Volume 47 · Issue 05 · 2011

Great achievements have been obtained in the studies on the pathogenesis of uveitis during recent years. However, the cellular and molecular mechanisms involved in the anterior chamber associated immune deviation, the development of autoimmune response and uveitis following infections are still not completely understood. The reason as to why there is a big difference concerning the clinical process between human uveitis and its counterpart, uveitis induced in animal, is expected to be investigated. Gene susceptibility to uveitis is not well understood. Behcet disease and Vogt-Kayanagi-Harada syndrome are the two most common uveitis entities in China. Therefore, studies should be focused on both diseases to clarify the aforementioned issues, which will greatly contribute to the development of strategy in the treatment and prevention of uveitis.

T regulatory cells (Tregs) have been recognized as the hotspot in recent immunology research. Because of the capability of immune suppression, they play an important role in regulating many immune associated diseases. It has been reported that they are involved in stabilizing local immune microenvironment of the eye and regulating many eye diseases such as corneal transplantation immune rejection, uveitis, allergic conjunctivitis, infectious keratitis and dry eye. Treatment with Tregs may provide novel method for immune related eye diseases.

Objective To investigate the changes of Th lymphocyte subsets in patients with Behcet disease. Methods From June 2007 to January 2009, thirty patients (male 16, female 14) with Behcet Disease who got treatment at Beijing Tongren Hospital were collected, whose age range was 21-45 years old and the average age wag 35 years old. All the patients were diagnosed according to the diagnostic criteria of International Uveitis Study Group, and the other system inflammatory diseases were ruled out. None the patients did receive any anti-inflammatory treatment before getting treatment in the hospital. Thirty health controls (male 15, female 15) were collected in Beijing Tongren Hospital Physical Examination Center. There was on significant difference in age and gender composition between the two groups. Peripheral blood and sera were obtained from 30 patients with Behcet disease and 30 normal persons. The ratio of the subsets of Th cells in peripheral blood was detected by automatic flow cytometer and the IL-17,IL-23,IL-6,IL-10 and TGF-β1 in sera was detected by ELISA. T-test of independent sampler was used to analysis all the scores of the two groups. Results Compared to normal controls, the patients with Behcet disease had significant higher percentages of Th1 (25.08% ± 7. 23% ) and Th17 (36. 38% ± 17.47% ) (t = - 1.43, -2. 187;P＜0.05) cells and lower percentages of T regulatory cells(Tregs)(4. 11% ±1. 32% ) (t =3. 70, P＜0. 05), and the Thl/Th2( 13. 34 ±2. 66) (t = -1. 41, P ＜0. 05) and Thl7/Tregs(9. 52 ±5. 82) (t =-2. 218, P＜0.05) ratio was higher. No differences in the percentages of Th2 cells between patients with Behcet disease and normal controls were observed. Patients with Behcet disease revealed significant increase in peripheral Thl7 related cytokines [IL-17 ( 13. 21 ± 4. 20) ng/L, IL-6 (6. 37 ± 6. 51 ) ng/L, TGF-β1 (4477. 20 ±2146. 60) ng/L, IL-23(10. 86 ±7. 86)ng/L] levels(t= -3. 61, -2. 33, -2.15 and -3.18; P＜0. 05) and obvious decrease in Tregs related cytokines [IL-10(6. 27 ±5. 56) ng/L] (t =5. 95, P＜ 0. 05) , compared with normal controls. Conclusion There are obvious changes in the number of Th17 and Tregs and their related cytokines during the process of Behcet disease, so it can be inferred that Th17 and Tregs probably have some effects on the onset of Behcet disease.

Objective To evaluate the effect of liposome mediated plasmids KDRn3 injected into the vitreous to inhibit experimental retinal neovascularization. Methods One-week-old C57BL/6N mice were exposed to 75% ± 2% oxygen for 5 days, then returned to the room air to induce retinal neovascularization. Cationic liposome mediated KDRn3 comp-lex (1 μl) was injected into the vitreous in the treatment group. PBS 1 μl or liposome were injected in the control group. The pEGFP-N1/ KDRn3 expression was observed by using fluorescence microscope. Retinal neovascularization was evaluated by counting the number of vascular endothelial cell nuclei on the vitreal side of the inner limiting membrane of the retina and measuring the areas of non-perfusionsin in central retina. Results KDRn3 protein was expressed both in the ganglion layer and in the inner layer. Retinal wholemount preparation of retinal neovascular animal model showed that prominent neovascular tuft and fluorescein leakage and large areas of non-perfusionsin in central retina. Fewer neovascular tufts and fewer areas of non-perfusionsin could be seen after pEGFP-N1/KDRn3 injection. There were statistic differences between control group and pEGFP-N1/ KDRn3 injecting group with the number of vascular endothelial cell nuclei on the vitreal side of the inner limiting membrane of the retina(0. 20 ±0. 51, 13. 58 ±2. 48,23. 05 ±3. 40,21. 70 ± 2. 89;F = 1085. 25, P ＜ 0. 05 ) and the areas of non-perfusionsin in central retina [(1. 33 ± 0. 49 ) , ( 2. 75 ± 0. 70 ) , ( 2. 12 ± 0. 35) mm2; F = 17. 61 , P ＜ 0. 01] . Conclusion pEGFP-N1/KDRn3 gene transfer can inhibit retinal neovascularisation in C57Bl/6J mice of ischaemia-induced retinal neovascularisation on some extent.

Objective To study the cell membrane of corneal endothelium with a micromolecular compound J2 in corneal allograft of rat using atomic force microscopy(AFM).Methods Cohort study.Subjects were divided into two groups: group A (n = 15): experimental group; group B(n = 15): placebo control group. At the fifth, tenth, fifteen, twentieth, twenty-fifth day after penetrating keratoplasty, the donor implant was separated from receipt bed, one part of which was stained by HE and the others fixed into AFM sample. Amplitude and height images were obtained in the tapping mode with a scan rate of 2 Hz and an integral gain of 0. 3 to 0. 5. Statistical analysis was performed using single-factor analysis of variance and P value was calculated. Results The average transplant survival time in group A was(33. 12 ±6. 80) d, and those in group B was (18. 87 ± 4. 19) d. There were significant difference between two group (F = 47. 7449, P = 0. 00 ) . There were obvious differences on ultrastructure measured by AFM between two groups. At the fifth day after penetrating keratoplasty, regular hexagonal structure of corneal endothelium was observed by AFM in both two group. The diameter of corneal endothelium was about 15 μm, uneven microstructure of cell could be found. The time being, different changes were arose in two group: a clear microstructure could be found in group A, however the microstructure of cell could not be recognized in group B. One way analysis of variance showed that significant differences on parameters ( Ra,Rp and Rv) were found between two groups ( P ＜0. 05 ). At the fifth day after penetrating keratoplasty, group A:Ra (97.64±31.58)nm, Rp(297. 79 ±25. 19)nm, Rv(545. 55 ±25. 83)nm; group B: Ra(112. 61 ±34.29) nm, Rp(265.06±24. 17) nm, Rv(544.41 ±21. 78)nm(Fa =30. 9416,P=0. 0000; Fp =263. 6018,P = 0.0000; Pv = 1.2013, P =0.2735). At the tenth day after penetrating keratoplasty, group A:Ra(102.98± 32.98)nm, Rp(711.38±21.94)nm, Rv(639. 89 ±22. 58) nm; group B:Ra (222. 85 ±31. 28) nm, Rp (111. 22 ±20. 35) nm, Rv (746. 49 ± 23.17) nm( Fa = 2086. 4535, P = 0.0000; Fp = 53768. 4676, P = 0.0000; Pv =3257.3178, P = 0.0000). At the fifteenth day after penetrating keratoplasty, group A:Ra (87.44±34.97)nm, Rp(344. 18 ±21. 09)nm, Rv(482.61 ±22.27)nm; group B:Ra( 197. 64 ±35. 72) nm, Rp(510.76±24.98)nm, Rv(545. 62 ±23. 17) nm( Fa = 1458. 1057,P =0. 0000; Fp =7788. 6963, P = 0. 0000;Pv = 1153. 2860,P =0.0000). At the twentieth day after penetrating keratoplasty, group A:Ra (85. 85±32.53)nm, Rp(348. 69 ±21. 26)nm, Rv(367. 65 ±23. 12)nm; group B: Ra (201. 36 ±34. 12) nm, Rp (788.58 ± 20.34) nm, Rv (563.33 ± 21.01 ) nm ( Fa = 1801. 1215, P = 0.0000; Fp = 67 057. 9516,P = 0. 0000; Fv = 11 770. 2195, P = 0. 0000 ) . At the twenty-fifth day after penetrating keratoplasty, group A:Ra (104. 97 ±32.47)nm, Rp(395.05 ±20.38)nm, Rv(396.17 ±21.59)nm; group B: Ra(43. 85 ±31. 28) nm, Rp(249. 88 ± 20. 79) nm, Rv( 154. 88 ±22. 37) nm(Fa =551. 4134, P = 0.0000; Fp = 7458.9255, P = 0.0000; Pv = 18 070.5189, P = 0.0000). Conclusions The morphology and ultrastructure of corneal endothelium in group A with J2 were different from group B by observation with AFM. J2 was an effect micromolecular in prevention of corneal allograft rejection.

Objective To investigate the feasibility and clinical effects of non-Descemet stripping endothelial keratoplasty ( nDSEK) on treating iridocomeal endothelial (ICE) syndrome in phakic eyes. Methods Retrospective noncomparative interventional case series. 7 patients (7 eyes) with ICE syndrome at the Affiliated Xiamen Eye Center of Xiamen University from January 2008 to December 2009 underwent non-Descemet stripping endothelial keratoplasty. All patients were followed up for 3-12 months, pre- and postoperative best corrected visual acuity ( BCVA) were compared, the adherence of the donor disc to the recipient endothelium and postoperative donor disc dislocation were monitored during the follow-up period. Graft clearance and endothelial cell density(ECD) were observed, too. Results After nDSEK, no primary graft failures dislocation and decentered graft occurred during the follow-up period. Study group intraoperative complications included 3 case with elevated intraocular pressure 2 day postoperatively. Subepithelial haze, donor-recipient interface haze, and interface particles were observed in all measurable cases by in vivo laser confocal microscopy. Anteriorsegment optical coherence tomography and ultrasound biomicroscopy showed the adherence of the donor disc to the recipient endothelium and peripheral anterior synechiae were separated. All corneas remained clear during the follow-up. 6 patients had improved BCVA while 1 patient had the same BCVA. The reason for poor VA was optic atrophy due to glaucoma. Postoperative mean EDC was (2176. 6 ± 267. 6) cells/mm2. Conclusions nDSEK for iridocorneal endothelial (ICE) syndrome is feasible, technically easy, safe and effective. It can be one of the surgical treatment option for bullous keratopathy.

Objective To explore the morphological characteristics on cornea in patients with vernal keratoconjunctivitis(VKC)by the application of in vivo laser scanning confocal microscopy(LSCM).Methods The experimental design was retrospective observation case series(case control study).Twenty-six patients, each diagnosed as bilateral VKC, were enrolled in the study, among which 13 were tarsal form, 5 were bulbar form and the rest were mixed form. Nine patients had the clinical course less than one year, eight subjects longer than three years, and the rest between them. Another twenty-six healthy volunteers with matching age and gender were selected as normal control. All participants had their right eyes examined with the in vivo confocal microscopy ( HRT Ⅱ/RCM). Central cornea and superior peripheral cornea were chosen as the examination points. The images were recorded automatically and cellular density of each layer was analyzed by installed software. Software Image J was utilized to analyze the density, diameter, branch number and tortuosity of subbasal nerve fiber in VKC patients. Independent t test was performed to assess the differences on cellular density between VKC patients and normal control, as well as those between central and peripheral cornea in VKC patients. Fisher chi-square test was used to compare the infiltration rate of Langerhans cells in corneal epithelium between VKC patients and controls. ANOVA was applied to assess the differences in cellular density among three subtypes, as well as among different duration of VKC. Independent t-test and chi-square test were applied to analyze the parameters of subbasal nerve fiber. Results The morphological changes in cornea included the absence of superficial hyperreflective polygonal epithelial cells, infiltration of Langerhans cells in and(or) underneath corneal epithelium and activation of keratocytes in anterior stroma. Corneal epithelium conjunctivalization and stromal neovascularization could be identified in patients with corneal neovascular epithelium. Longitudinal or oblique dark striae could be found in the posterior stroma in patients with complicated keratoconus. The density of epithelial cells at central and peripheral cornea in healthy controls were (6033. 1 ± 998. 7) cells/mm2 and (6098. 4 ± 298. 3 ) cells/mm2, while that in VKC patients were (5972.2 ± 1148.2) cells/mm2 and (6178.5 ± 318.9) cells/mm2 respectively, the differences being no statistical significant between them (t = 1. 191 , 1. 011; P =0.238, 0. 318). However, it's found in VKC patients that cellular density at peripheral cornea was significantly higher than that at central area( t = 2. 249, P = 0. 03). The density of anterior stromal cells at central and peripheral cornea in healthy controls was (1001. 4 ± 125. 3) cells/mm2 and (924. 6 ± 201.4) cells/mm2, while that in VKC patients was (1184. 5 ± 115. 3 ) cells/mm2 and (1101.4 ± 151. 1) cells/mm2, the difference bearing no statistical significance(t =6. 617,3.439;P =0. 001). The density of posterior stromal cells in normal subjects and VKC patients was (537. 7 ± 42. 6) cells/mm2 and (548. 7 ± 79. 8) cells/mm2, that of endothelial cells was (2985. 7 ± 401. 2 ) cells/mm2 and (3021. 5 ± 383. 3) cells/mm2, respectively, neither difference had statistical significance (t = 0. 174, 1. 112; P = 0. 864, 0. 282 ) . Langerhans cell infiltration could be identified in 61.5% (16 cases) VKC patients, which was significantly higher than normal control (2 cases, 7. 7% ) (x2 = 12. 49, P = 0. 001 ). Furthermore, much intense Langerhans cells infiltration was found in bulbar form and mix form than tarsal form. (t = 6. 617, P = 0. 001). The density and diameter of subbasal nerve fiber in VKC patients decreased significantly than those in normal subjects, whereas the tortuosity increased significantly. Conclusions The morphological changes of cornea in VKC patients mainly involve corneal epithelium, subbasal nerve fiber and anterior stroma. In vivo LSCM is helpful in discriminating the subtypes of VKC.

Objective To investigate the visual functional therapeutic effects of deep lamellar keratoplasty( DLK) and penetrating keratoplasty( PK) on perforated fungal keratitis. Methods 64 patients (64 eyes) of fungal corneal uncler in Ophthalmology Center of Ningbo Yinzhou People Hospital from 2004 to 2009 were retrospected, of which undergo DLK (36 patients, 36 eyes) and PK (28 patients, 28 eyes) , and followed up by 12 to 24 months. Check two sets of patients' VA and refraction before operation, and analyze the best-corrected visual acuity ( BCVA), corneal refraction changes, corneal endothelium counting and complications, using x2 test and t-test Results The BCVA after the operation of two sets are both improved, 32 eyes of DLK set were above 0.4, 19 eyes of PK set were above 0.4, of which the DKL set is a bit better than PK set (x2 = 4. 304 ,P ＞0.05). The astigmatism of DLK set is smaller than the PK set after operation, and there is significant difference(x2 = 4. 98,P ＜ 0. 05 ) . The astigmatism of two sets on the average were all no more than 5. 00 D. The reject reaction of keratoplasty of DLK is less than PK, there is obviously significant difference (x2 = 34. 17, P < 0. 05). Conclusions There is less complications of DLK than PK for fungal corneal uncler. DLK can reduce the occurrence of reject reaction of endothelium type, and the BCVA, refraction of DLK after operation is similar to PK, the incidence rate of surgical operation failure is low.

Objective To improve the knowledge of the clinicopathologic features of eosinophilic hyperplastic lymphogranuloma (Kimura disease) in the orbit. Methods It was a retrospective case series study. The clinical and pathological characteristic of 9 cases of Kimura disease from the pathology department of Tianjin Eye Hospital were reviewed, immunohistochemical staining was performed, including for CD20, D79a, CD3, CD45Ro, CD34, Ki67 and IgE. Results In the 9 cases, 7 cases were male, 2 cases were female; the age of onset were from 13 to 62 years, medium age was 25 years; 7 cases were simple, 2 case were bilateral orbit. These lesions occurred in the superior or superotemporal quadrant of the orbit and the majority of cases extended into deep orbital tissues, 6 cases involved the lacrimal gland, 5 case involved the lateral rectus muscle. The clinical features mainly included lid swelling, eye redness, proptosis and palpable mass, and the disease course ranged from 6 months to 15 years. 3 lymph node enlargements in the submandibular regions and 1 subcutaneous nodule on the bilateral elbow were found in one case. The documentation of peripheral-blood eosinophilia (11% - 14%) was found in 3 cases. The pathological characteristics of Kimura disease were lymphoid tissue hyperplasia with prominent lymphoid follicles, conspicuous eosinophils infiltration and capillary proliferation. Immunohistochemical study in our cases revealed B cells in lymphoid follicles and mostly T cells in the interfollicular regions. Conclusion Kimura disease of orbit is an uncommon lymphoid hyperplasia with prominent eosinophils infiltration and capillary vessels, which commonly occur superotemporal quadrant of the orbit, easy to involve lacrimal gland and lateral rectus muscle.

Objective To investigate the clinical and histopathologic features of the superficial tissue proliferation ( STP) following the implantation of MICOF keratoprosthesis, and to analyze the formation and treatment of STP. Methods Retrospective study. Eighty-five patients ( 85 eyes) received MICOF keratoprosthesis surgery from January 2000 through December 2009 in Genera) Hospital of PLA, which included 72 males and 13 females. The mean age of the patients was (45 ±15) years. Preoperative diagnoses were ocular burn (56 eyes) , end-stage of autoimmune dry eye ( 14 eyes) , severe ocular trauma (10 eyes) and repeated graft failure (5 eyes). Postoperatively, STPs of Kpro were observed and treated. The membranes anterior to the optical cylinder were removed and investigated by histological and immunohistochemical methods, and anterior segment specimens from normal eyes were taken as control. Results Twenty-two (26% ) patients presented STP during the follow-up, and proliferations occurred ranging from 2 to 63 months (median, 7 months). The incident rates of STP were 34% (19/56 eyes) in burned eyes,14% (2/14 eyes)in end-stage dry eye, 10% (1/10 eyes)in severe mechanical ocular trauma, and none in repeated grafts failure. Difference among four groups did not arrive significance statistically (x2 =5. 93, P = 0. 11). The epithelial proliferations were observed in 11 patients, which were removed easily. To prevent from recurrence, the height of the cylinder was adjusted. Other 4 patients underwent ultra-high frequency ocular surface plastic operation and 7 patients received membranectomy. Histologically, the superficial proliferative membrane was composed of proliferative epithelium and fibrovascular tissue incorporating inflammatory cells. The immunohistochemical staining demonstrated the expression of PCNA increased in the epithelium, compared with control cornea and conjunctiva. Many vimentin-positive fibroblasts and a few α-SMA-positive myofibroblasts presented in the interstitial tissue, and the numbers of CD45RO-positive T cells, CD11c-positive dendritic cells, and CD68-positive macrophages were increased in proliferative membranes. Conclusions The tissue proliferation around optical cylinder results in membrane formation anterior to the Kpro. The excessive inflammation at the prosthesis-corneal junction and the unsuited height of the optical cylinder might have been the main reasons of STP.

Objective To observe the changes of retinal thickness during critical period plasticity in rat, and to investigate whether apoptosis participates in the structural forming of retina. Methods Experimental research. 50 normal newborn pups of SD rat were randomly selected in the experiment In vivo consecutive scanning of retinal image was taken and the retinal thickness from RPE to ILM was recorded in 10 pups (20 eyes) with spectral domain optical coherence tomography (OCT) at postnatal day 14 (P14), P18, P21, P24 and P42. Bcl-2, Bax, Caspase-3 Mrna was assessed with fluorescent quantitative real-time polymerase chain reaction after total RNA extracted from 4 retinas of 2 pups at each time point from P14 to P42. Histological measurement of retinal thickness of sections with HE staining from 4 pups (8 eyes) at each time point was compared with the results of OCT scanning. TUNEL staining was used to detect the apoptotic cells in retinal cyrosections of 2 pups (4 eyes) at the same time point The data were analyzed by One-way ANOVA and Linear Regression through SPSS 11.5 software. Results There was significant difference between the retinal thickness measured through OCT in pups from P14 to P42 (F = 15.425 ,P = 0. 001). And the values were (243. 42 ± 13. 83) μm at P14, ( 218. 78 ± 8. 21) (μm at P18, (195.42 ± 8. 02) μm at P21, (195. 74 ± 14. 85) μm at P24, (190. 79 ± 11. 70) um at P42. The retinal thickness measured through OCT decreased significantly during the first 3 weeks after birth. The results of OCT measurement had linear correlation with histology measurement ( R = 0. 794, P = 0. 000 ) . There was significant difference between Mrna expression of Bcl-2, Bax and Caspase-3 in pups from P14 to P42 ( F = 18.684, F=47. 307,F =49. 611 ;P =0.000). The relative expression of Bax and Caspase-3 peaked at P24 while Bcl-2 was much more stable. There were a lot of apoptotic cells in the ganglion cells layer, the inner nuclear layer and the outer nuclear layer during P18 to P24 by TUNEL staining. And the apoptosis alleviated at P42. Conclusions The retinal thickness decreases when the retina continues to develop during critical period plasticity. Cirrus HD-OCT can be used as an effective instrument to show the layers of retina in rat in vivo. Apoptosis participates in the course of retinal development which possibly leads to the thinning of retina.

Objective To detect the change process of substance P ( SP) expression and the difference between fungus and bacterial keratitis and explore effects of SP on the damage and repair process of keratitis model of Wistar rats. Methods Wistar rats were divided randomly as blank controlled group, fungal keratitis group and bacterial keratitis group. Inoculate fusarium and staphylococcus into cornea of Wistar rats to make animal keratitis model. Choose the right eye as experimental eye and the left eye as control. After the model was created successfully,25 rats were executed randomly at 1,5,8,10 and 14 days after the surgery. Detailed record and hematoxylin-eosin dye were done to each group to examine the process of ulcer. Expression of SP were detected through immunohistochemistry and reverse transcription polymerase chain reaction. Use variance analysis, T test and Q test to evaluate the results. Results One day after infection, the cornea of experimental group showed ulcer with disordered shallow matrix layer collagenous fibre arrangement and neutral granular cell infiltration; after 5 days, ulcer worsened and granular cells infiltrated through the whole layer; after 8 days, ulcer shrinked and fibroblast began to increase with new vessels formed; after 10 days, new vessels began to decrease; after 14 days, the matrix level textile fiber assumes scar type restructuring. The expression of SP increased in endothelium cells, inflamatary cells, fibroblast cells and endothelium of new vessels 1 d after surgery (absorbance for fusarium and staphylococcus group were 0. 3313 ±0.0133 and 0. 3995 ±0.0191 respectively;Mrna were 0.4525 ±0.0170 and 0. 5532 ± 0. 0258), peeked at 8 d ( for fusarium and staphylococcus group were 0. 5525 ± 0. 0171 and 0. 7050 ± 0.0119 respectively; Mrna were 0. 5975 ± 0. 0221 and 0. 7150 ± 0. 0238) , began to decrease at 10 d (for fusarium and staphylococcus group were 0. 1533 ±0.0176 and 0.3125 ±0.0170 respectively; Mrna were 0. 2416 ± 0.0082 and 0.4835 ±0.0082) and dropped to lower than normal at 14 d ( for fusarium and staphylococcus group were 0. 1150 ± 0.0128 and 0. 1675 ± 0. 0126 respectively; Mrna were 0. 1275 ± 0. 0126 and 0. 2325 ±0. 0171) , which had significant difference (the absorbence of SP:for fusarium group, F = 832. 24, q = 35. 3675,12. 9044,27. 3621, 34. 6506,22.4632,62. 7296,70. 0182,40. 2664,47. 5550, 7.2886,P＜0.01;for staphylococcus group F= 636.17, q = 38. 7494, 11.4245, 10.8298, 28.6082, 27.3249,49.5791, 67.3575, 22.2543, 40.0327, 17.7784, P＜0.01. Mrna expression: for fusarium group F = 658.60,q= 18.9941,9.5132,27.4719,42.0007,9.4809,46.4661,60.9948,36.9852, 51. 5139,14. 5287 ,P＜0. 01 ;for staphylococcus group F = 335.13 ,q = 16. 9266,4. 1677,7. 1081,32. 4724, 12.7589,24. 0347,49. 3990,11. 2759,36. 6402,25. 3643, P ＜ 0. 01 ) . Two experimental groups showed similar changes as time changes, the bacterial group showed more SP expression than fungal group, which had significant difference ( absorbance of SP t = 6. 5493,7. 3867,16. 0505,14. 5479,6. 5360, P ＜ 0.05; Mrna expression t = 7. 2878,9. 5232, 8. 8149,43. 6256,11. 1269, P＜0. 05 ) . Controlled eyes showed increased SP expression at 1 d ( absorbance was 0. 2840 ± 0.0212; Mrna was 0. 3950 ± 0. 0129 ) and dropped to normal at 5 d (absorbance was 0. 2125 ± 0. 0174; Mrna was 0. 3321 ± 0.0041 ) . There was significant difference between bacterial group, fungal group and controlled eyes(absorbance of SP:compared with fusarium group t =4.2261,18. 3314,35. 5163,5. 3609,13. 4826;compared with staphylococcus group t =9. 0508,25. 6639,63. 4924,7. 4828,7. 1301 ,P＜0.05. Mrna expression:compared with fusarium group t = 6. 0249, 31. 9158, 26. 0413, 9. 1550, 19. 1741; compared with staphylococcus group t = 12. 2636, 53.4404,36. 8727,15. 8687,8. 2939, P < 0. 05 ). Conclusion SP possibly participated in the early time damage and the later period repair process in fungus keratitis and its lower expression level possibly participated in the mechanism of lighter ache in fungus keratitis.

A 39-year-old male went to the Department of Ophthalmology of Beijing Jishuitan Hospital on April 26, 2009 because he had lost sight in his left eye for 6 years, and his left eye was red and painful for 3 months. The patient suddenly lost sight in his left eye 6 years ago, and had undergone fluorescein fundus angiography in another hospital (the specific result is unknown), and was diagnosed as "retinal hemangioma of left eye". Three years ago, "right eye retinal hemangioma" occurred, and the left eye fundus laser treatment was performed twice, and the right eye fundus laser treatment was performed once; Symptoms of congestion, distension and pain, headache and nausea in the left eye began to occur 3 months ago.

acquired immunodeficiency syndrome (AIDS) is a fatal disease involving multiple systems of the umbrella, including ocular lesions. Since the first AIDS case was discovered in the United States in 1981, the number of human immunodeficiency virus (HIV) infected and AIDS patients has reached 56 million, the number of deaths has reached 20 million, and the number of new HIV infected people has reached 16,000 every day [1].

The patient was a 30-year-old male. He went to the Department of Ophthalmology of Qinhuangdao No.1 Hospital on April 6, 2004 due to boxing injury in his right eye for 5 days. The visual acuity of both eyes was normal in the past, and there was no history of hypertension or other diseases. No abnormalities were found in the physical examination. Ocular examination: The visual acuity was checked by international standard visual acuity chart, and the visual acuity of the right eye was 0.8, which could not be corrected. The visual acuity of the left eye was 1.2. The anterior segment, vitreous body, eyeball, intraocular pressure and visual field examination of both eyes were not abnormal.

Foreign bodies in penetrating eyeball injury can remain in any part of the eyeball, the more common ones are vitreous body, retina, lens, cornea, anterior chamber and ciliary body, but foreign bodies remaining in the iris are rarely reported. Foreign bodies located in the anterior segment of the eye are easily found and removed in time, and foreign bodies in the eye with deviated position and relatively concealed and small are easily missed.

A 65-year-old male was transferred from a foreign hospital to the Department of Ophthalmology of Qianfoshan Hospital of Shandong Province on September 29, 2009 due to "corneal endothelial detachment". On September 26, 2009, the patient underwent phacoemulsification and cataract aspiration combined with intraocular lens (IOL) implantation in a local hospital due to cataract in his left eye.

A 10-year-old child came to the Institute of Orbital Diseases of the Armed Police General Hospital on January 4, 2010 due to "the mass in the left eye for more than 2 months, gradually increasing". The child was accidentally found to have poor vision in the left eye in February 2009. The examination in another hospital showed that the vision in the left eye was manual in front of the eye, the intraocular pressure was 30 mm Hg (1 mm Hg =0.133 kPa), the iris was neovascularized, the pupil was slow to reflect light directly and indirectly, the vitreous body was flocculate and opaque, the retina was completely detached, and there was a large amount of subretinal hemorrhage.

A 59-year-old male was referred to the Department of Neurology of Beijing Tongren Eye Center of Beijing Tongren Hospital affiliated to Capital Medical University on July 17, 2010 due to "left blepharoptosis with walking instability for 40 days". He had a history of cerebral infarction for 1 year and type II diabetes for 1 year.

The patient was an 81-year-old female who came to Changchun Yinuo Eye Hospital on July 15, 2010 due to blurred vision and deformation of her left eye for 1 month. Ocular examination showed that the visual acuity was 0.6 in the right eye and 0.15 in the left eye, and the anterior segment of both eyes was basically normal. Scattered and isolated drusen can be seen in the macular area of the right eye, and the essence picture 1 can be seen in the fundus of the left eye.

α-crystallin is the predominant structural protein in the lens. It is a member of small heat shock proteins (sHsps)and has the common functions of sHsps. Α-crystallin also plays important roles in the protection of retinal ganglion cells (RGCs). Studying the protection mechanism significantly contributes to the theory and therapy of optic nerve injury. This review is focused on biological characteristics and functions of a-crystallin and the protection mechanism of α-crystallin towards RGCs.

Dry eye is a common eye disease, and its incidence rate has been escalating. The increased tear osmolarity is one of the main reasons for complaint, damage and inflammation of dry eye patients. With the breakthrough of testing technology for tear osmolarity, more research and application of tear osmolarity was reported, and papers on tear osmolarity of normal eye and dry eye in different regions were also published. In this article, the progress of the tear osmolarity research, the range of tear osmolarity and its application in diagnosis and therapy of dry eye was introduced, and the prospect for the clinical application of hypotonic artificial tears was also discussed.

dry eye is a kind of tear and ocular surface disease caused by many factors, including ocular surface discomfort symptoms, visual impairment and tear film instability with potential ocular surface damage, which may be accompanied by increased tear osmotic pressure and ocular surface inflammatory reaction. dry eye is the most common ocular surface disease, which can lead to blindness in severe cases. It is the key, hot and difficult problem in ophthalmology research in recent years [1].

Following the successful two "Chinese Ophthalmology Youth and Middle-aged Forum" held by the editorial board of Chinese Journal of Ophthalmology of Chinese Medical Association in 2009 and 2010, at the request of the majority of ophthalmologists, the "3rd Chinese Ophthalmology Youth and Middle-aged Forum (with Organizing Meeting)" sponsored by this journal will be held in Xiamen, Fujian Province from July 1 to 4, 2011. The content of this forum integrates the rational application of ophthalmic drugs and the promotion of new technologies and new equipment, focusing on comprehensively improving the diagnosis and treatment level of ophthalmologists. At that time, the academic leaders of ophthalmology in China (editorial board of this journal) will be invited to give wonderful special speeches.

The Ophthalmology Center of Tianjin Medical University will hold a national continuing medical education program on cataract, glaucoma, ocular surface diseases and corneal refractive surgery from July 28 to 31, 2011 in Qinhuangdao, Hebei Province. The conference was co-organized by Qinhuangdao Maternal and Child Health Hospital.

The Chinese Medical Association is scheduled to hold the 16th National Ophthalmology Academic Conference and the 4th Global Chinese Ophthalmology Academic Conference in Guangzhou, Guangdong Province from September 8 to 11, 2011. This conference is another large-scale international event of ophthalmology held in China after the 15th National Ophthalmology Academic Conference of Chinese Medical Association in 2010 and the 25th Annual Meeting of Asia-Pacific Ophthalmology Society (2010APAO). It is expected that the participants will reach 5,000 people.

The 3rd International Symposium on Uveitis will be held in Chongqing from December 1 to 3, 2011. This conference will be sponsored by Chongqing Medical University and the First Affiliated Hospital of Chongqing Medical University, co-organized by the Ophthalmic Immunology Group of Ophthalmology Branch of Chinese Medical Association, and undertaken by Chongqing Municipal Key Laboratory of Ophthalmology and Chongqing Institute of Ophthalmology. Renowned international and domestic uveitis experts will be invited to give special lectures. Ophthalmology colleagues are welcome to actively contribute and actively participate in the conference.

The 13th National Conference on Cataract and Intraocular Lens will be held in Ningbo, Zhejiang Province from June 2 to 5, 2011. This conference was sponsored by the Cataract Group of Ophthalmology Branch of Chinese Medical Association, and hosted by Zhejiang Medical Association and the Ophthalmology Center of the Second Affiliated Hospital of Zhejiang University.

With the development and improvement of clinical diagnosis technology, the role of all kinds of ophthalmology clinical pictures in disease diagnosis has been paid more and more attention. In order to encourage clinical accumulation of relevant data, promote experience exchange, improve clinical diagnosis and treatment technology, provide a new platform for academic exchange for readers, and at the same time enrich the content and form of this journal to better serve the majority of ophthalmologists, Chinese Journal of Ophthalmology continued to launch the "Picture Essence" column in 2011. The submitted pictures can be arranged according to the type of case or diagnostic technique, with relevant instructions,

The Chinese Journal of Ophthalmology was founded on October 1, 1950. It was sponsored by the Chinese Medical Association and edited by the Editorial Committee of the Chinese Journal of Ophthalmology. The editorial committee is composed of nearly 100 well-known ophthalmologists in China. The current editor-in-chief Zhao Kanxing and the editorial director Huang Yibin. The main readers of this journal are ophthalmologists across the country, and it is publicly distributed at home and abroad. China Standard Issue Number: ISSN0412-4081, CN11-2142/R; Postal code: 2-60; National map code: M93.

Sponsored by the Chinese Medical Association, this journal was founded on October 1, 1950, and is now a monthly magazine. The editorial committee is composed of more than 100 well-known ophthalmologists across the country. Currently Editor-in-Chief Zhao Kanxing, Deputy Editors-in-Chief Wang Ningli, Sun Xinghuai, Yin Zhengqin, He Shouzhi, Yao Ke, Cui Hao, Hui Yannian, Ge Jian, Xie Lixin (Academician of Chinese Academy of Engineering), Li Xiaoxin, and Director of Editorial Department Huang Yibin. For many years, the circulation, influencing factors, total citation frequency and other indicators of this journal are among the best in this professional journal in China.

In order to advocate the majority of ophthalmologists to pay attention to the prevention and treatment of glaucoma, Chinese Journal of Ophthalmology of Chinese Medical Association and Alcon (China) Ophthalmic Products Co., Ltd. jointly held the 2010 Alcon "Healthy Intraocular Pressure" Cup prize-winning essay contest in March 2010. By November 2010, dozens of related articles had been collected nationwide. After collective deliberation by a review committee composed of experts such as Wang Ningli, Pan Yingzi, Ren Zeqin and Wu Lingling, eight award-winning papers were selected.

In order to improve the writing level of authors' medical papers, especially English medical papers, the English edition of Chinese Medical Journal of Chinese Medical Association is scheduled to hold two "National Medical Paper Writing Seminars" in Guangzhou in June and Yinchuan in July, 2011. The seminar will invite domestic experts with rich experience in reviewing, submitting and writing in English to give lectures, including: how to write Chinese (English) medical papers that are easily accepted by magazines; How to report clinical randomized controlled trials; Ethical Problems in Essay Writing;

Ocular Surface Live Confocal Microscope (edited by Professor Xu Jianjiang), one of the Application Series of New Ophthalmology Technologies edited by Professor Sun Xinghuai of Eye, Ear, Nose and Throat Hospital affiliated to Fudan University, has been officially published by Fudan University Press. In vivo confocal microscope of ocular surface is a new type of high precision and high magnification microscope which has appeared in recent years. As a clinically practical auxiliary diagnostic device, ocular surface in vivo confocal microscope can perform non-invasive,

Conjunctivalochalasis is a common age-related ocular surface disease in the elderly. With the accelerating aging of the population, the number of people with conjunctiva relaxation will increase day by day. Severe conjunctival relaxation requires surgical treatment. In order to standardize the surgical treatment plan and prevent iatrogenic ocular surface damage, Professor Zhang Xingru combined his more than 10 years' research results on surgical treatment of this disease (including key technologies such as indications for surgical treatment, standardized surgical operation, prevention and treatment of surgical complications) with literature and materials to make a CD.

Corneal Disease Atlas, written by Professor Xie Lixin, academician of Chinese Academy of Engineering, leader of keratology group of Chinese Medical Association Ophthalmology Branch, and deputy editor-in-chief of Chinese Journal of Ophthalmology, was officially published by People's Medical Publishing House in March 2011. The book systematically reflects the clinical characteristics of corneal diseases in the form of images, characteristically reflects the effects of modern corneal imaging examination and modern scientific treatment, and enables readers to "read pictures".

Corneal disease is one of the main eye diseases causing blindness at present. According to statistics, there are more than 7 million blind people in China, of which about 8% are caused by corneal disease. The only hope for blindness caused by corneal disease is corneal transplantation. However, due to the lack of donor corneas, only 8,000 corneal transplantations are performed in China every year, and millions of patients can only pray for light in the dark. Therefore, early intervention for corneal diseases is crucial. "Protect the eyes and cherish the cornea" has become the focus of general concern in the society.