警惕“干眼症”来袭

夏季，随着空调使用增多，再加上长时间使用电脑，办公室人群患上“干眼症”的越来越多。

白领“流泪”不是罪

随着电脑和互联网的普及，人们足不出户就可以享受到各种信息和服务，但是电脑的广泛使用又正在悄悄地威胁着人类的健康，办公室一族易患的“干眼症”就是其中的一种眼部疾病。专家预测在未来5年中，“干眼症”患者的人数会以每年10％的比率上升。青岛眼科医院的于滨医师提醒大家，如果眼睛有异常感觉，最好别不当回事，及时检查就可能将疾病“消灭”在萌芽状态：

Effect of Flos Buddlejae Granules on Apoptosis Factors Bax,Bcl-2,Fas and FasL in Lacrimal Gland Cells of Castrated Male Rabbits

Objective To observe the effect of different concentration Flos Buddlejae(Mi Meng Hua,密蒙花)granules on apoptosis factors of lacrimal gland cells of castrated male rabbits,and study the treatment effects of Flos Buddlejae(Mi Meng Hua,密蒙花)granules in the dry eye model of castrated male rabbits.Methods Flos Buddlejae(Mi Meng Hua,密蒙花)raw material was made into granules.Thirty healthy adult New Zealand rabbits were randomly divided into five groups,six rabbits in each group.Group A:blank group,Group B:model group,Group C:Flos Buddlejae(Mi Meng Hua,密蒙花)granule group,Group D:placebo group,Group E:testosterone group.Except for group A,all rabbits underwent removal of bilateral testis and epididymis.Rabbits in group C were administered Flos Buddlejae(Mi Meng Hua,密蒙花)granules(100 mg/kg),three times per day;rabbits in group D were administered normal saline,three times per day.Rabbits in group E were injected with testosterone propionate(0.5 mL/kg)in the thigh muscle,every 3 days.All rabbits were tested by Schirmer I test(SIT)and tear film break-up time(BUT)before operation and 4 weeks after operation.After 4 weeks,all rabbits were sacrificed by air embolism and clipping of the lacrimal gland.Apoptosis factors,including Bax,Bcl-2,Fas and FasL of lacrimal gland cells were characterized by immunohistochemistry,and resulting data were statistically analyzed.Results(1)Comparison of SIT and BUT before and after operation:There were statistically significant differences between groups B and D(P<0.01),but not among other groups(P>0.05).(2)Comparison of apoptosis factors Bax,Bcl-2 Fas and FasL:In a comparison of groups B and D,there was no statistically significant difference after operation(P>0.05).In a comparison of the other groups,there were statistically significant differences(P<0.01).In comparisons among A,C and E groups,there were no statistically significant differences(P>0.05).Conclusion Compared with androgen,Flos Buddlejae(Mi Meng Hua,密蒙花)granules caused similar but slightly weaker depression of Bax,Fas and FasL,and increased expression of Bcl-2.

Linarin ameliorates innate inflammatory response in an experimental dry eye model via modulation of the NLRP3 inflammasome

Objective To investigate the effect and mechanism of linarin(LA) in an experimental dry eye model.Methods LA or vehicle was applied in two dry eye models: an in vitro hyperosmotic stress model and an in vivo desiccating stress(DS) murine model. The viability of human corneal epithelial cells(HCECs) was measured using a cell counting kit(CCK-8).Tear secretion was assessed using the phenol red cotton test. The tear break-up time(TBUT) was recorded using 0.1% liquid fluorescein sodium. Corneal epithelial permeability was evaluated through Oregon green dextran(OGD) staining.Conjunctival goblet cells were counted using periodic acid-Schiff(PAS) staining. Terminal deoxynucleotidyl transfer d UTP nickend labeling(TUNEL) staining was used to quantify apoptotic cells in both models. The expression of Ki-67 was measured in HCECs in the cell model while that of matrix metalloproteinase(MMP)-3 and-9 was measured in the murine model through immunofluorescence staining. Real-time quantitative PCR(RTqPCR) was performed to assess the expression of MMP-3 and MMP-9 in the corneal epithelium and NLRP3, ASC, Caspase-1,interleukin(IL)-1β, IL-18, and tumor necrosis factor(TNF)-α in the conjunctiva. The protein expression levels of NLRP3, ASC,Caspase-1, IL-1β, and IL-18 in the conjunctiva were assessed via Western blot.Results In the in vitro model, treatment of HCECs with LA showed no toxicity, increased proliferation, and reduced apoptosis. In the murine model, compared to the control, LA significantly increased tear production and TBUT, improved OGD staining, and increased the number of goblet cells. Topical treatment of LA to mice provided decreased expression of MMP-3, MMP-9, TNF-α, and apoptotic corneal epithelium. Topical administration of LA also suppressed the NLRP3 inflammasome in the dry eye disease(DED) murine model by decreasing the expression of NLRP3, ASC, Caspase-1, IL-1β, and IL-18 in the conjunctiva.Conclusion Our findings support the safety and efficacy of LA in the treatment of DED. LA alleviated corneal epithelial damage and suppressed NLRP3 inflammasome-mediated immunity in the conjunctiva in a murine model of DED.

Effects of Buddlejae Flos Granules on Inflammatory Factors TGF-β1,NF-κB,IL-10 and IL-12 in Lacrimal Gland Cells of Castrated Male Rabbits

Objective To observe the effects of Buddlejae Flos (Mi Meng Hua,密蒙花) granules on the expression of TGF-β1, NF-κB, IL-10 and IL-12 in lacrimal gland cells in castrated male rabbits. Methods A total of 30 New Zealand male white rabbits were randomly divided into 5 groups. Group A: blank group;group B: model group;group C: Buddlejae Flos (Mi Meng Hua,密蒙花) granules group;group D: placebo group;group E: testosterone group. Except for the group A, all rabbits were treated with bilateral testicular and epididymis resection before intervention. Rabbits in group C were administered with Buddlejae Flos (Mi Meng Hua,密蒙花) granules (100 mg/kg), 3 times per day;Rabbits in group D were administered with normal saline, 3 times per day. Rabbits in group E were injected with testosterone propionate (0.5 mL/kg) in the thigh muscle, every 3 days. Schirmer I test (SIT) and break-up time (BUT) were measured on 1st day before modeling and 30th day after modeling. After 30 days of intervention, all rabbits were sacrificed. The removal lacrimal gland was stained in immunohistochemica staining. The expression of TGF-β1, NF-κB, IL-10 and IL-12 in lacrimal gland tissue of each group was detected, and the structure of lacrimal gland was observed. Results The results of SIT and BUT showed that there was significant difference between group B and D compared with group A (P < 0.05). There were no significant differences between group C and E (P > 0.05). There were no significant differences in the comparison of inflammatory factors TGF-β1, NF-κB, IL-10 and IL-12 between group B and D (P > 0.05). There were significant differences between group B and D compared with other groups (P < 0.01). There was no significant difference between group A, C and E (P > 0.05). Conclusions Buddlejae Flos (Mi Meng Hua,密蒙花) granules have an inhibitory effect on the expression of TGF-β1, NF-κB, IL-10 and IL-12 in castrated male rabbit lacrimal gland cells, and alleviate the inflammation of lacrimal gland tissue by inhibiting the expression of TGF-β1, NF-κB, IL-10 and IL-12 in lacrimal gland tissue, so as to treat dry eye.

Intraocular complications of IFN-α and ribavirin therapy in patients with chronic viral hepatitis C

We report a panel of severe inflammatory and vascular intraocular disorders occurring during interferon-alpha （IFN-α） treatment in eight hepatitis C virus （HCV）- infected patients. These events include three cases of Vogt-Koyanagi-Harada like （VKH） disease （an association of panuveitis, retinal detachment, ear and meningeal detachment and skin and hair changes）, two cases of central retinal vein occlusion, one case of central retinal artery occlusion, one case of severe hypertensive retinopathy and one case of bilateral ischemic optic neuropathy with severe visual impairment. Rare as they are, such severe ophthalmological complications require a close follow-up of HCV-infected patients under IFN-α breabnent with ophthalmological monitoring if any ocular manifestation occurs.

生活资讯

三招防治“干眼症”；用洗涤剂要戴手套；大量饮酒骨质会流失；“膳食宝塔”需补水；

Acupuncture combined with pyonex for xerophthalmia

Objective To compare the clinical efficacy of acupuncture therapy and acupuncture combined with pyonex in treatment of xerophthalmia. Methods Eighty-eight xerophthalmia patients were randomly divided into group A （periocular acupuncture） and group B （acupuncture combined with pyonex）. The treatment was conducted once a day, twelve days were one course of treatment, and two courses were needed in total. The changes of symptom score of eyes, Schirmer I test （SIT） and break-up time （BUT） of patients in the two groups before and after treatment were observed. Results The symptom score of eyes （8.36＋2.54 vs. 5.36_＋2.65）, SIT （5.82＋4.61 vs. 8.33＋4.24） and BUT （5.92＋2.03 vs. 6.78＋2.46） of patients in the two groups after treatment were improved when compared with those before treatment. The total effective rate of group B was superior to that of group A （86.3% vs. 63.6%）（all P〈0.05）. Conclusion The efficacy of acupuncture combined with pyonex in treatment of xerophthalmia is significant, which can effectively improve the symptoms of xerophthalmia, and is superior to simple periocular acupuncture in terms of SIT and BUT.

Influence of electroacupuncture on histomorphology of lacrimal glands and ocular surface in experimental dry eye syndrome

Objective： To observe the influence of electroacupuncture （EA） on histomorphologies of lacrimal glands, cornea and conjunctiva in experimental dry eye syndrome, and to explore the repair effects of EA on lacrimal glands and ocular surface damage. Methods： Twenty-four healthy male New Zealand rabbits were randomly divided into a normal group, a model group, an EA group and a medication group, 6 rabbits in each group. Experimental dry eye syndrome models were prepared in rabbits by using 0.1% benzalkonium chloride for eye drops. Tear secretion volume, break-up time of tear film （BUT） and corneal fluorescein staining score were observed before and after the treatment. Periodic acid Schiff （PAS） staining method was used to observe the changes of conjunctival goblet cells in rabbits. After hematoxylin eosin （HE） staining, morphological changes of rabbit cornea, conjunctiva and lacrimal gland tissues were observed under light microscope. Results： Compared with the normal group, tear secretion volume and BUT were significantly reduced （both P^0.01）, while the corneal fluorescein staining score was significantly increased （P〈O.01） in the model group. Compared with the model group, tear secretion volume and BUT were significantly increased, while the corneal fluorescein staining score was significantly decreased in the EA group and the medication group （all P〈0.01）. Compared with the normal group, the number of conjunctival goblet cells in the model group was significantly reduced; compared with the model group, the numbers of conjunctival goblet cells were all relatively higher in the EA group and the medication group. Pathological lesions of cornea, conjunctiva and lacrimal glands all showed improvement by HE staining in the EA group and the medication group after the intervention. Conclusion： EA can improve tear secretion and tear film stability of rabbit dry eye syndrome, and repair the pathologic lesions of conjunctival goblet cells, corneal epithelia, cornea, conjunctiva and lacrimal glands.

Eyelid margin cleaning using Deep Cleaning Device for the treatment of meibomian gland dysfunction-associated dry eye: a preliminary investigation

Objective: To evaluate the safety and effectiveness of eyelid margin cleaning using Deep Cleaning Device for the treatment of meibomian gland dysfunction-associated dry eye. Methods: This was a prospective, randomized, open-label, investigator-masked, and self-controlled study. We randomly assigned one eye of patients with meibomian gland dysfunction-associated dry eye to the treatment group, and the other eye to the control group. Both groups received artificial tears and lid warming;the treatment group received an additional one-time in-office eyelid margin cleaning using Deep Cleaning Device. Non-invasive tear break-up time(NITBUT) and tear meniscus height(TMH) of each eye, and Standard Patient Evaluation for Eye Dryness II(SPEED II) score of each patient were evaluated before and at one week after treatment. Results: Thirty eyes of 15 patients were enrolled. No adverse effects occurred during the treatment. Compared with the baseline values, the SPEED score decreased significantly at one week after treatment(mean±95% confidence interval, 11.00±0.99 vs. 5.67±1.67, P<0.0001), the NITBUT-first in the treatment group increased significantly at one week after treatment((4.74±1.27) s vs.(7.49±2.22) s, P=0.01). The NITBUT-first was significantly longer in the treatment group((7.49±2.22) s) than in the control group((5.17±0.91) s) at one week after treatment(P=0.042). No significant differences were found in other tear film parameters between the two groups. Conclusions: Eyelid margin cleaning using the novel Deep Cleaning Device is a convenient, effective, and safe treatment for patients with meibomian gland dysfunction-associated dry eye.

Effects of dry eye syndrome and tear film mucin treated with acupuncture

Objective To explore the therapeutic effects and mechanism of dry eye syndrome treated with acupuncture therapy. Methods Thirty cases （60 eyes） of dry eye syndrome were treated with both local and distal acupuncture. Jingrning （睛明 BL 1）, Cuanzhu （攒竹 BL 2）, Tatiyang （太阳 EX-HN 5） and Quchi （曲池 LI 11） were selected; tear secretion quantity, break up time of tear film （BUT） and expression of tear film mucin were observed before and after treatment. Results Tear secretion quantity was increased and break up time of tear film was prolonged after acupuncture therapy, indicating the significant differences （both P〈0.05）; meanwhile, the expression of tear film mucin was increased [（0.67 ± 0.1） ng vs （0.89 ± 0.23） ng, P〈0.05]. Conclusion Acupuncture can promote the expression of tear film mucin, enhance the stability of tear film and remarkably improve the symptoms of dry eye.

Effects of electroacupuncture on conjunctival cell apoptosis and the expressions of apoptosis-related proteins Caspase-3,Fas and Bcl-2 in rabbits with dry eye syndrome

Objective:By observing the effects of electroacupuncture(EA)on the apoptosis of conjunctival cells of rabbits with dry eye syndrome(DES)and the expressions of apoptosis-related proteins Caspase-3,Fas and Bcl-2,to discuss the mechanism of EA in the treatment of DES from the perspective of cell apoptosis.Methods:Male New Zealand rabbits were randomly divided into a normal group(NG),a model group(MG),an EA group(EAG)and a sham EA group(SEAG).DES rabbit model was developed by eye drop of 0.1%benzalkonium chloride.The rabbit tear secretion and tear film break-up time(BUT)were measured;terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling(TUNEL)assay was used to detect the apoptosis of conjunctival cells;the expressions of Caspase-3,Fas and Bcl-2 proteins in conjunctival cells were detected by immunohistochemistry.Results:Compared with the NG,the rabbit tear secretion decreased and the BUT was shortened in the MG(both P<0.01);compared with the MG and the SEAG,the rabbit tear secretion increased and the BUT was prolonged in the EAG(all P<0.05).Compared with the NG,the apoptosis of rabbit conjunctival cells increased(P<0.01),the expressions of Caspase-3 and Fas proteins increased(both P<0.05),and the expression of Bcl-2 protein decreased(P<0.01)in the MG;compared with the MG and the SEAG,the apoptosis of rabbit conjunctival cells decreased(both P<0.01),the expressions of Caspase-3 and Fas proteins decreased(all P<0.05),and the expression of Bcl-2 protein increased(both P<0.01)in the EAG.Conclusion:EA can inhibit the apoptosis of rabbit conjunctival cells,down-regulate the expressions of apoptosis-related proteins Caspase-3 and Fas,and up-regulate the expression of Bcl-2 protein,which may be one of the mechanisms of EA in treatment of DES.

Acupuncture for dry eye syndrome:a meta-analysis of randomized controlled trials

Objective： To summarize and critically assess the evidence from randomized controlled trials（RCTs） of acupuncture in treating dry eye syndrome（DES） according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses（PRISMA） statement and the Cochrane Collaboration recommendations.Methods： A search of PubMed, the Cochrane Central Register of Controlled Trials, ClinicalTrials.gov and Embase was made from their inception to August 2016, as well as Chinese, Japanese, and Korean databases. Two reviewers independently selected RCTs and assessed the methodological quality. Meta-analysis and the level of evidence were processed by RevMan 5.3 and the Grading of Recommendations Assessment, Development and Evaluation（GRADE）approach.Results： After selection, 8 trials were subjected to our systematic review. The methodological quality was low generally.The 3-10 weeks follow-up showed that acupuncture improved the tear film break-up time（BUT）（MD=1.33, 95%CI=1.01-1.66, 619 participants）. The mean difference of Schirmer＇s test was 1.73 mm（95%CI=1.28-2.18, 618participants） between the acupuncture group and the control group. The subjective variables exhibited no significant differences.Conclusion： The low methodological quality of the trials does not suggest drawing firm conclusions on the value of acupuncture therapy for DES. Acupuncture treatment may have some effects on the tear film BUT and Schirmer＇s test,but not on the subjective symptoms. Well-planned large-scale high-quality RCTs are needed to make it clear whether acupuncture is effective in treating DES.

Efficacy of electroacupuncture for patients with dry eye syndromes:a randomized controlled trial

Objective To observe the efficacy of electroacupuncture(EA)in treating dry eye syndromes(DES)and its regulatory effects on patient’s quality of life(QOL),anxiety,and depression.MethodsBy following a randomized controlled study design,eligible DES patients were allocated to an EA group(EAG)or an acupuncture group(AG).Patients in the AG were intervened by acupuncture alone,while in the EAG,electrical stimulation was applied to Cuanzhu(BL2)and Taiyang(EX-HN5)in addition to the same treatment in the AG.Changes in clinical manifestations,ocular surface disease index(OSDI),Schirmer tear test-1(STT-1),tear-film break-up time(TF-BUT),cornea fluorescein staining(CFS),and corneal sensitivity(CS)were observed,as well as changes in the short-form 36-item health survey(SF-36)and hospital anxiety and depression scale(HADS)scores.ResultsThe scores of clinical symptoms,OSDI,and CFS decreased significantly in both EAG and AG when compared with the baseline values(P<0.05),respectively,while the TF-BUT and CS increased significantly(P<0.05),and the tear secretion of patients in the EAG increased(P<0.05).Compared with those before treatment,the scores of physical role functioning,general health perception,emotional role functioning,and mental health of patients in both EAG and AG showed significant increases after treatment(P<0.05),together with a marked decrease in the score of anxiety(P<0.05).Compared with the AG,the EAG obtained a more significant increase in STT-1(P<0.05).ConclusionDES patients respond well to both EA and acupuncture treatments,manifested by prolonged TF-BUT and improvement of CS.Meanwhile,the two approaches can improve QOL and reduce anxiety.Furthermore,EA appears more effective in increasing tear secretion than acupuncture alone.

Efficacy observation of acupuncture for dry eye syndrome of lung-yin deficiency pattern

Objective:To observe the clinical efficacy of combining two needling manipulations,Er Long Xi Zhu(two dragons playing with a pearl)and Guo Yan Re(heat produced to reach the eyes),in treating dry eye syndrome(DES)of lung-yin deficiency pattern.Methods:Fifty-six eligible DES patients of lung-yin deficiency were randomized into an observation group and a control group,with 28 cases in each group.Same acupoints were selected in the two groups:Cuanzhu(BL 2),Sizhukong(TE 23),Taiyang(EX-HN 5)and Fengchi(GB 20)were chosen as the major points and Feishu(BL 13)and Chize(LU 5)as the adjuvant.Er Long Xi Zhu and Guo Yan Re needling manipulations were applied in the observation group while twirling reinforcing manipulation was used in the control group.Treatment was conducted once per day in both groups,for two sets of 15 consecutive days at a 2-day interval.Changes in the symptom score,tear break-up time(BUT)and tear production were observed afterwards,and the clinical efficacy was also compared between the two groups.Results:The total effective rate was 92.8%in the observation group,higher than 71.4%in the control group,and the between-group difference was statistically significant(P<0.05).After treatment,the symptom score,tear BUT and tear production showed significant improvements in both groups(all P<0.05);the symptom score,BUT and tear production in the observation group were significantly different from those in the control group(all P<0.05).Conclusion:Given the same acupoint selection,combining Er Long Xi Zhu and Guo Yan Re needling manipulations can produce more significant clinical efficacy than twirling reinforcing manipulation in treating DES of lung-yin deficiency pattern.

Effects of auricular point sticking on dry eye in myopia patients after SMILE surgery:a prospective randomized controlled clinical trial

Objective:To observe the intervention effect of auricular point sticking on dry eye in myopia patients after small-incision lenticule extraction(SMILE)surgery.Methods:This was a prospective randomized controlled study conducted among the myopia patients who received SMILE surgery at Eye and ENT Hospital of Fudan University.The post-SMILE operation patients who screened by the inclusion and exclusion criteria were randomized into a control group and a treatment group.Patients in the control group were given 0.1%fluorometholone and 0.5%carboxymethylcellulose sodium eye drops,while the treatment group was given additional unilateral auricular point sticking for 1 month.The patients were estimated using ocular surface disease index(OSDI),Schirmer tear test-1(STT-1),tear film break-up time(TF-BUT),corneal fluorescein staining(CFS)score,corneal sensitivity(CS)and visual quality(VQ)at 1 d,1 week and 1 month after surgery;the changes in anxiety and depression were also observed in the patients.Results:Compared with the first day after operation,CS in the nasal region was improved in the treatment group,and the VQ score increased in the control group patients at 1 week after operation(both P<0.05);at 1 month after operation,the TF-BUT increased,CFS score decreased,CS in the central and nasal regions increased(all P<0.05),and VQ score increased(P<0.01)in the treatment group,and the CS in the central,upper,lower and nasal regions were improved(all P<0.05),and VQ score increased(P<0.01)in the control group.The between-group comparison showed that the differences in the change of TF-BUT were statistically significant at 1 week and 1 month after surgery,respectively(both P<0.05).Conclusion:Auricular point sticking therapy can increase the TF-BUT and accelerate the repair of ocular surface function in post-SMILE patients.

Diverse Needling Methods for Dry Eye Syndrome:A Randomized Controlled Study

Objective： To explore a proper acupuncture treatment protocol for dry eye syndrome （DES）, by comparing the therapeutic effects between ordinary acupuncture and electroacupuncture （EA）. Methods： Forty-seven eligible subjects with DES were randomized into an acupuncture group （n=23） and an EA group （n=24）. With the same acupoint formula, the acupuncture group was treated with ordinary acupuncture, and the EA group was treated with ordinary acupuncture plus electrical stimulation. After a treatment course, eye symptom score, Schirmer test （SIT）, Break-up Time （BUT） of tear film, Corneal Fluorescein Staining （CFS）, and Visual Analogue Scale （VAS） were adopted in evaluation and comparison of the two groups. Results： The total effective rate was 79.2% in the EA group versus 56.5% in the acupuncture group, and the difference was statistically significant （P〈0.05）. After treatment, both groups had marked improvements in eye symptom score, SIT, BUT, CFS, and VAS values （P〈0.001）; the EA group was better than acupuncture group in improving eye symptom score and SIT value （both P〈0.05）; the differences were insignificant in comparing VAS, BUT and CFS results between the two groups （P〉0.05）. Conclusion： Both EA and ordinary acupuncture are effective in treating DES, but EA is better than ordinary acupuncture in improving eye symptom and SIT score.

Clinical Study on Combined Acupuncture and Chinese Medicinal Fumigation for Dry Eye Syndrome

Objective:To observe the clinical effect of combined acupuncture and Chinese medicinal fumigation for dry eye syndrome(DES).Methods:A total of 90 DES cases(180 eyes)were randomized into a treatment group of 44 cases and a control group of 46 cases.Combined acupuncture and Chinese medicinal atomizer fumigation was used in the treatment group,whereas Sodium Hyaluronate eye drops was used in the control group.The subjective symptoms,Schirmer I Test(SIT)and Break-up Time(BUT)of tear film were observed before and after treatment.Results:The total effective rate in the treatment group was 78.4%,versus 12.0%in the control group,showing a statistical difference(P<0.01).After treatment,there were between-group statistical differences in SIT and subjective symptom grades(P<0.05,P<0.01).However,there was no between-group statistical difference in BUT grade(P<0.05).Conclusion:Combined acupuncture and Chinese medicinal atomizer fumigation can help alleviate DES symptoms.

Research on Acupuncture-moxibustion for Dry Eye Syndrome

Dry eye syndrome （DES） is a commonly encountered ophthalmological disease, with a relatively high incidence, and expects an effective treatment method. Acupunctureoxibustion therapy promotes tear production of lacrimal gland without causing a trauma, and thus has a great advantage in treating DES. Through literature analysis, this article summarized the research progress in both clinical practice and mechanism of acupuncture- moxibustion in treating DES during the recent 10 years, for providing valuable references for the application of acupuncture-moxibustion for DES.