Conclusion Compared with macular grid-like photocoagulation, panretinal laser photocoagulation may improve the retinal nerve fiber layer thickness around the nipple and macular retinal thickness in patients with proliferative diabetic retinopathy. It promotes the recovery of visual acuity, improves the quality of life of patients, and has definite curative effect.

目的 观察康柏西普玻璃体腔注射治疗湿性老年性黄斑变性病变对于视网膜神经纤维厚度的影响。方法 对2016年10月—2017年10月在汕头大学附属韶关市粤北人民医院采用康柏西普玻璃体腔注射治疗湿性老年性黄斑变性35例38眼中符合标准的患者18例（18眼）的临床资料进行回顾性分析,患者行最佳矫正视力、眼压（NCT）检查、OCT、荧光眼底血管造影（FFA）检查后,均接受0.05 mL康柏西普玻璃体腔注射,分别注射后1和2月观察患者最佳矫正视力 （BCVA）、视网膜神经纤维厚度（RNFL）变化。结果 18眼共接受康柏西普玻璃体腔注射54次,所有患眼均注射3次。注射3个月后,OCT检查结果显示有18眼视力有提高,CRT厚度有下降。第1次注射时和注射后1个月、2个月的BCVA分别为0.1（0.04,0.12）,0.20（0.10,0.30）和0.25（0.12,0.30）,总体比较差异有统计学意义（χ²=13.880,P<0.001）;第1次注射时和注射后1个月、2个月的CRT（μm） 319.50（269.50,390.50）, 271.00（219.00,296.25） 和234.50（182.75,273.25）总体比较差异有统计学意义（χ²=11.978,P<0.05）,第1次注射时和注射后1个月、2个月后的 ARNFL（μm）86.00（76.25,98.00） 83.00（76.00,95.50）和 83.00（76.25,94.75） 总体比较差异无统计学意义（χ²=11.978,P>0.05）,第1次注射时和注射后1个月、2个月眼压（kPa）2.27（1.97,2.44）,16.0（13.7,17.0）,和 2.00（1.84,2.31） 总体比较差异无统计学意义（χ²=1.604,P>0.05）。结论 玻璃体腔注射康柏西普治疗湿性老年性黄斑变性对视网膜神经纤维厚度无明显的损害,安全且有效,但仍需要大样本量及长期随访观察。

Objective To observe the effect on the thickness of retinal nerve fibers in the patients with wet age-related macular degeneration by adopted intravitreal injection with Conbercept. Methods We analyzed 18 cases （18 eyes） that conform to the standard from 35 cases（38 eyes） retrospectively,who were treated with wet age-related macular degeneration by adopted intravitreal injection with Conbercept in Shaoguan Yuebei People's Hospital Affiliated to Shantou University from October in 2016 to October in 2017.After undergoing best corrected visual acuity （BCVA）,intraocular pressure （IOP） and fluorescein angiography （FFA）,all of them were adopted intravitreal injection with 0.05mL Conbercept. We observed the changes of best corrected visual acuity （BCVA） and retinal nerve fiber thickness （RNFL） after 1 and 2 months of adopted intravitreal injection with 0.05 mL Conbercept. Results 18 eyes were adopted intravitreal injection Conbercept 54 times totally. All the eyes were injected three times. After 3 months of injection,OCT showed that the visual acuity of 18 eyes improved and the thickness of CRT decreased. The BCVA values at the first injection,after the first injection and after the second injection were 0.1（0.04,0.12）,0.20（0.10,0.30）和0.25（0.12,0.30）respectively. The overall difference was statistically significant （χ²=13.880,P< 0.001）. CRT（μm）values at the first injection,after the first injection and after the second injection were 319.50（269.50,390.50）,271.00（219.00,296.25） and 234.50（182.75,273.25）respectively. The overall difference was statistically significant （χ²=11.978,P< 0.05）. ARNFL（μm）values at the first injection,after the first injection and after the second injection were 86.00（76.25,98.00）,83.00（76.00,95.50） and 83.00（76.25,94.75）respectively. There was no significant difference （χ²=11.978,P> 0.05）. The IOP（mmHg）values at the first injection,after the first injection and after the second injection were 17.0（14.8,18.3）,16.0（13.7,17.0）,和 15.0（13.8,17.3）respectively. There was no significant difference（χ²=1.604,P>0.05）. Conclusion There was no obvious damage to the retinal nerve fiber by adopted intravitreal injection with Conbercept to treat the patients with wet age-related macular degeneration. That’s safe and effective,but need a large sample to follow-up for a longtime.

目的 分析并探讨应用通窍活血汤配合舒血宁注射液在治疗糖尿病视网膜病变(单纯型)中的临床效果。方法 80例患者(80只眼)按照随机的方式将其列入对照组(40只眼)和治疗组(40只眼)两组,对照组给以调节血糖、饮食控制、运动疗法等常规治疗控制血糖稳定并口服通窍活血汤,治疗组在对照组的基础上,口服通窍活血汤再配合舒血宁注射液离子导入,所有患者均由同一位眼科专科医生分别在治疗前后对所选患者行眼压、视力、眼底镜检查,同时观察其治疗前后血液流变学、血脂变化情况,观察治疗效果。结果 治疗前后血糖、糖化血红蛋白改变无差异,治疗组视力、眼底均较对照组明显改善(P＜0.01),血液流变学,血及血脂各指标的改善较对照组比较有统计学意义(P＜0.01)。结论 通窍活血汤配合舒血宁注射液在单纯型糖尿病视网膜病变中的治疗效果显著,可有明显改善患者的血脂及血液流变学,安全可靠,适合临床长期推广应用,具有较高的社会效益和经济效益,值得临床推广应用。

目的 初步研究2型糖尿病并视网膜病变患者的血浆趋化素(chemerin)水平及其与骨密度的关系。方法 选择150名糖尿病患者,按视网膜病变分为视网膜病变组(DR组)和眼底正常对照组(NDR组),采用全自动生化检测仪测定糖化血红蛋、甘油三脂、总胆固醇、低密度脂蛋白、高敏C反应蛋白;使用ELISA法检测血浆chemerin水平。骨密度采用双能X线骨密度仪分别测定腰椎正位(L2、L3、L4)、左侧股骨颈、大粗隆区、Ward's三角区的骨密度。结果 ①与NDR组相比,DR组的糖尿病病程较NDR组显著延长(P<0.05)。②DR组的TC、LDL-C、HbA1c、hs-CRP、chemerin水平较NDR组均显著升高(P<0.05)。③DR组的股骨颈、大粗隆区、Ward's三角区的骨密度较NDR组显著降低(P<0.05)。④血清chemerin水平与病程、BMI、HbA1C呈正相关,与股骨颈、大粗隆区、Ward's三角区的骨密度呈负相关。结论 DR患者的chemerin显著升高,chemerin可能参与DR的发生发展,并可能促使DR患者的骨密度降低。

Objective To explore the relationship between the circulation level of chemerin level and bone mineral density(BMD)in type 2 diabetes retinopathy patients. Methods A total of 150 patients with type 2 diabetes were selected. They were divided into two groups: retinopathy group(DR group), non- retinopathy group(NDR group). HbAlc, triglycerides(TC), total cholesterol(TG), low density lipoprotein cholesterol(LDL-C)and high-sensitivity C-reactive protein(hs-CRP)was measured by automatic biochemical detector. Bone mineral density was measured by the dual-energy X-ray absorptiometry. The BMD of lumbar vertebrae 2-4 and the left side of the femoral neck, the greater trochanter and Ward's triangle were assessed. Results ①Compared with the NDR group, the duration of diabetes in group DR was significantly longer(P<0.05); ②The levels of TC, LDL-C, HbA1c, hs-CRP and chemerin in DR group were significantly higher,③The BMD of the femoral neck, trochanter regionandward's triangle were significant reduction;④The level of chemerin was positively correlated with the duration of diabetes, BMI, HbA1C, and negatively correlated with the bone mineral density of the femoral neck, the greater trochanter, and the s' Ward triangle. Conclusion The level of chemerinin DR patients were significantly increased, and chemerin may play a role in the occurrence and development of DR, may promote the bone density decreased.

目的 了解惠州市早产儿视网膜病变的发病状况,并探讨相关危险因素。方法 回顾分析我院在2015年1月—2015年9月776例(1552只眼)早产儿和低体重儿的眼病筛查资料。结果 776例早产儿中,发现各期ROP共27例,检出率3.479%,其中包括1期11例(18只眼),2期11例(22只眼),3期2例(4只眼),AP-ROP3例(6只眼)。统计学分析显示,ROP组和无ROP组在出生胎龄、出生体重、吸氧史间比较,差异有统计学意义,提示早产、低出生体重与ROP的发生密切相关。结论 惠州地区ROP发病率3.479%,出生体重、出生胎龄、吸氧史及宫内缺氧、母体慢性高血压合并妊娠等孕期母体因素都是影响其发生的高危因素。

Objective To study the incidence of retinopathy of prematurity and to analyse the risk factors for ROP. Methods A retrospective analysis was conducted on 776 premature children from January 2015 to September 2015. Results In the 776 premature babies examinaion, 26 cases(54 eyes, 3.479%)developed ROP, including 11 cases (18 eyes) suffering from stage 1,11 cases (22 eyes) from stage 2,2 cases (4 eyes) from stage 3,3cases (6 eyes) from AP-ROP. The results of statistical analysis showed that gestational age, birth weight and oxygen therapy were significantly to ROP. Clinical analysis indicated that prematurity, low birth weight and oxygen therapy were closely related to the occurrence of ROP. Conclusion The incidence of ROP in Huizhou city is 3.479%. The gestational age, birth weight ,intrauterine hypoxia, and maternal prenatal factors such as chronic hypertension with pregnancy are the high risk factors of ROP.

目的 氧化苦参碱对视网膜母细胞瘤细胞SM-106凋亡的诱导作用及机制。方法 以不同作用时间(24 h、48 h、72 h)和不同作用浓度(12.5 μl/mL、25 μl/mL、50 μl/mL、100 μl/mL)氧化苦参碱处理视网膜母细胞瘤细胞SM-106,分别采用流式细胞仪及western blot检测视网膜母细胞瘤细胞SM-106细胞凋亡及其凋亡因子(Bax、Bcl-2)蛋白表达。结果 氧化苦参碱可促进SM-106细胞体外凋亡,上调Bax蛋白表达及Bax/Bcl-2蛋白表达比值,下调Bcl-2蛋白表达,并呈现剂量及时间依赖性。结论 氧化苦参碱可诱导视网膜母细胞瘤细胞SM-106凋亡,调控凋亡因子Bax、Bcl-2的表达是其可能作用机制。

Objective To evaluate the apoptosis and its mechanism of retinoblastoma cells SM-106 induced by oxymatrine. Methods Retinoblastoma cells SM-106 were treated with different time(24 h、48 h、72 h)and different concentrations(12.5 μl/mL, 25 μl/mL, 50 μl/mL or 100 μl/mL) of oxymatrine. The apoptosis and protein expression of apoptosis factors (Bax and Bcl-2) were respectively determined by flow cytometry and western blot. Results Oxymatrine significantly promoted the SM-106 cells apoptosis in vitro, raised Bax protein expression and Bax/Bcl-2 protein expression ratio, reduced the Bcl-2 protein expression, and showed the dose and time dependent. Conclusion Oxymatrine is able to induce the apoptosis in retinoblastoma cells SM-106. Regulating apoptosis related gene Bax and Bcl-2 expression may be the mechanism of apoptosis.

目的 观察葛根素对新西兰白兔视网膜缺血/再灌注损伤组织中细胞凋亡的保护作用。方法 新西兰白兔30只随机分为缺血再灌注对照组和葛根素治疗实验组,各组右眼应用前房灌注加压法建立视网膜缺血再灌注模型,分别于再灌注后第12、24、72 h处死动物,摘除眼球,制作石蜡切片,用TUNEL法检测细胞凋亡,计算凋亡指数。结果 对照组缺血再灌注12 h在神经节细胞层和内核层可见凋亡细胞;24 h神经节细胞层细胞数有所减少,视网膜神经节细胞层、内核层及外核层均见凋亡细胞明显增多;72 h神经节细胞层细胞数明显减少,神经节细胞层、内核层及外核层仍见凋亡细胞,但较24 h有所减少。葛根素治疗视网膜的凋亡细胞在各个时间段的表达规律与对照组相似,但凋亡细胞计数在12 h,24 h,72 h均较对照组明显减少,两组间差异有统计学意义。结论 葛根素能减轻缺血-再灌注损伤的视网膜细胞凋亡,对视网膜有保护作用。

Objective To observe the protective effects of Puerarin on apoptosis of ischemic injury in rabbit retina. Methods Retinal ischemia was induced in rabbits by increasing intraocular pressure to 120 mmHg for 60 minutes. TdT-mediated biotin-dUTP nick end labelling(TUNEL) staining technique was used to examine the apoptosis of retinal ganglion cells in the control group and the puerarin treatment group. Results The number of apoptotic cells in 12, 24 and 72h after reperfusion in the puerarin treatment group was obvious lower than that in the control group(P<0.05). Conclusion Puerarin has protective effects in protecting against apoptosis in ischemia reperfusion injury of rabbit retina.