Background Infectious keratitis is common blinding eye disease in China.Inflammatory runaway reaction often occurs in infectious keratitis, and its mechanism and treating approach are worthy of research.Objective This study was to investigate the clinical manifestation,mechanism and treatment outcome of doxycycline in overwhelming inflammation induced by Pseudomonas aeruginosa keratitis.Methods Pseudomonas aeruginosa suspension was intrastromal injected in 60 right eyes of 60 New Zealand white rabbits,and gatifloxacin eye drops was frequent instilled for consecutive 3 days to establish corneal inflammatory runaway reaction models,and 42 eyes with worse keratitis were defined as overwhelming inflammation.Then the models were randomly divided into gatifloxacin treatment group (15 rabbits), combined treatment group (gatifloxacin with doxycycline treatment, 15 rabbits) and balance salt solution (BSS) control group (12 rabbits), and corresponding eye drops was topically administered in the rabbits 8 times per day for 14 days.The symptoms of the models were observed under the slit lamp microscope on day 1,3,7 and 14 after treatment,and the corneal infiltration area was calculated.The corneal morphology was examined by using hematoxylin-eosin staining.The expressions of matrix metalloproteinase-2 (MMP-2) and MMP-9 in the corneal tissue were examined by immunohistochemistry.The contents of tumor necrosis factor α (TNF-α) and interleukin-1β (IL-1β) in corneal homogenate were detected by ELISA.The use and care of the animals complied with the ARVO Statement.Results The inflammatory scores were lower and infiltration area of cornea was smaller 7 days after treatment than those before treatment in the combined treatment group and gatifloxacin treatment group (both at P＜0.05).Hematoxylin-eosin staining result showed that the inflammation response of cornea subsided 14 days in comparison with 5 days after treatment in the combined treatment group, with the proliferation and rearrangement of fiberal tissue.The MMP-2 and MMP-9 were strongly expressed in corneal tissue with overwhelming inflammation in day 5 after treatment, however, the expression intensity weakened in 14 days after treatment in the combined treatment,showing significant differences in the absorbance between them (all at P＜0.05).ELISA assay showed that the contents of TNF-α and IL-1β in corneal tissue were significantly lower in the combined treatment group than those in the BSS group (P =0.00,0.03).In addition, contents of TNF-α and IL-1β in corneal tissue were significantly declined at day 14 in comparison with day 5 and day 7 after treatment in the combined treatment group (all at P＜0.05).Conclusions Overwhelming inflammatory keratitis models can be successfully established by corneal intrastromal injection of Pseudomonas aeruginosa suspension and immediately frequent 3-day instillation of gatifloxacin eye drops in rabbits.The topical application of doxycycline plays treating effect on overwhelming inflammatory keratitis by inhibiting the release of pro-inflammatory cytokines and MMPs.

To explore the prevalence and risk factors of depression in low-vision elder patients aged 60-85 years residing at Beizhuang Township,Miyun county.The activity of daily living scale (ADL) and geriatric depression scale (GDS) were used for diagnosis and grade the severity of depression.The prevalence rate of depression was higher in low-vision patients (36.2％) than in the control group (15.5％,P ＜0.05).The need for assistance in daily activities was higher in low-vision patients than in the control group(x2 =13.57,P ＜0.01).Patients with good economic conditions,being cared by relatives and living with their spouse had lower levels of ADL and GDS (all P ＜ 0.05).

Objeetive To investigate tear film lipid layer thickness (LLT) and its association with clinical symptom and sign in different types of dry eye patients.Methods A serial case-observational study was carried out.Three hundred and six eyes of 306 dry eye patients were included in Beijing Tongren Hospital from April to August 2016.Ocular surface disease index (OSDI) questionnaire,eyelid slit lamp examination,the measurement of tear film lipid thickness (LLT),tear film break-up time (TBUT),Schirmer Ⅰ test (S Ⅰ t) and the infrared meibomian photography were performed on the patients.The 157 patients with OSDI ＞12 and eyelid score ≥2 served as the MGD group;53 patients with OSDI ＞12 and S Ⅰ t value ＜ 5 mm/5 minutes served as ADDE group;96 patients with OSDI＞12,eyelid score ≥2 and S Ⅰ t value ＜ 5 mm/5 minutes served as MGD/ADDE group.Tear film LLT was detected with LipiView(R) ocular surface interferometer and the association of LLT with clinical characteristics of the patients was analyzed.This study protocol was approved by Ethic Committee of Beijing Tongren Hospital and written informed consent was obtained from each patient prior to any relative medical examination.Results Tear film LLT of the participants was normally distributed with the average was (60.41±18.57)nm.LLT in the MGD group,ADDE group,MGD/ADDE group were (57.04 ± 18.26),(63.52 ± 18.44) and (60.56 ± 18.71) nm,respectively,with a significant difference among the three groups (F =2.347,P =0.035),and the LLT value was significantly lower in the MGD group than that in the ADDE group (t =2.077,P =0.039).The LLT value showed negative correlations with the severity of dry eye symptom,S Ⅰ t and meibomian gland loss rate (r=-0.201,P=0.003;r=-0.146,P=0.005;r=-0.156,P=0.046).OSDI score was significantly correlated with LLT only in the MGD group (r =-0.285,P =0.000).No significant correlation was seen between LLT and S I t in all the groups (all at P＞0.05).In the MGD/ADDE group and MGD group,the correlation between LLT and meibomian gland loss rate was significantly greater than the overall correlation (r=-0.335,-0.248,-0.156).The dry eye symptoms in OSDI questionnaire like foreign body sensation,eye pain,discomfort when watching TV or computer showed significant correlations with LLT (r =-0.243,-0.205,-0.223,-0.258,all at P ＜0.05).Conclusions The tear LLT is appeared to be varied in different types of dry eye.The LLT is thinner in the dry eyes with MGD and thicker in the dry eyes with ADDE.There are association between tear LLT and foreign body sensation,eye pain,discomfort when watching TV or computer.