典必殊眼膏注入泪小管治疗泪小管炎的临床体会

目的:探讨改善临床治疗泪小管炎疗效的新方法。方法:针对我科门诊就诊的泪小管炎病例,先用生理盐水尽量冲洗泪道分泌物和泪道内结石,然后用庆大霉素冲洗,再用典必殊眼膏泪小管内注入保留。结果:所有5例泪小管炎病例均病情恢复迅速,15天至1月内均获得治愈,随访半年以上无复发表现。结论:采用冲洗后再加入典必殊眼膏泪小管内注入的新方法疗效确切,且起效迅速,操作简单,为临床治疗慢性泪小管炎提供了一条新途径。     

先天性泪囊炎的治疗及护理

目的探讨先天性泪囊炎的治疗及护理措施。方法对386例(407眼)先天性泪囊炎患儿采用泪囊按摩、泪道冲洗、探通、再冲洗的治疗方法及护理措施。结果泪囊区按摩法一次治疗成功率1.47%,泪道冲洗+探通+再冲洗一次治疗成功率94.34%,二次治疗成功率2.70%,三次治疗成功率1.47%。结论先天性泪囊炎患儿采取泪道冲洗+探通+再冲洗并配合临床护理可显著提高治疗效果。     

亚甲蓝在泪小管断裂手术中的应用

目的：探讨泪小管断裂实施手术修复时，利用亚甲蓝的粘膜染色功能寻找泪小管断端，从而提高泪小管吻合成功率的临床治 疗效果。方法：将65例眼睑撕裂伤伴泪小管断裂患者随机分为两组。A 组使用亚甲蓝为染色剂，B 组使用Worst 的猪尾巴探针，术 中帮助寻找泪小管鼻侧断端，比较两组患者的临床治疗效果。结果：两组患者手术治愈率比较，差异无统计学意义（P>0.05）；A 组 手术时间比B组短，差异具有统计学意义（P<0.05）。结论：亚甲蓝的粘膜染色功能有助于术中顺利找到泪小管鼻侧断端，减少术 源性再损伤，缩短手术时间，提高手术成功率，操作简便，患者耐受性较好。     

慢性泪囊炎行泪囊鼻腔吻合术围手术期护理

目的总结慢性泪囊炎鼻腔吻合术围手术期护理效果。方法对31例慢性泪囊炎行泪囊鼻腔吻合术患者于术前给予心理护理、患者准备,术后严密病情观察、加强健康教育、泪道冲洗、出院指导等护理措施。结果 31例(31眼)患者均痊愈出院,无1例并发症发生。结论积极有效的围手术期护理措施是提高手术成功率,减少术后并发症,促进患者顺利康复的重要保证。     

不同泪道硅胶引流管留置时间对慢性泪囊炎患者视力、生活质量及复发率的影响

目的:探讨不同泪道硅胶引流管留置时间对慢性泪囊炎患者的生活质量、视力及复发率的影响。方法:回顾性选取2018年1月2019年12月期间于我院就诊的慢性泪囊炎患者91例(128眼),根据术后泪道硅胶引流管留置时间分为A、B两组,其中A组泪道硅胶引流管留置时间6周,44例(61眼),B组泪道硅胶引流管留置时间12周,47例(67眼)。对比两组疗效、视力、并发症发生率、主诉溢泪发生率、生活质量及复发率。结果:A组拔管当天的总有效率高于B组(P<0.05),两组拔管后3个月总有效率对比无明显差异(P>0.05)。拔管后6个月两组社会功能、躯体疼痛、精神健康、生理功能、精力、情感职能、生理职能、总体健康维度评分均较术前升高(P<0.05),但两组组间对比未见统计学差异(P>0.05)。两组患者术前、拔管后3个月视力组间及组内比较均未见统计学差异(P>0.05)。两组患者主诉溢泪发生率比较未见统计学差异(P>0.05)。A组并发症发生率、复发率低于B组(P<0.05)。结论:泪道硅胶引流管留置时间的长短对慢性泪囊炎患者疗效、视力、生活质量、主诉溢泪发生率无明显影响,但留置6周者并发症发生率、复发率低于留置12周者,提示临床应视患者具体情况尽量缩短泪道硅胶引流管留置时间。     

典必殊眼膏加艾灸治疗中老年睑板腺功能障碍的临床观察

目的:观察糖皮质激素典必殊联合中药艾灸在治疗睑板腺功能障碍性的临床疗效。方法:对本院门诊就诊的睑板腺功能障碍的患者72例144只眼,进行眼科一般常规检查后,再做泪液分泌实验和泪膜破裂时间测定等检查,确定为睑板腺功能障碍后分成两组,一组给予典必殊加艾灸治疗;另一组给予常规治疗(热敷、氧氟沙星滴眼液、普拉洛芬滴眼液点眼等),观察记录治疗效果,进行统计学处理。结果,4到5周后,实验组治疗效果明显高于对照组的效果。实验组总有效率94.4%,对照组总有效率86.1%%。结论:睑板腺功能障碍用典必殊眼膏加艾灸治疗疗效显著,长期疗效优于其它疗法,经临床观察且无局部和全身的不良反应。     

改良泪囊鼻腔吻合术治疗慢性泪囊炎的治疗体会

慢性泪囊炎为眼科常见眼病之一,长期流泪、流脓,给患者带来极大痛苦.临床上多继发于鼻泪管狭窄或阻塞后而导致的,其治疗原则是重新建立鼻内引流通道,解除阻塞,消除感染[1].传统术式经鼻外内眦部行泪囊鼻腔吻合的创伤大.我院采用改良泪囊鼻腔吻合术治疗慢性泪囊炎149例（192眼）,效果较好,现报告如下.     

同期与分期鼻内镜手术治疗慢性泪囊炎合并慢性鼻-鼻窦炎的疗效对比研究

摘要 目的：探讨同期与分期鼻内镜手术治疗慢性泪囊炎合并慢性鼻-鼻窦炎的临床疗效。方法：回顾性分析本院2017年1月至2019年10月期间收治的76例慢性泪囊炎合并慢性鼻-鼻窦炎患者的临床资料,根据手术方式分为A组和B组,各38例。A组行分期手术（鼻腔鼻窦病变处理控制鼻腔鼻窦炎症后再行鼻内镜下泪囊鼻腔造孔术）。B组行同期手术（处理鼻腔鼻窦病变后立即行鼻内镜下泪囊鼻腔造孔术）,比较两组围术期指标、临床疗效、术后并发症发生情况,采用慢性泪囊炎生活质量量表（DQOLS）评价患者术前和术后6个月时的生活质量。结果：B组总有效率为94.74 %（36/38）,A组总有效率为92.11 %（35/38）,两组总有效率比较无明显差异（P>0.05）;B组术后并发症总发生率为13.16 %（5/38）,与A组的10.53 %（4/38）比较无明显差异（P>0.05）。两组患者术后6个月时的DQOLS各维度评分和总分均较术前升高（P<0.05）,但组间比较差异均无统计学意义（P>0.05）。B组患者住院总费用少于A组,住院时间、手术时间均短于A组（P<0.05）,两组术中出血量比较无明显差异（P>0.05）。结论：同期手术与分期手术治疗慢性泪囊炎合并慢性鼻-鼻窦炎患者具有相当的临床疗效和安全性,且对患者生活质量的改善程度亦无明显差异,但前者能够缩短手术时间、住院时间及减少住院费用。     

负压吸引联合冲洗法治疗慢性骨髓炎

目的探讨负压吸引联合冲洗法治疗慢性骨髓炎的临床疗效。方法分析总结我院2009年以来应用负压吸引加冲洗治疗的61例慢性骨髓炎患者的临床资料。结果全部病例均痊愈,经6个月~2年的随访无复发病例。结论负压吸引加冲洗治疗慢性骨髓炎的疗效显著,安全、可靠。     

慢性泪囊炎病原菌的初步调查

慢性泪囊炎病原菌的初步调查大连市二院眼科邵彦,李桂香,吴萍大连市二院护理组吕秀玉,单华慢性泪囊炎是一种比较常见的眼病。为了更好地指导其治疗工作,本文运用微生态学方法,对本病病原菌分布做了初步调查,并做了病原菌对四种常用眼药水敏感试验。１．材料与方法１...     

Development of a new lacrimal drainage conduit using POSS nanocomposite

Lacrimal surgery in cases of severely obstructed or missing canalicular ducts is highly challenging. In these cases, the placement of a bypass tube is currently the only option to restore the drainage of tears into the nose and reduce the symptomatic watery eye. Different approaches to achieve functional drainage have been tried using blood vessels or artificial implants. The implantation of the rigid Lester Jones tube is, since its introduction in the late 1960s, the gold standard. The functional success is satisfactory. However, complication rates are high and remain, even with many modifications of the original design, a major problem. These complications include mainly the displacement and blockage of the tube, requiring regular checkups, as well as irritation of the surrounding tissue including the nose and the eye. The objective of this study was to develop a new lacrimal duct conduit (LDC) to restore structural and functional integrity of the lacrimal drainage system. The conduit is constructed with a novel polymer, polyhedral oligomeric silsesquioxane-poly(carbonate-urea)urethane (POSS-PCU), that offers biocompatibility. We exploit nanotopography to evade the problems associated with current applications. A number of extrusion techniques were investigated for this purpose: ultrasonic atomization spraying, electrohydrodynamic atomization spraying/spinning, extrusion-coagulation, and high-pressure coagulation by autoclave and casting. Finally, the coagulation and cast technique were selected to construct an LDC superior to its predecessors, and its advantages highlighted.     

Beneficial effect of daidzin in dry eye rat model through the suppression of inflammation and oxidative stress in the cornea

Present investigation evaluates the effect of daidzin in dry eye rat model through the suppression of inflammation and oxidative stress in the cornea. Briefly, electron spine resonance was used for the estimation of radical scavenging activity of daidzin and COX Fluorescent Activity Assay Kit was used for the estimation of PGS activity. Dry eye rat model was developed by removing the lacrimal gland and effect of daidzin was evaluated in dry eye rat model by estimating the fluorescein score, tear volume and expressions of heme oxigenase (HO-1), TNF α, Interlukin 6 (IL-6), matrix metallopeptidase 9 (MMP-9) and PGS-2. Result of the present study suggested that daidzin possess tyrosyl radical scavenging activity and thereby decreases the oxidative stress. Activity of PGS significantly increases in dry eye which was inhibited by daidzin treatment due to competitive inhibition of PGS. It also recovers the tear volume in dry eye rat model in which lacrimal gland was removed. Thus corneal erosion was improved by daidzin in dry eye rat model. Thus present study concludes that treatment with daidzin protects the cornea in dry eye rat model by suppression inflammation and oxidative stress.     

Oxidative Stress Induced Inflammation Initiates Functional Decline of Tear Production

Oxidative damage and inflammation are proposed to be involved in an age-related functional decline of exocrine glands. However, the molecular mechanism of how oxidative stress affects the secretory function of exocrine glands is unclear. We developed a novel mev-1 conditional transgenic mouse model (Tet-mev-1) using a modified tetracycline system (Tet-On/Off system). This mouse model demonstrated decreased tear production with morphological changes including leukocytic infiltration and fibrosis. We found that the mev-1 gene encodes Cyt-1, which is the cytochrome b₅₆₀ large subunit of succinate-ubiquinone oxidoreductase in complex II of mitochondria (homologous to succinate dehydrogenase C subunit (SDHC) in humans). The mev-1 gene induced excessive oxidative stress associated with ocular surface epithelial damage and a decrease in protein and aqueous secretory function. This new model provides evidence that mitochondrial oxidative damage in the lacrimal gland induces lacrimal dysfunction resulting in dry eye disease. Tear volume in Tet-mev-1 mice was lower than in wild type mice and histopathological analyses showed the hallmarks of lacrimal gland inflammation by intense mononuclear leukocytic infiltration and fibrosis in the lacrimal gland of Tet-mev-1 mice. These findings strongly suggest that oxidative stress can be a causative factor for the development of dry eye disease.     

Calorie restriction: A new therapeutic intervention for age-related dry eye disease in rats

A decrease in lacrimal gland secretory function is closely related to aging and leads to an increased prevalence of dry eye syndrome. Since calorie restriction (CR) is considered to prevent functional decline of various organs due to aging, we hypothesized that CR could prevent age-related lacrimal dysfunction. Six-month-old male Fischer 344 rats were randomly divided into ad libitum (AL) and CR (−35%) groups. After 6 months of CR, tear function was examined under conscious state. After euthanasia, lacrimal glands were subjected to histological examination, tear protein secretion stimulation test with Carbachol, and assessment of oxidative stress with 8-hydroxy-2 deoxyguanosine (8-OHdG) and 4-hydroxynonenal (HNE) antibodies. CR significantly improved tear volume and tended to increase tear protein secretion volume after stimulation with Carbachol compared to AL. The acinar unit density was significantly higher in the CR rats compared to AL rats. Lacrimal glands in the CR rats showed a lesser degree of interstitial fibrosis. CR reduced the concentration of 8-OHdG and the extent of staining with HNE in the lacrimal gland, compared to AL. Furthermore, our electron microscopic observations showed that mitochondrial structure of the lacrimal gland obtained from the middle-aged CR rats was preserved in comparison to the AL rats. Collectively, these results demonstrate for the first time that CR may attenuate oxidative stress related damage in the lacrimal gland with preservation of lacrimal gland functions. Although molecular mechanism(s) by which CR maintains lacrimal gland function remains to be resolved, CR might provide a novel therapeutic strategy for treating dry eye syndrome.     

Dynamic Ocular Surface and Lacrimal Gland Changes Induced in Experimental Murine Dry Eye

Dry eye disease can be a consequence of lacrimal gland insufficiency in Sjögren’s Syndrome or increased tear film evaporation despite normal lacrimal gland function. To determine if there is a correlation between severity effects in these models and underlying pathophysiological responses, we compared the time dependent changes in each of these parameters that occur during a 6 week period. Dry eye was induced in 6-week-old female C57BL/6 mice by exposing them to an Intelligently Controlled Environmental System (ICES). Sixty mice were housed in ICES for 1, 2, 4 and 6 weeks respectively. Twelve were raised in normal environment and received subcutaneous injections of scopolamine hydrobromide (SCOP) 3 times daily for 5 days. Another sixty mice were housed in a normal environment and received no treatment. Corneal fluorescein staining along with corneal MMP-9 and caspase-3 level measurements were performed in parallel with the TUNEL assay. Interleukin-17(IL-17), IL-23, IL-6, IL-1, TNF-α, IFN-γ and TGF-β2 levels were estimated by real-time PCR measurements of conjunctival and lacrimal gland samples (LGs). Immunohistochemistry of excised LGs along with flow cytometry in cervical lymph nodes evaluated immune cell infiltration. Light and transmission electron microscopy studies evaluated LGs cytoarchitectural changes. ICES induced corneal epithelial destruction and apoptosis peaked at 2 weeks and kept stable in the following 4 weeks. In the ICES group, lacrimal gland proinflammatory cytokine level increases were much lower than those in the SCOP group. In accord with the lower proinflammatory cytokine levels, in the ICES group, lacrimal gland cytosolic vesicular density and size exceeded that in the SCOP group. ICES and SCOP induced murine dry eye effects became progressively more severe over a two week period. Subsequently, the disease process stabilized for the next four weeks. ICES induced local effects in the ocular surface, but failed to elicit lacrimal gland inflammation and cytoarchitectural changes, which accounts for less dry eye severity in the ICES model than that in the SCOP model.     

Aqueous, oil, and ointment formulations of ketorolac: efficacy against prostaglandin E2-induced ocular inflammation and safety: A technical note

The efficacy of aqueous, oil, and ointment formulations of ketorolac against PGE₂-induced ocular inflammation in rabbits was evaluated, with monitoring of blinking rate and PMN and protein migration in tear fluid, following topical PGE₂ instillation. Ketorolac ophthalmic formulations protected the eye against inflammatory insult. Chronic topical administration of formulations for 10 days into rats' eyes did not lead to any appreciable gastrointestinal ulceration, which indicates that the formulations are safe for long-term use.     

二号敷药外敷治疗膝骨性关节炎60例的临床研究

目的：观察和评价应用医院自制制剂治疗膝骨关节炎的疗效。方法：60例病人,均经过临床X线检查确诊,随机分成两组,治疗组外敷二号敷药,对照组外用扶他林乳胶剂四周后,通过WOMAC量表和本体感觉进行疗效评估,总结其疗效。结果：治疗四周后,对照组的晨僵、活动困难分和关节被动角度重现（PAR）,主动角度重现（ARA）,被动运动阈值测量值（TDPM）与治疗组相比有显著性差异（P〈0.01）。结论：二号敷药对膝骨关节炎治疗可以达到缓解晨僵,提高活动度和改善本体感觉,在临床治疗提高疗效上起到积极作用。     

Dietary lactoferrin alleviates age-related lacrimal gland dysfunction in mice

Background

Decrease in lacrimal gland secretory function is related to age-induced dry eye disease. Lactoferrin, the main glycoprotein component of tears, has multiple functions, including anti-inflammatory effects and the promotion of cell growth. We investigated how oral administration of lactoferrin affects age-related lacrimal dysfunction.

Methods and Findings

Twelve-month-old male C57BL/6Cr Slc mice were randomly divided into a control fed group and an oral lactoferrin treatment group. Tear function was measured at a 6-month time-point. After euthanasia, the lacrimal glands were subjected to histological examination with 8-hydroxy-2′-deoxyguanosine (8-OHdG) antibodies, and serum concentrations of 8-OHdG and hexanoyl-lysine adduct (HEL) were evaluated. Additionally, monocyte chemotactic protein-1(MCP-1) and tumor necrosis factor-α (TNF-α) gene expression levels were determined by real-time PCR. The volume of tear secretion was significantly larger in the treated group than in the control. Lactoferrin administration reduced inflammatory cell infiltration and the MCP-1 and TNF-α expression levels. Serum concentrations of 8-OHdG and HEL in the lactoferrin group were lower than those in the control group and were associated with attenuated 8-OHdG immunostaining of the lacrimal glands.

Conclusion

Oral lactoferrin administration preserves lacrimal gland function in aged mice by attenuating oxidative damage and suppressing subsequent gland inflammation.